Population Division, DESA, United Nations: World Population Ageing

Transcription

1 Population Division, DESA, United Nations: World Population Ageing

2 Population Division, DESA, United Nations: World Population Ageing an additional 30 plus years to life expectancy single fact 2

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4 optimizing opportunities for health, participation and security in order to enhance quality of life as people age. continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force. Active ageing aims to extend healthy life expectancy and quality of life for all people as they age. Maintaining autonomy and independence for the older people is a key goal in the policy framework for active ageing. 4

5 the most viable 5

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7 Early Adult Older Muscle mass / Strength Disability threshold SARCOPENIA Muscle function Birth Age (yr) The rise in the levels of physical inactivity has paralleled the increase in incidence of chronic metabolic diseases 7

8 Changes induced upon decreasing physical activity from high to low levels 2009 by The Physiological Society Booth F W, and Laye M J J Physiol 2009;587:

9 More than 2,000 medicines for older Americans are currently being tested in clinical trials or are waiting for Food and Drug Administration approval Source: Pharmaceutical Research and Manufacturers of America, Medicines in Development for Older Americans on the PhRMA 9

10 Sarcopenia A progressive neuromuscular syndrome that will lower the quality of life in the elderly by: decreasing the ability to lift loads, progressing to difficulty arising from a chair; and decreasing endurance, leading to an inability to perform the activities of daily living, which increases health care costs. Tseng and Booth, 1995 SARCOPENIA MUSCLE MASS MUSCLE MASS ABILITY FOR ADL STRENGTH DYNAPENIA PHYSICAL ACTIVITY PERCEPTION OF EFFORT 10

11 What can offset muscle loss in aging? E X E R C I S E 74 year old sedentary 70 year old triathlete 11

12 Why study resistance exercise? Men, leg strength, and mortality Newman A B et al. J Gerontol A Biol Sci Med Sci 2006;61:

13 Women, leg strength, and mortality Newman A B et al. J Gerontol A Biol Sci Med Sci 2006;61:72-77 Ruiz, J. R et al. BMJ 2008;337:a439 13

14 J Am Coll Cardiol. 2011;57(18): doi: /j.jacc If you accept that strength is a function of skeletal muscle mass, then these data suggest two things: 1.That greater strength/muscle mass means you are at a reduced risk for death, all cause or cancer, especially when you re over 60 years of age 2.As we age we need to practice strategies to retain muscle mass and strength 14

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16 Evidence based 16

17 and 12 hours/ 17

18 Part of the reason for the growing apathy to modify lifestyle habits is that current public health recommendations may be unrealistic and unattainable for the majority of the populace. In our opinion, it seems highly improbable that individuals who presently fail to undertake 30 min of continuous exercise will ever choose to perform double the amount of the same activity. Hawley JA and Gibala MJ. Diabetologia 55: ,

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20 Exercise snacking as a time effective means to control glucose homeostasis Traditional Exercise (CONT) 30 min incline 60% HR max (pre dinner) Oral Glucose Tolerance Test (OGTT) Exercise stress test (12 lead ECG) Exercise Snacking (ES) Composite Exercise Snacking (CES) ~18 x 1 min incline 90% HRmax (pre B, L, D) ~18 x 1 min alternate walking /REX (pre B, L, D) Glycemic control (CGMS) on the day of an exercise intervention Blood glucose concentration (mmol/l) TE CONT ES CES Breakfast Lunch Dinner ES & CES 24h [glucose] by mmol/l vs. CONT (P= 0.01) Francois M et al. Diabetologia 57: ,

21 Exercise snacks before meals: A novel strategy to improve glycemic control in pre diabetics Exercise snacking reduced 24 h mean glucose concentration and this reduction persisted for the subsequent 24. We conclude that dosing exercise as brief, intense 'exercise snacks' before main meals is a time efficient and effective approach to improve glycemic control in individuals with insulin resistance. Francois M et al. Diabetologia 57: , Evidence based 21

22 Optimizing health outcomes through exercisenutrient interactions 22

23 Leg lean mass (kg) 23

24 12000 Mean daily step-count Pre-intervention Post-intervention Leg skeletal muscle mass (kg) Breen et al. J.Clin.Endo.Metab. 98(6), 2013 Pre-intervention Plasma glucose (mmol ml -1 ) Post-intervention Plasma glucose AUC Pre * Post Time (min) Plasma insulin ( lu ml -1 ) Pre-intervention Post-intervention Time (min) Plasma insulin AUC Pre Post Breen et al. J.Clin.Endo.Metab. 98(6), 2013 * 24

25 % change from pre-intervention TNF- IL-6 CRP * * Breen et al. J.Clin.Endo.Metab. 98(6), 2013 Breen et al. J.Clin.Endo.Metab. 98(6),

26 Leg lean mass (kg) Normal Disuse-event Age (yr) Early Adult Older Muscle mass Disability threshold Muscle function Birth Age (yr) 26

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