Dr William Bird MRCGP MBE August 2016 Why Being Physically ...

Dr William Bird MRCGP MBE 17th August 2016

Why Being Physically Active Matters Northamptonshire Health and Wellbeing Board

© 2015 Intelligent Health

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


Sociable Green Valued

Our factory setting is to be in a sociable group, supportive environment and

have a purpose People Place Purpose


Loneliness Hostile Rejection

People Place Purpose

Fear and Chronic Stress


Chronic Stress

Anxiety and depression

Physical Inactivity

Poor diet


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


Inflammation: ‘the cause of causes’


Starts in children as young as 6 years old

Arthritis Arthritis

Cancers Cancers

Diabetes Diabetes

Obesity Obesity

Dementia Dementia

Cardiovascular disease

Anxiety and Depression


Inactivity causes inflammation

1. Increases visceral fat

3. Damages

healthy cells

2. Reduces anti- inflammatories


Inactivity: trilogy of inflammation


3. Damages

healthy cells



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


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




3. Damages

healthy cells



Reducing inflammation – muscles

Contracting muscles

release powerful anti-inflammatories

called Myokines

These Myokines Circulate

around the whole body

calming every cell




3. Damages

healthy cells



Chromosomes keep dividing

Immune system is

switched off until needed

Mitochondria, healthy

and active. Providing lots

of energy

Inside a healthy cell


‘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


Sedentary, high fat diet and stress

Mitochondria

Anti- Oxidants Reactive

Oxidative Species

Mitochondrial DNA

Oxidative Phosphorylation


Physically active, low fat and not stressed

Mitochondria

Oxidative Phosphorylation

Reactive Oxidative Species

Mitochondrial DNA

Anti- Oxidants


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


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.


This causes inflammation

Immune system is constantly switched on


Inflammation: ‘the cause of causes’


Starts in children as young as 6 years old

Arthritis Arthritis

Cancers Cancers

Diabetes Diabetes

Obesity Obesity

Dementia Dementia

Cardiovascular disease

Anxiety and Depression


People Place Purpose

Mitochondrial damage, telomere shortening, and chronic inflammation

Chronic stress Poor health behaviours

Cardiovascular disease, diabetes, cancer, depression

Pathway of Ill Health


Increases Hippocampus by 20%


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


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


‘Physical inactivity is the fourth

leading cause of death worldwide.’


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


Physical Activity is more than just

weight loss


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 (%)


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


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)


How many minutes

of exercise did you

do yesterday?

How much time did

you spend sitting

yesterday?


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

Dr William Bird MRCGP MBE August 2016 Why Being Physically ...

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