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Physical Activity and its
Impact on Chronic
Disease

What is Physical activity?
Any movement that results in the use of
energy

What is Exercise?
Physical activity that is structured and has
the goal of improving fitness.

How are these different?
Planning!
Our goal is to find ways to get people more
active without making it sound like work!

How can we do this?
S
M
A
R
T
Goals!
pecific
easureable
chievable
ealistic
ime-bound

Use SMART goals to help
members get more active in
their everyday lives!

Why are we so worried about getting our
members more active?
How does being more active help them?

CORONARY
HEART DISEASE
TYPE 2 DIABETES
BREAST AND
COLON CANCERS
SHORTER LIFE
EXPENTANCY
METABOLIC
SYNDROME
OBESITY
Physical
Inactivity
Major Risks of Physical Inactivity

If no activity is “bad” then how much is
“good”?
CDC recommends at least 150 minutes of
physical activity per week - 21.5 minutes/day
While this is ideal, studies have shown
significant reductions in incidence of disease
even at lower amounts21

Wen et.al21 showed a group exercising for an
average of 92min/week or 15min/day vs complete
inactivity and had:
• 14% reduced risk of all-cause mortality
• 3 year longer life expectancy
For every additional 15 minutes of daily exercise:
• Further reduction of all-cause mortality by 4%
• Additional reduction on all-cancer mortality by
1%

So, how do we determine the activity level of
our members?
QUESTIONNAIRES!
SURVEYS!

What surveys already exist and find what we’re looking for?
• Community Healthy Activities Model Program for Seniors
(CHAMPS)17,20
– Gauges changes in activity levels in primarily
underactive seniors
– 41 questions

• Patient-centered Assessment and Counseling for
Exercise (PACE)3,19
– Developed to assist physicians in counseling patients
on becoming more physically active
– 50 questions, covers wide variety of factors
• Rapid Assessment of Physical Activity (RAPA)1,18
– Developed specifically to be comprehensive, reliable,
and time efficient
– 9 questions, assesses activity level as well as
strength and flexibility

Which is the best option for an physical
activity assessment survey?
Steal the good parts from the surveys that
ask the questions you need answered.

Quick Survey of Physical Fitness(QSPF)
• Uses first seven question of RAPA to
gauge frequency and intensity of physical
activity
• Uses four follow-up questions to gauge
basic strength and endurance if necessary

Question # # of responses
(N=13)
1 0
2 0
3 1
4 4
5 0
6 5
7 3
At the Memorial Hermann Healthy
Advantage Fall Fair we had the opportunity
to test the QSPF.
The results show that an unprecedented number or respondents indicated
that they performed an above average or satisfactory amount of physical
activity.

What should we do if we find out a member
has an activity level that may be negatively
impacting their health?
• Try giving them some SMART goals
• Refer them to a Health Coach

Conclusions
• Almost any movement is good movement
and more is better than less
• The more you move, the less chance of
getting sick and dying early

References
1. Arraiz, G. a., Wigle, D. T., & Mao, Y. (1992). Risk assessment of physical activity and physical fitness in the Canada
health survey mortality follow-up study. Journal of Clinical Epidemiology. http://doi.org/10.1016/0895-
4356(92)90043-M
2. Balkau, B., Deanfield, J. E., Despres, J.-P., Bassand, J.-P., Fox, K. A. A., Smith, S. C., … Haffner, S. M. (2007).
International Day for the Evaluation of Abdominal Obesity (IDEA): A Study of Waist Circumference, Cardiovascular
Disease, and Diabetes Mellitus in 168 000 Primary Care Patients in 63 Countries. Circulation, 116(17), 1942–1951.
http://doi.org/10.1161/CIRCULATIONAHA.106.676379
3. Calfas, K. J., Sallis, J. F., Zabinski, M. F., Wilfley, D. E., Rupp, J., Prochaska, J. J., … Patrick, K. (2002).
Preliminary evaluation of a multicomponent program for nutrition and physical activity change in primary care:
PACE+ for adults. Preventive Medicine, 34(2), 153–161. http://doi.org/10.1006/pmed.2001.0964
4. Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness:
definitions and distinctions for health-related research. Public Health Reports, 100(2), 126–131.
http://doi.org/10.2307/20056429
5. Cassidy, S., Thoma, C., Hallsworth, K., Parikh, J., Hollingsworth, K. G., Taylor, R., … Trenell, M. I. (2015). High
intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2
diabetes: a randomised controlled trial. Diabetologia. http://doi.org/10.1007/s00125-015-3741-2
6. Hebestreit, Helge; Bar-Or, Oded (2008). The Young Athlete. Blackwell Publishing Ltd. p. 443. ISBN 978-1-4051-
5647-9.
7. Holten, M. K., Zacho, M., Gaster, M., Juel, C., Wojtaszewski, J. F. P., & Dela, F. (2004). Uptake , GLUT4 Content ,
and Insulin Signaling in Skeletal Muscle in Patients With Type 2 Diabetes, 53(February).
http://doi.org/10.2337/diabetes.53.2.294

References
8. Koster, A., Leitzmann, M. F., Schatzkin, A., Mouw, T., Adams, K. F., van Eijk, J. T. M., … Harris, T. B. (2008). Waist
circumference and mortality. American Journal of Epidemiology, 167(12), 1465–75.
http://doi.org/10.1093/aje/kwn079
9. Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., … Wells, J. C. (2012). Effect of
physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life
expectancy. The Lancet, 380(9838), 219–229. http://doi.org/10.1016/S0140-6736(12)61031-9
10.Martin, C. K., Church, T. S., Thompson, A. M., Earnest, C. P., & Blair, S. N. (2009). Exercise dose and quality of
life: a randomized controlled trial. Archives of Internal Medicine, 169(3), 269–78.
http://doi.org/10.1001/archinternmed.2008.545
11.Plowman, Sharon A.; Smith, Denise L. (1 June 2007). Exercise Physiology for Health, Fitness, and Performance.
Lippincott Williams & Wilkins. p. 61. ISBN 978-0-7817-8406-1
12.Shaw, B.S.; Shaw, I. (2005). "Effect of resistance training on cardiorespiratory endurance and coronary artery
disease risk". Cardiovascular Journal of South Africa (pdf) 16 (5): 256–9.PMID 16307157.
13.Shaw, B.S.; Shaw, I. (2009). "Compatibility of concurrent aerobic and resistance training on maximal aerobic
capacity in sedentary males" (pdf). Cardiovascular journal of Africa 20(2): 104–6. PMC 3721256. PMID 19421643
14.Shaw, I..; Shaw, B.S. (2014). Resistance Training and the Prevention of Sports Injuries. In: Hopkins, G. (Ed.).
Sports Injuries: Prevention, Management and Risk Factors. Nova Science Publishers, Hauppauge, NY.
USA. ISBN 978-1-63463-305-5

References
15.Sherrington, C., Whitney, J. C., Lord, S. R., Herbert, R. D., Cumming, R. G., & Close, J. C. T. (2008). Effective
Exercise for the Prevention of Falls: A Systematic Review and Meta-Analysis. Journal of the American Geriatrics
Society, 56(12), 2234–2243. http://doi.org/10.1111/j.1532-5415.2008.02014.x
16.Stensvold, D., Nauman, J., Nilsen, T. Il, Wisløff, U., Slørdahl, S. a, & Vatten, L. (2011). Even low level of physical
activity is associated with reduced mortality among people with metabolic syndrome, a population based study (the
HUNT 2 study, Norway). BMC Medicine, 9(1), 109. http://doi.org/10.1186/1741-7015-9-109
17.Stewart, A. L. (2001). CHAMPS Physical Activity Questionnaire for Older Adults: Outcomes for Interventions.
Medicine and Science in Sports and Exercise, 1126-141.
18.Topolski T.D., L. J. (2006). The Rapid Assessment of Physical Activity (RAPA) amoung Older Adults. Preventing
Chronic Disease, 3(4), 1-8.
19.University of California. (2007). PACE Projects. Retrieved 9 15, 2015, from www.paceproject.org
20.University of California, San Francisco. (2008). CHAMPS in the Community. Retrieved 9 15, 2015, from
http://dne2.ucsf.edu/public/champs/community/
21.Wen, C. P., Wai, J. P. M., Tsai, M. K., Yang, Y. C., Cheng, T. Y. D., Lee, M. C., … Wu, X. (2011). Minimum amount
of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. The Lancet,
378(9798), 1244–1253. http://doi.org/10.1016/S0140-6736(11)60749-6

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