Physical Activity and Chronic Disease Flashcards
What is the 2020 Goal?
> 47.9% participation in daily activity
How many individuals meet the aerobic or strength guidelines but not both?
50%
How many individuals meet the aerobic and strength guidelines?
20%
What is the minimum physical activity guidelines for individuals ages 18-65?
150 minutes/week of moderate intensity respiratory exercise and 2 days/week of bone and muscular condition
How long must bouts be to count towards minimum requirement guidelines?
10 minute bouts
Physical Activity
Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure (walking 4mph is low end)
Exercise
A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve and/or maintain one or more components of physical fitness
What are the 5 components of physical fitness?
Muscular Strength, Muscular Endurance, Cardiorespiratory Endurance, Body Composition, Flexibility
Physical Fitness
A set of attributes or characteristics that individuals have or achieve that relates to their ability to perform physical activity
Why is it important to focus on aerobic capacity improvement?
An increase in aerobic capacity causes an increase in VO2 max
What changes as we age?
Max Aerobic Capacity decreases (peak at mid-late 20’s because physical activity maturation) (Anaerobic peaks earlier) Lean body tissue also decreases (Rapid decrease between 50 and 60’s)
Because maximal aerobic capacity usually declines with age…
Exercise professional should understand that when older and younger individuals work at the same MET level; Relative exercise intensity (%VO2max) will usually be different
Older individuals will be working at…
Greater relative % of VO2max
VO2 (%) and HRR (%) Relative Intensity Values
Very Light: <20, Light: 20-<40, Moderate: 40-<60, Vigorous (hard): 60-<85, Vigorous (very hard): 85-<100, Maximal: 100
Maximal HR (%)
Very Light: <50, Light: 50-<64, Moderate: 64-<77, Vigorous (hard): 77-<94, Vigorous (very hard): 94-<100, Maximal:100
New ACSM-AHA Recommendations
All healthy adults aged 18-65 yr need Moderate intensity aerobic physical activity for minimum of 30 min 5 d/wk, or Vigorous activity for a minimum of 20 min 3 d/wk (Combinations of Moderate & vigorous intensity exercise can be performed to meet this recommendation)
Moderate intensity aerobic activity can be accumulated toward the 30 min minimum by…
Performing bouts each lasting 10 or more min
Every adult should perform activities that…
Maintain or increase muscular strength & endurance a minimum of 2 d/wk
Because of the dose-response relation btw physical activity and health…
Persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities, or prevent unhealthy weight gain (May benefit by exceeding the minimum recommended amounts of physical activity)
Dose- response relationship for additional health benefits and weight loss
Moderate Intensity for 300 min/week, Vigorous Intensity for 150 min/week
Global Physical Inactivity Prevalence
It is the fourth leading cause of global mortality; 31% of adults worldwide are physically inactive; Majority of North American and United Kingdom adults do not meet physical activity guidelines.
HEALTH-RELATED PHYSICAL FITNESS COMPONENTS
Cardiorespiratory endurance, Body composition, Muscular strength, Muscular endurance, Flexibility
Cardiorespiratory endurance
The ability of the circulatory and respiratory system to supply oxygen during sustained physical activity.
Body composition
The relative amounts of muscle, fat, bone, and other vital parts of the body.
Muscular strength
The ability of muscle to exert force.
Muscular endurance
The ability of muscle to continue to perform without fatigue.
Flexibility
The range of motion available at a joint.
SKILL-RELATED PHYSICAL FITNESS COMPONENTS
Agility, Coordination, Balance, Power, Reaction time, Speed:
Agility
The ability to change the position of the body in space with speed and accuracy.
Coordination
The ability to use the senses, such as sight and hearing, together with body parts in performing tasks smoothly and accurately.
Balance
The maintenance of equilibrium while stationary or moving
Power
The ability or rate at which one can perform work.
Reaction Time
The time elapsed between stimulation and the beginning of the reaction to it.
Speed
The ability to perform a movement within a short period of time.
Low fitness accounts for more deaths than
Obesity, Smoking,
High Cholesterol, Diabetes, and
Hypertension. (Physical inactivity may be the greatest public health threat of our time)
Cardiovascular Diseases
Coronary Heart Disease, Cardiomyopathy, Hypercholesterolemia, Congestive Heart Failure, Hypertension, Atherosclerosis
Musculoskeletal Disorders
Low Back Pain, Osteoarthritis, Bone Fractures and connective tissue tears, Osteoporosis
Psychological Disorders
Depression, Mood, Anxiety
Pulmonary Diseases
Asthma, Chronic Bronchitis, Emphysema
Cancer
Breast, Colon, Prostate, Lung
Metabolic Disorders
Overweight, Obesity, Diabetes
Physical Activity (PA) Recommendations for Adults
Aerobic exercise: ≥150 min/week of moderate intensity or
≥75 min/week of vigorous intensity; Muscular strengthening exercise:
≥2 days/week
PA Recommendations for Children
Aerobic exercise ≥60 min/day of moderate to vigorous intensity, ≥3 day/week of vigorous intensity; Muscular strengthening exercise ≥3 day/week,
≥3 day/week of bone strengthening activities
MET=
Metabolic Equivalent
1 MET=
3.5 mLO2/kg/minute at rest (energy cost of rest)
Average METS for adults
10 METS; MET’s are estimates for adults during various activities, including exercise (Does not take into account fitness status of individuals)
Exercise intensities using METS:
Light: <3 METs, Moderate: 3-6 METs, Vigorous: >6 METs
Examples of <3 METs
Walking slowly around home, store, or office = 2; Sitting using computer, working at desk = 1.5; Darts, Croquet, Fishing = 2.5
Examples of 3-<6 METs
Walking 3.0mph= 3, Walking 4mph= 5, Cleaning windows, car=3
Examples of >/=6 METs
Walking at 4.5mph= 6.3, Jogging at 5mph= 8, Running at 7mph= 11.5
Healthy adults (18-65) should be working out at moderate/ vigorous intensity at how many METs?
Moderate at 3-6 METs for 30 min/day, Vigorous at >6 METs for 20 min/day
Older adults (>65) should be working out at moderate/ vigorous intensity at how many METs?
Moderate at 5 or 6 METs for 30 min/day, Vigorous at 7 or 8 METs for 20 min/day
Health Benefits of PA: Lowers the Risk of Many Diseases such as…
Premature death, Coronary heart disease
Stroke, Type 2 diabetes and metabolic syndrome, High blood pressure, Adverse blood lipid profile, Colon, breast, lung, and endometrial cancers, Hip fractures, Abdominal obesity, Feelings of depression and anxiety
Health Benefits of PA
Aids weight loss and prevention of weight gain, Improved functional health, Increased bone density, Improved sleep quality
Dose–Response Relationship
Dose of exercise is related to volume (frequency x intensity x duration); Generally, health benefits increase with the dose of physical activity.
How does Dose–Response Relationship Lowers CHD risk?
150 min/week of PA = ↓CHD risk by 14%; 300 min/week of PA = ↓CHD risk by 20%; Multiple bouts (≥10 min) are better than a single session.
PA and Weight Management
150 min/week of moderate-intensity PA may not be sufficient for preventing weight gain.; ≥300 min/week (60 min/day) is recommended for weight management.
Cardiovascular Disease
Globally, coronary heart disease (CHD) kills more than other diseases do; Higher CHD prevalence for blacks than Hispanics or Caucasians in the United States; Myths: More prevalent in men and Afflicts only older population
CHD Risk Factors
Age, Family history, Hypercholesterolemia, Hypertension, Tobacco use, Diabetes mellitus or prediabetes, Obesity, Physical inactivity
PA and CHD Risk
Regular PA lowers CHD risk 1.5 to 2.4 times; Effects of PA are independent of other risk factors; Both PA and cardiorespiratory fitness lower CHD risk.
Hypertension Prevalence
15% to 40% of global population; Higher prevalence for Europeans and North Americans than for African, Asian, and Mediterranean adults; Substantially higher in blacks than other ethnicities in the United States
PA and Hypertension Risk
Inverse relationship between resting BP and level of PA; PA moderately reduces BP (5-7 mmHg); Even modest reduction in BP reduces CHD risk
Cholesterol
Fatlike substance essential to cell membranes, sex hormones, and bile acids
Hypercholesterolemia
High total cholesterol (sum of HDL, LDL and triglycerides)
Dyslipidemia
Abnormal lipid profile
Classes of Lipoproteins
Chylomicrons, Very low-density lipoproteins (VLDL), Low-density lipoproteins (LDL), High-density lipoproteins (HDL)
PA and Lipid Profile
Inverse relationship between PA level and TC and the TC/HDL-C ratio; Aerobic exercise= moderate increase in HDL-C; Effect of resistance training is equivocal.
Tobacco
Smoking is largest preventable cause of disease and premature death (Linked to CHD, stroke, lung diseases, various cancers); More prevalent in Asia than USA or UK (~20-25% in USA and UK, ~40-70% in Malaysia and Indonesia)
Diabetes Mellitus
Global epidemic, 1 in 4 U.S. adults (American Indians and Alaskan Natives have highest prevalence)
Type 1 Diabetes
Exercise has little to no effect
Type 2 Diabetes
90% of all diabetics (PA = lower risk of developing diabetes, PA improves HbA1c values)
HbA1c values
Measure of hemoglobin receptor response
Do we want high or low HDL and LDL?
HDL high (good cholesterol), LDL low (bad cholesterol, reduced by physical activity)
Hypercholesterolemia and Dyslipidemia
Aerobic physical activity helps improve elasticity which helps improve blood pressure)
BMI Calculation Formula
BMI= body mass (kg)/ height (m^2)
Overweight BMI
= 25 to 29.9 kg/m2
Obese BMI
≥ 30 kg/m2
Normal BMI
= 18-29.4
Underweight BMI
= <18
Metabolic Syndrome; Combination of ≥3 CVD risk factors
Hypertension, Dyslipidemia, Insulin resistance, Abdominal obesity; (Prevalence increases with age); Higher risk of CHD, CVD, diabetes
Waist Circumference risk criteria for Metabolic Syndrome
Males: >102cm (>40in); Females: >88cm (>35in)
Cancer
Physical inactivity is one of the main risk factors for some cancers; May need >150 min/week to reduce risk
Cancers most linked to low PA:
Colon, Breast, Endometrial
Absolute annual risk of exercise-related death among high school and college athletes:
One per 133,000 men, One per 769,000 women (Note that these rates, although low, include all sports-related nontraumatic deaths. Of the 136 total identifiable causes of death, 100 were caused by CVD)
Sudden Cardiac Death risk is very low for:
Individuals younger than 30-40 yr
Absolute incidence of death during or within 1 hr of sports participation among US HS & college athletes has been estimated as…
1 death/yr for every 133,000 men, 1 death/yr for every 769,000 women
In US, most common cause of exercise-related sudden death is:
Hypertrophic cardiomyopathy
In US, most common cause of exercise-related sudden death is:
Hypertrophic cardiomyopathy
Individuals w/sickle cell trait have a higher incidence of…
Exertion-related deaths (Must limit PA and give rest)
What is sickle cell anemia?
Disease passed down through families in which RBC form an abnormal crescent shape. (RBC are normally shaped like a disc)
What does sickle cell trait actually have resistance to?
Malaria
Relative risk of sickle cell anemia among African-Americans is…
27x higher than in those w/out it (More common in African-American than White population)
Absolute death rate during 8-11 wks basic training (military) due to sickle cell trait can be estimated as…
1 death for every 3,105 recruits; With an annual rate of
1 death for every 478 to 660 recruit
Absolute risk of sudden cardiac death during vigorous intensity, physical activity has been estimated at…
one per year for every 15,000–18,000 previously asymptomatic individuals (more recent research has confirmed the increased rate of sudden cardiac death and acute MI among adults performing vigorous intensity exercise compared to young)
The physically active or fit adult has about what percent lower risk of developing CVD compared to those who are inactive?
30%–40%
The risks of various cardiac events include
Acute MI, ventricular fibrillation, hospitalization, and death (data indicate that in a mixed pop risk of exercise testing is low, w approx. 6 cardiac events per 10,000 symptom-limited max tests)
