healthy body, healthy mind john spinks

Healthy Body, Healthy Mind

John Spinks

& Ali McManus

Dr. McManus

EXERCISE

THE VALUE OF EXERCISE

• What do the general public see as the value of exercise?

• What does the Surgeon-General think?

• What do magazines and other sources say?

(from website: www.medinfosource.com/resource/fitnexer.html)

Life Advice About Fitness and Exercise

Today, there is a growing emphasis on looking good, feeling good and living longer. Increasingly, scientific evidence tells us that one of the keys to achieving these ideals is fitness and exercise. But if you spend your days at a sedentary job and pass your evenings as a "couch potato," it may require some determination and commitment to make regular activity a part of your daily routine.

Equal Opportunity Benefits

Exercise is not just for Olympic hopefuls or supermodels. In fact, you're never too unfit, too young or too old to get started. Regardless of your age, gender or role in life, you can benefit from regular physical activity. If you're committed, exercise in combination with a sensible diet can help provide an overall sense of well-being and can even help prevent chronic illness, disability and premature death.

Some of the benefits of increased activity are:

Improved Health • increased efficiency of heart and lungs • reduced cholesterol levels • increased muscle strength • reduced blood pressure • reduced risk of major illnesses such as diabetes and heart disease • weight loss Improved Sense of Well-Being • more energy • less stress • improved quality of sleep • improved ability to cope with stress • increased mental acuity Improved Appearance • weight loss • toned muscles • improved posture Enhanced Social Life • improved self-image • increased opportunities to make new friends • increased opportunities to share an activity with friends or family members Increased Stamina • increased productivity • increased physical capabilities • less frequent injuries • improved immunity to minor illnesses

Effects of exercise in other areas!

Learning ability

Aging

Substance abuse

Better sleep

Greenough…1

• Group 1: free access to exercise• Group 2: treadmill one hour/day• Group 3: no exercise

• After 30 days, gp1 and gp2 had substantial increase in capillary densities in cerebellum

Greenough…2

• Both previous study and this one on rats!

• Taught rats to run through obstacle maze

• Increased number of connections between neurons in cerebellum

• Learning not movement

Kramer, Nature, 1999• 60-75 year olds• Inactive individuals• Test (psychological and physical)• Long walks three times a week for 6m.• 5% - 7% increase in cardio-respiratory fitness• Up to 15% improvement in mental tests• Comparison group did stretching and toning

exercises using weights• Therefore, it’s the TYPE of exercise you do• Argues that effects are due to increasing blood

flow in the brain

Smoking cessation

• 281 smokers, randomly divided into control and experimental groups…

• E…12 sessions of smoking cessation + 3 exercise sessions + 3 health lectures/week

• C…12 sessions of smoking cessation• E twice as likely to be successful in giving up, and

staying off (12% after 60 weeks, cf 5% from C)• E quitters gained less weight than C quitters• May not be that strong (see other reviews)

Sleep better?

• Review of 722 subjects…”regular exercise is associated with a reduction in the prevalence and risk of symptoms of disturbed sleep”

• If walked >6 blocks 33% drop in sleep disturbances

• If walked briskly, 50% drop• If engaged in regular exercise at least once a week

37%

EXCEPT…

• Females exercising regularly and vigorously at weekends 50% increase in sleep disturbances

• Why?

U.S. Surgeon General’s Report on Physical Activity and Health

• THE BENEFITS OF REGULAR PHYSICAL ACTIVITY: • Regular physical activity that is performed on most days of the week

reduces the risk of developing or dying from some of the leading causes of illness and death in the United States. Regular physical activity improves health in the following ways:

• Reduces the risk of dying prematurely. • Reduces the risk of dying from heart disease. • Reduces the risk of developing diabetes. • Reduces the risk of developing high blood pressure. • Helps reduce blood pressure in people who already have high blood

pressure. • Reduces the risk of developing colon cancer. • Reduces feelings of depression and anxiety. • Helps control weight. • Helps build and maintain healthy bones, muscles, and joints. • Helps older adults become stronger and better able to move about without

falling. • Promotes psychological well-being.

U.S. Surgeon General’s Report on Physical Activity and Health

……Mental Health• Physical activity appears to relieve symptoms of

depression and anxiety and improve mood. • Regular physical activity may reduce the risk of

developing depression, although further research is required on this topic.

Health-Related Quality of Life• Physical activity appears to improve health-related quality

of life by enhancing psychological well-being and by improving physical functioning in persons compromised by poor health.

……

Recent headlines(BBC in the U.K.)

Recent headlines(BBC in the U.K.)

Recent headlines(BBC in the U.K.)

Recent headlines(BBC in the U.K.)

Recent headlines(BBC in the U.K.)

Recent headlines(BBC in the U.K.)

STRESS AND EXERCISE

Quiz on stress and sport…

Under high levels of stress, athletes typically have a broad attention span.

T or F?

The clammy feeling we often get when stressed is caused by our body’s natural defence against bleeding to death

T or F?

Quiz on stress and sport…

Elite level performers have fewer nervous reactions to stress than do non-elite level performers.

T or F?

Quiz on stress and sport…

High levels of stress make it more difficult to think more clearly.

T or F?

Quiz on stress and sport…

Caffeine exaggerates the physical and mental effects of stress.

T or F?

Quiz on stress and sport…

The only time stress is good is when there is no stress.

T or F?

Quiz on stress and sport…

Sighing when you exhale is more relaxing than not sighing.

T or F?

Quiz on stress and sport…

Stress in Hong Kong

• Newspaper articles

• How many people in HK suffer from anxiety or stress reactions?

• Estimates are: over 1 million.

• How about HKU students?

Stress

• The concept of stress– Distress and eustress

• Approaches to the study of stress– Stimulus-based approaches– Response-based approaches– Other approaches (coping, appraisal)

Stimulus-based approaches

• Life change events

• Hassles

• Duration

Response-based approaches

• Selye’s views

• Short-term

• Long-term

• Health

• Type A/B

Type A/Type B

• Many factors case heart disease, but cannot predict 100%

• 1974 Rosenman and Friedman

• Type A characteristics

• Type B characteristics

• Test yourself

Effects of Type A/B

• 50-59 year olds Type As have 1.9 times the risk of heart attack cf Type Bs.

• 39-49 year olds Type As have 6.5 times the risk of heart attack cf Type Bs.

• These differences not due to cigarettes, age or heriditary factors

• Recent reviews not so clear

Gender differences

• Male and female Type Bs lowest risk

• Female Type As higher

• Male Type As highest

Response-based approaches

• Biochemical and endocrinological (e.g. increased nor-adrenaline)

• Physiological (e.g. muscle tension)• Autonomic (e.g. high blood pressure)• Immunological (e.g. NKCA)• Emotional (e.g. annxiety)• Cognitive (e.g. challenge)• Behavioural (e.g. run away)• Social (e.g. isolate)• Disease (e.g. ulcers, psychosomatics)

Stress situations

• Work-related stress

• Examination stress (test anxiety)

• Post-traumatic stress disorder (video)

See also video (The Mind #37)

Current views

• Not just stimuli (stressful events)

• It is the personal appraisal of these events

• Reference to self-evaluation of coping ability (past experience)

• And to support systems

Perceivedstress

Stressfulevents

Background characteristics of individual

Stress hormones

Health

Immune system

Mediators:Supports

Self-conceptCoping

ANS activity

A biopsychosocial stress model

Exercise and stress

• Lowers risk of heart attacks (Paffenbarger’s Harvard alumni studies)

• Continues to decrease risk, up to 20 miles/day• Has to be aerobic (sustained, increased O2

consumption), heart pumps more per beat lower heart rate

• Stress HR increase• Cardiovascular conditioning may counteract its

effects

Exercise and stress

• In other words, low levels of exercise HR increase after exercise or after stress anxiety high levels of noradrenaline more anxiety (vicious cycle) less exercise (another vicious cycle)…

• Aerobic exercise, on the other hand low levels of HR increase after exercise or after stress no heightened anxiety less perceived stress

Kathleen Light (1999)

• Men with history of hypertension

• Cardiovascular responsivity to stress predicts risk of hypertension 10 years later

• (Three times greater risk if very responsive)

• Effects of exercise on anxiety, moods, tension and depression more pronounced in subjects who are more stressed or physically unfit before study

If you’ve had a heart attack, should you exercise?

• Experimental group…year long rehabilitation including exercise 3 times per week (Dugmore et al, 1999, UK, 124 pts over 5 years)

1. Cardiovascular differences (E-C) shown 2. Less depression3. Less anxiety4. Required less drugs5. Less likely to visit doctor6. Returned to work earlier7. More likely to return to work full-time

Cholesterol

• Stress arousal Increase in catecholamines increase in plasma lipid levels

• Work-related stressors more clearly associated with cholesterol

• Modifying variables, such as diet, smoking and activity levels, appear to be important determinants of cholesterol levels

• How about in adolescents?

Coleman, Friedman & Burright

• 119 NY high school students (14-17)• Multiple regression…

– Family history | Combined, predicted– Dietary fat | 4% of variance of– Age | cholesterol levels– Daily life events 4%– Physical activity 3%– Season 10%– Sedentary behaviour n.s.– OVERALL 21%

• For females, daily life events 7%

• For males, n.s.

• For major life events, n.s.

• For family life events, n.s.

SO? Does exercise exert its effects on stress through…

• Feel good factor?

• Endorphin hypothesis? (little evidence)

• Social support?

• Distraction hypothesis?

• Cardiovascular conditioning?

Illness

Noexercise

Exercise

High stress

Low stress

How about other relationships?

• Bramwell et al ’75– LEs correlated with sports injuries!– Low LCUs 30% injury rate (U.S. football)– Med LCUs 50%– High LCUs 73%

– Why?

Why?

• Lack of vigilance?

• Attentional focussing?

• Increase in muscle tension?

Smith et al ‘90

• Increases in stress only predicted injuries in those athletes who had low social support

• (= coping/mediational factor; LCUs doesn’t look at this)

Physical Exercise

Physical well-being

Absolute health

Direct effect

Psychological well-being

Socialwell-being

Direct effect Direct effect

Indirect effect

Indirect effect

Indirect effect

Altered ?? Cardiorespiratory fitness Altered body morphologyStrength & muscle tone Co-ordination & skill Morbidity/mortality

Social supportOpportunity for social integrationPositive evaluation of self by others

CognitionAdaptive motivational orientation Adaptive attributional styleSelf esteem Internal LOC

AffectMood stabilityDepression Anxiety

From Schomer & Drake (2001)

Some websites for stress

http://www.bbc.co.uk/health/mens/stress.shtmlhttp://www.bbc.co.uk/health/mental/coping.shtml