Slide 1

3.Tobacco use 4.Substance abuse 5.Responsible sexual behaviour 6.Mental health 7.Injury and violence 7.Environmental quality 9.Immunizations 10.Access to health care Leading Health Indicators 1.Physical inactivity 2.Overweight and obesity US National Institute of Health

Slide 2

3.Tobacco use 4.Substance abuse 5.Responsible sexual behaviour 6.Mental health 7.Injury and violence 7.Environmental quality 9.Immunizations 10.Access to health care Leading Health Indicators 1.Physical inactivity 2.Overweight and obesity US National Institute of Health

Slide 3

Academy of Medical Royal Colleges UK Februray 2015

Slide 4

Heart Disease 40% Reduction Two-thirds of the burden of cardiovascular diseases can be attributed to the combination of diet and physical inactivity. Physical activity has a very strong effect in reducing the development of heart disease.17 Studies vary in quantifying the reduction in risk of heart disease as up to 50%, or 20 - 35% lower risk of cardiovascular disease and coronary heart disease. People who change from doing minimal activity to moderate activity have most to gain. Across a population, a move to active travel alone could reduce heart disease by 10%.

Slide 5

Hypertension Exercising regularly reduces the risk of ever developing hypertension by 52%.

Slide 6

Depresion Depression Lifetime risk 33% 50% Obese Patients Depressed Risk Reduction General Population30% There is a 20% to 33% lower risk of developing depression, for adults participating in daily physical activity

Slide 7

Dementia 30% The evidence is fairly consistent in quoting reduced risks of developing dementia at 20-50%. 20,35,77,78

Slide 8

Bowel Carcinoma 45% Reduction Physical activity has a very strong effect in reducing the occurrence of bowel cancer This is quantified at 30-50% lower risk. The 30 to 50% lower risk of colon cancer in men and women across 19 international studies was related to the beneficial effect of exercise on growth factors and insulin resistance

Slide 9

Stroke 30% Reduction Different reports quote exercise as reducing the risk of stroke or of mortality from stroke by 20 - 40%.

Slide 10

Osteoarthritis 50% Reduction Analysing several studies quantified the reduction in risk of developing arthritis by undertaking moderate exercise at between 22-83%.

Slide 11

Risk of diabetes physical activity is proven to reduce the risk of developing type 2 diabetes by 50-80%.

Slide 12

Diabetes Numbers to Treat for Benefit 6.4 Lifestyle including PA 10 Medication but medication more side effects

Slide 13

First 15 Minutes Exercise a day 416,175 people average follow 8years 3 years increase in Life expectancy 15mins/day - 14% reduction all cause mortality Every extra 15 mins/day 4% extra < Mortality Chi Pang Wan et al Lancet Vol. 378-9798 1244-1253 Aug 2011

Slide 14

Exercise in non-diabetics Decreases insulin release Stimulates glucose transport into muscle Therefore, increase in insulin sensitivity 14

Slide 15

Exercise in non-diabetics Increases cortisol, catecholamines Increases glucagon Free fatty acids and liver glycogen to be mobilized for energy 15

Slide 16

BENEFITS OF EXERCISE Increase insulin sensitivity Improved functional capacity Enhanced sense of well- being Reduced risk of CAD Reduced risk of MI Decreased stickiness of blood platelets Reduced risk of High BP Can reduce high BP Decreased triglyceride levels Increased HDL levels Decreased LDL levels Improved HDL / LDL ratio Decreased Body Fat Decreased risk of Osteoporosis Decreased risk of Diabetic associated complications

Slide 17

p

Lifestyle Intervention: Physical Activity Results 74% of volunteers assigned to intensive lifestyle achieved the study goal of > 150 minutes of activity per week at 24 weeks The DPP Research Group, NEJM 346:393-403, 2002

Slide 67

Placebo (n=1082) Metformin (n=1073, p