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Step Into Fitness and Health Don Hall, DrPH, CHES Wellsource, Inc. InStep for Life, NAD Health Ministries

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Step Into Fitness and Health Don Hall, DrPH, CHES Wellsource, Inc. InStep for Life, NAD Health Ministries

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    1. Updated for Gulf States Camp Meeting 5-27-08 Updated for NPUC, Jan. 22, 2008 DRH Used at Oregon Campmeeting 7-16-2008 Updated. Updated for NAD Health Summit 2009 Orlando Florida THE CONTENT of this presentation is based on healthy guidelines established by the government and leading health authorities, and is designed to use with healthy people to keep them healthy. Persons with existing disease should consult their physician for specific guidance. Updated for Gulf States Camp Meeting 5-27-08 Updated for NPUC, Jan. 22, 2008 DRH Used at Oregon Campmeeting 7-16-2008 Updated. Updated for NAD Health Summit 2009 Orlando Florida THE CONTENT of this presentation is based on healthy guidelines established by the government and leading health authorities, and is designed to use with healthy people to keep them healthy. Persons with existing disease should consult their physician for specific guidance.

    2. ? 2009 Wellsource, Inc. Holy in Every Way May the God of peace make you holy in every way, and may your whole spirit and soul and body be kept blameless until that day when our Lord Jesus Christ comes again. God who calls you is faithful; he will do it. 1 Thessalonians 5:23

    3. ? 2009 Wellsource, Inc. Walking Time and Heart Health Walking Reduces Risk of Heart Attack Researchers found that walking is one of the best activities for preventing disease and enhancing health. Nearly everyone can walk and it seldom causes any injuries. In this study, women who walked briskly for at least three hours per week cut their risk of a heart attack by nearly 50 percent. Brisk walking for five hours or more a week cut heart attack risk even further. Those who added another 90 minutes a week doing vigorous exercise such as aerobics, cut their risk by nearly 60% (age adjusted rates). Even women who had been sedentary most of their lives, began to benefit when they started exercising (brisk walking) as little as an hour a week. Other studies show that walking has similar benefits for men. Reference Manson JE et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary artery disease, The New England Journal of Medicine, August 1999;341:650-658 Walking Reduces Risk of Heart Attack Researchers found that walking is one of the best activities for preventing disease and enhancing health. Nearly everyone can walk and it seldom causes any injuries. In this study, women who walked briskly for at least three hours per week cut their risk of a heart attack by nearly 50 percent. Brisk walking for five hours or more a week cut heart attack risk even further. Those who added another 90 minutes a week doing vigorous exercise such as aerobics, cut their risk by nearly 60% (age adjusted rates). Even women who had been sedentary most of their lives, began to benefit when they started exercising (brisk walking) as little as an hour a week. Other studies show that walking has similar benefits for men. ReferenceManson JE et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary artery disease, The New England Journal of Medicine, August 1999;341:650-658 

    4. ? 2009 Wellsource, Inc. Physical Activity and Cholesterol Level The Cooper Institute for Aerobic Research studied the effect of fitness levels on overall risk of dying in some 25,341 men for 19 years (over 211,000 person years of follow-up). When comparing mortality rates in low fit to high fit men, both with normal and high blood cholesterol, fit men had significantly lower mortality rates. Notice that low fit men without high blood cholesterol had a higher mortality rate than high fit men with high blood cholesterol. This certainly illustrates the protective affect of physical activity even in people with high blood cholesterol levels. The bottom line is this. If you have high cholesterol, being fit can significantly decrease your risk, even if you can’t get your cholesterol levels lower. Reference Steven Blair, et.al, Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-cause Mortality in Men and Women, JAMA, July 17, 1996. The Cooper Institute for Aerobic Research studied the effect of fitness levels on overall risk of dying in some 25,341 men for 19 years (over 211,000 person years of follow-up). When comparing mortality rates in low fit to high fit men, both with normal and high blood cholesterol, fit men had significantly lower mortality rates. Notice that low fit men without high blood cholesterol had a higher mortality rate than high fit men with high blood cholesterol. This certainly illustrates the protective affect of physical activity even in people with high blood cholesterol levels. The bottom line is this. If you have high cholesterol, being fit can significantly decrease your risk, even if you can’t get your cholesterol levels lower. ReferenceSteven Blair, et.al, Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-cause Mortality in Men and Women, JAMA, July 17, 1996.

    5. ? 2009 Wellsource, Inc. Fitness and C-Reactive Protein Cooper Institute study of 722 men Tested fitness levels and CRP levels High fit men had lower C-reactive protein levels than low fit men C-reactive protein is a marker for inflammation and increased risk of coronary heart disease. In this study of 722 men, those who were the most fit had lower C-reactive protein levels than those who were unfit. Men who were most fit (top 20%) had the lowest C-reactive protein levels (0.7 mg/L) Unfit men had C-reactive protein levels more than twice as high (1.64 mg/L). Fit men were 83% less likely to have elevated C-reactive protein levels compared to unfit men (bottom 20%). This relationship exists even after controlling for obesity and waist girth. This finding helps explain one reason why fit men are less likely to have heart problems than unfit persons. Reference Church TS, et al. Associations between cardiorespiratory fitness and C-reactive protein in men, Arteriosclerosis, Thrombosis, and Vascular Biology, Nov 1, 2002; 22:1869-76   C-reactive protein is a marker for inflammation and increased risk of coronary heart disease. In this study of 722 men, those who were the most fit had lower C-reactive protein levels than those who were unfit. Men who were most fit (top 20%) had the lowest C-reactive protein levels (0.7 mg/L) Unfit men had C-reactive protein levels more than twice as high (1.64 mg/L). Fit men were 83% less likely to have elevated C-reactive protein levels compared to unfit men (bottom 20%). This relationship exists even after controlling for obesity and waist girth. This finding helps explain one reason why fit men are less likely to have heart problems than unfit persons. ReferenceChurch TS, et al. Associations between cardiorespiratory fitness and C-reactive protein in men, Arteriosclerosis, Thrombosis, and Vascular Biology, Nov 1, 2002; 22:1869-76 

    6. ? 2009 Wellsource, Inc. Activity & Prevalence of Hypertension Study included 2.548 Japanese men aged 35-59. Researchers looked at their daily activity level. Those men with the highest level of daily activity had the lowest rates of hypertension -- about half the risk of those who were least active. A uniqueness in this study is that the physical activity is “lifestyle activity” not an exercise program such as running or biking, but activity that the person does throughout the day such as walking to work or back home, or to the train and back, climbing stairs, gardening, manual work, bicycling to the store, etc. The trends of lower BP with higher activity held true even after adjusting for age, family history, alcohol intake, smoking, change in BMI, etc. Reference Nakanishi N et al. Daily Life Activity and the Risk of Developing Hypertension in Middle-aged Japanese Men, Archives of Internal Medicine 165:214-220, Jan. 24, 2005Study included 2.548 Japanese men aged 35-59. Researchers looked at their daily activity level. Those men with the highest level of daily activity had the lowest rates of hypertension -- about half the risk of those who were least active. A uniqueness in this study is that the physical activity is “lifestyle activity” not an exercise program such as running or biking, but activity that the person does throughout the day such as walking to work or back home, or to the train and back, climbing stairs, gardening, manual work, bicycling to the store, etc. The trends of lower BP with higher activity held true even after adjusting for age, family history, alcohol intake, smoking, change in BMI, etc. ReferenceNakanishi N et al. Daily Life Activity and the Risk of Developing Hypertension in Middle-aged Japanese Men, Archives of Internal Medicine 165:214-220, Jan. 24, 2005

    7. ? 2009 Wellsource, Inc. Burns Excess Calories Every minute of activity burns 3-12 times more calories than sitting. Notice the relative increase in calories burned for the various activities listed on the right Activity Increased Calories Sitting 1 X Calisthenics 3-8 X Climbing hills 5-10X Biking 10 mph 7 X Aerobic dance 3-9 X Walking, 4 mph 4.3 X Skipping rope, 70/min 9 X Running, 9 min/mile 11 X Tennis 4-9 X Swimming 4-8 X As you can see fro the chart above, physical activity is a good way to expend more calories and is generally more fun than just dieting or being hungry. This chart also helps explain why obesity is on the rise. With all of the “labor saving devices” in our modern society, there is very little opportunity for physical activity unless plans are made to be active. Very vigorous activates, like running at a 6.5 min/mile pace, or cross country ski racing, actually burn calories at a rate of 10-12 times faster than when sitting (which is the major requirement of most jobs today). Any added activities you do during the day (taking the stairs, walking to the store, etc.) all help burn up excess calories. Reference American College of Sports Medicine, Resource Manual, “Cardiorespiratory Endurance”, Fourth Edition, Lippincott Williams & Wilkins, Philadelphia, 2001 As you can see fro the chart above, physical activity is a good way to expend more calories and is generally more fun than just dieting or being hungry. This chart also helps explain why obesity is on the rise. With all of the “labor saving devices” in our modern society, there is very little opportunity for physical activity unless plans are made to be active. Very vigorous activates, like running at a 6.5 min/mile pace, or cross country ski racing, actually burn calories at a rate of 10-12 times faster than when sitting (which is the major requirement of most jobs today). Any added activities you do during the day (taking the stairs, walking to the store, etc.) all help burn up excess calories. ReferenceAmerican College of Sports Medicine, Resource Manual, “Cardiorespiratory Endurance”, Fourth Edition, Lippincott Williams & Wilkins, Philadelphia, 2001

    8. ? 2009 Wellsource, Inc. Body Weight, Fitness Level, and Risk of Mortality from All Causes Here we see the results of a large study comparing overall mortality levels from any cause with body weight (BMI) and level of physical activity. It was a very large study including 25,714 people followed for over 10 years (258,781 person years of follow-up). First, look at the blue bars (unfit people). Notice how mortality rates increase as body weight goes up. Next look at the yellow or tan bars. These are people who exercise regularly. Notice that their mortality rates hardly change at all as weight goes up. Exercise protects them against the health hazards of obesity. So, if you never reach your ideal weight in an exercise program, don’t be discouraged. You are obtaining your real objective, and that is to be healthy! Lastly, just compare the difference, at any of the weight levels, between those who are fit and those who are unfit. Those are big differences – two to three times increase in mortality. The level of fitness is more important than the weight in determining longevity. Note: Normal weight is defined as a BMI of 18.5-24.9, Overweight is a BMI of 25-29.9, Obese is a BMI of 30+ Reference Ming Wei, Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 282(16):1547-53, Oct. 27, 1999Here we see the results of a large study comparing overall mortality levels from any cause with body weight (BMI) and level of physical activity. It was a very large study including 25,714 people followed for over 10 years (258,781 person years of follow-up). First, look at the blue bars (unfit people). Notice how mortality rates increase as body weight goes up. Next look at the yellow or tan bars. These are people who exercise regularly. Notice that their mortality rates hardly change at all as weight goes up. Exercise protects them against the health hazards of obesity. So, if you never reach your ideal weight in an exercise program, don’t be discouraged. You are obtaining your real objective, and that is to be healthy! Lastly, just compare the difference, at any of the weight levels, between those who are fit and those who are unfit. Those are big differences – two to three times increase in mortality. The level of fitness is more important than the weight in determining longevity. Note: Normal weight is defined as a BMI of 18.5-24.9, Overweight is a BMI of 25-29.9, Obese is a BMI of 30+ ReferenceMing Wei, Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 282(16):1547-53, Oct. 27, 1999

    9. ? 2009 Wellsource, Inc. Fitness and Diabetes Risk 8,633 men free of diabetes, studied for 6 years Highly fit men were protected against getting diabetes Low fit men were 3.7 times more likely to get diabetes than highly fit men Moderately fit men were 1.7 times more likely to get diabetes than highly fit men In this study of 8,633 healthy men free of diabetes, fitness levels were found to be protective against the risk of developing diabetes. Fitness levels were determined by a treadmill test. Highly fit men were the top 40% of the group (top 2 quintiles). The least fit were defined as the bottom quintile or 20% of the group. Moderately fit were those in between (middle 40% of group). Those most fit had the lowest risk of getting diabetes. Moderately fit men had a relative risk of 1.7, and low fit of 3.7 times greater than highly fit men. All men at the beginning of the study were free of diabetes. Those who got regular exercise were protected against getting diabetes. The sedentary group were also twice as likely (RR 1.9) to develop high fasting blood glucose levels (but not diabetes yet) compared to the highly fit group. Reference: Gibbons WM, et al “The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men”, Annals of internal Medicine, 1999 Jan. 19; 130(2):89-96 In this study of 8,633 healthy men free of diabetes, fitness levels were found to be protective against the risk of developing diabetes. Fitness levels were determined by a treadmill test. Highly fit men were the top 40% of the group (top 2 quintiles). The least fit were defined as the bottom quintile or 20% of the group. Moderately fit were those in between (middle 40% of group). Those most fit had the lowest risk of getting diabetes. Moderately fit men had a relative risk of 1.7, and low fit of 3.7 times greater than highly fit men. All men at the beginning of the study were free of diabetes. Those who got regular exercise were protected against getting diabetes. The sedentary group were also twice as likely (RR 1.9) to develop high fasting blood glucose levels (but not diabetes yet) compared to the highly fit group. Reference: Gibbons WM, et al “The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men”, Annals of internal Medicine, 1999 Jan. 19; 130(2):89-96

    10. ? 2009 Wellsource, Inc. Walking Reduces Mortality in Diabetics Walking is a form of exercise that nearly everyone can do safely, especially diabetics. In this study of 2896 diabetics studied for 8 years, those who walked regularly had a significantly lower risk of death from cardiovascular disease and death from any cause. Those who walked 2 hours per week dropped their overall death rate by 39%. Those who walked 3-4 hours per week had even better results. They reduced their risk of dying fro any cause by over 50%. Those who reported any walking at a rate sufficiently brisk to increase their heart rate and cause heavy breathing, showed a decrease in mortality of 43%. This is good news for diabetics. Exercise helps counteract much of the harmful aspect of diabetes. If you do have diabetes, here is one way you can reduce your risk of death in half! If you don’t have diabetes, regular exercise can also cut your likelihood of getting diabetes in the future. For good health, aim for 30 or more minutes of brisk physical activity, such as brisk walking, every day! Reference: Edward W. Gregg et al. Relationship of walking to mortality among US adults with diabetes, Archives of Internal Medicine, 163:1440-47, Jun 23, 2003 Walking is a form of exercise that nearly everyone can do safely, especially diabetics. In this study of 2896 diabetics studied for 8 years, those who walked regularly had a significantly lower risk of death from cardiovascular disease and death from any cause. Those who walked 2 hours per week dropped their overall death rate by 39%. Those who walked 3-4 hours per week had even better results. They reduced their risk of dying fro any cause by over 50%. Those who reported any walking at a rate sufficiently brisk to increase their heart rate and cause heavy breathing, showed a decrease in mortality of 43%. This is good news for diabetics. Exercise helps counteract much of the harmful aspect of diabetes. If you do have diabetes, here is one way you can reduce your risk of death in half! If you don’t have diabetes, regular exercise can also cut your likelihood of getting diabetes in the future. For good health, aim for 30 or more minutes of brisk physical activity, such as brisk walking, every day! Reference:Edward W. Gregg et al. Relationship of walking to mortality among US adults with diabetes, Archives of Internal Medicine, 163:1440-47, Jun 23, 2003

    11. ? 2009 Wellsource, Inc. Physical Activity Protects Against Smoking And even with smoking, physical activity is protective. Notice that low fit men who were nonsmokers had a higher mortality rate than high fit men who were smokers. This certainly illustrates the protective affect of physical activity even in smokers. Reference: Steven Blair, et.al, Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-cause Mortality in Men and Women, JAMA, July 17, 1996. And even with smoking, physical activity is protective. Notice that low fit men who were nonsmokers had a higher mortality rate than high fit men who were smokers. This certainly illustrates the protective affect of physical activity even in smokers. Reference: Steven Blair, et.al, Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-cause Mortality in Men and Women, JAMA, July 17, 1996.

    12. ? 2009 Wellsource, Inc. Physical Activity & Stroke Risk Data from the Aerobic Research study. 16,878 men were tested on a treadmill to determine fitness levels. Follow-up was 10 years. Men who were moderately fit had 63% fewer strokes than low fit men. High fit men had 68% fewer strokes. These results are after adjusting for common stroke risk factors. Regular physical activity is a strong protector against the risk of stroke. Average peak aerobic capacity for the three fitness levels were: Low fit = 8.8 METS Moderately fit = 10.5 METS Highly fit = 13.1 METS Notice that most of the benefit from regular physical activity occurred in the moderately fit group. Exercise may protect against stroke by: helping maintain a healthy weight, lower blood pressure, improved blood lipids, improved sensitivity to insulin, blood coagulation and platelet aggregation, fibrinolysis, and antioxidant defense systems, all of which influence the risk of stroke. Reference Lee CD and Blair SN, Cardiorespiratory fitness and stroke mortality in men, Medicine and Science in Sports and Exercise, 2002; 34:592-95 Data from the Aerobic Research study. 16,878 men were tested on a treadmill to determine fitness levels. Follow-up was 10 years. Men who were moderately fit had 63% fewer strokes than low fit men. High fit men had 68% fewer strokes. These results are after adjusting for common stroke risk factors. Regular physical activity is a strong protector against the risk of stroke. Average peak aerobic capacity for the three fitness levels were: Low fit = 8.8 METS Moderately fit = 10.5 METS Highly fit = 13.1 METS Notice that most of the benefit from regular physical activity occurred in the moderately fit group. Exercise may protect against stroke by: helping maintain a healthy weight, lower blood pressure, improved blood lipids, improved sensitivity to insulin, blood coagulation and platelet aggregation, fibrinolysis, and antioxidant defense systems, all of which influence the risk of stroke. ReferenceLee CD and Blair SN, Cardiorespiratory fitness and stroke mortality in men, Medicine and Science in Sports and Exercise, 2002; 34:592-95

    13. ? 2009 Wellsource, Inc. Exercise – Best Predictor of Heart Health In all men, peak aerobic capacity was a better predictor of mortality than: High blood pressure Smoking Diabetes Cholesterol levels Abnormal ECGs History of heart disease Of all the traditional risk factors, the level of physical capacity was a stronger predictor of who would survive and who wouldn’t. Each 1-MET improvement in aerobic power resulted in a 12% improvement in survival. Reference Jonathan Myers, et al, Exercise Capacity and Mortality among Men Referred for Exercise Testing, New England Journal of Medicine 346:793-801, March 14, 2002 Of all the traditional risk factors, the level of physical capacity was a stronger predictor of who would survive and who wouldn’t. Each 1-MET improvement in aerobic power resulted in a 12% improvement in survival. ReferenceJonathan Myers, et al, Exercise Capacity and Mortality among Men Referred for Exercise Testing, New England Journal of Medicine 346:793-801, March 14, 2002

    14. ? 2008 Wellsource, Inc. All rights reserved. Fitness as Preventive Medicine Other Conditions Benefited by Physical Activity Fitness for Life -- Week 1 “Cardiovascular Fitness Basics” This section of Fitness for Life covers the knowledge area -- helping people know how to develop their fitness program safely and to achieve desired results. Objective: To help participants understand the basics of a good cardiovascular fitness program and to encourage participants to begin an exercise program immediately. Fitness for Life -- Week 1 “Cardiovascular Fitness Basics” This section of Fitness for Life covers the knowledge area -- helping people know how to develop their fitness program safely and to achieve desired results. Objective: To help participants understand the basics of a good cardiovascular fitness program and to encourage participants to begin an exercise program immediately.

    15. ? 2009 Wellsource, Inc. Walking and Risk of Hip Fracture Walking was the most common activity for exercise among women. Those women who walked at least 4 hours per week reduced their risk of hip fracture over the 12 year study by 41% which is a remarkable reduction! Reference Diane Feskanich, et al, Walking and leisure-time activity and risk of hip fracture in postmenopausal women, JAMA Nov. 13, 2002; 288:2300-06 Walking was the most common activity for exercise among women. Those women who walked at least 4 hours per week reduced their risk of hip fracture over the 12 year study by 41% which is a remarkable reduction! ReferenceDiane Feskanich, et al, Walking and leisure-time activity and risk of hip fracture in postmenopausal women, JAMA Nov. 13, 2002; 288:2300-06

    16. ? 2009 Wellsource, Inc. Recreational Activity and Risk of Breast Cancer Women’s Health Initiative study of 74,171 women followed for 4.7 years 30 minutes of brisk walking daily reduced cancer risk by 18% 1 hour of walking per day reduced risk by 21% This large prospective study of women (74171 ages 50-71) studied for nearly 5 years shows strong evidence that regular physical activity decreases the risk for breast cancer. The more active the women, the lower the risk of breast cancer. Based on these findings, 30-60 minutes of brisk walking daily would prevent 1 out of every 5 breast cancers in postmenopausal women. Data from the Women’s Health Initiative (WHI) study.This large prospective study of women (74171 ages 50-71) studied for nearly 5 years shows strong evidence that regular physical activity decreases the risk for breast cancer. The more active the women, the lower the risk of breast cancer. Based on these findings, 30-60 minutes of brisk walking daily would prevent 1 out of every 5 breast cancers in postmenopausal women. Data from the Women’s Health Initiative (WHI) study.

    17. ? 2009 Wellsource, Inc. Physical Activity and Colon Cancer Colon Cancer Study in Men 29,133 men, 12 year study Compared to sedentary workers, men doing light activity had 40% less colon cancer Moderate to heavy activity men had 55% less colon cancer Most active men at work and recreation had 67% less colon cancer This 12 year study of 29,133 men is part of the Alpha-tocopherol, Beta-carotene study. They looked at how active the men were in their occupation and recreational activity time. Men who were most active had a 67% decrease in number of colon cancer cases compared to sedentary men. The authors conclude their study by saying, “These data provide evidence for a protective role of physical activity in colon cancer and rectal cancer. Reference LH Colbert et al, Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers, Cancer Epidemiol Biomarkers Prev 10(3):265-8, Mar 3001This 12 year study of 29,133 men is part of the Alpha-tocopherol, Beta-carotene study. They looked at how active the men were in their occupation and recreational activity time. Men who were most active had a 67% decrease in number of colon cancer cases compared to sedentary men. The authors conclude their study by saying, “These data provide evidence for a protective role of physical activity in colon cancer and rectal cancer. ReferenceLH Colbert et al, Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers, Cancer Epidemiol Biomarkers Prev 10(3):265-8, Mar 3001

    18. ? 2009 Wellsource, Inc. Cardiorespiratory Fitness and Cancer Study 25,892 men age 30-87, followed for 10 years Results High fit persons had a 55% lower cancer mortality rate than low fit persons even after controlling for smoking, age, BMI, alcohol, and diabetes Medicine & Science in Sports, Exercise, and Fitness 34(5):735-739 This large prospective study shows an inverse association of fitness levels with cancer mortality, both smoking related cancers, and non-smoking related cancer. Mortality rates shown are adjusted for smoking, BMI, alcohol, diabetes, and other related risk factors. Exercise particularly reduces the risk for colon, prostate, and breast cancers. Researchers suggest that regular exercise protects against cancer by: Improving the pulmonary, immune, and antioxidant defense system Aerobic exercise increases natural killer cells and cytotoxic activity of T cells Enhances activities of glutathione peroxidase, superoxide dismutase, and catalase (natural antioxidants) that can protect against oxidative stress. Reference: Chong Do Lee and Steven Blair, Cardiorespiratory fitness and smoking related and total cancer mortality in men, Medicine and Science in Sports and Exercise 34(5):735-739, May, 2002This large prospective study shows an inverse association of fitness levels with cancer mortality, both smoking related cancers, and non-smoking related cancer. Mortality rates shown are adjusted for smoking, BMI, alcohol, diabetes, and other related risk factors. Exercise particularly reduces the risk for colon, prostate, and breast cancers. Researchers suggest that regular exercise protects against cancer by: Improving the pulmonary, immune, and antioxidant defense system Aerobic exercise increases natural killer cells and cytotoxic activity of T cells Enhances activities of glutathione peroxidase, superoxide dismutase, and catalase (natural antioxidants) that can protect against oxidative stress. Reference: Chong Do Lee and Steven Blair, Cardiorespiratory fitness and smoking related and total cancer mortality in men, Medicine and Science in Sports and Exercise 34(5):735-739, May, 2002

    19. ? 2009 Wellsource, Inc. Physical Activity and Mental Health Physical activity : Protects against depression Reduces dementia (cognitive decline with age) Reduces symptoms of anxiety Reduces feelings of distress Improves feelings of fatigue Enhances wellbeing From the new government report (President Bush’s initiative) on fitness and health.From the new government report (President Bush’s initiative) on fitness and health.

    20. ? 2009 Wellsource, Inc. Exercise and Depression Study of 156 sedentary, clinically depressed persons They were randomly divided into groups: One group received medication therapy. Another group ran at a moderate pace ˝ hour daily but took no medication After 16 weeks their depression was reevaluated Exercisers improved as much as those on medication But, only exercisers showed improvement in mental abilities such as concentration, planning, and organization The next question to ask is, “If exercise is linked to better mental help, can it help people suffering from mental health problems?” The study shown above addresses this question. Dr. James Blumenthal, Ph.D from Duke University studied the affects of exercise on mental depression, a very common mental health problem world wide. Using a carefully controlled study design, they found physical activity, used as a treatment for depression, was just as effective as medication therapy. They also tested subjects for mental acuity and found an improvement in the exercisers but not in those taking the medication for depression.. The researchers suggest that the mental health improvement probably comes from better circulation and blood flow in the brain. This study shows that regular exercise, such as running at a moderate pace, can help people feel better and think more clearly. Source Reviewed in Runner’s World magazine, April, 2001, research done at Duke University.The next question to ask is, “If exercise is linked to better mental help, can it help people suffering from mental health problems?” The study shown above addresses this question. Dr. James Blumenthal, Ph.D from Duke University studied the affects of exercise on mental depression, a very common mental health problem world wide. Using a carefully controlled study design, they found physical activity, used as a treatment for depression, was just as effective as medication therapy. They also tested subjects for mental acuity and found an improvement in the exercisers but not in those taking the medication for depression.. The researchers suggest that the mental health improvement probably comes from better circulation and blood flow in the brain. This study shows that regular exercise, such as running at a moderate pace, can help people feel better and think more clearly. SourceReviewed in Runner’s World magazine, April, 2001, research done at Duke University.

    21. ? 2009 Wellsource, Inc. Miles Walked/Week and Well-Being As the number of exercise miles per week go up, so do the well-being scores showing better emotional health with higher levels of activity.As the number of exercise miles per week go up, so do the well-being scores showing better emotional health with higher levels of activity.

    22. ? 2009 Wellsource, Inc. Physical Activity is Good Medicine “All who can possibly do so ought to walk in the open air every day, summer and winter. A walk, even in winter, would be more beneficial to the health than all the medicine the doctors may prescribe.” E.G.White, Counsels on Health, 52 In summary, physical activity is strong medicine. This is a classic quote from nearly a 100 years ago, health advice written in the late 1900s. I believe it sums up the benefit of physical activity very nicely.In summary, physical activity is strong medicine. This is a classic quote from nearly a 100 years ago, health advice written in the late 1900s. I believe it sums up the benefit of physical activity very nicely.

    23. ? 2008 Wellsource, Inc. All rights reserved. Physical Activity Guidelines 30+ min of moderate activity, 5+ days/wk 20-30+ minutes of vigorous activity, 3+ days/wk Strength training and stretching, 2-3 times/week Physical activity is the first and was determined to be the most important factor in improving health. Strong, healthy muscles are the basis for activity. Daily activity of 30 minutes or more, along with regular strength training, can make a positive difference in your health, enjoyment of life, and life span. Physical activity is the first and was determined to be the most important factor in improving health. Strong, healthy muscles are the basis for activity. Daily activity of 30 minutes or more, along with regular strength training, can make a positive difference in your health, enjoyment of life, and life span.

    24. Examples of Physical Activity Moderate Walking briskly, 3-4 mph Cycling for pleasure, 10 mph Swimming, moderate level Conditioning exercises Golf, carrying/pulling clubs Canoeing/rowing, 2-3 mph Mowing lawn, raking leaves, hoeing in garden Hard/Vigorous Walking briskly uphill or climbing stairs Cycling fast, 12-16 mph Swimming, fast crawl Active sports: Tennis Racquetball Basketball Jogging/running When first starting a physical activity program, it is safest to start with moderate activities. This helps prevent soreness and overexertion; two reasons why many people give up an activity program. To increase levels of fitness, gradually increase time and intensity. For example, if you are in good health, after building up a good fitness base, you may want to add more vigorous activities to your program two to three days per week. It’s best to alternate moderate and vigorous activities to help prevent injury and tiredness. Those who enjoy more moderate activity can gain more benefit by simply going longer, say 45 to 60 minutes, two to three days each week, alternating with their regular 30 minutes per day of moderate activity. If you are over age 40 or if you have any health problems, get your doctor’s clearance before engaging in vigorous activity such as jogging and strenuous sports. Source Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5. When first starting a physical activity program, it is safest to start with moderate activities. This helps prevent soreness and overexertion; two reasons why many people give up an activity program. To increase levels of fitness, gradually increase time and intensity. For example, if you are in good health, after building up a good fitness base, you may want to add more vigorous activities to your program two to three days per week. It’s best to alternate moderate and vigorous activities to help prevent injury and tiredness. Those who enjoy more moderate activity can gain more benefit by simply going longer, say 45 to 60 minutes, two to three days each week, alternating with their regular 30 minutes per day of moderate activity. If you are over age 40 or if you have any health problems, get your doctor’s clearance before engaging in vigorous activity such as jogging and strenuous sports. SourceCenters for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5.

    25. Total Activity Time It’s not necessary to do all of your activity at one time. You may want to break it up into Two 15-minute or Three 10-minute sessions Two 15-minute sessions Walk 1 mile briskly Ride the stationary bike for 15 minutes in the evening Three 10-minute sessions Walk 10 minutes to work Walk another 10 minutes at noon Mow lawn for 10 minutes in the afternoon Your 30 minutes of physical activity does not need to be done all at once in order for you to experience health benefits. It is OK to accumulate 30 minutes a day with two 15-minute or three 10-minute exercise sessions. Here are two examples of this principle. Source Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5. Your 30 minutes of physical activity does not need to be done all at once in order for you to experience health benefits. It is OK to accumulate 30 minutes a day with two 15-minute or three 10-minute exercise sessions. Here are two examples of this principle. SourceCenters for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5.

    26. Intensity Your activities should feel “fairly easy” to “somewhat hard.” Your activity should make you breathe deeply but not make you out of breath. A moderate sweat is a good indicator that health benefits are occurring. Always start and end each activity session with a warm-up and cool down. Keep intensity moderate when first beginning a physical activity program. After you have become used to regular exercise for several weeks you can increase the intensity if you want a more vigorous workout. If you are over age 40 or if you have a heart condition or other serious health problem, get your doctor’s permission before beginning. Warm-up/cool-down: It is important to ease into and out of exercise so you don’t strain or pull any muscles. Walk or do other easy exercises for several minutes to get your body warmed up or cooled down. This allows the heart, lungs, joints, and muscles to adjust gradually and is easier and safer on the body. This principle is most important with vigorous activities. Warm-up by simply going at an easy pace for a few minutes. Do the same at the end of your exercise session. Source Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5. Keep intensity moderate when first beginning a physical activity program. After you have become used to regular exercise for several weeks you can increase the intensity if you want a more vigorous workout. If you are over age 40 or if you have a heart condition or other serious health problem, get your doctor’s permission before beginning. Warm-up/cool-down: It is important to ease into and out of exercise so you don’t strain or pull any muscles. Walk or do other easy exercises for several minutes to get your body warmed up or cooled down. This allows the heart, lungs, joints, and muscles to adjust gradually and is easier and safer on the body. This principle is most important with vigorous activities. Warm-up by simply going at an easy pace for a few minutes. Do the same at the end of your exercise session. SourceCenters for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5.

    27. Progression Start with moderate activities activities you can do without getting out of breath, that are ‘fairly light” to “somewhat hard” Gradually build up to 30+ minutes per day For higher levels of fitness add vigorous activities or increase activity time after you are used to regular physical activity An important principle in physical activity is to start at an easy level and gradually build up your exercise tolerance. If you are not used to physical activity, start with just a 10-15-minute walk. Slowly increase your time and activity intensity as you become accustomed to activity. If you can’t continue activity for a full 30 minutes all at one time, break it into three 10-minute sessions or two 15-minute sessions. This makes it easier for your body to adapt. Work up to 30+ minutes per day. If you have a heart problem, diabetes, or other serious health problem, be sure to talk over your special needs with your doctor. Having a health problem does not necessarily mean you should avoid physical activity, but you may need special precautions and guidance to make exercise safe and effective. Ask your doctor for specific guidance. Source Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5. An important principle in physical activity is to start at an easy level and gradually build up your exercise tolerance. If you are not used to physical activity, start with just a 10-15-minute walk. Slowly increase your time and activity intensity as you become accustomed to activity. If you can’t continue activity for a full 30 minutes all at one time, break it into three 10-minute sessions or two 15-minute sessions. This makes it easier for your body to adapt. Work up to 30+ minutes per day. If you have a heart problem, diabetes, or other serious health problem, be sure to talk over your special needs with your doctor. Having a health problem does not necessarily mean you should avoid physical activity, but you may need special precautions and guidance to make exercise safe and effective. Ask your doctor for specific guidance. SourceCenters for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5.

    28. Medical Clearance Most adults do not need to see their physician before starting a moderate intensity physical activity program. However, men older than 40 years or women older than 50 years who plan a vigorous program, Or, anyone with either chronic disease or risk factors for chronic disease, should consult his or her physician to design a safe, effective program. Source: Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol 273, No. 5. This statement on medical clearance is taken directly from the American Medical Association’s National Journal and is a good, safe statement to present. If people have any questions or concerns, they should talk to their doctor, but most, normally healthy people should be able to start a moderate exercise program safely without seeing their doctor as it states above. Source Centers for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5. This statement on medical clearance is taken directly from the American Medical Association’s National Journal and is a good, safe statement to present. If people have any questions or concerns, they should talk to their doctor, but most, normally healthy people should be able to start a moderate exercise program safely without seeing their doctor as it states above. SourceCenters for Disease Control and Prevention and the American College of Sports Medicine, JAMA, Vol. 273, No. 5.

    29. ? 2009 Wellsource, Inc. Fitness and Longevity In the Good Health Practices study 6,900 people followed for nearly 10 years Level of activity was the best predictor of longevity Adventist Health Study 30,000 people. Physical activity level was the best predictor of a long life Of all the factors studied in the large population study, the level of physical activity was the best predictor of who would live the longest (even better than smoking, diet, weight, etc.) Source Berckman and Syme, Amer. Jour. of Epidemiology Vol. 109, No. 2: 186. Arch Intern Med 2001;161:1645-52 Of all the factors studied in the large population study, the level of physical activity was the best predictor of who would live the longest (even better than smoking, diet, weight, etc.) SourceBerckman and Syme, Amer. Jour. of Epidemiology Vol. 109, No. 2: 186. Arch Intern Med 2001;161:1645-52

    30. ? 2009 Wellsource, Inc. Harvard Alumni Study The higher the energy expenditure in weekly activity, the lower the risk of death Dr. Paffenbarger found that for every one hour the Harvard alumni exercised, they lived an additional 2 hours in increased longevity The Harvard Alumni Study by Dr. Ralph Paffenbarger was one of the first large studies to show that physical activity increased life expectancy. The study included 16,936 Harvard alumni, aged 35-74, with data from 12-16 years of follow-up. He found that exercise was inversely related to total mortality. As energy expenditure from physical activity increased, death rates steadily declined. People who burned at least 2000 exercise calories per week had about a 40% decrease in death from all causes. Those who expended over 3000 exercise calories per week lowered their risk of death by over 50%. He included miles walked, stairs climbed, and sports participated in for exercise calories. Notice that the greatest drop in mortality occurs from those who are sedentary to becoming only moderately active (burning 500-999 exercise calories weekly). This would be equivalent to walking 6-10 miles weekly. Benefits continued to occur however up to 3000+ exercise calories per week. This is equivalent to about 25-30 aerobic miles per week. When he looked just at walking, those who walked at least 9 miles weekly had a 21% decrease in risk of death. Reference Ralph S. Paffenbarger, et al, Physical activity, All-cause Mortality, and Longevity of College Alumni, The New England Journal of Medicine 314:605-13, Mar. 6, 1986 The Harvard Alumni Study by Dr. Ralph Paffenbarger was one of the first large studies to show that physical activity increased life expectancy. The study included 16,936 Harvard alumni, aged 35-74, with data from 12-16 years of follow-up. He found that exercise was inversely related to total mortality. As energy expenditure from physical activity increased, death rates steadily declined. People who burned at least 2000 exercise calories per week had about a 40% decrease in death from all causes. Those who expended over 3000 exercise calories per week lowered their risk of death by over 50%. He included miles walked, stairs climbed, and sports participated in for exercise calories. Notice that the greatest drop in mortality occurs from those who are sedentary to becoming only moderately active (burning 500-999 exercise calories weekly). This would be equivalent to walking 6-10 miles weekly. Benefits continued to occur however up to 3000+ exercise calories per week. This is equivalent to about 25-30 aerobic miles per week. When he looked just at walking, those who walked at least 9 miles weekly had a 21% decrease in risk of death. ReferenceRalph S. Paffenbarger, et al, Physical activity, All-cause Mortality, and Longevity of College Alumni, The New England Journal of Medicine 314:605-13, Mar. 6, 1986

    31. ? 2009 Wellsource, Inc. This chart shows the dramatic decrease in mortality from any cause as people get more regular exercise, increasing their level of fitness. Shown here are fitness quintiles from maximal treadmill testing. Notice that those getting little or no regular activity (quintile 1) had the highest mortality rate. Also notice that even some regular exercise (quintile 2) shows a remarkable drop in mortality. Persons getting the most exercise (quintile 5) cut their risk of death from any cause by 73% even after adjusting for age, sex, smoking, abnormal ECG, health problems, and BMI. Reference: Xuemei S, Blair SN, et al. Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults, Journal of the American Medical Association 2007;298(21):2507-16This chart shows the dramatic decrease in mortality from any cause as people get more regular exercise, increasing their level of fitness. Shown here are fitness quintiles from maximal treadmill testing. Notice that those getting little or no regular activity (quintile 1) had the highest mortality rate. Also notice that even some regular exercise (quintile 2) shows a remarkable drop in mortality. Persons getting the most exercise (quintile 5) cut their risk of death from any cause by 73% even after adjusting for age, sex, smoking, abnormal ECG, health problems, and BMI. Reference: Xuemei S, Blair SN, et al. Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults, Journal of the American Medical Association 2007;298(21):2507-16

    32. ? 2009 Wellsource, Inc. Do you want to be well? Jesus asked him, “Would you like to get well? Jesus told him, “Stand up, pick up your mat, and walk!” John 5:6,8

    33. ? 2009 Wellsource, Inc. Walking Program Advantages Nearly everyone can walk Safe Inexpensive Encourages social interaction

    34. ? 2009 Wellsource, Inc. Set Measurable Goals Measurable goals: Steps per day, e.g. 6,000-10,000 steps/day Miles per day, e.g. 2 aerobic miles per day Minutes of activity, e.g. 30-60 minutes of aerobic activity daily

    35. ? 2009 Wellsource, Inc. Record Daily Activity Keeps activity in mind Helps you work towards a specific goal Keeps you faithful Improves long term success

    36. ? 2009 Wellsource, Inc. Fitness Buddy Invite family members to join you Spouse Son or daughter Nephew or niece Invite a friend, neighbor, or work associate to join you Make your fitness adventure social and reach out to your community

    37. ? 2009 Wellsource, Inc. Participate in GetFit Adventures Mountain trails JMT,PCT, AT Trail of the Coeur d’ Alenes Coastal hikes Oregon Coast Historic journeys Adventist pioneers American revolution International Southern Italy China Hike across Switzerland Bible lands Follow the Steps of Jesus

    38. ? 2009 Wellsource, Inc. Church Integration Encourage church members to participate as a group Promote regularly in church Give monthly reports Participation rates Total group miles Give recognition to those achieving their goals Invite participants to share their experiences Give awards 500 Mile Club and the 1,000,000 step club Create a church culture that values activity and health

    39. ? 2009 Wellsource, Inc. How to Get Started Go to the InStep for Life web site InStepForLife.com Download the starter kit Get a pedometer Start walking Volunteer to be an InStep for Life coordinator in your church or organization

    40. For more information on health assessments, contact Wellsource on the web address shown.For more information on health assessments, contact Wellsource on the web address shown.

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