Final Countdown Flashcards
PA
Body movement produced by skeletal muscles that increases energy expenditure
Exercise
Planned, repetitive, purposeful movements to improve fitness components
Sport
Structured exercise with rules and competition
FITT
Frequency
Intensity
Type
Time
Top causes of female mortality
Dementia/alzheimers
Heart disease
stroke
Top causes of male mortality
Heart disease
Lung cancer
Emphysema/bronchitis
How many projected deaths are from chronic illness
41/61 million deaths/year
% of people in industrialized countries who are inactive
50-70%
% of males and females sufficiently active
50% males
42% females
% of elderly people meeting guidelines
6-26%
Rates of inactivity in developing countries
Less than us–> 18.7%
Ethnicities that are less active
Black and hispanic
Under 5 guidelines
Encourage PA from birth and reduce sedentary time
PA for 3 hrs/day when they can walk
5-18 Guidelines
60 min MVPA/day, up to several hours
Vigorous intensity at least 3 days/week
Include muscle and bone strengthening activity
19-64 guidelines
150 min of MVPA/week, at least 10 min at a time
OR 75 min of vigorous activity/week
Muscle strengthening activity 2 days/week
65 and over guidelines
Same as adult but include 2 days/week of balance and coordination activities
Best UK country for activity guidelines
Scotland–> 45% (M) and 33% (F) are active
Worst UK countries for activity guidelines
Ireland males (33%), wales women (24%)
Improvement rate over years for activity levels in UK
25% average increase–> males improved to 67% and females to 58%
Objectively measured activity levels in UK
6% males
4% females meet guidelines
Inactivity is responsible for what % of CHD
6% of all cases and 1/10 of premature deaths from CHD
What amount of deaths of any cause does inactivity cause
1/6
Financial cost of inactivity
900 million
Epidemiology
Distribution and determinants of health related events
Hippocrates
400BC– walking is man’s best medicine
Jerry Morris Experiments (4)
London bus driver/conductor
Postal worker/civil servants
Heart autopsy
Uniforms as obesity indicator
London Bus driver
Difference in CHD risk between drivers and conductors. Incidence and early mortality rate were both higher for driver
Post worker vs. civil servant mortality rates from CHD
1/3 of postmen died while 1/2 of servants died
Heart autopsy
Active jobs showed less myocardial fibrosis, hypertension and artery occlusion
Uniforms and obesity
Baseline and 5 year follow up. Conductors had lower BP, obesity and CHD incidence
PA and CHD patterns
Lower CHD for those who did MVPA outside of the workplace–> same high rates applied to men who did less than frequent activity
More linear relationship for older men
Paffenberger
Motivation required for exercise–> dockworkers and harvard alumni
Dockworkers
Study onset with 16 year followup–> BMI, cigarettes and BP crossed with PA to look at CHD. PA was the determining factor but other ones had additive effects
Harvard alumni
Risk of heart attack inversely related to energy expenditure. Pa is a protective factor for BP, smoking, BMI and family history
Less than 2000kCal expenditure/ week increases risk of CHD and all cause mortality by …
64% for CHD
28% in all cause
Death rates for chocolate consumers vs. non consumers
- 5% for non comers
- 9% for consumers
- - 20% lower risk and an extra year of life
MET
Metabolic equivalant to task
1 MET
Rest, cost of basic metabolism
3.5 ml/kg/ min
6 METs
Vigorous activity
How many METs are needed for longevity and health benefits
6
Steven Blair
Objectively measured fitness of people on a treadmill. PA is only important if it contributes to fitness
% of people that dont get treatment for mental illness
76-85% in low income countries
30-50% for high income
% of population effected by mental illness
15%
How more likely are inactive people to experience depression and anxiety
2x more likely
Biological mechanisms of mental illness
Serotonin, dopamine, neurotrophic factor
Endorphins and norepinephrine
% of global disease burden from depression
4.3%
How long does depression last
4-6 months
50% lasts over a year
Zschucke
Effects of PA in mental disorders. Short term, PA is just as effective as CT or antidepressants. Resistance exercise shows greatest effect
Zschucke study mechanisms
Therapeutic contact, social support, distraction
Harvey
Relationship between leisure/workplace PA and depression/anxiety
Harvey results
Inverse relationship between leisure PA, not workplace (not intensity dependant) Regular light (not vigorous) PA reduces anxiety Aerobic activity just as effective as CBT
Indirect measures
Aspects likely to associate with PA but rely on correlation. Less valid but easier
Examples of indirect measures
Heart rate, self-report, anthropometry, population data
Cross Comparison
Correlation of how well a result compares to a chosen golden standard
Population association
Good generalizability but poor validity
Often biased or focussed
Gives no specifics of mechanism
Co-correlation
% of people meeting guidelines based on BMI. Assumed that obese people would do less PA, but they actually did more than underweight people sometimes
Inquisiton
Self-report–> Biggest range of data, issues of validity and reliability
IPAQ
International physical activity questionnaire
Historical PA survey
Estimate how many hrs spent/week doing an activity over the last couple years
Heart rate
Assumes HR only increases during PA which is false
Resting and max HR
60-80 resting, 220 max
6 things that effect HR
Cardiac size Stress Age Response to illness Temperature regulation Food
Hypertrophic response
Males hearts grow more with exercise, and resting HR is lowered with fitness
% cardiorespiratory capacity
Define activity intensity as a % of max HR. Need to know an individuals max HR
Low and High intensity based on cardiorespiratory capacity
Low: 40-50%
High: 70-90%
Karoven’s % of range
HR reserve method, know the individuals max and resting HR
Moderate activity based on HRR
60-70% of HRR–> % of dynamic range
TRIMP
Training impulse–> Time at different % of work capacity as defined by Heart rate
TRIMP equation
D x HR x 0.64y
D= duration in minutes
HR= Heart rate as a fraction of reserve
Y= 1.92 for men, 1. 67 for women
Direct calorimetry assumptions
Heat production = metabolic rate
net work is 0
Body temperature is constant
Lavoisier/Seguin Ice caloromter
1790– Pack device with ice, heat from metabolism melts it
Convection/Air flow caloromter
Animal sealed in chamber uses O2, need an air flow and exhaust. Measure air flow rate and temperature of air coming and going
Gradient caloromter
Walls are insulated with conducting layer, temperature regulated by a water jacket, temperature changes between junctions in gradient layer is translated to voltage
Boyle
1660– Mouse in bell jar with candle. Candle went out and mouse died. Combustion processes require air
Mayrow
1668– Boyle experiment over water. Air breathed by mouse caused pressure to drop and water level to rise. Air is made of different parts and only some can be used for repiration
Black
1757– discovered CO2
Priestly
1774– discovered O2
Discoveries from ice caloromter
Larger people consume more oxygen
More O2 used while moving and after meals
Indirect calorimtery
Indirect measures of metabolism like respiration
Respiration
oxidation of glucose produces CO2, water and heat
1 L of oxygen to oxidize glucose and palmitic acid creates how much energy
- 9 kJ from glucose
19. 6 kJ from fat
Respiratory exchange ratio
Ratio between O2 and CO2–> 6Co2/6O2 = RER of 1 for glucose
Respiratory quotient
At the cellular level, not necessarily the same as RER
Flow through respirometry
Mask collects exhaled gas. See how much air is taken in vs what is being exhlaed
Respirometry equation
VO2= Vi(Fio2)- Ve(Feo2) V= volume of gas going in or out per unit of time F= fractional concentration of O2
Equivalent metabolic power
Assumes 20 ml/J of O2 and STPD
VO2= VO2 x 273/(273 +T) x P/760
Limitations to EMP
No anaerobic metabolism
Substrate use–> RER does not equal RQ
O2 analyzers are subject to drift and must be recalibrated
Double Labelled Water
18O shows rate that oxygen is used up as body water or CO2
2H shows how fast Hydrogen is used in body water
– heavy O2 is expelled faster
Limitations of labelled water
Better for population than individual
Isotopes are expensive
Shows expenditure between time periods but not intensity, duration, frequency
Active Energy Expenditure
Goes up with body mass, down with age
Assumptions of labelled water
No unmarked isotopes enter body
Isotope concentration is constant
4 things contributing to rate of energy expenditure
Basal metabolic rate
Temperature regulation
Movement
Specific dynamic action
Specific dynamic action
Increased metabolic rate after eating
Accelerometer
Measures 3 planes to find overall dynamic body acceleration
3 limitations of accelerometer
Doesnt account for non-movement expenditure
Acceleration and decelleration contribute equally to ODBA
Assumes constant efficiency between mechanical work and metabolic energy
Muscle contractions energy
Shortening contractions use more
Isometric
Stretch
What do non-calometric direct measures do
Measure total energy expenditure
Sedentary behavior
Doing less than 1.5 MET in a sitting or supine position
VO2 max
80 ml/kilo
1 MET in VO2
3.5 ml/kilo
Activpal
Measures change in posture. Spend very little time standing or stepping
Breaks in SB
reduce waist circumference but doesnt effect BMI as much because of height
3 effects of SB
Raises blood glucose and fat
Lowers HDL
Links to diabetes, cancer and CVD
FMD
Flow mediated dilation– vascular function decreases during SB– bigger is better. If you take breaks every hour, it wont change
Children activity prevalence in Scotland
76% male
67% females
Children activity level in England
32% male
24% females
Children activity level in Ireland
19% male
10% female
Riddoch
used accelerometers for 4 days to assess PA levels in European youth heart study for CVD risk – 9 year old boys, girls, 15 year old boys, girls – order of PA
Harding
Longitudinal changes in activity from 12-15.
Large increase in SB, decrease in light PA, Increase in MVPA in school but decreased outside
Collins
Contribution of school commute to PA levels with GPS and heart monitor. More than 1.5 miles chose passive
% of kids doing active commute
61%– 57% walk and 4% bike
% of kids doing passive commute
39%– 17% bus and 21% drove
Britten
Kids and adults were quicker and more accurate at manual tasks on a tablet while standing up
3 categories of defining old age
Chronology
Change in social role
Change in capability
% over age 65 in 2010 and 2030
17%–> 25%
Old age dependancy ratio
People over age 65 compared to working age will double by 2050
amount of people over 85 now and in 2035
1.5 million–> 3.5 million
Rowe and Khan
Pathological vs non-pathological aging
Usual and successful aging
Usual: Non-pathologic, high risk
Succesful: Low risk, high function
3 domains of succesful aging 2nd model
Avoid disease and disbaility
Engagement with life
High cognitive and physical fucntion
% of older males and females meeting guidelines
40% males
28% females
Public health england framework
Health, social and economic costs of PA
PH health cost
PA prevents and manages 20 conditons
PH social costs
High PA communities are more inclusive and cohesive
PH economic costs
Active person makes 6500 more a year
Cost of inactivity in England
8.2 billion
WHO
150 min/week is the goal but even a little less sedentary behavior will show population health gains
Falls
2nd leading cause of accidnetal death
424000 deaths/year
Where do falls occur
70% at home
10% on the stairs
Lamb
Physical and psychosocial risk factors for falling
Exercise reduces falls by…
16%
Leeds old people
15% increase in 85+ since 2001
Older better strategy
Improve health of old people in leeds
Help the poor first
Increase healthy life expectnacy and reduce health care burden
Dancing in time
8 weeks of dance to reduce falls–> increase PA balance and mobility, decrease SB, depression and fear of falling
Biggest barriers to exercise adoption
Perceievd frailty and poor health
4 domains of social cognitve theory
Exercise attitude
Percieved behavioral control and self-efficacy
Percieved social support
Percieved benefits and barriers
Primeval times
10K BC– Activity for hunting and survival.
Instinctual, practical movement
Neolithic times
10-8K BC– Agricultre made us farmers. Movement wa slimited and repetitive
Ancient history
4K- 476 AD– Strength and endurance for battle prep. Olympic games based on war skills
Dark ages
5-15 century– foccussed on mind not body– only rich did PA while training for military
Renaissance
14-1600– Interest in antomy, biology, health and PE
De feltre
Opened a PE school in Italy in 1420
Mendez
Published first book of exercise and its benefits in Spain in 1553
Industrial revolution
1760– increase in SB. Gymnastics recognize din 19th cent as a move to intentional PA
Muths
First systematic textbook in Germany in 1800
Gymnasticon
1796– First fitness machine
First english athletic contest
Royal miltary academy in 1849. Oxford trianed officers in 1858
3 reccomendations of House of lords science and tech report
Promote health benefits of PA and exercise
Prescribe exercises for management of specific chronic illness
Ensure professionals prescribe PA as a treatment
5 elements to remember in healthcare
O2 transport Vascular health Mental health Mobility Immunology
South Asians
Burn 50% less fat
2/3 less fit than us
Need 250 min/week
4 reasons why east africans are good at running
Favorable skeletal muscle fiber composition and oxidative enzyme profile
Traditional diet
Chronic exposure to altitude
Motivation for economic success
Women in olympics
Allowed in 1900, 800 m outlawed and reinstaed in 1928 and 1960
First 1500 in 72
First marathon in 84
Grete waltz
Norweigina first woman to run marathon under 2.5 hours
Tesla Lorogue
Kenyan, first african women to win NYC
Paula radcliffe
Marathon record holder
% aerobic fitness decrease
1% decrease every year of sedentary behavior, can be reversed with 6 months of training after 30 years of SB
