July 2005

Physical Activity & Chronic Disease Prevention

Presented by the Physical Activity Resource Centre

Funded by the Government of Ontario

Status of Chronic Disease in Canada

•More than 50% of Canadians live with at least one chronic illness (Advisory Committee on Population Health, 2002).

•Programs need to focus on primary as well as secondary prevention

Status of Chronic Disease in Canada

•$14.2 billion (9% of the total cost of illness), was related to cancer (Economic Burden of Illness in Canada, 1998)•One in four women and one in eight men over 50 have osteoporosis (Osteoporosis Society of Canada, 2001)•4 million Canadians live with arthritis (Canadian Community Health Survey, 2000).

Status of Chronic Disease in Canada

• 2 million Canadians have diabetes. Of those, 30-50% will develop gastrointestinal complications, 4-10% will develop foot ulcers. Other complications include blindness, kidney problems, thyroid problems and heart disease. (CDA, 2005)

• Cardiovascular diseases were the most expensive disease category in 1995 accounting for $7.3 billion or 17% of the total direct costs of illness (Economic Burden of Illness in Canada, 1998)

Risk Factors

• Each disease has specific risk factors associated with it

• Many are extrinsic lifestyle choices (such as physical activity, diet/nutrition, exposure to sun and tobacco)

• Weight/BMI can be intrinsic risk factors due to genetic predisposition to overweight

Risk Factors L

ifes

tyle

Ris

k F

acto

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Arthritis Cancer Type 2 Diabetes

Heart Disease

Osteoporosis Stroke

Dietary factors

Alcohol intake

Physical activity level

Sun exposure

Tobacco exposure

Weight/BMI

Chronic Disease

Risk FactorsL

ifes

tyle

Ris

k F

acto

r

Arthritis Cancer Type 2 Diabetes

Heart Disease

Osteoporosis Stroke

Dietary factors

Alcohol intake

Physical activity level

Sun exposure

Tobacco exposure

Weight/BMI

Chronic Disease

General Recommendations for Physical Activity

For prevention:• Follow Canada’s Physical Activity Guide for

age group• Encourage a gradual build up of activity

For people with chronic disease:• Ensure people who have a chronic disease

are followed by a physician familiar with the latest recommendations for the disease.

Cancer - Profile

• Cancer occurs when abnormal cells conglomerate and accumulate in the body

• Cancer can occur anywhere in the body• 149 000 new cases of cancer will occur in

2005• Lung cancer is the leading cause of

cancer death in both men and women• 1 in 4 Canadians will die from cancer

Cancer - How Physical Activity Helps

• Convincing evidence in reducing the risk of colorectal cancer

• Probable evidence in reducing the risk of breast cancer

• Possible evidence in reducing the risk of prostate cancer

• (WHO, 2002)

• Overweight and obesity are linked to many cancers (oesophagus, colorectal, endometrium, breast and kidney) - physical activity can help manage weight, reducing the effects of this risk factor

Arthritis - Profile

• There are 127 different kinds of arthritis! • Osteoarthritis: progressive loss of joint cartilage.

One or more joints: feet, knees, hips, spine, hands, fingers, toes. Caused by aging, repetitive impact, genetics, etc.

• Rheumatoid arthritis: inflammation of the membranes that line the inside of certain joints. Involves many joints and moves beyond musculoskeletal system and causing important complications. Rarer, cause unknown, more devastating.

Arthritis - How Physical Activity Helps

• Maintaining an ideal body weight and avoiding joint injuries reduces the risk of developing arthritis

• Athough a person can’t die from arthritis, the lack of physical activity will reduce their cardiovascular health. Aerobic exercise is necessary.

• Appropriate regular activity recommended, with physician’s approval. Inappropriate physical activity worsens arthritic pain.

Osteoporosis - Profile

• Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue.

• This leads to increased bone fragility and risk of fracture, particularly of the hip, spine and wrist.

• Osteoporosis is often known as "the silent thief" because bone loss occurs without symptoms

(Canadian Osteoporosis Society, 2005)

Osteoporosis - How Physical Activity Helps

• Physical activity increases peak bone mass in the growing skeleton

• Physical activity can slow the rate of bone loss in older adults

• Improves balance and stability, reducing the risk of falls and injuries

Type 2 Diabetes - Profile

• Type 2 diabetes occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin that is produced.

• 90 per cent of people with diabetes have type 2 diabetes.

• Scientists believe that lifestyle and type 2 diabetes are closely linked. This means that lifestyle is one area individuals can focus on to help prevent or delay the onset of the condition

(Canadian Diabetes Association, 2005)

Type 2 Diabetes - How Physical Activity Helps

•Helps prevent obesity, a major factor for diabetes. Fat makes insulin less effective at regulating blood sugar. Four out of five Type 2 diabetics are obese. •Exercise removes glucose from the blood during and after activity. It improves insulin sensitivity and helps the body’s ability to metabolize glucose.

•Stress can increase insulin levels in Type 2 diabetics. Exercise can help reduce stress.

Cardiovascular Disease - Profile

• Cardiovascular disease or heart disease is the number one killer in Canada

• Medical conditions such as high blood pressure, high blood cholesterol, obesity and diabetes are also potent risk factors.

• Men are generally more likely to develop CVD, but the risk increases with age for both sexes

Cardiovascular Disease - How Physical Activity Helps

• Increases oxygen supply and decreases oxygen demand on heart

• Improves heart contractions and impulse stability• Lowers resting heart rate• Increases diameter and capacity of arteries• Reduces progression of artherosclerosis• Can lower LDL (« bad » cholesterol) and triglycerides.• Can increase HDL (« good » cholesterol)• Helps lower blood pressure and reduces risk of developing

hypertension• Helps maintain a healthy body weight• Helps relieve stress, a factor in heart disease

(Lee & Paffenbarger, Edited by Thompson, 2000)

Metabolic Syndrome

• 1 in 4 Canadians can develop a cluster of medical conditions called "metabolic syndrome": • obesity - particularly abdominal fat• high blood sugar • high triglycerides• high blood cholesterol (low HDL, « good

cholesterol »)• high blood pressure

Metabolic Syndrome - Effects

Result: Increased risk for diabetes and heart disease

Abdominal fat

Muscles

Pancreas

Liver

Resistant to insulin

Difficulty to produce insulin

Sugar production

Request for pancreas to produce more insulin

Hormones

Reversing Metabolic Syndrome

• Increasing physical activity to increase metabolism

• Reducing weight

Where to find more information:

Arthritis Society of Canada - www.arthritis.caCanadian Cancer Society - www.cancer.caOsteoporosis Society of Canada -

www.osteoporosis.caCanadian Diabetes Association- www.diabetes.caHeart and Stroke Foundation -

www.heartandstroke.caMetabolic Syndrome in Canada -

http://www.cmeondiabetes.ca/pub/the.metabolic.syndrome.in.canada.php

Chronic Disease Prevention Alliance of Canada - http://www.chronicdiseaseprevention.ca/

Sharing Stories

• Do you have program ideas to share on primary prevention of specific chronic diseases through Physical Activity?

• Do you have programs addressing people with existing conditions?

Note: Workshop materials and fact sheets can be downloaded from http://www.ophea.net/parc

Contact information

Physical Activity Resource Centre

www.ophea.net/parc1-888-446-7432

Louise DawProvincial Consultant

Louise@ophea.org

519.646.2121