dr william bird mrcgp mbe august 2016 why being physically
TRANSCRIPT
Dr William Bird MRCGP MBE 17th August 2016
Why Being Physically Active Matters Northamptonshire Health and Wellbeing Board
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If we take an hour to equal 1,000 years, then four days is 100,000 years – the time from the origin of mankind to today
4 days ago
100,000 years ago
hunter gatherers
10 hours ago
10,000 years ago agriculture
4 hours ago
4,000 years ago civilisation
10 hours ago
10,000 years ago agriculture
4 hours ago
4,000 years ago civilisation
technology industrialisation industrialisation
9 minutes ago
9 minutes ago
80 seconds ago
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Sociable Green Valued
Our factory setting is to be in a sociable group, supportive environment and
have a purpose People Place Purpose
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Loneliness Hostile Rejection
People Place Purpose
Fear and Chronic Stress
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Chronic Stress
Anxiety and depression
Physical Inactivity
Poor diet
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Chronic Stress
Stress Hormones
Physical Inactivity
And other poor health behaviours
Chronic Inflammation
Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007
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Inflammation: ‘the cause of causes’
Chronic Inflammation
Starts in children as young as 6 years old
Arthritis Arthritis
Cancers Cancers
Diabetes Diabetes
Obesity Obesity
Dementia Dementia
Cardiovascular disease
Anxiety and Depression
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Inactivity causes inflammation
1. Increases visceral fat
3. Damages
healthy cells
2. Reduces anti- inflammatories
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Inactivity: trilogy of inflammation
1. Increases visceral fat
3. Damages
healthy cells
2. Reduces anti- inflammatories
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Reducing inflammation – fat
Visceral fat = 0.5 L Visceral fat = 1.1 L
Visceral fat = 1.3 L Visceral fat = 1.7 L
Visceral fat = 4.3 L Visceral fat = 4.2 L Visceral fat = 1.8 L
Visceral fat = 1.2 L
Variation in visceral fat content in men with the same waist circumference
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Visceral fat reduction with exercise
–25
–20
–15
–10
–5
0 Lean Obese Type 2 Diabetes
Subcutaneous Fat Visceral Fat
Lee S et al. J Appl Physiol 2005;99:1220-1225
Fat loss after 13 weeks of walking 60 mins a day and no weight loss
% Loss of Fat
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Inactivity: trilogy of inflammation
1. Increases visceral fat
3. Damages
healthy cells
2. Reduces anti- inflammatories
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Reducing inflammation – muscles
Contracting muscles
release powerful anti-inflammatories
called Myokines
These Myokines Circulate
around the whole body
calming every cell
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Inactivity: trilogy of inflammation
1. Increases visceral fat
3. Damages
healthy cells
2. Reduces anti- inflammatories
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Chromosomes keep dividing
Immune system is
switched off until needed
Mitochondria, healthy
and active. Providing lots
of energy
Inside a healthy cell
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‘The mitochondria is like a dynamo, it has to keep moving ...
... and in the body they weigh as much as a car battery’
Prof Mike Murphy, MRC Mitochondrial Biology Unit Cambridge University
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Sedentary, high fat diet and stress
Mitochondria
Anti- Oxidants Reactive
Oxidative Species
Mitochondrial DNA
Oxidative Phosphorylation
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Physically active, low fat and not stressed
Mitochondria
Oxidative Phosphorylation
Reactive Oxidative Species
Mitochondrial DNA
Anti- Oxidants
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Telomeres get shorter
Epel, Elissa, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Annals of the New York Academy of Sciences 1172.1 (2009): 34-53
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Senescence: the end of the cell
Hezel, Aram F., Nabeel Bardeesy and Richard S. Maser. ‘Telomere induced senescence: end game signaling.’ Current molecular medicine 5.2 (2005): 145-152.
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This causes inflammation
Immune system is constantly switched on
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Inflammation: ‘the cause of causes’
Chronic Inflammation
Starts in children as young as 6 years old
Arthritis Arthritis
Cancers Cancers
Diabetes Diabetes
Obesity Obesity
Dementia Dementia
Cardiovascular disease
Anxiety and Depression
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People Place Purpose
Mitochondrial damage, telomere shortening, and chronic inflammation
Chronic stress Poor health behaviours
Cardiovascular disease, diabetes, cancer, depression
Pathway of Ill Health
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Increases Hippocampus by 20%
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Physical activity is fundamental to human survival
Noakes T Spedding M: Olympics: Run for Your Life Nature 487, 295–296 (19 July 2012)
Brain Derived Neuro-trophic factor
Increases connectivity between neurones
Prevents Parkinson’s and Dementia
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After 20 minutes of sitting quietly After 20 minutes of walking
Hillman et al. (2009). Neuroscience,159, 1044-1054
Single Sessions of Physical Activity can enhance Attention and Memory
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‘Physical inactivity is the fourth
leading cause of death worldwide.’
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Top 5 non-communicable disease risk factors for mortality
28 WHO (2009) Global health risks: mortality and burden of disease attributable to selected major risks
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Physical Activity is more than just
weight loss
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Mortality due to Inactivity
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
CHD Type 2 Diabetes Breast Cancer Colon Cancer All Cause Mortality
Netherlands USA UK
Lee I-M et al. Effects of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet 2012 Published online July 18.
Population Attributable Fraction of mortality due to Inactivity (%)
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Proportion who are not active
Public Health England (2014) Everybody Active, Every Day; Based on Hallal PC et al. (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet.
International comparison of physical inactivity (at ages 15 and over)
Note: Comparator = Not meeting any of the following per week: (a) 5 x 30 mins moderate-intensity activity; (b) 3 x 20 mins vigorous-intensity activity; (c) equivalent combination achieving 600 metabolic equivalent-min.
UK 63.3%
USA 40.5%
Australia 37.9%
Finland 37.8%
France 32.5%
Germany 28.0%
Netherlands 18.2%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%%Inac've
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Physical Activity clears all CVD risk from patients with Diabetes
1
2.81
0.89 0.78
0
1
2
3
Less than 3 hours a week no Diabetes
Less than 3 hours a week with Diabetes
More than 3 hours a week no Diabetes
More than 3 hour a week with Diabetes
Moe B et al Diabetes Care March 2013 vol. 36 no. 3 690-695
Follow up of 53,973 Norwegian Men (recruited 1995). Adjusted for weight, 1,750 deaths from CVD in 2008. Less than 3 hours vs more than 3 hours a week of Physical Activity CVD Risk
(1.93 – 4.07)
(0.48 – 1.63) (0.63 – 0.96)
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How many minutes
of exercise did you
do yesterday?
How much time did
you spend sitting
yesterday?
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Summary ● We are designed to be continually active
● As soon as we stop we:
• Develop chronic inflammation that leads to long term conditions
• We age faster • Our brains lack the repair proteins called BDNTF
● Being active is the single most important factor in developing a healthy community