Sport and Health
Exam: Oct. 30th; 15:00u – 16:00u
Week 1 – Exercise is medicine
HC1 – Exercise in Medicine (04/09)
Pandemic: “in view of the prevalence, global reach, and health effect of physical inacitivity,
the issue should be appropriately described as pandemic, with far-reaching health,
economic, environmental, and social consequences.
Low fitness kills more people than ‘smokadiabesity’
→ ‘sitting is the new smoking’
• Short term
o Glucose and insulin levels go up
o Sitting down causes the muscles to go into “standby” mode within minutes
o Triglycerides pile up in the bloodstream
o Levels of fatmetabolizing enzyme lipoprotein lipase plunge by up to 95%
• Long term
o Increase in waist size
o Risk of diabetes
o Increased risk of back pain
o Risk of psychological stress
o Weight gain, especially among woman
o Increased risk of colon cancer
o Risk of heart disease
→ sitting: risk for heart disease!
• Research: Coronary heart disease and physical activity of work
• Results: Sedentary London bus drivers / telephonists were at a higher risk of cardiac
events than were their more active conductor / postmen peers!
Moderate-intensity: heartrate and breathing will go up; you are able to have a good
conversation without interruption; 5 days a week.
VO2Max: good measure for physical activity
• Low levels of cardiorespiratory fitness (CRF) are associated with a high risk of
cardiovascular disease, all-cause mortality, and mortality rates attributable to various
cancers.
• ‘Cardiorespiratory Fitness is the only major risk factor for cardiovascular disease and
mortality that is not assessed in clinical practice’
• ‘The addition of CRF for risk classification presents health professionals with unique
opportunities to improve patient management and to encourage lifestyle-based
strategies designed to reduce cardiovascular risk.’
1
,Long term benefits of exercise
WHO guidelines on physical activity and sedentary behaviour
Moderate intensity = heartrate rises, but it is still possible to talk
3 most common excuses for not being physically active:
1. No time
a. Exercise does not take a lot of time
2. Makes me tired
3. Makes me sweat
Exercise Snacks: A Novel Strategy to Improve Cardiometabolic Health
For example: Jumping Jacks, Lunges or Squats between lectures
Exercise is medicine
Hippocrates: “if we could give every individual the right amount of nourishment and
exercise, not too little and not too much, we would have found the safest way to health.”
→ People choose for pills and surgery, rather than lifestyle change
Medication versus Exercise
VB → Hypertension
2
,Research: “How does exercise treatment compare with antihypertensive medications? A
network meta-analysis of 391 randomised controlled trials assessing exercise and medication
effects on systolic blood pressure.”
• What is already known?
o Exercise interventions are effective in lowering systolic blood pressure
• What are the new findings?
o Across all populations, individuals who receive antihypertensive medications
tend to achieve greater reductions in systolic blood pressure than those who
adopt structured exercise regimes.
o In populations with hypertension, different types of exercise interventions
appear to be equally effective as most antihypertensive medications
o Structured exercise has not been evaluated as extensively as antihypertensive
medications.
VB → Mortality outcomes
Bewegen minstens zo effectief als medicijnen op mortaliteitsuitkomsten voor:
• Preventie van diabetes
• Secundaire preventie van hart/vaatziekten
• Revalidatie na CVA
• Behandeling van hartfalen
Indication
• Exercise during cancer treatment: less fatigue, less fear and depression, improvement
of physical function, improvement quality of life (QoL)
Exercise → less pain killers, less surgery, less ‘sickness leave’
Prehabilitation → better treatment outcome, less complications
Physical activity is an intervention with few adverse events that may improve pain severity
and physical function, and consequent quality of life.
Side effects: injuries (musculoskeletal)
Even during pregnancy and with lactation: all women without contraindication should be
physically active throughout pregnancy.
Warnings/precautions
• Start low, go slow
• 1 hour after meal
• Combine with healthy food, plenty of water and enough sleep
• Do not combine with smoking
• Be carefully with heat
Contra-indications & risk → preventive examination and personalized exercise prescription
F.I.T.T. → Frequency, Intensity, Time (duration), Type
Personalized prescription of exercise based on risk factors, mental and/or physical
limitations, injuries, motivation and obesity.
3
, Summarise
1. Physical inactivity is pandemic
2. Cardiorespiratory fitness is a vital sign
3. Prescribe exercise to your patients
Also important:
o WHO Guidelines on physical activity and sedentary behaviour 2020
https://apps.who.int/iris/bitstream/handle/10665/337001/9789240014886-eng.pdf
o Exercise is Medicine – Factsheet, available via
https://www.exerciseismedicine.org/assets/page_documents/EIM%20Fact%20Sheet
%202014_update%20March%202018.pdf
o The Miracle Drug: Exercise is Medicine, available via
https://www.exerciseismedicine.org/assets/page_documents/EIM_HCP_1_Page_Sum
mary.pdf
o Physical inactivity and non-communicable disease burden in low-income, middle-
income and high-income countries Br J Sports Med. 2022 Jan;56(2):101-106. doi:
10.1136/bjsports-2020-103640. Epub 2021 Mar 29
https://pubmed.ncbi.nlm.nih.gov/33782046/
o Exercise as medicine - evidence for prescribing exercise as therapy in 26 different
chronic diseases Scand J Med Sci Sports . 2015 Dec;25 Suppl 3:1-72. doi:
10.1111/sms.12581.https://pubmed.ncbi.nlm.nih.gov/26606383/
4
Exam: Oct. 30th; 15:00u – 16:00u
Week 1 – Exercise is medicine
HC1 – Exercise in Medicine (04/09)
Pandemic: “in view of the prevalence, global reach, and health effect of physical inacitivity,
the issue should be appropriately described as pandemic, with far-reaching health,
economic, environmental, and social consequences.
Low fitness kills more people than ‘smokadiabesity’
→ ‘sitting is the new smoking’
• Short term
o Glucose and insulin levels go up
o Sitting down causes the muscles to go into “standby” mode within minutes
o Triglycerides pile up in the bloodstream
o Levels of fatmetabolizing enzyme lipoprotein lipase plunge by up to 95%
• Long term
o Increase in waist size
o Risk of diabetes
o Increased risk of back pain
o Risk of psychological stress
o Weight gain, especially among woman
o Increased risk of colon cancer
o Risk of heart disease
→ sitting: risk for heart disease!
• Research: Coronary heart disease and physical activity of work
• Results: Sedentary London bus drivers / telephonists were at a higher risk of cardiac
events than were their more active conductor / postmen peers!
Moderate-intensity: heartrate and breathing will go up; you are able to have a good
conversation without interruption; 5 days a week.
VO2Max: good measure for physical activity
• Low levels of cardiorespiratory fitness (CRF) are associated with a high risk of
cardiovascular disease, all-cause mortality, and mortality rates attributable to various
cancers.
• ‘Cardiorespiratory Fitness is the only major risk factor for cardiovascular disease and
mortality that is not assessed in clinical practice’
• ‘The addition of CRF for risk classification presents health professionals with unique
opportunities to improve patient management and to encourage lifestyle-based
strategies designed to reduce cardiovascular risk.’
1
,Long term benefits of exercise
WHO guidelines on physical activity and sedentary behaviour
Moderate intensity = heartrate rises, but it is still possible to talk
3 most common excuses for not being physically active:
1. No time
a. Exercise does not take a lot of time
2. Makes me tired
3. Makes me sweat
Exercise Snacks: A Novel Strategy to Improve Cardiometabolic Health
For example: Jumping Jacks, Lunges or Squats between lectures
Exercise is medicine
Hippocrates: “if we could give every individual the right amount of nourishment and
exercise, not too little and not too much, we would have found the safest way to health.”
→ People choose for pills and surgery, rather than lifestyle change
Medication versus Exercise
VB → Hypertension
2
,Research: “How does exercise treatment compare with antihypertensive medications? A
network meta-analysis of 391 randomised controlled trials assessing exercise and medication
effects on systolic blood pressure.”
• What is already known?
o Exercise interventions are effective in lowering systolic blood pressure
• What are the new findings?
o Across all populations, individuals who receive antihypertensive medications
tend to achieve greater reductions in systolic blood pressure than those who
adopt structured exercise regimes.
o In populations with hypertension, different types of exercise interventions
appear to be equally effective as most antihypertensive medications
o Structured exercise has not been evaluated as extensively as antihypertensive
medications.
VB → Mortality outcomes
Bewegen minstens zo effectief als medicijnen op mortaliteitsuitkomsten voor:
• Preventie van diabetes
• Secundaire preventie van hart/vaatziekten
• Revalidatie na CVA
• Behandeling van hartfalen
Indication
• Exercise during cancer treatment: less fatigue, less fear and depression, improvement
of physical function, improvement quality of life (QoL)
Exercise → less pain killers, less surgery, less ‘sickness leave’
Prehabilitation → better treatment outcome, less complications
Physical activity is an intervention with few adverse events that may improve pain severity
and physical function, and consequent quality of life.
Side effects: injuries (musculoskeletal)
Even during pregnancy and with lactation: all women without contraindication should be
physically active throughout pregnancy.
Warnings/precautions
• Start low, go slow
• 1 hour after meal
• Combine with healthy food, plenty of water and enough sleep
• Do not combine with smoking
• Be carefully with heat
Contra-indications & risk → preventive examination and personalized exercise prescription
F.I.T.T. → Frequency, Intensity, Time (duration), Type
Personalized prescription of exercise based on risk factors, mental and/or physical
limitations, injuries, motivation and obesity.
3
, Summarise
1. Physical inactivity is pandemic
2. Cardiorespiratory fitness is a vital sign
3. Prescribe exercise to your patients
Also important:
o WHO Guidelines on physical activity and sedentary behaviour 2020
https://apps.who.int/iris/bitstream/handle/10665/337001/9789240014886-eng.pdf
o Exercise is Medicine – Factsheet, available via
https://www.exerciseismedicine.org/assets/page_documents/EIM%20Fact%20Sheet
%202014_update%20March%202018.pdf
o The Miracle Drug: Exercise is Medicine, available via
https://www.exerciseismedicine.org/assets/page_documents/EIM_HCP_1_Page_Sum
mary.pdf
o Physical inactivity and non-communicable disease burden in low-income, middle-
income and high-income countries Br J Sports Med. 2022 Jan;56(2):101-106. doi:
10.1136/bjsports-2020-103640. Epub 2021 Mar 29
https://pubmed.ncbi.nlm.nih.gov/33782046/
o Exercise as medicine - evidence for prescribing exercise as therapy in 26 different
chronic diseases Scand J Med Sci Sports . 2015 Dec;25 Suppl 3:1-72. doi:
10.1111/sms.12581.https://pubmed.ncbi.nlm.nih.gov/26606383/
4
