For content from the day, try searching twitter for @WalesExMed & #WalesExMed2016 or read this post for our overview of the day. We've outlined the sessions and also supplemented this list with some of our notes and additional links to reading and resources referred to by the presenters.
Professor Gareth Stratton-
Explained the background to, and launch of the adult physical activity infographic
Mr Jonathan Davies – Programme Director for Physical Activity in Wales - keynote
“The promotion of physical activity needs to be underpinned by improvements in communication and social marketing.”
There is work needed on common outcome measures for monitoring pa across a population. There are currently several measures but these are not widely adopted and tend to focus on sports participation and self-reported activity.
'Diabesity' and the influence of diet & physical activity Prof Ian Macdonald -
Diabesity/Metabolic Syndrome/Metabolic Flexibility
140g per day are needed for brain function therefore reasonable levels of carbohydrates are essential.
25% of the population have high levels of liver fat.
The Dangers of Physical Activity - Dr David Stensel
Cardiac Hypertrophic Cardiomyopathy, Atrial Fibrillation
Albert, C. M., Mittleman, M. A., Chae, C. U., Lee, I. M., Hennekens, C. H., & Manson, J. E. (2000). Triggering of sudden death from cardiac causes by vigorous exertion. New England Journal of Medicine, 343(19), 1355-1361.
Kim, J. H., Malhotra, R., Chiampas, G., d'Hemecourt, P., Troyanos, C., Cianca, J., ... & Baggish, A. L. (2012). Cardiac arrest during long-distance running races. New England Journal of Medicine, 366(2), 130-140.
Morrow Jr, J. R., DeFina, L. F., Leonard, D., Trudelle-Jackson, E., & Custodio, M. A. (2012). Meeting physical activity guidelines and musculoskeletal injury: the WIN study. Medicine and Science in Sports and Exercise, 44(10), 1986.
O'Keefe, J. H., Patil, H. R., Lavie, C. J., Magalski, A., Vogel, R. A., & McCullough, P. A. (2012, June). Potential adverse cardiovascular effects from excessive endurance exercise. In Mayo Clinic Proceedings (Vol. 87, No. 6, pp. 587-595). Elsevier.
Thompson, P. D., Franklin, B. A., Balady, G. J., Blair, S. N., Corrado, D., Estes, N. M., ... & Maron, B. J. (2007). Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation, 115(17), 2358-2368.
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.
Concussion in Sport - Dr Michael Grey
HeadGames – the movie, Concussion – the movie
McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvořák, J., Echemendia, R. J., ... & Sills, A. (2013). Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. British journal of sports medicine, 47(5), 250-258.
Example of good practice…Sport Scotland initiative, If In Doubt, Sit Them Out
Current research project…RECOS Trial
Older people, sedentary behaviour and physical activity - Professor Dawn Skelton
The benefits of physical activity in the old are not about disease prevention but more about function, maintenance of independence, staying at home and not in care, avoiding DVTs & constipation etc. There are Psychological, physiological and psychosocial benefits of exercise to older people.
Older people might have different motivations to engage with PA…memory, cognition, being able to live independently (eg cleaning)
It can be hard to get health professionals and family members to support the aim of being more active. Social norms can reinforce a sedentary lifestyle for older people.
We lose 1-2% of our strength each year from the age 0f 30
Between ages 30 – 80 we lose half our strength but our body weight can remain stable
Sedentary behaviour increases health risks by 42% even if guidelines (30mins,5days) are met
Sedentary behaviour increases health risks by 127% if no activity takes place
Falls in the elderly kill more people than CHD, cancer and diabetes combined
Sedentary behaviour increases health risks by 42% even if guidelines (30mins,5days) are met
Sedentary behaviour increases health risks by 127% if no activity takes place
Falls in the elderly kill more people than CHD, cancer and diabetes combined
Prof Skelton encouraged the audience to stand during her session and had everyone trying some one legged exercises to illustrate appropriate exercises for the elderly.
A 12 week study gave care home residents daily bouts of reasonably high intensity exercise and reported that 90% doubled their strength by the end of the programme.
Recommended resources
www.juststand.org
Sporting Senior Games, Glasgow, 2015
Recommended resources
www.juststand.org
Sporting Senior Games, Glasgow, 2015
Can a genetic test unlock your athletic potential?- Dr Alun Williams
@RugbyGeneStudy
den Hoed, M., Brage, S., Zhao, J. H., Westgate, K., Nessa, A., Ekelund, U., ... & Loos, R. J. (2013). Heritability of objectively assessed daily physical activity and sedentary behavior. The American Journal of Clinical Nutrition, 98(5), 1317-1325.
Webborn, N., Williams, A., McNamee, M., Bouchard, C., Pitsiladis, Y., Ahmetov, I., ... & Dijkstra, P. (2015). Direct-to-consumer genetic testing for predicting sports performance and talent identification: Consensus statement. British Journal of Sports Medicine, 49(23), 1486-1491.
Pitsiladis, Y. P., Tanaka, M., Eynon, N., Bouchard, C., North, K. N., Williams, A. G., ... & Ashley, E. A. (2015). The Athlome Project Consortium: A Concerted Effort to Discover Genomic and other" OMIC" Markers of Athletic Performance. Physiological genomics, physiolgenomics-00105.
The afternoon was split into 3 streams based on Physical Activity and Chronic Kidney Disease, Musculoskeletal health and Diabetes Mellitus.
Kidney Disease
Introduction & overview of exercise for CKD patients (Dr Alice Smith)
Fatigue in Haemodialysis (Dr Giorgios Sakkas, University of St Mark & St John)
Exercise on dialysis (Dr Alice Smith)
Practical experience of renal rehab (Ms Clare Weekes)
Musculoskeletal Health
Introduction to Rheumatoid Arthritis & Exercise (Prof Lemmey)
RA & Exercise (Prof Giorgios Metsios)
Does running cause knee osteoarthritis? (Mr Richard Leech)
Keeping patients active in early OA - the role of the orthopaedic surgeon (Mr Chris Wilson)
Diabetes
Prediabetes & Physical activity (Prof Gareth Stratton)
Type 2 Diabetes Mellitus & Physical Activity (Dr Richard Bracken)
Type 1 Diabetes Mellitus & Physical Activity (Prof Ian MacDonald)
Roundtable discussion - Diabetes & Exercise/Physical Activity (All workshop speakers)
The presenters expanded on how a combination of moderate and vigorous intensity exercises were essential in helping treat diabetes with regular exposure, duration and intensity to be considered. It was emphasised that there are many other benefits to aerobic exercise and not just reduced HbA1c or BMI. Just one session of sprint (HITT) has been shown to give a reduction in post exercise glycaemia.
In an open forum at the end of the sessions Professor Macdonald touched on protein synthesis and spoke of his reservation in regard to protein ingestion by individuals who exercise. He mentioned the common recommendation on protein shake packaging that 2.5g of protein is consumed per kilo of body mass. His own thoughts were that 1.5 – 2g should be the maximum with this being spread throughout the day. - Graham Keat
Thoughts from a delegate
To start with Prof Stratton highlighted that 18% of deaths in Wales were due to inactivity; kind of scary! It was interesting to hear from Jonathan Davies, as someone that was involved at government level, explaining how they are trying to implement changes within the population of Wales. Prof McDonald was most engaging with a no-nonsense highly knowledgeable manner, and of the whole day I found Professor Dawn Skelton to be a most engaging and inspiring speaker. She was obviously a high level academic who had bucket loads of passion along with plenty of experience working at the sharp end of elderly health care. Definitely one of the highlights of the day.
I found the Wales Exercise Medicine Symposium to be a fantastic opportunity to hear from world class speakers in the field and the non-stop format was most engaging and the day flew by.Many thanks Ben for arranging the trip and thank you to the current Marjon students for making me so welcome. I’m up for next year again if you’re going! - Graham Keat, HEPA graduate, 2014
Posted by Ben Jane with contributions from Graham Keat.
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