Physical Activity & Health This lecture has been dedicated to Olympics games in Beijing, China Aug 08-24, 2008 By Supercourse Team

Physical Activity & Health Lecture Developers (Supercourse Team) Soni Dodani MD, PhD Others: Ali Ardalan, Eugene Shubnikov, Francios Sauer,Faina Linkov, Mita Lovelaker, Jesse Huang, Nicholas Padilla, Rania Saad, Ron LaPorte Questions: How to join the Supercourse:

Learning Objectives To encourage students to be physically active To encourage students to be physically active To illustrate Exercise and its effect on disease prevention To illustrate Exercise and its effect on disease prevention To provide examples of simple, moderate intensity physical activity To provide examples of simple, moderate intensity physical activity To encourage regular physical activity in developing countries with focus on women To encourage regular physical activity in developing countries with focus on women To encourage physical fitness in people with disabilities To encourage physical fitness in people with disabilities To build an Olympic Physical activity and health supercourse To build an Olympic Physical activity and health supercourse

The Olympic Games This Year Beijing 2008 Numbers · Population 14,000,000 · Visitors 2-2.5,000,000 · Athletes 18,000 · Helpers 5,000 · Referees 2,500 · Volunteers 6,000 · Journalists 15,000

What is Physical Activity Physical activity Bodily movement produced by skeletal muscles that results in an expenditure of energy Physical activity Bodily movement produced by skeletal muscles that results in an expenditure of energy Physical fitness A measure of a person's ability to perform physical activities that require endurance, strength, or flexibility. Physical fitness A measure of a person's ability to perform physical activities that require endurance, strength, or flexibility. Regular physical activity A pattern of physical activity is regular if activities are performed in some order Regular physical activity A pattern of physical activity is regular if activities are performed in some orderCDC,1997

Anonymous “Physical activity is something you do. Physical fitness is something you acquire, a characteristic or an attribute one can achieve by being physically active. And exercise is structured and tends to have fitness as its goal" Anonymous

Spectrum of Physical Activity and Health Physically Fit Physically Active Physically disabled LaPorte RE: Am J Epidemiol Oct;120(4): LaPorte RE: Am J Epidemiol Oct;120(4):507-17

Differences between Exercise and Sport Exercise It’s a form of physical activity done primarily to improve one’s health and fitness. Sports Is complex, institutionalized, competitive and these very characteristics works against moderate and rhythmical exercise. CDC 1999

Common Reasons Not To Exercise I don’t have the time I don’t have the time I don’t like to sweat I don’t like to sweat I’ll look silly I’ll look silly It hurts It hurts I don’t know what to do I don’t know what to do It’s not important It’s not important

Why Exercise ???

Do you know? 13.5 million people have coronary heart disease million people have coronary heart disease. 1.5 million people suffer from a heart attack in a given year. 1.5 million people suffer from a heart attack in a given year. 250,000 people suffer from hip fractures each year. 250,000 people suffer from hip fractures each year. Over 60 million people (a third of the population) are overweight. Over 60 million people (a third of the population) are overweight. 50 million people have high blood pressure. (WHO, 2003) 50 million people have high blood pressure. (WHO, 2003)

Do you Know that……. Adjusted RR for CVD Mortality by Fitness and % Body Fat

Do you Know that……. Adjusted RR for All-Cause Mortality by Fitness and % Body Fat

Do you know that …… Childhood obesity has reached epidemic proportions in most part of the world Childhood obesity has reached epidemic proportions in most part of the world Children are eating more and exercising less. Children are eating more and exercising less. Time spent watching television or using computers Time spent watching television or using computers This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others

All of these can be Prevented by Regular Physical Activity !!!

How Physical Activity Impacts Health Helps control weight. Helps control weight. Reduces feelings of depression and anxiety. Reduces feelings of depression and anxiety. Helps build and maintain healthy bones, muscles, and joints. Helps build and maintain healthy bones, muscles, and joints. Reduces the risk of developing colon cancer. Reduces the risk of developing colon cancer. Helps reduce blood pressure in people who already have high blood pressure. Helps reduce blood pressure in people who already have high blood pressure. Causes the development of new blood vessels in the heart and other muscles. Causes the development of new blood vessels in the heart and other muscles. Enlarges the arteries that supply blood to the heart. WHO 2002 Enlarges the arteries that supply blood to the heart. WHO 2002

Health Risk of Physical Inactivity Leading causes of disease and disability associated with physical inactivity 1. Coronary Heart Disease (CHD) 2. Stroke 3. Obesity 4. Type II Diabetes 5. Hypertension 6. Colorectal cancer 7. Stress and Anxiety 8. Osteo-arthritis 9. Osteoporosis 10. Low back pain

What Can Exercise do for You? Reduce the risk of the three leading causes of death: Heart Disease, stroke, and cancer Reduce the risk of the three leading causes of death: Heart Disease, stroke, and cancer Control or prevent development of Disease Control or prevent development of Disease Enhance Mental Abilities Enhance Mental Abilities Improve Sleeping Habits and Increase Energy Levels Improve Sleeping Habits and Increase Energy Levels Lift Depression and Help Manage Stress Lift Depression and Help Manage Stress Control Weight, improving self-image, appearance and health Control Weight, improving self-image, appearance and health

Exercise & Cardiovascular Disease FACT Sedentary lifestyle is a risk factor for CVD, according to the American Heart Association Sedentary lifestyle is a risk factor for CVD, according to the American Heart Association Exercise reduces Blood Pressure High blood pressure (above 140/90) is the main cause of Heart Attack and Stroke High blood pressure (above 140/90) is the main cause of Heart Attack and Stroke Exercise prevents Atherosclerosis (clogged arteries) Exercise reduces cholesterol plaques that clog arteries and can lead to stroke and heart attack WHO 2002 Exercise reduces cholesterol plaques that clog arteries and can lead to stroke and heart attack WHO 2002

Exercise and Cancer The Basics Exercise helps to prevent obesity, a major risk factor for several types of cancer Exercise helps to prevent obesity, a major risk factor for several types of cancer Exercise enhances immune function Exercise enhances immune function Exercise activates antioxidant enzymes that protect cells from free radical damage WHO 2002 Exercise activates antioxidant enzymes that protect cells from free radical damage WHO 2002

Exercise and Diabetes Increase insulin sensitivity Control blood glucose Control Weight/Lower body fat Reduce risk of cardiovascular disease WHO 2002

Exercise and Depression Exercise can help prevent depression. In fact, recent studies have shown that exercise was found to be just as effective (despite a slower initial response) as antidepressant medication for treatment of depression. Exercise reduces health problems, making you feel better Exercise reduces health problems, making you feel better Exercise helps you sleep better Exercise helps you sleep better Exercise controls weight, enhancing self- esteem WHO 2002 Exercise controls weight, enhancing self- esteem WHO 2002

Exercise and Your Mind Short-term benefits: Short-term benefits: Boost alertness (possibly by triggering the release of epinephrine and nor epinephrine) Boost alertness (possibly by triggering the release of epinephrine and nor epinephrine) Improve memory Improve memory Improve intellectual function Improve intellectual function Spark creativity Spark creativity Long-term benefits: Long-term benefits: Exercise has been shown to slow and even reverse age-related decline in mental function and loss of short-term memory Exercise has been shown to slow and even reverse age-related decline in mental function and loss of short-term memory A report of Surgeon general, Physical Activity and health, 1996

Opportunities for Physical Activity At work For transport In domestic duties In leisure time The majority of people do very little or no physical activity in any of these domains

Getting Started….Setting Goals What will motivate you? What will motivate you? Think about your reasons for exercising Think about your reasons for exercising Are your goals important enough to keep you motivated long-term? Are your goals important enough to keep you motivated long-term? Think short-term and long-term Think short-term and long-term How will you benefit from your fitness plan day-to-day? How will you benefit from your fitness plan day-to-day? In 1 year? In 5 years? In 10 years? In 1 year? In 5 years? In 10 years?

Before You Start... If you are over 40 or have health problems (heart disease, high blood pressure, diabetes, obesity, muscle or joint problems) see a physician before beginning exercise If you are over 40 or have health problems (heart disease, high blood pressure, diabetes, obesity, muscle or joint problems) see a physician before beginning exercise Be informed Be informed Learn as much as you can about exercise by reading and talking to other people Learn as much as you can about exercise by reading and talking to other people Learn safety precautions before you do any exercise Learn safety precautions before you do any exercise

Fitness Equipment / Safety Buy Appropriate SHOES Buy Appropriate SHOES Wear Comfortable Clothing Wear Comfortable Clothing TOO HOT! TOO COLD! TOO HOT! TOO COLD! Run and Walk with a Friend Run and Walk with a Friend More fun, safer, with a physical and mental support system Night Time: stay to the well lit areas Night Time: stay to the well lit areas Select activities that are fun ……….. To YOU! Select activities that are fun ……….. To YOU!

Get Moving! Components of an exercise program Components of an exercise program Aerobic Activity Aerobic Activity Strength Training Strength Training Flexibility Training Flexibility Training Use an exercise log to help you plan and keep track of your exercise program WHO 2002

Aerobic Activity Definition Continuous movement that uses big muscle groups and is performed at an intensity that causes your heart, lungs, and vascular system to work harder than at rest Cardio respiratory Fitness is built through aerobic exercise Aerobic exercise conditions and strengthens our heart, respiratory system, muscles, and immune system CDC physical activity report 1999

Types of Aerobic Exercise Outdoor Activities Walking Walking Jogging/running Jogging/running Bicycling Bicycling Swimming Swimming Basketball Basketball Soccer Soccer Jumping Rope Jumping Rope Indoor Activities Treadmill machine Stair climbing machine Stationary bike Elliptical trainer Rowing machine Aerobics, boxing...

Strength Training Definition Muscle work against resistance that improves strength and endurance Strength allows us to move, and endurance allows us to perform work over time Strength allows us to move, and endurance allows us to perform work over time Muscles = 40% of our lean body mass Use it or lose it: unused muscle disappears (atrophy)

Types of Strength Training Free Weights use of dumbbells and/or bars with weights on the ends use of dumbbells and/or bars with weights on the ends involves balance and coordination; useful for enhancing function in daily activities and recreational sports involves balance and coordination; useful for enhancing function in daily activities and recreational sports Bonuses: convenient, cheap, and provides a wide variety of exercises that work several muscle groups together Bonuses: convenient, cheap, and provides a wide variety of exercises that work several muscle groups together Your body, your weight The most convenient form of resistance exercise The most convenient form of resistance exercise Pushups, pull-ups,. Lunges, squats…. Pushups, pull-ups,. Lunges, squats….

Flexibility Training Flexibility = The ability to move a joint through its range of motion We lose flexibility with disuse and aging We lose flexibility with disuse and agingBenefits Decreased chance of muscular injury, soreness, and pain Decreased chance of muscular injury, soreness, and pain Helps prevent and reduce lower back pain Helps prevent and reduce lower back pain Improves joint health (tight muscles stress our joints) Improves joint health (tight muscles stress our joints) Activities stretching, yoga, pilates, tai chi

How Much and How Hard? Frequency: 3-5 days per week Aerobic exercise: a minimum if 3 days a week are necessary to reach most exercise goals and minimize health benefits Aerobic exercise: a minimum if 3 days a week are necessary to reach most exercise goals and minimize health benefits Strength training: a minimum of 2 days per week Strength training: a minimum of 2 days per week Flexibility training: a minimum of 3-5 days per week Flexibility training: a minimum of 3-5 days per week Duration Duration Aerobic: minutes of continuous aerobic activity Aerobic: minutes of continuous aerobic activity Strength: 1-3 sets of 8-12 repetitions Strength: 1-3 sets of 8-12 repetitions Stretching: Stretch all muscle groups and hold positions for seconds Stretching: Stretch all muscle groups and hold positions for seconds

Timing Questions What time of day is best? What time of day is best? Choose the most convenient time for your schedule Choose the most convenient time for your schedule Choose a regular time--the same time every day Choose a regular time--the same time every day Timing may depend on the activity you choose Timing may depend on the activity you choose Can I eat before exercise? Can I eat before exercise? It is best not to eat a meal for 2 hours beforehand It is best not to eat a meal for 2 hours beforehand Be sure to drink plenty of water before and during exercise Be sure to drink plenty of water before and during exercise Should I exercise when I’m sick? Should I exercise when I’m sick? No, especially if you have a fever No, especially if you have a fever

Exercise for people with special needs People with disabilities are less likely to engage in regular moderate physical activity than people without disabilities, yet they have similar needs to promote their health and prevent unnecessary disease People with disabilities are less likely to engage in regular moderate physical activity than people without disabilities, yet they have similar needs to promote their health and prevent unnecessary disease Exercise is for everyone!!!!!!! Individuals who have physical disabilities or chronic, disabling conditions such as arthritis can improve muscle stamina and strength with regular physical activity

Exercise for people with special needs People with disabilities should first consult a physician before beginning a program of physical activity to which they are unaccustomed People with disabilities should first consult a physician before beginning a program of physical activity to which they are unaccustomed Provide community-based programs to meet the needs of persons with disabilities. Provide community-based programs to meet the needs of persons with disabilities. Ensure that environments and facilities conducive to being physically active are available and accessible to people with disabilities, such as offering safe, accessible, and attractive trails for bicycling, walking, and wheelchair activities. Ensure that environments and facilities conducive to being physically active are available and accessible to people with disabilities, such as offering safe, accessible, and attractive trails for bicycling, walking, and wheelchair activities. "You don't stop exercising because you grow old. You grow old because you stop exercising." Anonymous

Exercise for Women in developing countries There has been several studies which have shown that less emphasis is given to exercise especially in women There has been several studies which have shown that less emphasis is given to exercise especially in women The reasons are several and most important one is awareness. The reasons are several and most important one is awareness. Women sports are not encouraged in most of developing countries Women sports are not encouraged in most of developing countries There is stigma that women should not be involved in outdoor sports There is stigma that women should not be involved in outdoor sports

Exercise is for everyone There is need for awareness for physical fitness in developing countries There is need for awareness for physical fitness in developing countries Exercise is not only for men but for everyone Exercise is not only for men but for everyone With commitment, opportunities can be developed. With commitment, opportunities can be developed. Even shopping malls provide opportunities for fitness walking Even shopping malls provide opportunities for fitness walking CDC 1997

Health Risks of Physical Activity Most musculo-skeletal injuries sustained during physical activity are likely to be preventable Injuries sustained during competitive sports have been shown to increase the risk of developing osteoarthritis Serious cardiac events can occur with physical exertion. he overall benefit of regular physical activity is lower all-cause mortality T he overall benefit of regular physical activity is lower all-cause mortality

Injury Prevention Prevention exercise regularly exercise regularly gradually increase intensity gradually increase intensity rest between sessions rest between sessions warm-up and cool down warm-up and cool down stay flexible stay flexible don’t exercise when sick don’t exercise when sick don’t exercise when muscles are fatigued and straining don’t exercise when muscles are fatigued and straining know proper form for any activity you do know proper form for any activity you do Caring for Injuries Caring for Injuries Rest: stop immediately Ice: apply immediately and repeat every few hours for minutes Compress: wrap injured area with elastic bandage Elevation: raise injured area above heart After 2 days, apply heat if there is no swelling Gradually ease back into activity when pain is gone

Summary Physical inactivity is one of the top 10 leading causes of death and disability in the developed world Exercise improves our body and minds Exercise improves our body and minds Even moderate exercise has many health benefits Even moderate exercise has many health benefits It is important to set fitness goals that are realistic and meaningful for you It is important to set fitness goals that are realistic and meaningful for you It takes time to make fitness part of a lifestyle, and we will all have ups and downs in following our exercise programs It takes time to make fitness part of a lifestyle, and we will all have ups and downs in following our exercise programs Exercise feels good! Exercise feels good!

“The first wealth is health." Ralph Waldo Emerson