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Anabolic Exercise for Health Presented by: Dr. Robert Newton Foundation Professor in Exercise Science Edith Cowan University.

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Presentation on theme: "Anabolic Exercise for Health Presented by: Dr. Robert Newton Foundation Professor in Exercise Science Edith Cowan University."— Presentation transcript:

1 Anabolic Exercise for Health Presented by: Dr. Robert Newton Foundation Professor in Exercise Science Edith Cowan University

2 Physical 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

3 Chronic Disease slow progress, long continuanceslow progress, long continuance individual crosses threshold - ‘‘clinical horizon’’ to manifestindividual crosses threshold - ‘‘clinical horizon’’ to manifest mechanisms underlying active long before outwardly affectedmechanisms underlying active long before outwardly affected 3

4 Cost of Chronic Disease “there has been an epidemic emergence of modern chronic diseases in the latter part of the 20 th century” “costs in the USA are now approaching $1 trillion” Booth et al, JAP

5 Examples of Major Chronic Diseases coronary heart disease (atherosclerosis, heart failure, hypertension, and stroke)coronary heart disease (atherosclerosis, heart failure, hypertension, and stroke) obesityobesity Type 2 diabetesType 2 diabetes some cancerssome cancers osteoporosisosteoporosis sarcopeniasarcopenia 5

6 Only fighting half of the battle: being reactive instead of proactive Medical research and treatment is focused almost entirely on secondary and tertiary preventionMedical research and treatment is focused almost entirely on secondary and tertiary prevention Primary prevention is cheaper, more effective, and far less painfulPrimary prevention is cheaper, more effective, and far less painful 6

7 We are programmed for physical activity “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 health maintenance” Booth et al, JAP

8 “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,

9 Physical Inactivity and Chronic Disease ~ 250,000 deaths per year in the US are premature due to physical inactivity~ 250,000 deaths per year in the US are premature due to physical inactivity increases incidence of at least 17 unhealthy conditionsincreases incidence of at least 17 unhealthy conditions almost all of which are chronic diseases or considered risk factors for chronic diseasesalmost all of which are chronic diseases or considered risk factors for chronic diseases Booth et al, JAP

10 Physical Inactivity and Chronic Disease…2 Physical inactivity ranks second only to tobacco smoking in terms of the burden of disease from risk factors in Australia.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 males6% (second highest burden for men) of the total burden of disease and injury among males 8% among females (highest burden for women)8% among females (highest burden for women) AIHW: Mathers et al

11 Physical Inactivity and Chronic Disease…3 Adult participation in sufficient physical activity for a health benefit declined from 62% in 1997 to 57% in 2000.Adult participation in sufficient physical activity for a health benefit declined from 62% in 1997 to 57% in Overweight and obesity remains a serious problem, affecting around 65% of men, 45% of women and 22% of children aged 2-17 years.Overweight and obesity remains a serious problem, affecting around 65% of men, 45% of women and 22% of children aged 2-17 years. Australian Institute of Health and Welfare Australia’s Health

12 Cardiovascular Disease in Australia leading cause of death among Australians in 2000leading cause of death among Australians in ,741 deaths or 39% of all deaths.49,741 deaths or 39% of all deaths. coronary heart disease 53%coronary heart disease 53% stroke 25%stroke 25% heart failure 5%heart failure 5% peripheral vascular disease 5%peripheral vascular disease 5% Australian Institute of Health and Welfare Australia’s Health

13 How important is physical activity? image from “Living Longer Living Stronger” 13

14 Sarcopenia Loss of muscle mass and functionLoss of muscle mass and function 60% of over 80yrs60% of over 80yrs Anabolic exercise most effective strategy to prevent or reverse sarcopeniaAnabolic exercise most effective strategy to prevent or reverse sarcopenia image from 14

15 Causes of Sarcopenia nutrition (under-nutrition and lack of vitamin D)nutrition (under-nutrition and lack of vitamin D) decreased hormone levels (e.g growth hormone, testosterone)decreased hormone levels (e.g growth hormone, testosterone) reduced physical activity particularly high intensityreduced physical activity particularly high intensity loss of nerves that innervate the musclesloss of nerves that innervate the muscles Grounds, M.D. Biogerontology, 2002 image from 15

16 Diabetes Diabetes is the world's fastest growing diseaseDiabetes is the world's fastest growing disease It's Australia's sixth leading cause of deathIt's Australia's sixth leading cause of death Over one million Australians have it — but 50% are as yet unawareOver one million Australians have it — but 50% are as yet unaware Every 10 minutes someone is diagnosed with diabetesEvery 10 minutes someone is diagnosed with diabetes 16

17 Impaired Glucose Tolerance 17 Age-specific prevalence of impaired glucose tolerance, Age (years) Men% Women% 25– – – – – Source: Dunstan et al Metabolic stage between normal and diabetes Risk factor for Type 2 diabetes Also greater risk of heart disease Much higher in physically inactive and obese Improved with physical activity and weight reduction

18 Impaired Glucose Tolerance 18 “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.” Australian Institute of Health and Welfare Australia’s Health 2002

19 Resistance Exercise and Diabetes Exercise improves insulin resistanceExercise improves insulin resistance Beneficial for preventing and treating type 2 diabetesBeneficial for preventing and treating type 2 diabetes Aerobic exercise hindered in older, obese, co-morbid patientsAerobic exercise hindered in older, obese, co-morbid patients Anabolic exercise safe and effectiveAnabolic exercise safe and effective Willey and Singh. Diabetes Care,

20 Physical Activity and Diabetes It is estimated that appropriate levels of physical activity could prevent 30-50% of new cases of Type 2 diabetesIt 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 patternsBenefits for preventing and treating diabetes occur only with regular sustained physical activity patterns Manson & Spelsberg,1994) 20

21 Anabolic Exercise and Osteoporosis Evidence is conclusiveEvidence is conclusive Lifelong physical activity has strong preventative effectLifelong physical activity has strong preventative effect Anabolic exercise - greatest efficacyAnabolic exercise - greatest efficacy Example*Example* 1 year study of strength and endurance training1 year study of strength and endurance training 1.3% increase BMD in training group1.3% increase BMD in training group 1.2% decrease for control1.2% decrease for control *Kemmler et al. Archives of Physical Medicine & Rehabilitation,

22 Anabolic Exercise and Osteoarthritis Increased function e.g. stair climb and descend, chair rise, walkingIncreased function e.g. stair climb and descend, chair rise, walking Reduced ratings of painReduced ratings of pain Reduced stiffnessReduced stiffness Studies report anabolic exercise to be “safe, effective and well tolerated in OA patients”Studies report anabolic exercise to be “safe, effective and well tolerated in OA patients” 22

23 Anabolic Exercise and Rheumatoid Arthritis Feasible and safe in selected patients with well-controlled RAFeasible and safe in selected patients with well-controlled RA Significant improvements in strength, pain, and fatigue Without exacerbating disease activity or joint pain.Significant improvements in strength, pain, and fatigue Without exacerbating disease activity or joint pain. Hakkinen, A and

24 Physical activity and cancer risk People who are physically inactive are nearly twice as likely to develop colon cancerPeople 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 cancerPhysical activity is also associated with around a 30% reduction in the risk of women of all ages developing breast cancer (Thune & Furberg 2001). 24

25 Exercise for Cancer Patients Disease and treatment usually results in debilitating fatigueDisease and treatment usually results in debilitating fatigue Research examining exercise programs pre surgery and/or during treatmentResearch examining exercise programs pre surgery and/or during treatment Increased vigor Increased vigor Reduced muscle and bone loss Reduced muscle and bone loss Enhanced immune function Enhanced immune function Possible increase survival Possible increase survival Positive psychological influences Positive psychological influences Prostate and Breast cancerProstate and Breast cancer More accurate detectionMore accurate detection A n a b o l i c E x e r c i s e 25

26 Mental Illness, Dementia, Alzheimer’s Physical inactivity - risk factorPhysical inactivity - risk factor Mechanism unknownMechanism unknown Physical activity – strong positive effectPhysical activity – strong positive effect Slows progression of diseaseSlows progression of disease Ageing population – dementia will become major problemAgeing population – dementia will become major problem 26

27 Epidemiology 27 McDowell, I. Alzheimer's disease: insights from epidemiology. Aging-Clinical & Experimental Research. 13: , 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 protectiveEpidemiological 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

28 Cholesterol 28 Exercise and nutrition demonstrated effects on:Exercise and nutrition demonstrated effects on: Lowered TCLowered TC Lowered LDL-CLowered LDL-C Increased HDL-CIncreased HDL-C Lowered triglyceridesLowered triglycerides 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): , 2004

29 Hypertension 29 Exercise can lower BP in patients with stage 1 and 2 essential hypertensionExercise 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 BPAverage 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: , 2001.

30 Obesity and Overweight 30 Combination of exercise and dietary modification is the only effective long-term strategy for controlling body weightCombination of exercise and dietary modification is the only effective long-term strategy for controlling body weight

31 Falls - Cost 31 accidental falls for > 65 years $83 million in 2001/02accidental falls for > 65 years $83 million in 2001/ % of health expenditure in WA1.5 % of health expenditure in WA cost per fall was $6,500cost per fall was $6,500 Personal and family cost much largerPersonal and family cost much larger

32 Falls - Prevention 32 MultifactorialMultifactorial Range of physical activity interventions proven successfulRange of physical activity interventions proven successful Anabolic exercise reverse loss of muscle strength and slows bone loss – critical functionAnabolic exercise reverse loss of muscle strength and slows bone loss – critical function

33 Deficiencies of some physical activity programs for seniors Must reverse our concept of “gentle exercise”Must reverse our concept of “gentle exercise” To maintain function, reduce chronic disease, enhance quality of life – MUST simulate pre- industrial revolution!To maintain function, reduce chronic disease, enhance quality of life – MUST simulate pre- industrial revolution! Ageism! We need to change our perceptionsAgeism! We need to change our perceptions 33

34 Life-Long Prevention Strategy Clearly life-long physical activity including resistance exercise is crucial to maintaining optimal structure and function into old ageClearly life-long physical activity including resistance exercise is crucial to maintaining optimal structure and function into old age Primary prevention is imperative!Primary prevention is imperative! image from 34

35 Fighting Fit?? 35

36 Edith Cowan University 36 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. 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 Services, Education and Social Sciences; and the Faculty of Regional Professional Studies

37 Sport and Exercise Science 37 Certificates offeredCertificates offered Personal TrainingPersonal Training Women’s WellnessWomen’s Wellness Degrees offeredDegrees offered Bachelor of Science (Sports Science)Bachelor of Science (Sports Science) Masters and PhD by researchMasters and PhD by research Masters of Exercise Science (Strength and Conditioning)Masters of Exercise Science (Strength and Conditioning)

38 ECU Wellness Training and certificationTraining and certification Professional developmentProfessional development On-going supportOn-going support 38

39 Thank You 39


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