Activity and Exercise for Adults

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Activity and Exercise for Adults

• Hawarun Hussain
• Physical Activity Co-ordinator

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• Content
• Physical activity exercise and sport is it all
  the same?
• Activity recommendations
• Motivation and getting started
• Case studies (group work)

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Physical Activity

• Any bodily movement produced by skeletal muscles
  that results in energy expenditure.
• (Bouchard et al, 1990)

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Exercise

• Leisure time physical activity which is planned
  and structured, and repetitive bodily movement
  untaken to improve or maintain one or more
  components of physical fitness.
• (Bouchard et al, 1990)

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Sport

• A sport consists of a normal physical activity
  or skill carried out under a publicly agreed set
  of rules, and with a recreational purpose for
  competition, for self-enjoyment, to attain
  excellence, for the development of skill, or some
  combination of these. A sport has physical
  activity, side by side competition, and a scoring
  system. The difference of purpose is what
  characterises sport, combined with the notion of
  individual (or team) skill or prowess.

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Activity Recommendations

• The DoH guideline of 30 minutes of moderate
  activity (e.g. brisk walking) on 5 or more days
  of the week is based on improving cardiovascular
  fitness
• For weight loss the duration and intensity would
  need to be increased

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Activity Recommendations

• To prevent the development of obesity 45 60
  minutes of moderate intensity each day may be
  required
• 60 90 minutes of activity per day may be
  required to maintain weight loss in people who
  have been obese and have lost weight

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Getting started is the Key

• Activity recommendations may seem a lot to
  someone who is currently inactive. The key is to
  get started the work on gradually increasing
  activity levels

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Getting Started

• Physical activity should be enjoyable practical
  and fit into the lifestyle of the individual
• We need at assess motivation levels and build on
  these. How do we do this?
• Examples may include decisional balance
  questionnaire providing opportunistic brief
  intervention advice backed up with written
  material understanding barriers.

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Getting Started

• Set realistic goals with the individual and
  review them. Then set new goals.
• Help people identify where they can incorporate
  physical activity into their lifestyle. Consider
  using an dairy/calender

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• Invest in health prevention now which will
  provide long term savings to both the individual
  and the NHS

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• Case Studies

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Case Study 1

• White British Female 20 years. BMI 27kg/m².
  married with no children.
• No current health conditions and no family
  history of CAD.
• History
• Attends clinic every 6 months for family
  planning. Patient records show that her
• BMI has increased over the last three years. Her
  records show that she was
• given a BHF leaflet about weight loss at her last
  visit 6 months ago.
• She has just started a new job as PA in a busy
  office and she spends 2 hrs per
• day travelling to and from work. She used to go
  to a private health club next to
• her old office but now no longer attends. She
  works full-time.
• She tends to avoid breakfast and may buy
  something from the canteen at work
• for lunch.
• Evening meals are often takeaway or ready meals
  from the supermarket.
• She feels she has very little time to prepare and
  cook a meal
• She and her husband share a bottle of wine every
  evening (she deserves it!)
• and may drink more at weekends

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Case Study 2

• South Asian male 48 years. BMI 35 kg/m². family
  history
• of CAD, father died of MI at 58 years. Currently
  on medication for his
• blood pressure and cholesterol.
• History
• Salesman travelling round the country and lives
  away from home
• during the week. Married with two boys aged 7
  and 9 years. Patient
• notes tell you that he was referred to BEEP two
  years ago. He said he
• never completed the BEEP scheme as the swimming
  times were not
• convenient.
• He lives on hotel food and food from shops and
  takeaways during the
• week. He eats very little fruit and veg.
• He is very pleased to get home to his wifes
  cooking at the weekend.

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Case Study 3

• White British female aged 68. She has had
  trouble controlling her
• cholesterol for which she takes medication. She
  also takes medication
• for her blood pressure and arthritis. She also
  has angina. Her BMI is
• 30kg/m². She tells you that she is finding it
  difficult to walk up the hill to
• the bus stop and relies on family members taking
  her shopping.
• History
• She goes to a luncheon club once a week and uses
  the access bus to
• get there. She used to be a dinner lady and
  tells you that her weight is
• down to her age as she was always on the go. She
  tells you that at her
• age she cant imagine her doing exercise, pumping
  iron and wearing
• lycralycralycra leggings.
• She is a good cook and manages regular meals and
  snacks. She
• enjoys making cakes for her grandchildren who
  visit regularly. She is
• only able to shop once a week.

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Case Study 4

• South Asian female aged 32yrs. BMI 24kg/m².
  Family
• history of CAD. Complains of back ache.
• History
• She has been on many diets and has recently lost
  19kg on
• the slimfast diet. She helps her husband run the
  family
• business and has three children. Her oldest
  child has just
• started school. She has been taking her mum to
  cardiac
• rehab at the BRI and has very little time for
  herself.
• She has a mainly traditional South Asian diet.
  Her children
• enjoy chips, fish fingers and takeaway foods. She
  does
• cook this food for them almost daily whilst
  encouraging
• them to eat traditional food.