Physical Activity Flashcards
Fitness v.
Activity v.
Exercise
-measurable state
-any mvt
-planned
Muscle fiber types I&II
-mito
-E source
-duration
I: slow-twitch
-↑↑ mito
-E from ox metab
-fatigue resistant, long activities
II: fast-twitch
-E from glycolysis
-forceful, sprinting
TDEE =
(%’s)
REE (BMR) + TEM (TEF) + EEPA
(60-75%) + 10% +15-35%
EEPA =
EE from physical activity
= exercise + NEAT
~150-500 kcal/d
- most variable, up to 2000 kcal!
NEAT sources
occupational
transportation
leisure
fidgeting
*often most variable btw ppl
VO2
-def
-units
= volume of O2 consumed per minute
- L/min or mL/kg/min
measure of “aerobic fitness”
Predicted VO2 max based on:
1 mile walk test
3 min step test
MET
-def
-1 MET =
-2 MET =
= metabolic equivalent of task (i.e. E “cost”)
-estimates EE for PA
1 MET = avg resting O2 consumption (RMR)
= 3.5 mL/kg/min
2 MET = 2x RMR
MET categories
<3: Light (driving = 2)
3-6: Mod (e.g brisk walk = 5… 4 mph)
> 6: Vig (25-49 lbs up stairs)
Resting VO2 & age, BMI
VO2 ↓ with:
↑ age or ↑ BMI
Lean body mass % and breakdown
- widely variable btw indivuals (genetics, gender, race, age, nutrition, and PA)
75% of total body mass:
-40% muscle
-25% organs
-10% bone
-also water, ligs/tends
LBM vs. FFM
Both include h2o, minerals, protein, and glycogen
FFM:
DXA measures fat, soft tissue, bone
FFM = total mass - fat mass
*LBM also includes essential fat in organs, CNS, marrow
Sarcopenic obesity
-onset of mm loss
-contributors
*skeletal mm begins decline at age 30 yo, >65, >80
*factors: ↓ PA, ↓ BMR of adipose
*eccentric mvmts beneficial for strength and ↓ IM fat = “negs”, contract while lengthening
Obesity and walking
-source of biomechanical load linking obesity to OA, esp knee
-↑ ground rxn forces (GRF) with ↑ bw
-consider SLOWER speeds with WIDER stance
Exercise Rx
Freq
Int
Type
Timing
Enjoyment
Freq
-# days/wk is NOT DEFINED, except 2+ days of strength training
-choose something safe and realistic for individual
Int Recs
Mod:
150-300 min/wk
-starting to get challenging
-conversation more effort
Vig:
-75 min/wk
-hard work
-conversation difficult
Int by HR
Mod:
-HR: 64-76% x (220-age)
~70%
Vig:
-HR: 77-93% x (220-age)
~85%
Int by Borg scale
*preferred for pts taking rx affecting HR
6-20:
…6 = no exertion
…12-14 = moderate
…20 = max effort
x10 = HR (highly correlated)
Time
Mod: 150-300 min
Vig: 75-150 min
Strength: 2+/wk
Low risk aerobic options:
aqua classes, water walking
recumbent bike
elliptical
walking
chair aerobics
-20-30 min/day
-can divide into 5-10 min sessions
Resistance training
-2-3 d/wk nonconsec days
-2-4 sets x 8-12 reps w 2-3 min rest between
-6-10 exercises in 20-30 min session
-bw, bands, wts, machines
Kids: prevention of wt gain
-Screen < 2 hrs/day
-60-90 min play
-Routine physical activity
-Sedentary behavior assessment
Kids: structured wt mgmt
-Screen < 1 hr/d
-planned supervised play for 60 mins
-activity log
-consider ex physio
For substantial weight loss
> 300 min/wk may be required
(vs. 150 min to maintain)
Cals to prevent wt regain
?900/d for women
1500-2000/wk
% of US adults meeting PA guidelines
1 in 5!!
(20%)
highest in Western states
Stress test before starting exercise routine?
Non-exercisers with:
-CV, metab, or renal dz
-or S/S of such
All others, NOT NEEDED
Absolute contraindications to exercise
NONE
Conditions that require close supervision
recent MI
unstable angina
VT or other arrythmia
Dissecting aneurysm
acute CHF
severe AS
Myo/pericarditis
Thrombophlebitis
Intracardiac thrombus
Systemic or pulm emb
Acute infxn
Other conditions that require close supervision
-Untx / uncontrolled severe HTN
-Mod AS
-Sev subAoS
-Supraventrivular arrhythmias
-Vent an
-Freq / complex vent ectopy
-Cardiomyopathy
-Uncontrolled metab dz (DM, thyroid, etc)
-Electrolyte abnL
-Chronic / recurrent infxn (malaria, hepatitis)
-NM, MSK, or Rhuematoid dz exacerbated by exercise
-Complicated preg
Chronic conditions or Disabilities
-if unable to meet guidelines, do what they can according to abilities
-start low, go slow
-consult a healthcare professional or physical activity specialist
Exercise is Medicine
Rx in right “dosage” is effective for prev, tx, and mgmt of 40+ most common conditions
Encourage PA as vital sign, give rx @ each visit
Factors that play role in browning of white adipose tissue
-BF activated by cold
-↓ Brown fat w ↑ BMI
Exercise increases:
IL-6
FGF21
Irisin
Meteorin-like
Glucagon
Catechol
PA health benefits
CV
Endo
Pulm & sleep
CA
Ortho & rheum
Neuro & psych
Aerobic activity & CV fxn
↑
TBVol
V compliance
Venous return
Myo contractility
EDV
EF
SV
CO
Effectiveness of CO distribution
Peripheral blood flow
Flow to active mm
↓ resting HR
↑ Fitness & mortality
↓ CV death
↓ overall mortality
STRRIDE
-VO2
-HDL
↑ VO2 w ex
↑ HDL
Exercise and DM
↓
glucose
rx needs
IR
wt control
BP
LDL
TG
mm & bone strength
General well-being
↑
HDL
anxiety
Exercise in bariatric surg
ciritcal to maintain wt loss &
lasting DM2 remission
Muscle protein synthesis
-sensitve to changes in mech load & nutritional status
*LBM strong predctor of longevity and health
Exercise and visceral fat
Vig ex & HIIT ↑ visceral fat loss
Exercise and appetite
In response to mod-vig ex:
↓ Ghrelin
↑ PYY & other sat hormones
↓ appetite during & after PA, but highly variable
Physical Inactivity
> = 6 hrs sitting per day
Includes screen time
- Men w med-high sedentary behav had 65-&^% risk of met synd
>= 7.5 in college women, 10x ↑ tisk of ob
