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KIN 3282- Health & Wellness > Midterm > Flashcards

Midterm Flashcards

1
Q

epidemiology

A
  • study of health-event (frequency), health-characteristics (why) or health-determinant patterns in a society (prevent)
  • it is the cornerstone method of public health research & helps inform policy decisions and evidence based medicine by identifying risk factors for disease and targets for preventative medicine
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2
Q

traveling & health

A

increases health problems by transferring germs/diseases throughout countries

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3
Q

first ACSM recommendation

A

in 1978, 3-5x/week, 50-85% of VO2max or 60-90% of HR, 15-60 min each time

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4
Q

London bus study

A
  • 1949, bus drivers vs conductors
  • annual rate of CHD for drivers= 2.7/1000; conductors= 1.9/1000
  • could be due to drivers being more sedentary
  • this is really where PA and exercise research began
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5
Q

sports

A

actions/movements exerted in direction of game, struggle and effort, and whose practice involves a methodical training, respect for certain rules

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6
Q

exercise

A

actions/movements organized manner to maintain or develop the qualities or entities

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7
Q

physical activity

A

any bodily movement produced by skeletal muscles that result in higher energy expenditure

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8
Q

physical inactivity

A

not meeting national guidelines for PA

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9
Q

sedentary

A
  • sitting too much - 75% of our lives spent sitting
  • any waking behaviour characterized by an energy expenditure that is less than equal to 1.5x resting metabolic rate while in a sitting or reclining posture
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10
Q

incidence

A

number of new cases of a particular disease

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11
Q

prevalence

A

total number of affected persons present in a population at a specific time

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12
Q

confounder

A
  • variable with an effect that’s entangled with effect of PA which can’t be easily separated and studied independently
  • confounders need to be controlled for using statistical procedures to ensure accurate results
  • ex: effect of PA on chronic conditions= confounders= age or sex
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13
Q

cohort

A

a group followed over a period of time

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14
Q

p-value

A

used to quantify degree to which change may account for an association that was observed in a particular study

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15
Q

interaction

A
  • a variable has an impact on how another one will react to an outcome
  • 2 groups aren’t responding same way to same thing
  • ex: men and women at 80 have different PA levels
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16
Q

bias

A

any trend that affect to interpretation of results and put you away from the truth

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17
Q

risk factors

A

aspect associated with health-related conditions increase or not, the probability to develop a disease

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18
Q

MET

A
  • a measure of exercise intensity used in epidemiology studies
  • it is an absolute measure (doesn’t consider age or muscle mass)
  • vigorous exercise 6+ METs
  • moderate exercise 3 METs
  • rest 1 MET
  • metabolic equivalent of task
  • metabolic rate consuming 1 kilocalorie per kg of BW per hour= 1 MET
  • ex: 60 kg= 1440 kcal/day
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19
Q

oxygen levels

A
  • 1 MET= 3.5 ml/kg/min O2

- 10.5 ml/kg/min O2 is minimum required level to be considered healthy

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20
Q

MET minutes

A

4 METs x 200 min= 800 MET min

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21
Q

physical fitness

A

set of attributes that people have achieved that relates to ability to perform physical work, related to VO2max

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22
Q

wellness

A

holistic concept describing a state of positive health including physical, social, and psychological

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23
Q

disease

A

reduced, abnormal or lost structure of function cells, organism or systems of body

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24
Q

body compositions 1981 –> 2008

A

body compositions increased but fitness levels decreased

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25
Q

guidelines for 18-64 years

A
  • aerobic exercise 150 min/week
  • 2 sessions of resistance training/week - strengthens heart
  • kids= ~300 min/week
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26
Q

exercise reduces risk of 7 chronic conditions

A

hypotension, CVD, diabetes, stroke, osteoporosis, breast cancer, mortality

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27
Q

life expectancy

A
  • W: 84 years (72 health, 9 disabled)
  • M: 79 years (68 healthy, 8 disabled)
  • men more likely to die sooner due to gravity
  • just because you put more money into health system does not mean it will increase life expectancy
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28
Q

cost of disease

A

tend to put more work towards diseases that cost government more

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29
Q

aerobics center longitudinal study

A
  • impact of PA on mortality and chronic disease
  • 80 000 people since 1970 at Cooper Institute in Dallas
  • unique VO2max testing, more than 100 studies
  • each minute of increased treadmill time between the 2 times reduced mortality risk by 7.9%
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30
Q

gold standard measure

A
  • measure that we agree to use and trust answers the tool gives (ex: BP cuff)
  • we don’t have one for PA that’s accurate
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31
Q

what do we want to measure?

A
  • calories (METs, metabolic equations)
  • intensity (HR monitor, accelerometer)
  • time active (pedometer)
  • time sedentary (ActivPaL)
  • bouts of PA (accelerometer)
  • purpose: weight loss, portrait of population
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32
Q

questionnaires

A
  • before 60’s PA based on occupational class
  • 1st questionnaire specific to leisure PA in 1975 for community health study
  • now more than 60 PA validated questionnaire
  • pros: use for a lot of people, not expensive, can send questionnaires to remote areas
  • cons: some people can’t read/write, language barriers
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33
Q

validated questionnaire

A

when you look at how much PA someone does and measures it with questionnaire and it matches

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34
Q

measures of PA

A
  • self reports of PA are easiest methods for measuring PA in national surveys and surveillance systems
  • men over estimate, women under estimate
  • correlation coefficient between self-reported variables and accelerometer measures of PA is 30%
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35
Q

direct calorimetry

A
  • best way to measure O2 consumption
  • in a room exercising, producing CO2
  • increasing VO2 is also increasing CO2
  • REQ= CO/O2 –> not good when CO2 is higher than O2
  • expensive
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36
Q

indirect calorimetry

A

estimate energy expenditure from O2 consumption and CO2 production - mask on face

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37
Q

doubly labeled water

A
  • best overall measure of total daily energy expenditure
  • subject consumes water containing known concentration of stable isotopes of H+ (2H-deuterium) and O2 (18 O or oxygen-18)
  • costs $1000 and need spec mask to analyze
  • only way to lose O 18 is through sweat
  • how much O 18 left is how much energy you used
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38
Q

heart rate monitors

A
  • measure electrical activity of heart
  • conversion of HR to measure energy expenditure based on linear association between HR and O2
  • public health wise this is not the best solution
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39
Q

pedometer

A
  • need 10 000 steps a day to reach 30 min/day of PA
  • can get 6000 steps/day without trying
  • walking cadence - steps/min, measures intensity, need 100 steps/min for general (~120 steps/min older adults)
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40
Q

accelerometers

A
  • need to wear 10 hours/day to be valid
  • under 100 counts/min - assume they’re sedentary
  • need to wear 3 days in week and once on weekend
  • measures movement on 3 axis
  • best on hip to measure accurate movement
  • cons: don’t know posture, biking shows increased METs but decreased counts
  • ActivPaL costs 500 euros and measures posture
  • not gold standard measure but best we have
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41
Q

other popular activity monitors

A

Fitbit 1, Fitbit zip, and Withings Pulse performed best, methods is most important part of paper

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42
Q

popular body composition measures

A

densitometry, plethysmograph, absorptiometry (DXA), MRI & CT Scan

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43
Q

bioimpedence

A
  • methods of estimating body fat 1st validated by GSM & then equation created
  • Heyward (2001) said several precautions to optimize reliability of technique
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44
Q

premise

A
  • lean body mass consists of 60-75 average (73% H2O)
  • volume of body fat mass and free fat mass are constant
  • segments comply constant proportions from 1 person to another, all precautions taken - don’t use with pacemaker
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45
Q

Heyward precautions

A
  1. don’t eat/drink 4 hours before test
  2. no exercise 12 hours before test
  3. urinate 30 minutes before
  4. no alcohol 48 hours before
  5. don’t use diuretics during 7days leading up to test
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46
Q

skin folds

A
  • estimation of body fat using skin folds is possible because in adults 50-70% of body fat is located between skin and viscera
  • reliability of this technique depends mainly on level of adiposity of subject and expertise of evaluator
  • triceps is a good location for kids
  • not valid for BMI > 30
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47
Q

BMI

A
  • measures bone, fat, and fat free mass
  • kg/m2
  • waist circumference W: >88cm M: >102cm
  • 3 steps for public health:
    1. BMI
    2. waist
    3. if 1 and 2 are elevated - body composition
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48
Q

densitometry

A
  • measures bone density
  • similar to absortiometry (DXA)
  • more expensive and uses radiation but can account for different body segments
  • 4% difference can be seen due to body hair
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49
Q

plethysmograph

A
  • measures changes in volume within organ or whole body
  • the more air you push out the more body volume you have
  • no way to measure fat mass and free fat mass
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50
Q

MRI & CT Scan

A

no measurements, just estimates

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51
Q

gold standard measure for BMI

A

cadavre

52
Q

basic principles of fitness

A
  1. specificity
  2. overload
  3. initial value
  4. inter-individual variability
  5. diminishing returns
  6. reversibility
53
Q

specificity

A
  • physiological and metabolic adaptations to exercise
  • training are specific to type of exercise and muscle groups involved
  • includes specific angles, specific fatigue, etc.
  • impossible to think that best way to improve leg strength is to do elliptical machines
54
Q

overload

A
  • to improve our anatomy and physiology
  • must overload body beyond what it’s usually required to do
  • once body has adapted to particular training load
  • new load becomes regular challenge and to get further improvement “overload” must be imposed
  • you have best adaptation within first 6 weeks
55
Q

initial values

A
  • new exercisers improve faster because initial value is lower and takes less to improve
  • ex: VO2max= 12% improvement in first month
56
Q

inter-individual variability

A
  • biological age
  • initial level
  • genetics
  • gender
  • health
  • training state
  • fatigue
  • the dose-response relationship is highly individualistic
57
Q

impact factor

A
  • putting in order which journal is most prestigious
  • scale of 0-4, the higher the IF the more prestigious
  • 4 means it is well respected in science
  • # of citations/# of articles
58
Q

smokers

A

give patches to smokers to help them stop smoking because we invest so much in diseases caused by smoking (i.e., cancer, COPD)

59
Q

CRF

A

measured by doing a VO2max test

60
Q

genetics or environment?

A
  • spaniards train more but sleep less than Ethiopians

- spaniards don’t perform as well as ethiopians

61
Q

best way to prescribe intensity

A

heart rate reserve (HRR) because it takes into consideration your age and resting heart rate

62
Q

diminishing returns

A
  • each person has a genetic ceiling
  • as fitness level increases, more work or changes are needed to observe gains
  • less likely to improve if you’re already at max
63
Q

reversibility

A
  • use it or lose it
  • you can maintain your fitness level even if you need to reduce the frequency even for several months
  • in general, you need to exercise at about 70% of your VO2max at least once a week
  • resistance training more maintenance
64
Q

periodization

A
  • in its simplest form, the year training is divided in 3 phases:
    1. preparation
    2. competition
    3. transition
65
Q

VO2max

A
  • rate of O2 uptake during an effort that reflects the capacity of the heart, lungs, and blood to deliver O2 to the working muscle
  • unit for cardiorespiratory fitness:
    1. express by absolute VO2max - L/min
    2. express by relative to weight (ml/kg/min)
    3. VO2max between 40-60 is good, VO2max of 20 is not
    4. people that have high VO2max- skiers, people who train at high altitudes, genetically inclined people
66
Q

VO2max tests

A
  • maximal test (ex: bruce protocol, MCAFT)
  • sub-maximal test- need equipment (treadmill, step test)
  • field test- don’t need equipment (ex: beep test)
67
Q

moderate:

  • METs
  • %HRR or %VO2R
  • % HRmax
  • %VO2max
  • RPE (6-20)
A
  • METs: 3-5.9
  • %HRR or %VO2R: 40-59
  • %HRmax: 64-76
  • %VO2max: 46-63
  • RPE (6-20): 12-13
68
Q

people using beta blockers should use what?

A

RPE

69
Q

difference between HRmax and resting HR

A
  • HRmax typically uses 220-age

- proposed new formula 206.9-(0.67 x age)

70
Q

difference between %HRR and %HR to prescribe intensity of training

A

%HRR is greatly correlated to maximum capacity

71
Q

Intensity equivalence (RQ)

A
  • goes between 0.70-1.00
  • 0.70= fat; 1.00= glucose
  • RQ= CO2/O2
72
Q

resistance training guidelines - endurance

A
  • % 1RM: 60-70
  • reps: 12-20
  • # of sets: 2-3
  • rest: 20-30 secs
73
Q

resistance training guidelines - hypertrophy

A
  • % 1RM: 70-80
  • reps: 8-12
  • # of sets: 3-6
  • rest: 30-90 secs
74
Q

resistance training guidelines - strength

A
  • % 1RM: 80-100
  • reps: 1-8
  • # of sets: 3-5+
  • rest: 2-5 mins
75
Q

% 1 RM

A

percentage of max rep

ex: max weight for 1 rep is 200 lbs, do 80% of that = 160 lbs

76
Q

sedentarity consequences

A

associated with mortality from all causes, CV disease, and diabetes

77
Q

odd ratio

A
  • cross sectional

- might have the condition or not

78
Q

relative risk

A
  • longitudinal
  • did not have the condition at baseline
  • more important and higher on pyramid
  • long time & expensive
79
Q

objective- measurement studies

A
  • sedentary time- larger waist circumference and more adverse 2 h-h plasma glucose and triglyceride levels
  • breaking up sedentary time might help
  • study shows waist circumference increases when you don’t break up your time spent sedentary
80
Q

prospective studies

A
  • testing associations observed in observational studies
  • after 6.5 years- for each increment of 1 hour in TV time –> 11% increased risk in all-cause mortality and 18% increase in CVD related mortality AFTER controlling for PA, diet, smoking, BP, waist circumference
  • study done over 21 years:
  • – time in car: 10h vs less than 4h per week = 84% more risk of dying from CVD
  • –time in car + TV: 23h vs less than 11h per week= 64% greater risk
81
Q

walking vs standing

A
  • breaking up prolonged sitting with light intensity walking results in superior improvement in glucose tolerance, compared with breaks spent standing
  • less energy expenditure
  • treadmill work stations are likely to avoid some known problems with prolonged standing, namely pooling blood, headaches, and backaches
82
Q

kids 0-2 TV recommendations

A

shouldn’t watch TV

83
Q

kids 2-4 TV recommendations

A

should watch TV less than 1 hour a day

84
Q

kids 5-11 TV recommendations

A

should watch TV less than 2 hours a day

85
Q

kids 12-17 TV recommendations

A

should watch TV less than 2 hours a day

86
Q

treadmill workstation research

A
  • improvement in some risk factors for CV disease
  • reduction in BW
  • no significant impact on job productivity
  • interesting results but costly, require a lot of space, misconceptions, and many outcomes have not been explored
87
Q

pilot study main outcomes

A
  • PA level
  • health related measures
  • treadmill use
  • participants’ expectation and experience
88
Q

pilot study conclusions

A
  • women seem more interested in this intervention
  • preliminary results show that sharing a treadmill workstation:
  • –feasible and generally well accepted
  • – improve sleep
  • – improve BP
  • might have more health impacts if:
  • –adherence is improved
  • –length of interventions is increased
89
Q

which one is more convincing/important? PA or fitness

A
  • fitness level & mortality risk because you have a better VO2max with a good fitness
  • fitness is the physiological condition and PA is the behaviour
90
Q

95% CI less than 1.0; more than 1.0

A
  • reduced risk

- increased risk, if interval crosses 1.0 then it is not significant (0.89-12.00)

91
Q

mortality rate in US railroad workers

A

significantly lower for most active men

92
Q

Harvard Alumni Health Study

A

men aged 35-79 that expended more than 2000 kcal/week gained 2.15 years on their life compared to men that expended less than 500 kcal/week

93
Q

what determines how many calories you burn?

A

BW is difference in calorie expenditure when doing the same exercise as someone with a different weight

94
Q

Iowa women’s health study

A
  • stronger study since it has RR
  • might not be accurate since it used questionnaires
  • reduction of 33% (95% CI= 0.77) by doing mod-high PA compared to low PA
95
Q

CV health study

A
  • one of the first studies to incorporate different ethnicities
  • 12% died after 5 year follow up
  • those who expended more than 980-1890 kcal/week had 30% reduction risk
  • higher risk if income less than $50 000/year, low weight, male, BP, smoking, lack of PA
96
Q

Finnish twin study

A
  • can genetics explain effects of PA against premature death
  • RR for occasional exercisers was 0.80; for conditioning exercisers it was 0.76
  • dose-response reduction in risk of dying with increasing quintiles of estimated energy expended on exercise, not necessarily due to genetic factors
97
Q

veteran’s study

A

for each MET increase in peak exercise, RR of dying was decreased by 18%

98
Q

lifetime risk of developing hypertension is __%?

A

90%

99
Q

coronary heart disease

A
  • disease in which a waxy substance called plaque builds up inside the coronary arteries
  • also called coronary artery disease
100
Q

coronary heart disease possible consequences

A
  • angina
  • myocardial infarction (average age for men 65, women 70)
  • in US 935 000 events per year - 425 000 will die
  • CHD represent 50% of all death from cardio-vascular diseases
101
Q

main risk factor for many health problems?

A

age

102
Q

risk factors of coronary heart disease

A
  • related to behaviour
  • tobacco smoke
  • high cholesterol
  • high BP
  • physical inactivity
  • diabetes melitus
  • obesity
  • stress
  • high triglycerides
  • alcohol abuse
103
Q

atherosclerotic process

A

in coronary arteries, begins in childhood

104
Q

multiple risk factor intervention trial

A
  • tested 12 000 high risk men
  • 16 years later, men doing less than 5 minutes per day of PA increased their risk of CHD by 22%
  • if doing more than 20 minutes then no difference in RR
105
Q

women’s prospective study

A
  • studied female nurses for 8 years
  • inverse association between total energy expenditure and CHD risk (more exercise = less risk)
  • women’s study was more linear compared to mens (multiple risk factor intervention)
106
Q

weight training/intensity prospective study

A
  • men
  • weight training 30 minutes/week = 18% reduced risk of CHD
  • walking pace associated with 18% reduced risk of CHD
107
Q

lipid research clinics prevalence study

A
  • submit treadmill test
  • white males
  • strong association between cardiorespiratory fitness and lower CHD incidence and mortality
108
Q

cardiac rehab

A
  • all cause mortality 20% reduction
  • cardiac mortality 26% reduction
  • problem is after they tend to stop exercising since there is no support in case something happens
109
Q

cerebrovascular disease

A

group of conditions that affect the circulation of blood to the blood, causing limited or no blood flow to affected areas of the brain

110
Q

stroke

A
  • serious medical condition where one part of the brain is damaged by a lack of blood supply or bleeding into the brain from a burst blood vessel
  • 3rd leading cause of death in Canada
  • more women die than men
  • every 7 minutes a Canadian suffers a stroke
111
Q

signs of a stroke

A
  • facial weakness
  • arm weakness
  • speech difficulty
  • time loss is brain loss
112
Q

5 most important risk factors for stroke

A
  • high BP
  • abnormal obesity
  • tobacco smoking
  • heart disease
  • diabetes
113
Q

PA and stroke

A
  • 25-30% risk reduction
114
Q

prospective athletes study

A
  • for each km run/day = 7.% reduction in stroke incidence

- runners who averaged at least 4km/day had 55% reduction in stroke

115
Q

blood pressure

A
  • primary: not sure why we have it (92-94%)
  • secondary: have a specific gene or organ related to hypertension (3-5%)
  • risk if high BP, but haven’t found evidence for risks of low BP
  • a lot of people don’t know they have high BP
116
Q

hypertension

A
  • affects about 40% of canadians
  • most common reason to visit doctor and taking medication
  • BP is #1 risk factor for stroke and a major risk factor for heart disease
117
Q

treating hypertension

A
  • drug treatment
  • weight management
  • reduction in sodium intake
  • regular PA
  • limit alcohol
  • maintain adequate dietary potassium
  • diet
118
Q

how much reduction in BP can you expect when you start exercising?

A
  • 4.6 mmHg

- reduction of only 3 mmHg leads to reduction of 8% of strokes death, 5% of CV mortality and 4% all-cause mortality

119
Q

average age to reach max weight

A
  • 55-65

- after age 19 you tend to gain 1 pound/year

120
Q

fitness & cancer

A
  • Harvard: 50% less risk of cancer if spending more than 500 kcal/week
121
Q

breast cancer survivors and CRF

A

had better survival rate if you had high CRF

122
Q

colon & rectal cancer

A
  • RR of 0.76 (0.72-0.81) when comparing most active vs least active
  • 30-60 mins/day of mod-big PA may be necessary to significantly reduce risk of getting colon cancer (24%)
123
Q

lung & endometrial cancer

A
  • both seem to have a reduced chance of developing when engaging in PA
124
Q

rectal & prostate cancer

A
  • little support that PA reduces chances at developing these cancers
125
Q

risk factors for cancer

A
  • age
  • race (most common in white American women)
  • sex (most common in males- about 20% higher)
  • family history

KIN 3282- Health & Wellness (2 decks)

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