Creating a Health & Wellness Evolution Well. Into the Future.

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The Cooper Institute®

LEGACY

THE PROMOTION OF LIFE-LONG HEALTH AND WELLNESS THROUGH RESEARCH AND EDUCATION.

THE ROAD MAP OF HEALTH AND WELLNESS Laura F. DeFina, MD, FACP

The Cooper Institute, President and Chief Executive Officer

In late 2016, a very exciting scientific statement was published entitled “Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign.” The Cooper Institute applauds the development of this statement. Here at Cooper, this is a way of life. We would like to recognize that William Haskell, PhD, Senior Scientist of The Cooper Institute, was a member of the research team. This statement is supported by the hard work done at The Cooper Institute over the past 46 years.

As noted in the statement, in 1989, a groundbreaking paper was published using data from the Cooper Center Longitudinal Study (CCLS) showing that those who are unfit have higher mortality. After that was proven, the world was never the same. Running became an activity for not just elite athletes and service members but an activity that all needed to do to remain healthy.

Since that time, research from The Institute has shown that being fit decreases the risk of heart attacks, strokes, diabetes, death from certain cancers, and kidney disease among many other things. In recent years, we have looked at the impact of mid-life fitness on later life health and found that being fit in mid-life results in lower numbers of chronic diseases in an individual, less Alzheimer’s disease and related disorders, and lower healthcare costs and utilization in later life.

As noted in the CDC’s Physical Activity Guidelines from 2008, the average adult should participate in at least 150 minutes of moderate to vigorous aerobic activity a week. While to the non-exerciser that might seem like a lot, the benefits of living an active life and remaining fit are undeniable.

At The Cooper Institute, we encourage you to keep moving and get fit!

ABOUT THE CCLS: Dr. Cooper recognized the need for irrefutable research on fitness and activity and had the foresight to develop a rich repository of health-related information. The data collection began with Dr. Cooper’s first patient in December 1970 with information meticulously recorded on index cards and stored in a shoe box.

Today, the CCLS is one of the most highly referenced databases in the world and has helped establish links between fitness and cardiovascular diseases, dementia, healthcare costs and more.

The Cooper Institute was founded in 1970

by Dr. Kenneth H. Cooper, the “Father of Aerobics” with a simple vision to prove that exercise is medicine. For more than 46 years, The Institute has not only established the benefit of regular physical activity but helped provide links between fitness and many chronic and potentially preventable illnesses.

In the four decades since The Institute’s inception, our focus has expanded to include youth fitness initiatives and public health policy, helping ensure all have the opportunity to live Well. Into the Future.

Aerobics is published The Cooper Institute is founded and the Cooper Center Longitudinal Study is established.

Journal of the American Medical Association – The Cooper Institute’s landmark study illustrates the relationship between fitness and all-cause mortality, proving that exercise is medicine.

Journal of the American Medical Association – Research utilizing the CCLS establishes that low fitness levels are a precursor for death. The same study illustrated the positive effect that moderate fitness levels have on other predictors of mortality such as high blood pressure and cholesterol. The study continued to strengthen the theory that exercise is medicine.

An Evolution: Exercise is Medicine.

The CCLS reaches a milestone of 100,000 patients, far surpassing the Framingham Heart Study, the Dallas Heart Study, and several other large, notable longitudinal, population-based research groups. The CCLS would go on to become the world’s largest and longest running observational study on measured fitness.

Annals of Internal Medicine – The Cooper Institute establishes that high-fit individuals in mid-life have a 36% reduced risk for dementia in later life, versus low-fit individuals.

American Journal of Preventive Medicine – The Cooper Institute leads the research team that establishes effectiveness of NFL PLAY 60 physical activity programming in improving health outcomes in children in the US.

The Cooper Institute®

RESEARCH

The Cooper Institute began with a simple vision to investigate and prove that health and fitness influence quality of life and longevity. Established in 1970 a s a non-profit research institute, Dr. Cooper laid down five key objectives.

KEY OBJECTIVES By means of sequential testing and the establishment of a data repository, conduct longitudinal research to determine objectively the role exercise plays in the preventive and rehabilitative aspect of heart, lung, and blood vessel diseases.

Study normal versus diseased patients, untrained versus highly trained athletes, regardless of age or sex, in an effort to more clearly determine the physiological effects of aerobic conditioning in health and disease.

Conduct in-house projects and support contractual research studies evaluating the immediate and the long term effects of various levels and types of exercise.

Extensively study the occasional undesirable or untoward effect of exercise, eg., jogging deaths, in an attempt to determine the cause and the prevention of such occurrences.

Initiate studies with various ages of school children in an effort to improve the effectiveness of physical education programs in an attempt to educate, motivate, and prepare school children for the inherent health problems of an affluent society.

The Cooper Institute® is grounded in research and internationally recognized for landmark findings in exercise physiology, 700+ Alzheimer’s disease and healthcare economics.

ASSOCIATION BETWEEN SITTING TIME AND OBESITY Published papers in research journals.

To date, The Cooper Institute has published over 700 scientific papers.

HIGHLIGHTS FROM 2016 INCLUDE: GROUNDBREAKING NFL PLAY 60 STUDY

Today, Americans are more sedentary than ever, spending hours a day sitting.

Researchers at The Cooper Institute, led by Dr. Carolyn E. Barlow, evaluated 6,331 patients and found that men who sat almost all of the time were more likely to be obese when compared to men who sat almost none of the time.

While this might seem like common sense, it is estimated that upwards of 70 percent of the American population is overweight or obese.

Based on this study, sitting less as a first step to reduce sedentary time could help combat obesity in men. The researchers did not find an association in women between sitting time and cardiometabolic risk factors, which suggests more research is needed in this area.

These findings were published in Preventing Chronic Disease.

Research conducted by The Cooper Institute through its NFL PLAY 60 FitnessGram® Project revealed annual improvements in aerobic capacity and body mass index for students participating in NFL PLAY 60 programming when compared to schools not utilizing NFL PLAY 60 programs.

Approximately 33 percent of US children (6-19 yrs) are overweight and obese, and it is estimated that 80 percent of adolescents do not achieve the recommended 60 minutes of daily physical activity.

These results suggest the utility of the NFL PLAY 60 physical activity programming as a potential viable intervention to help improve youth aerobic capacity. This study also highlights the potential of such comprehensive school-based programs to help improve BMI scores in children.

This study highlights a positive association of participatory system intervention programs adopted by schools in an effort to improve health in school-aged children.

Considering the high rate of obesity in America, coupled with the global cost Implementing evidence-based physical of physical inactivity, reversing these activity programming, combined with FitnessGram assessments, may help trends in youth is critical. improve overall childhood health.

The study was published in the American Journal of Preventive Medicine.

THE RELATIONSHIP BETWEEN MIDLIFE FITNESS AND LATER-LIFE CHRONIC KIDNEY DISEASE In the United States, chronic kidney disease (CKD) is on the rise and is estimated to affect more than 20 million individuals and costs billions to treat annually. Led by Dr. Laura DeFina, CEO of The Cooper Institute, researchers evaluated fitness levels and the incidence of CKD in 17,979 patients comprising 116,973 person-years of observation in the Cooper Center Longitudinal Study.

The authors concluded that higher fitness levels are associated with lower risk of CKD decades later even in diabetics, which constitute a highly at-risk population. CKD is a leading cause of death in the US and extremely costly to treat.

Improving fitness through regular physical activity may reduce risk.

The study was published in the American Journal of Preventive Medicine.

The Cooper Institute®

YOUTH INITIATIVES

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FITNESSGRAM® When The Cooper Institute was founded over 46 years ago, one of the five primary objectives included a focus on youth fitness and quality physical education. Today, children in the US are faced with many health problems inherent in an affluent society including obesity, inactivity, type-2 diabetes and more. The Institute is dedicated to helping reverse these trends and building a healthier generation.

In 1982, The Institute launched FitnessGram, which is a non-competitive health-related fitness assessment based on the scientificallyestablished Healthy Fitness Zone standards.

FitnessGram is the most widely used fitness assessment, education, and reporting tool in the world. In the US alone, FitnessGram is used annually in tens of thousands of schools, reaching over 10 million children.

FitnessGram, combined with a quality physical education program, has proven to be a highly effective strategy to improve student fitness levels including aerobic capacity and body composition. These positive improvements have also been shown to correlate with improvements in student math and reading scores, as well as attendance.

It is no secret that students need daily physical activity to support healthy growth and cognitive development.

It is vital that we continue to build an active school environment that supports daily physical activity, quality physical education, recess and sports participation.

FitnessGram has been helping schools for over 30 years evaluate and evolve their curriculum into an education experience that supports the whole child.

For more information on FitnessGram, visit CooperInstitute.org/FitnessGram.

THE FIFTH OBJECTIVE FOCUSED ON YOUTH Initiate studies with various ages of school children in an effort to improve the effectiveness of physical education programs in an attempt to educate, motivate, and prepare school children for the inherent health problems of an affluent society.

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THESE HEALTH PROBLEMS ARE MANIFESTING AT ALARMING RATES AND THREATENING AN ENTIRE GENERATION.

CURRENT PROBLEM 33% of children are overweight or obese 80% of adolescences do not achieve the daily physical activity guidelines for youth 70% of Americans aged 17-24 are ineligible to serve in the military $67.5 billion – the estimated global cost of physical inactivity $190 billion - the annual estimated cost of obesity in the US 438 million – the projected number of people with diabetes globally by 2030 1 in 3 – projected diabetes rates in the US by 2050

DATA

DRIVES

DECISIONS - Kenneth H. Cooper, MD, MPH

Sources: American Heart Association Mission Readiness Centers for Disease Control and Prevention The Lancet U.S. Department of Health and Human Services

NFL PLAY 60 FITNESSGRAM® PROJECT In 2009, The Cooper Institute teamed up with the National Football League to create the NFL Play 60 FitnessGram Project, which provides schools across the US with resources and tools to teach, promote, and assess health-related fitness and physical activity in youth. The project, which focuses on schools and programs in each of the 32 NFL markets, is the largest school-based research initiative to date with over 1,100 sites annually enrolled, reaching more than six million students.

Recent research (see page 5) highlighted the benefits of NFL Play 60 programs and the positive impact they have on student fitness levels. The graphs below illustrate the improvements observed in students’ aerobic capacity in schools that implemented programming versus schools that did not during the study period.

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HEALTHY ZONE SCHOOL RECOGNITION PROGRAM® In partnership with the United Way of Metropolitan Dallas, The Cooper Institute developed the Healthy Zone School Recognition Program in 2011, which uses evidence-based knowledge and best practices to assist schools in promoting healthy behaviors. This program honors schools for their healthy practices and assists schools in their efforts to provide healthier environments for students.

The Healthy Zone School Recognition Program brings together multiple facets of the community including teachers, staff, parents and students to work collaboratively to help students develop healthy habits that will last a lifetime. The program provides training, equipment, resources and guidance to participating schools.

Research from the program continues to show improvements in students’ aerobic capacity and body composition, which have also been positively correlated with improvements in academics and attendance.

If you know of a school that would benefit from this program, please encourage them to apply through March 10, 2017 at HealthyZoneSchool.org

PRESIDENTIAL YOUTH FITNESS PROGRAM (PYFP) In 2012, FitnessGram was declared the national fitness assessment of the Presidential Youth Fitness Program, which replaced the longstanding President’s Challenge. The Challenge focused on recognizing athletic performance in students, whereas PYFP focuses on overall student health in an effort to ensure all students have the opportunity to be fit for life.

PYFP provides teachers and students with the resources needed to implement quality physical education concepts, assess fitness levels and recognize achievements.

To apply or for more information, visit pyfp.org

The Cooper Institute®

EVOLUTION Founded by Kenneth H. Cooper, MD, MPH, The Cooper Institute translates the latest scientific findings into proactive solutions that improve population health.

THE PATH TO CREATING A CULTURE SHIFT Creating a culture shift requires many facets working in concert including community engagement, public health policy that focuses on providing children with quality physical education and assessment, and public/private partnerships.

Investing in the health of our children today will build a brighter tomorrow.

ADVOCATING FOR CHANGE Quality Physical Education and Physical Activity The Cooper Institute is committed to ensuring students across Texas and throughout the country have the opportunity to engage in daily quality physical education that includes physical activity. We believe that students should be active throughout the day and that teachers should have the resources and professional development needed to ensure that our youngest generation has the opportunity to live a long, healthy life.

Fitness Assessment You can’t manage what you don’t measure and fitness assessment is a core component to any quality physical education program. Fitness assessment allows teachers to help their students understand where they are in their health-related fitness, and make meaningful changes both inside the classroom and outside, that help students build healthier habits.

THE PHIT ACT

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(Personal Health Investment Today) will give more individuals and families the opportunity to lead healthier lives.

MILLION STUDENTS

ACROSS THE UNITED STATES Used globally for more than 30 years, FitnessGram® is in tens of thousands of schools and impacts 10 million students in the United States alone.

The PHIT Act expands the IRS definition of qualified medical expenses to include physical activity as a form of prevention, allowing consumers to use money in pre-tax accounts (HSAs, FSAs, etc.) to pay for physical activity expenses such as youth and adult sports league fees, youth camps, personal trainers, health club membership dues and more.

Removing barriers to being active and healthy In an effort to help ensure all Americans have the opportunity to live a preventive lifestyle, The Institute supports meaningful public health initiatives including clean air and smoking policies, infrastructure projects that provide safe, walkable routes to schools and access to parks and recreation areas, as well as removing economic barriers for individuals and families to engage in physical activity.

For more information, visit CooperInstitute.org/advocacy

2016 LEGACY AWARD DINNER SPONSORS & DONORS

The Cooper Institute®

ENGAGEMENT

Millie and Dr. Kenneth Cooper

The 2016 Annual Legacy Award Dinner benefiting The Cooper Institute was held on November 9 at The Star in Frisco, new World Headquarters of the Dallas Cowboys.

Elizabeth and Drayton McLane, Jr. Lyda Hill The Arthur M. Blank Family Foundation Oncor

The Legacy Award dinner celebrates the critically important mission of The Institute and honors the visionary leaders who have improved the lives and health of men, women and children across the country and around the world. Past Legacy Award recipients include Ray Hunt, Peter O’Donnell, Jr., the late Fred Meyer and Lyda Hill.

This year, The Institute was pleased to honor longtime champion, philanthropist and two-time Super Bowl winning quarterback for the Dallas Cowboys, Roger “The Dodger” Staubach.

Peter and Edith O’Donnell The Glass Family Foundation Steve and Gail Reinemund Holly and Doug Brooks Family Foundation Governor Mike and Janet Huckabee

PAST LEGACY AWARD RECIPIENTS

Al G. Hill, Jr. Gardere Wynne and Sewell, LLP Orville C. Rogers

Ray Hunt

Peter O’Donnell, Jr.

Fred Meyer (1927-2012)

Lyda Hill

Mike and Mary Terry

Roger Staubach

An estimated 500 guests enjoyed VIP tours of the new Dallas Cowboys training facility as well as dinner on the field. The evening also featured the charismatic community activist, health advocate and two-time heavyweight boxing champion George Foreman as the keynote speaker. This year’s event surpassed last year’s successes by more than $200,000, raising over $650,000 that will directly support the work of The Institute.

Cinemark AT&T Neiman Marcus 7-Eleven LMT Wealth Management Group at Merrill Lynch Baylor Scott & White Health Sarah and Ross Perot, Jr. Foundation Karen and Les Alberthal, Jr. Cooper Aerobics Center

George Foreman, Roger Staubach & Dr. Kenneth Cooper

Drayton McLane, Jr. & Bill Arnold

Cary Maguire Chuck and Gena Norris for Kickstart Kids Robert B. Palmer Park Place Jaguar

George Foreman, Keynote Speaker

Stan Richards & Carol Murphy

Dr. Laura DeFina & Bob Shapard

Millie & Kenneth Cooper present Legacy Award to Roger Staubach

Dr. Jeremy & Ellen Lyon

Angie Cooper

For more information on the 2017 Legacy Award Dinner, visit CooperInstitute.org/annual-events

The Cooper Institute®

IMPACT

MEYER SOCIETY

Planned Giving DEVELOPMENT ADVISORY BOARD The Development Advisory Board is a group of community-minded individuals committed to strengthening The Institute’s presence within their sphere of influence.

This group of thought leaders sets an example of service and contribution while educating and engaging others in the mission of The Institute.

This past fall at The Institute’s Development Advisory Board meeting, Dr. Tyler Cooper demonstrated how the quintessential Cooper Clinic treadmill test measures maximum cardiorespiratory fitness and educated attendees on how fitness assessment can be useful in healthcare.

If only the benefits of fitness could be encapsulated in a simple pill but to date, that pill doesn’t exist.

Hard work is required, and the Development Advisory Board is certainly leading by example.

Fred Meyer,

The Cooper Institute Former President and CEO (1927 - 2012)

Fred Meyer served as Chief Executive Officer of The Cooper Institute from 2007 to 2012. His impact and legacy will be felt for years to come.

In Fred’s honor, The Fred Meyer Planned Giving Society was launched in an effort to ensure Fred’s legacy and his love for The Institute is everlasting.

For more information or to join the Fred Meyer Planned Giving Society, please contact The Cooper Institute, at 214-543-6533 or ajohnson@cooperinst.org

The Cooper Institute®

LEADERSHIP TEAM The Cooper Institute is committed to rebuilding a healthy and safe world and workforce through prevention, physical activity and healthy living. Our leadership team, guided and supported by our esteemed Board of Trustees, has a singular goal to make a positive health impact on the lives of men, women and children throughout our country and around the world. The Cooper Institute continues to be a beacon of inspiration, sharing the knowledge that through the power of prevention, everyone has the opportunity to live Well. Into the Future.

For more information contact The Cooper Institute:

HEALTHY EMPLOYEES, HEALTHY COMMUNITIES, HEALTHY COMPANY.

12330 Preston Road | Dallas, TX 75230 | 972.341.3200 | CooperInstitute.org

Kenneth H. Cooper, MD, MPH Chairman Emeritus

Laura F. DeFina, MD

Chief Executive Officer

Amy Johnson

Chief Development Officer

Claire Kinzy

VP - Communications and Public Affairs

THE COOPER INSTITUTE BOARD OF TRUSTEES

Tedd Mitchell, MD - Chairman Texas Tech University Health Sciences Center

Charles Anderson Vice Chairman Bandera Ventures

Stephen D. Good Secretary Gardere Wynne Sewell, LLP

Lester M. Alberthal, Jr. Electronic Data System (R)

Arthur M. Blank Atlanta Falcons

Brian O. Casey Westwood Holdings Group, Inc.

Susan Dell Michael & Susan Dell Foundation

Elmer L. Doty Accudyne Industries

David D. Glass Glass Investments, Inc. Kansas City Royals

Joseph Goldstein, MD University of Texas Southwestern Medical Center

Ray L. Hunt Hunt Consolidated, Inc.

James W. Keyes Key Development, LLC

Drayton McLane, Jr. The McLane Group

Robert B. Palmer Digital Equipment Corporation (R)

Hon. Jeanne L. Phillips Hunt Consolidated, Inc.

Kenneth H. Cooper, MD, MPH Chairman Emeritus Nina Radford, MD Cooper Clinic

Kenneth H. Cooper, MD, MPH Chairman Emeritus Steven S. Reinemund Wake Forest University

Kenneth H. Cooper, MD, MPH Chairman Emeritus Eduardo J. Sanchez, MD American Heart Association

Kenneth H. Cooper, MD, MPH Chairman Emeritus Roger Staubach JLL

Louis W. Sullivan, MD Morehouse School of Medicine

We all want the opportunity to live the best life we can.

At Oncor, we strive to offer employees the tools that help on the frontlines of life – family, community, health and finances.

The Oncor Live Well program brings together initiatives for health, fitness, community involvement and volunteerism.

These initiatives define who we are and help shape the communities we live in and serve, every day.

Oncor is proud to support The Cooper Institute and its dedication to promoting life-long health and wellness.

ONCOR.COM

A Super Bowl champion.

A champion of health and fitness.

Congratulations to Roger Staubach on receiving The Cooper Institute’s 2016 Legacy Award.

His support and dedication to advocating for the advancement of public health through education is changing the world on and off the field. Staubach’s legacy continues to make an impact through his philanthropic efforts with The Children’s Cancer Fund, The United States Naval Academy Foundation and The Cooper Institute, among others.

With Roger’s support and the help of many others like him, we are leading the world to ideal health now and well, into the future. Congratulations again, Roger.

- Millie and Kenneth H. Cooper, MD, MPH.

CooperInstitute.org