Focus on Women:Physical Activity from Pregnancy to Menopause

PARC 2007

Building Momentum

Women and Physical UnderActivity

Current Recommendations Current Population Trends Understanding the Gap Exercise Medicine Strategies for Success

Dr. Julia Alleyne

Exercise through a Women’s Lifecyle

Frequency 2-5 x week

Intensity Moderate

Time 30-90 minutes

Type Cardio- Flexiblity- Strength

Healthy Self Esteem

Low Risk Healthy Pregnancy

Work Life Family Balance

                            

Increased Quality of Life

Reality

Activities of Daily Living: 95% of Canadians engage in Light Physical effort during their usual daily activities

Leisure Activity: 20% of Canadian were involved in high energy activity, 22% were moderate activity, 57% Low energy Activity

National Population Health Survey

Energy Expenditure Calculator

Activity Energy Expenditure

Relaxing in Lying 70 kcal/hour

Driving a car 120 kcal/hour

Sitting and Typing 138 kcal/hour

Walking Pace 230 kcal/hour

Gardening in Standing

350 kcal/ hour

Golfing 320 kcal/hour

Swimming 500 kcal/hour

Fidgeting Fights Fat: NEAT

Sitting: Increase by 29% Standing : Increase by 38%Walking: Increase by 45%

A.J.of Clinical Nutrition, 72(6), 1451-54,Dec. 2000 JA Levine et al.

Weight Control

McMaster University, Dr. Oded Bar-Or Obesity and Youth Physical Activity must increase while sedentary

behaviour decreases and food is moderated Accumulated Daily Activity Slow but sure weight loss Measure inches not just pounds

Nomogram for Women’s Fitness

Fitness Norms for Women

Lower than Men 1% loss per year Less than 85% capacity

were 2x more likely to succumb to CV disease

NEJM August 2005

Ethnic Background & Physical Activity

Surveys and Studies- U.S. stats on Physical InactivityAfrican-American: 57.2%Hispanic 55.2%Asian 42.6%Caucasion 36.1%

- Strong Bones in New Canadian Women- Exercise and Pregnancy Education in Asian Women

UnderActivity and OverWeight

Challenge is the greatestWeight is higher with lower education levels Overweight increases with age & disease

2/3 of Overweight adults use activity for loss, Only…1/5

meet guidelines of 3 x week for 30 minutes.

Walking Programs

University of Manitoba, Dr. E. Ready 12 month monitor after walking supervision 30% walked 4 hrs/week, 50% walked 2-4

hours Frequency decreased not duration Barriers: Time, Injury, Motivation Enhancers: Felt better, positive feedback

Stages of Change Theory

Self-efficacy

The belief in one’s ability to actually carry out the actions required to achieve a certain outcome.

Cox, R, 2003

Vellicer et al, 1996

Identifying Stage of Change with Key Questions

Pre-ContemplationContemplationPreparationActionMaintenance

Pre-Contemplation

Patient Characteristics Not interested in exercise Does not believe that it will help,thinks it may hurt

Goals Encourage patient to discuss fears and disbeliefs Assist patient in knowing where resources are available if they

want to see Strategies

Personalize health goals of strength and endurance Offer factual information that dispels myths Don’t pressure, create emotional awareness

Contemplation

Patient Characteristics Considers exercise but presents barriers Acknowledges benefits but concerned regarding risk

Goals Discuss concerns and offer alternatives Find personal value

Strategies Summarize the patients views Ask what is important to them Establish their goal

Preparation

Patient Characteristics Ready to start, wants to accomplish Requires guidance and assistance

Goals Reinforce Commitment Provide concrete resources and game plan

Strategies Provide specific instructions Review barriers strategy Set-up personal trainer, buddy or follow-up

Action

Patient Characteristics Exerciser – new or renewed Coping with inconsistencies

Goals Reinforce Goals Refine program for success

Strategies Review Training Log Increase motivation resources

Maintenance

Patient Characteristics Well established routine Wants to lead others

Goals Allow patient to see risk reduction findings Assess for Consistency

Strategies Develop Long term planning Provide fitness feedback

  Precontemplation Contemplation Preparation Action Reinforcement

Frequency ADL ADL 2-3 x week 3-5 x week Daily

Intensity ADL ADL Light to Moderate

Moderate 10/20

Moderate to Somewhat Difficult 13/20

Time Moving5 minutes every hour

Moving 10 minutes every hour accumulated

10 –15 minutes of walking

30 minutes 30-45 minutes

Type Reduce Sitting Walking Errands

Dog or Neighbourhood walks

WalkingCyclingSwimmingTai Chi* Add Lower Body Resisitance

Variable intensity High/Low Full Resistance program 

 

Dose-Response Exercise

Arthritis Diabetes Cardiovascular Disease Depression and Anxiety Cancers Immune Disorders Infertility

Exercise used as a treatment

Irritable Bowel Syndrome Fibromyalgia Asthma Obesity Sleep Disorder Chronic Fatigue Syndrome

Treating Disease more Effectively Exercise is Medicine Benefits outweigh Risks Low Side Effect Rate Multiple benefits and targets Low cost intervention

Reducing Risk with Exercise

Exercise Heart Diabetes Arthritis Cancers

Aerobic **** **** ** ****

Strength *** ** **** **

Flexibility ** ** **** **

Treating Disease Effectively

Exercise Heart Diabetes Arthritis Cancer

F 4-5 x 7x 2-3x 3-4 x

I Mod.-High

Mod-High

Low-Mod

Mod

T 45-60 30-45 20-30 30-45

T Aerobic Aerobic Low impact Aerobic

Physical Activity linked with improved Mental Health Perception of Fitness is a predictor of

psychological well being Depression, anxiety, obsessions and

substance -abuse studies are positive Weight training, aerobics and mind-body

activities Walking away the blues

Risk of Cancer and Exercise

Colon Cancer decreased with moderate, consistent exercise

Prostate Cancer is decreased with moderate exercise

Limited evidence to support blood cancers Breast Cancer may be reduced with

moderate consistent exercise

Addressing Key Barriers

Injury: Soreness, Strain, FatigueStart Low, Go SlowStart Low, Go Slow

Cost: Memberships, Equipment, Cost: Memberships, Equipment, Start with Home-based ActivityStart with Home-based Activity

Time: Work, Family, TransportationTime: Work, Family, Transportation Accumulated Daily ActivityAccumulated Daily Activity

Social ActivitiesSocial Activities

Tips for Success

Supervision is training ground Monitor emotional not physical parameters Focus on Frequency of Activity Shoes are key supporters Formula for Progression Full environment must incorporate activity

10 Quick Tips

1. Get Good Shoes

2. Invest in a Pedometer

3. Waiting Time Work-Outs

4. Housework Energy

5. 5 Easy Stickers

10 Quick Tips

6. Start with a ‘Cycle

7. Buddy Up

8. Fridge Door Prescriptions

9. Count your Calories OUT

10. Telephone Tightners