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EXERCISE: MIRACLE DRUG OR UNREALISTIC MEDICINE?
William Denq, MD
University of Utah
BOTTOM LINE RECOMMENDATIONS
> 3 hrs/day of active play
3-5>60 mins/day moderate-vigorous intensity aerobic
6-17 >150 mins/week moderate-intensity aerobic
2 days of muscle strengthening
>18
LEARNING OBJECTIVES
1. Describe the national guidelines as they pertain to each age group
2. Explain the immediate and long term health benefits of physical activity
3. Summarize the different methodologies to encourage physical activity
Basic Concepts
Guidelines
• Physical Activity Benefits• Encouraging Physical Activity
Review the Evidence
1 MET: Average oxygen uptake of 3.5 mL/kg/min while sitting at rest
3.3 METs: Walking 3 mph
8.3 METs: Running 5 mph
Light-intensity: 1.6 – 2.9 METs
Moderate-intensity: 3.0 – 5.9 METs
Vigorous-intensity: >= 6 METs
BASIC LINGO
Ligh
t (1
.6-2
.9)
Cooking
Slow walking
Scanning groceries
Mod
erat
e (3
.0 –
5.9)
Walking briskly
Vacuuming
Raking a yard
Vig
orou
s (6
.0 +
)
Running
Carrying groceries up
stairs
Shoveling snow
Mowing
Aerobic class
QUIZ
Basic Concepts
Guidelines
• Physical Activity Benefits• Encouraging Physical Activity
Review the Evidence
BOTTOM LINE RECOMMENDATIONS
> 3 hrs/day of active play
3-5>60 mins/day moderate-vigorous intensity aerobic
6-17 >150 mins/week moderate-intensity aerobic
2 days of muscle strengthening
>18
Basic Concepts
Guidelines
• Physical Activity Benefits• Encouraging Physical Activity
Review the Evidence
$117 billion
10% premature mortality
WHAT IS THE COST TO US?
Basic Concepts
Guidelines
• Physical Activity Benefits• Encouraging Physical Activity
Review the Evidence
Physical Activity
All Cause Mortality
CV
Brain Health
Cancer
Pre-existing
conditions
Weight
Physical Activity
CV
Brain Health
Cancer
Pre-existing
conditions
Weight
PHYSICAL ACTIVITY AND ALL-CAUSE MORTALITY
Physical Activity
All Cause Mortality
Brain Health
Cancer
Pre-existing
conditions
Weight
https://i.ytimg.com/vi/lnR_kb5Wjf8/maxresdefault.jpg
Physical Activity
All Cause Mortality
CV
Cancer
Pre-existing
conditions
Weight
DOES HOW LONG MATTER?
https://i.ytimg.com/vi/lnR_kb5Wjf8/maxresdefault.jpg
http://www.yogameditationandhealing.co.uk/wp-content/uploads/2015/08/Morning-Yoga.jpg
Attention, memory, crystallized intelligence, processing speed, executive control
https://www.besthealthmag.ca/wp-content/uploads/sites/16/2018/08/how_many_squats.jpg
https://cdn1.medicalnewstoday.com/content/images/articles/318/318774/a-woman-practicing-yoga-on-the-beach.jpg
Academic and neuropsychological
performance
Aerobic activity, Muscle
Strengthening, Yoga, Play
https://www.alaskapublic.org/wp-content/uploads/2014/04/NPR-textbooks.jpg
https://i1.wp.com/teaser-trailer.com/wp-content/uploads/Tag-New-Banner-Poster.jpg?ssl=1
CAN EXERCISE MAKE YOU SMARTER?
http://2oqz471sa19h3vbwa53m33yj-wpengine.netdna-ssl.com/wp-content/uploads/2017/11/us-population-70.gif
ALZHEIMER’S AND PHYSICAL INACTIVITY
13% Worldwide
21% United States
25% reduction in physical inactivity
Prevent 230,000 cases
CAN PHYSICAL ACTIVITY REDUCE RISK FOR COGNITIVE DECLINE?
https://content.thriveglobal.com/wp-content/uploads/2018/11/Moon-in-blue-sky-over-clouds-for-sleep-article-1.jpg
INSOMNIA
https://i.kinja-img.com/gawker-media/image/upload/tdejfyn7d1kvi80qgukw.jpg
Cognition
Alzheimer’s and other dementia
Sleep
Physical Activity
All Cause Mortality
CV
Brain Health
Pre-existing
conditions
Weight
HOW DOES PHYSICAL ACTIVITY AFFECT CANCER PREVENTION?
Limited evidence: Lymphoma, myeloma, other HEENT, ovarian, pancreatic, prostate, glioma, meningioma
No evidence: Thyroid, rectal, liver, gallbladder, small intestine, soft tissue, melanoma
Physical Activity
All Cause Mortality
CV
Brain Health
Cancer
Weight
CV/Resp
HCM
HTN
DM2
OSA
Brain
ADHD
Schizophrenia
MS
Parkinson’s
CVA
Dementia
Insomnia
Cancer
Breast
Colorectal
Prostate
MSK
OA
LBP
Osteoporosis
Tendinopathy
PRE-EXISTING CONDITIONS
Physical Activity
All Cause Mortality
CV
Brain Health
Cancer
Pre-existing
conditions
DOES PHYSICAL ACTIVITY INFLUENCE DIET?
IS PHYSICAL ACTIVITY BAD?
http://www.heartwiseministries.org/heartwise/wp-content/uploads/2015/05/Sun-Exposure.jpg
MOVING HELPS, BUT DOES NOT MOVING HARM?
https://media0dk-a.akamaihd.net/98/96/dcb699613957429f9a8b33ee87cb3cd0.jpg
CANCER RISK
https://cdn-images-1.medium.com/max/1600/1*ay-T43f9simHpK17yBCMCg.jpeg
HIITHIIT
Physical Activity
All Cause Mortality
CV
Brain Health
Cancer
Pre-existing
conditions
Weight
NEED FOR FUTURE STUDIES
Aerobic vs anaerobic exercise How much is too much?
HIIT
Basic Concepts
Guidelines
• Physical Activity Benefits• Encouraging Physical Activity
Review the Evidence
https://i.ytimg.com/vi/lnR_kb5Wjf8/maxresdefault.jpg
http://www.yogameditationandhealing.co.uk/wp-content/uploads/2015/08/Morning-Yoga.jpg
Attention, memory, crystallized intelligence, processing speed, executive control
https://www.besthealthmag.ca/wp-content/uploads/sites/16/2018/08/how_many_squats.jpg
CAN WE JUST PRESCRIBE EXERCISE?
https://www.cebm.net/wp-content/uploads/2016/05/Activity-Sheffield-Miracle-Cure-pill-1080x500.jpg
DO WORKSITE INTERVENTIONS WORK?
https://d2q7nqismduvva.cloudfront.net/static/upload/images/post/its-ok-to-be-a-standing-desk-freak-24.jpg
WORKSITE ENVIRONMENTAL CHANGES
https://d10zm727sx51r.cloudfront.net/sites/www.library.kent.edu/files/Step%20Your%20Way%20Up%202.jpg
WEARABLES?
https://i.chzbgr.com/full/9257536000/h00DA7F08/
TECHNOLOGY
CAN WE CALL?
https://i.kym-cdn.com/entries/icons/original/000/007/447/yesthisisdog.jpg
https://i.kym-cdn.com/photos/images/newsfeed/000/194/670/58e.png
PICK THAT PHONE UP
http://images5.memedroid.com/images/UPLOADED18/50af7fa8a080d.jpeg
https://health.gov/MoveYourWay/Activity-Planner/
https://health.gov/MoveYourWay/Activity-Planner/
https://health.gov/MoveYourWay/Activity-Planner/
PROMOTING PHYSICAL ACTIVITY
Intervention
Prescribe Exercise
Worksite Intervention
Worksite Environment
Wearables
Wellness Platforms
Phones
BENEFITS OF PHYSICAL ACTIVITY
Physical Activity
All Cause Mortality
CV
Brain Health
Cancer
Pre-existing
conditions
Weight
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