Uusinta tietoa liikunnan ja terveyden välisestä yhteydestä

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1 Uusinta tietoa liikunnan ja terveyden välisestä yhteydestä Urho Kujala Liikuntalääketieteen professori Terveystieteiden laitos Jyväskylän yliopisto

2 Health and motor skills/functioning in children Motor impairments in many diseases/syndromes, in particular in neuro-muscular diseases and cerepral palsy Clinically relevant motor impairments are seen in autism, dyslexia and other learning disabilities, attention deficit hyperactivity disorder (ADHD), anxiety disorders, post-enchephalitis Mild impairments in motor abilities may contribute to or be associated with: Poor fitness, physical inactivity, obesity and cardiometabolic disease risk Academic, social and emotional functioning Early childhood is a window of opportunity for neurodevelopment

3 Brain development and motor skills Traditional knowledge The largest increases in brain weight occur during first 3 years of life Resting brain glucose metabolism is at its highest in early childhood (almost twice that of adult levels) Sensory and motor areas are typically the first to mature But However, prefrontal and lateral temporal cortices (important in integration of sensory-motor processes and higher congnitive functions) mature later Further development and maintaining the complexicity is important Training and maintaining motor skills contributes to health at all ages

4 Neuroradiological (MRI) studies on motor recovery Functional MR imaging (FMRI) of chronic stroke patients before and after 2 wk (6 h per day) hand exercise therapy. The activation patterns for paretic hand task before in red and after in green in sagittal and in horizontal views. Therapy-induced increase in activation in blue, motor area on lesioned hemisphere is circled. Diffusion tensor imaging (DTI) of stroke recovery 74-y-old female stroke patient, thalamic haemorrhage, DTI at start and at 6 months. White matter corticospinal tracts show good recovery after intensive gait training Peurala et al. Cerebrovasc Dis 2008;26: Könönen et al. Eur J Neurol 2012;19:

5 Physical activity and waist circumference Among 42 consistently physical activity discordant twin pairs (for 30 years) active co-twins had 8.4 cm (p<0.001) smaller waist than inactive co-twins (Waller et al. Int J Obesity 2008:32; )

6 Inactive co-twin Active co-twin Leskinen et al. Int J Obes 2009;33:

7 Liikunnan lopettaminen on voimakas riskitekijä metabolian häiriintymiselle!

8 Kaplan-Meier survival curves for type 2 diabetes incidence for inactive members (black) compared with active members (gray) among the MZ twin pairs Waller K et all. Leisure-time physical activity and type 2 diabetes during a 28 year follow-up in twins. Diabetologia 2010;53:

9 Physical activity Myös rasvakudoksen toiminnassa voi olla eroja! TRP met Support energy metabolism VLI deg CAA deg F-M met BUT met Urea cycle PRO met Muscle Main pathways of energy metabolism Glycolysis CoQ FA metab OXPHOS VLI deg PUFA syn Fat IL2RB PGA syn RECK T Cytotox Physical fitness Other cardio-metabolic risk factors Leskinen et al. PLoS ONE 2010;5(9):e12609.

10 Long-Term Leisure-Time Physical Activity and Serum Metabolome Kujala et al. Circulation 2013;127:

11 Long-Term Leisure-Time Physical Activity and Serum Metabolome Kujala et al. Circulation 2013;127:

12 Liikunta Fyysinen kunto (Kestävyyskunto, lihasvoima) Positiiviset muutokset lihaksen, luun ja rasvan rakenteessa ja metaboliassa Kehon rasva Ektooppinen rasva Sydämen rakenne ja toiminta Parasympaattinen tonus Perifeerinen resistanssi Inflammaatio Insuliiniherkkyys Sydämen sähköinen toiminta Verenpaine Glykeeminen kontrolli insuliiniresistenssissä Kaatumisriski, osteoporoosi, murtumariski Henkeä uhkaavien rytmihäiriöiden riski Neurotrooppiset vaikutukset HDL 2 kolesteroli Aivohalvauksen riski Dementiariski Verihiutaleiden aggregaatio Tyyppi 2 diabeteksen riski Ateroskleroosi Sydäninfarktiriski Riski toiminnanvajavuuksiin Modified from Kujala UM Br J Sports Med 2009; 43: Kuolemanriski

13 Lipid accumulation in atherosclerosis Libby P Nature 2002

14 Heritability of physical activity Australia Netherlands GB Sweden Finland Denmark 0 Heritability % by country (Stubbe et al. Plos One 2006

15 Increase in physical activity and cardio-metabolic risk profile change during lifestyle intervention in primary healthcare: one-year follow-up study among individuals at high risk for type 2 diabetes (FIN-D2D) P<0.001 P<0.001 P<0.001 The results persisted afted the adjustment for dietary change Kujala UM et al. BMJ Open 2011;1:e000292

16 Increase in physical activity and cardiometabolic risk profile change during lifestyle intervention in primary healthcare: 1-year follow-up study among individuals at high risk for T2D The results persisted after the adjustment for dietary change Kujala UM et al. BMJ Open 2011;1:e000292

17 Differences in sub-dimensions of motivation measure among longitudinally active and inactive men and women. (Aaltonen S et al. Scand J Med Sci Sports, in press.) Both men and women Sub-dimension Active Mean ± SD Inactive Mean ± SD Mean difference (95% CI) p-value Effect size Cohen s d Mastery 4.30 ± ± (-1.30 to -0.91) < Physical fitness 4.82 ± ± (-0.63 to -0.37) < Affiliation 3.68 ± ± (-1.14 to -0.71) < Psychological state 4.79 ± ± (-0.72 to -0.44) < Appearance 3.57 ± ± (-0.55 to -0.13) Others expectations 1.61 ± ± (0.08 to 0.45) Enjoyment 4.80 ± ± (-1.51 to- 1.20) < Competition/ego 3.44 ± ± (-0.61 to -0.15) Men Mastery 4.36 ± ± (-1.31 to -0.81) < Physical fitness 4.76 ± ± (-0.76 to -0.33) < Affiliation 3.87 ± ± (-1.33 to -0.76) < Psychological state 4.70 ± ± (-0.92 to -0.46) < Appearance 3.22 ± ± (-0.65 to -0.03) Others expectations 1.68 ± ± (-0.03 to 0.50) Enjoyment 4.81 ± ± (-1.71 to -1.27) < Competition/ego 3.39 ± ± (-0.80 to -0.15) Women Mastery 4.22 ± ± (-1.41 to -0.83) < Physical fitness 4.90 ± ± (-0.62 to -0.34) < Affiliation 3.43 ± ± (-1.09 to -0.41) < Psychological state 4.90 ± ± (-0.64 to -0.38) < Appearance 4.00 ± ± (-0.70 to -0.18) < Others expectations 1.52 ± ± (0.05 to 0.56) Enjoyment 4.79 ± ± (-1.44 to -1.02) < Competition/ego 3.49 ± ± (-0.63 to -0.02)