Unit 1 Flashcards
6 dimensions of the wellness model:
- Occupational
- Physical
- Social
- Intellectual
- Spiritual
- Emotional
Dimension of the wellness model: Occupational
A persons satisfaction in ones life through work.
- you contribute your gifts, skills and talents to work that is rewarding
- you convey your values through your activities
A. It is best to choose a career that is in line with your personal values.
B. Best to learn by being involved
Dimension of the wellness model: Physical
A persons need for regular physical activity; physical function of the body
- learn about diet and nutrition, appropriate use of medical care system
- know your body
A. Best to eat foods/drinks that enhance good health
B. Best to be physically fit than out of shape
Dimension of the wellness model: Social
Encourages contributing to the environment/community.
- interdependence between others and nature contributing to society
A. Best to contribute to common welfare of our community than to think only of ourselves
B. Best to live in harmony with others and our environment than to live in conflict with them
Dimension of the wellness model: Intellectual
Ones creative mental activities; expanding personal gifts with others.
- reading, problem solving, learning
A. Stretch minds with intellectual and creative pursuits than to become self-satisfied and unproductive
B. Identity potential problems and choose good courses of action based on available information than to wait, worry, and contend with major concerns later.
Dimension of the wellness model: Spiritual
Meaning of life; feelings of doubt and joy; “world view”
A. Best to ponder the meaning of life for ourselves and to be tolerant of the beliefs of others than to close our minds and be intolerant.
B. Live each day in a way that is consistent with our values and beliefs than to feel untrue to ourselves.
Dimension of the wellness model: Emotional
Feelings (awareness); coping.
A. Be aware and accept our feelings than to ignore them.
B. Be optimistic not pessimistic.
Health
State of complete physical, mental, and social wellbeing.
- health is multi-dimensional and well connected
- it is not merely the absence of disease or infirmity
Physical Activity
Any body movement; action
- contributes to multiple aspects of wellness
- prevents and treats many health conditions
- essential for health
- not enough people PA to reap all the benefits
Exercise
Activity that enhances aspect of fitness; specific and intentional; planned
Fitness or “fit” person
Attainment of specific criteria to function efficiently and effectively; combo of several aspects
Who is fittest between between a sprinter, wrestler, swimmer or gymnast
There is not right answer; they are all different in different categories of fitness
- fitness is multidimensional
Health related aspects of fitness
- cardiovascular endurance
- muscular endurance / strength
- flexibility
- body composition
Skill related aspects of fitness
- Agility
- Balance
- Coordination
- Power
- Speed
- Reactant time
Nonperformance Components of Fitness
Metabolic fitness
Bone Integrity
Nonperformance Components of Fitness: Metabolic Fitness
- Blood sugar levels
- Blood lipid levels
- Blood hormone levels
Nonperformance Components of Fitness: Bone integrity
- Bone density
- Bone strength
Public Health
To promote and protect health and prevent disease and disability in defined populations and communities.
- focus on population health and prevention
How has there been a shift in public health over the last 100 years?
From infectious disease (communicable) to chronic diseases (non-communicable)
Chronic disease is influenced by what?
Lifestyle and genetics
Areas of specialization in public health
- Epidemiology
- Environmental Health
- Health promotion and education
- Health administration and policy
- Biostatistics
Epidemiology
The study of distributions and determinants of disease and disability in populations.
- causes and consequences of a disease
Environmental Health
External influences of health.
ex. hand washing practices, clean drinking water
Health promotion and education
Strategies to help people change
Health Administration Policy
The management of health projects
Biostatistics
Analysis of data, interpretation of study results, putting results into action
Core functions in Public Health
Assessment –> policy development –> assurance
Core functions in public health STEPS
- Monitor health status
- Diagnose and investigate
- Inform and educate
- Mobilize community partnerships
- Develop policies
- Embrace laws and regulations
- Link to health care
- Assure competent healthcare workforce
- Evaluate health services
- Research solutions to health problems
Kinesiology and 3 disciplines
Study of the physiological processes and anatomy of the body during movement.
3 disciplines:
- exercise physiology
- movement sciences
- sport and exercise psychology
Exercise physiology
Physiological processes
Movement sciences
Motor learning, motor control, biomechanics
Sport and exercise psychology
Behaviors and outcomes related to sports or exercise
Movement: Sliding filament theory
Muscle contraction; series of chemical reactions - you need ATP
- myosin have heads which connect onto actin. The myosin shortens which causes contraction of the muscle
Fast twitch muscle fiber
- stains light
- anaerobic
- suited to strength and speed
Slow twitch muscle fiber
- stains dark
- aerobic
- suited to endurance activity
Energy
Comes from food (fats, proteins, carbs)
Energy production options: Anaerobic
Immediate source of energy
- creatine phosphate system
- fast energy production, short lasting (10 seconds)
Energy production options: Aerobic
Long term source of energy
- oxidative phosphorylation
- uses fat as energy source
- slower energy production; long lasting (3 minutes)
Short term source of energy
- glycolysis (glucose stored in cell within muscle)
- results in APT and pyruvate
- fast energy production, intermediate (20-120 sec)
Graded exercise test (GXT)
A way to study exercise
- conducted on a treadmill
- multiple stages (increase)
- max or submax
Determines a normal response and maximal aerobic capacity
Graded exercise test (GXT) measures?
heart rate, BP, perceived exertion, gas exchange, blood lactate
VO2 Max
Determined as the ability of the body to transport and use oxygen.
- maximal amount of O2 used at maximal exercise
- depends on the body type and the physical conditioning
- maximal aerobic capacity
Maximum oxygen consumption can also be defined as
VO2 max
How do you measure VO2 Max?
Start slow and go fast until you plateau until you need to stop. Then you get your VO2 max
?
VO2 Max equation
VO2 max = mL (oxygen) / kg (body weight) / min
Caloric expenditure
- Related to the volume of training over time
- about 30% of total energy expenditure - Exercise increases metabolic rate
- MET = metabolic equivalent
- Energy Expenditure (EE)
Exercise increases metabolic rate
Function of the amount of oxygen used by the body.
Volume of oxygen –> L/min or mL/kg/min
- kg body weight
MET = metabolic equivalent
1 MET = resting energy expenditure
1 MET = 3.5 mL oxygen / kg / min
1 MET = 1 kcal / kg / hour
Energy Expenditure (EE) types
Gross EE: PA plus resting EE
Net EE: PA only (subtract the resting EE)
Cardiovascular Exercise Variables
- Heart rate
- BP (systolic / diastolic)
- Stroke volume
- Cardiac output (Q)
Heart rate
Frequency of heart beats per minute
BP (systolic / diastolic)
The pressure that blood exerts on blood vessels
a. Systolic (contracting; pumping; 120 is ideal)
b. diastolic (relaxed; filling; 80)
Stroke volume
The amount of blood pumped with each heart beat
Cardiac output (Q)
The amount of blood pumped from the heart per minute of exercise (L/min)
heart rate x stroke volume
Cardiovascular Exercise Variables
- O2 extraction
- avO2 difference
- VO2
- VO2max
O2 Extraction
The amount of oxygen removed from the blood
avO2 difference
The difference between artery oxygen values and venous oxygen values in muscles
VO2
Volume of oxygen utilized during exercise
- directly related to intensity of exercise
- function of the amount of blood pumped and extracted
What is the bodies challenge during exercise?
The challenge is to maintain homeostasis during changes that exist due to movement to skeleton
Short term effects of one exercise session: Cardiovascular
- heart rate increases
- ventilation increases
- cardiac output increases
- avO2 difference increases
- blood flow increases
- BP (systolic) increases; diastolic stays about the same
- Coronary circulation increases
Short term effects of one exercise session: Resistance exercise
- heart rate increases
- ventilation increases
- BP (s&d) increase
- VO2 max increases
Short term effects of one exercise session: Stretching
- heart rate increases (slightly)
- ventilation increases (slightly)
- BP increases (slightly)
If you want to increase your fitness, you need to know the Principles of Training, which are…
- Specificity
- SAID = specific adaptations imposed demands - Overload
- training effect occurs when the body is challenged at a level beyond which its normally accustomed
- FITT (frequency, intensity, time, type) - Progression
- the overload must increase over time - Reversibility
- gains are lost once the overload is removed
Long term effects of exercise (6+ months): Cardiovascular
- resting heart rate decreases
- exercise heart rate decreases
- resting systolic BP decreases
- VO2max increases
- stroke volume increases
- cardiac output (max) increases
- avo2 difference increases
- blood flow (max) increases
- coronary circulation increases
Long term effects of exercise (6+ months): Resistance exercise
- muscle fiber types stay the same
- muscle fiber recruitment increases
- fast twitch muscle fiber size increases
- BP (rest and exercise) decreases
- vo2max increases (slightly)
Long term effects of exercise (6+ months): Stretching
- heart rate and BP stay same
- muscle fiber length increase
- CT length increases
Endurance training and VO2 max
Cardiovascular overload leads to a higher VO2 max
Expected changes:
- avg. = 15% increases in VO2 max
- 2-3% in those with high initial VO2 max
- 30-50% in those with low initial VO2 max
- “non-responders”
- 5-10% population will see no increase in VO2 max
- Genetic predispostion
- accounts for 40-66% of VO2 max value
- prerequisite for VO2max of 60-80 mL/kg^-1/min^-1
Why does VO2 max increase?
- The heart adapts to deliver more O2
- stroke volume increases
- coronary circulation increases - More mitochondria in muscles to use oxygen available
Lactate Threshold (LT)
Blood lactate - indication of glycolysis
The point at which lactate begins to accumulate in the blood.
- indicates a switch to anaerobic metabolism as the primary source of ATP
- corresponds with fatigue but not caused by lactate
rest is 2
Why does the lactate threshold (LT) shift after training?
- Increased blood flow (remove lactate)
- Greater reliance on aerobic metabolism due to more mitochondria (less lactate)
- Important marker for cardiovascular training
- train at the LT
- increase performance
Aerobic training: Metabolic changes
- More rapid transition from rest to steady state
- Reduce reliance on glycogen stores`
Aerobic training: Bone density changes
- Bone density, ligaments and tendon sheaths enhance
Aerobic training: cardiovascular
heart gets bigger
Aerobic training: thermoregulatory adaptations
You swear easier
Aerobic training: structural and biomechanical changes in muscle
- mitochondria increase
- capillary density increase
- increase storage of glycogen
- increase ability to use fat for fuel
Strength training: physiological adaptations
- Neural factors
- increased ability to activity motor units
- strength gains in initial 8-20 weeks - Muscular enlargements
- mainly due to the enlargement of fast twitch fibers (hypertrophy)
- may be due to the increase of fibers (hyperplasia)
Affects of aging
- changes due to aging are similar to detraining
- HR max decreases
- Stroke volume decreases
- reduction in…
- reaction time
- coordination
- balance
- flexibility
- strength
- loss of muscle fibers
Affects of sex
- women decrease cv and strength in muscles
why? - they have higher body fat
- they have lower hemoglobin levels
- their heart is smaller (less stroke vol., higher HR)
Men have higher testosterone which is good for muscle growth
Physical Activity Epidemiology (PAE)
The study devoted to understanding…
- who is physically active?
- how much activity do they do?
- where are they active?
- when are they active?
- why are they active?
- what do they do?
- how does this affect disease?
Morris, et al, 1953
Experiment in buses in London
- compared the driver (mostly sitting) vs conductor (mostly standing) because they most likely came from the same background
- looked at heart disease
- overall, drivers were more at risk for heart disease because they were less physically active
- look at this study in ch. 3 notes
PA measurement: Total Energy Expenditure (TEE)
- Thermic effect of food
- energy used to metabolize food/drinks
- 10% of TEE - Physical Activity
- 25% of TEE - Basal Metabolic Rate
- energy to maintain breathing and circulation at rest
- 65% of TEE
Lab Methods to measure PA
Indirect calorimetry and Doubley Labeled Water
Outside of the lab ways to measure PA
- Electronic
- accelerometer / pedometer
- expensive and not always practical - Direct observation
- trained observers - Indirect
- fitness tests (measure physical fitness) - Self reported instruments
- diaries (record your PA)
- interviews
- questionnaires (you respond to questions / can be face - to - face)
Indirect calorimetry: pros and cons
Pros:
- accurate
- measures BMEE
Cons:
- expensive
- time consuming
- no “real life” PA
Doubly labeled water: pros and cons
Pros:
- accurate
- measures TEE
Cons:
- expensive
- no data on PA behavior
- equipment
- can’t specify energy from PA
questionnaires: pros and cons
Pros:
- large #
- inexpensive
- practical
cons:
- time to analyze data
- validity (self-report)
- reliability (time)
Electronic & Direct Measurements: pros and cons
Pros:
- accurate, reliable
Cons:
- expensive, may influence behavior, time consuming to analyze data
Diary / logs: pros and cons
Pros:
- specific to activities
Cons:
- inconvenient for researchers / participants; may influence behavior; time consuming
PA Surveillance: Behavioral Risk Factor Surveillance System (BRFSS)
Phone survey that takes data on demographic info., health status, checkups, and behaviors
PA Surveillance: National College Health Assessment (NCHA)
800 UI students; HPAS courses; variety of health perceptions and behaviors
PA Surveillance data is used to:
- Identify health risks
- Identify population differences (disparities)
- Monitor change over time
- Direct health initiatives
- Measure progress
Compare how men and women spend their time
Men:
- household work has increased (10 hr/wk+)
Women:
- household work has decreased (18 hr/wk+)
PA trends in the last 50 years
- Leisure time PA: slightly increased
- Work related activity: decreased
- Transportation activity: decreased
- Activity in home: decreased
- Sedentary activity (TV): increased
- Total PA: decreased
Data on PA From: Brownson, et al., 2005
Statistics and Factors related to PA participation…
- Leisure time PA data
- Employment/occupation data
- Travel behavior
- Land use (where we live / how far away you are from where you need to be)
- Sedentary behaviors
Prevalence
Total number of cases of a disease/condition in a given population at a specific time
Trend
A long term movement or change in frequency
Recommended amount of PA
20 minutes vigorous 3x/wk or 30 minutes moderate 5x/wk
How do adults and UI students compare to the recommended amount of PA
(20 minutes vigorous 3x/wk or 30 minutes moderate 5x/wk)
Adults:
- 50.2% engage in PA at this level
- slight improvement from 2001-09
- highest: Alaska, Montana, Colorado, Idaho, Wyoming
- lowest: TN, Mississippi, Alabama
UI:
- 59% meet aerobic recommendations
- 46.1% of students did strengthening exercises 2x/wk
(not sure if these % are correct)
UI Students - Strengthening Exercise
- 47.9% of students did strengthening exercises (8-12 reps) at least 2 days a week
- increase from 41.8% in 2009, 43.3% in 2011, and 46.1% in 2012 - Men were more likely to meet the recommendations than women
- 58.7% of men vs 38.5% of female students
(not sure if these % are correct - see the most recent graph in the NCHA report)
Youth
- Physical activity (60 min., 7x/wk)
- 17.1% - Inactivity
- 24.2% male; 37.9% female
- 24.3% 9th grade to 38.9% 12th grade - Daily PE declined 1991 - 2010
- 41.6% to 30.3%
Recommendations for PA are higher for youth than adults
What age group is the most active of your population?
youth
Gender trends in PA
Men more active than women
Race / Ethnicity PA trends
White/non-hispanic > hispanic > black/non-hispanic
Does PA go up or down with age?
declines with age
- 18-24 year olds are most active (adults)
How does education and income levels reflect level of PA
They are more likely to get more PA if they have an education and a good income
Dose response
The amount of PA/exercise necessary to achieve a specific outcome
- based on FITT
Hypothesis - Benefit / Dose
- Curve A
- Curve B
- Curve C
Curve A: Disease risk is reduced from HIGHER levels of PA
Curve B: Disease risk is reduced A BIT by each incremental increase in PA
Curve C: Disease risk reduced from LOW to MODERATE levels of PA
How much PA is enough?
Depends on age, risk factors, health status, and PA/fitness goals
PA Recommendations: brief history
1960’s - focus on exercise and performance
- American Heart Association (1961) stated that exercise reduced the risk of heart disease
- American College of Sports Medicine (1975) –> exercise testing and prescription guidelines & recommended 3x/wk, 60-90% HRMax 15-60 minutes
1980’s
- evidence of benefits for moderate intensity exercise
History of the PA Guideline Books
1996: PA and Health
2008: 2008 PA Guidelines for American
2018: PA Guidelines for American 2nd edition
Surgeon General Report
Landmark Publication
- public health approach
- benefits of moderate intensity PA (30 min., 5x/wk recommendation)
There was a list of exercise that went from less vigorous and more time to more vigorous and less time. The activities were equivalent activities (~150 kcals / session)
Surgeon General Report challenges?
- FITT? Specifics?
- Combine different intensities of PA?
- resistance training?
Most benefits are attained w at least how much PA?
150-300 minutes of moderate PA a week
Move more sit less…sedentary behavior increases the risk of
- all cause mortality
- CV disease mortality
- CV disease
- type 3 diabets
- colon, endometrial, lung cancers
PA Guidelines for Adults: Aerobic
150 minutes of moderate of 75 minutes of vigorous intensity activity or and equivalent combination per week
- vigorous PA x2 = moderate intensity exercise
- additional benefits 300+ min./week
PA Guidelines for Adults: Muscle Strengthening
2 days per week
- moderate or greater level of intensity exercise
- major muscles (leg, hip, back, chest, abdomen, shoulders, arm)
1 set = 8-12 reps (2-3 sets is more effective)
Exercise Intensity: Absolute terms
Based on the absolute energy cost of PA (same for all)
- METs
- Moderate = 3-5.9 MET
- Vigorous = 6.0+
PA Guidelines uses Absolute intensity term
Exercise Intensity: Relative terms
Based on how easy or difficult PA is for that individual
Options:
- RPE = Rating Perceived Exertion
- % Heart Rate Max
- % MET max or % VO2 max
- Talk test (if you can hold basic convo with someone)
Key messages for adults:
- move more, sit less
- Some activity is better than none
- adults who sit less and do any amount of (mod/vig.) PA gain some health benefits
- Aim for 150 minutes of mod. intensity PA + 2 days of resistance training
- benefits up to 300 min. of moderate int. PA (no upper limit)
Key Guidelines for Preschool-Aged Children (3-5)
A specific amount of activity is not well defined
- reasonable target = 3 hr/day of light, moderate, and vigorous intensity
Should be physically active throughout the day to enhance growth/dev.
- active play
- structure activities (throwing games, bike/tricycle riding)
- bone strengthening (hopping, skipping, jumping, tumbling)
Adult caregivers should encourage active play that includes a variety of activity types.
Key Guidelines for School-Aged Children and Adolescents (6-17)
60 min. of daily PA; unlike adults, muscles strength activities DO count toward the 60 minutes.
We also do not distinguish between moderate and vigorous intensity activity (for children, we do not multiple vig. activity by 2 to get the moderate minutes)
- age appropriate, enjoyable, variety
Key Guidelines for School-Aged Children and Adolescents (6-17): Aerobic
Most of the 60+ min./day moderate-vigorous intensity
- vig. at least 3 days a week (20 min)
Key Guidelines for School-Aged Children and Adolescents (6-17): Muscles strengthening
As part of their 60 minutes
- at least 3 days of the week
Key Guidelines for School-Aged Children and Adolescents (6-17): Bone strengthening
As part of their 60 minutes
- at least 3 days a week
Key Guidelines for Older Adults
Same as adults; but just for the older adults…
1. Weekly PA should include multicomponent PA (balance training, aerobic and muscle strengthening)
- Level of effort relative to level of fitness
- Since older adults are more likely to have chronic cond.:
- they should know how their cond. affects their ability to do regular PA
- when unable to achieve 150 minutes of moderate intensity PA because their cond., they should still be as active as their bodies allow them to be
Key Guidelines for Adults with Chronic Health Conditions and Adults with Disabilities
- 150 minutes moderate intensity, spread through week
- 2 days of muscle strengthening activity; major groups
- be as active as condition allows
- discuss conditions with health care provider
Key Guidelines for Women During Pregnancy and the Postpartum Period
- Healthy women, inactive OR less than 150 min.:
- achieve 150 minutes of moderate PA during pregnancy and postpartum - Healthy, vigorously active women:
- continue regular activity during pregnancy and postpartum
Under the care of a healthcare provider who can monitor the progress of the pregnancy.
Women who are pregnant can consult healthcare providers about whether or how to adjust their PA during and after pregnancy
Key Guidelines for Safe Physical Activity
- Understand risks, yet be confident that PA can be safe for almost anyone
- Chose types of PA that’re appropriate for their current fitness level and health goals because some activities are safer than others
- Increase PA gradually over time to meet key guidelines for health goals. Inactive people should “start low and go slow” by starting with lower intensity activities and gradually increasing how often/long activities are done.
- Protect selves by using correct gear, choosing a safe environment, following rules and policy, and making sensible choices about when, where and how to be active
- Be under care of a healthcare provider if you have chronic conditions/symptoms. People with chronic conditions/symptoms can consult health care professional specialist about types and amounts of activity appropriate for them
