5 MINS A year on from GM Moving Launch: three things we’re here for: Reflect on the past year and what great progress we’ve made. Announce our co investment plans into this work, through the paper you have in front of you. A call to action for all of us to play our full part. With a little help from some friends.... Dr William Bird- a timely reminder of why this matters. Dawn Nisbet, GM Moving Ambassador.... Personal story of transformation..... We just need another 1 million stories like these. MENTION before you start- the work of the GM Moving Team (a blended team from a number of organisations- GMHSCP, GCMA, GreaterSport, Sport England, etc... And that of Chris Boardman’s team- Martin Key (Senior transport adviser, Cycling and Walking commissioner), Pete Burt (Chair, GM Active) which is highlighted in the paper.

Looking back Physical activity at the heart of our transformation work, and embedded throughout the system. Positioning of the role of physical activity as a cross cutting solution is unrivalled elsewhere Our commitment to doing things differently 20+ years of collaboration We are leading the way in this work, nationally, and are supporting a social movement where being active becomes normal again. Commitment to change is huge Significant milestones along the way – from the first meeting of minds.. Through to today eg- GM Active Formed MoU with Sport England GM Moving Blueprint for Change and Refresh in 2017 Appointment of Chris Boardman and production of Made to Move report in 2017. Announcement of Local Delivery Pilot in December.

Our factory setting is to be in a sociable group, supportive environment and have a purpose People Place Purpose       Sociable Nature Autonomy Be Active, Give Keep Learning Connect Take Notice

Fear and Chronic Stress People Place Purpose Loneliness Hostile Rejection Fear and Chronic Stress

Chronic Stress Inactivity Poor diet Obesity Smoking Chronic psychosocial stress, increases the risk of physical inactivity and contributes to the epidemic of disease. Tsatsoulis, A. and Fountoulakis, S., 2006. The protective role of exercise on stress system dysregulation and comorbidities. Annals of the New York Academy of Sciences, 1083(1), pp.196-213.

Chronic Stress Stress Hormones Chronic Inflammation Inactivity Poor diet Obesity Smoking Chronic Inflammation Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007

Inactivity causes inflammation 1. Increases visceral fat 2. Reduces anti- inflammatories 3. Damages healthy cells

Sedentary, high fat diet and stress Oxidative Phosphorylation Anti- Oxidants Reactive Oxidative Species Mitochondrial DNA Mitochondria

Physically active, low fat and not stressed Oxidative Phosphorylation Reactive Oxidative Species Anti- Oxidants Mitochondrial DNA Mitochondria

Telomeres get shorter Epel, Elissa, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Annals of the New York Academy of Sciences 1172.1 (2009): 34-53

We have a new disease that conventional medicine cannot treat Chronic Inflammation

Inflammation: ‘the cause of causes’ Inflammation of metabolic system Diabetes Heart Disease Inflammation of hear and arteries Inflammation of the brain Depression and Anxiety Chronic Inflammation Starts in children as young as 6 years old Inflammation and faulty immunity Cancers Obesity Inflammation of visceral fat Arthritis Inflammation of joints Dementia Inflammation of brain

Social Prescribing Pathway of Ill Health People Place Purpose Chronic stress Poor health behaviours Mitochondrial damage, telomere shortening, and chronic inflammation Cardiovascular disease, diabetes, cancer, depression https://www.youtube.com/watch?v=kYPRV-Ynilk

Exercise on Referral The focus has moved physical activity from a venue based strategy ... Exercise on Referral

Social Prescription … to a community based activity where activity happens everywhere Social Prescription

Social Movement But to get real scale we need to get lots of people becoming activity leaders themselves Social Movement

Your teams and colleagues Your family and friends Your community #GMMoving 3 MINS So – we need 1 million more stories like Dawn’s... The papers tell you what we’re doing, and how... through the implementation of the GM Moving Plan..., the Local Delivery Pilot, Made to Move, Transformation Fund investments, GM Active innovations and Active Ageing... we can work together in every community across GM. We have an opportunity to create the evidence base here – the story of what it takes....to show what happens when you truly work on a whole system basis from the individual, through to policy spheres... To achieve population scale change We have pockets of the ingredients at work in some places in Greater Manchester... but we’re not doing all of it anywhere, and we haven’t before created the conditions for success across GM... The outcomes? connection, community, aspiration, relationships, businesses thriving, people are happier, healthier, successful Our work together is all about aligning the forces.... (CLICK to align the arrows) So that all the influences on physical activity behaviour are working in the same direction... From our infrastructure and urban design, to our policies and practices, workplace culture, nudges and enabling in our communities and families..... Our job is to work together to turn things around- from negative to positive influences on physical activity behaviour. We need all your help to lead and enable this movement