Exam 2 Flashcards
Health risks of being underweight
- Malnutrition
- Fluid-electrolyte imbalances
- Osteopenia, osteoporosis,
and fractures - Muscle wasting
- Cardiac arrhythmias and
sudden death - Renal and reproductive
disorders
Health risks of obesity
- Ischemic heart disease and
stroke - Dyslipidemia
- Hypertension
- Glucose intolerance and
diabetes - Osteoarthritis
- Obstructive pulmonary
disease - Gallbladder disease
- Some cancers
- Menstrual irregularities
Android
Upper body obesity
Gynoid
Lower body obesity
What type of fat is associated with increased risk of CHD, diabetes,
and dyslipidemia?
Visceral fat
Fat distribution assessment
Waist-to-hip ratio
Waist-to-hip ratio risks
- Males at risk if WHR >0.94
- Females at risk if WHR >0.82
Obesity contributors
- Hormonal control of RMR
- Number of fat cells
* Inherited, but can increase with
overfeeding - Genes
* Deficiencies in melanocortin-4
receptor and leptin
* Fat distribution (VAT or SAT) - Environment
* Diet
* Physical activity
Gain weight
Positive energy balance
Lose weight
Negative energy balance
Kilocalorie
Unit of heat energy
Energy yield of macronutrients
- Carbohydrate: 4 kcal/g
- Protein: 4 kcal/g
- Fat: 9 kcal/g
1 lb of fat equals
3500 kcals
Energy balance
energy intake = energy expenditure
Total Energy Expenditure (TEE)
RMR + dietary thermogenesis + EAT + NEAT
Largest contributor to TEE
RMR
RMR
Resting metabolic rate
EAT
Exercise activity thermogenesis
NEAT
Non-exercise activity thermogenesis
Preliminary steps to a weight management program
- Set body weight goal
* Measure body composition
* Use FFM and desired %BF to set
realistic goal (target weight) - Assess kcal intake
* Food record and dietary
software - Assess kcal expenditure
* Factorial or TEE method
Sedentary
“Mostly seated or standing daily living activities; no exercise or
other leisure activities.”
Low active
“Light exercise and leisure activities (i.e., walking 50 minutes per
day at 3 mph or golfing 40 minutes per day.”
Active
“Moderate exercise and leisure activities (i.e., cycling 75 minutes
per day or playing tennis 90 minutes.”
Very active
“Heavy manual labor job or heavy exercise and leisure activities
(i.e., jogging 75 minutes per day or playing basketball 60 minutes
per day.”
Ideal body fat percentages for men
Essential: 2-5%
Athlete: 6-13%
Fitness: 14-17%
Average: 18-24%
Obese: 25%+
Ideal body fat percentages for women
Essential: 10-13%
Athlete: 14-20%
Fitness: 21-24%
Average: 25-31%
Obese: 32%+
Designing weight loss programs
- At least 500 to a max of 1,000 kcal/day deficit
- Calorie restriction and exercise combo
- Exercise: conserve FFM
- Collaborate with a nutritionist: ensure adequate nutrient intake
- Reassess body composition for fat loss
Exercise prescription for weight loss
- Exercise alone (without diet) has only modest effect
- Work with a nutrition professional for the diet
- 150 min/wk is insufficient to prevent weight gain
- > 250 min/wk is recommended
- Dose-response relationship
Exercise prescription for weight loss: Frequency
Daily
Exercise prescription for weight loss: Intensity
Moderate; duration is more important
Exercise prescription for weight loss: Time
≥60 min
Exercise prescription for weight loss: Type
Aerobic for weight loss, but use resistance training
to prevent weight regain and preserve FFM
1 lb of muscle equals
2800 to 3500 kcals
Protein intake for weight gain
1.4-2.0 g∙kg–1
Weight gain program: Exercise
High-volume resistance training
Weight gain program
- Use NIH Body Weight Planner
- Diet
* Work with nutrition professional
* Protein intake: 1.4-2.0 g∙kg–1 - Exercise: high-volume resistance training
- Monitor body composition
Exercise Prescription for Weight Gain: Frequency
- For novice: 3 days/wk
- For advanced: 5-6 days/wk split routine
Exercise Prescription for Weight Gain: Intensity
70%-75% 1-RM or 10- to 12-RM
Exercise Prescription for Weight Gain: Time
60 min
Exercise Prescription for Weight Gain: Type
Resistance; multiple sets and exercises per muscle group
Body Composition Change Programs
Combination of aerobic and resistance training is more effective than either used alone
Caloric intake should be at least
1200 kcals
Weight loss should be gradual
No more than 2 lb (1 kg) per week
Elements of Cardiorespiratory Workout
- Warm-up
- Endurance conditioning
- Cool-down
- Stretching
Warm Up for Cardiorespiratory Workout
- 5-10 minutes
- Low-moderate intensities
- Increased blood flow
- Increased core temperature
- Decreased likelihood of injury
- Reduce chance of cardiac arrhythmias
Endurance Conditioning
- Follow FITT-VP principle
- 20 to 60 min per session
- Depends on intensity
- Minimum single bout duration =
10 min continuous - Accumulate 30 min MIPA per day
or 20 min VIPA per day
Cool-down
- Immediately follows endurance conditioning
- Low-intensity exertion
- 5 to 10 minutes
- HR and BP return to near pre-exercise levels
- Maintains venous return to heart
* Prevents blood pooling
* Counters post-exercise
dizziness and fainting
Stretching
- 5 to 10 min
- Target major muscle groups
- May reduce soreness and cramping
Types of stretching
- Static Stretching
- Foam Rolling
- Dynamic
- PNF
Exercise Prescription for Improved Health: Type (Mode)
Endurance-type activities
Exercise Prescription for Improved Health: Intensity
At least moderate intensity
Exercise Prescription for Improved Health: Frequency and Duration
- Target 150 to 300 min/wk
- Duration depends on intensity and modality
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Frequency
5 days/wk MIPA, 3 days/wk VIPA, or
combination of both
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Intensity
- MIPA (3-6 MET; 40% to < 60% VO2R),
VIPA (>6 MET; 60% to < 89% VO2R),
or combination thereof - %HRR may be used instead of %VO2R
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Time (Duration)
≥150 min/wk MIPA, 20-60 min/wk
VIPA, or combination thereof
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Type (Mode)
- Aerobic, large muscle groups
- Rhythmic action
- Little skill required
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Volume
- ~ 1,000 kcal/wk
- 500-1,000 MET∙min∙wk–1
Exercise Prescription for Improved Health and
Cardiorespiratory Fitness: Progression
Increase per client ability to adapt
Type B Exercise
Vigorous, minimal skill but average fitness level required
Type A Exercise
Minimal skill and fitness level required
Type C Exercise
Requires skill and average fitness level
Type D Exercise
Recreational activities, may improve fitness
Give me an example of Type A Exercise
Walking, Cycling (indoors), aqua-aerobics, slow dancing
Give me an example of Type B Exercise
Jogging/running, rowing, stair climbing, elliptical, spinning, fast dancing, simulated climbing (rock wall, trainer), Nordic skiing
Give me an example of Type C Exercise
Swimming, aerobic dance, in-line skating, rope skipping
Give me an example of Type D Exercise
Basketball, downhill skiing, handball, racket sports, hiking
Considerations When Selecting Modes
- Can intensity be progressed easily?
- Does mode exceed client exercise capacity?
- Does mode present physiological problems for client?
- Is mode convenient and accessible?
- Is mode one that client enjoys?
Setting Exercise Intensity
- ACSM recommends using %VO2 reserve (%VO2R)
- VO2R = VO2max – VO2rest (can substitute METs instead)
- VO2rest ≈ 3.5 ml/kg/min or 1 MET
- VO2R ≈ HRR (HR reserve; HRmax – HRrest)
- Assess client’s cardiorespiratory fitness (CRF) level before
setting intensity
Setting Initial Exercise Intensity for Adults with Poor CRF levels
30% to 59% VO2R or HRR
Setting Initial Exercise Intensity For Apparently Healthy Adults
40% to <90% VO2R or HRR
Setting Initial Exercise Intensity to Improve CRF
55% to 80% VO2R or HRR
Limitations of MET Method
- MET values of activities are only estimates
- MET cost varies with skill
- Environmental factors (heat, altitude) affect MET cost
HRR Method
- HRR = HRmax - HRrest
- % intensity x HRR
- Add HRrest
Limitations of HR Method
- Predicting HRmax can lead to large errors in exercise intensity
- HRmax varies with exercise mode
- HR is affected by various factors (medications, environment)
Rating of perceived exertion (RPE)
- Useful in combination with HR targets
- Borg (6-20) vs OMNI (0-10)
- Strong correlations between RPE and intensity variables
- RPE is subjective: client’s perception only