Move it More >>> Especially When Teaching Online

1. Move it More >>> Especially When Teaching Online * Kirsti A. Dyer, MD, MS Columbia College If you have a question during the webinar, please type it in the chat window, preface it with ???, and raise your hand. This will help streamline the question and answer process.

2. Move it More >>> When Teaching Online

3. Webinar Objectives • Learn about potential health connections between online education and a more sedentary lifestyle. • Discover how sedentary lifestyle or “sitting disease” can have a major impact on your health. • Recognize how taking and teaching online classes may contribute to a more sedentary lifestyle. • Find ways to include more activity in your online work day. • Learn helpful tips to remind you to “Move it More” and eat more mindfully when teaching online.

4. Question? Type it in the chat window, preface it with ??? Practice: Move it More – Now • Practice standing up during this lunchtime webinar. • Put on your wireless headset, turn up the volume on the computer / laptop so you can hear the webinar. • Stand up, sway or walk around during the webinar. • Grab your laptop and go for a walk in wifi range.

5. Growth of Online Learning Source: The Sloan Consortium. 2013.Changing Course: Ten Years of Tracking Online Education in the United States. http://www.pearsonlearningsolutions.com/assets/downloads/reports/changing-course-survey.pdf

6. Growth of DE Courses in California The number of Distance Education (DE) courses offered nearly doubled from 21,414 in 2005 – 2006 to 40,038 in 2009 – 2010. California Community Colleges. DE Courses Sessions 2005 - 2010. California Watch. http://californiawatch.org/dailyreport/online-community-college-students-more-likely-fail-withdraw-11581

7. Question? Type it in the chat window, preface it with ??? Reasons for Online Course Popularity Some of the reasons for increased online enrollment include: • Costs • Choice • Convenience • Flexibility • Scheduling • No Commuting Images Microsoft Clipart

8. The Dark Side of Online Education… Image: Fat Man Shadow http://www.sxc.hu/photo/949285

9. Concerns with Online Education • Increased hours spent online. • Increased sedentary activity (little moving) and lifestyle. • Increased access to food. • Decreased activity level (desk job). • Decreased social contact (motivators). Question? Type it in the chat window, preface it with ???

10. Poll: Hours Spent Online How many hours do you spend online each day (work and non work)? A. < 2 hours B. < 4 hours C. 4 – 8 hours D. > 8 hours

11. Increasing Obesity and Overweight Rates • In 2010 33.8% of U.S. adults were classified as obese along with 34.6 % as overweight. • Over two-thirds of adults are either obese or overweight. • Predictions are it will be three-quarters (75%) by 2020. NCHS Data Brief. Prevalence of Obesity in the United States, 2009–2010. Number 82, January 2012 http://www.cdc.gov/nchs/data/databriefs/db82.htm

12. Question? Type it in the chat window, preface it with ??? Rates of Overweight and Obese by Age 1971–2006 65+ 45-65 30-44 18-29 • Overweight and Obesity Statistics. 2010. Weight-control Information Network. NIH Publication Number 04–4158. http://win.niddk.nih.gov/statistics/

13. Is Online Education Affecting our Waistlines? Image: Lunch by Jason Coleman http://www.flickr.com/photos/jason_coleman/3217778677/

14. Poll: Weight and Online Classes What has happened to your weight since taking or teaching online classes? A. Gained B. Maintained C. Lost

15. Online Classes and Sedentary Lifestyle Habits Image Microsoft Clipart

16. Question? Type it in the chat window, preface it with ??? Sedentary Lifestyles Online education can contribute to a more sedentary lifestyle for students and instructors.  • No commuting means no walking to class. (Passive exercise) • No work-related incentives to get up and move. • Working from home provides easier access to food. • Potential mindless eating in front of a computer or laptop while studying, preparing courses or grading.

17. Poll: Sedentary Lifestyle and Online Classes Have you become more sedentary (moving less) since taking or teaching online classes? A. Yes, a lot B. Yes, a little C. No change D. Not sure

18. Targeting Sedentary Lifestyles Many healthcare professionals advocate targeting sedentary lifestyle as an important way to manage the obesity epidemic. Source: Stein L. 2008. Work It Out: More Activity = Slower Aging. Scientific American. http://www.scientificamerican.com/article.cfm?id=new-study-links-exercise-to-longevity

19. Sedentary Lifestyle and Premature Death Researchers King's College, London Journal Archives of Internal Medicine • A sedentary lifestyle increases the propensity of aging-related disease and premature death. • Inactivity may diminish life expectancy not only by predisposing to aging-related diseases but also because it may influence the aging process itself. Stein L. 2008. Work It Out: More Activity = Slower Aging. Scientific American. http://www.scientificamerican.com/article.cfm?id=new-study-links-exercise-to-longevity

20. Obesity May Not be the Only Contributor Olivier L Charansonney, Jean-Pierre Després Nature Reviews: Cardiology • Obesity is a major health challenge facing the modern world. • Some evidence points to obesity itself as the main driver of premature mortality. • …this view is oversimplified. Charansonney O, Després J. 2010. Disease prevention--should we target obesity or sedentary lifestyle? Nature ReviewsCardiology 7, 468-472. http://www.nature.com/nrcardio/journal/v7/n8/fig_tab/nrcardio.2010.68_F2.html

21. Question? Type it in the chat window, preface it with ??? Targeting Sedentary Lifestyles Addressing the obesity issue, Charansonneyand Després combined epidemiological and physiological evidence to create a new paradigm that integrates: • Excess calorie intake • Sedentary lifestyles • Maladaptive response to stress Charansonney O, Després J. 2010. Disease prevention--should we target obesity or sedentary lifestyle? Nature ReviewsCardiology 7, 468-472. http://www.nature.com/nrcardio/journal/v7/n8/fig_tab/nrcardio.2010.68_F2.html

22. Sedentary Lifestyles and Chronic Disease Charansonney O, Després J. 2010. Disease prevention--should we target obesity or sedentary lifestyle? Nature ReviewsCardiology 7, 468-472. http://www.nature.com/nrcardio/journal/v7/n8/fig_tab/nrcardio.2010.68_F2.html

23. Sedentary Lifestyles & Chronic Disease - Simplified Sedentary lifestyle Calorie overload Immobilization Stress response Insulin resistance Hyperinsulinemia Central adiposity (obesity) Chronic disease Charansonney O, Després J. 2010. Disease prevention--should we target obesity or sedentary lifestyle? Nature ReviewsCardiology 7, 468-472. http://www.nature.com/nrcardio/journal/v7/n8/fig_tab/nrcardio.2010.68_F2.html

24. Question? Type it in the chat window, preface it with ??? How to Decreasing the Risks To decrease the risk from sedentary lifestyle focus on the factors that Charansonney and Després identified in their new paradigm by: • Promoting a more active lifestyle or moving. • Minimizing excess calorie intake. • Finding beneficial ways to respond to stress. Charansonney O, Després J. 2010. Disease prevention--should we target obesity or sedentary lifestyle? Nature ReviewsCardiology 7, 468-472. http://www.nature.com/nrcardio/journal/v7/n8/fig_tab/nrcardio.2010.68_F2.html

25. Poll: Minutes Spent Being Active How many hours do you spend in some way being active (exercise, physical activity, moving) each day? A. < 30 minutes B. 30 – 60 minutes C. > 60 minutes

26. Movement Recommendations • For health’s sake, American College of Sports Medicine (ACSM) recommend spending an accumulated minimum of 30 minutes in some sort of physical activity (movement) on most days. • For substantial health benefits the recommendations are to spend a combination of moderate and vigorous activity: • Moderate - 150 minutes (2 hours and 30 minutes) / week 20 minutes / 7 days 30 minutes / 5 days • Vigorous - 75 minutes (1 hour and 15 minutes) / week 10 minutes / 7 days 15 minutes / 5 days Physical Activity Guidelines for Americans, 2008

27. Ways to Include More Activity in a Day • Schedule periodic movement breaks. • Bookmark favorite exercise clips for easy access. • Include exercise modules in online classes. • Stand during online lectures or webinars. • Have walking or standing meetings. • Walk or move every day, whenever possible. The minutes add up! Question? Type it in the chat window, preface it with ???

28. Schedule Moving Breaks

29. Prolonged Sitting Causes Body Shutdown Dr. Tony Yancey Instant Recess ® • We just aren't really structured to be sitting for such long periods of time. • When we do that, our body just goes into shutdown. Neighmond P. 2011. Sitting All Day: Worse For You Than You Might Think. NPR http://www.npr.org/2011/04/25/135575490/sitting-all-day-worse-for-you-than-you-might-think

30. 10 Minute Workouts Can Help • Studies have shown that even a little exercise in the afternoon increases the likelihood that people will do more moving or exercise in the evening or on the weekend. • The Instant Recess® program promotes regular 10 minute exercise breaks that are easily incorporated into school, work, and community life. Image Woman Jumping by kirche222 http://www.sxc.hu/photo/818467 NeighmondP. 2009. Expert: 10-Minute Workouts Can Have Big Payoff. NPR. http://www.npr.org/templates/story/story.php?storyId=101151713&ps=rs

31. Instant Recess® Dr. Yancey’s research shows adding 10 minute Recess breaks in the work day: Helps control employees’ weight Prevents depression, diabetes, heart disease and cancer Improve employee productivity and morale Decrease injuries and absenteeism Instant Recess® KicKoff Tool Kit. http://recess.keenfootwear.com/wp-content/uploads/2011/09/1_Instant_Recess_Kickoff.pdf

32. Scientific 12-Station HICT Program All exercises can be done with body weight in almost any setting (e.g., home, office, hotel room, etc.). The exercise order allows for a total body exercise to increase the heart rate. The lower, upper, and core exercises maintain the increased heart rate while developing strength. • There is good evidence that high-intensity interval training provides many of the fitness benefits of prolonged endurance training but in much less time. Reilly M. 2013. The 7-minute workout that is as beneficial as a long run and a weights session. DailyMail UK. http://www.dailymail.co.uk/health/article-2322470/The-7-minute-workout-proven-good-long-run-weights-session--PAIN-reap-benefits.html

33. Sample 7-Minute HICT Program To do the program: Do each exercise at high intensity for 30 seconds If needed include a 10 second rest break. The total time for the circuit is 7 minutes. Repeat circuit up to 3 times. Jumping jacks - Total body Wall sit - Lower body Push-up - Upper body Abdominal crunch - Core Step-up onto chair - Total body Squat - Lower body Triceps dip on chair - Upper body Plank - Core High knees/running in place - Total body Lunge - Lower body Push-up and rotation - Upper body Side plank - Core Klika B, Jordan C. HIGH-INTENSITY CIRCUIT TRAINING USING BODY WEIGHT: Maximum Results With Minimal Investment. ACSM'S Health & Fitness Journal: May/June 2013 - Volume 17 - Issue 3 - p 8–13doi: 10.1249/FIT.0b013e31828cb1e8

34. Question? Type it in the chat window, preface it with ??? Develop Course Exercise & De-stressing Modules Create modules in online courses for: • Exercise • Relaxation • Stress Reduction Modules in online courses they can be used and shared by the instructors too. Image Microsoft Clipart

35. Survey Results from Nutrition Students Which type of module would you be interested in using more than once a week in an Online Course? Exercise Module 22.7% Relaxation Module 22.7% Stress Reduction Module 31.8% The Challenge would be how to ‘enforce’ or monitor use of the exercise module.

36. Question? Type it in the chat window, preface it with ??? Additional Resources Recess at Work • Dr. Tony Yancey with Keen Footwear http://recess.keenfootwear.com/recess-at-work/ Instant Recess (Other Different Versions) • Health*Matters, UC Berkeley - http://www.youtube.com/watch?v=tMuZ0_-Y7n4 • Tempe Campus Resources, ASUCampusRechttp://www.youtube.com/watch?v=b0k3zk8b-YU Leslie Sansone– 5 Minute Walk http://www.youtube.com/watch?v=PnsfbneFQ_8 Scientific 7 Minute Exercise Klika B, Jordan C. HIGH-INTENSITY CIRCUIT TRAINING USING BODY WEIGHT: Maximum Results With Minimal Investment. ACSM'S Health & Fitness Journal: May/June 2013 - Volume 17 - Issue 3 - p 8–13doi: 10.1249/FIT.0b013e31828cb1e8

37. Stand or Walk Whenever Possible Stand when giving online lectures. Stand when attending online webinars. Stand while grading. Plan walking meetings. Have stand and stretch breaks during meetings and conferences. Source: EBW Partners 17827. http://www.flickr.com/photos/taedc/8252351786/

38. Researchers in a 2008 study at New York School of Bioscience found that the energy expended was 4.1 kcal/h greater while performing work sitting on a therapy ball than while sitting in an office chair. 30 kcals / day 600 kcals / month Beers EA, Roemmich JN, Epstein LH, Horvath PJ. Epub 2008 Mar 20. Increasing passive energy expenditure during clerical work. Eur J Appl Physiol. 2008 Jun;103(3):353-60. http://www.ncbi.nlm.nih.gov/pubmed/18351381 Use an Exercise Ball for Your Chair Image: Working at Home by EdwinPhttp://www.sxc.hu/photo/515333

39. Mayo Clinic Researchers found that if sitting computer‐ time were replaced by walking‐and‐working, Energy expenditure could increase by 100 kcal/h. Levine JA, Miller JM. Epub 2007 May 15. The energy expenditure of using a "walk-and-work" desk for office workers with obesity. Br J Sports Med.2007. Sep;41(9):558-61. http://www.ncbi.nlm.nih.gov/pubmed/17504789 A Standing Desk Increases Energy Used Question? Type it in the chat window, preface it with ??? Image: Easy Standing Desk by Zieakhttp://www.flickr.com/photos/zieak/5373134473/

40. If obese and overweight individuals replaced 2-3 h/day sitting at the computer with walking computer time … They could lose 20–30 kg/year. Levine JA, Miller JM. Epub 2007 May 15. The energy expenditure of using a "walk-and-work" desk for office workers with obesity. Br J Sports Med. 2007. Sep;41(9):558-61. http://www.ncbi.nlm.nih.gov/pubmed/17504789 Benefits from Using a Standing Desk Image: Standing Desk by Eric J. Wilhelm http://www.instructables.com/community/Standing-desk/

41. Example of ingenuity at work. Good for watching online lectures, movies, video clips and reading online textbooks. More difficult to type and walk at the same time. Not the best option for grading (unless you use audio grading comments). A Walk Station for Working Question? Type it in the chat window, preface it with ??? Image: Walk station by Eliazarhttp://www.flickr.com/photos/eliazar/2089523822

42. Walktober = Walking in October Walking is an easy, healthy and inexpensive way to move more daily. It is also an activity that most everyone can do at any age for life. October is an ideal time to get outside for walking. The fall colors are spectacular and the days are cooler. Try a walk in October (Walktober) Image Microsoft Clipart

43. Working (and Eating) at Home Image: The Home Office by _fabiohttp://www.flickr.com/photos/_fabio/104792456/

44. Fueling up to Work at Home Image: Fuel = Coffee + Pastries by adactiohttp://www.flickr.com/photos/adactio/4356386978/

45. Poll: Eating and Online Classes Do you eat or snack while working on or studying for online classes? A. Yes, a lot B. Yes, a little C. No D. Not sure

46. Change the work space. Limit or restrict eating in front of the computer or while on the laptop. Practice Mindful Eating techniques. Be aware of the foods you are eating while working rather than munching and mindlessly eating. Easy Eating Interventions Question? Type it in the chat window, preface it with ???

47. Change the Workspace Environment • Cluttered and (possibly) disorganized work space. • Lots of food on the desk – large breakfast + snacks for later. • Note the plastic cover on the keyboard. Image: Full Breakfast by Justin http://www.flickr.com/photos/justin/533451823/

48. Improved Workspace Environment • Cleaner work space. • Real potted plant. • ? Natural lighting ? • Food on the working space with coffee, tea and croissants. Image: Reboot Breakfast by JakeCaptive. http://www.flickr.com/photos/jakecaptive/2612828640/

49. Question? Type it in the chat window, preface it with ??? Healthier Lunch Choices • Disorganized, cluttered work space. • Healthy food on the desk – large salad and coffee or tea. Image: PretLunch by Chumpolo. http://www.flickr.com/photos/chumpolo/269525021//

50. Clean, organized working space. View of nature though a window. No food on the desk, just a cup of tea or coffee. Scent sticks. Ideal (Healthy) Home Office Desk Image: A Clean Workspace by Herryhttp://www.flickr.com/photos/herry/5980686236/