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The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology James A. Stone BPHE, BA, MSc, MD, PhD, FRCPC, FAACVPR, FACC Clinical Professor of Medicine, University of Calgary Senior Medical Director,


  1. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology James A. Stone BPHE, BA, MSc, MD, PhD, FRCPC, FAACVPR, FACC Clinical Professor of Medicine, University of Calgary Senior Medical Director, Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services

  2. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology Acknowledgements • Rob and Jacques • Evidence-Based Marketing • National CPG Committee Memberships: 1. Canadian Cardiac Rehabilitation Cardiac Rehabilitation (Founding Chair and Chair 1999, 2004, 2009) 2. C-CHANGE (Canadian Cardiovascular HArmonization of National Guidelines Endeavour) (Co-Chair) 2011, 2014 3. Canadian Diabetes Association 2013, 2018 4. CCS Dyslipidemia Working Group 2009, 2012, 2015 5. CCS Committee on Chronic Stable Angina 2012 6. CCS Committee on Refractory Angina 2012 7. CCS Smoking Cessation 2011 8. Canadian Hypertension Education Program (2000 to 2015) 9. CSEP Physical Activity for Adults 2011 10. CESP Sedentary Behaviour 2015 11. Physical Activity for Persons with Spinal Cord Dysfunction (Chair) 2011 • All of You! Disclosures • Honoraria: Amgen • Consultant/Advisory Board: Amgen, Sanofi • Research Support: Sanofi

  3. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology Learning Objectives 1. Apply Current Knowledge in Sedentary Behaviour 2. Assess Sedentary Behaviour in Patients 3. Advise Patients about Sedentary Behaviour

  4. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity, Exercise, and Fitness • What Is Sedentary Behaviour? • What is the Biology of SedBeh? • What Are the CVD Effects of SedBeh? • How Do We Reduce SedBeh? • Summary

  5. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology Med Sci Sports Exerc 2009; 41: 998-1005

  6. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity, Exercise, and Fitness • What Is Sedentary Behaviour? • What is the Biology of SedBeh? • What Are the CVD Effects of SedBeh? • How Do We Reduce SedBeh? • Summary

  7. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity Any bodily movement produced by skeletal muscles that results in energy expenditure.

  8. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Exercise … a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness.

  9. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Fitness A set of attributes that are either health- or skill-related .

  10. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology Is Physical Fitness Important? n = 5,641

  11. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity and Exercise • What Is Sedentary Behaviour? • What Are the Effects of SedBeh? • How Do We Reduce SedBeh? • Summary

  12. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Sedentary Behaviour • < 1.5 METs • What is a MET? • M etabolic E quivalent of T ask • 3.5/ml/kg/min O2 Utilization

  13. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  14. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • How Much Time in SedBeh? • North America • NHANES III > 8 hours per day

  15. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  16. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology 71% Sedentary

  17. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Sedentary Society - ARIC Study  1/1000 all ideal HF Ideal Health Behaviours CVD Risk Factors  Diet  4-5 veggies daily  BP < 120/80  Physical Activity/week  TC < 5.2  ≥ 150 min of moderate to vigorous  FBS < 5.5  Non-smoking  BMI < 25s

  18. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • How Do We Measure SedBeh? • Self-Reported • People Lie 97% of The Time • PASE • Physical Activity Scale for the Elderly • Screen Time

  19. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • How Do We Measure SedBeh? • Motion Sensors ~20%  Energy • Accelerometers • Devices

  20. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity, Exercise, and Fitness • What Is Sedentary Behaviour? • What is the Biology of SedBeh? • What Are the CVD Effects of SedBeh? • How Do We Reduce SedBeh? • Summary

  21. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Caloric Imbalance • Oxidative Stress • More Deaths from Overabundance

  22. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  23. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  24. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  25. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  26. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity and Exercise • What Is Sedentary Behaviour? • What Are the CAD/CVD Effects of SedBeh? • How Do We Reduce SedBeh? • Summary

  27. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • “Whatever age does, exercise does the opposite.”

  28. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  29. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  30. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  31. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  32. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  33. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Physical Activity and Exercise • What Is Sedentary Behaviour? • What Are the Effects of SedBeh? • How Do We Reduce SedBeh? • Reduce Screen Time • Standing Desks • PA Breaks • Walk and talk • 10,000 + Steps • GET THE MESSAGE OUT!!! • Summary

  34. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  35. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  36. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  37. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  38. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology SUMMARY • Physical Activity, Exercise, and Fitness • What Is Sedentary Behaviour? • What is the Biology of SedBeh? • What Are the CVD Effects of SedBeh? • How Do We Reduce SedBeh?

  39. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology

  40. The CAD/CVD Risk of Sedentary Behaviour and Potential Implications of Sedentary Physiology • Canadian 24 Hour Movement Guidelines

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