Physical Activity & Physical Activity & HealthHealth

This lecture has been dedicated to This lecture has been dedicated to Olympics games in Beijing, China Olympics games in Beijing, China

Aug 08-24, 2008Aug 08-24, 2008By Supercourse TeamBy Supercourse Team

Physical Activity & HealthPhysical Activity & HealthLecture Developers (Supercourse Team)Lecture Developers (Supercourse Team)

Soni Dodani MD, PhDSoni Dodani MD, PhD

Others: Others: Ali Ardalan, Eugene Shubnikov, Francios Ali Ardalan, Eugene Shubnikov, Francios Sauer,Faina Linkov, Mita Lovelaker, Jesse Sauer,Faina Linkov, Mita Lovelaker, Jesse Huang, Nicholas Padilla, Rania Saad, Ron Huang, Nicholas Padilla, Rania Saad, Ron LaPorteLaPorte

Questions:  Questions:  Super1@pitt.eduHow to join the Supercourse:  How to join the Supercourse: 

www.pitt.edu/~super1/

Learning ObjectivesLearning ObjectivesTo encourage students to be To encourage students to be

physically activephysically activeTo illustrate Exercise and its effect To illustrate Exercise and its effect

on disease prevention on disease prevention To provide examples of simple, To provide examples of simple,

moderate intensity physical activitymoderate intensity physical activityTo encourage regular physical To encourage regular physical

activity in developing countries activity in developing countries with focus on womenwith focus on women

To encourage physical fitness in To encourage physical fitness in people with disabilitiespeople with disabilities

To build an Olympic Physical To build an Olympic Physical activity and health supercourseactivity and health supercourse

The Olympic Games This The Olympic Games This YearYear

Beijing Beijing 20082008NumbersNumbers

  ·        Population 14,000,000·        Population 14,000,000·        Visitors ·        Visitors 2-2.5,000,0002-2.5,000,000·        Athletes 18,000·        Athletes 18,000·        Helpers 5,000·        Helpers 5,000·        Referees 2,500·        Referees 2,500·        Volunteers 6,000·        Volunteers 6,000·        Journalists 15,000·        Journalists 15,000

What is Physical ActivityWhat is Physical Activity Physical activityPhysical activity

Bodily movement produced by skeletal Bodily movement produced by skeletal muscles that results in an expenditure of muscles that results in an expenditure of energyenergy

Physical fitnessPhysical fitnessA measure of a person's ability to perform A measure of a person's ability to perform physical activities that require endurance, physical activities that require endurance, strength, or flexibility.strength, or flexibility.

Regular physical activityRegular physical activityA pattern of physical activity is regular if A pattern of physical activity is regular if activities are performed in some orderactivities are performed in some orderCDC,1997CDC,1997

“Physical activity is something you do. Physical fitness is something you acquire, a

characteristic or an attribute one can achieve by being physically

active. And exercise is structured and tends to have fitness as its

goal"

AnonymousAnonymous

Spectrum of Physical Activity Spectrum of Physical Activity and Health and Health

Physically Fit

Physically Active

Physically disabled

LaPorte RE: Am J Epidemiol. 1984 LaPorte RE: Am J Epidemiol. 1984

Oct;120(4):507-17Oct;120(4):507-17

Differences between ExerciseDifferences between Exerciseand Sportand SportExercise

It’s a form of physical activity done primarily to improve one’s health and fitness.

Sports Is complex, institutionalized,

competitive and these very characteristics works against moderate and rhythmical exercise.

CDC 1999

Common Reasons Not To Common Reasons Not To ExerciseExercise

I don’t have the I don’t have the timetime

I don’t like to I don’t like to sweatsweat

I’ll look sillyI’ll look sillyIt hurtsIt hurtsI don’t know what I don’t know what

to doto doIt’s not importantIt’s not important

Why Exercise ???Why Exercise ???

Do you know?Do you know?13.5 million people have coronary heart 13.5 million people have coronary heart

disease.disease.1.5 million people suffer from a heart 1.5 million people suffer from a heart

attack in a given year.attack in a given year.250,000 people suffer from hip fractures 250,000 people suffer from hip fractures

each year.each year.Over 60 million people (a third of the Over 60 million people (a third of the

population) are overweight.population) are overweight.50 million people have high blood pressure.50 million people have high blood pressure.

(WHO, 2003)(WHO, 2003)

Do you Know that…….Do you Know that…….Adjusted RR for CVD Mortality by Fitness and % Body Fat

Do you Know that…….Do you Know that…….

00.20.40.60.8

11.21.41.61.8

2

lean<16%

Normal16-24%

Obese>24%

FitUnfit

Adjusted RR for All-Cause Mortality Adjusted RR for All-Cause Mortality by Fitness and % Body Fatby Fitness and % Body Fat

Do you know that ……Do you know that …… Childhood obesity has reached epidemic Childhood obesity has reached epidemic

proportions in most part of the worldproportions in most part of the world Children are eating more and exercising less.Children are eating more and exercising less. Time spent watching television or using Time spent watching television or using

computers computers This lack coupled with poor dietary habits This lack coupled with poor dietary habits

has led to significant increases in the number has led to significant increases in the number of children with Type II diabetes and of children with Type II diabetes and predisposition to hypertension, coronary predisposition to hypertension, coronary artery disease and othersartery disease and others

All of these can be Prevented by All of these can be Prevented by Regular Physical Activity !!!Regular Physical Activity !!!

How Physical Activity Impacts HealthHow Physical Activity Impacts HealthHelps control weight.Helps control weight.Reduces feelings of depression and anxiety.Reduces feelings of depression and anxiety.Helps build and maintain healthy bones, Helps build and maintain healthy bones,

muscles, and joints.muscles, and joints.Reduces the risk of developing colon cancer.Reduces the risk of developing colon cancer.Helps reduce blood pressure in people who Helps reduce blood pressure in people who

already have high blood pressure.already have high blood pressure.Causes the development of new blood Causes the development of new blood

vessels in the heart and other muscles.vessels in the heart and other muscles.Enlarges the arteries that supply blood to Enlarges the arteries that supply blood to

the heart.the heart. WHO 2002WHO 2002

Health Risk of Physical Health Risk of Physical InactivityInactivityLeading causes of disease and disability Leading causes of disease and disability

associated with physical inactivityassociated with physical inactivity1.1. Coronary Heart Disease (CHD)Coronary Heart Disease (CHD)2.2. StrokeStroke3.3. ObesityObesity4.4. Type II DiabetesType II Diabetes5.5. HypertensionHypertension6.6. Colorectal cancerColorectal cancer7.7. Stress and AnxietyStress and Anxiety8.8. Osteo-arthritisOsteo-arthritis9.9. OsteoporosisOsteoporosis10.10.Low back painLow back pain

What Can Exercise do for You?What Can Exercise do for You? Reduce the risk of the three leading causes of death: Heart Reduce the risk of the three leading causes of death: Heart

Disease, stroke, and cancerDisease, stroke, and cancer Control or prevent development of DiseaseControl or prevent development of Disease

Enhance Mental AbilitiesEnhance Mental Abilities

Improve Sleeping Habits and Increase Energy LevelsImprove Sleeping Habits and Increase Energy Levels

Lift Depression and Help Manage StressLift Depression and Help Manage Stress

Control Weight, improving self-image, appearance and healthControl Weight, improving self-image, appearance and health

Exercise & Cardiovascular Exercise & Cardiovascular DiseaseDiseaseFACTFACT

Sedentary lifestyle is a Sedentary lifestyle is a risk factorrisk factor for CVD, for CVD, according to the American Heart Associationaccording to the American Heart Association

Exercise reduces Blood PressureExercise reduces Blood PressureHigh blood pressure (above 140/90) is the High blood pressure (above 140/90) is the

main cause of Heart Attack and Strokemain cause of Heart Attack and StrokeExercise prevents AtherosclerosisExercise prevents Atherosclerosis

(clogged arteries)(clogged arteries)Exercise reduces cholesterol plaques that Exercise reduces cholesterol plaques that

clog arteries and can lead to stroke and clog arteries and can lead to stroke and heart attackheart attack WHO 2002WHO 2002

Exercise and CancerExercise and Cancer

The BasicsThe BasicsExercise helps to prevent obesity, a Exercise helps to prevent obesity, a

major risk factor for several types major risk factor for several types of cancerof cancer

Exercise enhances immune functionExercise enhances immune functionExercise activates antioxidant Exercise activates antioxidant

enzymes that protect cells from enzymes that protect cells from free radical damagefree radical damage WHO WHO 20022002

Exercise and DiabetesExercise and DiabetesIncrease insulin sensitivityIncrease insulin sensitivity

Control blood glucoseControl blood glucose

Control Weight/Lower body fatControl Weight/Lower body fat

Reduce risk of cardiovascular diseaseReduce risk of cardiovascular disease

WHO 2002WHO 2002

Exercise and DepressionExercise and DepressionExercise can help prevent depression. Exercise can help prevent depression. In fact, recent studies have shown that In fact, recent studies have shown that exercise was found to be just as exercise was found to be just as effective (despite a slower initial effective (despite a slower initial response) as antidepressant medication response) as antidepressant medication for treatment of depression.for treatment of depression.Exercise reduces health problems , making Exercise reduces health problems , making

you feel betteryou feel betterExercise helps you sleep betterExercise helps you sleep betterExercise controls weight, enhancing self-Exercise controls weight, enhancing self-

esteem esteem WHO 2002WHO 2002

Exercise and Your MindExercise and Your MindShort-term benefits:Short-term benefits:

Boost alertness (possibly by triggering the Boost alertness (possibly by triggering the release of epinephrine and nor epinephrine)release of epinephrine and nor epinephrine)

Improve memoryImprove memoryImprove intellectual functionImprove intellectual functionSpark creativitySpark creativity

Long-term benefits:Long-term benefits:Exercise has been shown to slow and even Exercise has been shown to slow and even

reverse age-related decline in mental function reverse age-related decline in mental function and loss of short-term memoryand loss of short-term memory

A report of Surgeon general, Physical Activity and A report of Surgeon general, Physical Activity and health, 1996health, 1996

Opportunities for Physical Opportunities for Physical ActivityActivity

At workFor transportIn domestic dutiesIn leisure time

The majority of people do very little or no physical activity in

any of these domains

Getting Started….Setting Getting Started….Setting GoalsGoals

What will motivate you?What will motivate you?Think about your reasons for Think about your reasons for

exercisingexercisingAre your goals important enough Are your goals important enough

to keep you motivated long-to keep you motivated long-term?term?

Think short-term and long-termThink short-term and long-termHow will you benefit from your How will you benefit from your

fitness plan day-to-day?fitness plan day-to-day?In 1 year? In 5 years? In 10 In 1 year? In 5 years? In 10

years?years?

Before You Start...Before You Start... If you are over 40 or have health If you are over 40 or have health

problems (heart disease, high problems (heart disease, high blood pressure, diabetes, blood pressure, diabetes, obesity, muscle or joint obesity, muscle or joint problems) see a physician before problems) see a physician before beginning exercisebeginning exercise

Be informedBe informedLearn as much as you can Learn as much as you can

about exercise by reading and about exercise by reading and talking to other peopletalking to other people

Learn safety precautions Learn safety precautions before you do any exercisebefore you do any exercise

Fitness Equipment / SafetyFitness Equipment / SafetyFitness Equipment / SafetyFitness Equipment / Safety Buy Appropriate Buy Appropriate SHOESSHOES Wear Comfortable ClothingWear Comfortable Clothing TOO HOT! TOO COLD!TOO HOT! TOO COLD! Run and Walk with a FriendRun and Walk with a FriendMore fun, safer, with a physical and More fun, safer, with a physical and

mental support systemmental support system Night Time: stay to the well lit areasNight Time: stay to the well lit areas Select activities that are fun ……….. To Select activities that are fun ……….. To

YOU!YOU!

Get Moving!Get Moving! Components of an exercise Components of an exercise

programprogramAerobic ActivityAerobic ActivityStrength TrainingStrength TrainingFlexibility TrainingFlexibility Training

Use an exercise log to help Use an exercise log to help you plan and keep track of you plan and keep track of

your exercise programyour exercise programWHO 2002WHO 2002

Aerobic ActivityAerobic ActivityDefinitionDefinition

Continuous movement that uses big muscle Continuous movement that uses big muscle groups and is performed at an intensity that groups and is performed at an intensity that causes your heart, lungs, and vascular causes your heart, lungs, and vascular system to work harder than at restsystem to work harder than at restCardio respiratory Fitness is built through Cardio respiratory Fitness is built through aerobic exerciseaerobic exerciseAerobic exercise conditions and strengthens Aerobic exercise conditions and strengthens our heart, respiratory system, muscles, and our heart, respiratory system, muscles, and immune systemimmune systemCDC physical activity report 1999CDC physical activity report 1999

Types of Aerobic ExerciseTypes of Aerobic ExerciseOutdoor Outdoor

ActivitiesActivitiesWalkingWalkingJogging/runningJogging/runningBicyclingBicyclingSwimmingSwimmingBasketballBasketballSoccerSoccerJumping RopeJumping Rope

Indoor ActivitiesIndoor ActivitiesTreadmill machineTreadmill machineStair climbing Stair climbing

machinemachineStationary bikeStationary bikeElliptical trainerElliptical trainerRowing machineRowing machineAerobics, Aerobics,

boxing...boxing...

Strength TrainingStrength TrainingDefinitionDefinition

Muscle work against resistance that Muscle work against resistance that improves strength and enduranceimproves strength and enduranceStrength Strength allows us to move, and allows us to move, and enduranceendurance

allows us to perform work over timeallows us to perform work over timeMusclesMuscles = 40% of our lean body mass = 40% of our lean body mass

Use it or lose it: unused muscle disappears Use it or lose it: unused muscle disappears (atrophy)(atrophy)

Types of Strength TrainingTypes of Strength TrainingFree WeightsFree Weights

use of dumbbells and/or bars with weights on the use of dumbbells and/or bars with weights on the endsends

involves balance and coordination; useful for involves balance and coordination; useful for enhancing function in daily activities and enhancing function in daily activities and recreational sportsrecreational sports

Bonuses: convenient, cheap, and provides a wide Bonuses: convenient, cheap, and provides a wide variety of exercises that work several muscle groups variety of exercises that work several muscle groups togethertogether

Your body, your weightYour body, your weightThe most convenient form of resistance exerciseThe most convenient form of resistance exercisePushups, pull-ups,. Lunges, squats….Pushups, pull-ups,. Lunges, squats….

Flexibility TrainingFlexibility Training

Flexibility = The ability to move a joint Flexibility = The ability to move a joint through its range of motionthrough its range of motionWe lose flexibility with disuse and agingWe lose flexibility with disuse and aging

BenefitsBenefitsDecreased chance of muscular injury, Decreased chance of muscular injury,

soreness, and painsoreness, and painHelps prevent and reduce lower back painHelps prevent and reduce lower back painImproves joint health (tight muscles stress Improves joint health (tight muscles stress

our joints)our joints)Activities Activities stretching, yoga, pilates, tai chistretching, yoga, pilates, tai chi

How Much and How Hard?How Much and How Hard?Frequency: 3-5 days per weekFrequency: 3-5 days per week

Aerobic exerciseAerobic exercise:: a minimum if 3 days a week are a minimum if 3 days a week are necessary to reach most exercise goals and necessary to reach most exercise goals and minimize health benefitsminimize health benefits

Strength trainingStrength training:: a minimum of 2 days per week a minimum of 2 days per weekFlexibility trainingFlexibility training:: a minimum of 3-5 days per a minimum of 3-5 days per

weekweek DurationDuration

AerobicAerobic:: 20-60 minutes of continuous aerobic 20-60 minutes of continuous aerobic activityactivity

StrengthStrength:: 1-3 sets of 8-12 repetitions 1-3 sets of 8-12 repetitionsStretchingStretching:: Stretch all muscle groups and hold Stretch all muscle groups and hold

positions for 10-30 secondspositions for 10-30 seconds

Timing QuestionsTiming QuestionsWhat time of day is best?What time of day is best?

Choose the most convenient time for your Choose the most convenient time for your scheduleschedule

Choose a regular time--the same time every dayChoose a regular time--the same time every dayTiming may depend on the activity you chooseTiming may depend on the activity you choose

Can I eat before exercise?Can I eat before exercise?It is best not to eat a meal for 2 hours It is best not to eat a meal for 2 hours

beforehandbeforehandBe sure to drink plenty of water before and Be sure to drink plenty of water before and

during exerciseduring exerciseShould I exercise when I’m sick?Should I exercise when I’m sick?

No, especially if you have a feverNo, especially if you have a fever

Exercise for people with Exercise for people with special needsspecial needs

People with disabilities are less likely People with disabilities are less likely to engage in regular moderate to engage in regular moderate physical activity than people without physical activity than people without disabilities, yet they have similar disabilities, yet they have similar needs to promote their health and needs to promote their health and prevent unnecessary diseaseprevent unnecessary diseaseExercise is for everyone!!!!!!!Exercise is for everyone!!!!!!!Individuals who have physical Individuals who have physical disabilities or chronic, disabling disabilities or chronic, disabling conditions such as arthritis can conditions such as arthritis can improve muscle stamina and strength improve muscle stamina and strength with regular physical activity with regular physical activity

Exercise for people with special Exercise for people with special needsneeds

People with disabilities should first People with disabilities should first consult a physician before beginning a consult a physician before beginning a program of physical activity to which program of physical activity to which they are unaccustomed they are unaccustomed

Provide community-based programs to Provide community-based programs to meet the needs of persons with meet the needs of persons with disabilities. disabilities.

Ensure that environments and facilities Ensure that environments and facilities conducive to being physically active are conducive to being physically active are available and accessible to people with available and accessible to people with disabilities, such as offering safe, disabilities, such as offering safe, accessible, and attractive trails for accessible, and attractive trails for bicycling, walking, and wheelchair bicycling, walking, and wheelchair activities. activities.

"You don't stop exercising because you grow old. You grow old because you stop exercising." Anonymous

Exercise for Women in Exercise for Women in developing countriesdeveloping countries

There has been several studies There has been several studies which have shown that less which have shown that less emphasis is given to exercise emphasis is given to exercise especially in womenespecially in women The reasons are several and The reasons are several and most important one is awareness.most important one is awareness. Women sports are not Women sports are not encouraged in most of developing encouraged in most of developing countriescountries There is stigma that women There is stigma that women should not be involved in outdoor should not be involved in outdoor sportssports

Exercise is for everyoneExercise is for everyone There is need for awareness for There is need for awareness for

physical fitness in developing physical fitness in developing countriescountries

Exercise is not only for men but for Exercise is not only for men but for everyoneeveryone

With commitment, opportunities can With commitment, opportunities can be developed.be developed.

Even shopping malls provide Even shopping malls provide opportunities for fitness walkingopportunities for fitness walking

CDC 1997CDC 1997

Health Risks of Physical Health Risks of Physical ActivityActivity

Most musculo-skeletal injuries sustained during physical activity are likely to be preventable

Injuries sustained during competitive sports have been shown to increase the risk of developing osteoarthritis

Serious cardiac events can occur with physical exertion.

The overall benefit of regular physical activity he overall benefit of regular physical activity is lower all-cause mortalityis lower all-cause mortality

InjuryInjury PreventionPrevention

exercise regularlyexercise regularly gradually increase gradually increase

intensityintensity rest between sessionsrest between sessions warm-up and cool downwarm-up and cool down stay flexiblestay flexible don’t exercise when sickdon’t exercise when sick don’t exercise when don’t exercise when

muscles are fatigued muscles are fatigued and strainingand straining

know proper form for know proper form for any activity you doany activity you do

Caring for InjuriesCaring for Injuries Rest: stop immediatelyRest: stop immediately Ice: apply immediately Ice: apply immediately

and repeat every few and repeat every few hours for 15-20 minuteshours for 15-20 minutes

Compress: wrap injured Compress: wrap injured area with elastic bandagearea with elastic bandage

Elevation: raise injured Elevation: raise injured area above heartarea above heart

After 2 days, apply heat After 2 days, apply heat if there is no swellingif there is no swelling

Gradually ease back into Gradually ease back into activity when pain is activity when pain is gonegone

SummarySummaryPhysical inactivity is one of the top 10

leading causes of death and disability in the developed world

Exercise improves our body and mindsExercise improves our body and mindsEven moderate exercise has many health Even moderate exercise has many health

benefitsbenefits It is important to set fitness goals that are It is important to set fitness goals that are

realistic and meaningful for yourealistic and meaningful for you It takes time to make fitness part of a It takes time to make fitness part of a

lifestyle, and we will all have ups and downs lifestyle, and we will all have ups and downs in following our exercise programsin following our exercise programs Exercise feels good!Exercise feels good!

““The first wealth is health."The first wealth is health." Ralph Waldo EmersonRalph Waldo Emerson