1. A joint Faculty of the Royal College of Physicians of Ireland (RCPI) and the Royal College of Surgeons in Ireland (RCSI)

2. Exercise as part of a Healthy Lifestyle Dr Laurence J Conway Sports and Exercise Medicine Specialist. FSEM RCSI &RCPI

3. Humans Hunter gatherer Brain development required energy Hunter survived because of endurance

4. Where has evolution led us?

5. Lessons from the aboriginal people of Australia Less Hunting/more gathering due supply

6. Where are we today? What is Best indicator risk of death in next 10 years?

7. Where are we today? What is Best predictor of mortality risk in next 10 years? Exercise Capacity = Aerobic capacity

8. Exercise is the best medicine

9. Relative Risk Score Mansoon JAMA, 2001, 285:1447 0 0.2 0.4 0.6 0.8 1 01-59 min1.0-1.5 h>2h Time Spent Walking per Week 1.0 0.68 0.37 0.33 Relative Risk of CVD

10. 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

11. Exercise = Treatment and Prevention Dose = Intensity + Duration Frequency = Frequency Treatment is life long Risk Benefit ratio Side effects

12. How do we Reduce risk? 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?

13. Disease Prevention Cardiovascular disease Diabetes Mellitus Cancers Obesity Bone Health Mood/stress Immune function Cognitive function Mobility / risk falls

14. Treatment Heart or Vascular Disease. High Blood Pressure Cholesterol Obesity Diabetes Mellitus Cancers Osteoarthritis Osteoporosis Respiratory illness Mood Cognitive Function Neurological Disorders

15. Exercise; the Cost Benefit ratio Effective Low Cost Effects multiple related problems Prevention other disease Quality of Life benefit Socialisation of isolated Dose tailored to individual

16. No Physical Exercise During a 7-Day Period Men Women 18-3435-5455+ Slan Survey 1999 14 11 21 18 17 27 21 26 27 33 37 0 10 20 30 40 Percent 198820021988200219882002

17. Why are people inactive?

18. No Time – Work – Family Cost Lost the Habit Poor motivation/mood due inactivity Health issues Social isolation Hard first few sessions so stop

19. How do we get message to those that need it the most How do we change lifestyle Those that need change are not here

20. Psychological states of change Pre contemplation Contemplation. Preparation Action Maintenance

21. Lifestyle Diet Quantity Quality Timing Hydration Risks Tobacco Leisure drugs Healthy BMI Positive Mental Attitude Rewards in life

22. 7 areas of Investment Schools Transport Urban Design Health Care Public Education Community Sports for all

23. Schools Greater opportunity National Schools Ways to keep girls active through out secondary Insurance issue Develop physical Literacy Curriculum

24. Transport Walking & Public Transport Cycling Drive children to school

25. Urban Design New Housing Estates Safe Friendly environment Urban Plan; Green areas Sports Facilities Cycle tracks Local facilities

26. Health Care 47% Primary Care Doctor say they ask about exercise 13% Patients report getting advice about exercise What can Medical Profession do?

27. What Can Medical Profession do? Ask people about exercise Give green prescriptions Do not tell people to stop exercise Modify where possible

28. What Can Medical Profession do? Educate doctors & student in exercise prescription Increase medical profession awareness Role Models Help remove barriers; – Cost – Time – Educate

29. Public Education Media need to have consistent clear message Irish innovation

30. National Physical Activity Guidelines ‘Get Ireland Active’ www.getirelandactive.ie

31. Community School Public Private sector Fitness Industry

32. Activity for ALL

33. Balance life Work Life balance We need find place all parts of our life Look Positive Beware of negative thoughts Goal setting

34. Work Life Balance StressorsRecovery _____________________________________ FinancialSleep Work relatedFood SocialSocial life HealthRewardsExercise

35. Health and Quality of life