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Transcript of A joint Faculty of the Royal College of Physicians of Ireland (RCPI) and the Royal College of...
A joint Faculty of the Royal College of Physicians of Ireland (RCPI)and the Royal College of Surgeons in Ireland (RCSI)
Exercise as part of a Healthy Lifestyle
Dr Laurence J ConwaySports and Exercise Medicine Specialist.
FSEM RCSI &RCPI
Humans
• Hunter gatherer
• Brain development required energy
• Hunter survived because of endurance
Where has evolution led us?
Where has evolution led us?
• Lessons from the aboriginal people of Australia
• Less Hunting/more gathering due supply
Where are we today?
• What is Best indicator risk of death in next 10 years?
Where are we today?
• What is Best predictor of mortality risk in next 10 years?
• Exercise Capacity = Aerobic capacity
Exercise is the best medicine
Rela
tive
Risk
Sco
re
Mansoon JAMA, 2001, 285:1447
0
0.2
0.4
0.6
0.8
1
0 1-59 min 1.0-1.5 h >2h
Time Spent Walking per Week
1.0
0.68
0.37 0.33
Relative Risk of CVDRelative Risk of CVD
First 15 minutes of Exercise per day
• 3 year increase in Life expectancy
• First 15min/day: there is 14% reduction all causes mortality
• Every extra 15 min/day there is a further extra 4% reduction mortality
Exercise = Treatment and Prevention
• Dose = Intensity + Duration• Frequency = Frequency• Treatment is life long• Risk Benefit ratio
• Side effects
How do we Reduce risk?• Start at realistic level• Build up slowly• Exercise should be FUN• As a group or on own• Warm up• Cool Down• Stretch• No intense exercise after
meals• Medical assessment?
Disease Prevention
• Cardiovascular disease• Diabetes Mellitus• Cancers• Obesity• Bone Health• Mood/stress• Immune function• Cognitive function• Mobility / risk falls
Treatment• Heart or Vascular Disease.• High Blood Pressure• Cholesterol• Obesity• Diabetes Mellitus• Cancers• Osteoarthritis• Osteoporosis• Respiratory illness• Mood• Cognitive Function• Neurological Disorders
Exercise; the Cost Benefit ratio
• Effective• Low Cost• Effects multiple related problems• Prevention other disease• Quality of Life benefit• Socialisation of isolated
• Dose tailored to individual
No Physical Exercise During a 7-Day PeriodNo Physical Exercise During a 7-Day Period MenWomen
18-34 35-54 55+
Slan Survey 1999
14
11
21 2118 17
27
21
26 27
33
37
0
10
20
30
40
Perc
ent
1988 2002 1988 2002 1988 2002
Why are people inactive?
Why are people inactive?• No Time
– Work– Family
• Cost• Lost the Habit• Poor motivation/mood
due inactivity• Health issues• Social isolation• Hard first few sessions so
stop
How do we get message to those that need it the most
• How do we change lifestyle
• Those that need change are not here
Psychological states of change
• Pre contemplation• Contemplation.• Preparation• Action
• Maintenance
Lifestyle
• Diet Quantity
QualityTiming
• Hydration• Risks Tobacco• Leisure drugs• Healthy BMI• Positive Mental Attitude• Rewards in life
7 areas of Investment
• Schools• Transport• Urban Design• Health Care• Public Education• Community• Sports for all
Schools
• Greater opportunity National Schools
• Ways to keep girls active through out secondary
• Insurance issue• Develop physical
Literacy Curriculum
Transport
• Walking & Public Transport
• Cycling• Drive children to school
Urban Design
• New Housing Estates• Safe Friendly
environment• Urban Plan; Green areas
Sports Facilities Cycle tracks Local facilities
Health Care
• 47% Primary Care Doctor say they ask about exercise
• 13% Patients report getting advice about exercise
• What can Medical Profession do?
What Can Medical Profession do?
• Ask people about exercise
• Give green prescriptions
• Do not tell people to stop exercise
• Modify where possible
What Can Medical Profession do?
• Educate doctors & student in exercise prescription
• Increase medical profession awareness
• Role Models• Help remove barriers;– Cost– Time– Educate
Public Education
• Media need to have consistent clear message
• Irish innovation
National Physical Activity Guidelines
‘Get Ireland Active’www.getirelandactive.ie
Community
• School• Public• Private sector• Fitness Industry
Activity for ALL
Balance life
• Work Life balance • We need find place all
parts of our life• Look Positive• Beware of negative
thoughts• Goal setting
Work Life Balance
• Stressors Recovery _____________________________________
Financial SleepWork related FoodSocial Social lifeHealth RewardsExercise Exercise
Health and Quality of life