Exercise Flashcards
1
Q
Describe the two lifestyle epidemics
A
- Obesity: 25% of children/adolescents overweight or obese, 67% of adults, 8.4% - burden of disease (AIHW 2018)
- Inactivity: 55% did not meet guidelines, 17% meet both muscle strengthening and physical activity
2
Q
List some conditions improved or prevented with exercise
A
- All cause mortality
- Cancer
- Obesity
- Type 2 Diabetes
- Lipid disorders
- Heart attacks
- Osteoporosis
- High blood pressure
- Mental health
- Performance
3
Q
Define METS
A
- One MET is the energy equivalent expended by an individual while seated at rest.
- Light-intensity aerobic activity = 1.1 to 2.9 METs
- Moderate-intensity activity = 3.0 to 5.9 METs
- Vigorous-intensity aerobic activity = 6.0 or > METs
- MET minutes = time engaged in an activity with consideration to the number of METs.
4
Q
What are the Australian guidelines regarding physical activity?
A
Physical Activity Recommendations
- Weekly Goals:
- 150 minutes of moderate or 75 minutes of vigorous intensity physical activity: will help imrpove BP, cholesterol, heart health, as well as muscle and bone
- Increasing to 300 minutes of moderate or 150 minutes of vigorous intensity for greater benefits, and may help to prevent cancer and unhealthy weight gain
- Muscle strengthening activities on at least 2 days each week.
- Intensity Levels:
- Moderate intensity activities allow you to talk while performing them.
- Vigorous intensity activities make you breathe harder and faster.
5
Q
Describe the effect of improving METS on biological age, death and CV health
A
- Age-dependent prognostic value of exercise capacity and derivation of fitness-associated biologic age
- Patients were followed for years for all-cause mortality and myocardial infarction
- Age- and gender-predicted METS achieved declines with age
- Better METS associated with younger biological age (which in turn means better overall performance, recovery etc)
6
Q
Describe the results of the 2016 sysrev
A
- Compared with insufficiently active individuals, the risk reduction for those in the highly active category was significant for breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke.
- 14% (relative risk 0.863) for breast cancer
- 21% (0.789, 0.735 to 0.850) for colon cancer
- 28% (0.722, 0.678 to 0.768) for diabetes;
- 25% (0.754, 0.704 to 0.809) for ischemic heart disease;
- 26% (0.736, 0.659 to 0.811) for ischemic stroke.
- Most health gains occur at relatively lower levels of activity, with diminishing returns at higher levels of activity.
7
Q
Describe the results from the 2022 review of cohort studies
A
- Relative risk per one MET increase in cardio-respiratory fitness (CRF) for all cause mortality (0.88), CVD (0.87), and Cancer (0.93)
- Relative risk for intermediate vs lowest CRF for all cause mortality (0.67), CVD (0.6), and Cancer (0.76)
- RR highest vs lowest CRF for all cause mortality (0.47), CVD (0.49), cancer (0.57)
8
Q
Describe the relationship between longevity and lifestyle factors
A
- Studies: Nurses’ Health Study (1980–2014; n=78,865) and the Health Professionals Follow-up Study (1986–2014; n=44,354)
- Key Factors: Never smoking, BMI of 18.5 to 24.9 kg/m2, ≥30 min/day of moderate to vigorous physical activity, moderate alcohol intake (5 to 15 g/day for women and 5 to 30 g/day for men), and a high diet quality score (upper 40%).
- Publication: Circulation. 2018;138:345–355.
-
Adjusted Hazard Ratios:
- For those with 5 vs. 0 low-risk factors: 0.26 for all-cause mortality, 0.35 for cancer mortality, and 0.18 for cardiovascular disease mortality
- Life Expectancy at Age 50: 29.0 years for women and 25.5 years for men with 0 low-risk factors; 43.1 years for women and 37.6 years for men with all 5 low-risk factors. - Life Expectancy Increase: On average, 14.0 years longer for women and 12.2 years longer for men with 5 low-risk factors compared to those with zero.
9
Q
What’s the effect of running?
A
Peak benefits (all-cause and CVD mortality reduction) at ~50 minutes. Plateaus after that.
10
Q
Describe the relationship between levels of activity and mortality
A
- **Meta-Analysis
- Results: Lower mortality risk for all-cause (HR=0.86) and CVD mortality (HR=0.73) at higher activity levels.
- Source: Br J Sports Med 2020;54:1195-1201.
- Participants: 10,284 individuals; treadmill exercise tests conducted at least 12 months apart.
- Results: Increasing fitness levels associated with lower risk of all-cause mortality (0.63m and 0.56 w); significant reduction in mortality risk for each 1-MET increase in fitness (0.87m, 0.84f).
- Publication: Mayo Clin Proc. 2017;92(3):383-390.
11
Q
Describe benefits of adherence to exercise
A
-
Findings: Increased mortality risk for those who remained inactive compared with those meeting physical activity recommendations throughout their lifespan (1.56 for all-cause, 1.94 for CVD mortality)
- Individuals who were inactive in 1984–86 and then adhered to recommendations in 2006–08 had HRs of 1.07 for all-cause mortality and 1.31 for cardiovascular disease mortality
- Conclusion: Remaining or becoming inactive significantly increases risk of all-cause and cardiovascular disease mortality.
- Source: http://dx.doi.org.virtual.anu.edu.au/10.1136/bjsports-2020-102350
12
Q
Describe relationship between CRF and CVD disability
A
- Population: 1mil male adolescents; study on cardiorespiratory fitness, muscular strength, BMI, and later chronic CVD disability.
- Outcomes: Strong inverse association between cardiorespiratory fitness and CVD disability, particularly for ischemic heart diseases (0.11)
- Publication: Eur Heart J, Volume 41, Issue 15, 14 April 2020.
13
Q
Describe effect of exercise in younger populations
A
-
Findings: Lower physical activity at age 18 associated with higher odds of diabetes, dyslipidemia, and high triglycerides later in life.
- Lower estimated MVPA score at age 18 was associated with a 12% higher odds of incident diabetes, a 4% higher odds of incident low high-density lipoprotein (HDL) and a 6% higher odds of incident high triglycerides
- Each additional annual 1-unit reduction in the MVPA score was associated with a 6% higher annual odds of diabetes incidence and a 4% higher annual odds of high TG incidence.
- Participants who were in the most active group at age 18 (over 300 min/week), but with sharp declines in midlife, had higher odds of high low-density lipoprotein and low HDL incidence, compared with those in the most active group at age 18 with subsequent gains.
- Source: British Journal of Sports Medicine Published Online First: 14 September 2021.
14
Q
Describe relationship between exercise and CVD outcomes
A
- Greatest risk reduction observed in moving from sedentary to moderately active.
- Consistent pattern of risk reduction with increasing level of fitness across 11 studies.
- Approximately 30 minutes of moderate intensity exercise on most days recommended.
- Further risk reduction at higher levels of activity.
- Valid for males and females in middle age and older.
- The lowest exercise dose significantly reduced CVD and CVRF prevalence, **with the largest reductions at 764 to 1091 MET-min/wk.
- for CVD (adjusted odds ratio 0.31
- for CVRFs (adjusted odds ratio 0.36)**
- Optimal health benefits were present with 170 to 242 min/wk of moderate-intensity exercise or 90 to 128 min/wk of vigorous intensity exercise (n=21,122)
Source: Mayo Clin Proc. 2016;91(6):745-754.
15
Q
Describe relationship of exercise and hypertension
A
- Aerobic training program can mean a reduction of up to 10mmHg systolic and 6 mmHg diastolic.
- Evidence supports prevention through:
- Moderate physical activity
- Normal body weight
- Limited alcohol consumption
- Reduced dietary sodium
- Adequate potassium intake
- Diet rich in fruits and vegetables and low in fat.
