A joint Faculty of the Royal College of Physicians of Ireland (RCPI)
and the Royal College of Surgeons in Ireland (RCSI)
Exercise as part of a Healthy
Lifestyle
Dr Laurence J Conway
Sports and Exercise Medicine Specialist.
FSEM RCSI &RCPI
Humans
• Hunter gatherer
• Brain development
required energy
• Hunter survived
because of endurance
Where has evolution led us?
Where has evolution led us?
• Lessons from the
aboriginal people of
Australia
• Less Hunting/more
gathering due supply
Where are we today?
• What is Best indicator
risk of death in next 10
years?
Where are we today?
• What is Best predictor
of mortality risk in next
10 years?
• Exercise Capacity =
Aerobic capacity
Exercise is the best medicine
Relative Risk of CVD
Relative Risk Score
1
1.0
0.8
0.68
0.6
0.4
0.37
0.2
0
0
1-59 min 1.0-1.5 h
0.33
>2h
Time Spent Walking per Week
Mansoon JAMA, 2001, 285:1447
First 15 minutes of Exercise per day
• 3 year increase in Life expectancy
• First 15min/day: there is 14% reduction all causes
mortality
• Every extra 15 min/day there is a further extra 4%
reduction mortality
Exercise = Treatment and Prevention
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Dose = Intensity + Duration
Frequency = Frequency
Treatment is life long
Risk Benefit ratio
• Side effects
How do we Reduce risk?
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Start at realistic level
Build up slowly
Exercise should be FUN
As a group or on own
Warm up
Cool Down
Stretch
No intense exercise after
meals
• Medical assessment?
Disease Prevention
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Cardiovascular disease
Diabetes Mellitus
Cancers
Obesity
Bone Health
Mood/stress
Immune function
Cognitive function
Mobility / risk falls
Treatment
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Heart or Vascular Disease.
High Blood Pressure
Cholesterol
Obesity
Diabetes Mellitus
Cancers
Osteoarthritis
Osteoporosis
Respiratory illness
Mood
Cognitive Function
Neurological Disorders
Exercise; the Cost Benefit ratio
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Effective
Low Cost
Effects multiple related problems
Prevention other disease
Quality of Life benefit
Socialisation of isolated
• Dose tailored to individual
Men
Women
No Physical Exercise During a 7-Day Period
40
37
33
30
Percent
27
20
26 27
21
21 21
18 17
10
0
14
11
1988
2002
18-34
1988
2002
35-54
1988
2002
55+
Slan Survey 1999
Why are people inactive?
Why are people inactive?
• No Time
– Work
– Family
• Cost
• Lost the Habit
• Poor motivation/mood
due inactivity
• Health issues
• Social isolation
• Hard first few sessions so
stop
How do we get message to those that
need it the most
• How do we change
lifestyle
• Those that need change
are not here
Psychological states of change
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Pre contemplation
Contemplation.
Preparation
Action
• Maintenance
Lifestyle
• Diet
Quantity
Quality
Timing
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Hydration
Risks Tobacco
Leisure drugs
Healthy BMI
Positive Mental Attitude
Rewards in life
7 areas of Investment
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Schools
Transport
Urban Design
Health Care
Public Education
Community
Sports for all
Schools
• Greater opportunity
National Schools
• Ways to keep girls
active through out
secondary
• Insurance issue
• Develop physical
Literacy Curriculum
Transport
• Walking & Public
Transport
• Cycling
• Drive children to school
Urban Design
• New Housing Estates
• Safe Friendly
environment
• Urban Plan; Green areas
Sports Facilities
Cycle tracks
Local facilities
Health Care
• 47% Primary Care
Doctor say they ask
about exercise
• 13% Patients report
getting advice about
exercise
• What can Medical
Profession do?
What Can Medical Profession do?
• Ask people about
exercise
• Give green prescriptions
• Do not tell people to
stop exercise
• Modify where possible
What Can Medical Profession do?
• Educate doctors &
student in exercise
prescription
• Increase medical
profession awareness
• Role Models
• Help remove barriers;
– Cost
– Time
– Educate
Public Education
• Media need to have
consistent clear
message
• Irish innovation
National Physical Activity Guidelines
‘Get Ireland Active’
www.getirelandactive.ie
Community
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School
Public
Private sector
Fitness Industry
Activity for ALL
Balance life
• Work Life balance
• We need find place all
parts of our life
• Look Positive
• Beware of negative
thoughts
• Goal setting
Work Life Balance
• Stressors
Recovery
_____________________________________
Financial
Work related
Social
Health
Exercise
Sleep
Food
Social life
Rewards
Exercise
Health and Quality of life