Mike Loosemore Presentation - Active by Design

The Built Environment

Dr Mike Loosemore

Consultant Sport and exercise Medicine. ISEH. UCLH.

Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise

Health benefits of physical activity

Regular physical activity at the correct intensity: • Reduces the risk of heart disease by 40% • Lowers the risk of stroke by 27% • Reduces the incidence of diabetes by almost 50% • Reduces the incidence of high blood pressure, by almost 50% • Can reduce mortality and the risk of recurrent breast cancer

by almost 50% • Can lower the risk of colon cancer by over 60% • Can reduce the risk of developing of Alzheimer’s disease by

one-third • Can decrease depression as effectively as Prozac or

behavioural therapy

Faculty of Sport and Exercise Medicine UK

Health through Sport and Exercise

A frightening effect

Obesity Smoker Hyper- tension

High Cholesterol

Diabetes Low

Fitness


The perils of inactivity

Active Movement



Inactivity

Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy

The Lancet, Volume 380, Issue 9838, Pages 219 - 229, 21 July 2012

doi:10.1016/S0140-6736(12)61031-9

I-Min Lee Eric J Shiroma Felipe Lobelo Pekka Puska Steven N Blair Peter T Katzmarzyk, for the

Lancet Physical Activity Series Working Group†



Endurance Hunting


Are we less physically active?

• Compared to 1980:

– the UK now travels 25% less on foot and by bicycle

– watches twice as much television

– half as many young people play extra-curricular sport

– half as many work in physically active employment

– daily life also involves a range of labour saving devices, including washing machines, dishwashers, lifts, car-washes and ride-on lawnmowers.

Foresight Obesity Report, 2007 Faculty of Sport and Exercise Medicine UK Health through Sport and Exercise

Trends in manual & non-manual occupations among

E nglis h adults . The Health S urvey for E ngland

35

45

55

65

1 991 1 993 1 994 1 997 1 998 1 999 2003 2004

Pe

r c

en

t

Manual Jobs Non-Manual Jobs



The genetic paradox

Endurance v Energy conservation

Active Movement Faculty of Sport and Exercise Medicine UK






Sedentary Behavior



Non-Vigorous PA and Mortality Risk A

ll C

ause

Mo

rtal

ity

Re

lati

ve R

isk

Non-Vigorous Physical Activity, MET-Hrs/week

Woodcock Int J Epi; 2010

2.5 hours/wk decreased mortality by 19%

7 hours/wk decreased mortality by 24%


Breaking the Geriatric Curve

NEJM, April 1998 Age

High-Risk Lifestyle (inactivity, smoking, obesity)

‘Deficient Survival’

Our ultimate goal

Active Movement

Low-Risk Lifestyle

(active, non-smoker)


Br J Sports Med2012;46:709-712 doi:10.1136/bjsm.2012.091485

Review

NON COMMUNICABLE DISEASE PREVENTION

Investments that Work for Physical Activity


1. ‘Whole-of-school’ programs

2. Active Transport

3. Urban Design

4. Integration into Primary Care

5. Public education

6. Whole-of-community

7. Sport for all


1. ‘Whole-of-school’ programs


2. Active Transport


3. Urban Design


3. Urban Design


3. Urban Design

Effect of increasing active travel in urban England and Wales

on costs to the National Health Service

• James Jarrett, James Woodcock, Ulla K Griffi ths, Zaid Chalabi, Phil Edwards, Ian Roberts, Andy Haines

• Lancet 2012; 379: 2198–205

Within 20 years, reductions in the prevalences of type 2 diabetes, dementia, ischaemic heart disease, cerebrovascular disease, and cancer because of increased physical activity would lead to savings of roughly UK£17 billion (in 2010 prices)

Faculty of Sport and Exercise Medicine UK


4. Integration into Primary Care


5. Public education


6. Whole-of-community


7. Sport for all


7. Sport for all


Inactivity


Inactivity


Conclusion

• Physical inactivity is the major risk factor for morbidity and mortality.

– There is a linear relationship between physical activity and health status.

– Changing the Built Environment is crucial.



Thank You

@doctorloosemore

[email protected]

[email protected]
