Anabolic Exercise for Health

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۱ Inactivity and Chronic Disease “Indeed, with the possible exception of diet modification, we know of no single intervention with greater promise than physical exercise to reduce the risk of virtually all chronic diseases simultaneously” Booth et al, JAP 2000 

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ECU 

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“there has been an epidemic Cost of emergence of . modern chronic Chronic diseases in the Disease latter part of the 20" century” “costs in the USA are now approaching $1 trillion” 

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Only fighting half of the battle: being reactive ¢Medical research and treatment is focused almost entirely on secondary and tertiary prevention ‏كنت‎ prevention is cheaper, more effective, and far less painful 3 

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“There is no pharmacological intervention that holds a greater promise of improving health and promoting independence in the elderly than does exercise” Evans & Campbell, Journal of ae 

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*leading cause of death among Australians in Cardiovasc 2000 °49,741 deaths or 39% 192 16 of all deaths. . . *coronary heart disease in Australia 53% *stroke 25% eheart failure 5% *peripheral vascular disease 5% Australian Institute of Health and Welfare a A NAPS aTia te TI RATER OND: 

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‎ac ce A Ce ale aca al‏ م۱ 

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*Loss of muscle mass and function °60% of over 80yrs eAnabolic exercise most effective strategy to prevent or reverse sarcopenia 

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Grdunds, M.D. Biogerontology, 2002 

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* Diabetes is the a world's fastest 22 Diabetes It's Australia's sixth leading cause of death *Over one million Australians have it — but 50% are as yet unaware eFvery 10 minutes someone is Giagnhes eri tahetesaustralia.com:au/ 

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Age-specific prevalence of impaired glucose tolerance, 1999- 2000 Age (years) Men% Women 2 4.9 2.1 ماري 8.5 4.8 35-44 112 5.4 45-54 ‎ae) 192‏ 55-4 )22,9 70۳۹ 65-74 20:7 25:5 7۳ Source: Dunstan et al. 2001. *Metabolic stage between normal and diabetes *Risk factor for Type 2 diabetes °Also greater risk of heart disease Much higher in physically inactive AE Be ets a 

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ECU ¢“In addition to controlling weight, physical activity also improves the body’s ‏رصتلاعط متا وا تاتوجهو‎ helping to lower blood sugar.” ¢“Even a single bout of vigorous physical activity will have an immediate effect on insulin sensitivity.” 

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°Exercise improves insulin resistance *Beneficial for Resistan preventing and treating type 2 ce ۲ diabetes Exercise e Aerobic exercise and hindered in older, ۰ obese, co-morbid Diabetes patients eAnabolic exercise sate and effective Willey and Singh. Diabetes Care, c 2003 

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Physical Activity and Diabetes *It is estimated that appropriate levels of physical activity could prevent 30-50% of new cases of Type 2 diabetes *Benefits for preventing and treating diabetes occur only with regular sustained physical activity 

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Anabolic Exercise and Osteoporo sis 61 ۵۷ 1 Archives of Physical Medicine & Rehahilitatinn 2002 °Evidence is conclusive *Lifelong physical 9۵2۱۵2۵۱2 999۵6 preventative effect eAnabolic exercise - greatest efficacy °Example* °1 year study of strength and endurance training °1.3% increase BMD in training group °1.2% decrease fo (+2۹ ۳ 

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*Increased function e.g. stair climb and descend, chair rise, walking Anabolic *Reduced ratings of Exercise pain Reduced stiffness *Studies report anabolic 2 2۵ exercise to be “safe, effective and well tolerated. in OA patients” 

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Anabolic Exercise and Rheumatoi d Arthritis Hakkinen, A. 2002 and 2003 °Feasible and safe in selected patients with well-controlled RA *Significant improvements in strength, pain, and fatigue Without exacerbating disease activity or joint pain. 

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*People who are physically inactive are < nearly twice as likely to Physical develop colon cancer ivi (Colditz et al. 1997). activity ¢Physical activity is also and associated with around a 30% reduction in the oe risk of women of all risk ages developing breast cancer (Thune & Furberg 22001 

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*Disease and treatment usually results in debilitating fatigue Research examining exercise programs pre surgery and/or during treatment ¥ Increased vigor ¥ Reduced muscle and bone loss ¥ Enhanced immune function Y Possible increase survival Y Positive psvchological 

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¢Physical inactivity - risk Mental ‏1ه‎ Illness, ¢Mechanism unknown ¢Physical activity - strong positive effect ¢Slows progression of disease eAgeing population - dementia will become major problem 

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eEpidemiological studies into Alzheimer disease indicates physical activity ~ appears beneficial, as does a diet with high levels of vitamins B6, B12 and folate, while red wine in moderate quantities also appears | protective Epidemiolo De A eR ee ES eee eRe Yee gE a eee ee meee ELE 

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Cholesterol aa ¢Exercise and nutrition demonstrated effects on: *Lowered TC *Lowered LDL-C eIncreased HDL-C *Lowered triglycerides Scranton, R,, et al. Predictors of 14-year changes in the total cholesterol to ۱ a ea Ie ‏الفمسمل تمع سمعتع صا .صعتم صذ‎ 147)6(:1033-1 038, 4 

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Hypertension *Exercise can lower BP in patients with stage 1 and 2 essential hypertension eAverage reduction in BP is 10.5 mm Hg ee Kokkinos, P. F., P. Narayan, and V. Papademetriou. 001 Hertel ieee ae oe 3 

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Obesity and Overweight aa Combination of exercise and dietary modification is the only effective long- term strategy for controlling body, weight 3 ۳ ae 

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°Multifactorial Falls - ۰۲۳۵1۱06 0۴ 0۳۹1۱0۵1 ۵ 2/۸ interventions proven successful eAnabolic exercise reverse loss of muscle strength and slows bone loss - critical ا ينا 

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وی Your MOTHER /s MAKING OUTSTANDIN PROGRESS WITH HER HIP REPLACEMENT, 

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Edith Cowan Universit Seen eae ar 77 ‏هل ناو‎ Oe pea eee eaters ECU's origins go back to 1902 when it began as a Peerage ma SORT ee 506020 ‏ل‎ Te ۱ esa Oe eee) Churchlands, Mount Lawley and Joondalup and a regional campus in Bunbury, a city 200kms south of ‏تروط‎ Dee Re Ree ee eee ge ec Den Eee eee Bat ea rere 1 Rar em cane) lore te ee eM er tas oe eet) Pee ee aed eae eee ema ‏براتصب‎ ا ‎ae AE ae Sh ie Aa‏ ور 

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°Certificates - 0 ort ۱ offered ۲ ‏ا لدان‎ Fxercis 6 0 Science Wellness *Degrees offered :3 *Bachelor of Science 0 ” 1۳۹ (Sports Science) *Masters and PhD by research إلا , °*Masters of Exercise 

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لامع ‎ECU Wellness‏ °Training and certification * Professional development 2 F/O ap ye Ltn eye ‏سك بسي‎ 

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wwgh-ecu.edu.au 

Anaboli c Exercis e for Presented by: Dr. Robert Newton in Foundation Professor Exercise Science Edith Cowan University “Indeed, with the possible exception of diet modification, we know of no single intervention with greater promise than physical exercise to reduce the risk of virtually all chronic diseases simultaneously” Booth et al, JAP 2000 2 Physical Inactivity and Chronic Disease •slow progress, long continuance •individual crosses threshold - ‘‘clinical horizon’’ to manifest •mechanisms underlying active long before outwardly affected 3 Chronic Disease “there has been an epidemic emergence of modern chronic diseases in the latter part of the 20th century” “costs in the USA are now approaching $1 trillion” 4 Cost of Chronic Disease •coronary heart disease (atherosclerosis, heart failure, hypertension, and stroke) •obesity •Type 2 diabetes •some cancers •osteoporosis •sarcopenia 5 Examples of Major Chronic Diseases •Medical research and treatment is focused almost entirely on secondary and tertiary prevention •Primary prevention is cheaper, more effective, and far less painful 6 Only fighting half of the battle: being reactive instead of proactive “the human genome evolved over at least the last 45,000 years within an environment of high physical activity” “the current human genome expects and requires humans to be physically active for normal function and 7 We are programme d for physical activity “There is no pharmacological intervention that holds a greater promise of improving health and promoting independence in the elderly than does exercise” Evans & Campbell, Journal of Nutrition, 1993 8 •~ 250,000 deaths per year in the US are premature due to physical inactivity •increases incidence of at least 17 unhealthy conditions •almost all of which are chronic diseases or considered risk 9 Physical Inactivity and Chronic Disease 1 •Physical inactivity ranks second only to tobacco smoking in terms of the burden of disease from risk factors in Australia. •6% (second highest burden for men) of the total burden of disease and injury among males Physical Inactivity and Chronic Disease…2 •Adult participation in sufficient physical activity for a health benefit declined from 62% in 1997 to 57% in 2000. •Overweight and obesity remains a serious problem, affecting around 65% of men, 45% of women and 22% of children aged 2-17 1 Physical Inactivity and Chronic Disease…3 •leading cause of death among Australians in 2000 •49,741 deaths or 39% of all deaths. •coronary heart disease 53% •stroke 25% •heart failure 5% •peripheral vascular disease 5% 1 Australian Institute of Health and Welfare Cardiovascu lar Disease in Australia How important is physical activity? image from http://www.cotavic.org.au/ “Living Longer Living Stronger” 13 •Loss of muscle mass and function •60% of over 80yrs •Anabolic exercise most effective strategy to prevent or reverse sarcopenia Sarcopenia image from http://www.cotavic.org.au/ 14 •nutrition (undernutrition and lack of Causes of vitamin D) Sarcopenia •decreased hormone levels (e.g growth hormone, testosterone) •reduced physical activity particularly high intensity •loss of nerves that Grounds, M.D. Biogerontology, 2002 image from http://www.cotavic.org.au/ 15 •Diabetes is the world's fastest growing disease Diabetes •It's Australia's sixth leading cause of death •Over one million Australians have it — but 50% are as yet unaware •Every 10 minutes http://www.diabetesaustralia.com.au/ someone is diagnosed 16 Age-specific prevalence of impaired glucose tolerance, 19992000 Age (years) Men% Women % 25–34 2.1 4.9 35–44 4.8 8.5 45–54 8.4 11.2 55–64 14.8 15.2 65–74 20.4 22.9 75+ 25.5 20.7 Source: Dunstan et al. 2001. •Metabolic stage between normal and diabetes •Risk factor for Type 2 diabetes •Also greater risk of heart disease •Much higher in physically inactive 17 Impaire d Glucose Toleranc e •“In addition to controlling weight, physical activity also improves the body’s sensitivity to insulin, helping to lower blood sugar.” •“Even a single bout of vigorous physical activity will have an immediate effect on insulin sensitivity.” 18 Impaire d Glucose Toleranc e •Exercise improves insulin resistance •Beneficial for Resistan preventing and ce treating type 2 Exercise diabetes •Aerobic exercise and hindered in older, Diabetes obese, co-morbid patients •Anabolic exercise safe and effective Willey and Singh. Diabetes Care, 2003 19 •It is estimated that appropriate levels of physical activity could prevent 30-50% of new cases of Type 2 diabetes •Benefits for preventing and treating diabetes occur only with regular sustained physical activity 20 Physical Activity and Diabetes •Evidence is conclusive •Lifelong physical activity has strong Anabolic preventative effect •Anabolic exercise Exercise greatest efficacy and •Example* •1 year study of Osteoporo strength and sis endurance training •1.3% increase BMD in training group •1.2% decrease for *Kemmler et al. Archives of Physical Medicine & 21 •Increased function e.g. stair climb and descend, chair rise, walking •Reduced ratings of pain •Reduced stiffness •Studies report anabolic exercise to be “safe, effective and well tolerated in OA patients” 22 Anabolic Exercise and Osteoarthr itis •Feasible and safe in selected patients with well-controlled RA •Significant improvements in strength, pain, and fatigue Without exacerbating disease activity or joint pain. 23 Anabolic Exercise and Rheumatoi d Arthritis Hakkinen, A. 2002 and 2003 24 •People who are physically inactive are nearly twice as likely to develop colon cancer (Colditz et al. 1997). •Physical activity is also associated with around a 30% reduction in the risk of women of all ages developing breast cancer (Thune & Furberg 2001). Physical activity and cancer risk 25 Increased vigor Reduced muscle and bone loss Enhanced immune function Possible increase survival Positive psychological Exercise for Cancer Patients Anabolic Exercise •Disease and treatment usually results in debilitating fatigue •Research examining exercise programs pre surgery and/or during treatment •Physical inactivity - risk factor •Mechanism unknown •Physical activity – strong positive effect •Slows progression of disease •Ageing population – dementia will become major problem 26 Mental Illness, Dementia, Alzheimer ’s •Epidemiological studies into Alzheimer disease indicates physical activity appears beneficial, as does a diet with high levels of vitamins B6, B12 and folate, while red wine in moderate quantities also appears protective 27 Epidemiolo gy McDowell, I. Alzheimer's disease: insights from epidemiology. Aging-Clinical & Experimental Research. 13:143-162, 2001. Cholesterol •Exercise and nutrition demonstrated effects on: •Lowered TC •Lowered LDL-C •Increased HDL-C •Lowered triglycerides 28 Scranton, R., et al. Predictors of 14-year changes in the total cholesterol to high-density lipoprotein cholesterol ratio in men. American Heart Journal. 147(6):1033-1038, 2004 Hypertension •Exercise can lower BP in patients with stage 1 and 2 essential hypertension •Average reduction in BP is 10.5 mm Hg for systolic and 7.6 mm Hg for diastolic BP Kokkinos, P. F., P. Narayan, and V. Papademetriou. Exercise as hypertension therapy. Cardiology Clinics. 19:507-516, 2001. 29 Obesity and Overweight •Combination of exercise and dietary modification is the only effective longterm strategy for controlling body weight 30 •accidental falls for > 65 years $83 million in 2001/02 •1.5 % of health expenditure in WA •cost per fall was $6,500 31 •Personal and family cost much larger Falls - Cost •Multifactorial •Range of physical activity interventions proven successful •Anabolic exercise reverse loss of muscle strength and slows bone loss – critical 32 Falls Prevention •Must reverse our concept of “gentle exercise” •To maintain function, reduce chronic disease, enhance quality of life – MUST simulate preindustrial revolution! 33 Deficiencies of some physical activity programs for seniors •Clearly life-long physical activity including resistance exercise is crucial to maintaining optimal structure and function into old age •Primary prevention is imperative! image from http://www.cotavic.org.au/ 34 Life-Long Prevention Strategy http://www.ucomics.com/closetohome/ 2004/03/07/ 35 Fighting Fit?? Edith Cowan Universit y International enrolments exceed 3,000 with students originating from more than 80 countries. ECU's origins go back to 1902 when it began as a teaching college. Today it is Western Australia's second largest university with almost 23,000 students. The University has three metropolitan campuses in Churchlands, Mount Lawley and Joondalup and a regional campus in Bunbury, a city 200kms south of Perth. 3 More than 330 courses are offered through the five faculties: Business and Public Management; Computing, Health and Science; Communications and Creative Industries, which incorporates the Western Australian Academy of Performing Arts; Community •Certificates offered •Personal Training •Women’s Wellness •Degrees offered •Bachelor of Science (Sports Science) •Masters and PhD by research 3 •Masters of Exercise Sport and Exercise Science ECU Wellness •Training and certification •Professional development 3 Than k You www.ecu.edu.au 39