The guest speaker for today is Dr. James Hicks, and he's the current chair. He's the chair of Ecology and Evolutionary Biology at UCI. He's also the director of Exercise Medicine and Sports Sciences. It's a very exciting new center at UCI, and if you don't know anything about the center, I highly recommend you go on the website and see all the exciting activities and programs that the center is offering. I can probably spend an hour just summarizing the CV of Dr. Hicks, but I'm going to just end his introduction by saying that he was the main Senior Advisor on the movie WALL-E. How many of you have seen that? Now you're going to really pay attention to Dr. Hicks. Well, thank you Mahtab, for inviting me to come here and give a talk today. As Dr. Jafari said, I'm the chair of Ecology and Evolutionary Biology and the director of Exercise Medicine and Sport Science Center. What is that exercise medicines Sport Science Center at UCI? It is an interdisciplinary center dedicated to the study of role of physical activity in health. Understanding both basic mechanisms on how regular physical activity can actually alter disease trajectories, improve quality of life, and prevent diseases. At the same time also we are engaged in education. At UCI, we introduced a new major called the Exercise Science Major, which is focused on preparing students who want to go either to graduate school or into the health sciences with a deep understanding of the role of physical activity. What I'm going to try to convince you today is that regular physical activity is not only important in improving your overall health and preventing disease but actually is a medicine, it actually alters disease trajectories improves outcomes both for mental health as well as for a variety of chronic illnesses such as cancer. With that, I usually have a slide projector advancer, I don't, I'm going to run back and forth. I tend to walk around a lot when I talk but the first thing is is that if you watch TV or even if you don't watch TV, if you cruise the internet, if you look at social media, we are constantly bombarded with a variety of ads that are giving us a variety of information about how to improve our life, how to reduce or delay the aging process, how to improve cognition and get smarter, some supplement that will do that. Supplements that can help prevent cancer. We are inundated all the time with how to stay younger, increase our functional brain capacity, and how to resist a variety of chronic illnesses. But what if I was to tell you that some of those may work, but there's one activity, there's one thing that we can do in life that has been shown over and over and over again to work, and it's not a new idea. That thing is physical activity, regular aerobic physical activity. This has been known for a very long period of time. We can go all the way back to Hippocrates, maybe in the 400 BC, where he wrote, "Walking is man's best medicine". I guess in our culture it would be, walking is a person's best medicine, but walking is man's best medicine. This has, as I said, been known for a very long period of time and in the 1700s in North America, this particular person Shadrach Ricketson, who was a theologian and naturalist, wrote in his book called Means of Preserving Health and Preventing Diseases, founded principally on attention to air and climate, drink, food, sleep, exercise, clothing, passions of the mind and retentions and excretions. This is the 1700s. People knew that regular physical activity was important for health. In fact, he wrote, "whose inclination, situation, or employment does not admit, does not allow you to be involved in regular exercise, soon become pale, feeble and disordered". In the 1700s, the term disordered meant disorder in terms of the mind. Somehow the mind was not maintained in a healthy state if you're not physically active. We know the physical activity, as I said, this is not new. It's been known empirically for a very long period of time. The 20th century was the age of discovery of the response of the human body and also other animals to exercise, the physical activity, and I call this the age of "blood and guts" physiology. How the heart works, how the lungs work, how the skeletal muscle works in response to increased demand by the muscles when we become active. For much of the 20th century, most of the physiology that was being done was just trying to understand mechanistically what our hollow bodies were responding to physical movement. There was the period, the great explosion across the country and across the world of departments of physical education, exercise physiology, kinesiology, exercise science, sport sciences. Every major university had one or more of these kinds of departments, and people doing research basically understanding the underlying physiological response and applying it primarily to human performance, because there was a big emphasis in the 20th century on human performance and how to maximize it in response to exercise. But at the same time in public health, there were a variety of studies that were starting to correlate the role of being active with actual prevention of disease. A very famous study that took place in the 1950s, was this study here called Relationship of Reported Coronary Heart Disease Mortality to Physical Activity of Work. What did they do? They studied the mail system in the US. They looked at those individuals that work in the offices compared to the mail carriers. Back in the '30s and '40s, and '50s, mail carriers weren't driving around in trucks and jumping out, putting the mail in the mailbox, they were walking a bit. They were walking around neighborhoods carrying a bag of mail and delivering it house to house, business to business. Public health officials studied this relationship, and what they found was that mail carriers had a lower incidence rate of coronary heart disease compared to the office workers; correcting for diet, whether they smoked or not, how much they drink or not. Somehow activity was preventing or lowering incidence of cardiovascular disease. Shortly after that, there was a major study right up here in Long Beach, studying longshoreman in Long Beach, and they found the exact same response. Those individuals working on the docks doing physical work on a daily basis were less likely to have coronary artery disease, than those who were working in the offices not being active throughout the day. While there's a simultaneous research going on at universities about how the human body responds to exercise, public health officials were also gathering evidence that there was this connection to the prevention of disease. We fast forward all the way now to the present 21st century, and there is a mountain of evidence that shows the overlying power of regular physical activity on both prevention of disease as well as now altering various disease trajectories. Here's one such study that shows us a result. This data that's just shown here, just solid lines. I'm not showing all the variants, of course. But this is a review of data from over a million people. What this shows is that the greater level of cardiorespiratory fitness that you have, the higher your aerobic fitness, the lower your incident or mortality risk is for all-cause mortality. The more fit you are, essentially, the longer you live, both for men in blue and women in red. Again, this is data in over a million people. It's been shown over and over by other studies as well. Your greater your cardiorespiratory fitness, the longer you live. You don't need an anti-aging supplement to make you live longer, you just need to be regularly physically active. Now, what changed in exercise physiology in the 21st century? Because as I said, exercise science was really focused on understanding the overall mechanisms of how the heart, and the lungs, and the skeletal muscle were all coordinated and interacting to support physical activity. I just want to mention these two individuals; Bente Klarlund and Bengt Saltin, both Danish physiologists, about 15 years ago discovered something that has radically changed exercise science and exercise physiology. It has moved exercise science away from just sports and just human performance to really thinking of exercise as medicine. What was that discovery? What they found is when you are physically active, the skeletal muscles actually are not only involved in the engines of locomotion, but they're actually becoming an endocrine organ. They're releasing molecules that can have downstream effects on various organ systems. Here's a paper by Bente Pedersen, who and some of the other people in that group who showed that they proposed that one particular factor was called IL-6. You don't have to really know exactly what this is, interleukin 6, but then it was that molecule plus other cytokines that are released by the skeletal muscle exerts their effects in other organs of the body. They call these compounds myokines. The skeletal muscle was not just the organ or engine of locomotion, it became an endocrine organ when it became active. That's a major finding. I think they'll get the Nobel Prize someday for this. Because what that does is that these myokines have downstream effects on other organ systems, all of them positive. This is just this complex slide summary of everything that they do, but in the middle is your skeletal muscle. See if I have a point over here, skeletal muscle here, and it shows then that these compounds in a whole variety, all sorts of names; irisin, IL-6, IL-15, myostatin, IL-7, IL-4, there's a whole FGF, all sorts of acronyms, but all of these are being released with activity. The reason I put this diagram in there is that these myokines are having effects on your immune system, on your renal system, on the liver, on blood vessels, on your pancreas, on the GI tract, on bones, on adipose tissue, on the way adipose tissue is distributed, and ultimately on your brain. This change, this was a game changer. This has been a game changer. Well, there's a meeting that goes on every year. It's called the American College of Sports Medicine. Twenty five, 35 years ago, you go to American College of Sports Medicine meetings and it was just dominated by talks and posters about how the heart works, and how the lungs work, and what happens during exercise, how to improve human sports performance and the like, that was just it. The whole meeting was like that. I just went to the American College of Sports Medicine meeting last year in San Diego. Every paper, every talk was on how regular physical activity is a medicine, how it acts like a therapeutic agent. The reason I emphasize this is this is going to change the way medicine is practiced. A lot of students have asked me and other people in the public have asked me, when is that going to happen? Because they go to a doctor and they'll say, well, just try to exercise more. We're going to get beyond that. That's where most physicians are now, just exercise more. But in the future, physicians are going to prescribe exercise. They're going to tell you exactly what kind of exercise to do for the kinds of disease, or illnesses that you might be dealing with, from metabolic disease, to mental health, to cancer. These diseases are going to be not only addressed by standard medical care, we're not saying that exercise is going to eliminate medicine, but that exercise is going to be a very powerful adjuvant, something that enhances standard medical practice. I'm very convinced with that and very passionate about that. I think it's true,. Therefore the term Exercise is Medicine is now a trademark saying, but it's used now by the American College of Sports Medicine and used by a variety of other medical practices emphasizing that you have to treat exercise as if you would treat any medicine that you were taking.
