2016 Conference - Dr. William Bird

© 2016 Intelligent Health
Building Active Communities
Dr William Bird, MBE

Dr William Bird MRCGP MBE
3 March 2016
Building Active
Communities

Intelligent Health
Knowledge Engagement Evidence

Knowledge

If we take an hour to equal 1,000 years,
then four days is 100,000 years – the time
from the origin of mankind to today
4 days
ago
100,000
years ago
hunter
gatherers
10 hours
ago
10,000
years ago
agriculture
4 hours
ago
4,000
years ago
civilisation
10 hours
ago
10,000
years ago
agriculture
4 hours
ago
4,000
years ago
civilisation
technologyindustrialisationindustrialisation
9 minutes
ago
9 minutes
ago
80 seconds
ago

Sociable Green Physical
Our factory setting is to be in a
sociable group, active environment and have a purpose
People Place Purpose

Fear and Chronic Stress
Loneliness Hostile Rejection
People Place Purpose

The Effect of Trees on Cognitive Performance
–3
–2
–1
0
1
2
3
4
5
6
7
No Tree Min Awareness Mod Awareness Heightened Awareness
Lin, Ying-Hsuan, et al. "Does awareness effect the restorative function and perception of street trees?“ Cognitive Science 5
(2014): 906.
Digit Span Backward Test

Exposure to Neighbourhood Green Space
and Mental Health
Beyer, Kirsten MM, et al. Int.J of environmental research and public health 11.3 (2014): 3453-3472

Association Between Trees, Vegetation, Depression
and Stress
–1.6
–1.4
–1.2
–1.0
–0.8
–0.6
–0.4
–0.2
0.0
25% more Tree Cover 25% Higher NDVI 25% more Greenspace
Depression Stress
Mitchell, R. and Popham, F. (2008) Effect of exposure to natural environment on health inequalities:
an observational population study. The Lancet 372(9650):pp. 1655-1660.
Normalized Difference Vegetation Index (NDVI)

Place: Green space moderates the effect
of stressful events in children
Nearby Nature
A Buffer of Life
Stress among Rural
Children NM Wells,
GW Evans Environment
and Behavior May
2003vol. 35 no. 3 311-
33
High Nature
Low Nature
0
2
4
6
8
10
12
14
Low Medium High
PsychologicalStress
Stressful events
High Nature Low Nature

Chronic
Stress
Anxiety and
depression
Physical
Inactivity
Poor diet

Chronic Stress
Stress
Hormones
Physical
Inactivity
And other
poorhealth
behaviours
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: trilogy of inflammation
1
Increases
visceral fat
3
Damages
healthy cells
2
Reduces anti-
inflammatories

1.
Increases
visceral fat

Reducing inflammation – fat
Visceral fat = 0.5 L Visceral fat = 1.1 L
Visceral fat = 1.3 L Visceral fat = 1.7 L
Visceral fat = 4.3 LVisceral fat = 4.2 LVisceral fat = 1.8 L
Visceral fat = 1.2 L
Variation in visceral fat
content in men with the
same waist circumference

Visceral fat reduction with exercise
–25
–20
–15
–10
–5
0
Lean Obese Type 2 Diabetes
Subcutaneous Fat Visceral Fat
Lee S et al. J Appl Physiol 2005;99:1220-1225
% Loss of Fat
Fat loss after 13 weeks of walking 60 mins a day and no weight loss

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

Reducing inflammation – muscles
Contracting
muscles
release powerful
anti-inflammatories
called Myokines
These Myokines
Circulate around
the whole body
calming every cell

Chromosomes
keep dividing
Immune
system is
switched off
until needed
Mitochondria,
healthy
and active.
Providing lots
of energy
Inside a healthy cell

‘The mitochondria is like a dynamo,
it has to keep moving ...
... but with the
weight of a 40 pound car battery’
Prof Mike Murphy,
MRC Mitochondrial Biology Unit Cambridge University

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

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

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

Senescence: the end of the cell
Hezel, Aram F., Nabeel Bardeesy and
Richard S. Maser. ‘Telomere induced
senescence: end game signaling.’ Current
molecular medicine 5.2 (2005): 145-152.

inflammation
Immune system
is constantly
switched on

Inflammation: ‘the cause of causes’
Chronic
Inflammation
Starts in children
as young as
6 years old
ArthritisArthritis
CancersCancers
DiabetesDiabetes
ObesityObesity
DementiaDementia
Cardiovascular
disease
Anxiety and
Depression

Chronic Stress
Stress
Hormones
Physical
Inactivity
Andother
poorhealth
behaviours
Mitochondrial damage and telomere shortening
which leads to inflammation
Depression
Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007
Cancers Diabetes DementiaCardiovascular

Good for children: single sessions of physical
activity can enhance attention and memory
After 20 minutes of sitting quietly After 20 minutes of walking
Hillman et al. (2009). Neuroscience,159, 1044-1054

Physical inactivity is also associated with
hypertension1 and metabolic risk2 , in children as
young as eight years old
1) Pardee PE, Norman GJ, LustigRH et al. Television
viewing and hypertension in obese children.Am J Prev
Med. 2007, 33: 439-443
2) Ekulund U, Brage S, Froberd K et al. TV viewing and
physical activity are independently associated with
metabolic risk in children: the European Youth Heart
Study. PLoS Medicine 2006, 2: 2449-2456

So what can we do?

To make a step change in
activity levels we need to be bold
Let’s
remove
boundaries
and turn a whole
town into a
playground!

Step change across a community

Beat the Street 2015 – schools are heart of the
community
300 schools
In 2015
100,000
children
75,000
adults

Beat the Street 2015
14% of a
population
took part =
175,000
people

45,136
people
registered.
Of these, 39%
were male and
61% were
female
Beat the Street 2015

Making a difference
said they
used the
car less.
Facebook
likes across
summer projects.
increase in
cycle traffic
in Lowestoft.
of participants
lifted into activity
(results from
Norwich, Thurrock
and Reading in 2014).
said they would
recommend
Beat the Street
to their friends
and family!
increase in
players for second
year of Reading
(15,074 – 23,992).
said Beat the
Street helped
them feel more
involved in
the community.
48%
7,983
30%
18% 94%
63%
69%

Motivation
Is what gets you started
Habit
Is what keeps you going
European Journal of Social Psychology, Volume 40, Issue 6,
pages 998–1009, October 2010

73 Schools
12 Secondary
61 primary
17,952
participants

Wolverhampton BTS

Evidence

Getting inactive people engaged
Beat the
Street well
represents
deprived
communities

A day in the life of …Annan Beat the Street

Changes in Physical Activity
Beat the Street Reading 2014
0%
10%
20%
30%
40%
50%
60%
Before Reading After Reading 3 months after Reading
Achieving 30 minutes of activity 5 days a week
P <0.05
P <0.05

Beat the Street Reading
35%
45%
36%
45% 46%
56%
40%
47%
0%
10%
20%
30%
40%
50%
60%
2014 registration 2014 registration
3 months after
2015 registration 2015 registration
3 months after
Took part in 2014 only Took part both years Took part 2015 only
Over two years in Reading there has been a 20% increase in the number of people
reaching the Government recommended activity levels of 150 minutes a week

Thank you
Dr William Bird MBE
@Intelligent_Hlt
Building
Active
Communities

2016 Conference - Dr. William Bird

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