Be active against cancer!
Wednesday, 4th of February 2015 (World Cancer Day)
Everday actions
Professor Nanette MutriePhysical Activity for Health Research CentreUniversity of Edinburgh
4/02/2015
• Physical inactivity has reached ‘Pandemic’ proportions
• Inactivity is as risky as smoking
• July 20124/02/2015
How does the risk of inactivity compare with smoking?
PAF% deaths caused in millions0
1
2
3
4
5
6
7
8
9
10
smokinginactivity
Lee et al. , Lancet, July 20124/02/2015
Percentage of worldwide burden of disease caused by
inactivity
CHD
Breast cancer
Type 2 Diabetes
Colon Cancer
Prem mortality
0 1 2 3 4 5 6 7 8 9 10
Percentage
Lee et al. , Lancet, July 20124/02/2015
4/02/2015
Public health guidelines on Physical Activity
CMOs 2011 ‘start active stay active’
150 mins of moderate activity/week– or 75 mins vigorous intensity per week– or combination
Strength exercise at least two days/week
Older adults all of above plus– balance and co-ordination 2/days/week
Limit sedentary behaviour
4/02/2015
% adults achieving minimum recommendations [SHeS 2013]
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey/Publications/Trendtables134/02/2015
Academy of Medical Royal Colleges press release 29/1/15
‘Major NHS action needed to tackle physical inactivity – say Scottish medical leaders’
4/02/2015
Goals
By the end of 2016, every GP in Scotland should have the training and mechanisms to give their patients advice and interventions for physical inactivity, in the same manner as is currently delivered for smoking and alcohol
By mid 2016, all hospital assessments will include questions about physical activity levels and diet alongside questions about smoking and alcohol
By the end of 2016, every person entering the care system will have their physical activity levels assessed
By the end of 2015, all medical schools in Scotland will include educational sessions on physical activity and health behaviour change
By the end of 2015, all Scottish hospitals will have clearly defined walking routes from the hospital to enable staff, patients and visitors to exercise
4/02/2015
Business Employment
Research and
Innovation
Young People
Early Years
Healthier Inequalities Tackled
Life Chances
Safe from Crime
Sustainable Places
Resilient Communit
ies
Environment
Valued
National Identity
Impact on Environm
ent
Older People
Supported
Public Services
We encourage and enable the inactive to be more
active
We encourage and enable the active to stay active
throughout life
We develop physical confidence and
competence from the earliest age
VISION – A MORE ACTIVE SCOTLAND Physical activity is about getting people moving. Daily walking, playing in a park, going to a gym, training with a team or aspiring to win a gold medal- it doesn’t really matter how people get active, it just matters that we do. Being physically active contributes to our personal, community and national wellbeing. Our vision is of a Scotland where more people are more active more often.
We improve our active infrastructure – people
and places
We support wellbeing and resilience in communities through physical activity
and sport
We improve opportunities to
progress and achieve in sport
4/02/2015
What is sedentary behaviour?
– Cluster of individual behaviours where sitting or lying is the dominant mode of posture
– Energy expenditure is very low
– Screen-time (TV viewing, computer use), motorised transport, sitting to read, talk, or listen to music
Odds of Metabolic Syndrome in Women – TV Viewing and Physical Activity
< 2.5 >= 2.5
<= 14
> 14 0
1
2
3
4
Physical activity time
(hrs/wk)
TV viewing time
(hrs/wk)
*
**
* P < 0.05 vs ref.
Courtesy Neville Owen
Dunstan et al. (2005). Diabetologia48, 2254-2261.
4/02/2015
Sedentary behaviour [SHS 2012]
16-24 25-34 35-44 45-54 55-64 65-74 75+0
1
2
3
4
5
6
7
8
Men WeekdayWomen Weekday
Age
Hours
Sedentary behaviour [SHS 2012]
16-24 25-34 35-44 45-54 55-64 65-74 75+0
1
2
3
4
5
6
7
8
Men WeekendWomen Weekend
Age
Hours
How adults and children typically allocate their time spent sedentary, in light-intensity physical activity and moderate-to-vigorous intensity physical activity (based on population
data from the 2003–2006 NHANES survey).58.
Owen N et al. Br J Sports Med 2014;48:174-177
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
Why is sitting bad for us?
• More time spent sedentary, less time spent in light intensity activity
• Energy expenditure decreases– Increased likelihood of overweight/obesity– Increases the risk of diseases like cancer
4/02/2015
Why is sitting bad for us?
• Lack of muscle contraction during sitting has been shown to supress activity of an enzyme (lipoprotein lipase)
– reduces the ability of the body to remove harmful fats from the bloodstream
– significantly decreases ‘good’ HDL cholesterol
Hamilton, Hamilton, ZdericDiabetes 56:2655–2667, 2007
4/02/2015
Why is sitting bad for us
LPP1 expression
• LPP1 regulates blood clotting and controls inflammation
• Suppression of LPP1 gene expression by over 50 % after 12 hours of sitting in humans
• Exercise was relatively ineffective at counteracting this effect
Zderic T, Hamilton M: Lipids in Health and Disease 2012, 11(1):137.
4/02/2015
Why is sitting bad for us
• Deep venous thrombosis
– Blood clots develop deep within the veins for idle leg muscles
– Specific molecular responses within the legs to inactivity which increases the risk of DVT
– Light, intermittent and frequent local muscle contractions of the legs can prevent it
4/02/2015
Biwas et al (2015) Annals of Internal Medicine
162, 126-132
4/02/2015
Cancer incidence predicted from self-reported sedentary time and controlling for
physical activity
4/02/2015
Every day actions for you and your clients
Sit less
Walk more
4/02/2015
The ABC of Physical Activity for Health: A consensus statement from the
British Association of Sport and Exercise Sciences BASES Journal of Sport Sciences 2010
• A- all adults; B- beginners; C-conditioned• Beginners
– Something is better than nothing– Set achievable goals– Find enjoyment– Seek support
4/02/2015
Stand up and discuss with neighbour
• When and how could you find ways to sit less at work or at home?
4/02/2015
Sit less at work and at home
• Stand up and stretch at least once an hour
• Stand to answer phone
• Walk and talk meetings
• Short activity breaks• Communal printer• Standing desks• Re-learn how to use
the buttons on the TV!
4/02/2015
Take mini activity breaks
4/02/2015
Take mini activity breaks
4/02/2015
For almost everyone the best place to start is to increase
walking
1) Walking is the easiest mode of activity for inactive people :
to get started with to sustain
2) Confers all the major benefits of activity
4/02/2015
Stand up and discuss with neighbour
• When and how could you find ways to walk more at work or at home?
4/02/2015
Walk more
• Take public transport• Park 10 min walk away• Lunch time walks• Use a pedometer
• Walk and talk meetings
• Take the stairs• Take part in step count
challenges• Walk the dog further
4/02/2015
Find out more:www.pathsforall.org.uk
Find a Health Walk near you:www.pathsforall.org.uk/findahealthwalk
4/02/2015
Community Pedometer Pack
4/02/2015
Paths for AllStrength & Balance Programme
10 simple exercises that will improve strength and balance and reduce the risk of falls in older adults
4/02/2015
Dr Mike Evans 23 ½ hourshttps://www.youtube.com/watch?v=aUaInS6HIGo
4/02/2015