Lecture 1 Study Guide

Prevalence of obesity in the United States (%)

42.4 % overall

what is the highest rates of obesity occur in what population

non-Hispanic black women

what is obesity a risk factor for

-cardiometabolic disease

-metabolic syndrome

what is metabolic syndrome associated with a higher risk for what

-diabetes

-cardiovascular disease (CVD)

what are possible phenotypes described in studies

-normal BMI and metabolically healthy

-obese BMI and metabolically healthy

-normal BMI and metabolically unhealthy

-obese BMI and metabolically unhealthy

can someone be obese and metabolically healthy

yes

characteristics of someone with normal BMI and metabolically healthy

-reduced fat

-increased muscle

-increased fitness

-normal insulin sensitivity

-normal blood sugar

-low cardiovascular risk

characteristics of someone with obese BMI and metabolically healthy

-excess subcutaneous fat (compared to visceral)

-increased muscle

-increased fitness

-hyperinsulinemia

-normal blood sugar

-mild cardiovascular risk

characteristics of someone with normal BMI but metabolically unhealthy

-chronic illness

-muscle loss

-excess visceral fat

-reduced fitness

-insulin resistence

-diabetes

-inflammation

-high cardiovascular risk

-high cancer risk

characteristics of someone with obese BMI and metabolically unhealthy

-excess visceral fat (subcutaneous)

-muscle loss

-reduced fitness

-hyperinsulinemia

-diabetes

-dyslipidemia

-inflammation

-high cardiovascular risk

-high cancer risk

sedentary behavior definition

characterized by the energy expenditure of less than 1.5 METs while sitting, reclining, or lying posture

long term sitting has a negative influence on

-glucose and insulin control

-lipid metabolism

-vascular function

long term sitting has an increased risk for

-diabetes

-heart disease

-cancer

-risk for all cause mortality

MET range for light activity

1.6-2.9 METs

exercises that fall into the MET range for light activity

-walking slowly around home/store (2)

-standing performing light work, making bed, etc. (2-2.5)

-leisure time and sports such as billiards, boating, etc. (2.5)

MET range for moderate activity

3-5.9 METs

exercises that fall into the MET range for moderate activity

-walking at he normal pace (3)

-walking at the brisk pace (5)

-household and occupation like cleaning, heavy washing, sweeping floors (3-3.5)

-walking lawn mower (5.5)

MET range for vigorous activity

greater than 6 METs

exercises that fall into the MET range for vigorous activity

-walking at a very very brisk pace (6.3)

-walking and hiking at a moderate pace (7)

-hiking at steep grades (7.5)

-jobbing at 5 mph (8)

-jogging at 6 mph (10)

-running at 7 mph (11.5)

2018 Physical Activity Guidelines for Americans

´Frequency: weekly

´Intensity: moderate, aerobic

´Duration: 150+ min/wk

OR

´Frequency: weekly

´Intensity: vigorous, aerobic

´Duration: 75+ min

PLUS

´2+ days/wk muscle-strengthening exercises

´OR

´Equivalent mix of moderate and vigorous aerobic activities + muscle strengthening

´MOVE MORE! Any amount of PA is good for you!

the physical activity guidelines added to the 2018 guidelines

-for inactive people, physical activity of any intensity (even light intensity) can lead to health benefits

-a single bout of physical activity provide health benefits

-any bout of moderate or vigorous physical activity can be counted towards physical activity volume when working towards meeting physical activity recommendations

moderate activity guidelines (2008)

-30 minutes

-5 days a week

vigorous activity guidelines (2008)

-20 minutes

-3 days a week

2018 moderate intensity guidelines

150-300 minutes of moderate intensity

2018 vigorous intensity guidelines

75-150 minutes of vigorous intensity

can you manipulate parameters to obtain a moderate dosage of physical activity when working toward meeting the physical activity guidelines

yes (you can manipulate multiple options)

what can you manipulate to obtain a moderate dosage of physical activity when working toward meeting the physical activity guidelines

-frequency (days)

-intensity (light, moderate, heavy)

-times (duration)

-type (mode)

dose-response relationship of physical activity/ risk reduction

there are greater benefits (and reduction in risk) with exercise/ physical activity done at high durations and/or intensity when the minimum recommendations in the physical activity guidelines for Americans are surpassed

what is the goal of physical activity

reduce risks

ACSM classifies intensity as

-very light/light

-moderate

-vigorous

-near maximal

RPE for very light exercise

less than 6

RPE for light exercise

9-11

RPE for moderate exercise

12-13 (fairly light but somewhat hard)

RPE for vigorous exercise

14-17

RPE for near maximal exercise

greater than 18

% HR max for light exercise

57-63%

% HR max for moderate exercise

64-76%

% HR max for vigorous

77-95%

what if you wanted your client to work at a light intensity, what % HR max range would you be aiming to keep you client in?

57-63%

what if you wanted your client to work at a light intensity, what MET level would correspond with this?

1.6-2.9 METs

what if you wanted your client to work at a vigorous intensity, what % HR max range would you be aiming to keep you client in?

77-95%

what if you wanted your client to work at a vigorous intensity, what would their RPE range be

14-17

physical activity definition

any bodily movement produced by skeletal muscles that results in energy expenditure

exercise definition

a type of physical activity that requires planned, structured, and repetitive bodily movements with the intent of improving or maintaining one or more components of physical fitness

physical fitness definition

The capacity of the body to function at optimal efficiency

components of physical fitness

-skill related

-health related

-physiological

skill related components of fitness

-agility, balance, coordination, speed, power, reaction time

-performance testing

health related components of fitness

-body composition, cardiorespiratory assessment, muscular fitness, and flexibility

-health related fitness testing

physiological components of fitness

status of metabolic systems, bone mineral density, body fat and regional body fat distribution

what is the MET level that client needs to do daily chores/activities

3 METs

benefits of regular physical activity

-improved cardiorespiratory function

-reduced cardiovascular disease risk factors

-decrease mortality and morbidity

what cardiorespiratory parameters might change with regular exercise

-increased maximum oxygen uptake

-lower minute ventilation

-decreased need for oxygen

-lower heart rate and blood pressure

-increased capillary density in skeletal muscle

-increased exercise threshold for the accumulation of lactate in the blood

-increased exercise threshold for the onset of disease or symptoms

reduction in cardiovascular disease risk factors

-reduce resting systolic/diastolic blood pressure

-increases serum HDLs and decreases serum triglycerides

-reduces total body fat and intra-abdominal fat

-reduces insulin needs, improves glucose tolerance

-decreases blood platelet aggregation/adhesion

-reduces inflammation

primary prevention

higher activity and/or fitness levels to help decrease a lot of chronic diseases (doesn't have the disease yet)

higher activity and/or fitness levels are associated with

-lower mortality from coronary artery disease

-lower incidence of rate for CVD, CAD, stroke, type 2 diabetes, metabolic syndrome, osteoporotic fractures, cancer

secondary prevention of physical activity

the client already has the disease or condition and is trying to prevent it from getting worse (occurs after the disease)

other benefits from physical activity

-decreased anxiety and depression

-improved cognitive function

-enhanced feelings of well-being

-improved sleep

-enhanced performance of work, recreational and sport activities

type of relationship between dosage of physical activity/fitness and incidence of chronic diseases

inverse relationship

strong evidence of increased physical activity to reduce the disease rates for

-all cause mortality

-breast/colon cancer

-cardiorespiratory health

-metabolic health

-weight loss

-muscle health

-improved quality of life and increased in independent living in elderly

moderate evidence of increased physical activity to reduce the disease rates for

-weight maintenance after losing weight

-abdominal obesity

-bone health

-functional health

-bladder/endometrial cancer

-sleep

weak/limited evidence of increased physical activity to reduce the disease rates for

-stroke

-ovarian/lung cancer

-anxiety

-weight gain

associated risks with vigorous exercise

-vigorous exercise increases one's heart rate

-there is an increased need for oxygen by the myocardium

-the heart spends less time in diastole, so perfusion time for the myocardium is decreased

-can cause arrhythmias

-risk of sudden death

cardiac cycle during exercise

-diastole allows the heart muscle to relax and fill the chambers up with blood

-systole contracts the filled ventricles

-vigorous exercise increases heart rate

-there is an increase need for oxygen by the myocardium

-heart obtains fresh blood supply during diastole but as the heart rate increases, there is less time in diastole

-perfusion time for the myocardium is decreased

-transient intermittent oxygen deficit in the heart can cause arrhythmias

how can 'risk of sudden death' during vigorous exercise occur

-most common causes are congenital and hereditary abnormalities

-higher risk in persons performing an exercise that for athletes

-untrained people can have an even during the vigorous exercise if they have a heart disease

what is a common heart disease

occluded arteries due to atheroscleosis

what can appear during vigorous exercise for young athletes

-hypertrophic cardiomyopathy

-coronary artery abnormalities

-aortic stenosis

-other 'hidden' conditions

what is known as the athletes heart

hypertrophic cardiomyopathy: vessel walls are abnormally thick)

what are cardiomyopathy characteristics

-narrow outflow tract

-thick septum

-leaky mitral valve

recommendations to reduce incidence/severity of complications during exercise

-ensure medical clearance and follow up

-provide onsite supervision

-educate clients/patients

-provide onsite medical supervision

-educate individuals

-start people at mild to moderate intensity

-EKG monitoring

-include warm up and cool down

regardless of the extend of the pre-exercise evaluation, the findings should guide the decision about the need for:

-medical clearance

-exercise testing

-exercise prescription

goals of health screening and risk stratification chiefly depends on knowing

-when to test and when not to test

-when to terminate a test// unsafe response to exercise testing

-identify people that have medical contradictions to exercise

-identify individuals with increased risks based on other factors

main step of pre-participation screening

determining the need for medical clearance

how does one determine need for medical clearance

-consent form

-PAR-Q+

importance of PAR-Q+

-used by non-medical professionals and can be used by us to gain additional information

-identifies presence of major CAD risks and other factors

-self-completed or with assistance as supplement to ACSM professionally guided screen

what is the minimum standard for entry into a moderate intensity exercise program

PAR-Q+

PAR-Q+ is designed to

identify the small number of adults who are inappropriate or who should receive medical advice on the exercise prescription

sign

objective evidence of disease usually observed by a physician or health care professional

symptom

subjective evidence of disease or physical disturbance observed by the patient

what is the difference between sign and symptom

-sign = objective and observed NOT by patient

-symptom = subjective and observed by patient

the PAR-Q+ identifies

presence of major signs/symptoms related to cardiovascular, pulmonary, or metabolic disease

if mark any on STEP 1 on the PAR-Q+, what should you do

-be aware that medical advice is probably needed

-may need to exercise with medical staff present

signs/symptoms on the PAR-Q+ that are red flags

-chest discomfort with exertion

-unreasonable breathlessness

-dizziness, fainting, blackouts

-ankle swelling

-feeling forceful or rapid heartbeat

-burning or cramping in lower legs when walking short distance

heart murmur

claudication

pain, tension, and weakness in a leg after walking has begun, but absence of pain at rest

some important points about pain being a sign/symptom

-cardinal symptom of cardiac disease

-mainly coronary artery disease

-provoked with exercise or other stress, or after meals

what the patient might feel as pain being a sign/symptom

-squeezing

-heaviness

-burning over sternum

-pain in one or both arms, shoulder, mid thorax, jaw, cheeks, teeth, forearms, fingers, and interscapular area

orthopnea

shortness of breath at rest in recumbent position that is relieved with sitting up

paroxysmal nocturnal dyspnea

dyspnea that begins shortly after a person lays down at night (about 2-3 hours) and is relieved by sitting up on the edge if bed

paroxysmal nocturnal dyspnea is a sign of what

left ventricular function

bilateral ankle edema is often seen as

-occurs at night

-heart failure

-chronic venous insufficiency