Transcript Soap Box 20/09/06

Soap Box
20/09/06
Physical Activity
Benefits and Hazards
Joanna Swallow
Swindon/Bath GP Registrar Day Release Course
Sport and Exercise Medicine
• Personal interest
• Elective/providing medical cover
• Uncertain training programme, (4 year post grad course.)
• Sports and Exercise doctors 02/06
• BASEM
• 2 Main Aims
• To promote good health through physical activity
• To provide sports medicine expertise to optimise athletic
performance at all levels
Preventative Role of Exercise
• A third of men and more than a quarter of
women will be obese by 2010, predicts the
"most accurate estimate so far" of the future
prevalence of obesity in England.
• More than 12 million adults and one million
children will be obese in England within four
years if nothing is done to reverse the trend.
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(2003-4 Health Survey for England published by the department of Health.)
The Problem
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Reduced Life Expectancy
Cost to the health service
Heart disease
Stroke
Type 2 diabetes
Some cancers
• July 2004 – Obesity PSA target.
• To halt the year-on-year rise in obesity among children aged
under 11 by 2010 in the context of a broader strategy to tackle
obesity in the population as a whole.
• Obstacles must be removed to prevent obesity through
increased physical activity
The rational prescription
Ogilvie, D. et al. BMJ 2005;331:1545-1548
Copyright ©2005 BMJ Publishing Group Ltd.
Olympic Incentive
Drug Issues in Sport
• Prescribing for athletes: BNF, www.wadaama.org
• Anabolic steroids
• Human Growth Hormone
• Erythropoietin
• Creatine Monohydrate
• Gene Therapy (synthetic genes
expressing IGF1 at high levels)
Anabolic Steroids
• Testosterone
• Anabolic Effects – increased
muscle size/strength,
decreased body fat and
recovery time from injury
• Androgenic Effects – increased
body hair, deepened voice
• Designer Steroids
Androstenedione, Nandrolone
Raised BP, Liver/Renal
Damage, Impotence,
Cardiovascular disease,
Aggression
Creatine Monohydrate
• Nutritional supplement not a drug
• Naturally present in muscle, brain and blood cells
• Increases energy content of muscle cells
• Recycles ADP to ATP and reduces lactic acidosis
• Daily req 2g, supplements 20g/day
• Largest selling sports supplement 200million dollars/year from sales
• No Evidence. 51 day study – GI upset and fluid retention
• Lancet paper 1998 – renal failure
• FDA recommends consulting a doctor prior to commencing.
EPO
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Peptide hormone
Naturally produced in kidneys
Stimulates RBCs and Hb
Increases oxygen carrying
capacity of blood (aerobic
capacity)
• MI, CVA, Clotting
Detection
Naturally occurring substances
Benchmark levels
‘Donations’ –
THG tetrahydrogestrione)
Mass Spectrometry
Testosterone/Epitestosterone
T/E ratio
EPO testing based on haematocrit
Triathlon
• 1500m Swim
• 40km Bike
• 10km Run
• Aquathlon
• 1km Swim
• 5km Run
Bike
2nd world aquathlon champs
Summary
Physical Activity is fundamental to the Health of the Nation and therefore to
general practice
We should encourage sport at all levels and support the consequences of
this.
References:
www.dh.gov.uk
www.wada-ama.org
www.bmjjournals.com
www.science.org.au
Any Questions?