This document summarizes the benefits of physical activity for health and reducing cancer risk. It discusses how physical inactivity has reached pandemic proportions and interventions are needed. Regular physical activity reduces the risk of several health issues including different cancer types. Inactivity is as harmful as smoking. Walking is presented as an easy and effective form of physical activity that provides health benefits using tools like pedometers to help monitor goals.

1. Be active against cancer!
Tuesday, 4th of February
2014 (World Cancer Day)
Be Active – Why and How?
Professor Nanette Mutrie
Physical Activity for Health Research Centre
University of Edinburgh

2. • Physical
inactivity has
reached
‘Pandemic’
proportions
• Interventions
are needed!
• July 2012

3. "Everything that gets worse when you
grow older gets better when you
exercise."

4. Regular physical activity
reduces risk of:
• All-cause mortality
• Coronary heart
disease
• High blood
pressure
• Stroke
• Falling
• Metabolic
syndrome
• Type 2 diabetes
• Breast cancer
• Colon cancer
• Depression
Lee et al. , Lancet, July 2012

5. Strong evidence of the
following benefits for adults:
– Increased cardiorespiratory and
muscular fitness
– Healthier body mass and composition
– Improved bone health
– Increased functional health
– Improved cognitive function
Lee et al. , Lancet, July 2012

6. How does the risk of inactivity
compare with smoking?
0
1
2
3
4
5
6
7
8
9
10
PAF% deaths caused in millions
smoking
smoking
Lee et al. , Lancet, July 2012

7. How does the risk of inactivity
compare with smoking?
0
1
2
3
4
5
6
7
8
9
10
PAF% deaths caused in millions
smoking
inactivity
Lee et al. , Lancet, July 2012

8. Percentage of worldwide
burden of disease caused by
inactivity
0 1 2 3 4 5 6 7 8 9 10
CHD
Breast cancer
Type 2 Diabetes
Colon Cancer
Prem mortality
Percentage
Lee et al. , Lancet, July 2012

10. Public health guidelines on
Physical Activity
CMOs 2011 ‘start active stay active’
150 mins of moderate activity/week
– or 75 mins vigorous intensity per week
– or combination
Strength exercise at least two days/week
Older adults all of above plus
– balance and co-ordination 2/days/week
Limit sedentary behaviour

11. Percentage adults achieving Scottish
strategy1 recommendations
[SHeS,2012]
39
37
39 39 38
0
10
20
30
40
50
strategy recommendations [5x30]
2008
2009
2010
2011
2012
1. Let’s make Scotland more active. 2003

12. Percentage adults achieving Scottish
strategy recommendations and ‘new’
recommendations [SHeS,2012]
0
10
20
30
40
50
60
70
strategy recommendations [5x30] new recommendations [150 mins]
2008
2009
2010
2011
2012

13. Odds of Metabolic Syndrome in Women –
TV Viewing and Physical Activity
Physical activity time
(hrs/wk)
TV viewing
time
(hrs/wk)
*
*
*
* P < 0.05 vs ref.
Courtesy
Neville Owen
Dunstan et al.
(2005).
Diabetologia
48, 2254-2261.

14. Independent of level of moderate
to vigourous activity, greater sitting
time was associated with
increased endometrial cancer risk

16. Physical Activity and Cancer Preventability
estimates (PAF%) (UK) (WCRF, 2013)
Site PAF% accounted for by low
physical activity
Breast 12
Colorectum 12
Endometrium 10
http://www.wcrf.org/cancer_statistics/preventability_estimates/preventability_estimates_food.ph
Low physical activity will also influence obesity and
increased risk for the following cancer sites
Oesphagus Breast
Pancreas Colorectum
Gallbladder Endometrium
Kidney

17. American Cancer Society Guidelines
on Nutrition and Physical Activity for
Cancer Prevention 2012
Physical activity may reduce the risk of
several types of cancer, including cancers of
the breast, colon, and endo- metrium, as
well as advanced prostate cancer, and
possibly, pancreatic cancer.

18. American Cancer Society Guidelines
on Nutrition and Physical Activity for
Cancer Prevention 2012
• Physical activity may help to prevent
certain cancers via:
• regulating sex hormones
• insulin
• prostaglandins
• various beneficial effects on the immune
system.

19. Be Active – Why and How?
The HOW part

20. The ABC of Physical Activity for Health:
A consensus statement from the
British Association of Sport and Exercise Sciences
BASES Journal of Sport Sciences 2010
• A- all adults; B- beginners; C-conditioned
• Beginners
– Something is better than nothing
– Set achievable goals
– Find enjoyment
– Seek support

21. 7 Investments that
work for physical activity
1. ‘Whole-of-school’ programs
2. Transport policies and
systems that prioritise walking,
cycling and public transport
3. Urban design regulations and
infrastructure that provides for
equitable and safe access for
recreational physical activity,
and recreational and transport-
related walking and cycling
across the life course
4. Physical activity and NCD
prevention integrated into
primary health care systems
5. Public education, including
mass media to raise
awareness and change social
norms on physical activity
6. Community-wide programs
involving multiple settings and
sectors & that mobilize and
integrate community
engagement and resources
7. Sports systems and programs
that promote ‘sport for all’
and encourage participation
across the life span

22. For almost everyone the best place
to start is to increase walking
1) Walking is the easiest mode of activity
for inactive people :
 to get started with
 to sustain
1) Confers all the major benefits of
activity

24. Why Walking for Health?
Social
Least affected by SIMD
Low to no expenseTRANSFORMATIVE
Habit/
routine
Non age dependent
1st pathway for the least active/sedentary
WHY?

25. Walking + pedometers?
• Pedometers have been identified as the
single most effective method of physical
activity promotion (Heath et al., 2012).

26. Understanding behaviour change
techniques [BCTs] in relation to walking
and cycling
• From studies with sig. intervention effects
(n=21) the most frequently coded BCTs were:
– “Prompt self-monitoring of behavior”
– “Prompt intention formation”
• In terms of walking
– the pedometer offers a perfect tool
• Bird EL, Baker G, Mutrie N, Ogilvie D, Sahlqvist S, Powell J. Behavior Change
Techniques Used to Promote Walking and Cycling: A Systematic Review. Health
Psychol. 2013 Mar 11. PubMed PMID: 23477577.

27. Pedometers make use of several
behaviour change techniques:
goal-setting (individuals can set daily step goals)
self-monitoring (check out daily steps)
self-efficacy (improve confidence in walking
ability)
problem-solving (adapt walking behaviour to suit
weather and setting)
motivation (provide instant feedback to
individuals on goals)
social support (a visual prompt for friends and
family)

28. • Week 1 and 2:
– an additional 1,500 steps at least 3 days/week
• Week 3 and 4:
– increase to 5 days/week
• Week 5 and 6:
– an additional 3,000 steps on at least 3
days/week
• Week 7:
– increase to 5 days/week
• Week 8-12:
– maintain week 7
WWW
Walking Goals

29. 12-week Results
step-counts
0
2000
4000
6000
8000
10000
Baseline Week 12
Time-point
Mean daily step-counts
Intervention Control
Steps/day
• 65% of intervention group achieved an increase of 15,000 steps/week
154 steps/day
*3,175 steps/day
• * indicates significant difference between baseline and week 12 at p < .001

30. Step counts
0
2000
4000
6000
8000
10000
12000
baseline 12 weeks 24 weeks 48 weeks
Time point
Steps
MAX
MIN

31. Cost effectiveness
• Shaw, et al. (2011).
'Pedometers cost
buttons': Bmc Public
Health, 11(1), 200.
• Under £100/person
to achieve
recommended levels
of PA

32. Find out more:
www.pathsforall.org.uk
Find a Health Walk near you:
www.pathsforall.org.uk/findahealthwalk

33. Community Pedometer Pack

34. Paths for All
Strength & Balance Programme
10 simple exercises that will improve strength and balance and reduce the risk
of falls in older adults