Health Promo Test 1 Flashcards
CNS and fatigue
Fiber recruitment has conscious aspect:
Stress of exhaustive exercise may be too much
Subconscious or conscious unwillingness to endure more pain
Discomfort of fatigue = warning sign
Elite athletes learn proper pacing, tolerate fatigue
Time to fatigue changes with ambient temperatures
11C (52 F) time to exhaustion longest
31C (88 F) time to exhaustion shortest
Muscle precooling prolongs exercise
Systematic reduction of training duration and intensity combined with an increased emphasis on improving technique and nutritional intervention prior to competition
Tapering
Objective is to attain peak performance at the time of competition
Fartlek training
Combined methods of training Easy running (~70% VO2 max) combined with hills or short fast bursts (~85-90% VO2 max)
Can be adapted for running or swimming
Benefits:
Enhance VO2 max
Increase lactate threshold
Improved running economy and fuel utilization
High prevalence of inadequate intake of ____ in all subgroups.
All over age 2, mean intakes of ___ are below the DRI.
inadequate intake:
Vitamin E
Magnesium
Below DRI:
Fiber
Potassium
Ideally the majority of carbs consumed. Complex carb. High nutrition. Slow digestion
Polysaccharides
Several studies have shown that an athlete’s ___ appears to be a better indicator of his/her aerobic endurance performance than ____
Lactate threshold better indicator than VO2 max
Ranks carbohydrates on speed of digestion and absorption
Glycemic index
Fat soluble vitamins
A- vision and bone health
D- maintain calcium levels
E- antioxidant
K- essential for blood clotting
Adult guidelines for activity - for substantial benefits
At least 150 minutes a week of moderate intensity OR 75 minutes vigorous intensity Aerobic OR a combo
Aerobic activity should be performed in episodes of at least 10 minutes and should be spread throughout week.
Vitamins that are not stored in the body
Water soluble
Moderate exercise
70-80% VO2 max or HR reserve
80-90% HR max
One of the most commonly measured adaptations to aerobic endurance training is
An increase in maximal oxygen uptake associated with an increase in maximal cardiac output
Carb recommendations for exercise intensity/duration
Low intensity training:
3-5 g/kg per day
> 60 min low, 60 min moderate, or < 30 min vigorous:
5-7 g/kg per day
1-3 hours per day moderate to high intensity:
6-10 g/kg per day
4-5 hours per day moderate to high intensity:
8-12 g/kg per day
Phosphorus…
Transports lipids
The average daily nutrient intake level considered sufficient to meet the needs of half of the healthy population within each life stage and sex
EAR: estimated average requirement
Hyperhydration signs/symptoms
Confusion Inattentiveness Blurred vision Muscle cramps/twitching Poor coordination Nausea/Vomiting Rapid breathing Weakness Acute weight gain
HIIT
Repeated high intensity bouts interspersed with brief recovery periods
Need to spend several minutes above 90% VO2 max for optimal stimulus
May be effective for improving running economy and running speed
Ex: Long-interval HIIT 2-3 min at 90% VO2 max withrelief bouts of = or < 2 min
___ of the top 10 causes of death in 2010 were chronic diseases.
___ and ____ combined accounted for nearly 48% of all deaths
7 of the top 10
Heart disease and cancer (48%)
Basic guidelines of TLC diet
Cholesterol intake kept below 200 mg day
Sodium limited to 2400 mg day
25-35% total calories should come from fat intake
Caloric intake should be level to maintain healthy weight
Physical activity must be maintained regularly (at least 30 min daily)
Aerobic exercise is recommended ___ per week
Significant improvements occur with ___
Plateau in improvements with..,
3-5 days per week
Significant improvements with > 3 days per week
Plateau with > 5 days with vigorous intensity and the same mode
Modifying intensity and mode will allow for daily training for some adults
DRI components (4 of the 6)
RDA: recommended dietary allowance
AI: adequate intake
UL: tolerable upper intake level
AMDR: acceptable macronutrient distribution range
Lactic acid accumulates during brief, high intensity exercise
If not cleared immediately, converts to lactate H ion
H ion accumulation causes decreased muscle pH (acidosis)
Buffers help pH but not enough
pH < 6.9 inhibits glycolytic enzymes, ATP synthesis
pH = 6.4 prevents glycogen breakdown
1 MET is = to ___ oxygen consumption
3.5 mL/kg x min
Fat burning zone
50-65% max HR
Glycogen depletion in muscle groups
Activity-specific muscles deplete first
Recruited earliest and longest for given task
Copper..
Iron metabolism
___ is a high energy substrate for prolonged, less intense exercise.
___ ATP yield
___ ATP production
Fat
High net ATP yield
Slow ATP production- must be broken down in FFA and glycerol
Only FFAs are used to make ATP.
Water soluble vitamins
C- immune system and collagen formation
B- convert food to energy
It takes ___ hours to restore normal hydration following heavy sweating
24-48 hours
Children and adolescents should do ___ or more physical activity DAILY. And include… weekly
60 minutes or more daily
Aerobic activity for most of the 60 min; moderate or vigorous. Vigorous at least 3x week.
Muscle-strengthening part of daily; at least 3x week
Bone-strengthening part of daily; at least 3x week
Astrand and rhyming bicycle test
Submaximal test
6 minutes
Primary measure is HR
BP also measured for determination of response to test
VO2 max estimated by plotting HR on nomogram
Primary functions of minerals
Structural components of bone, nails and teeth
Regulate fluid balance
Blood Congo
Muscle contraction
Regulate nerve impulses
Maintain acid-base balance in blood
Components of enzymes that facilitate a wide variety of metabolic functions
Activity that burns ___ METs is considered vigorous-intensity
> 6 METs
Benefits of fat in diet
Healthy cell membranes Brain and CNS development Healthy hair and skin Thyroid and adrenal function Hormone production Regulates BP and liver Regulates blood clotting Transport cholesterol
6 dimensions of wellness
Social Occupational Spiritual Physical Intellectual Emotional
Common for ___% loss of total body water during intense exercise
Water loss of ___% of total body weight can be fatal
1-6% total body water loss during intense exercise (homeostatic response is yo reduce blood flow to kidneys during exercise to conserve water)
Water loss of 9-12% of total body weight can be fatal
Iron…
Produce hemoglobin/ myoglobin
Factors related to aerobic endurance performance
VO2 max
Lactate threshold
Exercise economy
A positive outcome that is meaningful for people and for many sectors of society, because it tells us that people perceive that their lives are going well
Well-being
AMDR for protein
Children (1-3 yo) 5-30% total calories
Children (4-18 yo) 10-30% total calories
Adults (19-60 yo) 10-35% total calories
Homeostatic functions of water
- Biochemical reactions
- Maintain blood volume
- Transport nutrients
- Remove waste products
- Regulate body temp
- Optimal health
Target heart rate zone
65- 85% max HR
Foods to avoid- MIND diet
Red meat >4 servings per week Butter and margarine > Tbsp daily Cheese > serving a week Pastries and sweets> 5 servings a week Fried or fast food > 1 serving per week
____ affect enzyme activity
Co-factors (vitamins)
Certain rate of muscle glycogenolysis required to maintain…
NADH production in Kreb’s
Electron transport chain
No glycogen = inhibited substrate oxidation
Hyponatremia may occur…
From high water intake without electrolytes
Can occur during event or up to 24 hours after
Benefits of protein
Bone volume Energy Calcium absorption Satiety Thermal effect Growth repair body tissues
Energy from carbs and amount stored
4.1 kcal/g
~ 2500 kcal stored in body
Karvonen method - target HR calculations
APMHR: age predicted max HR
APMHR = 220 - age
HRR: heart rate reserve
HRR = APMHR - RHR
Target HR = (HRR x %intensity) + RHR
(Calc twice for upper/lower limits of range)
6 minute walk test
To determine CRF in older adults
Can predict mortality and morbidity
Need to be conducted on measured track/distance
Formula to estimate VO2 max
Distance measure also useful
3 main categories of lipids
Triglycerides
Sterols
Phospholipids
Types of maximal exercise tests
Treadmill tests - Bruce
Storer stationary bike test.
Timed tests: 1.5 mile run
2 classes of vitamins
Fat soluble
Water soluble
Chromium…
Enhances insulin action
Selenium…
Regulates thyroid hormone
___% adults obese and __% overweight or obese in 2011-2012
___% Children/teens were obese, ___% either overweight or obese
Adults:
- 9%
- 6%
Kids/teens:
17%
31.8%
What patient is appropriate for maximal exercise testing?
High risk for disease. (Physician and crash cart to be present)
Moderate risk for disease that intend to begin a vigorous intensity exercise program
NOT recommended for patients with low risk for disease- regardless of intensity of exercise program they intend to begin
Daily water intake by gender
Women:
2.7 L, 11.4 cups, 91.3 fluid ounces
Men:
3.7 L, 15.6 cups, 125 fluid ounces
The exercise intensity at which maximal lactate production is equal to maximal lactate clearance in the body
Maximal lactate steady state
Adaptations associated with aerobic endurance training
Increased: Max oxygen uptake Running economy Respiratory capacity Mitochondrial and capillary density Enzyme activity
Reduced:
Body fat
Blood lactate concentrations at submax exercise
Postseason
Active rest
Focus on revering from season while maintaining sufficient fitness
3 groups of carbs
Monosaccharides
Disaccharides
Polysaccharides
Signs/symptoms of severe hypohydration
Increased core body temp Sunken eyes Dry wrinkled skin Decreased BP Rapid breathing Fast HR Dizziness Irritability Confusion/Delerium Lack of urination Reduced SV and cardiac output Reduced blood flow to muscles Muscle cramping Exertional rhabdo
Eating after event..
Glycogen replenish 5-7% per hour
20-24 hours needed to fully restore
Carbs 1-1.5 g/kg body weight (1.2 g/kg optimal)
Repeat every 15-20 min for 4-6 hours or until goal achieved
Carb that is rapid source of energy
Monosaccharides
AMDR fat
20-35%
Children (1-3) 30-40%
Children (4-18) 25-35%
Adults 20-35%
In a study comparing LSD to HIIT on s treadmill…
Both effective
HIIT resulted in significant improvements beyond LSD
Hydration risks for older adults
Less sensitive thirst mechanism
Kidney function changes- low water conservation
Side effects from medication
PCr Depletion
Phosphorus-Creatine energy system
Coincides with fatigue
PCr used for short-term, high intensity effort
PCr depletes more quickly than total ATP
P(i) - inorganic phosphate- accumulation may be potential cause
Pacing helps defer PCr depletion
Common for Creatine monohydrate supplementation to reduce fatigue and speed up recovery
Treating hypertension early to reduce risk of cardiac arrest is an example of ____ prevention
Secondary
During the first ___ after training, muscles ____
45 minutes after training
Muscles rapidly absorb carbs resulting in rapid resynthesis of glycogen
Frequency of training depends on
Interaction of exercise intensity and duration
Training status of athlete
Specific sport season
Key factor in sport drink effectiveness
Carb concentration
<6% reported to improve performance
(High carb concentrations delays gastric emptying and can interfere with performance)
Protein quality determined by _____
Amino acid content and digestibility
As of 2012 ____ of all US adults had one or more chronic health conditions, and ___ have two or more.
Nearly half of all adults (117 million) have one or more chronic health condition, 25% have two or more.
Water makes up ___% total body weight for men and ___% for women
60% men
50% women
Failure may occur at neuromuscular junction, preventing muscle activation
Decreased ACh synthesis and release
Altered ACh breakdown in synapse
Increase in muscle fiber stimulus threshold
Altered muscle resting membrane potential
Fatigue may inhibit calcium release from SR
Hypohydration effects
Increase cortisol
Increase norepinephrine
2% decline strength/performance
3% decline power
10% decline muscular endurance
Decline in recovery
Interval training
Exercise at intensity close to VO2 max for intervals of 3-5 minutes
Work: Rest ration 1:1
Increases VO2 max and enhances anaerobic metabolism
Allows athletes to train at intensity close to VO2 max for greater amount of time
Interval training should be used sparingly, and only when training athletes with a firm aerobic endurance base
Takes into account the total caloric intake and also the amount of nutrition needed to reduce the risk of chronic disease
AMDR: acceptable macronutrient distribution range
Amount of oxygen consumed by body’s tissues
VO2
Oxygen uptake
Expressed L/min or mL/kg/min
Resistance training benefits to aerobic endurance training
Improvement in short term exercise performance
Faster recovery from injuries
Prevention of overuse injuries and reduction of muscle imbalance
Energy from fat and amount stored
9.4 kcal/g
~ 70,000 kcal stored
The total effect of individual and environmental factors on function and health status
Health related quality of life (HRQOL)
All vitamins are essential and generally act…
As coenzymes to facilitate numerous reactions in the body
12 min walk/run
Distance measured and converted to meters
Plug into formula to estimate VO2 max
Resistance training can increase muscle sensitivity to ___ for ___.
Amino acids for up to 48 hours after activity
The health outcome of a group of individuals, including the distribution of such outcomes within the group
Population health
Uncompensated loss of body water
Hypohydration
Benefits of carbs
Rapid breakdown and availability for energy. Allow for sparing protein as a source of fuel.
Dietary fiber for improved gastric motility. Reduces risk for colon cancer.
Helps control body weight when consumed in proper amounts and including fruits and vegetables
Inflammatory foods
Fried food Soda Refined carbs Lard Processed meat Processed foods Hydrogenated and trans fats Sweeteners- white sugar and artificial Iodized salt Food additives Dairy Meat Wheat and gluten grains Alcohol
Current dietary guidelines on unsaturated fat intake
Do not limit unsaturated fat intake
Magnesium…
Works with calcium
Hydration after exercise
Athletes should aim to consume 125-150% of fluid deficit
(20-24 oz per lb of body weight)
If sodium not consumed with beverage then much of fluid consumed will lead to increased urine output
Aerobic exercise with conventional therapy has been shown to ..
Increase pain threshold
Improve quality of life relating to pain, discomfort, physical role deficit, PF, and overall health perception
Diabetes is leading cause of..
Kidney failure
Lower-limb amputations (other than injury)
New cases of adult blindness
5 major fatigue causes
- Dehydration
- Inadequate energy delivery/metabolism
- Accumulation of metabolic by-products
- Failure of muscle contractile mechanism
- Altered neural control of muscle contraction
Lower activation energy for a chemical reaction
Enzymes
Resting - typically energy comes from…
Short exercise- typically energy comes from…
Long exercise- typically energy comes from….
Resting: 50% carb, 50% fat
Short exercise: more carbs
Long exercise: carbs and fat
Potassium..
Maintain steady HR
Too much vitamin K..
Can result in blood clots
10 food groups of MIND diet
- Green leafy veggies- at least 6 servings per week
- Other veggies- at least 1 a day
- Nuts- 5 servings per week
- Berries- 2 or more servings per week
- Beans- at least 3 servings per week
- Whole grains- 3 or more servings daily
- Fish- once week
- Poultry- 2x week
- Olive oil- use as main oil
- Wine- 1 glass daily
RDA for protein for adult men and women
0.80 g per Kg of body weight per day of high quality protein
Calcium …
Bone formation and muscle contraction
Reported benefits of a diet with low GL
Reduces insulin sensitivity in older, obese adults
Reduces inflammatory markers
Losing body water
Dehydration
Symptoms of hypohydration
Thirst/dry mouth Dry and cool skin Headache Muscle cramp Low urine production Dark urine
The most frequently used method for prescribing aerobic exercise intensity
HR
There is a high correlation between ___ and performance in aerobic endurance events
VO2 max
Primary function of protein
Tissue repair and regeneration
May be energy source at end of long duration event
Endurance athletes should consume 1.2-2.0 g/kg body weight. Higher range for ultra endurance activities. Can be on low end of range depending on duration and intensity.
Foods with a high glycemic index will produce…
High and rapid increase in blood glucose and trigger a high insulin release
Occurs when athlete reduces training duration or intensity or stops training altogether due to break in training program, injury, or illness
Detraining
Athlete experiences loss of physiological adaptations brought about by training
An improvement in exercise economy can enhance…
Maximal aerobic power (VO2 max) and lactate threshold
Anti-Inflammatory Diets AKA Healing Foods Diet
Structured to be eating plan for life
Many major diseases have been linked to chronic inflammation: cancer, heart disease, diabetes, arthritis, depression and Alzheimer’s
Components of food/beverages may have anti-inflammatory effects
Recommended by arthritis foundation.
Factors that can affect exercise economy - running economy
Form/technique Environment Topography of training Neurophysiological changes Biomechanical factors Humeral factors
Anaerobic/high intensity zone
85-100% max HR
Eggs, meat, soybeans and quinoa are high in ___
Essential amino acids
Measurements taken during exercise testing
Measures needed for VO2
HR, BP, workload, RPE
Other subjective indices: Dyspnea, Angina
Intensity can be set as a range if either
HR max or VO2 max
Anabolic window for protein consumption
Trained athletes: within 1 hour after event
Untrained: can delay 3 hours or more
4 major health risk behaviors
Inadequate physical activity
Poor nutrition
Tobacco use
Alcohol/drug use
Maximal effort objective indicators
RER + or > 1.1 (respiratory exchange ratio..more CO2 out than O2 in)
Plateau in VO2
Achievement of age-predicted Max HR
Rating if perceived exertion near max
Hyponatremia signs/symptoms
Core body temp < 104 Nausea/Vomiting Swelling hands/feet Lower blood sodium levels Progressive headache Apathy Altered state of consciousness Pulmonary edema Cerebral edema Rhabdomyolosis Seizures Confusion Lethargy Coma
Heavy exercise
> 80% VO2 max or HR reserve
> 90% HR max
Adult activity guidelines for more extensive health benefits
300 min week moderate intensive aerobic activity OR 150 min week vigorous intensity aerobic activity OR combo
Muscle-strengthening activity moderate or high intensity and involves all major muscle groups on 2 or more days per week
Fats AMDR, endurance athletes
AMDR 20-35% total energy intake
Endurance athletes should consume 1-2 g/kg body weight
Higher range for longer duration activities
Low fat diets can lead to less than optimal training adaptations as well as performance- should be limited to time point close to event.
One of the most important factors in improving and maintaining aerobic power
Intensity of training
A state of being that incorporates all facets and dimensions of human existence, including physical health, emotional health, spirituality and social connectivity. An active process through which people become aware of, and make choices toward, a more successful existence
Wellness
MIND
Mediterranean-DASH intervention for neurodegenerative delay
Developed to reduce mental decline and Alzheimer’s
Combo of DASH and Mediterranean diets
Lowers risk of Alzheimer’s by 53% with close adherence
Choose from wide variety of food groups
Maximal aerobic power
VO2 max
Major minerals
Calcium Magnesium Phosphorus Potassium Chloride Sodium
5 A model for building self-efficacy (Counseling and motivational interviewing)
Address agenda Assess Advise Assist Arrange follow up
A mode of training that can be used to maintain general conditioning in athletes during periods of reduced training due to injury or during recovery from a training cycle
Cross-training
A measure of the energy cost of activity at a given exercise velocity
Exercise economy
Zinc…
Immune function, nutrients/fluid absorption from intestines
A measure of the glycemic response if calculated in portion size
Glycemic load
Sodium..
Muscle contraction and sending nerve impulses
Too much Vitamin A can lead to…
Liver damage
Pace/tempo training
Intensity at or slightly above competition intensity, corresponding to lactate threshold
Intent is to improve lactate threshold and improve tolerance for lactate buildup
20-30 min of continuous training at lactate threshold (Borg 15-16)
Avoid high intensity or end up exceeding lactate threshold
In-season training
Designed around competition
Low-intensity and short-duration training just before race days
HRQOL
Health related quality of life
The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Health literacy
Rockport 1 mile walk
Patients with low fitness or unable to run
Record time takes to complete 1 mile walking (as fast as can but walking only- no running)
Immediately following, take pulse x15 sec, multiply by 4
Plug into formula to estimate VO2 max
Most athletes can maintain adequate hydration by consuming ___ fluid per hour
0.4-0.8 L (13-27 oz) per hour
Carb concentrations of 6-8% are ideal - higher concentrations can result in delayed gastric emptying
5 leading causes of death in US. Which account for ___% of all US deaths
Heart disease Cancer Chronic lower respiratory diseases Stroke Unintentional injuries 63%
The best dietary recommendations are from ___
Dietary reference intakes (DRI)
Top 3 diets
DASH: dietary approaches to stop hypertension
MIND: Mediterranean intervention for neurodegenerative delay
TLC: therapeutic lifestyle changes
Too much vitamin E..
Acts as anticoagulant
Most adults should exercise ___ per week and include ____ moderate intensity per session, ___ vigorous intensity per session.
Exercise should be ___ min per session
Adults should exercise 150 minutes or more per week
30-60 min moderate per session
20-60 min vigorous per session
Should be 10 or more minutes per session
There are __ calories per gram of fat.
Therefore if you have a 2000 calorie diet you need ___ grams of fat each day.
Keep total intake of saturated fats to ___% of total caloric intake
9 calories
44-77 grams per day
<10% of total caloric intake
Anti-inflammatory eating like the ___ diet, significantly decreases in mortality from ____, and out performs ___ for controlling cholesterol levels.
Mediterranean diet
Heart disease, diabetes, Alzheimer’s and Parkinson’s
Out performs statins.
Amino acids account for approximately __ total energy (endurance)
2-5%
Glycogen depletion and blood glucose
Muscle glycogen insufficient for prolonged exercise
Liver glycogen-> glucose in blood
As muscle glycogen decreases, liver glycogenolysis increases
Muscle glycogen depletion + hypoglycemia = fatigue
Warm-up/cool-down zone
50% or less max HR
___ focuses on treating disease and injury that is already present in an effort to reduce disability and assist individuals in gaining a higher level of functioning
Tertiary prevention
Increasing exercise intensity may benefit skeletal muscle adaptations by
Affecting muscle fiber recruitment
Key recommendations for managing fluid levels
- 2 hours before exercise, consume 14-22 oz water
- During exercise, consume fluid to minimize water losses to <2% of body weight
- After exercise, consume enough water to replace sweat losses occurring from exercise
- Sport drinks containing 4-8% carb concentration and Na concentration 0.5-0.7 g/L
- Consume food with high sodium content during recovery period
- Track performance and alter fluid consumption to prevent water loss >2% body weight
Rating of perceived exertion scale
1- nothing (lying down) 2- extremely little 3- very easy 4- easy (could go this all day) 5- moderate 6- somewhat hard (starting to feel it) 7- hard 8- very hard (making effort to keep up) 9- very very hard 10- maximum effort (can’t go any further)
Maximal oxygen uptake range is expressed as ____ METs
7.1 - 22.9 METs
Trace minerals
Iron Chromium Iodine Copper Manganese Fluoride Selenium Molybdenum Zinc
___ is considered to be a better indicator than lactate threshold and VO2 max
Maximal lactate steady state
A measure of the energy (oxygen) used by the body
MET
Metabolic equivalent
Preseason training
Focus on increasing intensity, maintaining or reducing duration, and incorporating all types of training
Mass action effect
Substrate availability affects metabolic rate
More available substrate = higher pathway activity
Excess of given substrate = cells rely on that energy substrate more than others
Cognitive-behavioral approaches to promote exercise
Reinforcement Goal setting Social support Relapse prevention Affect regulation Association vs Disassociation
Being physically inactive is responsible for ___% deaths in US adults
___% of American adults don’t meet physical activity recommendations
___% of adults are not sufficiently active to achieve health benefits
10% deaths
80% don’t meet recommendations
60% not active enough to achieve health benefits
The DRI guidelines are established to reduce ___
Reduce the risk of developing chronic diseases.
Previous guidelines were based on preventing deficiencies.
Substrate fatigue
Develops from inability to produce ATP from any source
Can be prevented with proper diet before/during event
Contributing to the growth and development of health
Health promotion
A state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity
Health
Muscle glycogen synthesis stages
- Insulin-independent stage 30-60 min after activity
2. Insulin-dependent stage 1-2 hours to 48 hours after activity
Glycogen depletion and FFA
With glycogen depletion, FFA metabolism increases
But FFA oxidation too slow, may be unable to supply sufficient ATP for given intensity
Average US consumption is higher than recommended for ____ and lower than recommend for ____
Higher intake than recommended for protein (meat, eggs and nuts) and grains.
Lower than recommended for veggies, dairy and fruit.
Protein yields ___ energy
It must be converted to ___
4.1 kcal/g
Must be converted into glucose (gluconeogenesis)
Can also convert into FFAs (lipogenesis) - for energy storage and cellular energy substrate
Iodine…
Production of thyroid hormone
4 core measures of health
- Our behaviors (lifestyle)
- Policies sand practices of our healthcare, government and other prevention systems
- Medical care we receive
- The environment and community we live in
Chronic adaptations to aerobic exercise
Cardiovascular:
Increases in: max cardiac output, SV, and fiber capillary density
Increased parasympathetic tone = decreas in resting/submaximal exercise HR
Respiratory:
Ventilatory- highly specific to type of exercise
Increased tidal volume and breathing frequency with max exercise
Neural:
Efficiency increased, fatigue of contractile mechanisms delayed
Muscular:
Increase in aerobic capacity of trained musculature- allows absolute intensity with greater ease
Bone/connective tissue:
Tendons, ligaments and cartilage grow and strengthen proportional to stimulus
Endocrine:
Increase- hormonal circulation and receptor changes
General indications to stop a test
Onset of angina or angina-like
Drop in SBP > or = 10 mmHg with increased work rate
Excessive rise in BP (SBP > 250 mmHg and/or DBP > 115 mmHg)
SoB, wheezing, leg cramps, or claudication
Signs of poor perfusion, lightheaded, confusion, ataxia, pallor, cyanosis, nausea, cold/clammy skin
Failure of HR to increase with increased exercise intensity
Noticeable change in heart rhythm
Physical/verbal signs of severe fatigue
Subject requests to stop
Failure of test equipment
Energy system used to supply ATP is dependent on…
Low intensity exercise, primary fuel is _____. High intensity ____. Endurance ____.
Rate ATP needed, availability of oxygen, and intensity of activity
Fats for low intensity
Carbs for high intensity
Amino acids for endurance (after fats and carbs depleted)
Protein can provide ___ of total energy needed during prolonged exercise
3-18%
Results in release of nitrogen and leads to rapid onset of fatigue
YMCA 3 minute step test
Step height 12”
Step rate: metronome set to 96 bpm
Take radial pulse x 1 min after completion
Compare HR to normative table
Pre-event eating (resistance)
Within hour.. Hydration Top off glycogen Decrease hunger Balance protein consumption for athletes who have high daily protein intake requirements
Very light exercise
45-55% VO2 max or HR reserve
60-70% max HR
Keys to nutrient intake for resistance training performance and recovery
Eating right foods
Eating at right time
The general physical, mental or spiritual condition of the body
Health
Submaximal exercise testing
Primary purpose:
Estimate VO2 max OR
Determine functional response to exercise
Modes:
Field test, treadmills, cycle ergometers, step testing
Select mode based on fitness program for patient; musculoskeletal limitations
A broad multidimensional concept that usually includes self-reported measures of physical and mental health
Health-related quality of life
Off-season training
Base training
Begin with long duration and low intensity. Gradually increase intensity and to a lesser extent duration
____ are primary energy substrates used during resistance training
Muscle glycogen and blood glucose
When should exercise test be conducted
Determine CRF level and tolerance for functional activity
Determine CRF level prior to beginning exercise program
Establish baseline- reassess to monitor progress
Results can be used in goal setting
Readiness for return to sport
Research is ____ on effectiveness of supplementation to improve health or treat disease.
Absorption of supplements is ___ naturally through the foods we eat.
Insufficient or inconclusive
Absorption of supplements is poor vs consuming vitamins and minerals naturally through food
Number of training sessions conducted per day or per week
Training frequency
Dietary guidelines for resistance athletes
RDA
Carbs 5-6 g/kg
Protein 1.4-1.7 g/kg
Frequency, intensity or duration should not increase by more than …
10% each week
Eating during event…
Choose carbs wisely- low fiber, low residue
Consuming during event can prevent substrate fatigue and improve performance
Consume 30-90 g per hour (not based on body weight)
Limiting factor is rate of absorption across intestinal wall.
Glucose absorption 60g per hour
Fructose absorption 30g per hour
Signs/symptoms of mineral deficiencies
Mouth ulcers or cracks in corners of mouth
Poor night vision and white growths on eyes
Brittle hair and nails
Scaly patches and dandruff
hair loss
Red or white bumps on skin
Restless leg syndrome
In 2011, __% adults (18+ years old) did not meet recommendations for aerobic exercise or physical activity and ___% did not meet recommendations for muscle strengthening
52% aerobic exercise/physical activity
76% muscle strengthening
Acclimation to altitude may occur between ___ but can take up to __.
12-14 days at moderate altitudes
Can take up to several months
In order to see an ergogenic effect, athletes need a hypoxic dose =or > 12 hours daily for minimum of 3 weeks at moderate altitude
Metabolic by-products and fatigue
P(i) - inorganic phosphate- from rapid breakdown from PCr, ATP
Heat: retained by body, core temp increase
Lactic acid… H ions, pH drops, acidosis
Energy is released at a controlled rate depending on ___.
Enzyme activity in a metabolic pathway
Enzymes do NOT start chemical reactions or set ATP yield
Enzymes facilitate breakdown (catabolism) of substrates
More enzyme activity = more product
Glycogen depletion
Glycogen reserves limited and deplete quickly
Depletion correlated with fatigue
Related to total glycogen depletion
Unrelated to rate of glycogen depletion
Depletes faster with high intensity
Depletes faster during first few minutes of exercise vs later stages
Ratings of perceived exertion scales uses..
Can be used to regulate intensity of aerobic endurance training across changes in fitness level
May be influenced by external environmental factors
Maximal exercise testing
AKA graded exercise tests (GXT) or stress tests
Test design is to use gradual increase workload until peak exertion is achieved
Purpose: Screen for presence of disease Diag disease when symptoms are present Establish a prognosis Treatment planning
Functions of water for athletics
Maintain body temperature
BP
Circulation of metabolites
Recommended daily intake of carbs
Sedentary adults 45-65% total calories
Aerobic training 8-10g per Kg body weight
Anaerobic training 5-6g per Kg body weight
Foods with high GI
Baked russet potato
Sugary foods
Breads with bleached white flour
Considered more accurate measure of glycemic response
GL: glycemic load
Light exercise
55-70% of VO2 max or HR reserve
70-80% HR max
Drinking too much alcohol is responsible for ___ deaths each year, more than half due to ___
88,000
Binge drinking
Every gram of carbohydrate retains ____
3-4 g water
US food consumption as % of calories
12% plant
25% animal
63% processed foods
A state of good health
Wellness
Foods with low GI
Complex carbs
Soy beans
Hummus
Hydration assessment
Plasma/urine osmolality USG: urine specific gravity test Sweat patches placed in skin Bio electric impedance analysis Body weight pre and post Urine color
___ aims to detect disease at an early stage when signs and symptoms are not evident so that disease can be controlled and it’s effects limited
Secondary prevention
Lower quality proteins are found in ___
Plants
___ is most common cause of disability
Arthritis
More than ___ adults, close to ___% smoke. Smoking accounts for ____ deaths each year
42 million adults
~20%
More than 480,000 annual deaths
___ involves actions that avert the onset of disease or injury through intervention strategies such as reducing risk factor levels.
Primary prevention
____ METs considered moderate intensity activity
3-6 METs
A ___% decrease in body weight due to dehydration results in declining performance
2%
Average person loses ___ L per hour through perspiration while sedentary
During training….
- 3 L per hour sedentary
0. 3-1.4 L per hour training
Maximum daily intake unlikely to cause adverse health effects
UL: Tolerable upper intake level
Muscle fiber type and recruitment patterns
Fibers recruited first or most frequently deplete fastest
Type I fibers depleted after moderate endurance exercise
Recruitment depends on exercise intensity
Type I recruit fist (light/moderate)
Type IIa next (moderate/high)
Type IIx last (maximal intensity)
CRF (cardiorespiratory fitness) is considered a health related component due to..,
- Low levels of CRF linked to development of chronic diseases as well as increased all-cause mortality
- Higher levels of CRF linked to decrease in all-cause mortality
- High levels of CRF associated with increased frequency of activity resulting in numerous health benefits and increased HRQOL
The art and science dealing with the protection and improvement of community health by organized community effort and including preventative medicine and sanitary and social science
Public health
Molybdenum
Produce RBC
Dietary fat is comprised primarily of ____
Triglycerides
Participants in endurance events are at risk for hyperhydration if…
They only consume water
To calculate the GL…
Multiply glycemic index by number of grams of carbs per serving of food
LSD
Long slow distance training
Intensity at < 20% normal training intensity
Program based on time rather than distance- progress by time (1-2x month) rather than distance
Recommended for marathon training programs
Adaptations:
enhances oxygen delivery to muscles and therefore improves ability to clear lactate
Causes eventual shift of type 2x fibers to type 1
Increased use of fat as energy source
____ are effective in maintaining HR during endurance exercise
Either water or saline
6 groups of nutrients
Minerals Carbohydrates Fats Vitamins Water Proteins
___% loss total body weight can increase core body temp and significantly affect performance
___% loss reduces blood flow to muscles
___% loss cause decrease in cardiac output, sweat production and blood flow to skin and muscles
1-3%
4%
6-10%
Wrapping up the fitness test
Share results with patient
Help patient establish goals for fitness program
Schedule a follow up time to assess performance
Modify fitness program as needed
RDA for fat for adult men and women
Children (1-3 yo) 30-40% total calories
Children (4-18 yo) 25-35% total calories
Adults (19-79 to) 20-35% total calories
Any effort taken to allow an individual, group or community to achieve awareness of- and empowerment to pursue- prevention and wellness
Health promotion
Too much vitamin D can lead to..
Heart arrhythmias and blood vessel calcification
Chloride…
Balances fluid in body
External and individual factors influencing adaptations to aerobic endurance training
Altitude-
Body must compensate for lower atmospheric pressure
Initial response is increase respiratory rate and HR
Acclimation expect to occur after 10-14 days due to increased RBC production
Smoking-
Increased airway resistance
Paralysis of cilia
CO binding to hemoglobin
Genetic potential-
Upper limit of genetic potential dictates absolute magnitude of adaptation
Age and sex-
Max aerobic power decreases with age
Power of women 73-85% of male values
Fitness is the ability to perform physical work that requires…
Cardiorespiratory function Muscular strength Endurance Flexibility Optimum body composition
Omega 3 and 6 are ___
Polyunsaturated
Essential fatty acids
1 MET is
The energy (oxygen) used by the body at rest
Length of time of training session
Duration
Anti-Inflammation foods
Tomato Fruit Nuts Olive oil Leafy greens Fatty fish
The practice of preventing disease and promoting good health by providing the resources and creating environments that help people stay healthy
Public health
Energy substrates
Carbs, fats, protein
Breakdown of these macronutrients provide fuel and are broken down to release the energy stored in bonds between molecules
Exercise mode is _____.
The specific activity performed by the athlete
Vitamins that are dissolved and stores in fat cells
Fat soluble
Anti- inflammatory diets are recommended by
Arthritis foundation American heart association American cancer society Hepatitis central American diabetes association
2 definitions of fatigue
- Decrements in muscular performance with continued effort, accompanied by sensations of tiredness
- Inability to maintain required power output to continue muscular work at a given time
RDA for fats
20-35% of total caloric intake
Fluoride…
Bone formation
DASH
Dietary approaches to stop hypertension
Lower BP in just 14 days
3 plans: original, weight loss and vegetarian
Lowers risk of several cancers, heart disease and failure, stroke, kidney stones, reduced risk of diabetes, can slow progression of kidney disease
Heat alters metabolic rate
Increases carb utilization
Hastens glycogen depletion
High muscle temp may impair muscle function
TLC diet
Therapeutic lifestyle changes
Not designed for weight loss, intended to lower cholesterol levels
Targets saturated fat intake and promotes foods high in unsaturated fatty acids
Intake of saturated fat should be kept below 7% total caloric intake
Submaximal Field tests
Rockport 1 mike walk
6 minute walk test
12 minute walk/run
Sodium losses range from ___ per liter of sweat
230-2277 mg of sodium per liter of sweat
High intensity aerobic endurance training augments the absolute secretion rates of
Many hormones in response to maximal exercise
High quality proteins are ____ and contain ___.
Highly digestible and contain all 9 of the essential amino acids
Barriers to treatment adherence in PT outpatient clinics
- Low levels of physical activity at baseline or in previous weeks
- Low in-treatment adherence with exercise
- Low self-efficacy
- Anxiety
- Depression
- Helplessness
- Poor social support or activity
- Greater perceived number of barriers to exercise
- Increased pain levels during exercise
Manganese…
Regulates blood sugar
Health and fitness programs are example of ____ prevention
Primary
Estimated that ___% US adults are obese
42%
Grains are
Polysaccharides
Basic functions of vitamins
Organ and immune functioning
Metabolism and facilitating energy production
Supporting muscle contraction and relaxation
Oxygen transport
Building and repairing body tissues
Protection from cellular damage
Vision
Children have ___ sweat rate, ___ skin temp, and…
Lower sweat rate
Higher skin temp
Need more time to acclimate to high temps
Lower sodium concentration in sweat (one factor that benefits children)
There are ___ calories per gram of carbohydrates.
Adequate intake if fiber ___ g per 1000 kcal.
4 calories per gram of carb
Fiber intake: 4g per 1000 kcal
Established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy
AI: adequate intake
The average daily level of intake sufficient to meet nutrient requirements of nearly all healthy people (97-98%)
RDA: recommended dietary allowance
Adding aerobic exercise to PT for chronic MSK resulted in …. (compared to PT without)
Improved pain pressure threshold
RER of 1.1:1
What higher?
RER (respiratory exchange rate) is CO2 to O2 ratio
1.1:1 means CO2 output higher
At VO2 max (and lactate threshold)
There are ___ calories per gram of fat.
For a 2000 calorie diet… ___ grams of fat per day
9
44-77 g daily
RDA fat
20-35% total caloric intake
<10% total caloric intake of saturated fats
Overtraining is a process that can result in ____ overreaching
Functional overreaching (intentional)
Nonfunctional overreaching
Functional overreaching
Intentional overtraining to stimulate supercompensative environment
Nonfunctional overreaching
Overtraining
Gradual onset resulting in declines of performance
May require weeks or months to fully recover
Cardiovascular overtraining responses
Greater volumes of training affect HR while resting BP generally do not change
Overtraining- biochemical response
High training volume results in increased levels of creatine kinase, indicating muscle damage
Muscle glycogen decreases with prolonged periods of overtraining
Overtraining- endocrine response
May result in decreased testosterone-to-cortisol ratio, decreases secretion of GH, and catecholamine levels
Decrease: insulin and testosterone
Increase: adrenaline, noradrenaline, ACTH, cortisol and glucagon
Potential markets of aerobic overtraining
Decreased: Performance % body fat Maximal oxygen uptake Muscle glycogen
Altered BP Increased muscle soreness Altered RHR Increased submax exercise HR Change in mood
Heart rate zones
50% or less - recovery
50-65% - fat burning
65- 85% - target HR zone
85-100% - anaerobic
Aerobic training design for client classification
Beginner:
2-3 days week/ 20-40 min
Intermediate:
4-5 days week/ 30-60 min
Advanced:
5+ days/ varies
HR max ranges
Very light. < 57% Light 57-63% Moderate 64-76% Vigorous 77-94% Near-max + or > 95%
