Physical
Activity
for LIFE
February 7, 2010
Rick Seip, PhD
Research Scientist, Genomas,
Inc.
& Senior Scientist (per diem)
Preventive Cardiology
Hartford Hospital
rseip@harthosp.org
860-545-5005
Who is this fitness expert?
Billy Blanks, 7 time World Champion in karate
Inventor of “Tae Bo”, combination of boxing and tae kwan do
Jack LaLanne
Overweight?
You’ve
gotta start
Who is
this
fitness
proponent?
MOVIN!!!
10,000 counts per day
Guidelines for healthy adults < age 65
Basic recommendations
from ACSM and AHA (2007):
Do moderately intense cardio 30 minutes a day,
5 days a week
Or
Do vigorously intense cardio 20 minutes a day,
3 days a week
And
Do eight to 10 strength-training exercises,
eight to 12 repetitions of each exercise
twice a week.
http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=CM/HTMLDisplay.cfm&CONTENTID=7764
Mortality Rates, 1900
Cause
33%
Pneumonia
11.8
Tuberculosis
Tuberculosis
Diarrhea Enteritis
11.3
8.3
HeartDisease
Disease
Heart
Liver Disease
6.3
5.2
Injuries
Injuries
Cancer
4.2
3.7
Senility
Senility
2.9
Diptheria
2.3
0
2
4
6
8
10
% of All Deaths
Source: Healthy People 2010, US Dept HHS
12
14
Mortality Rates, 2004
Heart disease
57%
28
Cancer
22.75
Stroke
Cause
6.4
5.2
4.5
COPD
Unintentional Injuries
Diabetes
3
2.7
2.6
1.7
1.4
Pneumonia
Alzheimer's
Kidney Disease
Septicemia
0
10,000 counts per day
5
10
15
20
25
30
% of All Deaths
Source: U.S. National Center for Health Statistics, Health, United States, 2005
Physical Activity on the JOB...
• 1900’s:
– 40% of occupations
developed or
required a high
level of fitness
• 1990: only 5% of
occupations require
high level of physical
fitness
– delivery person
– bicycle messenger
– airport baggage
handler
– various laborers
(farmers?)
– waiter, bellhop, valet
Increase Your “Health Span” . . .
Cardiovascular Disease
Obesity & Type II Diabetes
Mobility, Fall Prevention,
& Osteoporosis
Risk Factors for Coronary Heart Disease
• Modifiable
Nonmodifiable
– Dyslipidemia
– Age
 High LDLcholesterol
– Sex
 Low HDL-cholesterol
– Family history of premature
CHD
 High TGs
– Smoking
– Hypertension
– Diabetes mellitus
90% of those diagnosed
with CHD have at least one
of the four top risk factors
– Obesity
– Dietary factors
– Thrombogenic factors
– Sedentary lifestyle
Wood D, et al. Atherosclerosis. 1998;140:199-270.
Development of Atherosclerotic
Plaques
Fatty streak
Normal
Lipid-rich plaque
Foam cells
Fibrous cap
Thrombus
Lipid core
Ross R. Nature. 1993;362:801-809
Drug that Affect Serum Lipids
Drug class
LDL
HDL
Statins *
18-55%
 5-15%
Fibrates
5-20%
10-20%
20-50%
Nicotinic acid
5-25%
15-35%
20-50%
Resins
15-30%
3-5%
TG
7-30%
no 
NCEP ATP III. JAMA. 2001;285:2486-2497.
* Lipitor ® (atorvastatin), Crestor® (rosuvastatin), Zocor ® (simvastatin),
Pravastatin ® (pravachol), Mevacor® (Lovastatin); lovastatin was isolated from
Chinese red yeast rice
10,000 counts per day
Hypertension
• Systolic BP > 140 mmHg
• Diastolic BP > 90 mmHg
MILD HYPERTENSION
• Systolic BP
• Diastolic BP
130 - 140
80 - 90
How can Physical Activity
Improve Your Health?
• CR Fitness, Calorie
Expenditure, Low
Fat diet, Stop
Smoking, Active
Relaxation
• Obesity & Diabetes • Calorie Expenditure
• Cardiovascular
Disease
• Osteoporosis &
Fall Prevention
• Dietary calcium,
Vitamin D,
Resistance Training,
Flexibility Exercises
“Walking may be the only
physical activity suitable for the
entire lifespan”
P.O. Astrand, Swedish physiologist
Walking 1 mile
requires 80-100 kcal
energy expenditure
Energy Expenditure of Walking
(kcal per mile)
Min /
mile
30.00
24.00
20.00
17.14
15.00
13.33
12.00
Your Body Weight (lbs.)
132
154
176
198
80
93
106 120
73
86
98
110
69
81
92
104
66
77
88
99
64
75
85
96
62
73
83
93
61
71
81
91
A Long-Duration (118-day) Backpacking Trip (2669 km)
Normalizes Lipids Without Medication: A Case Study
DAY 89
DAY 118
%
Change
Chol 276
189
196
- 29
Trig
319
111
79
- 75
HDLc 41
68
63
+ 37
LDLc 167
99
118
- 29
5’ 7”
170 lbs
25.5
-13
-13
3130
48.7
25.5
+14
+36
+52
124
78
-6
-20
PRE
Ht
5’ 7”
Wt 188 lbs
BMI 29.4
Calories Eaten
2738
SatFat 35.7
Fiber 16.7
SBP 132
DBP 98
2653
31.9 g
31.7
Modal Travel in Urban Areas:
Europe and North America Percent of Trips
by Mode
Country
Netherlands
Germany
England
Italy
Canada
USA
Bicycle
Walking
Public
Transport
30
12
8
5
1
1
18
22
12
28
10
9
5
16
14
16
14
3
Transportation Quarterly 1997; 51:31
Car
4
49
62
42
74
84
Highway Vehicle Miles Traveled are projected to grow 60%
by 2030, in step with the growing U.S. population.
VMT (billions)
US population (Millions)
VMT (billions)
US population (millions)
5000
500
4500
450
4000
400
3500
350
3000
300
2500
250
2000
200
15000
Miles per year traveled by motor vehicle
per each person in US
12500
10000
7500
5000
1500
150
1000
100
500
2500
50
0
2000
2005
2010
2015
2020
2025
2030
0
0
Year
2000
2005
2010
2015
2020
2025
Year
2000
2005
2010
2015
2020
2025
Source: Transportation Vision for 2030
US Department of Transportation, January 2008
http://www.rita.dot.gov/publications/transportation_vision_2030/pdf/entire.pdf
Resistance Training
Bill Pearl, age 37
Mr. Universe, 1967
Bill Pearl, last formal pose, 1989
age 59 !!
Resistance Training … General Guidelines
Resistance Training … Tailor your Program!
Resistance Training … a sample Program
How can Physical Activity
Improve Your Health?
• CR Fitness, Calorie
Expenditure, Low
Fat diet, Stop
Smoking, Active
Relaxation
• Obesity & Diabetes • Calorie Expenditure
• Dietary calcium,
Vitamin D,
• Osteoporosis &
Resistance Training,
Fall Prevention
Flexibility Exercises
• Cardiovascular
Disease
Q: 1 pound of fat stores how
many calories?
A: 3500
10,000 counts per day???
WHAT IS YOUR BMI?
How to Find
Your BMI:
Height:
66”
Weight:
180 lbs.
160 lbs.
140 lbs.
BMI = 29.5
26.5
23
Obesity Classification Based on
Body Mass Index (BMI)
BMI
Classification
< 25
Normal (desirable) weight
25- 29.9
Overweight
> 30
Obesity Class I
> 35
Class II
> 40
Class III
40
35
a
b
BMI
30
c
c
25
20
15
10
<5000
5000 7499
7500 9999
Steps per Day
Krumm et al., J.Women’s Health 15:202-10, 2006
>10,000
CAN EXERCISE PREVENT
TYPE II DIABETES?
DPP - Results NIH news release (August, 2001)
Prevalence of T2DM at three years:
30
25
20
15
10
5
0
Normal
Care
Drug:
Metformin
Walking and dietary restriction
Lifestyle
Exercise and Diet Therapies
Contribute to Weight Loss
from J.S.Garrow, Acta Scand. Med. 711:67-73, 1986
RESTRICT DIET
Treatment
Emphasis
Exercise
Problem Obesity
24 26
24
28
30
32
34
36
Body Mass Index
38
40
42
How can Physical Activity
Improve Your Health?
• CR Fitness, Calorie
Expenditure, Low
Fat diet, Stop
Smoking, Active
Relaxation
• Obesity & Diabetes • Calorie Expenditure
• Dietary calcium,
Vitamin D,
• Osteoporosis &
Resistance Training,
Fall Prevention
Flexibility Exercises
• Cardiovascular
Disease
OSTEOPOROSIS & FALL
PREVENTION
Osteoporosis: The Bone Thief
Helen grew up on a dairy farm in the Midwest. She drank 3 glasses
of milk a day as a child. After high school she began work as a
secretary in a local law office where she spent her entire career.
Helen never jogged, walked as exercise, or played tennis. She
went through menopause at age 47. Shortly before retirement
at age 61, she slipped on a small rug in her kitchen and broke
her hip. After Helen recovered, she needed a cane to walk.
Ref: The National Institute of health Age Page
http://www.nih.gov/nia/health/agepages/osteo.htm (2/14/01)
50 y.o.
man
58 y.o.
man
76 y.o.
man
87 y.o.
woman
Snow-Harter
& Marcus, ESSR,
1991
Prevent the
Minimize the
FORCE
of the fall
FALL
THE
FRACTURE
PREVENTION TRIANGLE
Reduce the
FRAGILITY
of bone.
Wrist Fracture
Vertebral Fracture
Hip fracture
ABC TEST (Powell & Myers, J Gerontol: Med Sci 50A
M28-M34, 1995.)
HOW CONFIDENT ARE YOU THAT YOU WILL NOT LOSE YOUR BALANCE, OR
BECOME UNSTEADY, WHEN YOU:
0%
1.
2.
3.
4.
Walk around the house
Walk up and down the stairs
Pick up a slipper from the floor
Reach at eye level
10
20
30
40
50
60
70
80
90
100%
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
5. Reach on tip toes
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
6. Stand on chair to reach
7. Sweep the floor
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
8. Walk outside to a nearby car
9. Get in/out of a car
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
10.
Walk across a parking lot
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
11.
12.
13.
Walk up and down a ramp
Walk in a crowded mall
Walk in a crowd; bumped
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
14.
Ride escalator holding rail
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
15.
Ride escalator not holding rail |-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
16. Walk on icy sidewalks
|-------|-------|-------|-------|-------|-------|-------|-------|-------|-------|
LOW MOBILITY
HIGH MOBILITY
Falls occur because of both:
Internal (host) factors
External (environmental) factors
“Internal” factors
• Decreased vision
• Postural hypotension
• Impaired balance and/or gait
• Chronic diseases that impair mental or
physical functioning
• Certain medications, such as sedatives and
antidepressants
External (environmental) factors:
•
•
•
•
Poor lighting
Lack of handrails on staircases
Objects in pathways
Non-secured rugs
Preventing Falls
Problem
Postural Hypotension
Impaired muscle
strength/range of motion
Use of sedatives/hypnotics/
psychotropics
SOLUTION
Practice hand clenching, ankle
pumping, dorsi/plantar flexing
.
Balance and
strengthening exercises
Use medications properly;
learn non-pharmacologic treatment
for sleep disorders
Preventing Falls
Problem
SOLUTION
Review your meds
Complex drug regimens
with pharmacist or physician
Physical symptoms or
impairments: dizziness,
disability, poor vision
.
Install grab bars, handrails.
Correct foot or leg problems.
Exercises for balance
Balance impairment
and gait abnormalities
Preventing Falls
through a safer environment
Problem
Carpets, rugs, furniture
SOLUTION
Replace torn rugs, anchor loose edges
Add non-skid back to slippery rugs.
Arrange furniture so it is not obstructive
Use high back chairs
Bathroom
.
Label all medications.
Ensure adequate lighting.
Keep toilet seats raised.
Non-skid surfaces in bath/shower
Grab bars in or near commode
Preventing Falls
through a safer environment
Problem
Kitchen
SOLUTION
Nonslip wax on floors;
Use assistive devices (walker, handrails).
Stairway
Keep wood or vinyl floors dry and clean
Reducing Fragility… What can
You do to Improve Bone Mass?
• Diet rich in Calcium
• Adequate in Vitamin D
• Weight-bearing and resistance training
exercises
• Medication approved by the Food and Drug
Administration (FDA)
BECOME MORE ACTIVE
10,000 counts per day
Thank you
for
your Attention
EXTRA SLIDES
Cardiovascular Disease includes
Heart Disease and Stroke
What is the significance of this
symbol?
Women are Susceptible to Cardiovascular Disease
Prevalence of CVD by Age and Sex
Percent of Population
M a le
F ema le
80
70
60
50
40
30
20
10
0
18-1 9 20-2 9 30-3 9 40-4 9 50-5 9 60-6 9 70-7 9
>8 0
http://www.medslides.com/member2/Cardiology/women.ppt
9/98
NHANES III 1988-1991
medslides.com
5
GO RED FOR HEART
VISIT THIS WEBSITE TO CALCULATE YOUR RISK
FOR CARDIOVASCULAR DISEASE:
http://www.americanheart.org
Women and CVD … surprising facts:
• CVD, particularly coronary heart disease (CHD) and stroke,
remain the leading causes of death in women in America and
most developed countries
• Coronary heart disease claims the lives of 248,184 females
annually compared with 41,394 lives from breast cancer and
65,632 from lung cancer.
• CVD death rate… higher in black women than in white women
• CVD is #1 among all disease categories in hospital discharges
for women
• 38% of women vs. 25% of men die within 1 yr after a heart
attack
• Of the 4.8 million stroke survivors alive today, 56% are women
• Yet misperceptions still exist that CVD is not a real
problem for women.
http://www.americanheart.org/presenter.jhtml?identifier=2859
Family (children,
spouse, parents)
Household (food,
cleaning,upkeep)
Personal Health
Work
Money
Other commitments
Heart Attack Warning Signs
• Some heart attacks are sudden and intense
• the "movie heart attack," where no one doubts what's
happening
• But most heart attacks start slowly
• with mild pain or discomfort
• Often people affected aren't sure what's wrong and
• wait too long before getting help.
From: http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Symptoms of Heart Attack:
• Chest discomfort…
• Discomfort in the center of the chest that lasts more
than a few minutes… may go away and come back…
can feel like uncomfortable pressure, squeezing,
fullness or pain.
• Discomfort in other areas of the upper body…
• Pain / discomfort in one or both arms, the back, neck,
jaw or stomach.
• Shortness of breath…
• May occur with or without chest discomfort.
• Other signs:
• Cold sweat, nausea, or lightheadedness
From: http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Symptoms of heart attack may be quite
different in women:
As with men, women's most common heart attack
symptom is chest pain or discomfort. But women are
somewhat more likely than men to experience some of
the other common symptoms, particularly shortness of
breath, nausea/vomiting, and back or jaw pain.
•
•
•
•
Shortness of breath...with or without chest discomfort.
Nausea and light-headedness
Flu-like symptoms, including chills and cold sweats
Heart palpitations
From: http://www.americanheart.org/presenter.jhtml?identifier=3053#Heart_Attack
Stroke Warning Signs: Similar in Men & Women
If you notice one or more of these signs, don't wait. Stroke is a
medical emergency. Call 9-1-1 or your emergency medical services.
Get to a hospital right away!
The American Stroke Association wants you to learn the warning
signs of stroke:
• Sudden numbness or weakness of the face, arm or leg,
especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or
coordination
• Sudden, severe headache with no known cause
High LDL-C and Low HDL-C:
Increased Risk of CHD
3
Relative
CHD Risk
Over 4
years
2
25
1
45
65
85
0
100
160
220
HDL-C
(mg/dL)
LDL-C (mg/dL)
Castelli WP et al. Can J Cardiol. 1988;4(suppl A):5A-10A.
U.S. ADULTS
About 60-70% get no exercise or not
enough to maintain/increase CR
fitness
10,000 counts per day
BECOME MORE ACTIVE
10,000 counts per day
CAN EXERCISE PREVENT
TYPE II DIABETES?
Diabetes Prevention Program
NIH funded study of:
Prevention of diabetes, &
Cost effectiveness of preventive
measures
“Walking may be the only
physical activity suitable for the
entire lifespan”
P.O. Astrand, Swedish physiologist
Walking 1 mile
requires 80-100 kcal
energy expenditure
Highway Vehicle Miles Traveled are projected to grow 60%
by 2030, in step with the growing U.S. population.
VMT (billions)
US population (Millions)
VMT (billions)
US population (millions)
5000
500
4500
450
4000
400
3500
350
3000
300
2500
250
2000
200
15000
Miles per year traveled by motor vehicle
per each person in US
12500
10000
7500
5000
1500
150
1000
100
500
2500
50
0
2000
2005
2010
2015
2020
2025
2030
0
0
Year
2000
2005
2010
2015
2020
2025
Year
2000
2005
2010
2015
2020
2025
Source: Transportation Vision for 2030
US Department of Transportation, January 2008
http://www.rita.dot.gov/publications/transportation_vision_2030/pdf/entire.pdf
Metabolic Response to 10-lb Weight Loss:
Framingham Data
Small
changes
can add up
to
significant
changes in
long-term
risk
mg/dl
0
-1
-2
-3
-4
-5
-6
-7
-8
mm Hg
mg/dl
Men
Women
Cholesterol
Syst
BP
Higgins M et al. Acta Med Scand Suppl 1988;723:23-36.
Glucose
“Exercise Lite”
Every American adult should accumulate 30
minutes or more of moderate intensity
physical activity over the course
of most days of the week.
(recommendation of ACSM + CDC, 1993)
Guidelines for healthy adults < age 65
Basic recommendations
from ACSM and AHA (2007):
Do moderately intense cardio 30 minutes a day,
5 days a week
Or
Do vigorously intense cardio 20 minutes a day,
3 days a week
And
Do eight to 10 strength-training exercises,
eight to 12 repetitions of each exercise
twice a week.
http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=CM/HTMLDisplay.cfm&CONTENTID=7764
Energy Expenditure of Walking
(kcal per mile)
Min /
mile
30.00
24.00
20.00
17.14
15.00
13.33
12.00
Your Body Weight (lbs.)
132
154
176
198
80
93
106 120
73
86
98
110
69
81
92
104
66
77
88
99
64
75
85
96
62
73
83
93
61
71
81
91
Q: 1 pound of fat stores how
many calories?
A: 3500
10,000 counts per day???
So …What do you mean by 10,000
steps / day?
GOAL: ATTAIN > 10,000
pedometer counts per day
But…
Many people are sedentary, … and
most sedentary people are overweight.
Sedentary people attain ~ 5,000
pedometer counts per day
Activity Categories
Category
Sedentary
Low Active
Moderately Active
High Active
Daily Pedometer Counts
<5000
5000-7499
7500-10,000
>10,000
How can I lose weight?
How can a pedometer work for
me?
Suppose you weigh 190 lbs.
Current activity: 5,000 counts/day
If you decide to increase your
pedometer counts by +1,000 each day,
. . . to attain an average of
6,000 counts/day . . .
You will lose 5.2 lbs in one year
Calculations
For a 190 lb person, walking 1 mile expends 100 kcal
Since 1 mile = 2,000 counts, it follows that
½ mile = 1,000 counts.
then 1,000 counts expends ~ 50 kcal.
If you increase daily pedometer counts by 1000/day…,
this will result in an additional expenditure of
350 kcal/week,
1,400 kcal/month,
18,200 kcal/yr.
18,200 kcal ÷ 3,500 kcal/lb =
5.2 lbs of fat lost in 1 year
Risk Factor ...
• High Cholesterol &
triglycerides
• High BP
Exercise Effect:
• Lowers TG … little
effect on cholesterol if
do not have hi TG
• Lowers BP 5-10
mmHg
• Diabetes
• ½ as likely to
become diabetic
• Smoking
• (?)
Hard to smoke &
exercise
Obesity ? … Walk 1 mile, burn 100 kcal
Exercise and Diet Therapies
Contribute to Weight Loss
from J.S.Garrow, Acta Scand. Med. 711:67-73, 1986
RESTRICT DIET
Treatment
Emphasis
Exercise
Problem Obesity
24 26
24
28
30
32
34
36
Body Mass Index
38
40
42
Cardiovascular Disease Risk
• Major Risk Factors for Heart
Disease
and Stroke
High levels of blood cholesterol
Hypertension or high blood pressure
Tobacco use
Diabetes mellitus
• Other Risk Factors Include
Physical inactivity
Obesity & Poor diet (High Fat, Sat Fat)
ADOLESCENCE:
A time to Learn the Adult
Lifestyle of Inactivity !!!
10,000 counts per day
Young People Reporting Vigorous
Activity on 3 of the Previous 7 Days
Boys & Young Men
Girls & Young Women
80
Percentage
70
60
50
40
30
20
10
0
11
12
13
14
15
16
17
Age (yrs)
(Source : SG R p .1 9 1 ; NHIS-YR BS stud ie s)
18
19
20
21
22
Current Status:
Physical Activity of Children?
?
% of Pop.
Getting
Phys.Act.
Sufficient
to Maintain
Wt. Balance Childhood Adolesc
LIFESPAN
Adulthood
Kids in the 1990’s less active
compared to kids in the 1950’s
(William Strong, editorial in Circulation, 1990)
• TV Viewing in 1950’s: 4 hr / week
1990’s: 28 hr /week
• more kids in day care
– effect: day care centers tend to restrict activity
• more latch key children:
– effect: parents “stay indoors ‘til we get home”
• decreasing “green” space
Distribution of Hours of TV Per Day:
NHES Youth Aged 12-17 in 1967-70 and
NLSY Youth Aged 12-17 in 1990
35
30
25
Percent
Distribution
20
15
NHES 1967-70
NLSY 1990
10
5
0
0-1
1-2
2-3
3-4
4-5
TV Hours (Youth Report)
5+
Prevalence of Obesity by Hours of TV per Day:
Prevalence
(%)
NHES Youth Aged 12-17 in 1967-70
and NLSY Youth Aged 10-15 in 1990
40
35
30
25
20
NHES 1967-70
15
NLSY 1990
10
5
0
TV Hours Per Day (Youth Report)
Working Hypothesis:
Childhood Activity levels
may be re-setting to
a new low
% of Pop.
Getting
Phys.Act.
Sufficient
to Maintain
Wt. Balance Childhood Adolesc
LIFESPAN
Adulthood
New Risk Factors …
Ready for Prime Time?
Oxidized LDL
Homocysteine
Lp(a)
C-reactive protein (CRP)
C-Reactive Protein (CRP)
• What is it?
– Circulating protein produced by liver
– Marker for general inflammation
• How does it contribute to CVD risk?
– Atherosclerosis is an inflammatory disease,
CRP is (partly) a marker for inflammation
• How to reduce your risk:
Insulin
• What is it?
– Hormone responsible for allowing blood glucose
(sugar) to enter cells.
– Very important to muscle function; body is 40% muscle
• How does it contribute to CVD risk?
– Muscles become resistant to insulin, high insulin
promotes arterial thickening
• How to reduce your risk:
MOVE !!!!
• What is it?
Homocysteine
– Amino acid that is normally changed to another aa
– High level: > 12 umol/L
• How does it contribute to CVD risk?
– Disrupts thrombolysis (increased clotting)
– contributes to arterial thickening & “aging”
(deficient methylation)
• How to reduce your risk:
– Increase dietary folate, vitamins B6, B12
Sources (9/3/03):
http://familydoctor.org/handouts/249.html
http://www.bhf.org.uk/questions/index.asp?secondlevel=370&thirdlevel=378
Christen WG et al. Arch Intern Med. 2000 Feb 28;160(4):422-34
Energy Expenditure of Walking
(kcal per mile)
Min /
mile
30.00
24.00
20.00
17.14
15.00
13.33
12.00
Your Body Weight (lbs.)
132
154
176
198
80
93
106 120
73
86
98
110
69
81
92
104
66
77
88
99
64
75
85
96
62
73
83
93
61
71
81
91
Energy Expenditure of Running
(kcal per mile)
Min /
mile
10.91
10.00
9.23
8.57
8.00
7.50
7.06
Your Body Weight (lbs.)
132
154
176
198
108 126 144 162
107 125 143 160
106 124 142 159
105 123 141 158
105 122 140 157
104 122 139 157
104 121 139
156
Women themselves may lack appreciation
of their individual risk for heart disease.
Women present to the hospital one hour later
than a man will
Women:
• frequently continue activities when they feel ill
• mistake their symptoms as not serious, or
- fail to realize that they represent a cardiac
condition
From: http://www.womentowomen.com/LIBheartattacksymptoms.asp
accessed 2/7/06
Name that bodybuilder…
Ronnie Coleman
Seven time Mr. Olympia
Name that bodybuilder…
Bev Francis
1st woman to bench press 300 lbs.
Adela Garcia-Freidmansky
Ms. Olympia 2004 & 2006
Physical
Activity
and
Health
A Report of the Surgeon General
1996
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and HealthPromotion
President’s Council on Physical Fitness and Sports