Transcript Physical Activity & Cancer Prevention

Physical Activity & Diabetes:
Getting Patients Active
Shirley O’Shea
Senior Health Promotion Officer
Overview
• Evidence of physical activity and type 2
diabetes
• National Physical Activity Guidelines
• Health Professionals Promoting Physical
Activity
• How can patients be supported to become
active?
Health Benefits of Physical
Activity
• Reduction in CHD, hypertension, type 2
diabetes, some cancers,
• Reduce risk of musculoskeletal conditions
osteoarthritis, back pain, osteoporosis
• Mental health benefits, lower levels of anxiety,
managing stress increase self esteem
• Supports weight loss and weight management
Diabetes
• Some studies show that Physical activity
can possibly cause the reversal of early
insulin resistance, therefore, reducing the
risks of developing type 2 diabetes.
Evidence for activity
Participation in regular physical activity
• Improves blood glucose
• Prevent or delay Type 2 diabetes
• Positively affecting lipids
• Blood Pressure
• Cardiovascular events
• Mortality & quality of life
Not active enough
• Very inactive population- 3 out of 4 Irish adults do
not meet the National Guidelines for physical activity
• 4 out of 5 Irish children do not meet the guidelines
• Physical Inactivity – fourth leading risk factor for
global mortality
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(WHO 2010 Global recommendations on physical activity for health)
Get Ireland Active
• The National Physical Activity
Guidelines for Ireland provide clear,
concise and user friendly guidance to
support the public, professionals and
policy makers to Get Ireland Active
• Guidelines for children and young
people, adults and older adults,
people with disabilities and weight
management.
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Key message
Physical activity is for everyone and any level is better for your health
than none
For adults with disabilities – Aim for guideline or as much as ability allows.
Recommendations for Weight Loss and
Prevention of Weight Regain
• Levels greater than the minimum (150 mins)
amount of activity recommended per week
are important for weight loss.
• Aim to get participants to burn 300 kcal per
day in an activity session. 45 minutes walk at
12-15 minute per mile pace.
• Progress overweight/obese adults to 200-300
min of activity per week, gradually and over
time.
Significant improvements to health by
achieving minimum recommendation.
American Diabetes Association
PA Recommendations, 2006
Info given as preventative as follows:
• Patients with Impaired Glucose Tolerance should
partake in > 150 mins per week of moderate or
vigorous activity
• The physical activity should be distributed over at
least 3 days per week, with no more than 2
consecutive days without physical activity.
• Unless contraindicated, people with type II diabetes
should be encouraged to perform resistance exercise
3 times per week, targeting all major muscle groups.
This should progress to 3 sets of 8 to 10 repetitions
at a weight that cannot be lifted more than 8 to 10
times (ACSM)
Risk Factors Associated with PA
and Diabetes
• Hypoglycaemia needs to be prevented by patients who
take insulin and thus capillary blood glucose before, after
and several hours after a session of physical activity.
Until normal glycemic responses to activity can be
predicted.
• If patients are prone to hypoglycaemia after exercise,
measures can be taken to avoid it after exercise:
-Reduce dosage of insulin before PA
-Consume carbs before/during exercise or both if possible.
How do we measure physical activity?
• 1. “ I run around after the children all day long,
am always on the go”
• 2. “I have a sedentary job but I cycle 3 times a
week for up to 2 hours”
• 3. “I walk to town at lunch time a few days a
week”
• 4.”I go to the gym twice a week for an hour each
time”
Physical Activity
Discuss
• What are your current activity levels? (Activities of daily
living & planned activity
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Tell me about what you used to participate in and
specific interests, likes, dislikes you have?
• What is stopping you becoming more active? (barriers)
• What would you like to achieve? (client own goals)
• Who can support you in this change? (social support)
• How confident are you in becoming more active
• (self efficacy)
Types of Activity
• 4 major domains for Activity in daily life
• For transport – cycling or walking to work,
school, shops
• At work – manual labour
• At home – housework, DIY, gardening
• Leisure time – sport, exercise &
recreation
What are the
recommendations?
F.I.T.T. Principle
1. How often?
2. How hard?
Frequency
3. How long?
Intensity Moderate Level 60-80% M HR
4. What type?
Time
Most days of the week
30 minutes
Type Select activity that you enjoy & is
convenient e.g. walking or cycling
Moderate Intensity (pbt’s)
Moderate Intensity Physical Activity is
described as a level that causes your:
Beat a little faster
Breathe deeper and faster
(but not out of breath)
Brings a little sweat to your
brow
Limitation in role of Health Care
Professionals
• Your own level of exercise
• Knowledge of current messages on physical
activity
• Lack of time in consultation
• Lack of perceived importance of physical activity
• Lack of systems in place
Traditional advice giving: Powers of Persuasion
It’s about Acceptance
• Human nature resists being told what to
do!
Brief intervention to increase
activity levels
Involves opportunistic advice, discussion, negotiation or
encouragement and are delivered by a range of primary and
community care professionals. Varies from basic advice to more
extended, individually focused attempts to identify and change
factors that influence activity levels
Discussion between individuals and GPs, nurses etc are effective
and cost effective in encouraging individuals to be more active
Ref: Public Health Intervention Advisory Committee
NICE Public Intervention Guidance No.2, March 2006
MOVE.EAT.TREAT.
MI is….
• a client centred, directive method for
enhancing intrinsic motivation to change
by exploring and resolving ambivalence
Or……
• a collaborative, goal-oriented style of
communication with particular attention to
the language of change. It is designed to
strengthen personal motivation for and
commitment to a specific goal by eliciting
and exploring the person’s own reasons
for change within an atmosphere of
acceptance and compassion
ICGP- Promoting Physical Activity
eLearning Module
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Developed by ICGP in collaboration with HSE PAC group, Faculty
of Sports & Exercise Medicine, Irish Practice Nurses Association
Aim: support HP in routinely promoting PA in their practice
Free to participate
Competence credits
Distance learning
Module Content:
Evidence base for health benefits of regular exercise
National PA Guidelines for PA
Motivational Interviewing, exercise prescription and GP Referral
Practical suggestions, resources,
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Further support and info
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Email - [email protected]
Tel: - 021 4921643
www.healthpromotion.ie
www.hseland.ie
www.getirelandactive.ie