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Pushing the Physical Activity ‘Polypill’ – Cardiff Exercise Medicine Symposium 15th June 2013 (@CSEMSExMed2013)

10 May, 13 | by Karim Khan

Undergraduate perspective on Sports & Exercise Medicine - a BJSM blog series

By Bryn Savill (@BrynSavill) 

CSEMSThe evidence behind exercise as medicine is substantial and it can no longer be ignored.1 Prof. Blair (2009) named physical inactivity the “Biggest public health issue of the 21st Century” after discovering that physical inactivity was killing more Americans than smoking, diabetes and obesity combined.2 Cardiff Exercise Medicine Symposium hopes to explore the wealth of evidence about physical activity, and inspire us all to be more active and proactive in promoting physical activity both at an individual and policy level.

Symposium Rationale

Physical activity promotion in the UK is limited. This is not unexpected given the reality that healthcare is influenced heavily by the drug, devices and diagnostic trades with the aim of boosting their share price3. Further, the NHS has a strong track record of favoring interventions that involve something to swallow, breathe in and/or a syringe. We need to develop the skills, tools, and collective capacity to not only prescribe exercise as medicine but also move it to the front lines of government healthcare agendas. Of the four key adjustable risk factors to health: alcohol, smoking, food and physical activity – only physical activity seems to lack champions in the higher echelons of government.  We must act now and thrust this physical inactivity plague into the limelight. Physical activity is the polypill that we have been searching for; a moderate level of fitness causes a 44% reduction in mortality 4 – how many drugs are that effective?

Physical Inactivity vs Obesity

Everyday the newspapers, TV, and media are full with stories about the obesity crisis whilst we see little press on physical inactivity: yet which is the bigger public health issue – obesity or physical inactivity? Prof. Steven Blair has shown in a number of papers that being fit can alleviate the risks of being fat,5,6,7,8 and Weiler et al. (2010) argue that health policy should focus on physical inactivity not obesity.9

Prof. Blair will be presenting his latest research in the field at the symposium, whilst Prof. Terence Wilkin will be discussing the link between physical activity, genetics and childhood obesity. 

Sedentary behaviour

High levels of sedentary behaviour are damaging to our health, and sitting forms part of our everyday life so it’s an issue which we must address although I’m not in any way saying we should ban sitting; that’s mad! Indeed, sedentary behaviour is now included in the UK physical activity guidelines with the general advice to “minimise the amount of time spent sitting”.

Dr Emmanuel Stamatakis will discuss realigning are public health priorities with sedentary behaviour on the afternoon of Cardiff Exercise Medicine Symposium. 

National exercise guidelines – evidence or opinion?

There is growing confusion over how we should become active, perhaps stoked by programs such as the BBC documentary, “The Truth about Exercise” and Andrew Marr’s recent appearance on the BBC. Whilst providing mixed messages to the public can only serve to negatively impact physical activity levels, we need the debate and research between exercise professionals to continue so we can formulate clear evidence-based guidelines.

At the Symposium, Prof. Jamie Timmons will clear up the confusion by identifying if high intensity interval training has a role to play in the national exercise guidelines. 

Final Thoughts

It’s our responsibility, students and healthcare professionals alike,  to lobby for change, and form a voice to create a compelling fight for the role of physical activity in the health of the nation. Have you ever spoken to anybody who didn’t deem exercise as beneficial for your health? The response is most likely an emphatic “no.” However, do you have the expertise to lead by example and rally for change? Are you up to date with the latest developments in the exercise medicine field? Why not come to Cardiff Exercise Medicine Symposium to learn more about how we can construct effective models of physical activity intervention, the role of sedentary behaviour, the genetics of physical activity, and the interface between obesity and physical activity.

Remember we as emerging and seasoned healthcare practitioners can provide one of the seven “best investments” to combat this public health disaster10 – Listen to Fiona Bull’s podcast on the “Seven Best Investments”

Cardiff Exercise Medicine Symposium 2013 will be held on the 15th June at the University Hospital of Wales. For more information on Cardiff Exercise Medicine Symposium & to register CLICK HERE 

References

1 Department of Health (2012). Let’s Get Moving – A Physical Activity Care Pathway. 

2.Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med 2009;43:1–2.

3. Stamatakis E, Weiler E, and Ioannidis JPA. Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review. Eur J Clin Invest 2013. Article first published online: 25 MAR 2013

4.Lee DC, Sui X, Ortega FB, et al. Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med 2011;45:504–10.

5. Ortega FB, Lee DC, Katzmarzyk PT, Ruiz JR, Sui X, Church TS, Blair SN. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013 Feb;34(5):389-97.

6. McAuley PA, Artero EG, Sui X, Lee DC, Church TS, Lavie CJ, Myers JN, España-Romero V, Blair SN. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012 May;87(5):443-51

7. Lee DC, Sui X, Church TS, Lavie CJ, Jackson AS, Blair SN. Changes in fitness and fatness on the development of cardiovascular disease risk factors hypertension, metabolic syndrome, and hypercholesterolemia. J Am Coll Cardiol. 2012 Feb 14;59(7):665-72.

8. Lee DC, Park I, Jun TW, Nam BH, Cho SI, Blair SN, Kim YS. Physical activity and body mass index and their associations with the development of type 2 diabetes in korean men. Am J Epidemiol. 2012 Jul 1;176(1):43-51.

9.Weiler R, Stamatakis E, Blair S. Should health policy focus on physical activity rather than obesity? Yes. BMJ 2010;340:c2603.

10. Global Advocacy for Physical Activity (GAPA) the Advocacy Council of the International Society for Physical Activity and Health (ISPAH). NCD prevention: investments that work for physical activity. Br J Sports Med 2012;46:709–12.

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Bryn Savill BSc (Hons) is a fourth year medical student at Cardiff University, Wales, having undertaken an intercalated BSc in Sports and Exercise Science at Loughborough University. He sits on the undergraduate committee of the European College of Sports and Exercise Physicians (ECOSEP) and is a Move. Eat. Treat. Ambassador.

Liam West BSc (Hons) is a final year medical undergraduate student at Cardiff University, Wales. He coordinates the “Undergraduate Perspective on Sports & Exercise Medicine” Blog Series for BJSM.

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