KIN 481 Quiz 3: Comprehensive Review of Dietary Guidelines and Exercise Impacts

hypertension

high blood pressure

BP is determined by what two things?

the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries

the more blood the heart pumps and the narrower the arteries, the ______ the blood pressure

higher

negative cycle of blood pressure

if BP is too high, artery wall muscles will respond by pushing back harder, making them thicker, leaving less space for blood flow, making BP even higher

what happens when BP is too high?

higher pressure puts extra force on heart and vessels, increasing the risk of heart disease, stroke, kidney disease over time

risk factors for hypertension

lack of physical activity, smoking, alcohol consumption, family history, too much salt, older age

how many people in the US have hypertension? this is _ in _ adults

108 million; 1 in 3

in 2017, how many deaths in the US included hypertension as a primary or contributing cause?

472,000 (1300 deaths each day)

hypertension is defined as a systolic blood pressure at or above

130 mmHg

hypertension is defined as a diastolic BP at or above

80 mmHg

systolic pressure

the amount of pressure the heart generates when it contracts and pumps out blood

diastolic pressure

the amount of pressure in the arteries when the heart rests between beats

normal BP

120/80 mmHg

elevated BP

systolic is 120-129; diastolic is at or below 80

stage 1 hypertension

systolic is 130-139 or diastolic is 80-89

stage 2 hypertension

systolic is greater than 140 or diastolic is greater than 90

BP increases during

exercise

during exercise, in people with hypertension, SBP could be extremely high, sometimes even greater than

250 mmHG

what happens to DBP during exercise? why?

remains constant or sometimes decreases; to create more space for the increased blood flow during exercise, arteries dilate so DBP remains the same

what three factors that affect blood pressure increase during exercise to meet muscles' increased oxygen demand and cause SBP to rise?

blood volume, stroke volume, heart rate

effects of aerobic exercise training on BP

5-10 mmHG reduction in resting BP

how does regular physical activity lower your BP?

regular PA makes your heart stronger, so it can pump more blood with less effort, lowering the force on your arteries, lowering BP

stop exercise testing when SBP is greater than ___ mmHg and/or DBP is greater than ... mmHG

250; 150

true or false: you should consult with a physician and obtain clearance prior to PA in people with hypertension

true

senior fitness test

30 sec chair stand, 30 sec arm curls, 8 ft up and go, 6-min walk, 2-min step test, sit and reach, and back scratch

for exercise programming for individuals with hypertension, benefits are greater when

the individual loses weight

for exercise programming for individuals with hypertension, it is advisable to accumulate more than how many minutes per week?

150

if you're exercise programming for an individual with only hypertension and no other conditions, follow

healthy individual guidelines

if you're exercise programming for an individual with both hypertension and other conditions, follow

chronic disease individual guidelines

special considerations for hypertension

meet physician, self-guided methods, watch out for adverse effects of hypertension medicine, increase caloric expenditure and reduce caloric intake, do moderate PA

general exercise prescription for individuals with hypertension

emphasis on aerobic training, but can be supplemented with moderate intensity resistance training, should do flexibility after warmup/cooldown and follow guidelines for healthy adults

frequency recommendation for hypertensive individuals

aerobic on most/all days, RT on 2-3 days

intensity recommendation for hypertensive individuals

moderate intensity aerobic exercise, RT at 60-80% 1RM

time recommendation for hypertensive individuals

30-60 min per day of continuous or intermittent aerobic (minimum 10 min bouts); at least 1 set of 8-12 reps

progression recommendation for hypertensive individuals

same as healthy adults, but should give consideration to level of BP control, and effects of BP meds

dyslipedmia

abnormal blood lipid and lipoprotein concentrations

hypertension and ____________ frequently occur together due to physical inacitvity

dyslipidemia

__% of the US population has dyslipidemia and nearly half (108 million or 45%) have ____________

30; hypertension

lipoprotein

soluble proteins that combine with and transport fat or other lipids in the blood

which lipoprotein decreases in dyslipidemia? which increases?

HDL decreases; LDL increases

why is LDL bad?

it becomes a part of plaque that clogs arteries and increase risk of stroke and heart attack

___________ is in all cells of the body, and we need it to make hormones and substances that help digest food

cholesterol

true or false: we need dietary forms of cholesterol

false; your body produces all of the cholesterol it needs

why is HDL good?

carries LDL away from arteries and back to liver to be broken down

true or false: dyslipidemia is a major cause of CVD, heart attacks, and stroke

true

meta-analysis

statistical procedure for combining data from multiple studies and identifying the common effect/finding among studies

benefits of exercise on blood lipids

5-10% increase in HDL, 5-10% decrease in LDL

although patients with dyslipidemia should consult with their doctor prior to PA and follow self-guided methods and CVD risk factor classifications, this is not required for ____________ patients at....

asymptomatic; light to moderate intensity

if an individual only has dyslipidemia with no other conditions,

follow healthy individual guideline

if a patient has dyslipidemia with other conditions,

use chronic individual guidelines

the FITT principle for patients with dyslipidemia without comorbidities is very similar to the FITT principle for healthy adults, but an important difference is

weight maintenance should be emphasized; use aerobic exercise

special considerations for dyslipidemia

FITT may need to be modified is dyslipidemia is present with other chronic diseases

true or false: being overweight or obese can lead to CVD risk factors, diabetes, cancers, and musculoskeletal problems

true

in the US, more than __% of adults are overweight or obese, with __% obese

68; 34

in the US __% of children are overweight or obese, with __% obese

32; 18.5

overweight and obesity accounts for how much of the total health care cost in the US?

10%

underweight bmi

normal bmi

18.5-24.9

overweight bmi

25-29.9

obese class I bmi

30-34.9

obese class II bmi

35-39.9

extreme obesity class III bmi

over 40

weight gain is a complicated process determined by causes and risk factors such as

activity, diet, genes, social/economic issues

how is activity related to obesity?

obesity occurs when people take in more calories than they burn via activity

how is diet related to obesity

lots of Americans' diets are too high in calories; people with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety

how do genes affect obesity?

may affect amount and location of body fat, may affect food to energy conversion, appetite, and calories burned during exercise, tends to run in families due to genes and similarities in eating/activity habits

the 2015-2020 dietary guidelines for Americans recommends cutting ___-___ calroies per day to lose 1.0-1.5 lbs per week

500-700

cushing syndrome

rare disease where too much cortisol produced, raises blood glucose, so insulin is released in response and distributes glucose to fat cells, which get bigger and increase in number (obesity)

exercise testing is often not necessary in OW/OB populations prior to _____ intensity exercise. Individuals should use the self-guided method, pre-screening, and CVD risk factor classification and the senior fitness test

light

exercise programming for individuals with obesity alone

follow healthy individual guidelines with the goal of more than 250 minutes of MVPA per week (freq = 5-7 days/wk)

exercise programming for individuals with obesity with other conditions

use chronic disease individual guidelines; LMPA 5-7 days/wk; multiple bouts as an option (10 minute minimum per bout)

special considerations for obesity

target a minimum reduction in at least 3-10% weight over 6 months (reduction of 500-1000 calories per day to achieve 1-2 lbs/wk), and incorporate exercise into daily life

________ is the leading cause of kidney failure, lower limb amputations, and adult onset blindness

diabetes

in the last twenty years, the number of adults diagnosed with diabetes has more than _______ as the American population has aged and become more overweight or obese

tripled

___ million US adults have diabetes and _ in _ of them don't know they have it

30.3; 1 in 4

in the US, __ million adults (more than 1 in 3) have prediabetes, and __% of them don't know they have it

84.1; 90%

Prediabtetes

condition in which blood sugar levels are higher than normal, but not high enough to be type 2 diabetes

diabetes

a group of metabolic diseases that affect how the body uses glucose

glucose comes from two major sources:

food and liver

glucose is absorbed into the _____, where it enters cells with the help of _______

blood; insulin

brain's main source of fuel

glucose

most common types of diabetes

type 2 mellitus, type 1 mellitus, prediabetes, gestational diabetes

causes of diabetes

body can't make enough insulin or does not produce insulin or can't use its own insulin (resistance)

insulin

hormone produced by pancreas that unlocks cells so glucose can enter and be used for energy; regulates blood glucose levels by signaling cells to take in glucose

criteria for diabetes

fasting BG > 125 mg/dL OR two-hour glucose > 200 mg/dL

fasting BG for prediabetes

100-125

fasting BG for diabetes

126 or higher

normal fasting BG

70-100

two hour glucose diabetes level

over 200

two hour glucose normal level

less than 140

two hour glucose prediabetes

140-199

type 2 diabetes

cells are resistant to insulin; obesity adds pressure on using insulin, most common type (more than 90% of cases), exact cause is unknown

type I diabetes

no/not enough insulin produced; immune system destroys insulin producing cells in pancreas; need to take insulin every day; no cure; exact cause is unknown

diabetes complications

CVD: increases risk of CAD, MI, stroke, atherosclerosis

Nerve damage: high glucose damages BV walls that supply nerves, especially in lower body

Kidney damage: damages filtering system of kidneys due to too much glucose being filtered

Eye damage: high glucose damages BVs of retina

Skin conditions: more susceptible to skin problems that lead to infection

Alzheimer's: high BG increases risk of Alzheimer's but hasn't been proven

True or false: senior fitness test and 6 minute walk are recommended for exercise testing for diabetes patients

true

medical supervision is necessary for what intensity of exercise for diabetes pts?

MVPA

exercise programming for diabetes

follow healthy individual guidelines; start with LPA. gradually increase to 150-250 min/wk of MPA (aerobic), could try VPA (aerobic)

goal for diabetes patients for aerobic exercise

more than 250 min/wk of MPA