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