1. July 2005 Physical Activity & Chronic Disease Prevention Presented by the Physical Activity Resource Centre Funded by the Government of Ontario

2. Status of Chronic Disease in Canada More than 50% of Canadians live with at least one chronic illness (Advisory Committee on Population Health, 2002). Programs need to focus on primary as well as secondary prevention

3. Status of Chronic Disease in Canada $14.2 billion (9% of the total cost of illness), was related to cancer (Economic Burden of Illness in Canada, 1998) One in four women and one in eight men over 50 have osteoporosis (Osteoporosis Society of Canada, 2001) 4 million Canadians live with arthritis (Canadian Community Health Survey, 2000).

4. Status of Chronic Disease in Canada 2 million Canadians have diabetes. Of those, 30-50% will develop gastrointestinal complications, 4-10% will develop foot ulcers. Other complications include blindness, kidney problems, thyroid problems and heart disease. (CDA, 2005) Cardiovascular diseases were the most expensive disease category in 1995 accounting for $7.3 billion or 17% of the total direct costs of illness (Economic Burden of Illness in Canada, 1998)

5. Risk Factors Each disease has specific risk factors associated with it Many are extrinsic lifestyle choices (such as physical activity, diet/nutrition, exposure to sun and tobacco) Weight/BMI can be intrinsic risk factors due to genetic predisposition to overweight

6. Risk Factors

8. General Recommendations for Physical Activity For prevention: Follow Canada’s Physical Activity Guide for age group Encourage a gradual build up of activity For people with chronic disease: Ensure people who have a chronic disease are followed by a physician familiar with the latest recommendations for the disease.

9. Cancer - Profile Cancer occurs when abnormal cells conglomerate and accumulate in the body Cancer can occur anywhere in the body 149 000 new cases of cancer will occur in 2005 Lung cancer is the leading cause of cancer death in both men and women 1 in 4 Canadians will die from cancer

10. Cancer - How Physical Activity Helps Convincing evidence in reducing the risk of colorectal cancer Probable evidence in reducing the risk of breast cancer Possible evidence in reducing the risk of prostate cancer (WHO, 2002) Overweight and obesity are linked to many cancers (oesophagus, colorectal, endometrium, breast and kidney) - physical activity can help manage weight, reducing the effects of this risk factor

11. Arthritis - Profile There are 127 different kinds of arthritis! Osteoarthritis: progressive loss of joint cartilage. One or more joints: feet, knees, hips, spine, hands, fingers, toes. Caused by aging, repetitive impact, genetics, etc. Rheumatoid arthritis: inflammation of the membranes that line the inside of certain joints. Involves many joints and moves beyond musculoskeletal system and causing important complications. Rarer, cause unknown, more devastating.

12. Arthritis - How Physical Activity Helps Maintaining an ideal body weight and avoiding joint injuries reduces the risk of developing arthritis Athough a person can’t die from arthritis, the lack of physical activity will reduce their cardiovascular health. Aerobic exercise is necessary. Appropriate regular activity recommended, with physician’s approval. Inappropriate physical activity worsens arthritic pain.

13. Osteoporosis - Profile Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fracture, particularly of the hip, spine and wrist. Osteoporosis is often known as "the silent thief" because bone loss occurs without symptoms (Canadian Osteoporosis Society, 2005)

14. Osteoporosis - How Physical Activity Helps Physical activity increases peak bone mass in the growing skeleton Physical activity can slow the rate of bone loss in older adults Improves balance and stability, reducing the risk of falls and injuries

15. Type 2 Diabetes - Profile Type 2 diabetes occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin that is produced. 90 per cent of people with diabetes have type 2 diabetes. Scientists believe that lifestyle and type 2 diabetes are closely linked. This means that lifestyle is one area individuals can focus on to help prevent or delay the onset of the condition (Canadian Diabetes Association, 2005)

16. Type 2 Diabetes - How Physical Activity Helps Helps prevent obesity, a major factor for diabetes. Fat makes insulin less effective at regulating blood sugar. Four out of five Type 2 diabetics are obese. Exercise removes glucose from the blood during and after activity. It improves insulin sensitivity and helps the body’s ability to metabolize glucose. Stress can increase insulin levels in Type 2 diabetics. Exercise can help reduce stress.

17. Cardiovascular Disease - Profile Cardiovascular disease or heart disease is the number one killer in Canada Medical conditions such as high blood pressure, high blood cholesterol, obesity and diabetes are also potent risk factors. Men are generally more likely to develop CVD, but the risk increases with age for both sexes

18. Cardiovascular Disease - How Physical Activity Helps Increases oxygen supply and decreases oxygen demand on heart Improves heart contractions and impulse stability Lowers resting heart rate Increases diameter and capacity of arteries Reduces progression of artherosclerosis Can lower LDL (« bad » cholesterol) and triglycerides. Can increase HDL (« good » cholesterol) Helps lower blood pressure and reduces risk of developing hypertension Helps maintain a healthy body weight Helps relieve stress, a factor in heart disease (Lee & Paffenbarger, Edited by Thompson, 2000)

19. Metabolic Syndrome 1 in 4 Canadians can develop a cluster of medical conditions called "metabolic syndrome": obesity - particularly abdominal fat high blood sugar high triglycerides high blood cholesterol (low HDL, « good cholesterol ») high blood pressure

20. Metabolic Syndrome - Effects  Result: Increased risk for diabetes and heart disease Abdominal fat Muscles Pancreas Liver Resistant to insulin Difficulty to produce insulin Sugar production Request for pancreas to produce more insulin Hormones

21. Reversing Metabolic Syndrome Increasing physical activity to increase metabolism Reducing weight

22. Where to find more information: Arthritis Society of Canada - www.arthritis.cawww.arthritis.ca Canadian Cancer Society - www.cancer.cawww.cancer.ca Osteoporosis Society of Canada - www.osteoporosis.ca www.osteoporosis.ca Canadian Diabetes Association- www.diabetes.cawww.diabetes.ca Heart and Stroke Foundation - www.heartandstroke.ca www.heartandstroke.ca Metabolic Syndrome in Canada - http://www.cmeondiabetes.ca/pub/the.metabolic. syndrome.in.canada.php http://www.cmeondiabetes.ca/pub/the.metabolic. syndrome.in.canada.php Chronic Disease Prevention Alliance of Canada - http://www.chronicdiseaseprevention.ca/ http://www.chronicdiseaseprevention.ca/

23. Sharing Stories Do you have program ideas to share on primary prevention of specific chronic diseases through Physical Activity? Do you have programs addressing people with existing conditions? Note: Workshop materials and fact sheets can be downloaded from http://www.ophea.net/parc http://www.ophea.net/parc

24. Contact information Physical Activity Resource Centre www.ophea.net/parc 1-888-446-7432 Louise Daw Provincial Consultant Louise@ophea.org 519.646.2121