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