Physical Activity for LIFE February 7, 2010 Rick Seip, PhD Research Scientist, Genomas, Inc. & Senior Scientist (per diem) Preventive Cardiology Hartford Hospital [email protected]860-545-5005
98
Embed
Physical Activity for LIFE February 7, 2010 Rick Seip, PhD Research Scientist, Genomas, Inc. & Senior Scientist (per diem) Preventive Cardiology Hartford.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Slide 1
Physical Activity for LIFE February 7, 2010 Rick Seip, PhD
Research Scientist, Genomas, Inc. & Senior Scientist (per diem)
Preventive Cardiology Hartford Hospital [email protected]
860-545-5005
Slide 2
Who is this fitness expert? Billy Blanks, 7 time World Champion
in karate Inventor of Tae Bo, combination of boxing and tae kwan
do
Slide 3
Jack LaLanne
Slide 4
Overweight? Youve gotta start MOVIN!!! 10,000 counts per day
Who is this fitness proponent?
Slide 5
Guidelines for healthy adults < age 65 Basic recommendations
from ACSM and AHA (2007):
http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=CM/HTMLDisplay.cfm&CONTENTID=7764
Do eight to 10 strength-training exercises, eight to 12 repetitions
of each exercise twice a week. Do vigorously intense cardio 20
minutes a day, 3 days a week And Do moderately intense cardio 30
minutes a day, 5 days a week Or
Slide 6
Mortality Rates, 1900 Source: Healthy People 2010, US Dept HHS
Senility Tuberculosis Heart Disease Injuries 33%
Slide 7
Mortality Rates, 2004 57% 10,000 counts per day Source: U.S.
National Center for Health Statistics, Health, United States,
2005
Slide 8
Physical Activity on the JOB... 1990: only 5% of occupations
require high level of physical fitness delivery person bicycle
messenger airport baggage handler various laborers (farmers?)
waiter, bellhop, valet 1900s: 40% of occupations developed or
required a high level of fitness
Slide 9
Increase Your Health Span... Cardiovascular Disease Obesity
& Type II Diabetes Mobility, Fall Prevention, &
Osteoporosis
Slide 10
Risk Factors for Coronary Heart Disease Modifiable Dyslipidemia
High LDL- cholesterol Low HDL-cholesterol High TGs Smoking
Hypertension Diabetes mellitus Obesity Dietary factors Thrombogenic
factors Sedentary lifestyle Wood D, et al. Atherosclerosis.
1998;140:199-270. Nonmodifiable Age Sex Family history of premature
CHD 90% of those diagnosed with CHD have at least one of the four
top risk factors Sedentary lifestyle
Slide 11
Slide 12
Development of Atherosclerotic Plaques Normal Fatty streak Foam
cells Lipid-rich plaque Lipid core Fibrous cap Thrombus Ross R.
Nature. 1993;362:801-809
Slide 13
Drug that Affect Serum Lipids Statins * 18-55% 5-15% 7-30%
Fibrates 5-20% 10-20% 20-50% Nicotinic acid 5-25% 15-35% 20-50%
Resins 15-30% 3-5% no Drug class LDL HDL TG NCEP ATP III. JAMA.
2001;285:2486-2497. 10,000 counts per day * Lipitor (atorvastatin),
Crestor (rosuvastatin), Zocor (simvastatin), Pravastatin
(pravachol), Mevacor (Lovastatin); lovastatin was isolated from
Chinese red yeast rice
Slide 14
Hypertension Systolic BP Diastolic BP MILD HYPERTENSION >
140 mmHg 130 - 140 > 90 mmHg Systolic BP Diastolic BP 80 -
90
Slide 15
How can Physical Activity Improve Your Health? Cardiovascular
Disease Obesity & Diabetes Osteoporosis & Fall Prevention
CR Fitness, Calorie Expenditure, Low Fat diet, Stop Smoking, Active
Relaxation Calorie Expenditure Dietary calcium, Vitamin D,
Resistance Training, Flexibility Exercises
Slide 16
Walking may be the only physical activity suitable for the
entire lifespan P.O. Astrand, Swedish physiologist Walking 1 mile
requires 80-100 kcal energy expenditure
Slide 17
Energy Expenditure of Walking ( kcal per mile )
Slide 18
A Long-Duration (118-day) Backpacking Trip (2669 km) Normalizes
Lipids Without Medication: A Case Study PRE Chol 276 Trig 319 HDLc
41 LDLc 167 189 111 68 99 DAY 89 DAY 118 Change 196 79 63 118 % -
29 - 75 + 37 - 29 Ht 5 7 Wt 188 lbs BMI 29.4 5 7 170 lbs 25.5 -13
Calories Eaten SatFat Fiber 2738 35.7 16.7 2653 3130 +14 31.9 g
48.7 +36 31.7 25.5 +52 SBP 132 DBP 98 124 -6 78 -20
Slide 19
Netherlands 30 18 54 Germany 12 22 1649 England 8 12 1462 Italy
5 28 1642 Canada 1 10 1474 USA 1 9 384 Netherlands 30 18 54 Germany
12 22 1649 England 8 12 1462 Italy 5 28 1642 Canada 1 10 1474 USA 1
9 384 Modal Travel in Urban Areas: Europe and North America Percent
of Trips by Mode Modal Travel in Urban Areas: Europe and North
America Percent of Trips by Mode Transportation Quarterly 1997;
51:31 Public CountryBicycleWalkingTransportCar Public
CountryBicycleWalkingTransportCar
Slide 20
Highway Vehicle Miles Traveled are projected to grow 60% by
2030, in step with the growing U.S. population.
http://www.rita.dot.gov/publications/transportation_vision_2030/pdf/entire.pdf
Source: Transportation Vision for 2030 US Department of
Transportation, January 2008
Slide 21
Bill Pearl, age 37 Bill Pearl, last formal pose, 1989 age 59 !!
Mr. Universe, 1967 Resistance Training
Slide 22
Resistance Training General Guidelines
Slide 23
Resistance Training Tailor your Program!
Slide 24
Resistance Training a sample Program
Slide 25
Slide 26
How can Physical Activity Improve Your Health? Cardiovascular
Disease Obesity & Diabetes Osteoporosis & Fall Prevention
CR Fitness, Calorie Expenditure, Low Fat diet, Stop Smoking, Active
Relaxation Calorie Expenditure Dietary calcium, Vitamin D,
Resistance Training, Flexibility Exercises
Slide 27
Q: 1 pound of fat stores how many calories? A: 3500 10,000
counts per day???
Slide 28
WHAT IS YOUR BMI?
Slide 29
How to Find Your BMI: Height: 66 Weight: 180 lbs. BMI = 29.5
160 lbs. 26.5 140 lbs. 23
Slide 30
Obesity Classification Based on Body Mass Index (BMI)
BMIClassification < 25 Normal (desirable) weight 25- 29.9
Overweight > 30 Obesity Class I > 35 Class II > 40 Class
III
Slide 31
Slide 32
a b c c Krumm et al., J.Womens Health 15:202-10, 2006
Slide 33
CAN EXERCISE PREVENT TYPE II DIABETES? DPP - Results NIH news
release (August, 2001) Prevalence of T2DM at three years: %
diagnosed with T2DM Walking and dietary restriction
How can Physical Activity Improve Your Health? Cardiovascular
Disease Obesity & Diabetes Osteoporosis & Fall Prevention
CR Fitness, Calorie Expenditure, Low Fat diet, Stop Smoking, Active
Relaxation Calorie Expenditure Dietary calcium, Vitamin D,
Resistance Training, Flexibility Exercises
Slide 36
OSTEOPOROSIS & FALL PREVENTION
Slide 37
Osteoporosis: The Bone Thief Helen grew up on a dairy farm in
the Midwest. She drank 3 glasses of milk a day as a child. After
high school she began work as a secretary in a local law office
where she spent her entire career. Helen never jogged, walked as
exercise, or played tennis. She went through menopause at age 47.
Shortly before retirement at age 61, she slipped on a small rug in
her kitchen and broke her hip. After Helen recovered, she needed a
cane to walk. Ref: The National Institute of health Age Page
http://www.nih.gov/nia/health/agepages/osteo.htm (2/14/01)
Slide 38
50 y.o. man 58 y.o. man 76 y.o. man 87 y.o. woman Snow-Harter
& Marcus, ESSR, 1991
Slide 39
THE FRACTURE PREVENTION TRIANGLE FALL FORCE FRAGILITY Prevent
the Minimize the of the fall Reduce the of bone.
Slide 40
Wrist Fracture V e r t e b r a l F r a c t u r e Hip
fracture
Falls occur because of both: Internal (host) factors External
(environmental) factors
Slide 43
Internal factors Decreased vision Postural hypotension Impaired
balance and/or gait Chronic diseases that impair mental or physical
functioning Certain medications, such as sedatives and
antidepressants
Slide 44
External (environmental) factors: Poor lighting Lack of
handrails on staircases Objects in pathways Non-secured rugs
Slide 45
Preventing Falls Practice hand clenching, ankle pumping,
dorsi/plantar flexing Balance and strengthening exercises SOLUTION
Use medications properly; learn non-pharmacologic treatment for
sleep disorders
Slide 46
Preventing Falls Review your meds with pharmacist or physician
Install grab bars, handrails. Correct foot or leg problems.
SOLUTION Exercises for balance and gait abnormalities
Slide 47
Preventing Falls through a safer environment Replace torn rugs,
anchor loose edges Add non-skid back to slippery rugs. Arrange
furniture so it is not obstructive Use high back chairs SOLUTION
Label all medications. Ensure adequate lighting. Keep toilet seats
raised. Non-skid surfaces in bath/shower Grab bars in or near
commode
Slide 48
Nonslip wax on floors; Use assistive devices (walker,
handrails). Keep wood or vinyl floors dry and clean Preventing
Falls through a safer environment SOLUTION
Slide 49
Reducing Fragility What can You do to Improve Bone Mass? Diet
rich in Calcium Adequate in Vitamin D Weight-bearing and resistance
training exercises Medication approved by the Food and Drug
Administration (FDA)
Slide 50
BECOME MORE ACTIVE 10,000 counts per day
Slide 51
Thank you for your Attention
Slide 52
EXTRA SLIDES
Slide 53
Cardiovascular Disease includes Heart Disease and Stroke
GO RED FOR HEART http://www.americanheart.org VISIT THIS
WEBSITE TO CALCULATE YOUR RISK FOR CARDIOVASCULAR DISEASE:
Slide 57
CVD, particularly coronary heart disease (CHD) and stroke,
remain the leading causes of death in women in America and most
developed countries Coronary heart disease claims the lives of
248,184 females annually compared with 41,394 lives from breast
cancer and 65,632 from lung cancer. CVD death rate higher in black
women than in white women CVD is #1 among all disease categories in
hospital discharges for women 38% of women vs. 25% of men die
within 1 yr after a heart attack Of the 4.8 million stroke
survivors alive today, 56% are women Yet misperceptions still exist
that CVD is not a real problem for women.
http://www.americanheart.org/presenter.jhtml?identifier=2859 Women
and CVD surprising facts:
Slide 58
Personal Health Family (children, spouse, parents) Household
(food, cleaning,upkeep) Work Money Other commitments
Slide 59
Heart Attack Warning Signs Some heart attacks are sudden and
intense the "movie heart attack," where no one doubts what's
happening But most heart attacks start slowly with mild pain or
discomfort Often people affected aren't sure what's wrong and wait
too long before getting help. From:
http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Slide 60
Symptoms of Heart Attack: Chest discomfort Discomfort in the
center of the chest that lasts more than a few minutes may go away
and come back can feel like uncomfortable pressure, squeezing,
fullness or pain. Discomfort in other areas of the upper body Pain
/ discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath May occur with or without chest discomfort.
Other signs: Cold sweat, nausea, or lightheadedness From:
http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Slide 61
Symptoms of heart attack may be quite different in women: As
with men, women's most common heart attack symptom is chest pain or
discomfort. But women are somewhat more likely than men to
experience some of the other common symptoms, particularly
shortness of breath, nausea/vomiting, and back or jaw pain.
Shortness of breath...with or without chest discomfort. Nausea and
light-headedness Flu-like symptoms, including chills and cold
sweats Heart palpitations From:
http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Slide 62
Stroke Warning Signs: Similar in Men & Women If you notice
one or more of these signs, don't wait. Stroke is a medical
emergency. Call 9-1-1 or your emergency medical services. Get to a
hospital right away! The American Stroke Association wants you to
learn the warning signs of stroke: Sudden numbness or weakness of
the face, arm or leg, especially on one side of the body Sudden
confusion, trouble speaking or understanding Sudden trouble seeing
in one or both eyes Sudden trouble walking, dizziness, loss of
balance or coordination Sudden, severe headache with no known
cause
Slide 63
Stroke Risk Factors Stroke risk factors similar to overall CVD
risk factors Risk is higher if you have existing heart
disease!!
Slide 64
Prediction of Stroke Using the Modified Framingham Stroke Risk
Profile Source: Goldstein et al. AHA/ASA Guidelines: Prevention of
Primary Stroke. Stroke 37:1583, 2006.
Slide 65
Prediction of Stroke Using the Modified Framingham Stroke Risk
Profile Source: Goldstein et al. AHA/ASA Guidelines: Prevention of
Primary Stroke. Stroke 37:1583, 2006.
Slide 66
0 1 2 3 100160220 LDL-C (mg/dL) Relative CHD Risk Over 4 years
HDL-C (mg/dL) 85 65 45 25 Castelli WP et al. Can J Cardiol.
1988;4(suppl A):5A-10A. High LDL-C and Low HDL-C: Increased Risk of
CHD
Slide 67
U.S. ADULTS About 60-70% get no exercise or not enough to
maintain/increase CR fitness 10,000 counts per day
Slide 68
BECOME MORE ACTIVE 10,000 counts per day
Slide 69
Diabetes Prevention Program NIH funded study of: Prevention of
diabetes, & Cost effectiveness of preventive measures CAN
EXERCISE PREVENT TYPE II DIABETES?
Slide 70
Walking may be the only physical activity suitable for the
entire lifespan P.O. Astrand, Swedish physiologist Walking 1 mile
requires 80-100 kcal energy expenditure
Slide 71
Highway Vehicle Miles Traveled are projected to grow 60% by
2030, in step with the growing U.S. population.
http://www.rita.dot.gov/publications/transportation_vision_2030/pdf/entire.pdf
Source: Transportation Vision for 2030 US Department of
Transportation, January 2008
Slide 72
Metabolic Response to 10-lb Weight Loss: Framingham Data
Higgins M et al. Acta Med Scand Suppl 1988;723:23-36. Cholesterol
Small changes can add up to significant changes in long-term risk
Syst BP Glucose mg/dl mm Hg mg/dl Men Women
Slide 73
Exercise Lite Every American adult should accumulate 30 minutes
or more of moderate intensity physical activity over the course of
most days of the week. (recommendation of ACSM + CDC, 1993)
Slide 74
Guidelines for healthy adults < age 65 Basic recommendations
from ACSM and AHA (2007):
http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=CM/HTMLDisplay.cfm&CONTENTID=7764
Do eight to 10 strength-training exercises, eight to 12 repetitions
of each exercise twice a week. Do vigorously intense cardio 20
minutes a day, 3 days a week And Do moderately intense cardio 30
minutes a day, 5 days a week Or
Slide 75
Energy Expenditure of Walking ( kcal per mile )
Slide 76
Q: 1 pound of fat stores how many calories? A: 3500 10,000
counts per day???
Slide 77
So What do you mean by 10,000 steps / day? GOAL: ATTAIN >
10,000 pedometer counts per day But Many people are sedentary, and
most sedentary people are overweight. Sedentary people attain ~
5,000 pedometer counts per day
Slide 78
Activity Categories Sedentary Low Active Moderately Active High
Active Category Daily Pedometer Counts 10,000
Slide 79
How can I lose weight? How can a pedometer work for me?
Slide 80
Suppose you weigh 190 lbs. Current activity: 5,000 counts/day
If you decide to increase your pedometer counts by +1,000 each
day,... to attain an average of 6,000 counts/day... You will lose
5.2 lbs in one year
Slide 81
Calculations For a 190 lb person, walking 1 mile expends 100
kcal Since 1 mile = 2,000 counts, it follows that mile = 1,000
counts. then 1,000 counts expends ~ 50 kcal. If you increase daily
pedometer counts by 1000/day, this will result in an additional
expenditure of 350 kcal/week, 1,400 kcal/month, 18,200 kcal/yr.
18,200 kcal 3,500 kcal/lb = 5.2 lbs of fat lost in 1 year
Slide 82
Risk Factor... High Cholesterol & triglycerides High BP
Diabetes Smoking Exercise Effect: Lowers TG little effect on
cholesterol if do not have hi TG Lowers BP 5-10 mmHg as likely to
become diabetic (?) Hard to smoke & exercise Obesity ? Walk 1
mile, burn 100 kcal
Cardiovascular Disease Risk Major Risk Factors for Heart
Disease and Stroke High levels of blood cholesterol Hypertension or
high blood pressure Tobacco use Diabetes mellitus Other Risk
Factors Include Physical inactivity Obesity & Poor diet (High
Fat, Sat Fat)
Slide 85
ADOLESCENCE: A time to Learn the Adult Lifestyle of Inactivity
!!! 10,000 counts per day
Slide 86
Slide 87
Current Status : Physical Activity of Children? LIFESPAN
Adolesc Adulthood % of Pop. Getting Phys.Act. Sufficient to
Maintain Wt. Balance Childhood ?
Slide 88
Kids in the 1990s less active compared to kids in the 1950s (
William Strong, editorial in Circulation, 1990) TV Viewing in
1950s: 4 hr / week 1990s: 28 hr /week more kids in day care effect:
day care centers tend to restrict activity more latch key children:
effect: parents stay indoors til we get home decreasing green
space
Slide 89
Distribution of Hours of TV Per Day: NHES Youth Aged 12-17 in
1967-70 and NLSY Youth Aged 12-17 in 1990 0-1 1-2 2-3 3-4 4-5 5+ TV
Hours (Youth Report)
Slide 90
Prevalence of Obesity by Hours of TV per Day: NHES Youth Aged
12-17 in 1967-70 and NLSY Youth Aged 10-15 in 1990
Slide 91
Working Hypothesis : LIFESPAN Adolesc Adulthood % of Pop.
Getting Phys.Act. Sufficient to Maintain Wt. Balance Childhood
Childhood Activity levels may be re-setting to a new low
Slide 92
New Risk Factors Ready for Prime Time? Oxidized LDL
Homocysteine Lp(a) C-reactive protein (CRP)
Slide 93
C-Reactive Protein (CRP) What is it? Circulating protein
produced by liver Marker for general inflammation How does it
contribute to CVD risk? Atherosclerosis is an inflammatory disease,
CRP is (partly) a marker for inflammation How to reduce your
risk:
Slide 94
Insulin What is it? Hormone responsible for allowing blood
glucose (sugar) to enter cells. Very important to muscle function;
body is 40% muscle How does it contribute to CVD risk? Muscles
become resistant to insulin, high insulin promotes arterial
thickening How to reduce your risk: MOVE !!!!
Slide 95
Homocysteine What is it? Amino acid that is normally changed to
another aa High level: > 12 umol/L How does it contribute to CVD
risk? Disrupts thrombolysis (increased clotting) contributes to
arterial thickening & aging (deficient methylation) How to
reduce your risk: Increase dietary folate, vitamins B 6, B 12
Sources (9/3/03): http://familydoctor.org/handouts/249.html9/3/03
http://www.bhf.org.uk/questions/index.asp?secondlevel=370&thirdlevel=378
Christen WG et al. Arch Intern Med. 2000 Feb 28;160(4):422-34
Slide 96
Energy Expenditure of Walking ( kcal per mile )
Slide 97
Energy Expenditure of Running ( kcal per mile )
Slide 98
Women themselves may lack appreciation of their individual risk
for heart disease. Women: frequently continue activities when they
feel ill mistake their symptoms as not serious, or - fail to
realize that they represent a cardiac condition Women present to
the hospital one hour later than a man will From:
http://www.womentowomen.com/LIBheartattacksymptoms.asp accessed
2/7/06
Slide 99
Falls and Fracture Prevention NIH ORBD~NRC News Volume 2, No.
1, December 1999 http://www.osteo.org/newsvol2no1.html To view this
information on the world wide web:
Slide 100
Ronnie Coleman Seven time Mr. Olympia Name that
bodybuilder
Slide 101
Adela Garcia-Freidmansky Ms. Olympia 2004 & 2006 Bev
Francis 1 st woman to bench press 300 lbs.
Slide 102
Physical Activity and Health A Report of the Surgeon General
1996 U.S. Department of Health and Human Services Centers for
Disease Control and Prevention National Center for Chronic Disease
Prevention and HealthPromotion Presidents Council on Physical
Fitness and Sports