Week 3 - Benefits & Risks of PA Flashcards
Physical Activity and Health Connection
Physical activity is an essential lifestyle behaviour when it comes to promoting health and preventing many major chronic diseases
- It provides health benefits that cannot be obtained in any other ways
- It can assist with every other aspect of a healthy lifestyle and is central to wellness
Accelerometry
Objective measurement
Pedometer vs accelerometer
- Pedometer = measures steps
- Accelerometer = measures changes in speed?
Benefits = objective data, track changes/progress over time, easy, accessible
more accurate than subjective recall
Blue Zones
looking at Longevity Hotspots
Greece, Italy, California, Japan, Costa Rica = living longer!!!
Four Factors Contributing to Blue Zones
- If you are moving naturally (ambulatory movement) from point A to B
Walkability affect your overall health - Surrounded by the right people that encourage health/activity
- Right outlook, positive, happy
- Eat healthy
Dose-Reponse
Need ____ amount of physical activity to get ____ health benefit
Can PRESCRIBE exercise
- LPA = leisure physical activity (walking around, gardening, etc.
- not purposefully trying to be exercising
- Graphs: see a PLATEAU at 300 minutes
Want 300 active minutes, or 150 of M/V PA
Association of Daily Step Count and Intensity with Mortality
- 12,000-16,000 steps = PLATEAU
- If you can get 10,000+ steps per day, you INCREASE your lifespan
Major Chronic Diseases
Cancer
CVD
CRD
Diabetes
Modifiable Risks
sedentary behaviour, smoking, alcohol, unhealthy eating, inactivity
Physical activity WILL keep you young
Assess yourself
The Me I Want To Be
my action plan
General Trend in Benefits
- Risk of getting one of the 4 major chronic diseases
- Your activity level (not active, active)
trend = active, lower risk of getting disease
Guidelines
150 minutes of MVPA per week (or 300 minutes of leisure time)
Major Reason for Importance of PA
you SLEEP better which impacts many aspects of your life
London Bus Study
- Compared the rates of CHD between the DRIVERS and the CONDUCTORS
Conductors = men in physically active jobs
- Have LOWER rates of CHD than those who are inactive (drivers)
- Also disease is less severe in active workers if they do get it
2.7 VS 1.9% risk of getting CHD between the 2 groups
LOWER physical activity = HIGHER risk for CHD
5 Benefit Take-Aways
- Live longer
- Mental health
- Reduce risk of CHD
- Better sleep
Benefits of Regular Physical Activity and/or Exercise
1) Improvement in Cardiovascular and Respiratory Function
2) Reduction in Cardiovascular Disease Risk Factors
3) Decreased Morbidity and Mortality
4) +Other benefits
Decreased Morbidity and Mortality
PRIMARY PREVENTION:
- higher activity associated with lower death rates from CAD
- higher activity lower incidence rates for CVD, CAD, stroke, T2DM, metabolic syndrome, osteoporotic fractures, cancer of the colon and breast, and gallbladder disease
SECONDARY PREVENTION:
- cardiovascular and all-cause mortality are reduced with post-MI patients who participate in rehab exercise training, esp as a component of multifactorial risk factor reduction
Other Benefits
- decreased anxiety and depression
- improved cognitive function
- enhanced physical function and independent living in older individuals
- enhanced feelings of well-being
- enhanced performance of work, recreational, and sport activities
- reduced risk of falls and injuries from falls in older adults
- prevention or mitigation of functional limitations in older adults
- effective therapy for many chronic diseases in older adults
Benefits of Physical Activity and Exercise
- Reduce incidence of diabetes by 25-58%
- Reduce incidence of hypertension by 33-60%
- Reduce incidence of CVD by 33-50%
- Reduce risk of stroke by 31-45%
- Reduce risk of colon cancer by 30-60%
- Reduce mortality and risk of recurrent breast cancer by 25-50%
- Reduce risk of developing Alzheimer’s by 40%
- Decrease depression as effectively as medications or cognitive behavioural therapy
- Reduce risk of premature death by 31-50%
Physical Activity & Depression Prevention
Physical activity CAN decrease depression and its severity
Physical Activity & Resilience
‘bounce back’
Regular exercise and its association to emotional resilience
POMS = personal outcome measures
Ability to bounce back or change mood to become positive is EASIER with activity
Happier people live more active lives
Exercise = more open minded, happy, peace of mind, etc.
Physical Activity & Cognition: Bigger Brains
Exercise training increases the size of hippocampus = improves memory
Physical Activity and Cognition: Better Performance
Moderators = intensity, duration, time elapsed, fitness level
Improvement on cognitive function was greater with intensity of exercise
Economic benefits of risk factor reduction in Canada
1% = $2 Billion
How much does it cost us to have people living with modifiable risk factors?
- Tobacco smoking, excess weight, physical inactivity
Results suggests that the annual economic burden of risk factors is 50 billion dollars
If a 1% relative annual reduction in EACH of the 3 risk factors each year, results in 8.5 billion annual reduction in 2031
- Means that 1% relative reduction in each of the 3 modifiable risk factors can have a substantial health AND economic impact at a population level
T/F:
Regular exercise reduces symptoms related to depression
TRUE
According to recent research, aerobic exercise, or cardiorespiratory fitness (CRF), and performing regular MVPA (within guidelines):
- improves immune markers in several chronic diseases, including cancer, HIV, cardiovascular disease, diabetes, cognitive impairment, and obesity
- improves immune responses to vaccination
- lowers chronic low-grade inflammation and infection risk
T/F:
Recent literature has demonstrated that higher physical activity levels and exercise confer protective effects on incident depression
TRUE
Employees at work are more likely to participate in physical activity if:
the workplace offers shower/change room facilities
Maximal aerobic capacity usually declines with age
- While older and younger individuals work at the same MET level, the reflective exercise intensity will usually be different
- Older individual will be working at a greater relative percentage of maximal oxygen consumption
Public Health Perspectives for Current Recommendations
The ACSM-AHA Primary Physical Activity Recommendations
- Minimum of 30 min on 5 days/week moderate intensity aerobic or vigorous intensity aerobic activity for a minimum of 3 days/week
- Can be accomplished by performing bouts each lasting 10 min or more
- Increase muscular strength and endurance for a minimum of 2 days/week
- May benefit from exceeding recommended amounts of PA
Important health benefits can be obtained by performing a moderate amount of PA on most, if not all, days of the week
- Additional health benefits result from greater amounts of PA
– Longer in duration, of greater intensity, or both are likely to derive greater than those who engage in lesser amounts - PA that is sufficient to reduce the risk of developing chronic diseases and delaying mortality may be insufficient to prevent or reverse weight gain and/or obesity given the typical American lifestyle
- Dose-response relationship between PA and CVD and premature mortality
- Greater amounts of PA or increased CRF levels provide additional health benefits
2008 Physical Activity Guidelines Advisory Committee Report
- 150 min per week of moderate intensity aerobic activity, 75 min per week of vigorous intensity aerobic activity, or a combination
- Additional health benefits are obtained with 300 min per week of moderate or 150 min per week of vigorous
- Moderate or high intensity and involve all major muscle groups in 2 or more days per week
Relative Risk Ratio CVD and PA
Physical inactivity is a global pandemic
one of the four leading contributors to premature mortality
- globally 31.1% of adults are physically inactive
Sedentary Behaviour and Health
- Associated with deleterious health consequences independent of PA levels
- Independently associated with a greater risk for all-cause mortality, CVD incidence or mortality, cancer incidence or mortality and type 2 diabetes mellitus
- 30% lower relative risk for all-cause mortality among those with high levels of PA
- Adverse outcomes associated with sedentary time decrease in magnitude among persons who are more physically active
Health Benefits of Regular PA and Exercise
- Inverse relationship with negative outcomes
- Strong evidence of dose-response relationship with PA
- Aerobic capacity has an inverse relationship with risk of premature death from all causes and specifically from CVD
Health Benefits of Improving Muscular Fitness
Higher levels of muscular strength are associated with a significantly better cardiometabolic risk factor profile, lower risk of all-cause mortality, fewer CVD events, lower risk of developing physical function limitations, and lower risk for nonfatal disease
- Improvements in body composition, blood glucose levels, insulin sensitivity, and blood pressure in individuals with mild or moderate hypertension
- Resistance training is as effective as aerobic training in the management and treatment of T2DM and improving the blood lipid profiles of overweight/obese
- Positively affects walking distance and velocity in those with peripheral artery disease (PAD)
- Resistance training may be effective for preventing and treating the dangerous constellation of conditions referred to as Metsyn
- Also increases bone mass and bone strength of the specific bones stressed and may serve as a valuable measure to prevent, slow, or reverse the loss of bone mass in individuals with osteoporosis
- Reduce pain and disability in individuals with osteoarthritis
- Effective in treatment of chronic back pain
- May prevent and improve depression and anxiety, increase vigor, and reduce fatigue
Benefits of Regular Physical Activity and/or Exercise
Risks Associated with Physical Activity and Exercise
- Increased risk for musculoskeletal injury (MSI) and cardiovascular complications
- MSI is the most common exercise-related complication
- Sudden cardiac death (SCD) and acute myocardial infarction (AMI) are usually associated with vigorous intensity exercise; much less common than MSI
Exercise-related Musculoskeletal Injury
- Walking and moderate intensity physical activities are associated with very low risk of MSI
- Jogging, running, and competitive sports increased risk of injury
- Risk higher in activities where there is direct contact with participants or with the ground
- Highest risk found in children between the ages of 12-17 and children younger than 12
- Most common anatomical sites = lower extremities (higher in knees, then foot and ankle)
- Meeting national guidelines of 150 or more min/week mod/vig = modest increase in PA-related MSI
- Risk inversely related to physical fitness level
- Methods to reduce MSi (ie. stretching, warm up, cool down, and gradual progression of exercise intensity and volume) may be helpful but lack of controlled studies confirming
Sudden Cardiac Death among Young Individuals
- Most common causes are congenital and hereditary abnormalities including hypertrophic cardiomyopathy, coronary artery abnormalities, and aortic stenosis
- Death rates higher in African American male athletes and basketball players
- International Olympic Committee and AHA have endorsed practice of preparticipation cardiovascular screening
Exercise-related Cardiac Events
- Risk of SCD and AMI very low in apparently healthy individuals performing moderate intensity PA
- Acute and transient increase in the risk of SCD and AMI in individuals performing vigorous intensity exercise, particularly sedentary men and women diagnosed or occult CVD
- Risk decreases with increasing volumes of regular exercise
- Transient risks substantially higher during acute vigorous physical exertion
- Fivefold increase of SCD and 3.5-fold increased risk of AMI
- Risk higher middle and older adults due to higher prevalence of CVD
- Disproportionately higher in the most sedentary individuals
- Absolute risk of these events if very low
- Risk is extremely low, vigorous intensity exercise has a small but measurable acute risk of CVD complications
- Increased frequency of cardiac contraction and excursion of the coronary arteries produces bending and flexing of arteries may be underlying issue
– May cause cracking of the atherosclerotic plaque with resulting platelet aggregation and possible acute thrombosis
Exercise testing and the risk of cardiac events
In a mixed population, the risk of exercise testing is low with approximately 6/10,000 tests
Risk of Cardiac Events during Cardiac Rehabilitation
- Highest risk of cardiovascular events occurs in those individuals with diagnosed CAD
- Complication rates are low
- Mortality rate appears to be 6X higher when patients exercised in facilities without the ability to successfully manage cardiac arrest
Prevention of Exercise-related Cardiac Events
- Benefits of habitual physical activity substantially outweigh the risks
- Professionals should know the pathological conditions associated with exercise-related events
- Physically active individuals should know nature of cardiac prodromal symptoms and seek prompt medical care
- Athletes should undergo preparticipation screening
- Athletes with known condition or family history should be evaluated prior to competition
- Facilities — staff trained in managing cardiac emergencies and have specific plan
- Active individuals should modify exercise program in response to variations in exercise capacity
- All sedentary individuals should participate in exercise preparticipation screening to determine the need for medical clearance
- Exercise professionals should have training in basic and/or advanced cardiac life support and emergency procedures
- Individuals should be educated on signs and symptoms
