Inside the Effects of Exercise: From Cellular to Psychological Benefits

[Music] so what do i want to get across so i will get across today how long we live and what impacts the quantity and quality of our lives i will speak about how exercise might extend the quantity and quality of our lives and also how we can increase exercising in previously inactive adults and does it have an impact on health you're all familiar with the lifespan we are born and then slowly over time after we have some many successes hopefully and some setbacks throughout our lifespan we eventually will die there's nothing we can do about that uh there has been some uh about the death there's nothing we can do about dying uh until there's a pill out there um there has been a really great study that was published a couple of years ago in the lancet and this is uh the economist took their data and its hundreds of data points and they summarized it into this beautiful figure and right now don't look at all the different colors let's look at the uh the the end of the red this is the lifespan this site is for women and this size is for men let's look at the lifespan of women uh in uh who are born in 2013 and the how long it is expected that they will live which is around 86 years old in japan and for men it is approximately 80 years old 79 years old if we look at united states that changes considerably where the health span is uh 72 years old for the sorry 79 years old for the woman and 72 years old for the men so that's our lifespan that's the expected lifespan for the average person in japan or the average person in the united states to live if they were born in 2013. but then there's also this concept of the health span what is happening in our final years what is happening during the period from as we're entering older age before we die and now let's look at these colors and let me break them down for you this is in japan for an average man who was born in 1990 they were likely to die at the age of 76 whereas their health span how long how many years they were healthy before a disease took over that was on average 68 years old so there's an eight year expected period of of disease and morbidity if a person was born in 2013 they've ex the the life span is expected to be by about four years so now they're expected to live until they're 80 and for but their health span doesn't increase as much by four years it increases three years so there's an increase in their health span so they will likely in japan men will will likely live until 71 years old healthily and then spend the next nine years on average living an unhealthy life what about in the united states the lifespan uh the lifespan from 1990 was 72 for men and for women was 79. their health span was 63 and 67 so a nine year difference here an eight year difference here of unhealthy years for those born in 2013 there's an extension of four extra years in their lifespan for men an extension of two extra years for women and the health span increases three years so you can see by the time that adults in the united states enter their late 60s they'll likely live for another eight nine to ten years with disease in canada we take this seriously very seriously there's a campaign that has been out for the past few years if you can see it's called how will you spend your last 10 years and it's an image of a person either in a kayak or in a hospital bed versus a fisherman and i'm just going to play you the commercial that we have on had on television and also online [Music] what will your last 10 years look like [Music] will you be quick enough for a game of tag with your grandchild strong enough to embrace every moment will you grow old with vitality or get old with disease [Music] it's time to decide the average canadian will spend their last 10 years in sickness change your future at makehealthlast.ca the first time i watched that i think i cried so now i try to restrain all of my tears when i watch that video so on the same website from the canadian heart and stroke foundation um there are tips on how to extend your life by looking at some of the lifestyle risk factors you'll see unhealthy diet physical inactivity unhealthy weight smoking stress and excessive alcohol and drug use i'm going to walk you through this so don't worry about it this is data from ontario ontario is one of our provinces we have 10 of them and uh this is in ontario the average age expectancy this is 10 years old this data at this point the average age expectancy in ontario was around 82 years old in 2007. and what you can see here is what what does it mean to smoke or not smoke so this is not smoking how many years extra does it provide to your lifespan or over compared to smoking how much does it decrease from your lifespan you can see that smoking has a serious decrease in the extent to which we'll live there's data on alcohol data on physical activity data on diet and stress levels and what do all the five risk factors provide and what does it decrease from someone's life spends and you can see over here that there's a 20-year decrease for those who are categorized as having high stress not eating well which for them from this measure was really just a questionnaire on fruits and vegetables that were being consumed physical activity or physical inactivity excessive binge drinking or drug use and being a smoker it decreases the life expectancy compared to those people who have none of those factors by about 20 years what happens if you change your behaviors how many extra years does it add to your life and you can see that on average by decreasing smoking and becoming a non-smoker reducing alcohol intake becoming physically active to the levels recommended by the cdc or the public health agency of canada improving one's diet reducing stress will add approximately 10 years of life so what's the take-home so far quality is equally as important as quantity is life health behaviors and stress matter and i focus on the importance of physical activity hippocrates in a time when man was dominant said walking is man's best medicine i would like to say walking is a person's best medicine and at this point i have a quiz so i'm going to ask you to do a show of hands usually if you go to see a re talk by a physical activity researcher they get you to stand up and then you have to do like some jumping jacks and i'm not going to force anyone to do that right now but i will do a quiz so the first question and don't show it in an answer yet is how many minutes of moderate physical activity are recommended per week so a moderate activity level is three to six metabolic metabolic equivalent tasks so the acronym is mets three metabolic tasks equivalent task is three times the amount of uh energy that's required to support movement and to support your body compared to just sitting so the average for sitting is a one met so three for a met is three times the amount of energy is required for your body to function while engaging in that behavior some types of examples are brisk walking ballroom dancing gardening and water aerobics i want to see who wants to take a take a guess of how many minutes are required over here 150 minutes she's right i'm not asking her next there's no way um so are they in canada and this is actually from recommendations by the cdc and a working group that it's required 150 minutes in total spread out over five days with 30 minutes during each activity there's also the requirement that each one should last minimally ten minutes okay so how many minutes of vigorous activity are recommended per week if you didn't engage in moderate activity vigorous activity are greater than six men so it's required six times the amount of energy to do these types of activities and those kind are jogging and running and swimming laps and jumping and so on jumping rope is actually i think a met of about ten it's considered one of the most strenuous activities that one could engage in i will ask the same woman to answer this for vigorous it's 75 minutes so what is recommended is half the amount of time to engage 75 minutes per week spread out over three days in chunks of 25 minutes or a combination of the two so somewhere between 75 to 150 minutes are recommended for optimum for for good health so how many days of strength training are recommended anyone want to answer this question two two days are recommended for strength training muscle strength activities two days per week here it says high intensity but you'll see it also says moderate intensity moderate intensity is fine for some reason they're highlighting this high intensity because that's kind of where a lot of people really like to do some workouts lately so moderate intensity of lifting weights doing some lunges doing works on your muscles and your bones how do we fare in the world in terms of physical activity levels so this is physical inactivity among adults in the unit in across the world you will see some very deep reds those very deep reds are greater than 50 percent of their populations self-report and that's important self-report that they are physically inactive in the united states it's somewhere between 30 and 40. in canada it's somewhere between 20 and 30. this is self-reported if you ask people how much they say in the united states how much activity they take they do it's about 50 percent and that's consistent across practically every single study that i have had somewhere to between 50 and 55 say that they are physically active in the united states if you slap an accelerometer on them and track them for an entire week it's somewhere around twenty percent [Laughter] and that's consistent in canada too you have a fifty uh forty sixty percent say they're physically active and thirty percent actually are children i think because children are required to do 60 minutes of movement per day for children with accelerometers on them it's 15 percent so why is this important well we've been talking about health span and lifespan and i'll show you some data here on published recently in the in jama published in 2015 by aaron and colleagues and let me walk you through this i won't ever put a figure on here without walking you through the results here you see some met hours per week so the minimum amount of mets is a moderate level in 150 minutes and one a moderate brisk walk is three mets 150 minutes is two and a half hours so two and a half hours times three is 7.5 so we have here this is for the people who are just basically meeting the recommended requirements by the cdc or other agencies the who has the exact same requirements and this is if you multiply how many more so this person's actually engaging in 10 times the amount of recommended physical activity what does mortality look like look look this drastic drop just from becoming a physical but just by being physically active at recommended levels there's a 20 decreased risk of early mortality and when you get to this area of being three to five times there's a forty percent decrease but the extent benefits of exercise don't extend just to mortality they bet this is from the amer uk government this is uh the benefits of exercise reduce the risk of cardiovascular disease by 30 percent type 2 by diabetes by 40 cancers by 30 and so on and so on so at the end of the day there's a significant amount of research accumulated over the past many many decades that physical activity is essential for disease outcomes for reducing risk for disease for decreasing the uh the progression of disease and for decreasing early mortality and at the root of many of these diseases of aging they're called diseases of aging at the root of many of these diseases diseases is our immune system and our immune system functions to keep uh to keep our our body intact in check it responds to a physical blunts if someone attacks me and i have a cut my immune system will heal will heal that cut if i have a cold my immune system functions better in order to deal with the virus or the bacteria that's the importance of our immune system and what they've discovered is that over time our immune system ages exercise is known to benefit the immune system our immune system ages over time and underpinning all of these diseases is a weathered immune system that is pumping up all these this pro-inflammation into our body that's then circulating through our blood and attacking different areas of different physiological physiological systems and that one of the markers of an aging immune system is the telomere have has everyone heard here about the telomere i'm going to do a little crash course that's going to take two minutes on what a telomere is so telomeres are the highlighted yellow here at the end of a chromosome the purple codes for dna and the yellow is simply a repeated sequence of ttaggg repeated thousands of times it was discovered by elizabeth blackburn from ucsf and who want a nobel prize for discovering telomeres and also discovering the enzyme that extends or that extends the telomeres every time a cell divides and that enzyme is called telomerase so the dna as many of you know is transcribed into an rna molecule which then is translated into a protein the blue which was in the previous slide purple the blue is important for coding proteins damage preferentially when damage occurs to the chromosome it preferentially occurs on the ends of the chromosome so if you're going to damage something let's damage something that does encode so the telomeres don't code for anything they're there to protect all the blue they're there to keep the cell viable to keep the chromosomes viable to keep the proteins being produced as proteins that are still able to function well but every time a cell divides even if we have telomerase the telomeres get shorter and at some point telomeres get to such a length that's so short that the cell stops division because it realizes that any more division any more loss will actually start affecting some of the proteins that are some of the dna that's coding for some very essential proteins so the cell stops dividing sometimes the cell dies and sometimes the cell enters a state of senescence senescence is a cell that's not dead and it's pumping out inflammation inflammatory proteins and this is one of the root causes of of of diseases of aging is a shortened telomeres there's a debate always raging in the literature is it really important is it a marker and there's some research really showing that this is a meta-analysis of the association between telomere length and cardiovascular disease and here it says uh retrospective data so this is data studies where i have a whole room full of you and you unbeknownst i've taken your blood i know if you you actually have to consent and i'll take your blood and i'll also find out if you have cardiovascular disease at this point across all these different studies there's an increased likelihood of having cardiovascular disease at the same time of hazing short telomeres an 80 increase in having cardiovascular disease here are some prospective studies these are healthy participants across all these different studies none of them have heart disease but in the future they will develop some of them will develop heart disease what is their rate what is the risk of having short telomeres with developing cardiovascular disease in the future here their increased risk is 54 percent similarly we have risk for mortality and here's some a recent figure on the relationship between uh having short telomeres and having uh having an increased likelihood of early mortality and here there's a 54 increase risk if you are short compared to the longest group um in this sample of of participants so what is the research on exercise and telomere length there over since 2007 or eight uh there have been studies that have been published some most of those samples have been small samples looking at the relationship between self-reported physical activity cardiovascular fitness [Music] and also sedentary time and accelera accelerometry based physical activity levels all those studies were predominantly showing that cardio respiratory fitness having a good heart and a strong heart and being able to take in oxygen and use it well is related to longer telomeres telomeres the physical activity literature because of the sample size product i'd say in the majority demonstrated links between exercise and short and longer telomeres but there were a lot of studies that were showing the ops showing null effects that kind of changed with this nationally representative sample and haines larry tucker went into the data 5843 participants had telomere length data and they also had data on their physical activity levels so they wanted to create different groups of physical activity four different groups the by quartile the lowest physically active all the way up to the top 25 percent of most physically active sadly he found that 50.8 of the participants reported zero physical activity over the previous uh over the time that they were assessing no physical activity so he wasn't able to really do these quartiles that were evenly distributed by 25 percent so he said he chunked out this 50 and the remaining 49 were chunked up into three tertiles and what did he find what were the odds of having short telomeres compared to the highest group so those who had zero physical activity over the time of assessment had a 95 percent increase likelihood of having short telomeres in the sample that's almost twice as likely to be in the short telomere group compared to the non-short telomere group those in the low physical activity group so they engage in some health some physical activity but not a lot in this sample there's a 66 percent increased likelihood of having been categorized as short compared to the high group and even those who engaged in a moderate amount of physical activity still had a 73 increased risk of having short telomeres compared to the high group this has been repeated in a different sample an older woman by sadhyab they use data from the healthy women's initiative study showing leisure time physical activity also being associated with telomere length and this was also a pretty large sample in the same sample use data not from self-reported physical activity levels but accelerometry measured physical activity levels so that's when you slap on an accelerometer like a fitbit or one that's used for research purposes the actigraph or the active pal or the active pal there's all these different companies they also found a relationship between the amount of sedentary time people engaged in these women engaged in and their and short telomeres the more sedentary time the more sitting around the more sitting at the computers not moving much was related to telomere length shorter telomeres that was quite the study and got a lot of attention in the media this is just one of the articles of by time magazine saying that sitting too much ages you by eight years that was their take-home message my take-home message is that any increase i think exercise matters for your health span and your lifespan but the effect and the effects can be seen all the way deep into ourselves but of course more is better that's my takeaway from here so this says for those who can't see i'm prescribing exercise think of it as a stress pill that takes 30 minutes to swallow why am i bringing stress into this so i'm a health psychologist and i do a lot of work on stress and the first paper i ever read was a paper by not ever read in my entire life but the first paper i read on the research that really excited me was this research by alyssa epple about stress and telomere length how do you measure stress you can measure it with questionnaires you can look at different events that happen in people's lives you can look at their psychological experience you can look at acute stressors like a hurricane or you can look at a chronic stressor like caregiving and alyssa dr epple um was interested in looking at family caregiving why family caregiving family caregivers uh put in four there are 40 million family caregivers in the united states in 2013 putting in 37 billion hours of care accounting for 470 billion of unpaid service this is from the alzheimer's association or the caregivers alliance kind of comparing what those ma what that 470 billion dollars equals it's similar to the money that's made at walmart it's more than the expenditures by medicaid why is this important they report 18 hours per week on average of care provision 60 percent are caring for an adult while they're employed 68 are using their own money and 39 feel financially strained one in four workers are are 72 of uh of workers uh are over the age of 40 providing care and still working family caregiving increases the risk for depression by uh twofold it increases the risk for cardiovascular diseases twofold and has an increased risk by 63 percent of more early mortality so as i was saying dr apple published the first paper that got me so excited and when i heard her first speak about this research and she's one of the most exciting speakers that i've ever heard in science and i'm not saying that just because she's sitting here she really is um she published an article in the proceedings in the national academy of science linking short telomeres to life stress and caregivers she had a sample of women who are premenopausal who are providing care for a child for a disabled for a child with a disability she looked at just she had a sample of these caregivers and she looked at how many years have they provide been providing this care for the patient for their child and what was their relationship between the number of years that they were providing care and their length in their telomeres and what she found was a strong relationship accounting for 20 percent of the variation in telomere length by the amount of years that they were providing care so more years shorter telomeres she also found that if she had a sample of not just the red caregivers but blue control participants who reported low levels of stress or they were actually low they were reporting low levels of stress and they didn't have a child with a disability but they were mothers and they also filled out a psychological measure called the perceived stress scale and found that an increase across all the women in this study an increase in the in their perceptions of stress over the past month was related to shorter telomeres since then there have been studies on prenatal maternal stressors early childhood diversity and this list goes on and on socioeconomic disadvantage like lower income poor education poverty unemployment domestic violence and other papers linking psychological stressors and psychosocial stressors to shorter telomeres the question for us became what happens if you accumulate stress over your lifespan most of those studies have been one-offs looking cross-sectionally at individuals who are currently stressed or reporting domestic violence or and what their telomere length is right now what happens over time can do you accumulate stress and does it get under your skin and embed itself and change your the length of your telomeres we had this opportunity to look at the at this question in a sample drawn from the nationally representative u.s health and retirement study i'm not going to walk through all this but the health and retirement studies started in 1992 and has been tracking adults for the past uh we're 2018 now so actually since 90 for the past 26 years there's different cohorts in it there's 50 to 64 50 to 65 year old participants men and women and there's also a 65 to 80 year old group that tracked in the first couple of years and as people dropped out of the study for uh health reasons or mortality reasons or they just dropped out of the study they kept reintroducing new cohorts into the study and that's what all these arrows represent there were 20 000 people at the start of the study on average and they're in 2008 they got data from the saliva for telomere length and what we did was we went into this 20 years worth of data or 16 years worth of data and tried to find all types of events that may be considered a stressor did they report unemployment at some time did they report financial loss at some point and we looked through the questionnaire and we found that there was at some point they also said hey what happened in your early life and there were questions related to that they had to relocate when they were a child to a new home due to financial difficulties that they their father was not was unemployed at a certain point so there were childhood adversities and then adult adversities such as experiencing the death of a child the death of a spouse and also some financial difficulties in adulthood what we found in this study was that none of these in adjusted or unadjusted or adjust models so we can ignore that let's look at the adjusted models which means that i'm in this model i'm co-varying and controlling for everything under the sun their current education level their current marital status their current health behaviors their current medication use their current disease status after adjusting for all those factors nothing really alone dominated the length of their telomeres or predicted the length of their telomeres but when you added them up together there was a significant relationship between adding up and accumulating stressors across the lifespan and having short telomeres and this was an eight percent increase likelihood that for every one extra event no event in particular but for every one extra event there was an increased likelihood of having short telomeres by eight percent so life stressors can predict uh the the extent the the the way that we age in a healthy way or an unhealthy way but we also have factors that kind of make us more vulnerable or make us more resilient to stress i look at healthy lifestyle predominantly and physical activity pretty much all the time but there are other factors that we have examined to look at to see do they buffer or mitigate the effects of stress on aging and our health we've looked at psychological stress resilience are you a good emotional coper are you emotionally resilient are you uh do you not ruminate very much and do you have strong social connections and i'll show you the first study so i was excited by alyssa's paper and i email i met her at a conference and i think i harassed her for a good year trying to convince her that we have to look to see if you're physically active does stress still have an impact so she's like finally come come to san francisco i broke her so what we um looked at she had a new sample of caregivers these weren't they were family caregivers but they weren't pre-menopausal caring for a child with a disability they were postmenopausal caring for a spouse a parent a sibling who had alzheimer's disease or another type of dementia and instead of looking at the well first i looked at the whole sample and found a link between similar to the previous study that per greater amount of psychological stress these participants the control that we all said they also had a shell side control participant so they were postmenopausal not providing care so the amount of stress that all these participants reported was similarly related to shorter telomeres but i pulled apart we had a few days of how much physical activity they self-reported at the end of a day saying how much physical activity did you do so i pulled it apart and found the partitions who said none over those few days and those who said that they did and i teased it apart and fortunately it was none or people met the cdc recommendation so it was a good split to make and what we found was that the relationship in those who were not physically active at all the relationship between their psychological stress and their length of their telomeres was even stronger than for the whole sample and for the ones who exercised they may have been stressed but it had no impact or there was no relationship with their telomere length but this is cross-sectional and there are always problems with cross-sectional studies so we then create designed a study where we wanted to look at the determinants of telomere lengthening or shortening over a one-year period only and we asked individuals to report at the end of that year that we had blood from two different time points we asked them to fill out a questionnaire on how many types of stressors may have happened to that year in that year did they become family caregivers did they lose a home did they divorce did they are they having financial difficulties and what we found was that for every extra event that occurred over that one year period and some women actually reported six events over that one year period this was a study in post-menopausal women only what we found was that for each one additional event there was an extra increased loss of 33 base pairs fortunately we also repeatedly assess their exercise levels their diet levels and their sleep quality and we calculated it over that one year period we summed it up we made a score out of it and we are we called it a healthy behavioral lifestyle so even if they're stressed out or not they might have engaged in high levels of physical activity they may have engaged in low levels of physical activity we summed it all up we created this healthy behaviorist score and what we found was for the woman who engage who were stressed out or sorry for the woman who engaged in poor levels of health behavior so they didn't they weren't physically active they didn't eat very well and their sleep quality wasn't that great that the loss in base pairs per event was 55 not the average for the sample of 33 but it was 55 for those who engaged in the moderate it was similar to the average for the whole sample and for those who engaged in a high physical high levels of physical activity those who uh ate well and those who reported good sleep quality their um the amount of events the number of events that occurred over that one year period had no relationship with their the amount that their telomere length shortened over that one year period we similarly looked at cross-sectionally in a sample of depressed participants and what we found was that in depressed participants that there's there was no real effect of our resiliency scores on uh the length of their telomere length but when you looked at their resiliency and i'm going to describe this in a moment but since the figure's up i'll walk you through this for those who are depressed if they were highly resilient they had likelihood of having longer telomeres compared to those who were lowly resilient and they had the shortest of all the telomeres those who were low resilient and had depression so what was resilience in the resiliency in this uh study resiliency in this study uh was a mixture of and all sometimes based on the sample that is collected and this was secondary analyses in a sample that was already collected they had scores of physical activity level and they had sleep quality they had uh how good of an emotion regulator you are were you someone who avoided difficult uh emotions um and uh we also had social connections so this is a combination of what that bubble was i showed you this idea that you have these multiple areas that you can pull forth from for resiliency some of it being physical activity and other health behaviors some of it beings connections between one another and also being a good emotion regulator so what's this take home message well stress accumulates and reduces telomere length but that exercise and other health behaviors and social connections and emotion being a good motion regulator also matter for telomere length and health which brings me to my exciting findings i'm going to spend some time to kind of walk everyone through so this was the fast study that we got i got funding for from the nih to complete one of the biggest problems with all the previous studies is that who are the kind of people who when they have five stressors over a one year period eat well diet sleep well stay strong socially connected regulate their emotions with every single hit it's really hard so the biggest criticism and i'm not saying criticism as in other than an academic criticism of this is what happens if you take someone who is physically inactive and provide them the opportunity to become physically active and that's what the fast study was which is the fit this aging and stress study and it was meant to improve the fitness levels in family caregivers so i'll walk you through the design of the study it was a pretty intense study so they filled out a whole bunch of questionnaires so ignore all this they did a stretching trial so we wanted to make sure that they wanted to participate they had the motivation to participate in the study so we asked them to watch a video for 10 minutes every day that was just stretching we created this video for them and every day they said yeah i did it or no i didn't do it and if they did three times that week we're like you know what you're ready for an exercise intervention they came in and we drew their blood we then and we did cardiorespiratory fitness the vo2 max test the stress test some of you might know about that test on the treadmill with the mast and you're pushed to your maximal capacity when they look at oxygen consumption then they look at how well your heart functions during this test we then randomize these uh 68 women and men into either an aerobic exercise intervention arm or a wait list control group where they just waited for six months and we asked them to maintain their low levels of physical activity which some people were actually very happy to do we had a few participants were like oh god i'm so happy i didn't get randomized to that exercise so um we then had them fill out a whole bunch of questionnaires and i'll talk about this ecological week after and then we had them come in and repeat all these measures how did we get them to exercise for six months so uh this is with permission of our participant this was our uh our volunteer um who is our fitness instructor or fitness coach uh and this is one of our participants he gave us permission to use this photo in slides we met them we gave them a six month free gym membership to any ymca that was convenient to them paid for by us half and the other half was by the ymca it was a donation we met them at the gym we walked through this is what the next six months is going to be like for you we provided them with the next solar accelerometer to track their movement we also gave them a heart rate monitor because we gave them based on their their vo2 their stress tests we gave them their range of what moderate activity means for their heart and their heart rate so it's called heart rate reserve and we use the data from our lab from our test to tell them what their individualized heart rate goals should be in the first week you'll see we said you know what let's start off with three sessions of 20 minutes let's get you at the low level of your heart rate reserve which is this is your target and this is someone else's some other participants data so we asked them to do 60 minutes of brisk walking by week 9 we had them up to 150 minutes and we had their goal at the 59 sorry the 59 percent of their moderate zone so we wanted them to stay at their moderate zone keep them healthy get them physically active for six months on a weekly basis as i said they wore an accelerometer they strapped they plugged in their accelerometer to computer we gave them at their house they uploaded their accelerometry data we downloaded it from the cloud on our end and we turned it into a pretty report saying look how much light activity you did this week look how many steps you did look at how much figures that moderate activity you did and look how much vigorous activity and we counted how many minutes and then we would send them an email and then we tabulated it and we showed them week by week progression and we sent them an email with this report saying congratulations you did 199 minutes this week great job keep it up if you have any questions please let us know for those who didn't maintain or attain the 150 minutes of our goal we said congratulations you did 20 minutes it must have been a tough week for you but you still did 20 minutes let's talk to talk about facilitators and barriers to get you going for another week five times a week we sent them text messages different types of one one of our participants said i don't think you can write five times uh 24 so what's that 120 brand new text messages through six months and we said you'll see and we said we sent 120 unique text messages five times a week for 24 weeks to these participants today is a great day for a walk meet a friend for a brisk walk instead of coffee if they didn't reach their goals we also scheduled a phone call and we use motivational interviewing best practices this idea that i can have a conversation with someone or at least i trained my coaches how to do this have a conversation around what are your goals do we need to adjust your goals what are the what helped you get out for those 20 minutes this week and what made it difficult for you to not reach your goal this week and we then strategized with them on methods to overcome those barriers and how to use that information that they said made it easier for them to come overcome their barriers it was an intense study and it paid off what did we attain we attained approximately 73 percent of participants reached our 150 minute goals per week it's pretty good for an intervention study in high stress caregivers who at this point had been doing nothing i was told by someone you're likely to get five people in the study but we got 68 and we got 73 of them to reach their goal if i looked at 120 minutes so reduce the bar a little but this is most most interventions go for the 120 minute gold what we found was that 81 of participants reached that their weekly goals at 120 minutes that's pretty good we improved their cardiovascular fitness so their vo2 peak which is their ability to use oxygen and how much oxygen is being consumed we improved their vo to peak in the exercisers and not surprisingly um they the in the control group it didn't change over a six month period went down a little but not significantly what about their telomere length this is in the control group there was a slight decrease that was not significant and in the exercise group their telomeres lengthened by about 60 base pairs and this effect so when you do a trial you first have to look to see whether the effect between the groups is different and the effect is significant what happened in the exercise group was significantly different from what happened in the waitlist control group fortunately the exercise the weightless control group also received the gym membership and some support at the end of the study we also changed their perceived stress levels so stress plays out caregiving plays out on a daily basis in these individuals lives so we use this technique called ecological momentary assessments to assess how they're feeling and what they're thinking during the day ecological momentary assessments people wake up they go to sleep and we kind of chunk up their day into six intervals and during that day we'll ping them in the morning and say hey how are you feeling right now how much uh how much control do you feel over your life how much ruminating are you doing about stressors we do it six times at random times during the day and we do it for a whole week and you'll see it's just randomly split our days are chunked up equally but it's randomly sent as pings to these participants i'll present some data on what happens at each ping so at each ping we assess how much control they feel over their lives we assessed how much ruminating they're doing about stressful situations so have you been unable to stop thinking about stressful situations and that was asked at every single time point and we asked about their negative affects so looking at their anger their anxiety whether they're feeling embarrassed some fatigue frustration some loneliness what did we find we decreased rumination in the exercisers they went down a significant amount in how much they ruminated whereas the control group stayed the same in how much they were ruminating on a daily basis we shifted their controllability they felt more control over their lives on a daily basis throughout the whole day in the exercises compared to where they were six months earlier before they started the intervention whereas there were no changes in the control group and we reduced their negative affect and in fact the exercises went down in their negative affect and how negative their mood was on a daily basis whereas the control group went up so what the take home is exercise improves traditional and novel markers of health and improves how we experience our days and it gives us an understanding into how our motivation our the barriers and the facilitators that we experience how they affect our health behavior change and it's important it's essential that when we think about our own changing of our own behaviors it's essential for us to really sit back and think am i able to do this am i motivated to do this what are the barriers it's so cognitive but it's and boring sometimes to go through this but it actually works what are the barriers that i'm facing that are stopping me from exercising tomorrow or eating well tomorrow and what will help me to get through it and this is a constant re-evaluation another really boring thing that people have to do in order to become physically active or eat well is scheduling all of us are really stressed out we thrive on telling each other i'm really stressed today and we think that all of a sudden at new year's or all of a sudden at our birthday that we're gonna change everything within the context of feeling stressed out all the time and part of it is we don't take to take care of ourselves when we're stressed out but we also don't make the time to take care of ourselves and it's quite essential when you're building a new practice to look at one's calendar and think where am i going to fit this in and how does this become as much of a task as washing dishes as taking getting groceries how do i make this a task in my calendar which sounds so boring but it's essential to build a new behavior how do you make that a task so that you can start following through with it another important thing that scientists have learned about what keeps people exercising is how good you feel during the exercise and after the exercise people who push themselves in that first week of not having worked out for six years and they're like i'm working out and i'm gonna go to the gym and i'm gonna spend three hours there and i'm gonna take the aerobic class then i'm going to take the step class and i'm going to do the weights and then the next day they're in pain and they're not they didn't enjoy those two hours and their body is aching and they did not enjoy the experience because they also pushed themselves they took crossfit all of a sudden they decided that crossfit it was the thing that they're going to do but they their body wasn't ready for it but psychologically their mind wasn't ready for it for it either there's actually research showing that once you pass the level of how much oxygen can be consumed compared to carbon dioxide pushed out at that level and that's in the high intensity zone at that level you start go you move from exercises feeling good to exercises feeling bad and it's at that point what is called the ventilatory threshold when you surpass or pass that ventilatory threshold you now are not feeling good and that has been shown that when you pass that and you're reporting after that i'm not feeling good or it wasn't that great that that amount that feel good feeling is predicting future engagement and behaviors so if anyone here is planning on changing a behavior don't push yourself too hard in the beginning and then if you need to and you start enjoying it your ventilatory threshold changes as you get more fit just keep pushing yourself a little bit more so what are the next steps well there's from a biological perspective there all these telomeres are protected or elongated by the telomerase enzyme and protected by all these different proteins that make up this sheltering complex we know from rodent literature and from just one acute bout of exercise in the lab that all these protein transcriptions so these the amount of protein in the cell of these proteins or the amount of protein of these in the cell we know that this goes up to even one acute bout of exercise so in the future what we're hoping to do is look to see if someone exercises for six months are we changing the basal levels of these proteins over a six-month period or is it just in response to stress we're also taking people and we're putting them on the in a treadmill test in the lab and we are putting them at different levels of physical activity so some are at high intense levels some are at moderate intensity levels and some are at low levels and some are sitting and then we're stressing them out in the lab and we're with this with this stress test which is kind of like this where someone's giving a speech but none of you are laughing and none of you are enjoying this talk and all of you are staring at me blankly so this is a task that is done in the lab and what we are hoping to look is what is the effect of different levels of intensity on how we feel after the task and all the hormones that flood us like stress hormones the cortisol or our heart rate going up does exercise kind of mitigate some of that stress response immediately after you work out and we're also going to play around with how much time is happening between the exercise bow and stress does exercise only have an effect 30 minutes later on the stress response or does it last three four hours later too and we're also taking all this work into children um this is a recent movement in canada this 24 hour movement guidelines so instead of just looking at exercise levels in children or adults our day is actually made up of 24 hours so you increase exercise or you decrease exercise you're increasing sedentary time or you're decreasing sedentary time and you're changing sleep too so our day is actually made up and a children's day a child's day is made up of sweating and stepping and sleeping and sitting and there's recommendations for 60 minutes per day per child of sweating doing some moderate to vigorous activity stepping for 60 minutes per day or several hours actually how much sleep is required nine to 11 hours of sleep of uninterrupted sleep in five to 13 year olds and eight to 10 hours and 14 to 17 year olds and to reduce sitting in children to less than two hours per day which is almost an impossible task with sitting at school but that is means when they come home from school reduce the amount of sitting when they come home from school so that's my conclusion of this talk start moving uh and i want to thank all the funders the nih and the alzheimer's association for sen funding my projects uh cihr in canada and uh innovation which fund funds my lab up in canada all the infrastructure and all of my amazing collaborators at ucsf and ubc thank you [Music] you

Channel: University of California Television (UCTV)

Views: 167,758

Keywords: exercise, stress, lifespan, healthspan, telemorepue, aging

Id: an6LKlx3JH8

Length: 55min 37sec (3337 seconds)

Published: Thu Apr 12 2018