Chapter 7: Exercise, Sleep, and Injury Prevention

Physical Activity

Bodily movement produced by skeletal muscles

Physical Exercise

Planned, repetitive, and purposeful physical activity

Aerobic Exercise

Light-to-moderate-intensity exercise

Anaerobic Exercise

High-intensity exercise

Basal Metabolic Rate (BMR)

Minimum amount of calories the body needs to maintain bodily functions while at rest

Calorie

Measure of food energy equivalent to the amount of energy needed to raise the temperature of one gram of water to one degree Celsius

Physical Fitness

Includes set of attributes or characteristics that people have or achieve that relates to ability to perform physical activity

Muscular Strength

The amount of force a muscle can produce

Muscular Endurance

The ability of a muscle to sustain repeated contractions against resistance for an extended period

Flexibility

The range of motion available at a joint

Body Composition

The proportion of fat and non-fat mass in the body

Cardiorespiratory Endurance (Aerobic Fitness)

Ability of the heart, blood vessels, and lungs to supply oxygen to working muscles during physical activity for prolonged periods of time

VO2, VO2max

Measures of the maximum amount of oxygen the body can utilize during intense exercise

Costs of Inactive Lifestyle

Globally, physical inactivity costs $67.5 billion each year in health care costs and lower workplace productivity

Recreational Sitting

Engaging in sedentary activities during leisure time

Screentime

The amount of time spent using devices with screens, such as computers, televisions, and smartphones

Active Workstations

Work environments that encourage physical activity while working

Weight Control

Lower ghrelin during aerobic and resistance exercise; elevated peptide tyrosine-tyrosine (PYY) after aerobic exercise; reduced feelings of hunger after aerobic and resistance exercise

Healthy adults age range

Adults between the ages of 18 and 64 years.

Minimum moderate-intensity physical activity

At least 30 minutes, five days each week.

Minimum vigorous-intensity physical activity

At least 75 minutes of vigorous-intensity physical activity throughout the week.

Protection Against Chronic Illness

Increased physical strength, maintaining bone density through regular exercise; osteoporosis.

Chronic adult illnesses

Includes cardiovascular disease, certain cancers, diabetes, and metabolic syndrome.

Cholesterol levels

Lower triglycerides, lower LDL cholesterol levels, and higher HDL cholesterol levels.

Age-related declines

Delay of some age-related declines in white blood cells.

Metabolic Syndrome (MetS)

Cluster of conditions that include increased blood pressure, high blood sugar level, abdominal obesity, low HDL cholesterol level, and high triglyceride level.

Risks associated with Metabolic Syndrome

Increases a person's risk of heart disease, stroke, and diabetes.

Factors linked to Metabolic Syndrome

Closely linked to obesity, lack of physical activity, and insulin resistance.

Metabolic flexibility

Ability to adapt fuel oxidation to fuel availability.

Metabolic inflexibility

Inability to adapt fuel oxidation to fuel availability.

Psychological Benefits of Regular Exercise

Improved mood and improved sense of well-being.

Buffer against stress

Increased buffer against stress, anxiety, and depression.

Cognitive functioning

Predicts better cognitive functioning and reduced risk of dementia and Alzheimer's disease.

CDC recommendations for older adults

75-150 minutes of moderate to vigorous intensity aerobic exercise per week.

Muscle strengthening activities

Recommended twice weekly for older adults.

Benefits of physical activity in older adults

Associated with lower morbidity and mortality among physically active older adults.

Exercise participation decline

Percentage of people who exercise regularly declines with age and varies significantly across socioeconomic and ethnic groups.

Reasons for not exercising

Why do people not exercise?

Motives of People Who Are Most Likely to Stick with Exercise Programs

Enjoy exercise and believe in individual responsibility for personal health, have previously formed the habit, have social support for exercising, have a favorable attitude and a strong sense of self-efficacy.

Best Interventions for Individuals

Stage is matched to readiness and realistic expectations of the participant, variety of behavior change techniques (BCTs) are employed, focus addresses increasing participants' motivation, intentions, and perceptions of behavioral control and exercise self-efficacy.

Best Interventions for Community Programs

Involve individual and environmental factors, including demographic, biological, psychological, and social/cultural factors and public policy.

WHO Global Action Plan (2018b)

mHealth uses smartphones and other mobile technologies to promote health and well-being, associated with a small overall decrease in sedentary behavior and a moderate increase in physical activity levels.

Promoting Physical Activity During Cancer Treatment

Physical activity is safe and has benefits for many cancer patients.

Exercise Hazards

Exercise poses some hazards if done to excess, including exercise-related injury, death (sudden cardiac death), compulsive exercise, and exercise addiction; behavioral addiction.

Short Sleep Duration

Sleeping less than 7 hours each night.

Sleep Disorder

Any problem with sleeping.

Circadian Rhythm

24-hour cycle of night and day, internal biological clock, influenced by zeitgebers, or 'timekeepers'.

Sleep Stages

Brain operates on a 90-minute biological rhythm—four distinct sleep stages.

Types of Sleep

Non-rapid eye movement (NREM) and rapid eye movement (REM).

Sleep Patterns for Newborns

Newborns sleep 15 to 17 hours daily; one- to three-hour segments.

Sleep Needs for Adults

Average 6.8 hours sleep per day on weekdays, 7.4 hours a night on weekends for North American adults.

Social Jet Lag

Insufficient sleep correlates with social environmental factors impacting group differences.

Work Schedule and Stress

People who work long hours, at multiple jobs, and those who do shift work report poor sleep and a host of negative consequences including fatigue, sleep loss, and cognitive decline.

Sleep Debt

Cannot be repaid by one long sleep, slows reaction times, increases errors on visual attention tasks, and is a predictor of depression.

Poor Sleep

Takes a toll on physical and psychological well-being, includes partial sleep loss, sleep restriction, and short sleep.

Insomnia

One of 10 other sleep-wake disorders.

Effects of Chronic Sleep Loss

Increased body weight, BMI, and obesity; higher percentage body fat; increased ghrelin and decreased leptin; elevated levels of cortisol; suppressed immune functioning; chronic inflammation; insulin resistance; cardiometabolic disease promotion; impaired concentration, memory, and creativity.

Cognitive-Behavioral Therapy for Insomnia (CBT-I)

Targets underlying insomnia causes, treatment is individually tailored and may include a variety of approaches such as stimulus control therapy, relaxation training, sleep environment improvement, sleep restriction, and sleep hygiene.

Narcolepsy

Characterized by sleep attacks and abnormal REM sleep, triggered by a gene deficiency in hypothalamus cells that produce hypocretin.

Sleep Apnea

Temporary cessation of breathing, higher risk with higher BMI, most common is obstructive sleep apnea; some help from CPAP.

Tips for Improving Sleep

Set a bedtime that is early enough for you to get at least 7 hours of sleep. Don't go to bed unless you are sleepy; if you don't fall asleep after 20 minutes, get out of bed. Use your bed only for sleep and sex.

Limit exposure to bright light

Turn off electronic devices at least 30 minutes before bedtime.

Large meal before bedtime

Don't eat a large meal before bedtime.

Light, healthy snack at night

If you are hungry at night, eat a light, healthy snack.

Caffeine consumption

Avoid consuming caffeine in the late afternoon or evening.

Alcohol consumption before bedtime

Avoid consuming alcohol before bedtime.

Fluid intake before bedtime

Reduce your fluid intake before bedtime.

Exercise and diet

Exercise regularly and maintain a healthy diet.

Sleep deprivation

Increases risk of human error-related accidents.

Intentional injuries

Injuries that are purposely inflicted.

Unintentional injuries

Injuries that occur without intent to harm.

Healthy People 2030 goal

Reduction of overall rate of unintentional injuries and motor-vehicle-crash-related deaths.

Leading causes of death for ages 1 to 24

Includes a number of causes, shifting as age increases.

Chronic conditions in older age groups

Account for more deaths than external causes do.

Injuries in Childhood

Healthiest time for school-aged children in developed nations.

Unintentional Injury in Adolescence

Leading cause of death among adolescents.

Poor decision-making and impulsivity

Contributes to unintentional injuries in adolescents.

fMRI scans in adolescents

Indicate brain areas that respond to excitement and pleasure are more active than areas that control inhibition.

Teen drivers' underestimation

Teens are more likely to underestimate dangerous situations.

Preventive measures for young drivers

Four measures have saved hundreds of lives.

Graduated driver licensing (GDL)

A preventive measure for young drivers.

Restricted night driving

A preventive measure for young drivers.

No teenage passengers

A preventive measure for young drivers.

Zero tolerance for alcohol

A preventive measure for young drivers.

Leading Causes of Death in Adulthood

Includes car accidents, poisoning, and homicide among ages 25 to 34.

Unintentional poisoning death

Increasing steadily since 1992; 98,000 worldwide in 2013.

Homicide statistics in 2015

There were 17,793 homicides in the United States.

Suicide prevalence

Nearly one million people worldwide die by suicide each year.

Firearms in suicides

Most commonly used method among males.

Falls as a cause of death

Second leading cause of unintentional death worldwide.

Injury Prevention Targets

Includes individual behaviors, physical environment, access to service, social environment, and societal-level factors.

Levels of Prevention

Includes primary prevention, secondary prevention, and tertiary prevention.