FITT for CV population

• Worldwide Facts:

  • physical inactivity causes 6 to 10% of all major non-communicable diseases including coronary heart disease, type 2 diabetes, breast and colon cancers
  • physical inactivity caused 9% of the premature mortality, or more than 5.3 million of the 57 million deaths in 2008
  • for a perspective: smoking causes 5 million deaths a year worldwide
• Adults (aged 18 to 64 years) including those with chronic conditions and those living with disability pt1:

  • all adults should undertake regular physical activity
  • adults should do at least 150 to 300 mins of moderate intensity aerobic physical activity, or at least 75 to 150 minutes of vigorous intensity aerobic physical activity, or an equivalent combination of moderate intensity and vigorous intensity activity throughout the week for substantial health benefits
  • adults should also do muscle strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits
• Adults (aged 18 to 64 years) including those with chronic conditions and those living with disability pt2:

  • adults should limit the amount of time spent being sedentary
  • replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits
  • to help reduce the detrimental effects of high levels of sedentary behaviour on health, adults should aim to do more than the recommended levels of moderate to vigorous physical activity
• Older adults (aged 65 years and older) including those with chronic conditions and those living with disability:

  • as part of their weekly physical activity, older adults should do varied multicomponent physical activity that emphasises functional balance and strength training at moderate or greater intensity on 3 or more days a week, to enhance functional capacity and to prevent falls
  • adults should limit the amount of time spent being sedentary
  • replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits
  • to help reduce the detrimental effects of high levels of sedentary behaviour on health, adults should aim to do more than the recommended levels of moderate to vigorous physical activity
• Sedentary Behaviour:

  • is any walking behaviour characterised by an energy expenditure equal to or less than 1.5 METs, while in a sitting, reclining, or lying posture
  • sedentary behaviour can hinder cardiovascular health, even if at least 150 minutes of moderate to vigorous activity is being achieved
• Cardiorespiratory Fitness:

  • CRF is the capability of heart, blood vessel, lung and muscles to perform at optimal efficiency
  • CRF is the ability to carry out daily tasks with vigour and alertness without undue fatigue and with ample energy to enjoy leisure time pursuits and response to emergencies
• Children and adolescents (5 to 17 yr olds) including those living with disability

  • should do at least an average of 60 mins per day of moderate to vigorous intensity, mostly aerobic, physical activity, across the week
  • vigorous intensity aerobic activities as well as those that strengthen muscle and bone should be incorporated at least 3 days a week
  • should limit the amount of time spent being sedentary, particularly the amount of recreational screen time
• How is CRF measured?

  • maximal exercise involves increasing workload till exhaustion
  • in the absence of open circuit spirometry, fitness is estimated by using regression equations (r = 0.92)
• • for every 1 increase in MET, there is a 13 to 15% reduction in all cause mortality
• Strength/resistance training:

  • 8 to 10 different muscle strengthening activities involving all larger major muscle groups on 2 or more non-consecutive days each week
  • 8 to 12 repetitions on each exercise
• Health benefits of PA:

  • decrease:
  • all cause mortality by 30%
  • CVD by up to 35%
  • type 2 diabetes by up to 40%
  • colon cancer by 30%
  • breast cancer by 20%
  • depression by up to 30%
  • hip fractures by up to 68%
  • dementia by up to 30%
• • physical inactivity can cause
  • obesity
  • diabetes
  • high blood pressure
  • high cholesterol
  • bad mental health
  • all of the above and smoking are all CVD risk factors
• Exercise is cardioprotective

  • anti-atherosclerotic
  • improved lipids
  • blood pressure
  • adiposity
  • insulin sensitivity
  • inflammation
  • psychological
  • depression
  • stress
  • social support
  • anti-thrombotic
  • platelet adhesiveness
  • fibrinolysis
  • fibrinogen
  • blood viscosity
  • anti-ischaemic
  • myocardial oxygen demand
  • coronary blood flow
  • endothelial dysfunction
  • nitric oxide
  • anti-arrhythmic
  • vagal tone
  • adrenergic activity