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Nutrition and PhysicalActivity for Health

John M. Jakicic, PhD

Linking Nutrition and Physical Activity to Health Outcomes

Nutrition andPhysical Activity for

Health

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Nutrition and Physical Activity for HealthNutrition andPhysical ActivityforHealth

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Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Theoretical Pathway for Lifestyle Factors to

Influence Health-Related OutcomesTheoreticalPathwayforLifestyleFactors

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Is Physical Activity Linked to Improved Health

Is

Ph

ys

ic

al

Ac

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it

y

Lin

ke

d

to

Im

pro

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d

Hea

lt

h

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The Foundation of this Relationship

Image Source Note 1

Transport workers

The Foundation ofthisRelationship

The Foundation of this Relationship

Image Source Note 1

Postal workers

The Foundation ofthisRelationship

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Relative risk of death (from all causes)

according to measures of physical activity.

0.40

0.50

0.60

0.70

0.80

0.90

1.00

1.10

3500

Physical Activi ty Index (kcal per week)

RelativeRisk

Image Source Note 2

Physical Activity and Risk of Type 2 Diabetes in Women

0.840.87

0.770.74

1.0

0.5

0.75

1

0-2.0 (0.8) 2.1-4.6 (3.3) 4.7-10.4 (7.7) 10.5-21.7 (15.7) >=21.8 (35.4)

Activi ty (MET-hrs per Week)

Image Source Note 3

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Physical Activity and Treatment of

Depression47%

30%29%

0

5

10

15

20

25

30

35

40

45

50

Control Low Dose High Dose

Image Source Note 4

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Diagram

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Association Between Cardiorespiratory Fitness and

Risk of Cardiovascular Disease Mortality in Diabetics

Relative

Risk

Image Source Note 5

Fitness - METs

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Diagram

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Cardiovascular Disease Mortality by

Body Fatness and Fitness

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Lean Normal Obese

RelativeRisk

Fit

Unfit

Adjusted for age (single year), examination year, smoking habit, alcohol intake, and parental history of ischemic heart disease

Image Source Note 6

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Is Diet and Nutrition Linked to Health Outcomes?IsDietandNutrition LinkedtoHealthOutcomes?

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Nutrition and Health Outcomes Links have been shown with:

Cardiovascular disease

Diabetes

Cancer

Obesity

Others

Nutrition and Health Outcomes

Dietary patterns can influence blood lipids

Transfats

Saturated Fat

Dash diet pattern

Encourage fruits and vegetables, whole grains, poultry/fish, legumes/nuts, low-fat dairy ,vegetable oils

Limit sweets, beverages containing sugar, red meat

Dietary patterns can influence blood pressure

Sodium intake

Dash diet pattern

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Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Is Diet and Nutrition Linked to Health Outcomes?

Is

Di

et

an

d

Nut

ri

ti

on

Li

nk

ed

to

He

al

th

Ou

tc

om

es

?

Health Consequences of Obesity

Hypertension

Dyslipidemia

Type 2 Diabetes

Coronary Heart Disease

Stroke

Gallbladder Disease

Osteoarthritis

Sleep Apnea and Respiratory disorders

Some forms of cancer

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Health Costs of Obesity Estimated to be $147 billion in the United States in

2008

Finkelstein et al. 2009

Estimated to account for 0.7% to 2.8% of total healthcare costs in a country worldwide

Withrow and Alter, 2011

Health costs are estimated to be 30% higher in obese

adults compared to normal weight adults

Withrow and Alter, 2011

Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Nutrition and Physical Activity for HealthNutritionandPhysical

ActivityforHealth

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Behavior

PhysicalActivity

Health-Related

Outcomes

Diet /Nutrition

Fitness

Body Weightand Body

Composition

Theoretical Pathway for Lifestyle Factors to

Influence Health-Related Outcomes

The

or

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ica

l

Pat

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fo

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Li

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Summary

Physical activity is an important healthbehavior that can have an independenteffect on health

Eating behaviors that influence diet andnutrition are also important and canhave an independent effect on health

Physical Activity and Nutrition mayinteract to maximize the health benefits

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Image Source Notes1. Chart created by instructor based on data from: Morris, J . N., Heady, J . A., Raffle, P., Roberts, C. G., & Parks, J . W.

(1953). Coronary heart-disease and physical activity of work. The Lancet, 262(6795), 1053-1057. doi: 10.1016/S0140-6736(53)91495-0

2. Chart created by instructor based on data from: Paffenbarger, R. S., Hyde, R., Wing, A. L., & Hsieh, C. (1986).Physical activity, all-cause mortality, and longevity of college alumni. New England Journal of Medicine, 314(10), 605-613. doi: 10.1056/NEJ M198603063141003

3. Chart created by instructor based on data from: Hu, F. B., Sigal, R. J ., Rich-Edwards, J . W., Colditz, G. A., Solomon,C. G., Willett, W. C., ... Manson, J . E. (1999). Walking compared with vigorous physical activity and risk of type 2diabetes in women. The Journal of the American Medical Association, 282(15), 1433-1439. doi:10.1001/jama.282.15.1433

4. Chart created by instructor based on data from: Dunn, A. L., Trivedi, M. H., Kampert, J . B., C lark, C. G., & Chambliss,

H. O. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of PreventiveMedicine, 28(1), 1-8. doi: 10.1016/j.amepre.2004.09.003

5. Chart created by instructor based on data from: Church, T. S., LaMonte, M. J ., Barlow, C. E ., & Blair, S. N. (2005).Cardiorespiratory fitness and body mass index as predictors of Cardiovascular disease mortality among men with

diabetes. JAMA Internal Medicine (formerlyArchives of Internal Medicine), 165(18), 2114-2120. doi:10.1001/archinte.165.18.2114

6. Chart created by instructor based on data from: Lee, C. D., Blair, S. N., & J ackson, A. S. (1999). Cardiorespiratoryfitness, body composition, and all-cause and cardiovascular disease mortality in men. The American Journal of ClinicalNutrition, 69(3), 373-380.