Be active against cancer!
Wednesday, 4th of February
2015 (World Cancer Day)
Everday actions
Professor Nanette Mutrie
Physical Activity for Health Research Centre
University of Edinburgh
4/02/2015
• Physical
inactivity has
reached
‘Pandemic’
proportions
• Inactivity is as
risky as smoking
• July 2012
4/02/2015
How does the risk of inactivity
compare with smoking?
0
1
2
3
4
5
6
7
8
9
10
PAF% deaths caused in millions
smoking
inactivity
Lee et al. , Lancet, July 2012
4/02/2015
Percentage of worldwide
burden of disease caused by
inactivity
0 1 2 3 4 5 6 7 8 9 10
CHD
Breast cancer
Type 2 Diabetes
Colon Cancer
Prem mortality
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 Employmen
t
Research
and
Innovation
Young
People
Early Years Healthier Inequalities
Tackled
Life
Chances
Safe from
Crime
Sustainable
Places
Resilient
Communitie
s
Environmen
t Valued
National
Identity
Impact on
Environmen
t
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
Physical activity time
(hrs/wk)
TV viewing
time
(hrs/wk)
*
*
*
* P < 0.05 vs ref.
Courtesy
Neville Owen
Dunstan et al.
(2005).
Diabetologia
48, 2254-2261.
4/02/2015
Sedentary behaviour
[SHS 2012]
0
1
2
3
4
5
6
7
8
16-24 25-34 35-44 45-54 55-64 65-74 75+
Hours
Age
Men Weekday
Women Weekday
Sedentary behaviour
[SHS 2012]
0
1
2
3
4
5
6
7
8
16-24 25-34 35-44 45-54 55-64 65-74 75+
Hours
Age
Men Weekend
Women Weekend
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, Zderic
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
1) 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 All
Strength & 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 hours
https://www.youtube.com/watch?
v=aUaInS6HIGo
4/02/2015
Everyday Actions | Prof Nanette Mutrie MBE

Everyday Actions | Prof Nanette Mutrie MBE

  • 1.
    Be active againstcancer! Wednesday, 4th of February 2015 (World Cancer Day) Everday actions Professor Nanette Mutrie Physical Activity for Health Research Centre University of Edinburgh 4/02/2015
  • 2.
    • Physical inactivity has reached ‘Pandemic’ proportions •Inactivity is as risky as smoking • July 2012 4/02/2015
  • 3.
    How does therisk of inactivity compare with smoking? 0 1 2 3 4 5 6 7 8 9 10 PAF% deaths caused in millions smoking inactivity Lee et al. , Lancet, July 2012 4/02/2015
  • 4.
    Percentage of worldwide burdenof disease caused by inactivity 0 1 2 3 4 5 6 7 8 9 10 CHD Breast cancer Type 2 Diabetes Colon Cancer Prem mortality Percentage Lee et al. , Lancet, July 20124/02/2015
  • 5.
  • 6.
    Public health guidelineson 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
  • 7.
    % adults achievingminimum recommendations [SHeS 2013] http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey/Publications/Trendtables134/02/2015
  • 8.
    Academy of MedicalRoyal Colleges press release 29/1/15 ‘Major NHS action needed to tackle physical inactivity – say Scottish medical leaders’ 4/02/2015
  • 9.
    Goals By the endof 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
  • 10.
    Business Employmen t Research and Innovation Young People Early YearsHealthier Inequalities Tackled Life Chances Safe from Crime Sustainable Places Resilient Communitie s Environmen t Valued National Identity Impact on Environmen t 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
  • 11.
    What is sedentarybehaviour? – 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
  • 12.
    Odds of MetabolicSyndrome in Women – TV Viewing and Physical Activity Physical activity time (hrs/wk) TV viewing time (hrs/wk) * * * * P < 0.05 vs ref. Courtesy Neville Owen Dunstan et al. (2005). Diabetologia 48, 2254-2261. 4/02/2015
  • 13.
    Sedentary behaviour [SHS 2012] 0 1 2 3 4 5 6 7 8 16-2425-34 35-44 45-54 55-64 65-74 75+ Hours Age Men Weekday Women Weekday
  • 14.
    Sedentary behaviour [SHS 2012] 0 1 2 3 4 5 6 7 8 16-2425-34 35-44 45-54 55-64 65-74 75+ Hours Age Men Weekend Women Weekend
  • 15.
    How adults andchildren 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.
  • 16.
    Why is sittingbad 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
  • 17.
    Why is sittingbad 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, Zderic 4/02/2015
  • 18.
    Why is sittingbad 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
  • 19.
    Why is sittingbad 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
  • 20.
    Biwas et al(2015) Annals of Internal Medicine 162, 126-132 4/02/2015
  • 21.
    Cancer incidence predictedfrom self- reported sedentary time and controlling for physical activity 4/02/2015
  • 22.
    Every day actionsfor you and your clients Sit less Walk more 4/02/2015
  • 23.
    The ABC ofPhysical 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
  • 24.
    Stand up anddiscuss with neighbour •When and how could you find ways to sit less at work or at home? 4/02/2015
  • 25.
    Sit less atwork 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
  • 26.
    Take mini activitybreaks 4/02/2015
  • 27.
    Take mini activitybreaks 4/02/2015
  • 28.
    For almost everyonethe 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 1) Confers all the major benefits of activity 4/02/2015
  • 29.
    Stand up anddiscuss with neighbour • When and how could you find ways to walk more at work or at home? 4/02/2015
  • 30.
    Walk more • Takepublic 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
  • 32.
    Find out more: www.pathsforall.org.uk Finda Health Walk near you: www.pathsforall.org.uk/findahealthwalk 4/02/2015
  • 33.
  • 34.
    Paths for All Strength& Balance Programme 10 simple exercises that will improve strength and balance and reduce the risk of falls in older adults 4/02/2015
  • 35.
    Dr Mike Evans23 ½ hours https://www.youtube.com/watch? v=aUaInS6HIGo 4/02/2015