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Physical Activity as a Foundation for a High Performing Life: The Why, What and How. moira@activ8-u.com www.activ8-u.com 612.226.7882. What does health / wellbeing mean to you? Are you currently as healthy as you’d like to be? If not, what gets in the way?
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Physical Activity as a Foundation for a High Performing Life: The Why, What and How
What does health / wellbeing mean to you? • Are you currently as healthy as you’d like to be? • If not, what gets in the way? • If yes, what helps to keep you there? Consider…
“Not being in pain during the day” • “Not being a burden to those I care about” • “Being able to do my work with energy and vitality” • “Ability and energy to play with my grandkids” • Shift from “not sick” to “high performance” What does health mean to you?
Why do we view physical activity as a foundational practice for health and performance? • What and how much physical activity should we do? • How can we create communities and organizations that support active and healthy lives? Leadership + Health = High Performance
Designed to move Lieberman, DE. Exerc Sport Sci Rev, 40(2): 2012 Booth F. et al. J Appl Physiol, 2000
We expend 62% less energy than our human ancestors Estimates of Hominid Daily Energy Expenditure Over the Past 3.5 Million Years H. africanus = Physical Activity H. Sapiens H. afirensis H. erectus Energy/[Body Weight x Day] H. habilis Modern H. Sapiens (Us) Millions of Years Ago Total Energy Expenditure Resting Metabolic Rate Cordain et al., 1998. Int J Sport Med
How much exercise would we require to match our ancestors? +12 miles per day!
Prevalence of chronic disease has increased from 117 to 140 million Population in Millions NCQA State of HealthCare Quality Report, 2010
Physical activity presents the largest opportunity to prevent chronic disease %of U.S. Population at Risk Risk Ratio 2.1 2.4 2.5 1.9
In 1920, 1 in 150 adults were obese If current trends continue, 87% of US adults will be overweight with 51% obese by 2030 Wang et al. Obesity, 2008 16(10)2323
Nutrition provides the building blocks, but only appropriate movement can create a strong structure Recreational Runner Inactive Student
“no single intervention has greater promise than physical activity to reduce the risk of virtually all chronic diseases simultaneously” — F. Booth, 2000 Booth F. et al. J Appl Physiol, 2000 Booth F. et al. Eur J Appl Physiol, 2008
Employees who engage in fitness programs have…. change productivity less stressed errors on tasks absenteeism job grievances Loehr & Schwartz “The Power of Full Engagement”, NY, 2003. Ackerman et. Al Am J Prev Med 2003; 25:232-237.
Physical activity is necessary for optimal brain function Ratey, J. “Spark: The Revolutionary New Science of Exercise and the Brain” 2008
In an appropriate dose exercise… • Benefits: Reduce the risk of every major chronic disease and support better treatment outcomes • Side-effects: Improved brain function, reduced stress, improve mood, less pain, increased productivity at work, more energy, improved sex life… Exercise as Medicine
ACSM / CDC / WHO “moderate-intensity aerobic physical activity for a minimum of 30 minutes on five days each week or vigorous-intensity aerobic activity for a minimum of 20 minutes on three days each week.” Institute of Medicine “..to prevent weight gain as well as to accrue additional, weight independent health benefits of physical activity, 60 minutes of daily moderate intensity physical activity.” Exercise Prescription: How much is enough? Blair et. al, Am J Clin Nutr 2004 MSSE 43(7):1334-1359 Ewing et. Al., 2011
Health benefits associated with cardiovascular fitness 1 Most benefit in the first 30 min. From 30-60 min another 20% reduction in chronic disease plus weight management 0.8 Relative Risk (CVD) 0.6 0.4 0.2 0 25 50 75 100 Physical Fitness (Percentage) Williams PT. Med Sci Sports Exerc. 2001. Blair et. al, Am J Clin Nutr 2008
Frequency: 5 days per week Intensity: “Talk-Sing” Time: 30 minutes as a minimum, then work up to 60 minutes as a benchmark *Can be broken into several 10 min. bouts Type: Any aerobic activity (walking, biking, etc.) Consider flexibility and strength training 2 days/wk Public Health Guidelines: FITT
mid-70’s • overweight, heart disease, arthritis, knee pain • active with grandchildren • Doc says exercise as feels good Pat Need to consider progression and underlying musculoskeletal pain and weakness
Mid-50’s Walks his dog at a brisk pace for 30-60 min each day, Housework, garden, etc. Cholesterol over 400 mg/dL High BP; High %fat & BMI (27) Stiffness he blames on “just being old” Jim Need to address progression and underlying musculoskeletal pain / weakness
Early 40’s • Mom of 3 children • Exercises 30-60 min. 6-7 days/week • Healthy weight, good fitness • Occasional back pain / stiffness • Increased fatigue and high resting HR • Concerned about injuries as she ages and continues to train Dawn Need to address underlying musculoskeletal weakness and signs of overtraining
Musculoskeletal issues are a common theme http://www.boneandjointburden.org/pdfs/BMUS_chpt1_overview.pdf
Musculoskeletal pain is increasing • 1 in 5 adults has diagnosed arthritis • Low back pain – 80% of all adults • Musculoskeletal symptoms #2 reason for Dr.’s visits in 2003 • 50-90% of people get injured in the first 6 weeks of a new exercise program designed for injury prevention Need to consider prevalence of musculoskeletal conditions in program design Harkness et al, Rheumatology, 2005 CDC, Vital Health Stats, 2006
Musculoskeletal conditions make up the majority of missed days from work 53% http://www.boneandjointburden.org/pdfs/BMUS_chpt1_overview.pdf
Principles of rehabilitation and exercise science • Progressive overload • Appropriate sequence • Intentional recovery • Individual differences
Cholesterol went from over 400 mg/dL to <200 mg/dL Cardiorespiratory fitness improved Blood pressure decreased from 148/83 pre to 135/83. No injuries and continued participation 24 months later What’s possible if we apply these principles? +5 lbs Lean -3.2 lbs weight -8.5 lbs Fat *Change over 16-weeks
“I have Rheumatoid Arthritis and have have never found a class I could do before…I feel better and have more energy during the day…this has been so good for me…” -56 yr old woman with Rheumatoid Arthritis “…the FIT program has allowed me to progressively build my strength so I no longer have daily back pain and can move more freely while doing everyday activities…I’m more productive and work and happier at home” -44 yr old woman with multiple back surgeries and chronic pain Functional changes
“Nowhere is the gap wider between what we know and what we do than in the area of physical activity, and nowhere is the potential pay-off greater”-National Center for Chronic Disease Prevention and Health Promotion, 2001
“We have to create a culture of health… We have to get to the point where people start valuing the energy and vitality that health brings, instead of only thinking they are healthy because they don’t have diabetes” • Dee Edington, PhD – Zero Trends Culture of Health
Find Purpose Build Community Create effective Practices Framework for High Performing Cultures Young TD, 2005 Heath GW, Lancet 2012; 380
Find Purpose: Connecting to Intrinsic Motivation Short-term reward Avoid punishment Outcomes: health, quality of life, etc. Pure enjoyment of the activity itself Positive for wellbeing Sustainable behavior Short-term engagement More negative psychology Less likely to be sustained • Autonomy • Competence • Relatedness Teixeira, P et al. 2012, Int J Behav Nutr Phys Act 9:78 Ryan & Deci. 2000, American Psychologist, 55:68
Find Purpose:Sustainable Behavior Change is Driven from Intrinsic Motivation Teixeira, P et al. 2012, Int J BehavNutrPhys Act 9:78 Ryan & Deci. 2000, American Psychologist, 55:68
Purpose stems from awareness which leads to choice 88% of the population thought they were in good-excellent health. <15% actually were. • Awareness • What impact do my choices have on me and those I care about? • Allow people to find their own relevance • Choose to vs. Have to
Smoking cessation by a coworker decreases the chance of smoking by 34%. Build Community • If one spouse becomes obese, the likelihood that the other spouse becomes obese increases by 37%. • If a friend who lives within a mile of you becomes happy, it increases the probability that you will become happy by 25% Christakis NA, Fowler JH. N Engl J Med. 2007. 26;357(4):370
“…like schools of fish changing direction in unison, we are unconsciously led by the people around us.” –Nicholas Christakis, MD, PhD and James Fowler, PhD Social connection
Create practices to take effective action "prayer without action is no prayer at all. you have to do your work as if everything depends on you and then leave the rest to god" -Mother Teresa • 3 key elements of an effective practice • Intentional • Consistent • Experiential
Leadership Training • Awareness • Intrinsic motivation • Peer-fitness program • Social support / connection • Self-efficacy • Progressive / sequential Putting it all together
Change in body composition with leadership and peer-fitness program Unpublished pilot data, 2012
Shifting the culture 39% 51% 68%
Humans were designed to move and every aspect of our physiology is optimized when we do • Physical activity is a foundational practice for health and high performance • Thoughtful progression and sequencing, with attention to musculoskeletal health can help optimize outcomes • Cultures of health and performance are supported when we: find purpose, build community, and create effective practices (take action) Summary
““I didn’t realize the power of doing an exercise program together...you almost feel guilty not going to class because you know you’ll get calls and emails...you feel like you’re letting yourself and your co-workers down if you don’t show up.” “I really like that everyone in my row is doing the classes together. When one of us gets up to go, I think I better get up and go too.” "This is the most impactful program we've ever done…and we’ve done them all”
A Culture of Health: The New Normal