Exercise…

1. Exercise… Michael Heidkamp Clinical Exercise Physiologist Advocate Weight Management September 26th, 2014 What is it?

2. Exercise Vs. Physical Activity • 5 flights of stairs • Walking the dog • Football Game • Soccer Practice • Bicycling (<10mph) • 4 hours of gardening • 4 mile run

3. Physical Activity • Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. • Physical inactivity (lack of physical activity) has been identified as the fourth leading risk factor for global mortality (6% of deaths globally). • Moreover, physical inactivity is estimated to be the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and approximately 30% of ischemic heart disease burden. Physical Activity. Centers for Disease Control and Prevention, 14 July 2014. Web. 16 Sept. 2014. <ww.cdc.gov/physicalactivity/index.html>

4. Exercise • The term "physical activity" should not be mistaken with "exercise". Exercise, is a subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective. • Cardiovascular minimums for weight maintenance are 150 minutes of moderate, 75 minutes of vigorous or a combination of the 2. • Exercise requires an intensity that is challenging enough to stress the body (moderate to vigorous) and must last for 20-60 minutes to truly be effective. • 5-7 days per week for 45-60 minutes is ideal • Strength training should include 2-3 sets of 8-10 exercises that challenge the entire body. These should be performed with a weight that causes fatigue in 8-12 repetitions. • 2-3 days per week with a rest day between similar workouts. Physical Activity. Centers for Disease Control and Prevention, 14 July 2014. Web. 16 Sept. 2014. <ww.cdc.gov/physicalactivity/index.html>

5. Exercise Intensity • Moderate: “labored talking” • The work load should cause a rise in heart rate and breathing to a point to interfere with regular talking, but not enough to prevent you from having a conversation. • Walking briskly (a 15-minute mile). • Rowing • Snow shoveling. • Actively playing with children. • Biking at a casual pace. • Vigorous: “Breathless” • Your work load causes a substantial increase in your heart rate and breathing rate beyond the point of holding a conversation. • Jogging/running. • Swimming laps. • Rollerblading/inline skating at a brisk pace. • Cross-country skiing. • Most competitive sports (football, basketball, or soccer). • Jumping rope. Physical Activity. Centers for Disease Control and Prevention, 14 July 2014. Web. 16 Sept. 2014. <ww.cdc.gov/physicalactivity/index.html>

6. Activities for physically compromised patients

7. New and chronic Injuries • First course of action should be an orthopedic diagnosis and physical therapy to access what will cause more damage and what will improve current ailment • Second course of action to recommend activities that will strengthen current issues • Give exercises they can do to improve cardiovascular health without causing more pain or further damage.

8. Chronic pain with activity • First step is to increase activity and work on frequency ( 3 ten minute bouts, 10 3 minute walks, etc.) • Next you want to add individual bouts of higher intensity workloads. • Then you want to increase duration and frequency of the higher intensity activities.

9. Importance of long-term sustainment of exercise

10. Inflammation Control • Exercising at an intensity above ones tolerance will cause an increase in the pro-inflammatory cytokinesIL-1ß, IL-6, IL-8, TNFα C- reactive protein, and creatine kinase • Once an individual has built a tolerance for moderate to vigorous intensity exercise, it will stimulate an increase in IL-6, IL-10 without TNFα • IL-6 without TNFα has shown to enhance lipid oxidation, increased Insulin-mediated glucose uptake, and a strong anti inflammatory response • Diet, Exercise, and Chronic Disease. The Biological Basis ofPrevention. Edited by C . Murray Ardies. CRC Press 2014.

11. Inflammation Control • IL-6 is released from muscles as a means to activate glycogenolysis • Adequate glycogen depletion does not happen at light intensities or shorter time intervals • Inactivity contributes to a chronic increase in systemic inflammation and radical production which causes cellular damage and contributes to muscle atrophy and insulin resistance. • Diet, Exercise, and Chronic Disease. The Biological Basis ofPrevention. Edited by C . Murray Ardies. CRC Press 2014.

12. Exercise reduces the risk of atherosclerosisthrough: • Calorie expenditure to decrease adiposity • Decreases in BP • Decreased insulin resistance • Increased antioxidant status • Decreased pro-inflammatory signaling • Altered lipid profile and decreased oxidation of cholesterol • Diet, Exercise, and Chronic Disease. The Biological Basis ofPrevention. Edited by C . Murray Ardies. CRC Press 2014.

13. Works cited • Diet, Exercise, and Chronic Disease. The Biological Basis of Prevention. Edited by C . Murray Ardies. CRC Press 2014. • Physical Activity. Centers for Disease Control and Prevention, 14 July 2014. Web. 16 Sept. 2014. <ww.cdc.gov/physicalactivity/index.html>