Women s s Health and Fitness. Michele Kettles, MD, MSPH Director of Education Cooper Clinic Dallas, TX

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1 Women s s Health and Fitness Michele Kettles, MD, MSPH Director of Education Cooper Clinic Dallas, TX

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3 Men and Women: Anatomy The female pelvis is shallower and wider and has anterior tilt. Female Male Reprinted by permission from A. Cowlin, 2002, Women s Fitness Program Development, Champaign, IL: Human Kinetics, p4.

4 Men vs. Women: Dynamics of landing

5 Men and Women: Anatomy The female pelvis is shallower and wider and has anterior tilt. Women have more tendency to genu valgum or knock knees. Males generally have more stable posture when landing from a jump or changing direction. These differences result in more knee stress (patellofemoral stress syndrome) and increased risk for ACL (anterior cruciate ligament) injury for women.

6 Men and Women: Physiology Women have (on average) 10% higher body fat. Men have 30-50% more upper body strength. Women have smaller hearts with lower stroke volume. Men have 10% more hemoglobin Women have menstrual symptoms that may affect performance.

7 The Female Heart

8 Fitness and Health: CV disease Regular walking lowers risk of coronary events Prolonged sitting increases risk of coronary events The amount of benefit in reducing coronary events is proportional to the duration of exercise For stroke, intensity of exercise correlates with risk reduction

9 Fitness and Health: CV disease Aerobic exercise lowers risk of cardiovascular disease and stroke by: Reducing blood pressure Improving the cholesterol profile Reducing inflammation in the blood vessel walls Treating/preventing type 2 diabetes mellitus Reducing body weight

10 Fitness and Health: Blood pressure Exercise lowers blood pressure in people with and without hypertension. The effect is more pronounced in people with hypertension than those who have normal blood pressure The type, frequency, and intensity of aerobic exercise don t t seem to matter. All aerobic exercise lowers blood pressure

11 Fitness and Health: Cholesterol Exercise improves multiple cholesterol panel measures. Those who exercised more often and more intensely received the most benefit, including reduction in the percentage of small cholesterol particles Resistance training decreases total cholesterol, LDL cholesterol, and total cholesterol/hdl cholesterol ratio

12 Women and Cancer

13 Fitness and Health: Cancer Colorectal cancer risk is clearly decreased in those who are regularly physically active. Higher levels of activity reduce risk by about 50 percent! Physical activity may decrease the risk of endometrial cancer. Physical activity may decrease the risk of pancreatic cancer, especially among those who are overweight.

14 Fitness and Health: Cancer The results regarding the relationship between breast cancer and physical activity are mixed. Results are mixed regarding ovarian cancer. Some studies show no effect, some show a protective effect, and others show increased risk of ovarian cancer with regular exercise.

15 Women and Diabetes

16 Fitness and Health: Diabetes The more frequent and vigorous the exercise, the lower the risk of developing type 2 diabetes. Sedentary behaviors (sitting, watching TV) predicted risk for diabetes independent of exercise level. Sedentary behaviors must be reduced AND exercise activity increased to reduce risk for type 2 diabetes.

17 Fitness and Health: Diabetes Regular physical activity may have a more powerful protective effect against type 2 diabetes for women than for men. In people at risk for type 2 diabetes, regular physical activity as part of intensive lifestyle change had a greater benefit than treatment with glucose-lowering lowering medication.

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21 Exercise and menopause

22 Inactivity and aging

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24 Fall prevention is a must In an average year, 20-30% of people over age 65 will fall For the most part, adults who do not fall will not fracture their hip or forearm. Reducing the risk of falling is likely to be as important as improving bone density in reducing the incidence of fractures.

25 Fall prevention Those who fall on their outstretched hands are more likely to fracture a wrist and less likely to fracture a hip than those who fall on their hip. Those who fall on their hip but have a substantial amount of fat or muscle padding over their hips have less risk of fracture than those who have little padding.

26 Fall prevention The most dangerous room is the bathroom install grab bars, non skid mats/strips, bath chair/bench. Don t t use bath oils Use night lights and stair handrails, secure rugs, avoid stepstools/ladders, wear safe shoes, correct vision, stand up slowly, beware drug side effects

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28 Types of Exercise Aerobic or (cardiovascular) Strength and Stability Flexibility

29 Exercise prescription Aerobic (cardiovascular) exercise should be done at least 3 times a week for at least 30 minutes Strength/stability training should be done at least 2 times a week and is critical as we age Flexibility work can be done daily

30 Aerobic exercise So many choices

31 Excuses and Solutions Most common excuses for lack of structured exercise in lifestyle: I don t t like structured exercise I don t t have 30 minutes at any one time during the day I am running around all day long; I think I get enough activity that way

32 If you don t t like structured exercise be active!

33 If you don t t have 30 minutes take take 10! Exercise for 10 minutes at least 3 times a day (walk before work, walk at lunchtime, play basketball with the kids after work) If you choose this option, make sure your exercise intensity is at least moderate If you choose this option, make sure you do it EVERY day

34 If you run around all day prove it! Do a treadmill test, OR Use a pedometer Pedometers should count every step taken (doesn t require you to enter stride length, doesn t t report calories burned, etc) Test it: Walk and count 100 steps. The pedometer should be within 5 steps of being correct. Monitor yourself for a week, then start goal setting. Start small and increase goal every few weeks Target: achieve 10,000 steps (about 5 miles walking) per day

35 Aerobic exercise the next step Cross training - Try new activities! Interval training Do high intensity spurts of exercise during your usual activity.

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38 Strength training

39 Strength training - a fountain of youth

40 Strength

41 Strength and stability

42 Strength and more stability

43 Stability

44 Flexibility

45 Flexibility

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47 Exercise programs must be individualized

48 Sample individualized training Aerobic exercise program Walk 3 times a week for 30 minutes Aquatic exercise once a week Strength/stability Free weights/machines once a week Pilates once a week Flexibility Yoga/stretching most days of the week

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