The cost of physical inactivity in Scotland. â¢2,500 Scots die prematurely/year inactivity. â¢Costs NHS Scotland £660 million per year. â¢Cost of physical inactivity to ...
Physical Activity for Health Research Centre (PAHRC)
Cycling, Health and Longevity Cycling and Health 2018
Prof Chris Oliver @CyclingSurgeon CyclingSurgeon.Bike
Retired Consultant Orthopaedic Trauma Surgeon
Trauma Orthopaedics
Obesity
Cycling
Keeping Active
Edinburgh Orthopaedic Trauma Unit 800,000 Lothian population Lothian per year • 223,000 attend A&E • 3,460 all RTA to A&E • • • •
1930 vehicle occupants 340 motorcyclists 230 pedestrians 960 cyclists (total)
• 80+ tram injured cyclists
Scotland recent • 180 RTA deaths • 12 cycling deaths http://www.ed.ac.uk/clinical-sciences/orthopaedics-trauma/clinical/trauma
Some Cycling Safety Facts in Britain • Benefits cycling outweigh life-years lost through injuries by 20:1 • One cyclist killed every 29 million miles travelled • Unlikely to be killed cycling as walking • Have good road safety record • Cycle safety in is one of the poorest in Europe
Cycling UK (CTC)
Physical inactivity a ‘pandemic’ “…physical activity is not about sport and it is about more than just exercise…. It is not about running on a treadmill, whilst staring at a mirror and listening to your iPod. It is about using the body that we have in the way it was designed, which is to walk often, run sometimes, and move in ways where we physically exert ourselves regularly whether that is at work, at home, in transport to and from places, or during leisure time in our daily lives.” Das and Horton, Lancet 2012
Which is Different and Why?
40-year-old triathlete
74-year-old sedentary man
70-year-old triathlete
Sarcopaenia
The cost of physical inactivity in Scotland • 2,500 Scots die prematurely/year inactivity • Costs NHS Scotland £660 million per year
• Cost of physical inactivity to UK economy £8 billion • Diabetes destroy the NHS
Age- and sex-related differences in the contributions of the domains of PA to total MVPA amongst adults in Scotland who met the aerobic PA guidelines in 2013 Source: Strain et al.
Smokadiabesity 10 9
8 7 6 5
smoking
% premature mortality
4
inactivity
3 2 1 0 PAF population attributable fractions (PAFs)
deaths caused in millions Lee et al. , Lancet, July 2012
Policy
Vision: A More Active Scotland Physical activity is about getting people moving. Daily walking, playing in a park, going to a gym, training with a team or aspiring to win a gold medal- it doesn’t really matter how people get active, it just matters that we do. Being physically active contributes to our personal, community and national wellbeing. Our vision is of a Scotland where more people are more active, more often.
National Outcomes
Active Scotland Outcomes We encourage and enable the inactive to be more active
We improve our active infrastructure – people and places
We encourage and enable the active to stay active throughout life
We support wellbeing and resilience in communities through physical activity and sport
Equality – Our commitment to equality underpins everything we do
We develop physical confidence and competence from the earliest age
We improve opportunities to participate, progress and achieve in sport
Have you seen these guidelines before?
A dose response
Schiphorst, Murray, Kelly, Oliver, Bull Br J Sports Med 2017;51:1227-1228 bjsm.bmj.com/content/51/16/1227
Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
MOOC Sit Less, Get Active www.coursera.org/learn/get-active @GetActiveMOOC Free 6th Cycle 153K visitors, 51K enrolled, 29K active, 2.5K completed
7,500 preschool kids cycling in Glasgow National roll out? Daily Mile
International Policy Context • WHO Global Action Plan for Physical Activity 2018 • Based on Bangkok Declaration for Physical Activity and Sustainable Development • 10% reduction sedentary behaviour by 2025
http://www.who.int/ncds/governance/physical_activity_plan/en/
Cycling and Longevity – The Dutch Dutch Cycling: Quantifying the Health and Related Economic Benefits • Fishman. American Journal of Public Health 2015. 105(8):e13-e15 • 6,500 deaths prevented yearly • Dutch have half-a-year longer life expectancy • Health benefits translate in economic benefits - 3% of Dutch GDP
Cycling and Longevity – Glasgow Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study Celis-Morales. BMJ. 2017. doi: https://doi.org/10.1136/bmj.j1456 • Cycle commuting was associated with a lower risk of: • CVD, cancer, all cause mortality.
• Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions.
Cycling and Longevity – Sustrans Nov 2017 Sustrans Report • Meeting government walking and cycling targets would save • 13,000 lives from air pollution over next 10 years • £9.31bn • every area in London exceeds WHO limits for PM2.5 • 10% of journeys by bike Scotland’s Cycling Action Plan could save 4,000 premature deaths & £3.64bn
Cycling and Longevity - Muscles Properties of the vastus lateralis muscle in relation to age and physiological function in master cyclists aged 55–79 years • Ross, Aging Cell. 2018. DOI: 10.1111/acel.12735 • 125 active cyclists. 55-79 years • There is little evidence of age-related changes in the properties of Vastus Lateralis muscle across the age range studied • No age related deterioration of muscle • High levels of exercise training are able to maintain many of the properties of muscle with ageing
Cycling and Longevity – Immune Cells Major features of immunesenescence, including reduced thymic output, are ameliorated by high levels of physical activity in adulthood Duggal, Aging Cell 2018 DOI: 10.1111/acel.12750 Immune profiles in 125 adults (55–79 years) who had maintained a high level of physical activity (cycling) for much of their adult lives 75 age-matched older adults and 55 young adults not involved in regular exercise. Frequency of naïve T cells and recent thymic emigrants (RTE) were both higher in cyclists compared with inactive elders. Cyclists had significantly higher serum levels of the thymoprotective cytokine IL-7 and lower IL-6, which promotes thymic atrophy. Cyclists reduced immunesenescence, namely lower Th17 polarization and higher B regulatory cell frequency than inactive elders. Many features of immunesenescence may be driven by reduced physical activity with age.
In summary… • Important • Cycling & Health • Cycling & Pollution • ↓ sedentary behaviour • Do what works at scale • Culture is changing
Physical Activity for Health Research Centre (PAHRC)
Cycling, Health and Longevity Cycling and Health 2018
Prof Chris Oliver @CyclingSurgeon CyclingSurgeon.Bike
