Exercise Is Medicine—Putting Science in to Clinical Practice.ppt

CVD Mortality Risk* by Fitness and BMI Categories, 2316 Men with Diabetes, 179 CVD Deaths Church TS et al. Arch Int Med 2005; 165:2114 *Adj for age and examination year p for trend 0.0001 p for trend 0.0001 p for trend 0.002 Joint Associations of CRF and % Body Fat with All-cause Mortality, ACLS Adults 60+ Death rate/1,000 person-years Rates adjusted for age, sex and exam year Deaths 151 190 29 72 Sui M et al. JAMA 2007; 298:2507-16 Muscular Strength and Mortality Strength, Adiposity, and Cancer Mortality 8,677 men, 20-82 years 18.8 years of follow-up, 211 cancer deaths Muscular strength assessed by 1-RM bench press and leg press Significant trend across strength categories remained after further adjustment for BMI, % body fat, waist circumference, and cardiorespiratory fitness Thirds of Strength Odds of Cancer Death* *Adj for age, exam yr, smoking alcohol intake, and health status P for trend=0.003 Ruiz J et al. Cancer Epidemiol Biomarkers Prev 2009; 18:1468 Yes, But Those Are Observational Studies, and We Require Randomized Clinical Trial Evidence Change in Physical Health Martin CK et al. Arch Int Med 2009; 169:269-78 Change in Mental Health Martin CK et al. Arch Int Med 2009; 169:269-78 Change in Energy Martin CK et al. Arch Int Med 2009; 169:269-78 Reduction in Risk of Developing Diabetes in Comparison with Controls, DPP  58% 31% 0 20 40 60 80 100 Risk reduction (%) *Moderate intensity exercise of ?150 min/week; low calorie, low fat diet Lifestyle Intervention* Metformin DPP Research Group. NEJM 2002; 346:393-403 Cost Effectiveness of Diabetes Prevention-DPP The lifestyle and metformin groups cost $2,250 more/year than placebo As implemented in the DPP and from a societal perspective, lifestyle was more cost effective than metformin DPP Res Group. Diab Care 2003; 26:2518 Summary Gain in Longevity for a 45-Year Old Male Years of added life Comparison of Low, Moderate, and High Fitness Levels Health Care Overview Medica