Step Into Fitness for Life

Relative risk of Heart Attack Step Into Fitness for Life Holy in Every Way Step Into Fitness and Health Don Hall, DrPH, CHES Wellsource, Inc. Fred Hardinge, DrPH, RD May the God of peace make you holy in every way, and may your whole spirit and soul and body be kept blameless until that day when our Lord Jesus Christ comes again. God who calls you is faithful; he will do it. 1 Thessalonians 5:23 2 2009 Wellsource Walking Time and Heart Health Physical Activity and Cholesterol Level All Cause Mortality Men n=25,341 19 yrs. of follow-up n=72,000 women 3 2009 Wellsource Hours of Walking per Week The New England Journal of Medicine 341:650-58 4 2009 Wellsource JAMA, Vol 276. No. 3, pp.205-210 Fitness and C-Reactive Protein Activity & Prevalence of Hypertension Cooper Institute study of 722 men Tested fitness levels and CRP levels High fit men had lower C-reactive protein levels than low fit men Arteriosclerosis, Thrombosis, & Vascular Biology, Nov 1, 2002 C-Reactive Protein Levels Low fit High fit Fitness Level Hypertension (RR) n=2,548 15 year study Least active Men with the highest activity level had lowest rates of high BP Most active Daily Activity Level (Quartiles) 5 2009 Wellsource 6 2009 Wellsource Archives of Internal Medicine, Jan 24, 2005 1

Burns Excess Calories Body Weight, Fitness Level, and Risk of Mortality from All Causes Every minute of activity burns 3-12 times more calories than sitting. Notice the relative increase in calories burned for the various activities listed on the right 7 2009 Wellsource Activity Increased Calories Sitting 1 X Calisthenics 3-8 X Climbing hills 5-10X Biking 10 mph 7 X Aerobic dance 3-9 X Walking, 4 mph 4.3 X Skipping rope, 70/min 9 X Running, 9 min/mile 11 X Tennis 4-9 X Source: ACSM Resource Manual Swimming 4-8 X Relative risk, all cause mortality (n)=25,714 10.1 years of follow-up 8 2009 Wellsource JAMA 282:1547-53 Fitness and Diabetes Risk Walking Reduces Mortality in Diabetics 8,633 men free of diabetes, studied for 6 years Highly fit men were protected against getting diabetes Low fit men were 3.7 times more likely to get diabetes than highly fit men Moderately fit men were 1.7 times more likely to get diabetes than highly fit men Relative Risk of Diabetes Men Annals of Internal Medicine 130:89-96 9 2009 Wellsource Fitness Level n=2896, 8 year study 10 2009 Wellsource Hours of Walking per Week Archives of Internal Medicine 163:1440-47 Physical Activity Protects Against Smoking Physical Activity & Stroke Risk All Cause Mortality Men n=25,341 19 yrs. of follow-up Stroke Mortality (RR) 11 2009 Wellsource Journal Amer Med Assoc 276:205-210 16,878 men, 10 yr follow-up Med & Science in Sports & Exercise, 2002; 34:592-95 12 2009 Wellsource 2

Exercise Best Predictor of Heart Health Fitness as Preventive Medicine In all men, peak aerobic capacity was a better predictor of mortality than: High blood pressure Smoking Diabetes Cholesterol levels Abnormal ECGs History of heart disease NEJM, 346:793-801, Mar 14, 2002 Relative Risk of Death 6,124 men, 6.2 yrs follow-up Least fit Most fit Quintile of Aerobic Fitness Other Conditions Benefited by Physical Activity 13 2009 Wellsource 2009 Wellsource Walking and Risk of Hip Fracture Recreational Activity and Risk of Breast Cancer Hip fracture rate (RR) Low exercise 15 2009 Wellsource Hours walked per week n = 61,200 12 year study High exercise JAMA 288:2300-06 Women s Health Initiative study of 74,171 women followed for 4.7 years 30 minutes of brisk walking daily reduced cancer risk by 18% 1 hour of walking per day reduced risk by 21% 16 2009 Wellsource Breast Cancer (RR) Daily Activity Level JAMA 290:1331-36, Sept 10, 2003 Physical Activity and Colon Cancer Cardiorespiratory Fitness and Cancer Colon Cancer Study in Men 29,133 men, 12 year study Compared to sedentary workers, men doing light activity had 40% less colon cancer Moderate to heavy activity men had 55% less colon cancer Most active men at work and recreation had 67% less colon cancer 17 2009 Wellsource Colon cancer (RR) Cancer Epidemiol Biomarkers Prev, 10:265-8 Study 25,892 men age 30-87, followed for 10 years Results High fit persons had a 55% lower cancer mortality rate than low fit persons even after controlling for smoking, age, BMI, alcohol, and diabetes Medicine & Science in Sports, Exercise, and Fitness 34(5):735-739 18 2009 Wellsource All Cancer mortality (RR) Fitness Level 3

Physical Activity and Mental Health Exercise and Depression Physical activity : Protects against depression Reduces dementia (cognitive decline with age) Reduces symptoms of anxiety Reduces feelings of distress Improves feelings of fatigue Enhances wellbeing 19 2009 Wellsource Summary, Physical Activity Guidelines for Americans, 2008 Study of 156 sedentary, clinically depressed persons They were randomly divided into groups: One group received medication therapy. Another group ran at a moderate pace ½ hour daily but took no medication After 16 weeks their depression was reevaluated Exercisers improved as much as those on medication But, only exercisers showed improvement in mental abilities such as concentration, planning, and organization Source: Duke University Report, 2001 20 2009 Wellsource Miles Walked/Week and Well-Being Physical Activity is Good Medicine Well-Being Scores Note: A high well-being score is desirable 21 2009 Wellsource 5,230 men 1,222 women <1 1-9 10+ 20+ <1 20+ Reference: Medicine and Science in Sports and Exercise 38:173-78, Jan. 2006 All who can possibly do so ought to walk in the open air every day, summer and winter. A walk, even in winter, would be more beneficial to the health than all the medicine the doctors may prescribe. E.G.White, Counsels on Health, 52 22 2009 Wellsource www.instepforlife.com Examples of Physical Activity Physical Activity Guidelines 30+ min of moderate activity, 5+ days/wk 20-30+ minutes of vigorous activity, 3+ days/wk Strength training and stretching, 2-3 times/week Moderate Walking briskly, 3-4 mph Cycling for pleasure, 10 mph Swimming, moderate level Conditioning exercises Golf, carrying/pulling clubs Canoeing/rowing, 2-3 mph Mowing lawn, raking leaves, hoeing in garden Hard/Vigorous Walking briskly uphill or climbing stairs Cycling fast, 12-16 mph Swimming, fast crawl Active sports: Tennis Racquetball Basketball Jogging/running 2009 Wellsource 24 2009 Wellsource 4

Total Activity Time Intensity It s not necessary to do all of your activity at one time. You may want to break it up into Two 15-minute or Three 10-minute sessions 25 2009 Wellsource Two 15-minute sessions Walk 1 mile briskly Ride the stationary bike for 15 minutes in the evening Three 10-minute sessions Walk 10 minutes to work Walk another 10 minutes at noon Mow lawn for 10 minutes in the afternoon Your activities should feel fairly easy to somewhat hard. Your activity should make you breathe deeply but not make you out of breath. A moderate sweat is a good indicator that health benefits are occurring. Always start and end each activity session with a warm-up and cool down. 26 2009 Wellsource Progression Medical Clearance Start with moderate activities 27 2009 Wellsource activities you can do without getting out of breath, that are fairly light to somewhat hard Gradually build up to 30+ minutes per day For higher levels of fitness add vigorous activities or increase activity time after you are used to regular physical activity Most adults do not need to see their physician before starting a moderate intensity physical activity program. However, men older than 40 years or women older than 50 years who plan a vigorous program, Or, anyone with either chronic disease or risk factors for chronic disease, should consult his or her physician to design a safe, effective program. Source: Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol 273, No. 5. 28 2009 Wellsource Fitness and Longevity Harvard Alumni Study In the Good Health Practices study 6,900 people followed for nearly 10 years Level of activity was the best predictor of longevity Adventist Health Study 30,000 people. Physical activity level was the best predictor of a long life The higher the energy expenditure in weekly activity, the lower the risk of death Dr. Paffenbarger found that for every one hour the Harvard alumni exercised, they lived an additional 2 hours in increased longevity Relative Risk of Death, All Causes 29 2009 Wellsource Arch Intern Med 2001;161:1645-52 30 2009 Wellsource Exercise Calories Burned Weekly 5

Physical Inactivity and Risk of Death Do you want to be well? n=2,603 men and women, 12 yrs study, age 60+ Compared to inac>ve persons, those gecng regular physical ac>vity cut their risk of death from any cause by 50 73%. Fitness levels determined from treadmill testing. Jesus asked him, Would you like to get well? Jesus told him, Stand up, pick up your mat, and walk! John 5:6,8 Low Fit 31 2009 Wellsource Fitness Quintiles High fit JAMA 298:2507 16, Dec. 5, 2007 32 2009 Wellsource Join the NAD InStep for Life Walking Challenge It is Primarily a Walking Program Advantages of walking Nearly everyone can walk Safe Inexpensive Encourages social interaction 33 2009 Wellsource 34 2009 Wellsource Set Measurable Goals Record Daily Activity Using one of three methods: Steps per day, e.g. 6,000-10,000 steps/day Miles per day, e.g. 2 aerobic miles per day Minutes of activity, e.g. 30-60 minutes of aerobic activity daily Keeps activity in mind Helps you work towards a specific goal Keeps you faithful Improves long term success 35 2009 Wellsource 36 2009 Wellsource 6

Fitness Buddy Participate in GetFit Adventures Invite family members to join you Spouse Son or daughter Nephew or niece Invite a friend, neighbor, or work associate to join you Make your fitness adventure social and reach out to your community Mountain trails JMT,PCT, AT Trail of the Coeur d Alenes Coastal hikes Oregon Coast Historic journeys Adventist pioneers American revolution International Southern Italy China Hike across Switzerland Bible lands Follow the Steps of Jesus 37 2009 Wellsource 38 2009 Wellsource Church Integration How to Get Started Encourage church members to participate as a group Promote regularly in church Give monthly reports Participation rates Total group miles Give recognition to those achieving their goals Invite participants to share their experiences Give awards 500 Mile Club and the 1,000,000 step club Create a church culture that values activity and health Go to the InStep for Life web site InStepForLife.com Download the starter kit Get a pedometer Start walking Volunteer to be an InStep for Life coordinator in your church or organization (you can sign-up online). 39 2009 Wellsource 40 2009 Wellsource We invite you to join today. Begin enjoying the benefits of regular physical activity. Copies of this presentation will be available at: www.fit4heaven.com Contact: fred@positivechoices.com www.instepforlife.com 42 2009 Wellsource 7

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