3. How much exercise is enough?
http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg
Let’s look at the evidence relating physical activity with health…
4. Outline
• Defining terms
• Physical activity vs. exercise
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
7. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
8. Physical Activity
“Any bodily movement produced by the
contraction of skeletal muscles that results in
a substantial increase over resting energy
expenditure.”
- ACSM
9. What does that mean?
http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg
Skeletal Muscle – attaches
to and moves your bones
Resting Energy Expenditure
- estimated value of how
much energy your body
requires in a day at rest
http://img.ehowcdn.com/article-new/ds-
photo/getty/article/78/104/86500437_XS.jpg
10. Our definition of Physical Activity
Becomes…
• Any movement you make using your muscles
that requires more energy than your body
would need to lie on a couch
http://tsh.to/img/Raking.jpg
http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the-
dog.jpg
11. What comes to mind when you
hear exercise?
http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
12. Exercise
“A type of physical activity consisting of
planned, structured, and repetitive bodily
movement done to improve or maintain one or
more components of physical fitness.”
- ASCM
13. Our Definition of Exercise Becomes…
• A planned or organized workout you do in
order improve aspects of fitness such as
flexibility or cardiovascular endurance
http://www.faqs.org/photos/physical-fitness-2476.jpg
http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line-
image.jpg
14. Physical Inactivity
“A lack of physical activity…currently the 4th
leading risk factor for mortality worldwide.”
- WHO
15. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
16. Canadian Recommendations
“All healthy adults aged 18-65 need
moderate intensity physical activity for a
minimum of 30 minutes five days per week”
*Or a total of 150 minutes/week
http://media.coreperformance.com/images/411*308/people-who-take-the-stairs-
are-fitter-and-more-productive.jpg
17. Intensity
• Moderate intensity exercise for 150 minutes a
week
Intensity Example Activity Affect on breathing Affect on body
temperature
Sitting Watching TV Normal Normal
Very light Effort Dusting Normal Normal
Light Effort Light Gardening Slight Increase Start to Feel Warm
Moderate Effort Brisk Walking Greater Increase Warmer
Vigorous Effort Jogging More out of breath Quite Warm
Very Hard Effort Fast Run Greater Increase Hot/Sweating
Maximal Effort All-Out Sprint Completely Out of
Breath
Sweating/Very Hot
*Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
20. http://armstrongpodnsportshealth.files.wordpress.com/2
010/12/evelyn_musclepose1.jpg
FICTION!
Resistance also known as
strength training has recently
been proven to show important
health benefits that are not
gained from aerobic training.
A study conducted by
researchers from the Centre for
Hip Health and Mobility
(Vancouver), recently found that
women that did strength
training showed lasting
improved cognitive function and
functional brain plasticity, while
the women doing other forms of
exercise did not.
21. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
23. #1 Choose the parking space farthest away
http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
24. #2 Take the stairs instead
of the elevator
http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
25. #3 Grocery shop with
a basket instead of
a buggy
http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store-
shopping-Basket-with-food.jpg
26. #4 Go for a walk – with friends, colleagues, or
a pet!
http://blog.northernhealth.ca/nhblog/wp-
content/uploads/2012/09/walkingmeeting500x350.jpg
29. can CDC, 2011
FICTION! Remember, physical
activity DOES NOT have to be
organized exercise
30. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
32. #1 About one-third to one-half of the world’s
adult population is insufficiently physically
active
(WHO)
http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr
eview.jpg
http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of-
adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a-
year.jpg
33. #2 Physical inactivity is a major contributor to
death and disability from non-communicable
diseases (NCDs) worldwide
Warburton, Health benefits of PA: the evidence. CMAJ 2006
34. #3 Many Canadian deaths are attributed to
physical inactivity
(CMAJ, 2000)
The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
35. #4 Musculoskeletal fitness is shown to reduce the
risk of falling
Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
36. #5 Physical activity has been proven to slow
the early memory decline in Alzheimer’s
Disease
http://www.alz.org/braintour/images/alzheimer_brain.jpg
37. Are There Risks?
• More is not always better
• Overuse injuries
• Most gains are in the first bout of exercise
• Acute risks of exercise
• Risk of training:
•Men 1 SD per 1.51 million episodes of exertion
• Always consult your doctor before beginning
an exercise program
38. Question - fact or fiction:
Does getting enough
physical activity
automatically mean
you will get the body
of your dreams?
40. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
41. Physical Activity – A Prescription?
• Pedometer based study
• Showed a decrease in blood pressure & increase
in walking time
• Exercise…
• If your doctor says so
• Physical activity is preventative medicine
42. Take Away Messages
• This presentation is not intended to promote
or discredit a specific mode of exercise
• Activity doesn’t have to been organized
exercise programs
• In terms of activity something is better than
nothing
• Inactivity is associated with a higher rate of
mortality & morbidity
43. “Lack of activity destroys the good condition
of every human being while movement and
methodical physical exercise save it and
preserve it”
- Plato
http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
44. References
1. American College of Sports Medicine, Guide to Personal Training
2. British Journal of Cancer, 2009
3. Journal of Alzheimer’s Disease, 2013
4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in
Canada, CMAJ, 163(11):1435-40
5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12,
2012 May-Jun.
6. Mayo Clinic, Website
7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in
men. Am J Med 2004;117:912-8.
8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker
Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323
9. The Lancet, Physical Activity Series Working Group (5 papers), 2012
10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence
of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608
11. Warburton, Health benefits of PA: the evidence. CMAJ 2006
12. World Health Organisation, website
13. *URLs of all photo references are pasted on specific slides
46. How much exercise is enough?
http://ocnutrition.files.wordpress.com/2010/06/istock_workout1.jpg
Let’s look at the evidence relating physical activity with health…
47. Outline
• Defining terms
• Physical activity vs. exercise
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
50. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
51. Physical Activity
“Any bodily movement produced by the
contraction of skeletal muscles that results in
a substantial increase over resting energy
expenditure.”
- ACSM
52. What does that mean?
http://fitnessbodybuilding.co.uk/images/1musclesatside.jpg
Skeletal Muscle – attaches
to and moves your bones
Resting Energy Expenditure
- estimated value of how
much energy your body
requires in a day at rest
http://img.ehowcdn.com/article-new/ds-
photo/getty/article/78/104/86500437_XS.jpg
53. Our definition of Physical Activity
Becomes…
• Any movement you make using your muscles
that requires more energy than your body
would need to lie on a couch
http://tsh.to/img/Raking.jpg
http://www.thedogtrainingsecret.com/s/g1PTdejmiUmyW1ip-Afz6A/walking-the-
dog.jpg
54. What comes to mind when you
hear exercise?
http://www.macrichmond.com/wp-content/uploads/2011/12/exercise-heart.gif
55. Exercise
“A type of physical activity consisting of
planned, structured, and repetitive bodily
movement done to improve or maintain one or
more components of physical fitness.”
- ASCM
56. Our Definition of Exercise Becomes…
• A planned or organized workout you do in
order improve aspects of fitness such as
flexibility or cardiovascular endurance
http://www.faqs.org/photos/physical-fitness-2476.jpg
http://www.downtownvancouver.com/images/gallery/2006-Sun-Run-finish-line-
image.jpg
57. Physical Inactivity
“A lack of physical activity…currently the 4th
leading risk factor for mortality worldwide.”
- WHO
58. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
59. Canadian Recommendations
“All healthy adults aged 18-65 need
moderate intensity physical activity for a
minimum of 30 minutes five days per week”
*Or a total of 150 minutes/week
http://media.coreperformance.com/images/411*308/people-who-take-the-stairs-
are-fitter-and-more-productive.jpg
60. Intensity
• Moderate intensity exercise for 150 minutes a
week
Intensity Example Activity Affect on breathing Affect on body
temperature
Sitting Watching TV Normal Normal
Very light Effort Dusting Normal Normal
Light Effort Light Gardening Slight Increase Start to Feel Warm
Moderate Effort Brisk Walking Greater Increase Warmer
Vigorous Effort Jogging More out of breath Quite Warm
Very Hard Effort Fast Run Greater Increase Hot/Sweating
Maximal Effort All-Out Sprint Completely Out of
Breath
Sweating/Very Hot
*Table adapted from Prescribing exercise as preventative therapy. Warburton, D., Nicol, C., & Bredin S
63. http://armstrongpodnsportshealth.files.wordpress.com/2
010/12/evelyn_musclepose1.jpg
FICTION!
Resistance also known as
strength training has recently
been proven to show important
health benefits that are not
gained from aerobic training.
A study conducted by
researchers from the Centre for
Hip Health and Mobility
(Vancouver), recently found that
women that did strength
training showed lasting
improved cognitive function and
functional brain plasticity, while
the women doing other forms of
exercise did not.
64. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
66. #1 Choose the parking space farthest away
http://farm1.static.flickr.com/202/490057821_c43bda0d79.jpg
67. #2 Take the stairs instead
of the elevator
http://www.summitsofcanada.ca/canatrek/graphics/pix/banner-TakeTheStairs.jpg
68. #3 Grocery shop with
a basket instead of
a buggy
http://watermarked.cutcaster.com/cutcaster-photo-100810270-Grocery-store-
shopping-Basket-with-food.jpg
69. #4 Go for a walk – with friends, colleagues, or
a pet!
http://blog.northernhealth.ca/nhblog/wp-
content/uploads/2012/09/walkingmeeting500x350.jpg
72. can CDC, 2011
FICTION! Remember, physical
activity DOES NOT have to be
organized exercise
73. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
75. #1 About one-third to one-half of the world’s
adult population is insufficiently physically
active
(WHO)
http://media.onsugar.com/files/ed2/192/1922729/46_2009/3f52b5f0448c5aa0_dv2014006.pr
eview.jpg
http://www.bellenews.com/wp-content/uploads/2012/07/About-a-third-of-
adults-are-not-doing-enough-physical-activity-causing-5.3-million-deaths-a-
year.jpg
76. #2 Physical inactivity is a major contributor to
death and disability from non-communicable
diseases (NCDs) worldwide
Warburton, Health benefits of PA: the evidence. CMAJ 2006
77. #3 Many Canadian deaths are attributed to
physical inactivity
(CMAJ, 2000)
The Economic Burden of Physical Inactivity, Peter T. Katzmarzyk,* Norman Gledhill,* Roy J. Shephard, 2000
78. #4 Musculoskeletal fitness is shown to reduce the
risk of falling
Shaw & Snow, 1998; Campbell et al., 1999; Buchner et al., 1997
79. #5 Physical activity has been proven to slow
the early memory decline in Alzheimer’s
Disease
http://www.alz.org/braintour/images/alzheimer_brain.jpg
80. Are There Risks?
• More is not always better
• Overuse injuries
• Most gains are in the first bout of exercise
• Acute risks of exercise
• Risk of training:
•Men 1 SD per 1.51 million episodes of exertion
• Always consult your doctor before beginning
an exercise program
81. Question - fact or fiction:
Does getting enough
physical activity
automatically mean
you will get the body
of your dreams?
83. Outline
• Defining terms
• Physical activity & exercise vs. inactivity
• Canadian recommendations for physical
activity
• How can we achieve these guidelines
• Consequences of inactivity – the evidence
• The future of prescribed exercise
84. Physical Activity – A Prescription?
• Pedometer based study
• Showed a decrease in blood pressure & increase
in walking time
• Exercise…
• If your doctor says so
• Physical activity is preventative medicine
85. Take Away Messages
• This presentation is not intended to promote
or discredit a specific mode of exercise
• Activity doesn’t have to been organized
exercise programs
• In terms of activity something is better than
nothing
• Inactivity is associated with a higher rate of
mortality & morbidity
86. “Lack of activity destroys the good condition
of every human being while movement and
methodical physical exercise save it and
preserve it”
- Plato
http://www.departments.bucknell.edu/history/carnegie/plato/plato_bust.jpg
87. References
1. American College of Sports Medicine, Guide to Personal Training
2. British Journal of Cancer, 2009
3. Journal of Alzheimer’s Disease, 2013
4. Katzmazyk, P.T., Gledhill, N., & Shephard, R.J. (2000). The economic burden of physical inactivity in
Canada, CMAJ, 163(11):1435-40
5. Kolt GS. Schofield GM. Kerse N. Garrett N. Ashton T. Patel A., Annals of Family Medicine. 10(3):206-12,
2012 May-Jun.
6. Mayo Clinic, Website
7. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in
men. Am J Med 2004;117:912-8.
8. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker
Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323
9. The Lancet, Physical Activity Series Working Group (5 papers), 2012
10. Wannamethee, G.S., Shaper, G.A., & Walker, M. Changes in physical activity, mortality, and incidence
of coronary heart disease in older men. The Lancet, Volume 351, Issue 9116, Pages 1603-1608
11. Warburton, Health benefits of PA: the evidence. CMAJ 2006
12. World Health Organisation, website
13. *URLs of all photo references are pasted on specific slides