The role of walking in workplace physical activity promotion
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Transcript of The role of walking in workplace physical activity promotion
The role of walking in workplace physical activity promotion
Marie H Murphy PhD, FACSMSport & Exercise Sciences Research Institute
School of Sports Studies
Physical Activity and Health: current activity guidelines
Why walking?
Walking for short and long term health benefit – the evidence
Stairclimbing
Promoting workplace walking
“All parts of the body which have a function,
if used in moderation and exercised in labours in which each is
accustomed,
become thereby healthy, well developed and age more slowly,
but if unused and left idle they become liable to disease, defective in
growth and age quickly”
Hippocrates (460-370 BC)
The decline in physical activity
Pre historic hunting and gatheringhigh energy expenditure survival of the fittest
10,000 yrs ago domesticated animalsrise in farming
1800-1900 Industrial revolutionIncreased urbanisation
Post WWII auto transportlabour saving devices in home and workless strenuous jobs
1950s television1970s video1980s computers1990s internet / www / online shopping
MORBIDITY & MORTALITY
1900 Measles Polio Diphtheria Tetanus Rubella, Influenza Diarrheal diseases Tuberculosis Pneumonia Food scarcity Vitamin /mineral deficiency
2000 Cardiovascular Disease Overweight and obesity Type 2 Diabetes Osteoporosis Cancer
Risk altered by behaviours
Physical InactivitySmoking
Diet
PA and Health: EvidenceCoronary Heart DiseasePhysical activity > 2000kcal per week = 1/3 lower risk of MI (Kohl 2001)
Cardiovascular DiseaseDose-response relationship between walking and CVD up to a 32% risk
reduction (Manson et al 2002)
StrokePhysical inactivity responsible for 3-fold increase in stroke in middle
age men (Wannamethee and Shaper 1992)
Blood LipidsPhysical Activity > 1200kcal per week raises HDL (good) cholesterol
and lowers LDL (bad) cholesterol in hyperlipidemic (Kraus et al 2002)
High Blood PressurePhysical activity normalises moderately elevated blood pressure
(Fagard et al 2001)
PA and Health: Evidence
Overweight and Obesity45-60 mins per day prevents transition from overweight to obese (IASO
2002)
OsteoporosisWeight bearing exercise slows and/or reverses decline in bone mineral
loss (Dalsky et al 1998) and reduces osteoporotic fractures (Siris et al 2001)
Type II diabetesRisk of developing diabetes decreases by 6% with each 500kcal per
week of activity (Helmrich et al 1991)
CancerLower cancer mortality among physically active- strongest relationship
breast and colon cancers (Thune 2001)
PA and Health: Evidence
Inactivity is physiologically abnormal
Sedentary living is a contributory factor to 17 disease
conditions and results in ¼ of all preventable deathsBooth et al (2000) J Appl Physiol 88:774-787
“There are few public health initiatives that have greater
potential for improving health and well-being than
increasing physical activity levels” Prof Sir Liam Donaldson CMO @ Dept of Health
Current Physical Activity Guidelines
30 mins of moderate intensity exercise 5 d.wk -1OR
20 mins of vigorous intensity 3 d.wk -1
>accumulated in bouts of 10 min or more
Haskell et al (2007) Med Sci Sports Exer 39 (8) 1423-1434
Translating Intensity
% of
VO2 max
% HR max
METS kcals /min
Feeling
Moderate 40-60% 55-70% 3-7* 5-8# WarmerBreathingConversation
Vigorous 60-85% 70-90% 5-10* 7-12# Warm/HotHeavy breathingConversation difficult
* Age dependent # body weight dependent
Current Physical Activity Guidelines
Physical activity guidelines have existed since 1978
Despite guidelines physical inactivity has now reached epidemic proportions
60-70% of adults do not meet current guidelines
What are the main barriers to physical activity among the
sedentary majority?
Perceived Barriers to Exercise
Not ‘the sporty type’
Facilities
Expense
Not fit / healthy enough
Age
Lack of time
Weather
Lack of social support
How much walking
Walking•Socially acceptable- no age, gender or race barriers
•Little/no skill, equipment or facility requirement
•Low impact- low injury risk
•Easily incorporated in lifestyle /useful for personal transport
•Activity of CHOICE-
Dunn (1998) Project ACTIVE –
sedentary individuals asked to incorporate 30 mins of any additional
activity into lifestyle ~ on average added 19-20 mins walking
Dunn et al (1998) Am J Prev Med 15 (4) 398-412
Physiological demands of brisk walking
•Major muscle groups - over half the body’s muscle mass
•Low impact- 1 foot always in contact with ground- low risk of injury
Physiological demands of brisk walking
Energy expenditure:
• proportional to body mass
increases with
-speed
-slope
-uneven terrain
-arm movement
Walking not perceived as physical ‘exercise’
How intense is brisk walking?
Is walking intense enough to meet guidelines and elicit health benefits?
28M 54F (mean age 48) walking in park-
covertly observed
Self selected speed (n=82) - 5.6 km.h -1 (3.5mph)
Asked to ‘walk briskly’ (n=59) - 6.4 km.h -1 (4mph)
Murtagh et al (2002) Preventive Medicine vol 35 p 324-328
11 of these subjects walked in lab
self selected pace = 59% of VO2 max, 67% of HR max
‘brisk walk’ pace = 69% of VO2 max, 78% of HR max
Moderate = 50-70% VO2 max, 60-80% of HR max
Murtagh et al (2002) Prev Medicine vol 35 p 324-328
Brisk walking at self-selected pace- is moderate intensity / meets current physical activity recommendations
Is walking intense enough to meet guidelines and elicit health benefits?
•Facility provision / Membership
•Encouraging Active Transport
•Promotion of ‘Lifestyle’ activities in and around worksite e.g.-Walking-Stairclimbing
Using lifestyle activity:-•Most cost effective
•Better long terms adherence•Easy to incorporate into daily routines
Workplace Options for PA promotion
Walking and CVD risk factors: Meta-analysis
24 randomized clinical trials
1128 subjects, 52 yrs, 83% women
On average 35 week programme, 4.4 days per
week, 189 mins per week
Murphy et al (2007) Prev Med 44: 377-385
Does walking work?
Walking and CVD risk factors: meta-analysis
VO2max +2.7 ml/kg/min 9% ↑
Weight -0.95 kg 1.4 % ↓
BMI -0.28 kg/m 21.1 % ↓
Body fat -0.63 % 1.9 % ↓
Systolic BP -1.1 mmHg not sig
Diastolic BP -1.5 mmHg 3.4 % ↓
Murphy et al (2007) Prev Med 44: 377-385
Acute Effects
At least some of the effects of physical activity are due to the acute effects derived from the most recent bout
Such ‘last bout’ effects may be important for health
What do we know about the acute effects (0-48 hours) of walking?
Acute Effects of Walking
Walking 10 mins 4 times during the course of a day reduces blood pressure for up to 11 hours after the last walk
Park et al (2005) J of Hypertension 24 (9) 1761-1770
Three 10 minute walks reduces the lipids circulating in the bloodstream after a meal
Murphy et al (1999) Int J of Obesity vol 24 (10) 1303-1309
One 40 minute walks reduces inflammation known to increase risk of a cardiovascular event 24 hours after the walk
Murtagh et al (2006) JPAH vol 3, 324-332
How much walking 30 mins minimum
10,000 steps per day from all walking sources
Office-based employees typically accumulate 4000-6000 steps/day Tudor-Locke and Bassett (2004). Sports Medicine, 34: 1-8
15000-2000kcal per week
Accumulation is as good as continuous
Some is good…………………more is better
Stairclimbing
Independent of weather Suitable for worksite environments where landscape limited Low cost No facilities Inconspicuous Ideal for accumulated approach Large Muscle Groups – develops leg strength Vigorous intensity
Does stairclimbing work
15 females 8 weeks progressive stairclimbing:
1 ascent (195 steps in 135 seconds) per day in week 16 ascents per day by week 6,7 and 8
Cadence 90 steps per minute
Fitness improved by 17.1%7.7% decrease in cholesterol
Maximum time investment~13.5 minutes per day
Boreham Kennedy and Murphy (2005) BJSM 39:590-593
Stairclimbing vs WalkingWalking Can be low moderate or
vigorous intensity Health Benefits Fitness benefits Suits sedentary Suites ‘most’ pre-existing
health conditions
Stairclimbing Vigorous for all ages – even those
already active Health Benefits Fitness Benefits Requires reasonable baseline fitness Not suitable for some pre-existing
health conditions
Walking is a good start point or a ‘stepping stone’ to ……..Accumulated stairclimbing…….
Mixed walking and stairclimbing (interval training)
Walking & Stairclimbing @ worksome practical suggestions
Make active choices easy choices:
Map out 10, 20 and 30 minute routes inside + outside workplace
Train some staff as walk leaders
Pedometer challenges (weekly / monthly)
Make stairwells attractive (lighting paint, artwork, music)
Do a walkability audit of your workplace
Put water cooler, toilets or supplies on top floor
Role models / Senior executive ‘champions’
Active Buddy system
Encourage meetings on the move
½ hour approved absences
Email prompts
Inactivity monitors
Perceived Barriers to Exercise
Not ‘the sporty type’
Facilities
Expense
Not fit / healthy enough
Age
Lack of time
Weather
Lack of social support
Walking
Accumulated approach
Walking / stairclimbing groups
Stairclimbing
Stairclimbing
Conclusion
Walking and stairclimbing ideally suited to workplace physical activity promotion
Walking can be moderate or vigorous depending on age fitness and chosen terrain
Accumulating exercise is short bouts is as effective as continuous exercise for yielding health benefits
Increasing activity and increasing fitness will both (independently) enhance health and reduce disease risk
Take home message:Some physical activity is good……………more is better
The role of walking in workplace physical activity promotion
Marie H Murphy PhD, FACSMSport & Exercise Sciences Research Institute
School of Sports Studies