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Presentation by Dr William Bi
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StreetGames National Conference
11th April 2013
Dr William Bird MRCGP MBE
© 2012 Intelligent Health/NHS London
© 2012 Intelligent Health/NHS London
Attributable fractions (%) for all-cause deaths in 40 842 (3333 deaths) men and 12 943 (491 deaths) women in the Aerobics Center Longitudinal Study.
Blair S N Br J Sports Med 2009;43:1-2
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
Attributable fractions (%) for all-cause deaths in 40 842 (3333 deaths) men and 12 943 (491 deaths) women in the Aerobics Center Longitudinal Study.
Blair S N Br J Sports Med 2009;43:1-2
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
80 seconds ago
Mankind has evolved well If we take an hour to equal 1000 years then four days is 100,000 years; the time from the origin of mankind to today.
4 Days ago
10 hours ago 4 hours ago 9 minutes ago
4000 yrs civilisation 10,000 yrs ago
Agriculture Technology
100,000 yrs ago
Hunter gatherers
industrialisation
People
Wellbeing
Purpose
Place
People
Causes of Stress and Free Radicals
Chronic Stress
People Place Purpose
1. Physical activity plays a key role in the control of the body’s response to physical stress1 and prevents telomere shortening2
2. Chronic stress reduces levels of physical activity3.
Physical activity and Stress
1 Rimmele et al Level of PA affects adrenal and Cardiovascular Reactivity to Psychosocial Stress: Psychoneuroendocrinology (2009) 43 190-198 2 Puterman E, Lin J, Blackburn E, O'Donovan A, Adler N, et al. (2010) The Power of Exercise: Buffering the Effect of Chronic Stress on Telomere Length. PLoS ONE 5(5): e10837. doi:10.1371/journal.pone.0010837 3Vitaliano P et al A Path Model of Chronic Stress, The Metabolic Syndrome and Coronary Heart Disease Pyschosomatic Medicine 64:418-435 (2002)
e
Chronic Stress
Stress Hormones
Physical Inactivity
e
Chronic Stress
Physical Inactivity
People Purpose Place Chronic Stress
Stress Hormones
Mitochondrial damage
Physical Inactivity And other poor health
behaviours
Cancers Cardiovascular Diabetes Dementia Depression
e
Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007
Health Benefits of Physical Activity Disease Risk reduction Strength of
evidence Death 20-35% Strong CHD and Stroke 20-35% Strong Type 2 Diabetes 35-50% Strong Colon Cancer 30-50% Strong Breast Cancer 20% Strong Hip Fracture 36-68% Moderate Depression 20-30% Strong Alzheimer’s Disease 60% Moderate
REF: Department of Health, Start Active Stay Active 2011
© 2012 Intelligent Health/NHS London
Anti-ageing effect
• Increases Reactive Oxidative Species (Free Radicals)that stimulate the production of antioxidants in the Mitochondria.
• This is a powerful anti-ageing mechanism that protects the cell from DNA damage.
• In fact taking anti-oxidants orally interferes with this mechanism.
© 2012 Intelligent Health/NHS London
• Increases Reactive Oxidative Species (Free Radicals) that stimulate the production of antioxidants in the Mitochondria.
• This is a powerful anti-ageing mechanism that protects the cell from DNA damage.
• In fact taking anti-oxidants orally interferes with this mechanism
Anti-ageing effect
• Increases Reactive Oxidative Species (Free Radicals)that stimulate the production of antioxidants in the Mitochondria.
• This is a powerful anti-ageing mechanism that protects the cell from DNA damage.
• In fact taking anti-oxidants orally interferes with this mechanism.
© 2012 Intelligent Health/NHS London
• Increases Reactive Oxidative Species (Free Radicals) that stimulate the production of antioxidants in the Mitochondria.
• This is a powerful anti-ageing mechanism that protects the cell from DNA damage.
• In fact taking anti-oxidants orally interferes with this mechanism
Sedentary
Mitochondrial DNA
Reactive Oxidative Species
Anti-Oxidants
Mitochondria
Oxidative Phosphorylation
Physically Active
Mitochondrial DNA
Reactive Oxidative Species
Oxidative Phosphorylation
Anti-oxidants
Mitochondria
How Does Physical Activity Work? • All Conditions:
– Anti-inflammatory. • Release Cytokines from muscle • Improves endothelial function
– Enhances mitochondrial antioxidant production
– lengthened telomeres
• Cardiovascular: – Increases Stroke Volume – Reduces Blood Pressure – Improves Heamostatic function
(reduced Fibrinogen etc) – Improves cholesterol ratio – Halts and can reverse plaque formation
• Cancer
– Reduces sex hormone formation – Increases Insulin sensitivity – Increases production of Natural Killer
Cells
© 2012 Intelligent Health/NHS London
Health Benefits of Physical Activity Disease Risk reduction Strength of
evidence Death 20-35% Strong CHD and Stroke 20-35% Strong Type 2 Diabetes 35-50% Strong Colon Cancer 30-50% Strong Breast Cancer 20% Strong Hip Fracture 36-68% Moderate Depression 20-30% Strong Alzheimer’s Disease 60% Moderate
REF: Department of Health, Start Active Stay Active 2011
© 2012 Intelligent Health/NHS London
Anti-Inflammatory Two possible mechanisms: • the reduction in visceral fat mass;
– Visceral fat increases inflammatory agents and reduces anti-inflammatory ones creating a permanent state of Inflammation.
• Increased production anti-inflammatory cytokines from contracting muscle.
© 2012 Intelligent Health/NHS London
Two possible mechanisms: • the reduction in visceral fat mass;
– Visceral fat increases inflammatory agents and reduces anti-inflammatory ones creating a permanent state of Inflammation.
• Increased production anti-inflammatory cytokines from contracting muscle.
© 2012 Intelligent Health/NHS London
© 2012 Intelligent Health/NHS London
© 2012 Intelligent Health/NHS London
Muscles
© 2012 Intelligent Health/NHS London
© 2012 Intelligent Health/NHS London
Natural Killer Cells
© 2012 Intelligent Health/NHS London
Fitness and Fat
© 2012 Intelligent Health/NHS London
Physical Activity and Weight Loss
• To reduce or maintain weight loss between 120mins and 250mins of moderate activity are required.
• To achieve significant weight loss over 250 mins a week of moderate activity is required.
American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise [2009, 41(2):459-71
© 2012 Intelligent Health/NHS London
Risk of cardiovascular disease mortality by cardiorespiratory fitness and body mass index categories, 2316 men with type 2 diabetes at baseline, 179 deaths.
Blair S N Br J Sports Med 2009;43:1-2
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved. © 2012 Intelligent Health/NHS London
Risk of cardiovascular disease mortality by cardiorespiratory fitness and body mass index categories, 2316 men with type 2 diabetes at baseline, 179 deaths.
Blair S N Br J Sports Med 2009;43:1-2
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
Normal Weight and Unfit Fat and Fit
© 2012 Intelligent Health/NHS London
Cardiorespiratory Fitness and Body Mass Index as Predictors of Cardiovascular Disease Mortality
Among Men With Diabetes Timothy S. Church, MD, MPH, PhD; Michael J. LaMonte, PhD; Carolyn E. Barlow, MS; Steven N. Blair, PED Arch Intern Med. 2005;165:2114-2120
© 2012 Intelligent Health/NHS London
179 CVD deaths during a mean (SD) follow-up of 15.9 (7.9) years and 36 710 “manyears” of exposure.
Cumulative all-cause mortality associated with randomization to dietary weight loss in the Trial of Nonpharmacologic Intervention in the Elderly (TONE). 1Based on Cox proportional
hazards regression.
Shea M K et al. Am J Clin Nutr 2011;94:839-846
©2011 by American Society for Nutrition
CVD Mortality Risk Factors Modified by Physical Activity
In Summary
© 2012 Intelligent Health/NHS London
NEW WAY OF RECORDING AND INCENTIVISING SPORT
© 2012 Intelligent Health/NHS London
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
www.beatthestreet.me
The Beat Boxes were installed around the school in three circles. The Beat Boxes in the outer circle had three points, the middle circle, two points and the inner circle (the school) one point.
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
Each Child has an online consul to see their progress
© Copyright 2012 Intelligent Health | Beat The Street
SCHOOL RANKINGS 1st Laura Secord 58% Vancouver 2nd Lord Kitchener 56% Vancouver 3rd Zenchuan School 42% Shanghai 4th Cleeve Park 35% London 5th Reading Girls 34% Reading 6th Lammas School 29% London 6th George Mitchell 28% London 7th Langley Park 27% London 7th Highdown School 27% Reading 10th Hugh Farringdon 18% Reading 11th Bow School 17% London 12th Bexleyheath Academy 12% London 13th Ravensbourne School 7% London
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
2012 London Reading Vancouver Shanghai
Health Minister Congratulates the winning Beat the Street children. Houses of Parliament October 26th 2012
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
London 2012 Canadian Silver Medallist Andrew Byrne supports Laura Secord School
Most incentivising components
2012 London Reading Vancouver Shanghai
The Global School Walking Competition
• Sports providers hold NFC phones (e.g West Ham FC)
• Children touch phone with cards to register attendance
Get Children into Sport after Beat The Street
© 2012 Intelligent Health/NHS London
Mile End Park
© 2012 Intelligent Health/NHS London
Thank you [email protected]
Now Get Moving