Involuntary or passive smoking is associated with premature disease and death. Estimates indicate that 38,000 to 43,000 nonsmokers who are regularly exposed to environmental smoke die annually from smoking related causes. 16 The majority of these (35,000 to 40,000) die from heart disease, and 3000 die from lung cancer. There is a dose response effect. The more the nonsmoker is exposed to environmental smoke, the greater the risk for premature morbidity (illness) and mortality (death).
Children of smoking parents are more likely to experience a higher incidence of influenza, colds, bronchitis, asthma, and pneumonia. The impact of passive smoking on them can last a lifetime and may range from delayed physical and intellectual development to the hazards associated with prolonged exposure to carcinogenic substances.
An alarming trend is the escalating sale of smoke less tobacco products. Chewing tobacco and dipping snuff have become popular among high school and college men. The world health organization (WHO) has described the growing use of smokeless tobacco as a new threat to society. Nicotine is an addictive drug regardless of the method of delivery, and its effects are similar whether it is inhaled, as in smoking, or absorbed through the tissues of the oral cavity, as in dipping and chewing. The incidence of oral cancer may be 50 times higher among long term users of smokeless tobacco products than among nonusers. Smokeless tobacco is addictive and deadly.
Physical inactivity is finally being officially recognized as a major risk factor for cardiovascular disease by the AHA. The upgrading of physical inactivity appeared in their latest position statement and reflects the importance of participating in physical activities regularly. The change occurred because the weight of the evidence that has been accumulating in the last 10 years shows that exercise produces many important health benefits. This is good news for those who have been physically active, and it may motivate some sedentary people to become active.
Physical inactivity (hypokinesis) is debilitating to the human body. A couple of weeks of bed rest or chair rest produces muscle atrophy, bone demineralization, and decreases in aerobic capacity and maximum ventilatory capacity. Your body was constructed for and thrives on physical exertion. The american college of sports medicine has established guidelines for the development and maintenance of physical fitness. The amount of physical activity needed to improve and maintain good health and to affect longevity is currently under investigation.
The evidence of investigators at the centers for disease control provided the statistical basis for the position change by the AHA. These researchers showed a relationship between physical inactivity and heart disease that was similar in magnitude to that of cigarette smoking, high serum cholesterol levels, and hypertension. approximately 26% of the population smokes cigarettes, 30% have blood pressures greater than 140/90, and 32% have cholesterol levels greater than 200 mg/dl.
Although these numbers are impressive and a significant change in any one would lower the incidence of heart disease, the researchers concluded that regular exercise was the one lifestyle change that could most affect the health of the nation. This is based on the fact that 78% of americans are sedentary or exercise too infrequently to enhance their health. Regular physical activity also has a modifying effect on many of the risks for cardiovascular disease.
Other major studies have supported the view that people who regularly engage in physical activities of moderate intensity have significantly less heart attacks and experience fewer deaths from all causes than people who exercise little or not at all. Moderate activity was the equivalent of walking 1 to 2 miles per day for a total of 5 to 10 miles per week. The greatest health benefits were gained by those who expended 1500 to 2000 calories per week (15 to 20 miles of walking) in physical activity.
A total of 17,000 men were followed for more than 30 years. Those who regularly walked, climbed stairs, or participated in sports activities decreased their risk from all causes of mortality. Those who expended a minimum of 500 calories per week (5 miles of walking or its equivalent) to a maximum of 3500 calories per week (35 miles of walking or its equivalent) experienced a progressive increase in longevity.
Investigators at the cooper institute for aerobics research 22 studied the relationship between physical fitness and mortality from all causes. The uniqueness of this study was twofold: first, the researchers measured the physical fitness level of all subjects by treadmill testing, and second, more than 3000 of the 13,344 subjects were women. Because of their lower risk for cardiovascular disease, women have essentially been neglected as subjects in heart disease studies.
The results of this study indicated that a low physical fitness level increased the risk of death from cardiovascular disease, cancer, and all other forms of disease. The difference in all cause mortality was greatest between those who were in the moderately fit category and those in the low fit category . The difference between the moderately fit and the highly fit was insignificant. For people who exercise regularly, the risk of dying from a heart attack compared with the risk for sedentary people is 35% to 55% less.
A study completed using only women as subjects investigated the physical fitness benefits versus the health benefits of three levels of walking intensity. One group walked at 5 mph, a second group walked at 4 mph, and a third group walked at 3 mph. The results showed that physical fitness improved on a predictable dose response basis. The fastest walkers improved the most and the slowest walkers improved the least, but the cardiovascular risk was reduced equally among the three groups. Low level exercise was as effective as the highest level in promoting cardiovascular health. Exercise for health does not have to be as strenuous as exercise for physical fitness.
A sedentary lifestyle imposes a financial burden on all people. Active people pay a price a lifetime subsidy of approximately $1900 to support the medical costs of sedentary people. The costs come from collectively financed programs, such as health insurance, sick leave coverage, disability insurance, and group life insurance. Because premiums and payroll taxes that finance these programs are equal for both sedentary and active people, the programs subsidize unhealthy behaviors. If sedentary people became more active, they would live longer and healthier, thus reducing the cost they impose on others.
The health and longevity returns from exercise and a physically active lifestyle are significant. Estimates indicate that longevity is increased by 1 minute for every minute spent walking and by 2 minutes for every minute spent jogging. The potential for improving the health status of Americans through appropriate lifestyle behaviors is evident from estimates indicating that 60% of all deaths are premature and approximately 50% to 60% of all illness and disabilities are preventable.
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