Nutrition and Physical Activity for Health

Nutrition and Physical Activity for Health

John M. Jakicic, PhD

Linking Nutrition and Physical Activity to Health Outcomes

Nutrition and Physical Activity for Health

Nutrition and Physical Activity for Health

Physical Activity

Behavior

HealthRelated Outcomes

Diet / Nutrition

Theoretical Pathway for Lifestyle Factors to Influence Health-Related Outcomes

Physical Activity
Theoretical Pathway for Lifestyle Factors

Fitness

Behavior

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Is Physical Activity Linked to Improved Health

H e a l t h I m p r o v e d t o L i n k e d

Physical Activity

Behavior

A c t i v i t y P h y s i c a l I s

Fitness

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

The Foundation of this Relationship

The Foundation of this Relationship

Transport workers

Image Source Note 1

The Foundation of this Relationship

The Foundation of this Relationship

Postal workers

Image Source Note 1

1.10 1.00 Relative Risk 0.90 0.80 0.70 0.60 0.50 0.40

Relative risk of death (from all causes) according to measures of physical activity.

<500

500-999 10001499

15001999

20002499

25002999

30003499

>3500

Physical Activity Index (kcal per week)

Image Source Note 2

Physical Activity and Risk of Type 2 Diabetes in Women

1 1.0 0.84 0.75 0.87 0.77 0.74

0.5
0-2.0 (0.8) 2.1-4.6 (3.3) 4.7-10.4 (7.7) 10.5-21.7 (15.7) >=21.8 (35.4)

Activity (MET-hrs per Week)

Image Source Note 3

Physical Activity and Treatment of Depression

50 45 40 35 30 25 20 15 10 5 0 47%

29%

30%

Control

Low Dose

High Dose

Image Source Note 4

Diagram
Physical Activity Fitness

Behavior

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Association Between Cardiorespiratory Fitness and Risk of Cardiovascular Disease Mortality in Diabetics

Relative Risk

Fitness - METs
Image Source Note 5

Diagram

Physical Activity

Fitness

Behavior

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Cardiovascular Disease Mortality by Body Fatness and Fitness

4.5 4 3.5
RelativeRisk

3 2.5 2 1.5 1 0.5 0 Lean Normal Obese Fit Unfit

Adjusted for age (single year), examination year, smoking habit, alcohol intake, and parental history of ischemic heart disease Image Source Note 6

Is Diet and Nutrition Linked to Health Outcomes?

Is Diet and Nutrition Linked to Health Outcomes?

Physical Activity

Fitness

Behavior

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Nutrition and Health Outcomes

Links have been shown with:
Cardiovascular disease Diabetes Cancer Obesity Others

Nutrition and Health Outcomes

Dietary patterns can influence blood lipids
Transfats Saturated Fat Dash diet pattern
Encourage fruits and vegetables, whole grains, poultry/fish, legumes/nuts, low-fat dairy , vegetable oils Limit sweets, beverages containing sugar, red meat

Dietary patterns can influence blood pressure

Sodium intake Dash diet pattern

Is Diet and Nutrition Linked to Health Outcomes?

O u t c o m e s ? H e a l t h t o L i n k e d N u t r i t i o n a n d D i e t

Physical Activity

Behavior

I s

Fitness

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Health Consequences of Obesity

Hypertension Dyslipidemia Type 2 Diabetes Coronary Heart Disease Stroke Gallbladder Disease Osteoarthritis Sleep Apnea and Respiratory disorders Some forms of cancer

Health Costs of Obesity

Estimated to be $147 billion in the United States in 2008
Finkelstein et al. 2009

Estimated to account for 0.7% to 2.8% of total health care costs in a country worldwide
Withrow and Alter, 2011

Health costs are estimated to be 30% higher in obese adults compared to normal weight adults
Withrow and Alter, 2011

Nutrition and Physical Activity for Health

Nutrition and Physical Activity for Health

Physical Activity

Behavior

HealthRelated Outcomes

Diet / Nutrition

10

Theoretical Pathway for Lifestyle Factors to Influence Health-Related Outcomes

O u t c o m e s H e a l t h R e l a t e d I n f l u e n c e t o F a c t o r s L i f e s t y l e f o r P a t h w a y T h e o r e t i c a l

Physical Activity

Fitness

Behavior

HealthRelated Outcomes
Body Weight and Body Composition

Diet / Nutrition

Summary
Physical activity is an important health behavior that can have an independent effect on health Eating behaviors that influence diet and nutrition are also important and can have an independent effect on health Physical Activity and Nutrition may interact to maximize the health benefits

11

Image Source Notes

1. Chart created by instructor based on data from: Morris, J. N., Heady, J. A., Raffle, P., Roberts, C. G., & Parks, J. W. (1953). Coronary heart-disease and physical activity of work. The Lancet, 262(6795), 1053-1057. doi: 10.1016/S01406736(53)91495-0 2. Chart created by instructor based on data from: Paffenbarger, R. S., Hyde, R., Wing, A. L., & Hsieh, C. (1986). Physical activity, all-cause mortality, and longevity of college alumni. New England Journal of Medicine, 314(10), 605613. doi: 10.1056/NEJM198603063141003 3. Chart created by instructor based on data from: Hu, F. B., Sigal, R. J., Rich-Edwards, J. W., Colditz, G. A., Solomon, C. G., Willett, W. C., ... Manson, J. E. (1999). Walking compared with vigorous physical activity and risk of type 2 diabetes in women. The Journal of the American Medical Association, 282(15), 1433-1439. doi: 10.1001/jama.282.15.1433 4. Chart created by instructor based on data from: Dunn, A. L., Trivedi, M. H., Kampert, J. B., Clark, C. G., & Chambliss, H. O. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Preventive Medicine, 28(1), 1-8. doi: 10.1016/j.amepre.2004.09.003 5. Chart created by instructor based on data from: Church, T. S., LaMonte, M. J., Barlow, C. E., & Blair, S. N. (2005). Cardiorespiratory fitness and body mass index as predictors of Cardiovascular disease mortality among men with diabetes. JAMA Internal Medicine (formerly Archives of Internal Medicine), 165(18), 2114-2120. doi: 10.1001/archinte.165.18.2114 6. Chart created by instructor based on data from: Lee, C. D., Blair, S. N., & Jackson, A. S. (1999). Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. The American Journal of Clinical Nutrition, 69(3), 373-380.

12