1. Sedentary Lifestyle Are We So Lazy That It’s Killing Us?

2. Outline Recommended activity levels What is “sedentary?” Some statistics & facts Overview of Health Consequences Benefits & risks The Evidence Sedentary Lifestyle is an Independent Risk Factor for Cardiovascular Disease & Mortality What Can Be Done? Recommended activity levels What is “sedentary?” Some statistics & facts Overview of Health Consequences Benefits & risks The Evidence Sedentary Lifestyle is an Independent Risk Factor for Cardiovascular Disease & Mortality What Can Be Done?

3. Recommend: > 30 min/day of moderate intensity exercise 5 days per week Or, vigorous intensity for minimum of 20 min/day on 3 days per week Recommend: > 30 min/day of moderate intensity exercise 5 days per week Or, vigorous intensity for minimum of 20 min/day on 3 days per week Center for Disease Control and American College of Sports Medicine

4. Look Familiar? Sedentary lifestyle or physical inactivity is a lack of meeting these recommended levels Sedentary lifestyle or physical inactivity is a lack of meeting these recommended levels

5. Population Group National Statistics (Health People 2010) Adults40% do not participate in any leisure activity Adults61% are obese or overweight High School Students 35% do not participate in vigorous physical activity Children (2-18 years old) Average 4 hours/day being sedentary (TV, computers) US householdsTake 12 auto trips/day; 1/4 are less than a mile

6. 2005 Prevalence of Recommended Physical Activity

7. It’s Crazy to be Lazy… “Physical inactivity contributes substantially to the global burden of disease, death and disability.” WHO: ~ 2 million deaths per year “Physical inactivity contributes substantially to the global burden of disease, death and disability.” WHO: ~ 2 million deaths per year

8. Positive Health Effects Cardiovascular disease Overweight & obesity Diabetes Cancer Musculoskeletal health Psychological well-being Cardiovascular disease Overweight & obesity Diabetes Cancer Musculoskeletal health Psychological well-being

9. Reduction of CVD Risk Greatest benefit of physical activity Inactive people have 2x risk vs active Prevents stroke Improves CVD associated risk factors Greatest benefit of physical activity Inactive people have 2x risk vs active Prevents stroke Improves CVD associated risk factors

10. Sedentary Lifestyle and Cardiovascular Fitness Most reliable index of physical activity Define “Cardiorespiratory Fitness” Decrease in Cardiorespiratory Fitness Powerful Predictor Cardiovascular Disease Mortality Type II Diabetes Mellitus Most reliable index of physical activity Define “Cardiorespiratory Fitness” Decrease in Cardiorespiratory Fitness Powerful Predictor Cardiovascular Disease Mortality Type II Diabetes Mellitus

11. Overweight & Obesity “Ex-Ur-Size!” Dramatic increase in prevalence over last 20 years (Remember last week?) Energy intake>>>total energy expenditure Physical activity  weight loss Decreases risks of obesity Health benefits independent of weight loss!! Dramatic increase in prevalence over last 20 years (Remember last week?) Energy intake>>>total energy expenditure Physical activity  weight loss Decreases risks of obesity Health benefits independent of weight loss!!

12. Diabetes Increasing prevalence in U.S. Usual onset after age 40 Emerging in children… Evidence: 30% lower risk in active Moderate and vigorous activity levels Increasing prevalence in U.S. Usual onset after age 40 Emerging in children… Evidence: 30% lower risk in active Moderate and vigorous activity levels

13. Cancer Physical activity  Colon cancer risk Breast cancer Prostate cancer? Physical activity  Colon cancer risk Breast cancer Prostate cancer?

14. Musculoskeletal Health Regular physical activity Reduces age decline Strength and flexibility Reduces risk of falls & hip fractures Weight-bearing activities Prevents osteoporosis Regular physical activity Reduces age decline Strength and flexibility Reduces risk of falls & hip fractures Weight-bearing activities Prevents osteoporosis

15. Psychological Well-Being Physical activity Reduces symptoms of depression, and possibly stress, & anxiety Positive self image and self- esteem Increases social interaction Builds social skills among children Improves quality of life Physical activity Reduces symptoms of depression, and possibly stress, & anxiety Positive self image and self- esteem Increases social interaction Builds social skills among children Improves quality of life

16. THE EVIDENCE FOR EXERCISE…

17. The European Youth Heart Study Cross-sectional 1732 randomly chosen 9 and 15 year olds Physical activity on cardiovascular risk factors in children 4 levels of physical activity Results: OR of 3.29 Independent of weight status!!! Cross-sectional 1732 randomly chosen 9 and 15 year olds Physical activity on cardiovascular risk factors in children 4 levels of physical activity Results: OR of 3.29 Independent of weight status!!!

18. The Health and Retirement Study Pre-retirement aged U.S. adults Relationship between physical activity and mortality across socioeconomic and CVD risk groups Results: OR = 0.62 Adjusted for age, sex, race, smoking, obesity, cancer, health status, income, and CVD risk Pre-retirement aged U.S. adults Relationship between physical activity and mortality across socioeconomic and CVD risk groups Results: OR = 0.62 Adjusted for age, sex, race, smoking, obesity, cancer, health status, income, and CVD risk

19. Kuopio Ischemic Heart Disease Risk Factor Study 1069 Finnish men Increased risk of “Metabolic Syndrome” Strong predictor of cardiovascular mortality Study conclusion: Sedentary lifestyle is actually a “feature” of MS 1069 Finnish men Increased risk of “Metabolic Syndrome” Strong predictor of cardiovascular mortality Study conclusion: Sedentary lifestyle is actually a “feature” of MS

20. Summary Physical activity: Many benefits… Decreases cardiovascular risk factors Independent of weight loss Physical activity is an independent predictor of mortality… Leanness ≠ invincible Physical activity: Many benefits… Decreases cardiovascular risk factors Independent of weight loss Physical activity is an independent predictor of mortality… Leanness ≠ invincible

21. Focus for Change Individual attitudes Belief in abilities Micro environment Conduciveness of activity at work & home Macro environment Socioeconomic culture & environment Individual attitudes Belief in abilities Micro environment Conduciveness of activity at work & home Macro environment Socioeconomic culture & environment

22. How to Avoid Death (Or At Least Postpone It) Daily walks Take the stairs Gardening Cycling, swimming, sports You get the idea… Daily walks Take the stairs Gardening Cycling, swimming, sports You get the idea…

24. REFERENCES Kahlmeier et al. Physical actvity and health in Europe: evidence for action, World Health Oranization, 2006 Lakka, et al. Sedentary Lifestyle, Poor Cardiorespiratory Fitness, and the Metabolic Syndrome, Medicine & Science in Sports & Exercise, March 2003 Richardson, et al. Physical Activity and Mortality across Cardiovascular Disease Risk Groups WHO website CDC website Kahlmeier et al. Physical actvity and health in Europe: evidence for action, World Health Oranization, 2006 Lakka, et al. Sedentary Lifestyle, Poor Cardiorespiratory Fitness, and the Metabolic Syndrome, Medicine & Science in Sports & Exercise, March 2003 Richardson, et al. Physical Activity and Mortality across Cardiovascular Disease Risk Groups WHO website CDC website