A joint Faculty of the Royal College of Physicians of Ireland (RCPI)

and the Royal College of Surgeons in Ireland (RCSI)

Exercise as part of a Healthy
Lifestyle
Dr Laurence J Conway
Sports and Exercise Medicine Specialist.
FSEM RCSI &RCPI
 Humans
• Hunter gatherer

• Brain development
required energy

• Hunter survived
because of endurance
Where has evolution led us?
Where has evolution led us?
• Lessons from the
aboriginal people of
Australia

• Less Hunting/more
gathering due supply
 Where are we today?
• What is Best indicator
risk of death in next 10
years?
 Where are we today?
• What is Best predictor
of mortality risk in next
10 years?

• Exercise Capacity =
Aerobic capacity
Exercise is the best medicine
 Relative Risk of CVD

1
1.0
0.8
Relative Risk Score

0.6 0.68

0.4
0.37 0.33
0.2
0
0 1-59 min 1.0-1.5 h >2h
Time Spent Walking per Week
Mansoon JAMA, 2001, 285:1447
First 15 minutes of Exercise per day
• 3 year increase in Life expectancy

• First 15min/day: there is 14% reduction all causes

mortality

• Every extra 15 min/day there is a further extra 4%

reduction mortality
 Exercise = Treatment and Prevention
• Dose = Intensity + Duration
• Frequency = Frequency
• Treatment is life long
• Risk Benefit ratio

• Side effects
 How do we Reduce risk?
• Start at realistic level
• Build up slowly
• Exercise should be FUN
• As a group or on own
• Warm up
• Cool Down
• Stretch
• No intense exercise after
meals
• Medical assessment?
Disease Prevention
• Cardiovascular disease
• Diabetes Mellitus
• Cancers
• Obesity
• Bone Health
• Mood/stress
• Immune function
• Cognitive function
• Mobility / risk falls
 Treatment
• Heart or Vascular Disease.
• High Blood Pressure
• Cholesterol
• Obesity
• Diabetes Mellitus
• Cancers
• Osteoarthritis
• Osteoporosis
• Respiratory illness
• Mood
• Cognitive Function
• Neurological Disorders
 Exercise; the Cost Benefit ratio
• Effective
• Low Cost
• Effects multiple related problems
• Prevention other disease
• Quality of Life benefit
• Socialisation of isolated

• Dose tailored to individual

No Physical Exercise During a 7-Day Period Men
Women

40
37
33
30
27
26 27
Percent

20 21 21 21
18 17

14
10
11

0
1988 2002 1988 2002 1988 2002
18-34 35-54 55+

Slan Survey 1999

Why are people inactive?
Why are people inactive?
• No Time
– Work
– Family
• Cost
• Lost the Habit
• Poor motivation/mood
due inactivity
• Health issues
• Social isolation
• Hard first few sessions so
stop
How do we get message to those that
need it the most
• How do we change
lifestyle

• Those that need change

are not here
 Psychological states of change
• Pre contemplation
• Contemplation.
• Preparation
• Action

• Maintenance
Lifestyle
• Diet Quantity
Quality
Timing
• Hydration
• Risks Tobacco
• Leisure drugs
• Healthy BMI
• Positive Mental Attitude
• Rewards in life
7 areas of Investment
• Schools
• Transport
• Urban Design
• Health Care
• Public Education
• Community
• Sports for all
 Schools
• Greater opportunity
National Schools
• Ways to keep girls
active through out
secondary
• Insurance issue
• Develop physical
Literacy Curriculum
Transport
• Walking & Public
Transport
• Cycling
• Drive children to school
 Urban Design
• New Housing Estates
• Safe Friendly
environment
• Urban Plan; Green areas
Sports Facilities
Cycle tracks
Local facilities
Health Care
• 47% Primary Care
Doctor say they ask
about exercise
• 13% Patients report
getting advice about
exercise

• What can Medical

Profession do?
 What Can Medical Profession do?
• Ask people about
exercise

• Give green prescriptions

• Do not tell people to

stop exercise
• Modify where possible
What Can Medical Profession do?
• Educate doctors &
student in exercise
prescription
• Increase medical
profession awareness
• Role Models
• Help remove barriers;
– Cost
– Time
– Educate
 Public Education
• Media need to have
consistent clear
message

• Irish innovation
National Physical Activity Guidelines

‘Get Ireland Active’

www.getirelandactive.ie
 Community
• School
• Public
• Private sector
• Fitness Industry
Activity for ALL
 Balance life
• Work Life balance
• We need find place all
parts of our life
• Look Positive
• Beware of negative
thoughts
• Goal setting
 Work Life Balance
• Stressors Recovery
_____________________________________

Financial Sleep
Work related Food
Social Social life
Health Rewards
Exercise Exercise
Health and Quality of life