Transcript to access Joe Conway`s powerpoint presentation
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 Conway Sports 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
Relative Risk of CVD
1 0.8
1.0
0.6
0.4
0.68
0.37
0.33
0.2
0
0 1-59 min 1.0-1.5 h >2h Time Spent Walking per Week
Mansoon JAMA, 2001, 285:1447
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 Period
40
Men Women
33 37 30 20 27 21 26 27 21 21 18 17 10 14 11 0 1988
18-34
2002 1988 2002
35-54
1988
55+
2002
Slan Survey 1999
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 Quality Timing 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
• • • • Greater opportunity National Schools Ways to keep girls active through out secondary Insurance issue Develop physical Literacy Curriculum Schools
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
• • • • School Public Private sector Fitness Industry Community
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 Work related Social Health Exercise Sleep Food Social life Rewards Exercise
Health and Quality of life