Physical Activity and Health (UIowa): Exam 3

Type II Diabetes Non-Modifiable Risk Factors

-Age (45)+ -Family History (2-6x more likely) -Ethnicity Diabetes during a previous pregnancy

Specific ways PA prevents, reduces risk, or treats cancer

-Avoidance of weight gain -reduce insulin resistance -improve immune function -lower sex hormones -improved immune function

How does PA ↓ Cancer?

-Avoidance of weight gain / promote weight loss -Reduce insulin resistance: Insulin- enhances cell proliferation, Immediate & chronic. -Lower systemic inflammation -Reduced colon transit time -Lower sex hormones: Directly- exercise ↓ estrogens & androgens. Indirectly- less fat tissue -Improved immune function

PA & Blood Pressure

-BP= (Heart Rate x Stroke Volume) x peripheral resistance -Following exercise- BP lower by 3-15 mmHg for 10-15 hours. -PA can slow progression of hypertension -PA Goal: short (10 min.) or long (30+ min.)= lower BP. Multiple PA sessions may keep BP lower through the day.

Osteoporosis Sex Difference

-Childhood (girls mature sooner and less active). -Hormones: estrogen and testosterone (maintains bone mass) and Menopause. -Adulthood: men more active, particularly more resistance training.

Groups of disorders of the heart and blood vessels

-Coronary Heart Disease (heart attack) -Cerebrovascular Disease (brain-stroke) -Peripheral vascular disease (limbs).

Cancer Non-Modifiable Risk Factors

-Genetics -Family History -Age -Gender -Race -Ethnicity

Mechanisms of Exercise Modification of Insulin Resistance

-Improved insulin sensitivity (whole body and skeletal muscle) -Increased muscle mass (increased glucose uptake) -Contraction stimulated glucose uptake -Improved blood cell function

Specific ways PA prevents, reduces risk, or treats CHD

-Increased blood lipid profile -Reduces coagulants in blood -Reduces BP -Enhances energy expenditure -Decreases Weight -Lowers Stress

How does PA ↓ CVD

-Increases the heart's "fitness" & coronary circulation -Reduces inflammatory responses in the blood -Reduces coagulants in blood -Lowers insulin resistance -Enhances blood lipid profile -Regulates blood pressure -Increases energy expenditures

Hypokinetic Disease

-Low levels of movement→ abnormal function & deterioration. -Cardiovascular Disease, Cancer, Type II Diabetes, and Osteoporosis.

Type II Diabetes Modifiable Risk Factors

-Obesity -Diet -Physical activity

CVD Risk Factors (Modifiable)

-Physical Inactivity: under 90 min./week and under 3 months -Obesity: BMI over 30 and waist over 40 inches men and over 35 inches women. -Cigarette Smoking: current smoker, quit less than 6 months. Environmental exposure(s). -Damages blood vessels and increases clotting. -Hypertension: high pressure in the arteries. -Dyslipidemia: Cholesterol (lipids) and fats (triglycerides) in blood, -Diabetes: inability to regulate blood glucose levels.

Dyslipidemia Increased Risks

-Total Cholesterol is greater than 200 mg/dL. -HDL less than 40 mg/dL -LDL more than 130 mg/dL -Triglycerides more than 150 mg/dL -Reduced Risk more than 60 mg/dL -PA:↓ triglyceride, ↓ LDL, ↑ HDL

Types of Diabetes

-Type I: insulin dependent -Type II: non-insulin dependent

Relative Risk

-chance that a disease or side effect will occur given certain conditions or factors. -RR = [a/(a + b)] / [c/(c + d)]

Relationship between PA and Type II Diabetes

-directly related to physical inactivity

Specific ways PA prevents, reduces risk, or treats Type II Diabetes

-improved insulin sensitivity, whole body and skeletal muscle -increased muscle mass, increased glucose intake -contraction stimulated glucose intake -improved B-cell function

Specific ways PA prevents, reduces risk, or treats Osteoporosis

-increases bone mass -slows decline in bone mass -reduces risk of falls

Elevated BP

120-129 (systolic) / Less than 80 (Diastolic)

High Blood Pressure (Hypertension) Stage 1

130-139 (systolic) / 80-89 (Diastolic)

High Blood Pressure (Hypertension) Stage 2

140+ (systolic) / 90+ (Diastolic)

High Blood Pressure (Hypertension) Stage 3

180+ (systolic) / 120+ (Diastolic)

Reduce Sedentary Time

2 minute light to moderate PA "breaks" every 20-30 minutes Improved blood glucose & insulin levels (controls no activity breaks over 5 hour periods).

What is HbA1C?

A blood test that reveals how well you manage your blood sugar levels over the past 3 months.

Type II Diabetes Definition

A condition results from insufficient production of insulin, causing high blood sugar. Directly related to PA.

Osteoporosis Definition

A condition when bone strength weakens and is susceptible to fracture. It usually affects the hip, wrist or spine. Low bone mass/strength, structural deterioration, and increased bone fracture risk in hip, vertebrae and wrist.

Cancer Definition

A disease resulting from uncontrolled growth and division of abnormal cells.

Functional health

capacity to perform a task, activity or behavior independently. Influences health at any age. Caused by: low aerobic capacity, lack of muscular strength, and poor balance. Poor functional health- risk of falls.

Risk Factor

lifestyle or genetic variable that can predict the occurrence of disease.

Osteoarthritis Definition

loss of articular cartilage. Joint pain & dysfunction (costly).

Osteoarthritis Risk Factors

physical inactivity, excessive PA or overuse, excessive body weight, and age/sex/genetics/history of joint injury.

Osteoporosis Modifiable Risk Factors

physical inactivity, tobacco use, thin or underweight, low sex hormones, and nutrition (low calcium & vitamin D intake, excessive caffeine over 400 mg, and excessive alcohol).

Secondary Prevention

prevents injury/disease once exposure to risk factors occurs but still in early, "preclinical" stage.

Tertiary Prevention

rehabilitating persons with injury/disease to reduce complications (vocational rehab to retrain workers after injury).

Sedentary Death Syndrome

signs and symptoms associated with sedentary living.

Prevention

strategies to prevent the onset of disease through risk reduction but also mitigate the complications of existing disease.

Primary Prevention

targets risk factors leading to injury/disease (safety belt laws or vaccinations).

Primordial Prevention

targets social and economic policies affecting health.

Cancer Modifiable Risk Factors

tobacco use/smoking physical activity weight diet alcohol use sexual partners sun exposure

Diagnosis for Diabetes

various glucose tests. Fasting plasma glucose, oral glucose tolerance, random plasma glucose.

Cognitive Benefits (Youth)

Academic achievement- school performance (usually measured by scores on standardized tests).

Non-Modifiable Risk Factors: Mental Health Conditions

Age (younger) Sex (women) Genetics Traumatic experiences Chronic medical conditions

Coronary Heart Disease Mechanisms

Atherosclerosis- plaque buildup in the arteries.

How to lower risk of falls

Balance training and muscle strengthening: 3x/week for 30 minutes. Backwards/sideways/heel/toe walking. Sit to stand. Supported- progressing to non-supported. Moderate walking: 2+ times per week, total of 60 minutes Tai Chi- may prevent falls

Metabolic Syndrome

Cluster of biomedical markers that increases risk of diabetes. Abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and high fasting blood Glucose.

Intervention Spectrum: Early Intervention

Dealing with issues as they arise- aims to prevent it from becoming more serious.

Scientific evidence supports that physical activity lowers the risk of..

Dementia, anxiety symptoms, anxiety disorder, depressive symptoms, major depressive disorder, and age-related decline in cognitive function.

PA ↓ Cancer

Dose response: More activity, more benefit. Relationship may be different when considering: Prevention, treatment, and post treatment.

How much PA to prevent, reduce risk & treat cancer?

Evidence still being developed. 150 minutes of moderate aerobic PA or 75 minutes of vigorous aerobic PA, 2x/week of resistance training.

Children (Brain Health)

FIT Kids Randomized Control Trial: 8-9 years, 9 months after school program or wait list control group, and intervention group (age-appropriate PA (aerobic + motor skill) and 70 minutes each day). Changes: ↑ fitness, ↑ ability to match and arrange colored shapes, ↑ attendance, ↑ improvement, and causal effect of PA program on brain function.

PA → Glut 4 Regulation

GLUT 4- protein required for insulin to stimulate glucose uptake. When physically active: GLUT 4↑. Improves insulin sensitivity. When physically inactive: GLUT 4↓. Insulin resistance.

What is GLUT 4?

Glucose transporter type 4, is a protein encoded in humans by the SLC2A4 gene.

Brain Health Conditions

Good mental health? World Health Organization: State of well-being Individuals realizing his/her own potential Can cope with normal stressors of life Work productively and fruitfully Able to make a contribution to the community. Common conditions studied: Cognitive & age related decline Mood disorders (anxiety and depression) Psychological distress Low self-esteem

HDL and LDL

High-Density Lipoprotein and Low-Density Lipoprotein. Lipoprotein is any group of soluble proteins that combine with and transport fat or other lipids in the blood plasma.

Relationship between PA and Cancer

Higher levels of physical activity are linked to lower risks of cancers. It also prevents weight gain and obesity and reduces the risk of developing cancers linked to excess body weight.

Hypoxia (low oxygen)- Cancer Growth?

Hypoxia- causes cells to seek out other nutrients & escape the "hostile" environment. Cells become more aggressive→ metastasis

Mental Health Treatment Options

Individual or family therapy Medication Hospitalization Self-Help

Children/Adolescents Bone Health Guidelines (mode, impact, resistance, and aerobic)

Intensity → > 3.5 x body weight→ > 60% 1 RM→ Mod. to Vig. Duration→ 100 impacts→ > 30 min.→ 30-40 min. Frequency→ 3x/week→ 3x/week→ daily Program Length→ > 7 months→ > 7 months→ unknown

Cancer Causes

Internal Factors: heredity, immune dysfunction, abnormal metabolism. External Factors: behaviors, environments. Interaction: environment ↔ genetics

Intervention Spectrum: Active Intervention/Treatment

Intervention once serious issues are present (treatment)- aims to reduce negative impact and aid recovery (may include crisis management).

Cardiovascular Disease definition

Is a condition where the major blood vessels supplying the heart are narrowed. The reduced blood flow can cause chest pains and shortness of breath.

Normal BP

Less than 120 (systolic) / Less than 80 (Diastolic)

Diabetes Treatment

Medication: ↑ insulin sensitivity. ↑ insulin release. Weight Loss: Promote loss of abdominal fat. Challenge to maintain. Cardiovascular Exercise: Exercise stimulates glucose uptake. ↓ HbA1C, BP, BMI, & lipids. Challenges include orthopedic problems and low fitness. Resistance Training: ↑ insulin sensitivity. More muscle tissue to use glucose. Glucose homeostasis.

Cognitive Benefits (Adults)

Memory decline- ability to recall short-term and long-term events and information

Multistage Model of Carcinogenesis

Normal Cells→ Stage 1: Initiation (converted cells and stable cells) → Stage 2: Promotion (precancerous cells and stable cells) → Stage 3: Progression (cancerous cells)

Intervention Spectrum: Recovery and Maintenance

Ongoing support once treatment has been sought. Critical issues resolved

Relationship between PA and Osteoporosis

PA reduces risk of Osteoporosis

PA ↓ risk of Osteoporosis

PA- increases peak bone mass, slows decline in bone mass, and reduces risk of falls. Best time to address- childhood & adolescence (opportunity for intervention right before puberty). Adulthood (emphasized bone overload).

Modifiable Risk Factors: Mental Health Conditions

Physical inactivity Substance Abuse Low self-esteem Distress Negative lifestyle behaviors

Brain Health Mechanisms

Physiological: cerebral capillary growth, brain blood flow, oxygenation, increased cerebral activity (↑ regulation of neurotransmitters, ↑ growth of brain cells, ↑ ability of nerves to conduct impulses). Biomechanical and Physical: fitness & biomechanical improvements: efficiency, economy of movement. Balance, stability and movement. Improvements in self-esteem. More PA options & confidence (self-efficacy).

Cognitive Benefits (Youth and Adult)

Reaction time- time between a mental stimulus and an intended physical response Learning and intelligence score- gaining new knowledge or modifying previous knowledge Cognitive function- ability to process information, learn, and problem solve

PA & Brain Health

Regular PA improves quality of life Brain health benefits from aerobic or a combo of aerobic + resistance training. 3-5 days/week for 30-60 mins.. Intensity at least moderate level (≥ 3 MET).

PA reduced CVD

Regular PA ↓ risk by 25-30%: Applies to men & women all ages, & all races. Aerobic PA Guidelines: Benefits may be evident at lower levels (120 min. MPA/week) Resistance training- some evidence regarding effectiveness Secondary prevention- reduce risk factors: Obesity, diabetes, blood pressure, cholesterol. Tertiary prevention- cardiac rehabilitation to improve function of the heart and skeletal muscle.

Exercise and Sleep

Rough night sleep → feel tired and skip workout→ less tired at bedtime → poor quality sleep. Good night sleep→ energized to exercise→ tired at bedtime→ fall asleep faster Acute bouts and regular PA participation can improve several sleep outcomes (improve how fast you are able to fall asleep, total sleep time, and how quickly you can wake up in the AM). Regular PA is associated with better overall sleep quality.

Low muscle mass

Sarcopenia- loss of strength- limited movement. Not necessarily linked with a specific disease process but influences functional health.

Relationship between PA and Coronary Heart Disease

Sedentary Lifestyle increases change of CHD so individuals would be less at risk if they exercised more. Exercising helps with obesity and better diet habits.

PA, Depression, & Anxiety

Short, acute bouts of exercise can reduce anxiety Reduces risk of developing major depression and depressive symptoms Reduce the symptoms of depression among people that already have it.

PA and Cognitive Function Among Healthy Individuals

Strong evidence demonstrates that short exercise bouts, short-term benefit for cognition (improvements in attention, memory, and processing speed). Stronger effects for children & older adults (than adults).

Intervention Spectrum: Health Promotion & Prevention

To prevent issues occurring and promote wellbeing.

Role Ability

ability to perform activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs).

Type II Diabetes Visceral Obesity

adipose tissue (fat) around organs (abdominal obesity).

CVD Risk Factors (Non-Modifiable)

age (> 45 men, > 55 women) family history, < 55 yrs father, < 65 yrs mother.

Osteoporosis Non-Modifiable Risk Factors

age (greater than 50 for women and greater than 70 for men), sex (women), genetics, ethnicity/race (white, Asian, and Latino), and history of fractures.

Why is it important to understand the different types of prevention?

getting preventive care reduces the risk for disease, disabilities, and death.