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Sedentary behavior and inactivity physiology slideshare presentation
- 1. Sedentary Behavior and Inactivity Physiology Killing you softly and gently Yannis Guerra Endocrinology Department John H. Stroger Jr. Hospital of Cook County [email_address] @yannisguerra on Twitter
- 5. What does the literature says?
- 8. Seems that we don’t agree. And these definitions concentrate in the presence/absence of exercise
- 9. A more “big picture” approach
- 10. A distinct class of behaviors (e.g., sitting, watching TV, driving) characterized by little physical movement and low energy expenditure ( Less/equal to 1.5 METs) Appl. Physiol. Nutr. Metab. 35: 725–740 (2010)
- 11. Not only the lack of exercise CC www.TheNounProject.com
- 13. Accelerometers are all around us! CC http://www.flickr.com/photos/oskay/1193147290/sizes/o/in/photostream/ http://www.flickr.com/photos/terrypaton/4613655114/ http://www.flickr.com/photos/zzathras777/2071956401/sizes/o/in/photostream/
- 15. This is the result of the “active day”
- 16. And over the long run?
- 17. Active Couch Potato Exerc. Sport Sci. Rev., Vol. 38, No. 3, pp. 105Y113, 2010 Appl. Physiol. Nutr. Metab. 35: 725–740 (2010 )
- 18. http://www.flickr.com/photos/ptooey/5018659279/ Does it make any difference?
- 19. Mayo Clin Proc. • December 2010;85(12):1138-1141
- 20. Understanding the Distribution of Energy Expenditure in Humans
- 21. European Journal of CliniCiI Nutrition (1996) 50, 72-92
- 22. European Journal of CliniCiI Nutrition (1996) 50, 72-92 Total exercise expenditure (TEE) , Mega Joules
- 23. Components 0 Kcal/day 2000 Kcal/day 1000 Kcal/day Basal Metabolic Rate (BMR) Activity Thermogenesis Thermal effect of food
- 24. European Journal of ClinicaI Nutrition (1996) 50, 72-92 Weight+Height+Gender Predict 86% of BMR Basal Metabolic Rate (BMR), MegaJoules
- 26. Weight+Height+Gender Predict only 7% Physical Activity Level
- 27. Returning to the Total Energy Expenditure 0 Kcal/day 2000 Kcal/day 1000 Kcal/day Basal Metabolic Rate Activity Thermogenesis Thermal effect of food
- 28. More detailed! 0 Kcal/day 2000 Kcal/day 1000 Kcal/day Non Exercise Activity Thermogenesis (NEAT) Exercise
- 29. Which one is more affected by Sedentary behaviors? Some arguments in favor of NEAT
- 31. Arterioscler Thromb Vasc Biol 2006;26;729-736
- 32. Easy solution, right? Just tell them to exercise more! I think you’ll find it’s a bit more complicated than that Ben Goldacre, www.Bad Science.net
- 34. Am J Clin Nutr 1995;62:722-9 .
- 35. What we thought would happen Non Exercise Activity Thermogenesis (NEAT) Exercise Non Exercise Activity Thermogenesis (NEAT) Exercise
- 36. What really happened Non Exercise Activity Thermogenesis (NEAT) Exercise Non Exercise Activity Thermogenesis (NEAT) Exercise
- 39. Science 307:584-586 164 min 152 min
- 42. Science 283: 212-214 Weight changed from 0.36 kg to 4.23 kg, mainly correlated to activity thermogenesis.
- 43. How does this affect our current paradigm of thinking about activity and weight/metabolic effects? To decrease NEAT, increase inactivity
- 45. First
- 49. Evidence at all levels www.wikipedia.org
- 50. Image: Acta ortop. bras. vol.12 no.1 São Paulo Jan./Mar. 2004
- 52. Three types of pattern Down and up to normal Up and staying up Up and down to normal
- 57. Arterioscler Thromb Vasc Biol. 2007;27:2650-2656
- 58. Metabolism Clinical and Experimental
- 59. Image: Br J Sports Med 2006; 40 :779-784 doi:10.1136/bjsm.2006.027276
- 62. Important: Effect even when adjusted for higher intensity activity
- 66. What about the 4 th tenet? Times that people spend sitting versus participating in exercise based leisure time physical activity are different classes of behavior with distinct determinants AND INDEPENDENT RISKS FOR DISEASE Diabetes 56:2655–2667, 2007
- 69. Epidemiology 1998; 9: 632-35 NEAT
- 70. NEAT
- 71. Med. Sci. Sports Exerc., Vol. 41, No. 5, pp. 998–1005, 2009
- 72. Exercisers Non Exercisers Even if you exercise, the effects are still there!
- 73. J Am Coll Cardiol 2011;57:292–9
- 74. And the beat goes on, and on, and on
- 77. Statistics of direct measurement CC www.TheNounProject.com No, it’s not Pac-man eating pie
- 78. European Heart Journal doi:10.1093/eurheartj/ehq451 http://www.bionetics.ca/exercise/mti%20actigraph.htm
- 79. JAMA. 2006;296:171-179 Absolute risk 12% 17.6% 24.7%
- 81. http://www.flickr.com/photos/knitbunny/753713999 / What can we do about it?
- 82. Diabetes Care 31:661–666, 2008
- 83. But besides that study…
- 85. But do not despair!
- 88. Unpublished Data Glucose Insulin Breaking news: New data All are statistically significative!
- 92. We have changed as a species Int. J. Sports Med 19: 328-35, 1998 Estimated daily energy expenditure
- 93. We have changed as a species http://www.flickr.com/photos/xuxiaohui/15902318/
- 95. But not so much
- 96. We are failing http://www.flickr.com/photos/8185675@N07/3902633122/ exercise
- 97. But we may be missing something big Exercise NEAT inactivity
- 98. We want to avoid this http://www.flickr.com/photos/tedmurphy/3830352762/
- 99. And we need to accomplish this! http://www.flickr.com/photos/31364755@N08/2942780396/in/photostream
- 100. Thanks to David Dunstan Associate Professor Baker IDI Heart & Diabetes Institute Travis Saunders Healthy Active Living and Obesity Research Group Obesity Panacea Blog Mark E. Benden Associate Professor Texas A&M Health Science Center School of Rural Public Health
Notas del editor
- Failures to affect our patient’s weight and clinical measurements with exercise therapy.
- 6 trials used energy expenditure (but different ways to get to it) 5 trials didn’t even defined sedentary
- Healthy Active Living and Obesity Research Group
- 1 MJ=238 kcal
- R for weight 0.48, for height 0.50, age -0.13 Total regression 86% SD 10%
- Department of Human Biology, University of Limburg, Netherlands
- Endocrine Research Unit Mayo.n 10 Lean BMI 23, n 10 Obese BMI 33. Movement monitored for 10 days, energy expenditure by doubly labeled water.
- Endocrine Research Unit, Mayo. N 16 non obese. Overfeed for 8 weeks 1000 kcal
- Endocrine Research Unit, Mayo. N 16 non obese. Overfeed for 8 weeks 1000 kcal
- Dr. Hamilton’s team, University of Missouri- Columbia. 60 rats. 12 hours of HU, then 4 hours of low intensity ambulatory activity. Only used genes that changed more than 1.5x expression to decrease false positives.
- Heparin releasable=HR
- Glycolytic= Used when exercising “extra”, Oxidative= Used for postural tone and day to day activity
- Herbert Morrison, the Hindenburg
- 20 healthy subjects, 5 days of bed rest
- 14 non obese young fit individuals, 3 conditions NOSIT(2900kcal), SIT(same), SITBAL(2200 kcal)
- Metabolic risk score: Skin folds, HDL, TG, fasting insulin, FPG
- NHANES data from 1999-2000. Metabolic syndrome definition ATPIII. Self reported leisure activity time for 43 activities. Self reported screen time
- Canadian Fitness Survey 1981. Females >30 yold, no CAD. 6620 women, f/u 7 years
- Canadian Fitness Survey Started with 17013 patients
- Active is 7.5 MET/h/wk
- 4757 participants in NHANES 2003-2006, accelerometer based
- Based on Health ABC study, 302 healthy elderly patients. Used accelerometer AND DLW
- AusDiab Data
- Mention ABLE study