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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: Super1@pitt.edu
How to join the Supercourse: www.pitt.edu/~super1/
Learning Objectives
   To encourage students to be
    physically active
   To illustrate Exercise and its
    effect on disease prevention
   To provide examples of simple,
    moderate intensity physical
    activity
   To encourage regular physical
    activity in developing countries
    with focus on women
   To encourage physical fitness in
    people with disabilities
   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 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
                                        CDC,1997
“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
                                 Physically Active
  disabled

LaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17
Differences between Exercise
Exercise        and Sport
  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 like to
  sweat
 I’ll look silly
 It hurts
 I don’t know what
  to do
 It’s not important
Why Exercise ???
Do you know?
 13.5 million people have coronary heart
  disease.
 1.5 million people suffer from a heart
  attack in a given year.
 250,000 people suffer from hip
  fractures each year.
 Over 60 million people (a third of the
  population) are overweight.
 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

  2
1.8
1.6
1.4
1.2
  1                                    Fit
0.8
                                       Unfit
0.6
0.4
0.2
  0
        lean   Normal    Obese
       <16%    16-24%    >24%
Do you know that ……
   Childhood obesity has reached epidemic
    proportions in most part of the world
   Children are eating more and exercising less.
   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
All of these can be Prevented by
   Regular Physical Activity !!!
How Physical Activity Impacts Health
    Helps control weight.
    Reduces feelings of depression and
     anxiety.
    Helps build and maintain healthy bones,
     muscles, and joints.
    Reduces the risk of developing colon
     cancer.
    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.
    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
q   Coronary Heart Disease (CHD)
q   Stroke
q   Obesity
q   Type II Diabetes
q   Hypertension
q   Colorectal cancer
q   Stress and Anxiety
q    Osteo-arthritis
q    Osteoporosis
q   Low back pain
What Can Exercise do for You?
   Reduce the risk of the three leading causes of
    death: Heart Disease, stroke, and cancer
   Control or prevent development of Disease

   Enhance Mental Abilities

   Improve Sleeping Habits and Increase Energy

    Levels

   Lift Depression and Help Manage Stress

   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
Exercise reduces Blood Pressure
   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 and Cancer

The Basics
   Exercise helps to prevent obesity, a
    major risk factor for several types
    of cancer
   Exercise enhances immune
    function
   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 helps you sleep better
 Exercise controls weight, enhancing self-
  esteem
                                  WHO 2002
Exercise and Your Mind
 Short-term     benefits:
  Boost alertness (possiblyby triggering the
   release of epinephrine and nor
   epinephrine)
  Improve memory
  Improve intellectual function
  Spark creativity

 Long-term      benefits:
  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?
   Think about your reasons for
    exercising
   Are your goals important enough to
    keep you motivated long-term?
 Think short-term and long-term
   How will you benefit from your
    fitness plan day-to-day?
   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
   Be informed
     Learn as much as you can about
      exercise by reading and talking
      to other people
     Learn safety precautions before
      you do any exercise
Fitness Equipment / Safety

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

   Components of an exercise
    program
      Aerobic Activity
      Strength 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    Indoor Activities
   Walking              Treadmill   machine
   Jogging/running      Stair climbing
   Bicycling             machine
   Swimming             Stationary bike

   Basketball           Elliptical trainer

   Soccer               Rowing machine

   Jumping Rope         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
 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
   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
Your body, your weight
   The most   convenient form of resistance
    exercise
   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
Benefits
   Decreased   chance of muscular injury,
    soreness, and pain
   Helps prevent and reduce lower back pain
   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
     Strength training: a minimum of 2 days per
      week
     Flexibility training: a minimum of 3-5 days
      per week
   Duration
     Aerobic: 20-60 minutes of continuous aerobic
      activity
     Strength: 1-3 sets of 8-12 repetitions
     Stretching: Stretch all muscle groups and
      hold positions for 10-30 seconds
Timing Questions
   What time of day is best?
     Choose the most    convenient time for your
      schedule
     Choose a regular time--the same time every
      day
     Timing may depend on the activity you
      choose
   Can I eat before exercise?
     Itis best not to eat a meal for 2 hours
      beforehand
     Be sure to drink plenty of water before and
      during exercise
   Should I exercise when I’m sick?
     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
       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
"You don't stop exercising because you grow old.
You grow old because you stop exercising." Anonymous

   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.
   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.
Exercise for Women in developing
                countries
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.
 Women sports are not encouraged
in most of developing countries
 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
   Exercise is not only for men but for
    everyone
   With commitment, opportunities can be
    developed.
   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.
       The overall benefit of regular physical
        activity is lower all-cause mortality
Injury
   Prevention                     Caring for Injuries
       exercise regularly             Rest: stop immediately
       gradually increase             Ice: apply immediately
        intensity                       and repeat every few
       rest between sessions           hours for 15-20
       warm-up and cool                minutes
        down                           Compress: wrap
       stay flexible                   injured area with
                                        elastic bandage
       don’t exercise when
        sick                           Elevation: raise injured
                                        area above heart
       don’t exercise when
        muscles are fatigued           After 2 days, apply heat
        and straining                   if there is no swelling
       know proper form for           Gradually ease back
        any activity you do             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
   Even moderate exercise has many
    health benefits
   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
                       Exercise feels good!
“The first wealth is health."
             Ralph Waldo Emerson

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Physical Activity & Health Lecture

  • 1. Physical Activity & Health This lecture has been dedicated to Olympics games in Beijing, China Aug 08-24, 2008 By Supercourse Team
  • 2. 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: Super1@pitt.edu How to join the Supercourse: www.pitt.edu/~super1/
  • 3. Learning Objectives  To encourage students to be physically active  To illustrate Exercise and its effect on disease prevention  To provide examples of simple, moderate intensity physical activity  To encourage regular physical activity in developing countries with focus on women  To encourage physical fitness in people with disabilities  To build an Olympic Physical activity and health supercourse
  • 4. 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
  • 5. What is Physical Activity  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.  Regular physical activity A pattern of physical activity is regular if activities are performed in some order CDC,1997
  • 6. “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
  • 7. Spectrum of Physical Activity and Health Physically Fit Physically Physically Active disabled LaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17
  • 8. Differences between Exercise Exercise and Sport 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
  • 9. Common Reasons Not To Exercise  I don’t have the time  I don’t like to sweat  I’ll look silly  It hurts  I don’t know what to do  It’s not important
  • 11. Do you know?  13.5 million people have coronary heart disease.  1.5 million people suffer from a heart attack in a given year.  250,000 people suffer from hip fractures each year.  Over 60 million people (a third of the population) are overweight.  50 million people have high blood pressure. (WHO, 2003)
  • 12. Do you Know that……. Adjusted RR for CVD Mortality by Fitness and % Body Fat
  • 13. Do you Know that……. Adjusted RR for All-Cause Mortality by Fitness and % Body Fat 2 1.8 1.6 1.4 1.2 1 Fit 0.8 Unfit 0.6 0.4 0.2 0 lean Normal Obese <16% 16-24% >24%
  • 14. Do you know that ……  Childhood obesity has reached epidemic proportions in most part of the world  Children are eating more and exercising less.  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
  • 15. All of these can be Prevented by Regular Physical Activity !!!
  • 16. How Physical Activity Impacts Health  Helps control weight.  Reduces feelings of depression and anxiety.  Helps build and maintain healthy bones, muscles, and joints.  Reduces the risk of developing colon cancer.  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.  Enlarges the arteries that supply blood to the heart. WHO 2002
  • 17. Health Risk of Physical Inactivity Leading causes of disease and disability associated with physical inactivity q Coronary Heart Disease (CHD) q Stroke q Obesity q Type II Diabetes q Hypertension q Colorectal cancer q Stress and Anxiety q Osteo-arthritis q Osteoporosis q Low back pain
  • 18. What Can Exercise do for You?  Reduce the risk of the three leading causes of death: Heart Disease, stroke, and cancer  Control or prevent development of Disease  Enhance Mental Abilities  Improve Sleeping Habits and Increase Energy Levels  Lift Depression and Help Manage Stress  Control Weight, improving self-image, appearance and health
  • 19. Exercise & Cardiovascular Disease FACT 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 Exercise prevents Atherosclerosis (clogged arteries)  Exercise reduces cholesterol plaques that clog arteries and can lead to stroke and heart attack WHO 2002
  • 20. Exercise and Cancer The Basics  Exercise helps to prevent obesity, a major risk factor for several types of cancer  Exercise enhances immune function  Exercise activates antioxidant enzymes that protect cells from free radical damage WHO 2002
  • 21. Exercise and Diabetes Increase insulin sensitivity Control blood glucose Control Weight/Lower body fat Reduce risk of cardiovascular disease WHO 2002
  • 22. 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 helps you sleep better  Exercise controls weight, enhancing self- esteem WHO 2002
  • 23. Exercise and Your Mind  Short-term benefits:  Boost alertness (possiblyby triggering the release of epinephrine and nor epinephrine)  Improve memory  Improve intellectual function  Spark creativity  Long-term benefits:  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
  • 24. 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
  • 25. Getting Started….Setting Goals  What will motivate you?  Think about your reasons for exercising  Are your goals important enough to keep you motivated long-term?  Think short-term and long-term  How will you benefit from your fitness plan day-to-day?  In 1 year? In 5 years? In 10 years?
  • 26. 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  Be informed  Learn as much as you can about exercise by reading and talking to other people  Learn safety precautions before you do any exercise
  • 27. Fitness Equipment / Safety Fitness Equipment / Safety  Buy Appropriate SHOES  Wear Comfortable Clothing  TOO HOT! TOO COLD!  Run and Walk with a Friend More fun, safer, with a physical and mental support system  Night Time: stay to the well lit areas  Select activities that are fun ……….. To YOU!
  • 28. Get Moving!  Components of an exercise program  Aerobic Activity  Strength Training  Flexibility Training Use an exercise log to help you plan and keep track of your exercise program WHO 2002
  • 29. 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
  • 30. Types of Aerobic Exercise Outdoor Activities Indoor Activities  Walking  Treadmill machine  Jogging/running  Stair climbing  Bicycling machine  Swimming  Stationary bike  Basketball  Elliptical trainer  Soccer  Rowing machine  Jumping Rope  Aerobics, boxing...
  • 31. 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 Muscles = 40% of our lean body mass Use it or lose it: unused muscle disappears (atrophy)
  • 32. Types of Strength Training Free Weights  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  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  Pushups, pull-ups,. Lunges, squats….
  • 33. Flexibility Training Flexibility = The ability to move a joint through its range of motion  We lose flexibility with disuse and aging Benefits  Decreased chance of muscular injury, soreness, and pain  Helps prevent and reduce lower back pain  Improves joint health (tight muscles stress our joints) Activities stretching, yoga, pilates, tai chi
  • 34. 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  Strength training: a minimum of 2 days per week  Flexibility training: a minimum of 3-5 days per week  Duration  Aerobic: 20-60 minutes of continuous aerobic activity  Strength: 1-3 sets of 8-12 repetitions  Stretching: Stretch all muscle groups and hold positions for 10-30 seconds
  • 35. Timing Questions  What time of day is best?  Choose the most convenient time for your schedule  Choose a regular time--the same time every day  Timing may depend on the activity you choose  Can I eat before exercise?  Itis best not to eat a meal for 2 hours beforehand  Be sure to drink plenty of water before and during exercise  Should I exercise when I’m sick?  No, especially if you have a fever
  • 36. 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 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
  • 37. Exercise for people with special needs "You don't stop exercising because you grow old. You grow old because you stop exercising." Anonymous  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.  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.
  • 38. Exercise for Women in developing countries 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.  Women sports are not encouraged in most of developing countries  There is stigma that women should not be involved in outdoor sports
  • 39. Exercise is for everyone  There is need for awareness for physical fitness in developing countries  Exercise is not only for men but for everyone  With commitment, opportunities can be developed.  Even shopping malls provide opportunities for fitness walking CDC 1997
  • 40. 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. The overall benefit of regular physical activity is lower all-cause mortality
  • 41. Injury  Prevention  Caring for Injuries  exercise regularly  Rest: stop immediately  gradually increase  Ice: apply immediately intensity and repeat every few  rest between sessions hours for 15-20  warm-up and cool minutes down  Compress: wrap  stay flexible injured area with elastic bandage  don’t exercise when sick  Elevation: raise injured area above heart  don’t exercise when muscles are fatigued  After 2 days, apply heat and straining if there is no swelling  know proper form for  Gradually ease back any activity you do into activity when pain is gone
  • 42. 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  Even moderate exercise has many health benefits  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 Exercise feels good!
  • 43. “The first wealth is health." Ralph Waldo Emerson

Notas do Editor

  1. This lecture proposes to integrate the Olympic ideas plus our knowledge of the science of physical activity and health Supercourse: www.pitt.edu/~super1/ Prepared by Dr. Soni Dodani
  2. The Olympic Games are associated with the development of a country, it will give Beijing a chance to show that its wealth is not only its past, but that it has a creative, modern profile as well.
  3. A pattern of physical activity is regular if activities are performed most days of the week, preferably daily,5 or more days of the week if moderate-intensity activities are chosen or 3 or more days of the week if vigorous-intensity activities are chosen.
  4. The Spectrum of Activity ranges from those with several impaired activity of the disabled, which often represents 20% of a countries population. This ranged upward to sedentary white color workers. The physical fitness branch include those whose fitness is increased due to activity, but also those whose fitness is primarily the result of genetics. There are also many very physically active individuals who are not fit, for example, postal carriers, waitresses, or even mothers with young children. When we are examining physical activity and health, we need to evaluate the physical activity spectrum.
  5. It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness—cardio Exercise causes respiratory fitness, muscular strength, muscular endurance, flexibility, and body composition
  6. The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis.
  7. Despite the proven benefits of physical activity, more than 50% of American adults do not get enough physical activity to provide health benefits. 25% of adults are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education. Furthermore, there are racial and ethnic differences in physical activity rates, particularly among women
  8. Blair SN: Cin J Sport Med. 2003 Sep;13(5):319-320 According to a study conducted by Steve Blair of Cooper Institute, Texas, Hazard ratios were higher for cardiovascular mortality (1.39 [P &gt; 0.10], 1.53 [P &lt; 0.05], 1.95 [P &lt; 0.05] for the categories). Similar hazard ratios for the same comparisons were found for men for all-cause mortality (hazard ratios, 1.25, 1.44, and 1.49 [P &lt; 0.05 for each]) and cardiovascular mortality (hazard ratios, 1.39 [P &lt; 0.06], 1.55 [P &lt; 0.06], 1.67 [P &lt; 0.05]). Physical activity did not predict mortality.
  9. Blair SN: Cin J Sport Med. 2003 Sep;13(5):319-320 Fatness and lack of fitness are associated with all-cause and cardiovascular mortality. Compared with fit/not fat women, adjusted Cox proportional hazard ratios for all-cause mortality are higher for fit/fat (1.32 [P &lt; 0.05]), unfit/not fat (1.30 [P &lt; 0.05]), and unfit/fat women (1.57 [P &lt; 0.05]).
  10. Dempsey T J Okla State Med Assoc. 2004 Mar;97(3):119-21 One of the major reasons is the lack of physical activity due to 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. Physicians can help reduce this trend.
  11. http://www.cdc.gov/nccdphp/dnpa/physical/starting/index.htm
  12. The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis. (CDC Report 1997)
  13. A sedentary lifestyle is detrimental to health. Many of the leading causes of disease and disability in our society, such as Coronary Heart Disease (CHD), strokes, obesity, type II diabetes, hypertension, colorectal cancer, stress, anxiety, osteoarthritis, osteoporosis and low back pain, are associated with physical inactivity. 1
  14. The good news about regular physical activity is that everyone can benefit from it (USDHHS, 1996).
  15. FACT : CVD is the number one killer of Americans. Over one million will suffer a heart attack this year; 30% will not survive the acute episode, and 10% more will die during the following year. About 500,000 will suffer a stroke , 40% will be left with a significant disability, and 30% will die within the following year.
  16. Colon Cancer : Physical activity speeds movement of food through the gastrointestinal tract, reducing the risk of colon cancer For e.g. Breast Cancer : High levels of circulating estrogens influence the development of cancers of the female reproductive system; exercise reduces levels of circulating estrogen, thus reducing risk.
  17. Increase insulin sensitivity Exercise has been shown to increase the ability of the body to use insulin, which improves how the body uses sugar Control blood glucose Exercise removes come glucose directly from the blood to use for energy during and after activity Control Weight/Lower body fat 4 out of 5 people with diabetes are overweight Studies show that when diabetics lose weight, their condition improves Reduce risk of cardiovascular disease People with diabetes are at increased risk for CVD
  18. 18 million people suffer from depression each year in the US. (CDC report 1997). Everyone under stress, including persons experiencing anxiety or depression can benefit. Regular physical activity improves one&apos;s mood, helps relieve depression, and increases feelings of well-being.
  19. Studies show that physically fit older people react to normal challenges as quickly as unfit people who are 30 years younger A report of Surgeon general, Physical Activity and health, 1996
  20. Opportunities for people to be physically active exist in four major domains of one’s day-to-day life:   At work, for example if a job involves manual labour; For transport, for example walking or cycling to school, work or to the shops; In domestic duties at home, for example housework, gardening or do-it-yourself; In leisure time, for example, in sports, exercise or recreational activities.   Despite the numerous opportunities for people to be physically active the majority of the population in the UK do very little or no physical activity in any of these domains. 1
  21. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Examples Health goals I want to lower my blood pressure I want to feel good about my weight and health Fitness goals I want to run in a road race
  22. To improve physical fitness, the body must be challenged by loads greater than normal. For example, when muscles are stressed by a greater load than they are used to, they adapt and their function improves. This principle applies to aerobic activity, strength training, and flexibility
  23. the efficiency of our lungs, heart, and vessels in delivering oxygen to our body tissues Oxygen sustains us…. It is the fuel for metabolic reactions Efficient delivery of oxygen allows our muscles, brain, and other tissues to work their best; aerobic exercise promotes this!
  24. Hiking/skiing is also included in Outdoor activities
  25. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Benefits of increased lean body mass (muscle) Greater ease in performing daily activities Reduce body fat: muscle burns more calories at rest than fat Prevent injuries Prevent and treat lower back pain
  26. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Safety Warm-up your muscles first Know proper use of machines, and use correct form Do not exercise alone when using weights (spotter) Don’t “over train”; know your limits, and increase intensity gradually Breathing Don’t hold your breath! E xhale with E xertion Perform shortening and lengthening phases of each exercise Balance your muscle use Strengthen opposing muscle groups Use both sides of your body for each exercise
  27. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Stretching Regimen Warm-up Move into stretch gently, until you feel tension but NO PAIN Hold pose for 10-30 seconds and BREATHE Move out of stretch gently
  28. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt Aerobic : 20-60 minutes of continuous aerobic activity. Note: moderate levels throughout the day have been shown to have significant health benefits Strength : 1-3 sets of 8-12 repetitions, involving 8-10 exercises that condition the major muscle groups Stretching : Stretch all muscle groups and hold positions for 10-30 seconds Intensity Fitness benefits occur when we exercise harder than our normal level of activity. In aerobic activity, the heart rate should rise above normal, and to develop muscular strength a person must lift a heavier weight than normal Two methods to monitor intensity Target Heart Rate: measures in beats/minute (220-age) Rate of perceived exertion: use this scale to “describe” and gauge your effort when exercising; rate how you feel on a scale of 1-10 where 0 is sitting quietly on a bench and walking at a moderate pace would be a 3/
  29. Exercise for life by Melissa www.som.tulane.edu/groups/bht/ Presentations/exercise.ppt If your symptoms are all above your neck and do not include fever or swollen lymph nodes, light exercise is usually done.
  30. A report of Surgeon General, Physical Activity and health, 1996 The International Paralympics Committee (IPC) is the international representative organization of elite sports for athletes with disabilities. IPC organizes, supervises and co-ordinates the Paralympics Games and other multi-disability competitions on elite sports level, of which the most important are world and regional championships. It is an international non-profit organization formed and run by around 160 National Paralympics Committees and 4 disability specific international sports federations.
  31. A report of Surgeon General, Physical Activity and health, 1996 Ensure that people with disabilities are involved at all stages of planning and implementing community physical activity programs.
  32. Hallal PC Med Sci Sports Exerc. 2003 Nov;35(11):1894-900 Social environments such as school, work, family and friends can significantly influence an individual&apos;s level of physical activity. However, characteristics of our communities such as the accessibility and location of parks, trails, sidewalks, and recreational centers as well as street design, density of housing, and availability of public transit may play and even greater role in promoting or discouraging an individual or family&apos;s level of physical activity. There are also significant environmental barriers from water and air pollution to crime and dangerous automobile traffic. CDC 1997
  33. Active Community Environments Initiative project to promote and support the awareness and development of places where people of all ages and abilities can easily enjoy walking, bicycling, and other forms of recreation.  There are many opportunities within our environment in developing countries for women that support physical activities. What is required is awareness and will to do. Even malls provide opportunities for fitness walking. Understanding environmental opportunities and barriers that we face in our pursuit for a healthy lifestyle may provide some of the knowledge necessary to promote healthy living.  
  34. Davis EK J Okla State Med Assoc. 2004 Jan;97(1):18-21 Although physical activity has numerous health benefits, there are potential adverse effects associated with being physically active, ranging from those that cause minor inconvenience to those that are life threatening.   Most musculoskeletal injuries related to physical activity are likely to be preventable by gradually working up to a desired level of activity and by avoiding excessive amount of activity. Although there is no evidence that physical activity itself causes osteoarthritis, injuries sustained during competitive sports have been shown to increase the risk of developing osteoarthritis. Although serious cardiac events can occur with physical exertion, the overall benefit of regular physical activity is lower all-cause mortality.
  35. Davis EK J Okla State Med Assoc. 2004 Jan;97(1):18-21