16 Overall Benefits PA_SW.ppt

16 Overall Benefits PA_SW.ppt - Overall Overall Benefits of...

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Unformatted text preview: Overall Overall Benefits of Physical Activity US Surgeon General’s Report on Physical Activity and Health (1996) Physical http://www.cdc.gov/NCCDPHP/sgr/contents.htm The main message is that Americans can substantially The improve their health and quality of life by including moderate amounts of physical activity in their daily lives lives Underpinning such recommendations is a growing understanding of how physical activity affects physiologic function. The risks associated with physical activity must also be considered. Despite common knowledge that exercise is healthful, more than 60 percent of American adults are not regularly active, and 25 percent of the adult population are not active at all. Moreover, although many people have enthusiastically embarked on vigorous exercise programs at one time or another, most do not sustain their participation. The effort to understand how to promote more active lifestyles is of great importance to the health of this nation. Summary Statement: Arthritis Summary “Physical activity is essential for Physical maintaining the health of joints and appears to be beneficial for control of symptoms in patients with osteoarthritis.” osteoarthritis.” Surgeon General’s Report, 1996 Summary Statement: Osteoporosis Osteoporosis “Physical activity appears to build greater bone Physical mass in childhood and to help maintain peak bone mass in adulthood. Physical activity may protect against the rapid decline in bone mass after the menopause. Resistive exercise may be more effective than endurance types of exercise.” than Surgeon General’s Report, 1996 Summary Statement: Summary Mental Health “…. A beneficial effect of physical beneficial activity on relieving symptoms of depression and anxiety and on improving mood … Some evidence that physical activity may protect against the development of depression.” the Surgeon General’s Report, 1996 Surgeon Summary Statement: Breast Cancer Breast The studies lend limited support to the The hypothesis that physical activity during adolescence and young adulthood may be protective against later development of breast cancer.” of Surgeon General’s Report, 1996 Thune et al Study Design Thune Followed 25,624 women for an average Followed of 14 yrs of Leisure-time and occupational physical Leisure-time activity scored on a 4 point scale activity Breast cancer cases determined by Breast Cancer Registry of Norway and Statistics Norway Statistics 351 new breast cancer cases Thune et al Study Results Thune Physical activity in leisure-time is associated Physical with reduced risk of breast cancer with Occupational physical activity is associated Occupational with reduced risk of breast cancer with Risk reduction with increased physical Risk activity is greatest in lean women activity Summary Statement: Other Hormone-Dependent Cancers in Women Women “The data are either too limited or too The inconsistent to establish relationships between physical activity levels and other hormone-dependent cancers (ovarian, uterine) in women.” (ovarian, Surgeon General’s Report, 1996 Summary Statement: Prostate Cancer Prostate “The research conducted to date shows The no consistent relationships between physical activity and prostate cancer.” physical Surgeon General’s Report, 1996 Summary Statement: Testicular Cancer Testicular “No meaningful conclusions about a No relationship between physical activity and testicular cancer can be drawn.” and Surgeon General’s Report, 1996 Exercise and other cancers Exercise Intensity of leisure-time physical activity and Cancer mortality in men (Laukkanen, et al. Br. J. Sports Med, 2009) 17 year follow-up of men in Finland (2560 men) Cancer risk was inversely related to physical Cancer activity and intensity. The risk of cancer death was 50% lower among men who exercised at least 30 minutes per day on average. Results were strongest for cancer of GI tract and lung lung Summary Statement: Summary Colon Cancer “The research strongly suggest that The occupational and leisure-time or total physical activity has a protective effect against the risk of developing colon cancer.” Surgeon General’s Report, 1996 Surgeon Meta-analysis Study (20 years of studies) the most active people are 24 percent less the 24 likely to develop colon cancer than sedentary people are, regardless of their diets, smoking habits or body weight. diets, (Wolin, et al. Br. J. of Cancer. 2009) (Wolin, Summary Statement: Rectal Cancer Rectal “The risk of developing rectal cancer is The not related to physical activity levels.” not Surgeon General’s Report, 1996 2006 American Cancer Society Complete Guide—Nutrition and Physical Activity for Cancer Prevention Cancer People who engage in moderate to People vigorous levels of physical activity are at a lower risk of developing colon and breast cancer than those who do not. Risk is lowered whether or not the activity affects the person's weight. person's National Physical Activity Guidelines Guidelines Individuals engaging in aerobic physical activity Individuals for approximately 3 to 4 hours per week at moderate or greater levels of intensity have on average a 30% reduction in colon cancer risk and a 20% to 40% lower risk of breast cancer, compared with those who are sedentary. A dose-response relation also is apparent, with risk decreasing at higher levels of physical activity. May help with effects of cancer treatment May Some limited evidence that PA can improve Some prognosis in patients with cancer. prognosis REVIEW REVIEW Surgeon General Report Does PA help? – – – – – – – – Arthritis _____________ YES Osteoporosis _________ YES YES Mental Health _________ Maybe/YES Breast CA ____________ No data Ovarian/uterine CA _____ No data Prostate CA __________ No data Testicular CA _________ YES Colon CA ____________ Studies: – Breast CA, Thune More PA, less RR Higher Int, less RR Body weight effects – Finnish study 2009 Regular PA, decr RR 50% lower w/30 min/d GI tract & Lung – Wolin 2009 Meta analysis 24% dec colon cancer Overall Overall Benefits of Physical Activity Dengel et al Study Design Dengel 9 older, sedentary, obese, hypertensive older, men men Had a number of CV disease risk Had factors assessed initially factors Then underwent a 9 month program of Then physical activity and weight loss physical All CV disease risk factors measured All again at the end of the intervention again Dengel et al Study Results Dengel “Overall, a 50% reduction in the Overall, number of CV disease risk factors evident in these high risk individuals after only 9 months of altering their lifestyle in terms of physical activity and diet.” physical Rogers et al Study Design Rogers 9 men with CV disease Plasma lipid profiles measured Plasma initially, and then again after 1 and yrs of exercise training yrs Running an average of 18 miles/wk Running after 1 yr and 26 miles/wk after 7 yrs yrs Rogers et al Study Results Rogers LDL-C 150 HDL-C 38 1 Yr Training 208 140 45 7 Yrs Training 210 127 53 Initial Chol Chol 218 Rogers et al Study Results Rogers Exercise training continued for Exercise long periods, i.e.- many years, may result in even greater improvements in CV disease risk factors than is believed at present. present. Dunn et al. Comparison of lifestyle and structured intervention to increase physical activity and CV fitness. JAMA 1999. activity 235 men and women age 35 – 60 yrs Baseline measures of CV fitness and Baseline CV disease risk factors CV 6 months intensive intervention months followed by 18 months of a maintenance intervention maintenance Dunn et al. Comparison of lifestyle and structured intervention to increase physical activity and CV fitness. JAMA 1999. activity Lifestyle intervention: accumulate 30 Lifestyle min of moderate-intensity physical activity on most, preferably all, days of the week of Structured intervention: 50-85% Structured VO2max exercise prescription 3-5 VO max times/wk for 20-40 min at exercise facility facility 24-Month Adjusted Mean Changes in Clinical Measures Measures Lifestyle Group Structured Structured Exercise Group Exercise Between Group Between Difference Difference Mean Change Mean Change P Values Total Cholesterol Total Level (mg/dl) Level -4.31 -5.11 0.81 HDL-C level HDL-C (mg/dl) (mg/dl) -1.05 -2.04 0.42 LDL-C level LDL-C (mg/dl) (mg/dl) -1.51 -4.85 0.31 Triglyceride level Triglyceride (mg/dl) (mg/dl) -9.42 6.64 0.05 Systolic blood Systolic pressure (mmHg) pressure -3.63 -3.26 0.79 Diastolic blood Diastolic pressure (mmHg) pressure -5.38 -5.14 0.83 Dunn et al. Comparison of lifestyle and structured intervention to increase physical activity and CV fitness. JAMA 1999. activity Conclusion In previously sedentary adults, a In lifestyle physical activity intervention is as effective as a structured exercise program for improving physical activity, CV fitness, and CV disease risk factors. disease Reduction in estimated 12-year risk of coronary heart disease resulting from different interventions in hypertensive patients. resulting Blood pressure (mmHg) (mmHg) Total Total cholesterol (mg/dl) (mg/dl) HDL HDL cholesterol (mg/dl) (mg/dl) Estimated Estimated 12-year risk (%) risk 160/100 240 40 32 Diuretic Diuretic 140/90 255 40 30 Diuretic plus beta Diuretic blocker blocker 140/90 255 35 33 Beta blocker 140/90 240 35 31 Exercise training 150/90 230 45 25.5 Initial Initial Characteristics* Characteristics* Characteristics after Characteristics intervention intervention *Based on 55-year old male smokers with no evidence of diabetes or left ventricular *Based hypertrophy. hypertrophy. Overall Risk Reduction Potential for Exercise Training in Hypertensives Exercise 50 yr old man, BP 154/100, cholesterol 240, 50 HDL 45, has NIDDM & LV hypertrophy. – His 10 yr risk of developing CVD = His 48% 48% If exercise training ↓ BP by 10/10, ↓ cholesterol If by 10, ↑ HDL to 54, and eliminates NIDDM and LV hypertrophy LV – His 10 yr risk of developing CVD = His 19% 19% FDA Criteria for Approving a New Drug Approving What are the benefits of the drug in What terms of how many people benefit and what is the magnitude of the benefit? benefit? What are the negative aspects of the What drug in terms of frequency and magnitude? magnitude? Risks??? Risks??? Musculoskeletal injuries Dehydration Hypoglycemia Anemia Rhabdomyolysis Hazards Cardiac events Exercise can preserve something of our early strength even in old age. strength Cicero, 75 BC The wise for cure on exercise depend exercise God never made his God work for man to mend. work John Dryden, 17 century century th ...
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This note was uploaded on 10/18/2011 for the course KNES 260 taught by Professor Hagberg during the Spring '08 term at Maryland.

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