TYPED: 1 pg 12pt font, Times New Roman, 1in margins, Single-Spaced.
Reflection on your journey this semester with this course. Cited things you have learned into health & fitness (i.e. concepts, terms, practices), ideas for principles to put into practice, and how you plan to continue living a healthy lifestyle.

CHAPTER 1
INTRODUCTION TO HEALTH,
WELLNESS, AND FITNESS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

COMING UP IN THIS CHAPTER
Define health, wellness, and fitness
Examine the dimensions of wellness
Survey the major health challenges affecting Americans, as well as their underlying causes and risk factors
Identify key healthy-lifestyle behaviors
Assess your personal wellness status

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Q

Evolving Definitions of Health

There are no universally accepted definitions
Health comes from the Old English word hoelth
“A state of being sound and whole”
WHO definition: emphasizes idea that health is more than just the absence of disease

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I haven’t been sick in over a year.
Can I rate myself as healthy?
Q

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Evolving Definitions of Health
Health: a condition with multiple dimensions that falls on a continuum from negative to positive
Negative: illness and premature death
Positive: capacity to enjoy life and withstand
life’s challenges

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FIGURE 1-1 THE HEALTH CONTINUUM
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Q

Actively Working Toward Wellness

Wellness: more personalized concept than health
Key characteristics of wellness:
Clearly defined dimensions
Active process
Individual responsibility and choice are critical components
Reflects status of one’s perceptions of their own health and well-being

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Are health and wellness the same?

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Q

Discovering
Dimensions of Wellness

Six dimensions in our wellness:
Physical
Emotional
Intellectual
Social
Spiritual
Environmental

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Can you be physically unfit but still be happy and social at the same time?

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Discovering
Dimensions of Wellness
PHYSICAL WELLNESS
The complete physical condition and functioning of the body
Both the visible aspects, such as how fit one looks, and those that are not, such as blood pressure and bone density
Reflected in your ability to accomplish your daily activities and to care for yourself
Regular physical activity and healthy eating are the foundation behaviors of physical wellness, but they are just a beginning

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Emotional- accept feelings; not defeated by setbacks and failures; able to control and deal with anger

Discovering
Dimensions of Wellness
Ask yourself these questions:
Do I get enough sleep?
Do I use alcohol and drugs responsibly?
Do I make intentional and responsible sexual choices?
Do I use sunscreen?
Do I practice safe driving?
Do I manage injuries and illnesses appropriately, practice self-care, and seek medical assistance when necessary?

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Discovering
Dimensions of Wellness
Physical fitness: the ability to carry out daily tasks with vigor and alertness, without undue fatigue, and with ample energy to enjoy leisure-time pursuits and respond to emergencies
Closely relates to wellness and quality of life but also has measurable components

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Discovering
Dimensions of Wellness
For physical wellness, one should strive for a fitness level that meets one’s goals for daily functioning and recreational pursuits
Physical fitness usually requires exercise: planned, structured, repetitive body movements

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FIGURE 1-2 THE RISK OF DYING PREMATURELY DECLINES AS PEOPLE BECOME PHYSICALLY ACTIVE
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Discovering
Dimensions of Wellness
EMOTIONAL WELLNESS
One’s ability to manage and express emotions in constructive and appropriate ways
Be aware of your thoughts and feelings
Monitor your reactions
Recognize strengths and limitations

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Discovering
Dimensions of Wellness
Qualities associated with emotional wellness:
Optimism
Enthusiasm
Trust
Self-confidence
Self-acceptance
Resiliency
Self-esteem

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Discovering
Dimensions of Wellness
INTELLECTUAL WELLNESS
The ability to think logically and solve problems in order to meet life’s challenges successfully
An active and engaged mind
People who enjoy a high level of intellectual wellness are creative, open to new ideas, and motivated to learn new information and new skills
Actively seek ways to challenge their minds and pursue intellectual growth

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Health-behavior gap- Acting on accepted principles of wellness and assuming responsibility for eliminating the discrepancy between knowledge and behavior
Locus of control- a person’s view or attitude about his/her role in wellness and illness; can be internal or external
Self-efficacy- a person’s belief in his/her ability to accomplish a specific task or behavior

Discovering
Dimensions of Wellness
SOCIAL WELLNESS
The ability to develop and maintain positive, healthy, satisfying interpersonal relationships
and appropriate support networks
Family
Friends
Community

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Discovering
Dimensions of Wellness
SPIRITUAL WELLNESS
Having a set of guiding beliefs, principles, or values that provide meaning and direction in life
Compassion, forgiveness, altruism,
tolerance, love
Sense of belonging to something greater than oneself
Sometimes considered a controversial part
of wellness models, but essential to overall
well-being

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Spiritual- includes developing a strong sense of values, ethics, and morals; overlaps with the emotional component; does not adhere to any particular religious structure
Examples: yoga, dance therapy, music therapy, art therapy, prayer and mental healing
Social- ability to maintain intimacy; respect and tolerance for different opinions and beliefs

Discovering
Dimensions of Wellness
ENVIRONMENTAL WELLNESS
One’s wellness and the condition
and livability of one’s surroundings
are interdependent
Your own wellness depends on your surroundings
The environment could support your wellness or detract from it

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Discovering
Dimensions of Wellness
OTHER WELLNESS DIMENSIONS
Financial wellness
Appropriate management of financial resources, a task that typically requires self-discipline and critical thinking skills
Occupational wellness
Satisfaction, fulfillment, and enrichment obtained through work

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Q

Integrating the Dimensions: Recognizing
the Connections and Striving for Balance

To improve wellness, you must integrate all the dimensions of wellness with the personal choices that affect your health and well-being
Don’t focus on a few dimensions and neglect
the others

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If you change your behavior for fitness, will that help other areas of your life too?

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FIGURE 1-3 WELLNESS INTEGRATOR
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Q

Measures of Health and Wellness

There is no single best measure of health
How long do people live?
How well do they live?
What do they die from?
What are the rates of specific diseases and injuries?
How much money is spent on health care?

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By what standards is health measured?

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Q

Measures of Health and Wellness

Life expectancy: the average number of years people born in a given year are expected to live
It depends on your age, location, and current
health status
Life expectancy has increased dramatically
U.S. ranked 51st overall in life expectancy
Why do people live longer than they used to?
Vaccinations, hygiene, less tobacco use, vehicle safety

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What are the chances of living to 100?

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Q

Measures of Health and Wellness

In the developed world, women live 5–10 years longer
Behavioral and biological factors:
Men practice more risky behaviors
Higher accidents, assaults, and suicide rates in men
Women develop heart disease later in life

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Why do women usually live longer
than men?

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Q

Measures of Health and Wellness

QUALITY OF LIFE
Superior health helps, but it does not guarantee longevity—that is, a long life
The goal is not only more years but more
healthy years
Years of healthy life

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Do you have to be super healthy to
live longer?

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FIGURE 1-4 QUALITY OF LIFE AMONG AMERICANS: UNHEALTHY DAYS AND ACTIVITY LIMITATIONS DURING A 30-DAY PERIOD

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Q

The National Healthy
People Initiative

Healthy People 2020
Four overarching goals:
Attain high-quality longer lives
Achieve health equity
Create healthy social and physical environments
Promote quality of life and healthy development and behaviors across all life stages

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Has there been any substantial improvement in physical health in the past few years in the U.S., or are we all just getting less and less healthy?

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Q

Leading Causes of Death

In developing nations, people die from diseases and conditions related to lack of necessities and public health measures
In the U.S., the primary causes of death are linked to lifestyles
Most deaths in developed countries are due to noncommunicable disease (not caused by pathogens and not contagious)

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How does the United States compare to other countries in terms of disease?

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FIGURE 1-5 CAUSES OF DEATH IN DEVELOPED AND DEVELOPING REGIONS OF THE WORLD
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Q

Leading Causes of Death

For many age groups, but heart disease is still
the number-one killer of Americans

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It seems as if everyone has some kind of cancer. Is cancer now the leading cause of death for Americans?

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Q

Leading Causes of Death

The top causes of death in this age group are accidents, assault (homicide), and suicide

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What is the leading cause of death for young adults like most college students?

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TABLE 1-1 LEADING CAUSES OF DEATH IN THE UNITED STATES, ALL AGES
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FIGURE 1-6 LEADING CAUSES OF DEATH AMONG YOUNG ADULTS

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Q

Leading Causes of Death

We must understand risk factors, factors that increase your susceptibility for the development, onset, or progression of a disease or injury
Some can be changed (smoking); others can’t (age)

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What can be done to decrease the leading causes of death?

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Leading Causes of Death

Obesity is an important underlying cause of many chronic diseases
Ranked near the top of actual causes of death in the United States

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How many people die from obesity?

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TABLE 1-2 ACTUAL CAUSES OF DEATH
AMONG AMERICANS
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Q

Health and Wellness on Campus

Back pain and allergies top the list among
college students
Most health problems for college students aren’t of the chronic variety
There is much room for improvement in multiple wellness dimensions

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What are the main health and wellness concerns of college students?

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FIGURE 1-7 MOST COMMON HEALTH PROBLEMS REPORTED BY COLLEGE STUDENTS
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TABLE 1-3 ACADEMIC IMPACT OF SELECTED
HEALTH PROBLEMS
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Q

Behavior Choices
That Influence Wellness

Be physically active
Choose a healthy diet
Maintain a healthy weight
Avoid tobacco in all forms
Manage stress and get adequate sleep
Limit alcohol consumption
Avoid risky behaviors More…

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What basic things should I do every day or every week for a healthy lifestyle?

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Behavior Choices
That Influence Wellness

Limit exposure to radiation and toxins
Seek appropriate medical care
Apply critical thinking skills as a health consumer
Cultivate relationships and social support
Nourish your spiritual side
Have fun!

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What basic things should I do every day or every week for a healthy lifestyle?

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FIGURE 1-8 FACTORS DETERMINING HEALTH AND WELLNESS STATUS
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Q

Other Factors That
Influence Wellness

Genes are just one factor in disease risk and overall health status
Biology
Social and economic factors
Environmental factors
Access to health care
Public policies and interventions

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Is my health mostly dependent on my genes and family history?

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Q

Wellness: What Do you Want for Yourself—Now and in the Future?

Energy, vitality, curiosity, empowerment, enjoyment—a high quality of life
How do you rate your own levels of health and wellness today?

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What does it feel like to be well?

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CHAPTER 2
POSITIVE CHOICES/
POSITIVE CHANGES
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Identify the factors that influence your wellness behaviors
Develop strategies for increasing your motivation to change for the better
Apply techniques that match your stage in the change process
Develop a personalized plan for successful behavior change, including appropriate goals and strategies for overcoming barriers

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Q

Factors Influencing Health
Behavior and Behavior Change

Behavior is influenced by many factors
Behavior: an observable action or response
Habit: a behavior that recurs, often unconsciously, and develops into a pattern

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Why is behavior change so hard?

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Factors Inside and Outside
Your Control
Behavioral influences include:
Heredity/genetic makeup
Sex
Childhood and past experiences
Knowledge, skills, and abilities
Age
Beliefs
Attitudes
Values
Religious and cultural norms and practices
Socioeconomic status (income, education, occupation)
Environment

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FIGURE 2-1 FACTORS THAT INFLUENCE
HEALTH BEHAVIORS
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Q

Predisposing, Enabling, and Reinforcing Factors

Predisposing factors: those factors that you bring to the table
Enabling factors: those factors that help you change your behavior
Reinforcing factors: those factors that follow a behavior and either encourage or discourage your new behavior
Internal or external

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Is there some way I can bribe myself into making a change in my habits?

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FIGURE 2-2 FACTORS AFFECTING BEHAVIOR CHANGE
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Q

Motivation for Behavior Change
Motivation: energized state that directs and sustains behavior
Increased or decreased based on internal and external factors
Factors affecting motivation:
Locus of control
Self-efficacy
Goal setting
Decisional balance

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How can I find motivation?

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Q

Locus of Control:
Do You Feel in Charge?

Internal locus of control: belief that one’s personal outcomes largely depend on what one does and how hard one tries
External locus of control: belief that factors outside one’s control largely determine the outcomes of what one does

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What Determines my motivation?

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Q

Self-Efficacy:
Do You Anticipate Success?

Optimism: the expectation of success

SELF-EFFICACY EXPECTATIONS
Self efficacy: belief in one’s capability to perform a task that leads to a specific outcome

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How do I stick with the plan?

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Self-Efficacy: Do You Anticipate Success?
HOW SELF-EFFICACY DEVELOPS—
AND CAN BE INCREASED
Past performance
Direct experience is the most powerful influence on self-efficacy expectations
Observational learning
Persuasion
Interpreting internal cues

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Q

Self-Efficacy for Behavior Change

Start by rating your degree of confidence in reaching your goal
Set realistic goals and monitor your behavior
Identify obstacles
Find a role model, and ask for support
Visualize and celebrate success

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I’m discouraged because I have failed at my exercise goals in the past. Is there a way to improve my chances of success?

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Q

Goal Setting:
What Are You Trying to Achieve?

Use the SMART principle:
Specific
Measurable
Achievable
Realistic
Time-bound

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How do I come up with a good goal that fits me as an individual?

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FIGURE 2-3 SAMPLE SMART GOALS
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Q

Decisional Balance: What Are the Pros and Cons of Change?

Self-defeating behaviors accomplish one goal (usually a short-term one) but interfere with more important goals (usually long-term)
Analyze pros and cons of changes you want to make

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What if I don’t have any motivation
to do anything?

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Q

Stages of Change

Transtheoretical model (TTM)
Precontemplation
Contemplation
Preparation
Action
Maintenance

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How do I get organized, motivated, and focused to change my behavior?

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Stages of Change
PRECONTEMPLATION
Not yet actively thinking about change; rationalizing behavior
CONTEMPLATION
“Thinking” stage
Weighing pros and cons
PREPARATION
“Planning and getting ready” stage
Move from thinking to doing

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Stages of Change
ACTION
Implementing the plan
Behavior change begins
MAINTENANCE
Working to maintain new behavior and to avoid relapse
Seeking out and using social support

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Q

Stages of Change

Termination
Zero temptation and total self-efficacy
Not realistic for most
Considering oneself in a lifetime maintenance stage is a better option
Lapses and relapses are common

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Is it possible to modify behavior beyond the point of relapse?

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FIGURE 2-4 STAGES OF CHANGE IN THE TRANSTHEORETICAL MODEL OF BEHAVIOR CHANGE
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Q

Processes and Techniques
of Change

Consciousness raising
Emotional arousal (dramatic relief)
Self-reevaluation
Environmental reevaluation
Commitment (self-liberation)

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According to the questionnaire, I’m in the contemplation stage. Now what?
More…

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Processes and Techniques
of Change
Helping relationships
Seek social support
Countering
Substitute the healthy behaviors
Reinforcement management (rewards)
Environment control
Remove cues and triggers
Social liberation
Seek different or additional social alternatives

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Q

Overcoming Common Barriers
to Change

I don’t have enough time
Practice time management
I can’t get motivated
Pros vs. Cons
I’ll get around to changing—later
Don’t procrastinate

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What is the greatest obstacle to overcome in dealing with behavior change?
More…

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Overcoming Common Barriers
to Change
I don’t know how
Seek reliable information
I don’t have enough money
Healthy lifestyles are generally less expensive than unhealthy ones
I lack will power
Avoid temptation
It is too hard—and no fun
Personalize your goal and develop a realistic goal
Make new health habits pleasurable

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More…

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Overcoming Common Barriers
to Change
I’m too tired
Know your rhythms
I can’t say “no”
Be more assertive
I have a negative outlook
Reframe your self-talk
I don’t feel supported
Utilize support groups, family, friends

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More…

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Overcoming Common Barriers
to Change
I do OK at first and then backslide
Know that lapses are a normal part of the process
Schedule check-ins with yourself

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Q

Developing a Personalized
Behavior-Change Program

Complete a pros-versus-cons analysis
Monitor your current behavior
Set SMART goals and plan rewards
Develop strategies for overcoming obstacles and supporting change
Identify helpers and resources

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What is the best way to start if I am trying to change a behavior?
More…

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Q

Developing a Personalized
Behavior-Change Program

Put together your program plan
Make a commitment . . . and act on it
Track your progress and modify your plan as needed

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*
What is the best way to start if I am trying to change a behavior?

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FIGURE 2-5 SAMPLE PROS-VERSUS-CONS ANALYSIS FOR BEHAVIOR CHANGE
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FIGURE 2-7 SAMPLE BEHAVIOR-CHANGE LOG
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Q

Developing a Personalized
Behavior-Change Program

Encourage, but don’t push
Recommend change frequently, but be patient
Discuss specific past instances of the problem
Acknowledge positive behavior change for healthy behavior

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How much can I say or do to encourage a family member to quit smoking or lose weight?

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CHAPTER 3
FUNDAMENTALS OF PHYSICAL FITNESS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Define physical activity, physical fitness, and exercise
Identify the benefits of physical activity and fitness
Become familiar with the various components of health and skill fitness
Survey methods of assessing fitness and assess your own fitness level
Apply key training principles
Adapt a fitness program to different environmental conditions

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Q

Physical Fitness, Physical
Activity, and Exercise

Not exactly
Physical fitness: ability to carry out tasks with vigor and alertness
Physical activity: any movement of the body
Exercise: a subset of physical activity
Repetitive body movement that has been planned
and structured

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Does all activity count as exercise?

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Q

Physical Fitness, Physical
Activity, and Exercise

Yes, both physical activity and physical fitness are linked to longer and healthier lives

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Will I really lose years of my life if
I’m unfit?

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Q

Physical Fitness, Physical
Activity, and Exercise

Absolutely
Any increase in physical activity will increase
your health and fitness

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Is there any point in exercising if I can’t become super-fit?

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FIGURE 3-1 PHYSICAL ACTIVITY, EXERCISE, AND PHYSICAL FITNESS
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TABLE 3-1 BENEFITS OF PHYSICAL ACTIVITY
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Q

Physical Fitness, Physical
Activity, and Exercise

More than half of all American adults don’t engage in much activity during their leisure time

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Isn’t the “couch potato” thing overblown? I seem to see more people exercising all the time.

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FIGURE 3-2 RATES OF REGULAR LEISURE-TIME PHYSICAL ACTIVITY AMONG AMERICANS
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Types of Fitness
Fitness components are typically divided into two major categories:
Health-related fitness: components have a direct effect on health status, disease risk, and day-to-day functioning
Skill-related fitness: components or attributes influence performance level in various activities and are less directly related to health

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Q

Skill-Related Fitness

Agility—change direction in quick and precise manner
Balance—maintain equilibrium
Coordination—synchronize multiple movement patterns in a sequenced, controlled movement
Power—exert maximum force in minimum time
Reaction time—time between stimulus and response
Speed—perform a movement in a short period of time

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How is skill related to fitness?

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Q

Health-Related Fitness

Cardiorespiratory
endurance
Muscular strength
Muscular endurance
Flexibility
Body composition

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I’m terrible at sports and have no interest in them. Are there other ways to be fit and healthy?

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Health-Related Fitness
CARDIORESPIRATORY ENDURANCE
Ability of the circulatory and respiratory systems to sustain physical activity by supplying oxygen to working muscles
Developed through aerobic activities
Brisk walking
Jogging
Swimming
Cycling

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Health-Related Fitness
MUSCULAR STRENGTH
Ability of a muscle or group of muscles to generate or apply force
Developed through activities that increase muscular strength and endurance
Weight training
MUSCULAR ENDURANCE
Ability of a muscle or group of muscles to sustain an effort for an extended period of time
Like strength, it requires resistance exercises

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Health-Related Fitness
FLEXIBILITY
The ability of a joint to move through its full range of motion
Best maintained through stretching
BODY COMPOSITION
The makeup of your body
Relative amounts of muscle, fat, bone, and other
vital tissues
Affected by diet and various types of physical activity

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Q

Assessing Physical Activity
and Fitness

It is important to know your current fitness status before beginning a fitness program
Physical Activity Readiness Questionnaire (PAR-Q) (Lab Activity 3-1)
Check with your doctor if:
You answered yes to any of the PAR-Q questions
You are not used to being very active
You are outside the age-range listed (15–69)

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Is it safe for anyone to exercise?

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Q

Medical Clearance

Yes, although it may need to be modified
Physical activity can be beneficial to those with arthritis
She should check with health care provider

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My mother-in-law has arthritis in her knees. Is she supposed to do any exercise?

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Q

Assessing General Physical Activity Levels

There is no technique that is both simple and precise to judge your overall level of physical activity
Pedometers can provide an approximate measure
Useful for checking your activity level
People who use pedometers tend to have an increase in activity level; they can be a good motivational tool

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What do sedentary and active actually mean? I’m busy all the time, so I feel really active.

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TABLE 3-2 PHYSICAL ACTIVITY LEVEL BASED ON PEDOMETER TRACKING
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FIGURE 3-3 A BASIC PEDOMETER-BASED STEPPING PROGRAM FOR INCREASING PHYSICAL ACTIVITY
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Q

Principles of Training

Progressive overload: over time, performance
is increased by gradually increasing the overload
Gradual application of increasing amounts of stress
on the body during exercise
Overload must be increased gradually

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How do I improve my fitness level?

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FIGURE 3-4 PROGRESSIVE OVERLOAD
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Q

Principles of Training

Yes, human physiology has limits that are influenced by genetics and training

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Is there a limit on how fit a person
can be?

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Q

Reversibility

Reversibility: Use it or lose it!
You can lose all your gains within 2 months

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If I stop exercising for a while, will I lose fitness?

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Q

Recovery

With increase in activity comes the need for rest and recovery
Recovery: the time needed by the body to rebuild and improve tissues weakened from increased activity (overload)

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Is it harmful to my fitness if I work out every day?

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Q

Specificity

The effects of training are directly related to the type of activities in which you participate
Specificity: the body will adapt to the specific types and amounts of stress placed on it

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What kinds of activities do I need to do to increase fitness?

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Q

Individuality

We all respond to training differently
Our response depends on overall health, body type, genes, and other factors

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Could everyone be as fit as, say, Lance Armstrong, if they worked hard enough?

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The FITT Formula
The FITT formula principles can form a foundation for any exercise program
Frequency
Intensity
Time
Type

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Q

Frequency: How Often

Depends on the component you are training, your goals, and your current fitness level
Affected by other aspects of the FITT formula
ACSM guidelines:
Cardiorespiratory endurance training: 3–5 days/week
Muscle-fitness training: 2–3 days/week
Flexibility training: 2–3 days/week

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How many times per week should I
work out?

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Q

Intensity: How Hard

You must do more than you’re used to doing—trying to reach your target zone and threshold
Target zone: the ideal intensity for achieving maximum benefit from the activity
Threshold: the minimum intensity for achieving specific fitness benefits
Intensity is measured differently for various fitness components

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How do I know if my workout is hard enough for me?

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FIGURE 3-5 TARGET ZONE FOR TRAINING INTENSITY.
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Q

Time: How Long

This depends on the fitness components and intensity you choose, the design of your program, and your goals

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How long should I exercise, per day and per week?

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Q

Type: Choice of Activities

In FITT, type refers to the kind of activity
The best type of exercise for you is based on the fitness component and the goals related to that component
The best fitness program for you depends on what you want to accomplish

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What is the best kind of exercise?
What is the best fitness program?

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TABLE 3-3 SUMMARY OF ACSM FITT GUIDELINES
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Q

Putting Together a Complete Workout

Phases of a workout:
Warm-up (5–10 minutes)
Low-intensity activity
Conditioning
Endurance—cardiorespiratory
Resistance—muscular strength and endurance
Cool-down (5–10minutes)
Slower-paced activity
Stretching, after warm-up or cool-down

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What does a complete workout look like?

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Q

Warm-Up and Cool-Down

This is related to shifts in blood flow and changes in blood vessels that occur during exercise
You must properly warm up and cool down
Warm-up: 5–10 minutes of low-intensity activity that prepares the body for exercise
Cool-down: 5–10 minutes of slower-paced activity that helps the body transition to a normal resting state

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Why do I sometimes feel a bit dizzy after exercise?

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TABLE 3-4 WARM-UPS AND COOL-DOWNS
SUMMED UP
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Q

Putting Together a Complete Program

Investigate the different ways to plan a routine
Examples are given in Figure 3-6

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What is the best weekly exercise routine for health?

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FIGURE 3-6 SAMPLE FITNESS PROGRAM DESIGN—EXAMPLE 1
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FIGURE 3-6 SAMPLE FITNESS PROGRAM DESIGN—EXAMPLE 2
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FIGURE 3-6 SAMPLE FITNESS PROGRAM DESIGN—EXAMPLE 3
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Q

Putting Together a Complete Program

Yes, any activity is better than none
Be active during your daily routine
Park far away from your destination
Take the stairs
Walk during your lunch or breaks
Stretch while you watch TV
Walk short distances instead of driving
Do active chores

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I don’t exercise at all, and I’m crazy busy. Does any amount of activity help, even five minutes?

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Other Considerations When You’re Starting a Fitness Program
Clothes and safety gear
Exercise equipment and facilities
Weather
Heat
Cold
Air quality

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Q

Clothing and Safety Gear

Loose-fitting, comfortable clothing is probably sufficient
Wicking properties
Light-colored/reflective clothes at night

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Are some kinds of clothes really better for exercising than others, or is it all just a sales gimmick?

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Q

Clothing and Safety Gear

Probably not
Get a good shoe that will meet your needs

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Do I need different shoes for different activities? That’s way too expensive.

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Q

Clothing and Safety Gear

Yes, for some activities safety equipment is necessary
Common safety equipment includes:
Elbow and wrist guards, and knee pads
Helmets
Eye protection
Mouth guards
Athletic supporters/cups
Sports bras

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Do knee pads help that much?
I think they look goofy.

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Q

Exercise Equipment and Facilities

Equipment that you will use
Research your options
Consider your personal preferences

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What’s the best type of home exercise equipment?

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Q

Exercise Equipment and Facilities

Things to consider:
Location and hours
Environment
Equipment and classes
Staff
Amenities
Cost and policies
Trials offered

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Should I join a gym?

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TABLE 3-5 POPULAR HOME EXERCISE EQUIPMENT OPTIONS
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TABLE 3-6 FREE AND LOW-COST EXERCISE ALTERNATIVES
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Q

Weather

Consider the heat index
Exercise during a cooler part of the day
Wear appropriate clothing
Wear a light-color hat and sunglasses
Consider safety gear
Use sun-screen
Take frequent breaks and stay hydrated

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Is exercising in hot and humid conditions unsafe?

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FIGURE 3-7 HEAT INDEX
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Q

Weather

It is best to develop a personal hydration plan
that fits your sweat rate, exercise intensity, and environmental conditions
For workouts of less than an hour, water is best
For long or particularly intense workouts, sports drinks can replace sodium, potassium, and other electrolyte loss

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How much water should I drink during a workout? Are sports drinks a good option?

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TABLE 3-7 HYDRATION RECOMMENDATIONS FOR EXERCISE
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Q

Weather

It is safe for most, but it could be a problem
for some with high blood pressure or other
heart-related problems
Dress in layers
Be aware of the wind chill index, or wind
chill factor

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Is it bad for you to run in cold air?

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FIGURE 3-8 WIND CHILL INDEX
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TABLE 3-8 TEMPERATURE-RELATED PROBLEMS, SIGNS, AND TREATMENTS
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Q

Air Quality

Special precautions may be necessary
The air quality index (AQI) rates daily air quality and indicates if there is a risk to health
Measures five different pollutants

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Can I exercise on smoggy days?

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Air Quality
Tips for exercising in areas with poor
air quality:
Avoid congested streets
Work out in the early morning or late evening
Avoid combinations of high temperatures, high humidity, and high AQI
Exercise indoors if possible
Exercise at a lower intensity if needed
Seek medical attention if you have difficulty breathing or other symptoms

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Q

Injury Prevention and Management
Start slowly
Research what activity would be right
Choose activities appropriate for your fitness level
Increase activity duration before switching to activities that take more effort
Use correct safety gear and choose safe place
See health care provider if necessary

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If a person is not physically active at all but would like to be, what is the best way to start?

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Q

Injury Prevention and Management

Ice is often the best initial treatment for a sprain
Prevention is always best
Most exercise injuries are caused by overuse
Massage sore muscles gently
Engage in low-intensity movement
Take an over-the-counter pain medication

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Is ice or heat better for a sprain? And what can I do about sore muscles?

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TABLE 3-9 COMMON ACTIVITY-RELATED INJURIES
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CHAPTER 4
CARDIORESPIRATORY FITNESS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Learn how your cardiorespiratory system works and what affects its functioning
Discover the benefits of cardiorespiratory fitness
Assess your level of cardiorespiratory fitness
Develop a personalized cardiorespiratory fitness program

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Factors Affecting
Cardiorespiratory Fitness
Cardiorespiratory fitness (CRF)
The ability of the circulatory and respiratory systems to sustain physical activity
Also known as cardiorespiratory endurance, aerobic fitness, or aerobic endurance

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Q

Factors Affecting
Cardiorespiratory Fitness

Things to consider:
Genes
Health
Cardiorespiratory (CR) conditioning
Nutrition
Training

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I have a friend on the track team. I tried running with her once and it was so hard. Why is it so easy for her?

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Q

The Condition of the Cardiorespiratory System

Major components of the cardiorespiratory (CR) system:
Heart
Lungs
Network of blood vessels (vascular system)

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What are the parts of the system that make my muscles go?

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The Condition of the Cardiorespiratory System
Heart
Acts as muscle pump to circulate blood
Lungs
Take in oxygen and expel carbon dioxide; exchange takes place in the alveoli
Respiratory system: air passages, lungs, breathing muscles

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The Condition of the Cardiorespiratory System
Vascular system
Circulates blood to lungs and around body
Arteries: carry blood away from heart
Veins: carry blood toward the heart
Capillaries: tiny blood vessels with thin walls; substances can pass between the blood they carry and the surrounding cells and tissues

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FIGURE 4-1 THE CARDIORESPIRATORY SYSTEM
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FIGURE 4-2 CIRCULATION OF OXYGEN AND
CARBON DIOXIDE
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Q

The Condition of the Cardiorespiratory System

As exercise intensifies, CO2 and lactate (lactic acid) accumulate
Increased ventilation lowers both
In fit individuals, this effect is lessened
Increased CR system efficiency is directly related to increased training

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When I try to run fast, why does it feel like I can’t breathe?

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FIGURE 4-3 INCREASE IN BREATHING RATE
DURING EXERCISE
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Q

The Condition of the Cardiorespiratory System

It depends on the type of exercise
Exercise redirects blood to active muscles
Less blood to the gut to help digest
Can result in “side stitch”

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Can I eat before I exercise?

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Q

Energy Production

Energy level versus energy production:
Adenosine triphosphate (ATP) is fuel for muscles
Catabolism
ATP is produced from carbohydrate, fat, or protein
Carbohydrates are the main source
Converted to ATP from blood glucose or from carbohydrates stored in the liver and skeletal muscle (glycogen)

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I feel tired all the time. What can I do to get more energy?

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Energy Production
Carbohydrates (glucose or glycogen) are stored in limited amounts, but are the most readily converted
Preferred energy source for ATP
Fats have unlimited storage but do not convert readily to ATP
Beta-oxidation
Protein has limited storage; it is inefficient for energy conversion
Distant third choice for energy

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Energy Production
The three energy systems that can produce ATP and generate energy:
ATP/CP energy system
Short duration, less than 10 seconds
Glycolytic energy system
Activities that last longer than 10 seconds
Aerobic energy system
Occurring in the presence of oxygen

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Energy Production
ATP/CP ENERGY SYSTEM
When the body needs energy fast
Anaerobic
Ideally suited for extremely short bouts of activity
Jumping, throwing, lifting, sprinting
Can replenish itself rapidly
Fueled by stored ATP and creatine phosphate (CP)
Stored creatine is critical
Red meat is the best source of this compound

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Energy Production
GLYCOLYTIC ENERGY SYSTEM
This system will take over when activities last more than 10 seconds
Anaerobic
Glycolysis
Pyruvate (pyruvic acid)
Can be converted to lactate under certain conditions
Relatively inefficient at generating ATP
Best suited for activities that last up to 90 seconds

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Q

Energy Production

To build cardiorespiratory fitness (CRF), you’ll need to perform activities that primarily use the oxygen-dependent aerobic energy system
It does not produce ATP fast enough for a brief,
all-out intense effort
When oxygen is present, the potential for ATP production increases dramatically when compared to the other systems
Mitochondria

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How is aerobic exercise different, and why is it so important?

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FIGURE 4-4 TIME SPAN OF ACTION OF THE THREE ENERGY SYSTEMS
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Q

Diseases Affecting the Cardiorespiratory System

Asthma and COPD (chronic bronchitis and emphysema)
Can exercise; but frequency, intensity, duration, and type of exercise may be restricted
Cardiovascular disease
Exercise is critical in both primary and secondary prevention

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Can you still achieve cardio fitness if you have something like asthma? Is cardio exercise safe after a heart attack?

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Q

Genetics

How much you like exercise not affected
by genes, but genetics may play role in your ability to get fit
No more than 50% of your ability to improve your cardio respiratory fitness is inherited
The other half is based on how active we are and what activities we engage in

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I don’t like to exercise, and neither do my parents. Is my problem genetic?

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Q

Biological Sex

Men and women have the same ability to increase their levels of cardiorespiratory fitness
Men can typically achieve a higher absolute level of cardiorespiratory function
Difference is in size between the sexes

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How do men and women differ in
getting fit?

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Q

Use and Age

It is never too late to start a fitness program
A natural result of aging is a steady decline in the functioning of the cardiorespiratory system
The rate of decline is lower in those who exercise on
a regular basis
“Use it or lose it”

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My dad is 58 and wants to start exercising. Is he too old?

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Q

Improved Performance

VO2: volume of oxygen consumed over time
Largely determined by the amount of oxygen you bring into your lungs, which is affected by size
VO2max: maximum amount of oxygen you can consume during peak exercise

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My boyfriend made me do an online fitness survey and it said my VO2 was 41. What does that mean?

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Q

Improved Performance

Start gradually
Over time:
Your heart muscle will grow stronger
Your lungs will become more efficient
Your blood vessels will become more elastic
Your cells will develop more mitochondria

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Every time I start an exercise program I feel worse! Does it ever get better?

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Q

Improved Performance

The heart can grow in size (hypertrophy)
Regular exercise allows the heart muscle to stay flexible
Greater stroke volume
Higher cardiac output

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If your heart is a muscle, can you bulk
it up?

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Q

Reduced Risk of Disease

Positive effects of physical exercise:
Improved blood pressure
Improved cholesterol levels
Reduced risk of type 2 diabetes
Reduced risk of certain cancers
Reduced risk of osteoporosis
Reduced risk of cardiovascular disease (CVD)

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My mom’s doctor told her to walk every
day to help lower her blood pressure.
Does just walking really work?

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FIGURE 4-5 SUMMARY OF THE EFFECTS OF CARDIORESPIRATORY EXERCISE
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Q

Reduced Risk of Disease
Regular cardiorespiratory exercise may increase longevity and quality of life

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Will exercise make me live longer?

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Q

Healthier Body Composition

Healthy weight loss is 1–2 pounds per week
A one-pound change in body weight represents a change of 3,500 calories through diet, exercise, or both
The best choice of exercise is one that you will
do regularly

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How much exercise do I need if I want to lose some serious weight before spring break? And what is the best weight-loss exercise?

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Q

Stress Management and Improved Emotional Wellness

Almost any type of physical activity, moderate
in duration and intensity, can cause feelings of elation
Provides distraction
Increases body temperature
Changes brain chemistry

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I feel better after exercising. Why is that?

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Q

Types of Cardiorespiratory
Fitness Tests

Take the same type of CRF assessment
Lab tests
Field tests
Resting heart rate assessment
The usual point is for motivation

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How do my friend and I figure out who is more fit?

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Types of Cardiorespiratory
Fitness Tests
LAB TESTS
Measure VO2 accurately
Metabolic cart
FIELD TESTS
Rockport walk test
Walk a mile as quickly as possible
1.5-mile run/walk test
3 minute step test
See Lab Activity 4-1

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Types of Cardiorespiratory
Fitness Tests
RESTING HEART RATE
Measuring your true RHR doesn’t involve exercise at all
Heart rate is counted for 1 full minute after waking

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Q

Evaluating Assessment Results
and Setting Goals

Improvement varies
Aerobic capacity can increase by 10–30%
It is best to progress no more than 10% a week in frequency, intensity, or time (not all at once)
Recall the principle of progressive overload

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How much can I improve? How much do I really need to improve?

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Q

Evaluating Assessment Results
and Setting Goals

Achieve goals, then set new ones
Re-assess your fitness 4–6 weeks initially and then every 8–12 weeks
Use your exercise performance as a guide
Get baseline measurements

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How often should I do an assessment to check for improvement in my cardio fitness? Can I judge my fitness without taking a test?

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Q

Getting Started

For a successful cardiorespiratory fitness program:
Apply the FITT formula
Include activities you enjoy and will stick with
Finding exercise you like is most important

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How do I learn to like exercise?
Right now, I just don’t.

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Q

Applying the FITT Formula

Use the FITT formula:
Frequency
Intensity
Time
Type

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How do I know I’m doing the right things—not going too far, or too fast, or too slow?

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Q

The FITT Formula: Frequency
Most guidelines encourage 1–2 days of rest to prevent injury and burnout
Daily is fine if you vary routine, exercises, intensity
Intensity and frequency need to be balanced
ASCM: 3 days a week for vigorous intensity (for at least 20 minutes a day) and 5 days a week for moderate intensity
Bouts of at least 10 minutes count toward the minimum-duration recommendation

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Is it safe to work out every day?

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Q

The FITT Formula: Intensity
Exercise in your target intensity zone
Balance with frequency and duration
Intensity is tied to your personal goals
Difference between moderate-intensity and vigorous-intensity:
Two minutes of moderate activity confers the same benefit as one minute of vigorous activity

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How hard should I exercise?

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Q

The FITT Formula: Intensity

The talk test is a simple method for judging intensity
Moderate-intensity exercise: you can talk but not sing
Vigorous-intensity exercise: you can say only a few words before pausing to take a breath

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What’s considered moderate activity and vigorous activity?
More…

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The FITT Formula: Intensity
Other methods for judging intensity:
Heart-rate maximum method (HRmax)
Exercising at certain percentage of maximum heart rate (MHR)
Target heart rate = MHR × %
Can also use age; subtracting age from 220
Target heart-rate range

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More…

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The FITT Formula: Intensity
Heart-rate reserve (HRR) method
More complicated but more accurate
Target heart rate = [(MHR – RHR) × %] + RHR
RHR determined by counting pulse before you get out
of bed
Rating of perceived exertion (RPE)
Subjective measure of exercise intensity
Rate on scale of 6 to 20
Metabolic equivalents (METs)
Estimates amount of oxygen body uses during physical activity

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TABLE 4-1 RECOMMENDED STARTING INTENSITY OF EXERCISE BASED ON CURRENT ACTIVITY LEVEL
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FIGURE 4-7 RATING OF PERCEIVED EXERTION
(RPE) SCALE
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Q

Applying the FITT Formula

Heart-rate monitor
Fingers on the inside of the wrist at the radial artery or on the neck by the carotid artery

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What’s the best way to take my heart rate when I’m exercising?

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Q

Applying the FITT Formula

What matters is total calories used
Lower intensity uses more fat; higher intensity uses more overall calories and total fat

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Doesn’t lower-intensity exercise burn more fat?

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FIGURE 4-8 INTENSITY LEVELS OF DIFFERENT PHYSICAL ACTIVITIES
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FIGURE 4-9 FAT AND CARBOHYDRATE USED
DURING EXERCISE
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Q

The FITT Formula: Time

Balance time with intensity
Individual workouts and weekly exercise plan:
ACSM: moderate-intensity exercise at least 30 minutes/day, 5 or more days/week; or 20 minutes of vigorous exercise, 3 days a week
HHS: 150 minutes of moderate-intensity or 75 minutes of vigorous intensity (doubling brings even greater health)
Beware of time spent sitting

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How many hours of cardiovascular activity are necessary to be healthy?

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FIGURE 4-10 RELATIONSHIP BETWEEN EXERCISE TIME AND INTENSITY
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The FITT Formula: Type
Cardiorespiratory fitness can improve through a variety of activities
Those that are aerobic, rhythmic, and involve regularly performed work by large muscle groups
Individual activities and team “pick-up” activities
Outside or in the gym

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Q

Putting Together a Complete Workout

No; because you will probably start off slower
and increase speed as you go (you will in fact be warming up)
A workout has three stages:
Warm-up
Conditioning
Cool-down

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Do I really need a warm-up just to go walking with my friends?

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FIGURE 4-11 CARDIORESPIRATORY WORKOUT

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Q

Making FITT Work for You

You need to consider your:
Current level of fitness
Schedule
Activity options
Preferences
Goals

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I don’t have much time to work out but I still want to get fit. What can I do?

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TABLE 4-2 SUMMARY OF RECOMMENDED EXERCISE GUIDELINES

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Q

Making Progress Toward Your Fitness Goals

Choose proper progression

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How long until I can run for 5 miles?

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Q

Making Progress Toward Your Fitness Goals

Diet can’t directly increase CRF, but it can go a long way in improving overall health
Fitness gains come from training
Diet impacts the quality of training

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Do I need a special diet to increase cardio fitness?

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Q

Making Exercise Safe

Yes, if you don’t have a fever and your symptoms are from the neck up
Maybe at a slower pace or for a shorter duration
If you have the flu, take time off and start back slowly

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I have a cold. Can I still work out?

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Q

Personal Training Online, in Person,
or Somewhere in Between?

Look for certification and a relevant degree
Ask for references
Check the fees
Read the fine print
Discuss expectations

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How do I know who is a good personal trainer?

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Q

Fine-Tuning Your Program to Maintain Success and Enjoyment

Setting goals and tracking progress are good strategies for success
You can track your miles, minutes, days per week, heart rate, RPE, etc.
It helps in seeing your progress and in identifying problems

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Is there anything in particular I should keep track of over time?

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Q

Fine-Tuning Your Program to Maintain Success and Enjoyment

Investigate boredom-busting technology
Add faster or higher intensity spurts (interval training)
Cross-training
Investigate skill-related sports

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I get bored easily. Any suggestions?

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Q

Sticking with Your Program—and Restarting It After a Lapse

Maintaining an exercise program is the hard part
Have a plan to prevent relapses
6–12 weeks before exercise becomes a routine

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How am I supposed to stick with exercise over time? I’ve never had much luck.

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Q

Sticking with Your Program—and Restarting It After a Lapse

Keep a time log to identify time to exercise
Fit mini-exercises into the day

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How do I find more time to exercise?

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Q

Sticking with Your Program—and Restarting It After a Lapse
Start back slowly
Focus on progression without increasing too much or too fast

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I used to exercise but haven’t for a while. What would you recommend for me since I’m just getting back into working out?

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CHAPTER 5
MUSCLE FITNESS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Learn how your muscles work and what affects their functioning
Discover the benefits of muscle fitness
Assess your level of muscle fitness
Develop a personalized muscle-fitness program

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Q

Factors Affecting Muscle Fitness

Muscle fitness is the ability of muscles to perform routine tasks without undue fatigue.

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What’s muscle fitness? Is it the same as weight lifting?

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Factors Affecting Muscle Fitness

Muscle force: effort required to overcome resistance
Muscle endurance: sustained effort
Muscle strength: generate maximal force against resistance
Muscle power: rapid exertion of optimal force

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Q

Types of Muscles

There are three types of muscle:
Skeletal muscle moves your bones to produce body motions
Cardiac muscle is found only in the heart and has its own electrical conduction system
Smooth muscle is found in the walls of body organs such as the stomach and intestines
Cardiac and smooth muscle are involuntary

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Is it true that there are different kinds of muscles?

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Types of Muscles
Skeletal muscles can be activated with conscious thought
Can shape and strengthen over time
Tendons: the fibrous connective tissue by which a muscle attaches to a bone
Ligament: a sheet or band of tough, fibrous tissue connecting bones or cartilage at a joint or supporting an organ

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Q

Types of Muscles

Muscle fibers (muscle cells)
Myofibrils: protein filaments
Nucleus: cellular structure that contains genetic material; controls gene expression
Mitochondria: convert energy for food into fuel for the muscle
Sarcoplasmic reticulum (SR): plays important role in triggering muscle contraction

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What is it that makes my muscles actually work?

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FIGURE 5-1 BASIC COMPONENTS OF SKELETAL MUSCLE TISSUE
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Types of Muscles

Sliding filament theory
Actin and myosin slide over each other to move or contract skeletal muscle
Adenosine triphosphate (ATP) needs to be present
Produced within mitochondria

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FIGURE 5-2 SLIDING FILAMENT THEORY
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Q

Types of Muscles

Increased blood flow in arm muscles
Redistribution of blood to active muscles
Other areas, like gut, see less blood flow
Must be careful about eating right before exercise

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What makes my arms feel “pumped” when I’m lifting?

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Q

Types of Muscle Fibers

Skeletal muscle is made of two fiber types:
Slow-twitch muscle fibers (Type I)
Endurance
Sacrifice rapid force for fatigue resistance
Fast-twitch muscle fibers (Type IIa and Type IIx)
Power and sprinting
These fibers can generate force quickly
More prone to hypertrophy—can grow more easily

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How can I get more “fast” muscles?
More…

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Types of Muscle Fibers

The percentage of each type of muscle fiber is largely determined at birth
Play a significant role in determining your muscle fitness abilities
A typical person has about 50% of each type
Proper training can enhance what a person has

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Q

Biological Sex

Women experience significant benefits
from muscle-fitness training
Prevent age-related loss of muscle and bone mass
Maintain health and lifelong independence
Don’t be afraid of getting “too big”
Differences in muscle-fibers and hormonal differences
Typical training program unlikely to increase muscle mass (overload principle)

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As a woman, do I really need to lift?
What can I do to get toned instead of becoming too muscular?

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Q

Biological Sex

It is possible, but not likely
Muscle tissue weighs more than fat tissue, but a pound of muscle tissue is smaller than a pound of fat tissue
Changes that occur when starting a muscle-training program:
Loss of body fat
Increased muscle mass (after a few weeks)
Loss of inches in some areas
Might not show up on scale, but has other benefits

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I heard that weight lifting will make me gain weight. Is that true?

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Q

Age and Use
Muscle mass and strength decrease with age, starting around 25 or 30 years old
Strength training is effective for maintaining muscle fitness
At ages of 20–60, active and well-trained people can maintain most of their muscle fitness
After 60, reduction in testosterone and growth hormone causes rapid decline in muscle strength
Important to continue muscle fitness training

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At what age do I start losing my strength?

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Q

Age and Use

Muscle cannot change into fat
Muscle can be negatively affected if you are overly sedentary and as you age
Atrophy
Sarcopenia: age-related loss of muscle fiber, muscle strength, and muscle mass

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Doesn’t muscle turn to fat if you quit working out?

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Q

Age and Use

Muscle size increases after 6–8 weeks
Increase in strength noticed almost immediately
Improved neuromuscular functioning
Hyperplasia versus hypertrophy
Atrophy will begin if training ceases for more than 4 weeks

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How long until I start getting big? How long do I stay big if I have to stop my training for some reason?

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FIGURE 5-3 CHANGES IN MUSCLE AND FAT TISSUE IN RESPONSE TO TRAINING
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Q

Genetics
Genetics plays a clear role in overall fitness, but its influence on muscle fitness is difficult to study
Heritability of muscles differs between sexes
Also, heritability varies for strength, endurance, and power
Heritability of strength is about 50 percent
Power, a bit more than 50 percent
Endurance is lowest of the three

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Is my strength mostly genetic?
More…

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Genetics
Genes are responsible for no more than about
50 percent of any of your muscle functions
Training is key
Hypertrophy is one area in which there is a strong genetic influence

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Benefits of Muscle Fitness
Control of body weight
Improved performance
Reduced risk of injury and disease
Improved emotional and psychological wellness

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Q

Body-Weight Control

The scientific literature is mixed on the connection between weight lifting and increased metabolism
Metabolic rate is closely related to the amount of
fat-free mass, which can be increased through muscle-fitness training
Hypertrophy can increase your resting metabolism
For each new pound of muscle, you will burn 35–50 more calories a day

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Will weight lifting increase my metabolism?

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Q

Body-Weight Control

Both burn calories
The number of calories burned is dependent on intensity
Continuous versus discontinuous
Running has the potential to burn more calories
Rests during weight lifting allow for consistently higher intensity
Tabata-like training may be best when limited time
is available

Which burns more calories—running or lifting weights?
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Q

Improved Performance

Muscle training can improve overall performance
Optimal performance requires a balance of overall strength and sport-specific skill
For recreational athletes, training at a moderate intensity of 6–10 repetitions/2–3 days a week is enough to see improvement

What can I do to improve my sports performance?
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Q

Reduced Risk of Injury and Disease

Strength training reduces the risk of injury
Improves balance and susceptibility to tendinitis and muscle strain

What can I do to keep from spraining my ankle all the time?
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Q

Reduced Risk of Injury and Disease

Strength training has positive effects with
regard to osteoporosis, back pain, arthritis, cardiovascular disease, and diabetes
It can also lower LDL cholesterol, improve HDL cholesterol, and improve the movement of glucose throughout the body

I thought walking and jogging were enough to prevent diseases. Do I really need to strength-train?
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Q

Improved Emotional and Psychological Wellness

Strength training enhances positive psychological states and increases feelings of energy
The mechanism of the change is not clear but may be related to distraction, endorphins, increased core temperature, and changes in brain chemistry
Benefits are mostly short term, but longer-term benefits are also seen
Effects on depression, self-esteem

Why does weight lifting always make me feel better?
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TABLE 5-1 CHANGES AND BENEFITS IN RESPONSE TO MUSCLE-FITNESS TRAINING
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Q

Assessing Your Muscle Fitness

Muscle strength assessment
1-repetition maximum (1-RM)
Maximum amount of weight you
can lift one time
Muscle endurance assessment
As many repetitions as possible
Norms available
Perform periodic reassessment

How strong do I need to be—and how do I know how strong I am?
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Putting Together a
Muscle-Fitness Program
Putting together a muscle-fitness program involves:
Choosing appropriate equipment and facilities
Selecting types of muscular training
Applying the FITT formula
Frequency
Intensity
Time
Type

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Q

Choosing Appropriate Equipment and Facilities

Consider access, preference, and what you
will use
Free weights are objects or devices that can be moved freely in any direction
Can promote quicker strength gains due to
the need for balance and coordination
Less expensive
Require the help of a spotter
Associated with a higher risk of injury

Aren’t free weights a lot better than machines?
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Q

Choosing Appropriate Equipment and Facilities

One of the most effective strength-training tools is your own body weight and gravity
Push-ups, planks, squats, lunges, step-ups
Resistance increases as muscle fitness increases (overload principle in play)
It costs nothing and can be done anywhere, anytime

I want to work out in my dorm.
What do I need?
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Q

Choosing Appropriate Equipment and Facilities

Consider the convenience, cost, equipment, classes, and feel of the gym
Don’t be afraid to ask for help in setting up an appropriate program
Remember gym etiquette:
Don’t sit on a machine when done; rack weights
Bring a towel and wipe down equipment
Follow the rules

What’s the best gym to join for strength training?
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Q

Selecting Types of
Muscular Training

To get fit you must:
Choose a type of equipment
Choose a type of muscle-training program
Static training
Isokinetic training
Dynamic training

I want to get more fit, but I don’t want big muscles. What type of training is right for me?
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Selecting Types of
Muscular Training
Static (isometric) training
Involves muscle contraction without any change to the length of the muscle
Exercise against a stationary force
Small range of motion (ROM)
Planks, bridges
Good for core strength, muscular rehabilitation

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Selecting Types of
Muscular Training
Isokinetic training
Exertion of a constant force at a constant speed throughout the entire ROM
Requires special machines that control the speed of contraction so that you move at a steady rate and apply a constant force throughout the entire exercise
Used for rehabilitation
Limited use for general fitness

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Selecting Types of
Muscular Training
Dynamic (isotonic) training
Most popular type
The exertion of the muscle force occurs throughout the length of the contraction
Regardless of the resistance type, the speed of dynamic contraction varies
Resistance may be fixed (free weights) or variable
(as with certain machines)
Dynamic training can be performed with body weight, rubber tubing, machines, or free weights

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TABLE 5-2 TYPES OF MUSCULAR TRAINING
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Q

Selecting Types of
Muscular Training

There are two types of contractions in each dynamic lift:
Concentric contraction: muscle shortens as it contracts
Eccentric contraction: muscle lengthens as it contracts

Is it true that muscles get bigger if you go slower in your workout?
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Selecting Types of
Muscular Training

The idea of going slow or fast has limited application
Slow eccentric contractions can increase muscle strength
This is an effect of the overload principle throughout
ROM, not speed
Faster contractions may be advantageous for certain athletes, for sports requiring rapid explosive movements

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FIGURE 5-4 CONCENTRIC VERSUS ECCENTRIC MUSCLE CONTRACTION
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Q

Applying the FITT Formula: Frequency

This depends on your goals
The ASCM recommends 2–3 days a week, with a 48-hour rest between training sessions
Add more as you move beyond the beginner level

Should I lift every day if I want to get really strong?
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Q

Applying the FITT Formula: Frequency

Delayed-onset muscle soreness (DOMS)
Seems to be related to microtears and injuries suffered within the muscle cell during new or intensive activity
Recovery is critical
When fibers rebuild, they are stronger than before

Why am I sometimes so sore the day after lifting?
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TABLE 5-3 TRAINING FREQUENCY RECOMMENDATIONS FOR RESISTANCE TRAINING
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Q

Applying the FITT Formula: Intensity

You need to lift enough weight to overload your muscles
Intensity is the amount of weight or resistance required to elicit a training response (overload principle)

What’s the best amount to lift to get stronger?
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Applying the FITT Formula: Intensity
Intensity is often calculated as a percentage of an individual’s 1-RM
60–70 percent of 1-RM for deconditioned persons, older adults, or beginners
60–80 percent of 1-RM for improvement in overall strength, mass, and to some extent endurance
70–100 percent of 1-RM for advanced-level training
Repetitions (useful alternative to 1-RM)
ASCM recommends 8–12
Number of sets
ASCM recommends 2–4 sets to fatigue (with good form)

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Q

Applying the FITT Formula: Time

The recommended two sets of 8–10 exercises should take no more than 30 minutes
Short bouts of high-intensity exercise may be effective but can lead to injury
Ways to manipulate time:
Allocate enough time to perform each movement with proper form
Alternate “push” and “pull” exercises or upper-body/
lower-body exercises

Can I get stronger in just a few minutes with extreme workouts?
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Q

Applying the FITT Formula: Type

Focus on movements, not muscles
Two types of muscle resistance exercises:
Single-joint exercises
Use one major muscle group or joint
Multiple-joint exercises
Stress more than one muscle group or joint
Has certain advantages: greater resistance, mimics
real-life activities, makes workouts more time-efficient

I like to bench and do curls.
Is that not enough?
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Applying the FITT Formula: Type
Remember that every muscle has a reciprocal
An agonist muscle pulls in one direction and an antagonist muscle pulls in the opposite direction
Must be equally developed

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Q

Applying the FITT Formula: Type

Focus on curl-ups, planks, and bridges
Less stress on the back
Must be combined with high-intensity aerobic training

What’s the best way to get a 6-pack? Is it still recommended to do endless amounts of sit-ups?
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TABLE 5-4 PROGRAM DESIGN PARAMETERS FOR RESISTANCE TRAINING
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Q

Putting It All Together
One that you do regularly and lets you work toward your goals
Total body workouts
Multi-joint exercises that work the body’s major muscle groups
Good for everyone
Time efficient

What is the best workout routine?
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Putting It All Together

Upper- and lower-body split workouts
Upper body on one day, lower body on another
Greater total amount of work; more sport-specific
More time consuming
Muscle-group split routines
Exercises for specific muscle groups
Mostly used by bodybuilders, and those seeking hypertrophy
Not practical for athletes, or for those seeking general muscle fitness

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FIGURE 5-5 MAJOR SKELETAL MUSCLES OF THE BODY (FRONT)
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FIGURE 5-5 MAJOR SKELETAL MUSCLES OF THE BODY (BACK)
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Q

Weight-Training Safety and
Injury Prevention

Warm up before you start resistance training
Use proper technique during your actual workout
Use a spotter for free weights
Don’t hold your breath
Check your equipment
Cool-down after you are done

What’s the best way to lift weights and not get hurt?
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Q

Weight-Training Safety and
Injury Prevention

Whatever works best for you

Should I run before or after I lift?
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Q

Making Progress

Use the 5–10% rule
Track your progress
Training logs, notebook, spreadsheets
The more you track, the more effective you will be in reaching your goal

When should I increase my training?
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Q

Making Progress

If your layoff has been less than 3 weeks:
reduce FITT by about 10%
Longer layoffs: drop FITT by 25%

I didn’t work out at all during spring break. How should I start back?
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FIGURE 5-6 SAMPLE MUSCLE-FITNESS TRAINING LOG
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Q

Making Progress

Try new exercises frequently
Vary your number of sets, number of repetitions, and resistance levels
Vary between traditional and functional training

I get bored with the same old workout and lose my motivation. Any ideas?
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Q

Making Progress

Core training focuses on the muscles of the abdominal region and lower back
Improves fitness, sport performance
Stabilizes the spine, improves posture
Functional training is training that mimics
real-life movement patterns
The ability to control your body weight
Integrates multiple muscle groups

Core training, functional training:
What do these even mean?
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Q

Making Progress

No—you can do both in a weight room with equipment or at home with your body weight
Also consider rubber bands, tubing, stability balls

Do I need special equipment for core training and functional training?
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Q

Making Progress

Yes—Pilates can help you build muscle fitness
as well as increase flexibility, improve body composition, and reduce stress
Try Pilates at home with an instruction book or DVD

Can I do Pilates for muscle-fitness training?
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Q

Avoiding Drugs and Supplements

Creatine should be used with caution
Taking in extra creatine triggers the body to reduce its own creatine synthesis
A better choice is to improve your diet

Creatine is a natural substance, so it’s safe to take, right?
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Q

Avoiding Drugs and Supplements
Usually money is the reason; and it can help athletes get stronger and perform better and longer
Anabolic steroids: derived from testosterone
Steroid use is illegal, immoral, unethical,
and unsafe
Side effects: liver failure, cardiovascular
disease, irritability, aggressiveness, nervous
tension, and frequent mood swings.

If steroids are so bad, why are athletes always using them?
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Q

Avoiding Drugs and Supplements
You don’t need them if you eat a healthy diet and do regular moderate exercise
Recommended daily protein intake:
0.36 grams/pound of body weight
Moderate muscle fitness does not increase protein needs
There is no need to exceed 1.0g/lb of body weight even with vigorous strength training

Are protein shakes really worth it?
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CHAPTER 6
FLEXIBILITY AND LOW-BACK FITNESS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Identify factors that affect your flexibility
List the benefits of flexibility
Assess your flexibility
Develop a flexibility training program
Identify ways to protect and care for your back

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Q

Factors Affecting Flexibility

Flexibility is the ability of a joint to move through its full range of motion
Varies from person to person
Both too little and too much can be detrimental
The goal of flexibility training is to move a joint through its normal range of motion (ROM) without pain or limitation

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Why are some people more flexible than others?

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Q

Joint Structure

Some of your joints (where two bones meet) are designed to have a greater ROM than others
Flexibility also varies from joint to joint due to other factors

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Why are some of my joints more flexible than others?
More…

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Joint Structure

Synovial joints move more freely
Cartilage cushions the ends of bones that meet in
the joint
A joint capsule surrounds the joint; the inner layer secretes synovial fluid
Ligaments connect bones and joints and provide stability
Muscles connected to tendons around the joint contract and move the bones

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FIGURE 6-1 BASIC STRUCTURE OF A JOINT
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Q

Connective Tissues and Nervous System Action

You become more flexible by increasing the range of motion in a joint
Flexibility is affected by:
Length of tissues
Connective tissue changes
Collagen
Tolerance of stretching
After holding a stretch, then repeating, you begin to feel less pain when you apply the same force

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How can I be more flexible?

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Q

Injury and Disease

Recovery from acute injuries is likely
Flexibility and strength exercises will help
Osteoarthritis
Strengthening and stretching exercises will help stabilize joints and increase ROM

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I recently recovered from a knee injury and don’t have the same movement.
Will I get it back?

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Q

Genetics

Some people are more flexible than others
Some genetic basis
Hypermobility
Hypermobile joints are less stable and can be more prone to injury and arthritis

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Do double-jointed people have a higher flexibility level than others?

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Q

Sex
In general, women are more flexible
Due to anatomical and hormonal differences

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Are women more flexible than men?

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Q

Use and Age

“Use it or lose it”
It is hard to differentiate between the effects of aging
and disuse
Without regular ROM activities, tissues may shorten and tighten
People of any age can benefit from a flexibility-exercise routine

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Why are people less flexible as they get older?

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Benefits of Flexibility
Improved performance
Reduced risk of injury
Other benefits of flexibility and stretching exercises

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Q

Improved Performance

For activities in which joints move through the full range of motion, stretching may improve performance
Flexibility affords greater efficiency of movement

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Will flexibility help me play basketball better?
More…

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Improved Performance

Different sports require different amounts of flexibility for optimal performance
Hypermobility can increase the risk of injury and reduce the speed, strength, and power needed for
a sport
Flexibility enables you to perform daily activities
Such as lifting a back pack, backing the car up, hanging a picture

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Q

Reduced Risk of Injury
It depends
There is no evidence to support stretching (as part of a warm-up) before an exercise session reduces muscle soreness and the risk of injury
It may help reduce certain injuries in non-athletes
It can be key to rehabilitation after an injury
It is important for good posture, which reduces joint strain
Flexibility in joints is critical as you age

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Does stretching prevent injuries?

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Q

Other Benefits of Flexibility and Stretching Exercises

Stretching enhances the relaxed physical state
Reduced muscle tension, blood pressure, and breathing rate
Improved mood, reduced stress, relaxed state
Stretching can be used to treat
exercise-associated muscle
cramps

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I feel better when I stretch after a workout. Does stretching help me relax?

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Q

Assessing Your Flexibility
There is no single test to assess flexibility
Flexibility is specific to each joint
The most common test is the sit-and-reach test
ROM of hamstrings, primarily
No measures are associated with peak performance
You should aim to achieve and maintain a normal range of motion in all major joints

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How is flexibility rated? How flexible should I be?

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TABLE 6-1 FACTORS THAT AFFECT FLEXIBILITY TESTS
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Q

Putting Together a Flexibility Program

To put together a safe and effective program, consider the types of training, and then apply the FITT formula
Training techniques:
Static stretching
Ballistic stretching
Dynamic stretching
Proprioceptive neuromuscular facilitation (PNF)

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What is the best way to stretch? What are the different kinds of stretches, and what are the benefits of each?

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Putting Together a Flexibility Program
STATIC STRETCHING
A slow and steady stretch with a hold at the end of the range of motion
Active stretching
Take an active role by contracting the muscles opposite to those being stretched
Passive stretching
Outside force assists in the stretching

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FIGURE 6-2 ACTIVE VERSUS PASSIVE STRETCHING
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Putting Together a Flexibility Program
BALLISTIC STRETCHING
Uses quick, jerky or bouncing movements to move joints to the end of their range of motion
Uses the momentum of the body
Not recommended for most people
Greater potential for injury
Benefits athletes involved in ballistic movements
Lunging, throwing, batting, or kicking

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Putting Together a Flexibility Program
DYNAMIC STRETCHING
Controlled movement through the active range of motion of a joint
Useful as a prelude to other activities
Elevates body and muscle temperatures
Prepares the body for optimum performance

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Putting Together a Flexibility Program
PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF)
Originally developed for rehabilitation
Affects both connective tissues and nerves in order to increase flexibility
Combines muscle contraction and stretching
Some PNF stretches require a partner or another source of resistance
Two basic PNF techniques:
Contract-relax
Contract-relax-opposite contract

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FIGURE 6-3 CONTRACT-RELAX PNF STRETCH OF THE
HAMSTRING
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TABLE 6-2 COMPARISON OF STRETCHING TECHNIQUES
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Q

Applying the FITT Formula

Stretching can hurt muscles if done incorrectly
Apply the FITT formula
Frequency:
At least 2–3 times a week
May increase frequency with experience

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Can stretching hurt my muscles?
How often should I stretch?

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Q

Applying the FITT Formula

Intensity:
Stretch to the point of slight tension or mild tightness but not discomfort or pain
Once you reach your threshold, move slightly beyond it
Time:
Total time of the session:10–15 minutes
Each static stretch should be done four times, and held for 15–60 seconds each

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How do I determine the right amount of stretch? And how long should I stretch?

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Q

Applying the FITT Formula

Stretching is physical activity
However, it does not count toward daily
or weekly aerobic or muscle-fitness goals

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Is stretching considered physical activity?

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Q

Applying the FITT Formula
Type:
Perform a stretch for each major muscle/tendon group or joint: neck, shoulders, upper and lower back, pelvis, hips, and legs
Apply the principle of specificity
Avoid stretches involving full bends of the knee, significant arching or rounding of the lower back, or pressure on the neck

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What are the best stretches? Are there any stretches that are unsafe?

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TABLE 6-3 FLEXIBILITY AND TRAINING PRINCIPLES
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FIGURE 6-4 TYPES OF STRETCHES TO AVOID—
AND SAFER ALTERNATIVES
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Q

Low-Back Fitness

Poor posture not only gives the appearance of low self-esteem and apathy, but it can also have negative effects on your health

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Why did my mother always nag me to sit up straight? Other than making me look a little better, what difference does it make?

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Structure and Function of the Spine
The spinal cord is a long, thin bundle of nerves, fluid, and support cells that extends from the brain down the back
The spinal cord is enclosed in the spinal column:
Five sections of 33 individual vertebrae
Cervical (neck)
Thoracic (upper back)
Lumbar (lower back)
Sacrum
Coccyx (tailbone)

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More…

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Structure and Function of the Spine

The upper three vertebrae sections differ from
the bottom two
Intervertebral disks: flat, elastic, gel-filled disks that act as shock absorbers
Processes: form synovial joints

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Structure and Function of the Spine
The spine has several functions
Provides structural support for the body
Allows the upper body to bend and twist
Protects the spinal cord and the roots of nerves
Serves as an attachment site for muscles, tendons, and ligaments
Supports and distributes much of the body’s weight
Absorbs impact and helps maintain balance

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FIGURE 6-5 THE SPINE
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FIGURE 6-6 VERTEBRAE AND INTERVERTEBRAL DISKS
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Q

Understanding Body Mechanics and Good Posture
Body mechanics: application of basic mechanical principles to the human body
Closely related to body mechanics is posture: the position of body parts in relation to one another

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What does body mechanics mean?

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Q

Understanding Body Mechanics and Good Posture
Good posture is essential for optimal body function
Good posture means that the body is properly aligned
See Lab Activity 6-3

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I think I have pretty good posture.
Is there a way to tell?

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Q

Understanding Body Mechanics and Good Posture

Poor posture can lead to headaches and other health problems
Poor posture has many causes:
Hereditary or congenital
Ill-fitting clothes, inappropriate furniture, excessive sitting and standing in place
Fatigue, excess weight, weak muscles, emotional issues

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I’ve been told my headaches are probably caused by bad posture. Could this be true?

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Q

Understanding Body Mechanics and Good Posture
Think about your posture; awareness is key
Improve strength and flexibility in muscles surrounding the spine
Static posture: standing or sitting straight
Dynamic posture: alignment of the body when in motion
Use a stance and movements that are mechanically efficient and least stressful on your body

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How can I improve my posture?

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Q

Prevention and Management of Low-Back Pain
Proper low-back function is critical for almost all activities of daily living
Pain may come from strains, spasms, soreness, or compression of nerves
Acute pain and chronic pain
Degeneration of intervertebral disks is a normal part of aging, and a contributor to back problems
Sciatica

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What causes back pain?

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Prevention and Management of Low-Back Pain
Many important risk factors for back pain are controllable
Poor physical fitness
Poor posture
Overweight, especially around the middle
A job that involves heavy lifting, twisting, or bending
Smoking—past or current
Stress and fatigue

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Q

Prevention and Management of Low-Back Pain
Examine the list of risk factors and develop a plan
Be physically active
Build strength and flexibility in the back and core muscles
Maintain a healthy diet
Consume adequate calcium and vitamin D to keep bones strong, etc.
Don’t smoke
Manage stress effectively
Practice good posture and body mechanics

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What helps prevent back pain? Are there special exercises?

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FIGURE 6-7 RECOMMENDED SITTING POSTURE
AND COMPUTER PLACEMENT FOR DESKTOP AND LONG-TERM LAPTOP USE
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Q

Management of Back Pain
Rest for a few days
Take a safe dose of acetaminophen or a nonsteroidal anti-inflammatory drug such as ibuprofen
Use hot or cold packs
Gradually get back to usual activities
See your physician if pain is severe or accompanied by other symptoms

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If you have back problems, what can you do to help them improve?

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CHAPTER 7
BODY COMPOSITION BASICS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

*

COMING UP IN THIS CHAPTER
Understand the basic composition of
your body
Identify factors that influence your body composition
Examine the relationship between body composition and health
Assess your body composition
Identify strategies for making changes in your body composition

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Q

Basics of Body Composition
Body composition: the makeup of the body
The relative proportions of different types of
body tissues
Muscle
Bone
Fat
Other vital tissues
Percent body fat is the measure most often used to define and evaluate body composition

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What is body composition?

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Q

Basics of Body Composition
The body needs fat in order to function
Essential fat
Found in the central nervous system, bone marrow, various organs
Surrounds nerve fibers in the brain allowing for the transmission of messages
Key component of cell membranes
Important in healthy hormone production
8–12 % in females and 3–5 % in males

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Is there such a thing as good body fat?
More…

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Basics of Body Composition
Storage fat (adipose tissue)
Site for storage of energy
Also releases molecules and hormones that that affect appetite, blood pressure, immune system function, insulin and glucose levels
Too much has negative health effects
Visceral fat
Found deep within the abdominal cavity
Surrounds internal organs
Subcutaneous fat
Found just beneath the skin
Insulates the body and regulates temperature

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Q

Basics of Body Composition
Differences in tissue density
Differences between muscle and fat
Differences in body composition

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My friends and I look about the same, but most of them weigh around 15 pounds less than I do. How is that possible?

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FIGURE 7-1 BODY COMPOSITION OF YOUNG ADULTS (AGES 20–24)
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FIGURE 7-2 VISCERAL AND SUBCUTANEOUS FAT IN THE ABDOMEN
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Q

Basics of Body Composition
Metabolism: all the processes that require energy (calories from foods) and maintain body functioning
Energy balance: connection between metabolism and body composition

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What is metabolism?

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Basics of Body Composition
The amount of energy your body requires depends on three criteria:
Resting metabolic rate (RMR)
Energy required to maintain essential processes at rest
Depends on genetics, body size, and body composition
Muscle is more metabolically active than fat
Resistance training increases RMR
Dietary thermogenesis
The energy required to digest and process food
Physical activity
Energy expended in daily living as well as formal exercise

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Q

Basics of Body Composition
The body produces and stores fat when more energy is consumed than is used to maintain body functions and fuel activities
Protects from starvation
3,500 calories is the equivalent of a pound of body weight

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How do we get fat, literally? What causes the body to retain fat, and where does it go?
More…

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Basics of Body Composition
Most fat is stored in fat deposits, which are about 80 percent fat and 20 percent support cells, immune cells, and blood vessels
If you gain weight as fat, these fat cells enlarge, storing more fat
If you lose body fat, your fat cells shrink

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Q

Basics of Body Composition
Obesity is considered more extreme and serious
Overweight: weight above a recommended range, based on large-scale population surveys or studies
Obesity: higher degree of overweight, characterized by excessive body fat
Height and waist circumference are also considered
in evaluating health risks

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Do overweight and obese mean the same thing?

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Q

Basics of Body Composition
On average, the American population has become heavier
The average weight for adults in their twenties is 15 pounds heavier today than 20 years ago
The prevalence of obesity has increased significantly

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Have Americans gotten fatter?

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FIGURE 7-3 TRENDS IN OVERWEIGHT AND OBESITY AMONG U.S. ADULTS, 1962–2010
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Q

Factors Affecting Body Composition
Body composition is based on a combination of factors
Height is related, but doesn’t predict the amount of body fat within your body
Height is a body composition factor not in your control
Some of the other factors, you can control

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Do shorter people have a higher
body-fat percentage?

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Q

Genetics
The contribution of heredity will be between 25 and 75 percent
Hundreds of genes affect body fat
INSIG2 and FTO genes
Influence body size; amount and distribution of body fat; and response to exercise
Body composition is also influenced by numerous environmental factors

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Is my body composition going to be similar to that of my parents? Is body composition based on genetics at all?

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Q

Genetics
High resting metabolic rate
Bodies that aren’t designed for muscle gain
Can build muscle, but won’t be able to radically change body type

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Why is it so hard for skinny guys to gain muscle mass?

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Q

Biological Sex
Body composition differs between the sexes and varies with age
Birth weights
Young years
Adolescence and puberty
Mid-life

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I know men and women’s bodies are different, but when my boyfriend and I
eat together, it seems as if I am more susceptible to weight gain than he is. Why?

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FIGURE 7-4 AVERAGE PERCENT OF BODY FAT BY AGE AND SEX
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Q

Biological Sex
Men are more likely to store excess fat in the abdomen; women, in hips and thighs
Android: apple-shaped; more common in men and postmenopausal women
Gynoid: pear-shaped; more common in premenopausal women

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Why do men gain fat in their belly, and women in their hips?

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FIGURE 7-5 BODY-FAT DISTRIBUTION
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Q

Age
It is hard to separate the effects of age from use
Less physical activity and exercise:
With each decade they don’t strength train, adults lose about 4–6 pounds of muscle mass, and their resting metabolic rate also declines
Physical activity and exercise, especially resistance training, can maintain muscle mass through the aging process

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Does body composition always get worse as we get older?

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Q

Ethnicity
Body composition patterns related to sex and age are consistent across all ethnic groups
However, ethnic differences have been found in average height, weight, and body composition
Differences related to culture and ethnicity

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Do different ethnic groups have different body compositions?

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TABLE 7-1 COMPARISON OF AVERAGE HEIGHT, WEIGHT, BODY MASS INDEX, AND TOTAL ABDOMINAL FAT AMONG ADULTS FROM FOUR ETHNIC GROUPS
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Q

Lifestyle and Environment
Genetics, age, and sex are factors in body composition, but different lifestyles and environments also play a role

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Some of my cousins are really fat, but my brothers and I are skinny. Why aren’t we more alike since we have many of the same genes?
More…

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Lifestyle and Environment
Energy intake: if you consume more calories than you burn, you will gain weight
Physical activity: daily activity and exercise affect energy balance and body composition
Sleep: insufficient sleep is associated with increased body fat; may interfere with the ability to regulate appetite; and increases the risk of diabetes
Stress: psychological stress linked to increased energy intake, weight gain, and excess abdominal fat; along with insulin resistance

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Q

Body Composition and Wellness
Body composition is one component of
health-related fitness
Maintaining an appropriate level of body fat is vital to a healthy, longer life

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Why is it important to know how much fat is in your body? What can one statistic like percent body fat tell you about health?

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Q

Problems Associated with Excess Body Fat
Cardiovascular disease
High blood pressure and fat in the blood
Type 2 diabetes
There is a direct relationship between excess body fat and type 2 diabetes
Cancer
Breast, prostate, colon, pancreas, esophagus, endometrium, and kidney

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My dad is really big (I don’t like to say “fat”) and I worry about him. What are his greatest health risks?

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Problems Associated with Excess Body Fat
Other problems associated with excess
body fat:
Joint problems
Osteoarthritis
Sleep apnea
Asthma
Gall bladder and liver diseases
Reproductive problems
Shortened life expectancy

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Q

Problems Associated with Excess Body Fat
The consequences of excess body fat and weight are controversial and the subject of ongoing research
Certain factors can make a difference
Age and weight history
An overweight youngster will be exposed to the effects of overweight for a longer period
We usually gain fat and weight as we age

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Can you be sort of overweight or overfat and healthy at the same time?
More…

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Problems Associated with Excess Body Fat
Body-fat distribution
Greater risk if excess is stored in abdomen rather than in hips and thighs
Other health risk factors
Additional risk factors: high blood pressure, elevated glucose
Lifestyle
Regular exercise can improve body composition and reduce risks associated with being overweight

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Q

Problems Associated with Too Little Body Fat
It is not possible for anyone to have zero body fat
A certain amount of body fat is essential for proper body function
Consequences of low body fat, being underweight:
Fluid imbalances, vitamin and mineral deficiencies,
kidney problems
Loss of bone mass, osteoporosis
Reproductive disorders

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What is the lowest body-fat percentage you can have and still maintain a healthy lifestyle? Is it even possible for a woman to have absolutely no body fat?

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Q

Problems Associated with Too Little Body Fat
Female athlete triad
Energy availability
Low energy as a result of insufficient calorie intake or increased energy expenditure without increased calorie intake
Menstruation
Amenorrhea
Bone health
Reduced bone density

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If I exercise a lot and my period stops,
is that a good thing or a bad thing?

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FIGURE 7-6 THE FEMALE ATHLETE TRIAD
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Q

Body Composition and Athletic Performance
Many factors beyond body composition determine performance
All being equal, a decreased level of body fat
(that is still in the healthy range) might improve
your performance and reduce your susceptibility
to performance-related injuries
Too little energy intake and body fat can harm both health and athletic performance
There is no ideal percent body fat for each sport

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I’m a runner. Will decreasing my body fat help make me faster?

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Q

Body Composition, Body Image, and Emotional Wellness
Body image: a mental picture of your own body and how you feel about it
Body dysmorphic disorder (BDD)—preoccupation with imagined defect in appearance
Those with BDD generally have low self-esteem and
may engage in compulsive behaviors
More common in women
Muscle dysmorphia—obsessed with the idea that one’s muscularity isn’t enough
More common in men

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What exactly is body image?

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Body Composition, Body Image, and Emotional Wellness
The two key sources of body image (and
self-esteem) are family and the media
Family life
Parents criticize the look of their children
Friends and teachers also have an influence
Media
Fashion magazines
TV shows and TV commercials
Social networking

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Where does body image come from?

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FIGURE 7-7 AVERAGE YOUNG WOMEN VERSUS FASHION MODELS AND MISS AMERICA (1920s–2000s)
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Q

Body Composition, Body Image, and Emotional Wellness
What’s important is what’s healthy
Assess your body composition according to health criteria
Avoid comparing yourself to unachievable ideals
Instead, change the way you think about your body

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So we’re supposed to worry about how we look for health reasons but not worry about how we look. How does that work?
More…

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Body Composition, Body Image, and Emotional Wellness
Accepting your body:
Focus on the positives
Focus on health and healthy habits
Realistically evaluate which aspects of your body
you can change
Set goals that are small and attainable
Avoid negative self-talk about your body
Recognize advertisements from the fitness and beauty industries as what they are
Don’t judge the appearance of others

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Q

Assessing Body Composition
It is hard to define an ideal weight
It depends on other health risk factors
Consider body composition
Percent fat is a better indicator of health status than scale weight

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What’s my ideal weight?

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Q

Body Mass Index:
An Indirect Measure
Body mass index (BMI)
One of most common techniques for assessing
body fat
Weight(kg) / Height2(m)
BMI does not take into account muscle mass
Waist circumference is used to classify health risks associated with different BMI values

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How do I determine my BMI?

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Q

Body Mass Index:
An Indirect Measure
BMI is only an indirect measure of body composition
It is less accurate for athletes, those with
above-average muscle mass, older adults,
and certain ethnic groups

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Is BMI relevant and accurate for both athletes and people who are out of shape?

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FIGURE 7-8 BODY MASS INDEX
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TABLE 7-2 BODY MASS INDEX (BMI) CLASSIFICATION AND DISEASE RISK
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Q

Methods for Estimating Percent Body Fat
Skinfold measurements
Underwater (hydrostatic) weighing
Bioelectrical impedance analysis (BIA)
Air displacement plethysmography
Dual X-ray absorptiometry

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How can you determine body-fat percentages?

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TABLE 7-3 PERCENT-BODY-FAT ASSESSMENT METHODS
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Q

Methods for Estimating Percent Body Fat
This depends on your age, sex, current body composition, and health status
Goals are important too

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What’s the right percent body fat for me?

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FIGURE 7-9 PERCENT-BODY-FAT STANDARDS FOR MEN AND WOMEN
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Q

Methods for Assessing Body-Fat Distribution
Body shape makes a difference
Waist circumference
Waist-to-hip ratio
Waist-to-height ratio
These provide some estimate of the risks associated with abdominal fat

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Does body shape make any difference when assessing weight and percent body fat?

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Q

Making Changes in
Body Composition
Set appropriate goals based on health assessments, health-risk factors
Apply SMART criteria
Seek medical advice if necessary
Track progress toward goal

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What’s a good goal for body weight and body fat?

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Q

Making Changes in
Body Composition
Focus on energy balance
Look at both sides of the energy balance equation
On the “energy out” side of the scale, body composition is best improved by a combination of exercise activities

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What’s the best way to lose body fat? What’s the best kind of exercise to lose body fat?

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FIGURE 7-10 ENERGY BALANCE
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Q

Making Changes in
Body Composition
Weight loss does not automatically equal fat loss
Dieting alone is not the best way to decrease body fat and improve body composition
The best programs for fat loss include increased exercise and modest reductions in energy intake

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Why do I lose weight but not body fat?

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Q

Making Changes in
Body Composition
To prevent weight gain:
A minimum of 150 minutes per week of
moderate-intensity aerobic exercise, or 75 minutes
of vigorous-intensity exercise

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How much exercise do I need to maintain my weight range over time?
More…

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Making Changes in
Body Composition
To lose a modest amount of weight or to maintain weight loss:
More is better: 50 minutes a day of moderate-intensity exercise or 25 minutes of high-intensity exercise
To lose significant amounts of weight:
300 minutes per week of moderate-intensity exercise or 150 minutes high-intensity exercise

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TABLE 7-4 APPROXIMATE CALORIE COSTS OF SELECTED PHYSICAL ACTIVITIES
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Q

Making Changes in
Body Composition
It is impossible to target one area for fat burning
You can strengthen muscles in one area, but not reduce fat
The exact area in which the body will mobilize fat for fuel depends on a number of factors, including genetics

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Why can’t I just focus on improving one part of my body, such as getting rid of unwanted fat in one area?

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CHAPTER 8
NUTRITION BASICS:
ENERGY AND NUTRIENTS
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Learn about the sources of energy in your diet
Discover essential nutrients for your health and wellness
Use food labels to compare the energy and nutrients in food choices
Measure your energy and nutrient intake against recommended intakes—and identify areas of concern for you

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Q

Dietary Components
and Concepts
Dietary patterns are important no matter your size
Consequences of a diet that is not balanced:
Short term: reduced energy, impaired body processes
Long term: health risks, disease
Appropriate energy intake now is key to optimal functioning of your body

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I’m already thin so does it matter what
I eat?

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Q

Macronutrients, Micronutrients,
and Energy
No one food contains everything you need
Nutrients
Must be obtained from food
Required for growth and survival
Carbohydrates, fats, proteins, vitamins, minerals, water

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Do we really need to eat from all the food categories?
More…

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Macronutrients, Micronutrients,
and Energy
Macronutrients
Nutrients, such as carbohydrates, proteins, and fats, that provide calories and that you need to consume in fairly large amounts
Micronutrients
Nutrients in the form of vitamins and minerals
Needed in small amounts
Provide compounds that liberate energy from macronutrients and regulate chemical reactions in
the body

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FIGURE 8-1 DIETARY INTAKE OF SELECTED NUTRIENTS AND FOODS IN COMPARISON TO RECOMMENDED INTAKE OR LIMIT
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FIGURE 8-2 THE DIGESTIVE SYSTEM
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Q

Macronutrients, Micronutrients,
and Energy
A calorie is a measure of the energy in a food,
as well as a measure of the energy burned through physical activity
Kilocalorie is the amount of energy required to raise the temperature of 1 kilogram of water by 1° Celsius

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What exactly is a calorie?

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Q

Energy and Nutrient Recommendations
This depends on sex, age, weight, activity level
Between 1,600 and 3,600 calories per day
Dietary Reference Intakes (DRIs)
Specify the recommended intake of nutrients for Americans of all ages
Helps prevents nutrient deficiencies and reduces risk of chronic disease
Tracking what you eat for a few days is a good way to get a good picture of your current diet

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How much should I eat each day?

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TABLE 8-1 ESSENTIAL NUTRIENTS
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TABLE 8-2 ESTIMATED CALORIE REQUIREMENTS FOR ADULTS, AGE 20 YEARS
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Q

Energy Density and Nutrient Density
Nutrient rich:
Low in calories, naturally abundant in vitamins, minerals, and other beneficial food compounds
Nutrient-dense foods are usually high in both water and fiber
Energy density:
The amount of energy in a food per unit of weight
Foods with high energy density tend to be processed and provide a large number of calories per serving

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Is there really such a thing as the
“best” food?

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The American Diet and Recommended Diet
Dietary Guidelines for Americans, 2010
Departments of Agriculture and Health and Human Services
Guidelines issued every five years
Incorporate DRIs, reflect expert reviews of nutrition research
Two overarching recommendations:
Maintain calorie balance over time to achieve and sustain healthy weight
Focus on consuming nutrient-rich foods and beverages

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Carbohydrates
Carbohydrates: a category of essential nutrients that includes sugar, starches, and dietary fiber
Main component of bread, pasta, cereal, grains, vegetables, fruit
When carbohydrates are digested they break down into glucose
Glucose that is not immediately needed can be converted into glycogen
Excess consumption can lead to weight gain and increased body fat

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Q

Simple and Complex Carbohydrates
Simple carbohydrates occur naturally (as opposed to refined sugars)
Glucose, sucrose, fructose, and lactose
Often added to foods during processing and preparation and at the table
Added sugars provide calories but few other essential nutrients
Complex carbohydrates
Wheat, oats, rice, legumes, other vegetables

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What’s the difference between a simple carb and complex carbs?

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FIGURE 8-3 ADDED SUGARS AND INTAKE OF SELECTED NUTRIENTS
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Simple and Complex Carbohydrates
Whole grains contain the entire seed
Bran: outer protective covering; rich in fiber and contains several vitamins
Germ: inner part of the seed; contains vitamins
Endosperm: center of the seed; contains complex carbohydrates
Refined whole grains
Refining strips whole grains of their germ and bran
Only the starchy endosperm remains
Most of the nutrients removed

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FIGURE 8-4 ANATOMY OF A WHOLE GRAIN
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Q

Recommended Carbohydrate Intake
DRI minimum is about 130 grams for adults
Most Americans should consume more
Acceptable Macronutrient Distribution Ranges (AMDRs)
Range of healthy values for intake of macronutrients
Suggest carbs make up 45–65% of total daily calories
Only 5–15% of total daily calories should come from solid fats and added sugars (SoFAS)

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Will eating carbs make me fat?

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Q

Fiber
Dietary fiber is a nondigestible carbohydrate with tremendous health benefits
Soluble (viscous) fiber
Improves insulin sensitivity
Delays the return of hunger
Improves the removal of cholesterol
Insoluble fiber
Makes bulky and softer stools
Makes elimination easier and more complete

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What’s the deal with fiber?
Isn’t that like prune juice for old people?

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Q

Fiber
Found in whole grain products, whole fruits with the skin, legumes, high-fiber cereals
Recommended: 14 grams per 1,000 calories
Glycemic index (GI)
How quickly carbohydrates increase blood glucose
Simple carbs create a faster increase
Follow GI principles:
Choose foods high in fiber
Choose fresh or raw foods
Limit intake of added sugars

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What are the best sources of fiber?

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FIGURE 8-5 FIBER CONTENT OF SELECTED HIGH-FIBER FOODS
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Protein
Protein is an essential nutrient that is the major structural component of all body cells
Needed for repair and growth of muscle and bone
Also functions as enzymes and hormones
4 calories per gram
Energy not liberated as easily, so not considered primary energy source of fuel for body

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Q

Complete and Incomplete Proteins

Red meat is a good source of protein, but there is more to the story
Protein is made up of molecules called amino acids
The building blocks of the body’s protein molecules
Non-essential amino acids (11) can be made by the body
Essential amino acids (9) cannot be made by the body and must be supplied by diet
Complete proteins contain all essential amino acids
Incomplete proteins lack one or more essential amino acids

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Is red meat the best kind of protein?

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Complete and Incomplete Proteins
Sources of proteins:
Complete proteins: meat, fish, dairy products,
eggs, soy
Incomplete proteins: legumes, nuts, seeds,
whole grains
For plant proteins, consume a sufficient variety
Complimentary protein pairs
Plant foods contain fiber and are lower in fat and calories
A variety of protein sources is the best plan

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TABLE 8-3 PROTEIN, SATURATED FAT, AND ENERGY CONTENT OF SELECTED PROTEIN SOURCES
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Q

Recommended Protein Intake
Healthy adults:
0.36 grams per pound (or 0.8 grams per kilogram)
10–35 percent of total
daily calories

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How much protein should I eat?

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Q

Fats
Some fats are good
Cellular integrity
Healthy reproduction
Absorption of fat-soluble vitamins
Cushioning of organs
Thermal insulation
Energy (9 calories per gram)

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I know, I know—fats are bad and should be avoided, right?

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Types of Fats
Fats in foods are made up of different types
of fatty acids
Triglycerides: the major form of fat found in foods and stored in the body
Consists of three fatty-acid molecules and a glycerol molecule

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More…

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Q

Types of Fats
Saturated fatty acids are solid at room temperature
Butter
Increase LDL; and associated with insulin resistance
The body makes all saturated fats it needs; it doesn’t need any from diet
Replace saturated with unsaturated fats

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Saturated fats, trans fats… What’s the difference?
More…

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Types of Fats
Unsaturated fatty acids are liquid at room temperature
Oils
Consumed moderately, they pose little health risk
Trans fats
Produced during hydrogenation (hydrogen atoms added into them so they are more resistant to spoilage)
Yields a new type of fat called trans fatty acids
Raise LDL levels and lower HDL levels
The less trans fat in your diet, the better

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Q

Types of Fats
Omega-3 fatty acids are found in certain fish
They are considered heart healthy: reduce blood clots and inflammation; normalize hearth rhythms
Tuna, salmon, herring, sardines, trout, mackerel, anchovies
Caution: fish can contain mercury and other heavy metals
Plant sources: flaxseed and walnut oils
Other essential fatty acids in the human diet:
alpha-linolenic acid (ALA) and linoleic acid

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Is it true that fish oil is good for you?

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FIGURE 8-6 TYPES OF FATS
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Q

Cholesterol
Dietary cholesterol is found only in animal products
Consuming dietary cholesterol in moderation is OK
Limiting saturated and trans fats is key
Blood cholesterol circulates through your body in protein packages called lipoproteins
Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)

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Which is the good and which is the bad cholesterol?
More…

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Cholesterol
Phytosterol
Found naturally in plant foods
Competes with dietary cholesterol for absorption, resulting in lower blood cholesterol levels

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Q

Water
Water is a vital nutrient needed for digestion and absorption of food
Main ingredient in blood; provides lubrication, cushioning, temperature control
To maintain a healthy water balance and sustain life, you must consume enough fluids to balance what you lose through urine, sweat, evaporation in the lungs, and bowel movements

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Why is drinking water important?

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Q

Sources of Water
On average, fluids are 80% of your daily water intake; food provides 20%
Water (obviously the best source for hydration)
Juice
Fruits
Vegetables
Soft drinks: loaded with sugar and chemicals

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Can I drink juice or soda instead of water?

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Q

Recommended Water Intake
Drinking eight glasses of water a day was long considered the norm
Dietary guidelines for Americans, 2010
Reinforces that the combination of quenching thirst and practicing usual drinking patterns (especially fluid consumption with meals) is sufficient to maintain a normal level of hydration in most cases
Daily intake may vary between individuals

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Don’t I need eight glasses of water
a day?

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Q

Vitamins and Minerals
Vitamins are organic compounds
Humans need 14 different types
Necessary for regulation of certain body functions
Tissue growth; releasing energy from nutrients; preserving healthy cells, maintaining nerves, skeletal tissue, red blood cells, immune function
Minerals are inorganic compounds
Humans need 17 different types
Essential for metabolism, growth and development, regulation of cell activity

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Are minerals different from vitamins?

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Vitamins and Minerals
Vitamins
Water-soluble vitamins
Vitamin C and the B vitamins
Travel through blood; excess excreted in urine
Must be regularly replaced
Fat-soluble vitamins
Vitamins A, D, E, and K
Absorbed differently; can be stored in liver, fatty tissues
Not as critical to consume daily

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TABLE 8-4 VITAMINS: SOURCES, FUNCTIONS, AND RECOMMENDED INTAKES
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Vitamins and Minerals
Minerals
Major minerals are required in large amounts—more than100 mg/day
Sodium, calcium, phosphorus, magnesium, potassium, chloride
Trace minerals are required in smaller amounts
Copper, fluoride, iodine, iron, selenium, zinc

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TABLE 8-5 SELECTED MINERALS: SOURCES, FUNCTIONS, AND RECOMMENDED INTAKES
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Sources and Recommended Intakes of Vitamins and Minerals
There are two sets of standards:
Recommended Dietary Allowances (RDAs)
Established to meet the essential vitamin and mineral needs of almost all individuals
Adequate Intakes (AIs)
Set if there is insufficient data to set an RDA

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Q

Sources and Recommended Intakes of Vitamins and Minerals
Most Americans can meet their entire vitamin and mineral needs by eating nutrient-rich foods without supplements
Vitamins and minerals are abundant in food, especially in whole grains, vegetables, fruits, legumes, lean meats, and nonfat dairy products

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Is it really possible to eat all the recommended vitamins each day?

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Q

Sources and Recommended Intakes of Vitamins and Minerals
Excess intake of a vitamin or mineral may cause illness immediately or over time
Fat-soluble vitamins are of concern because they are stored in the body (vitamins A, D, E, K)
Vitamin A is of particular concern
Be aware of the Tolerable Upper Intake Level (UL)
The highest level of daily intake of a nutrient that is likely to pose no risk of adverse health effects

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Can you overdose on vitamins?

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TABLE 8-6 TOLERABLE UPPER INTAKE LEVEL (UL) FOR ADULTS FOR SELECTED VITAMINS AND MINERALS
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Sources and Recommended Intakes of Vitamins and Minerals
Antioxidants
May protect cells from free radicals
Member of a broader class of compounds known as phytochemicals
Found in plants; may have positive health effects,
but have not been classified as essential nutrients
Current evidence supports a diet high in antioxidants and other disease-protecting nutrients instead of supplements

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Q

Vitamins and Minerals of Special Concern
Most Americans are short on calcium and
vitamin D
Critical in the formation of healthy bones, teeth
Deficiency can lead to osteoporosis
Milk the richest source of both
Ultraviolet radiation helps skin produce vitamin D
Skin cancer concerns; northern climates
Consider eating foods fortified with these nutrients

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How much milk should I be drinking?

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Q

Vitamins and Minerals of Special Concern
Excess sodium consumption can raise blood pressure, contribute to hypertension
Increased potassium can lower blood pressure and reduce sodium’s negative effects
Has been shown to:
Reduce cardiovascular disease death
Cut medical costs
Decrease bone loss
Reduce risk of kidney stones

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I love salty foods; can I be eating too much?

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Q

Special Recommendations for Specific Groups
Most vegetarians don’t experience any real vitamin deficiencies
Vitamin B12 is a problem for vegans because it is only found in animal foods
Iron in plant form is harder for the body to absorb
Can lead to anemia
Folic acid
All women should be concerned with consuming adequate amounts

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My girlfriend is a vegetarian. What should she be doing for her vitamins?

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TABLE 8-7 DIETARY REFERENCE INTAKE ADJUSTMENTS FOR SPECIAL CIRCUMSTANCES
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Q

Choosing and Using Supplements
Supplements are not regulated by the FDA
Research supplements; look for “seals of approval”
It is best to obtain your essential nutrients from food rather than relying on supplements
There is no evidence that supplements prevent chronic diseases in the general, healthy population
There are some special population groups that may benefit from supplements

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I’m trying to stay healthy, so which supplements should I take?

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Q

Food Labels: An Important Tool for Consumers
Food labels are meant to be a means of informing consumers of calorie content and nutrition breakdown
Regulated by the FDA
For current labels, the percentages refer to Daily Values (DVs)
Standards used on food labels help you place the food in the context of your overall daily diet
Based on a diet of 2,000 calories a day

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Should I bother with food labels?

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Food Labels: An Important Tool for Consumers
Three things to keep in mind about food labels:
Numbers can be rounded off
Use caution when reading claims on the front of food packages
Some claims and aspects of packaging are more closely regulated than others
Consider the full profile of the food

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FIGURE 8-7 NUTRITION FACTS LABEL
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Assessing Your Diet for Energy and Nutrient Intakes
There are many different ways to assess
your diet
Track to assess your diet
Keep a food log
Don’t underestimate portion sizes
A few days of data collection will give you a realistic portrait of your typical diet

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CHAPTER 9
EATING FOR WELLNESS AND WEIGHT MANAGEMENT
Questions and Answers:
A Guide to Fitness and Wellness 3rd Edition

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COMING UP IN THIS CHAPTER
Learn how to combine foods into a healthy eating plan
Improve your food selection, preparation, and safety skills
Evaluate strategies and products for weight loss and maintenance
Learn recommended techniques for healthy weight gain
Identify symptoms of eating disorders
Assess your eating habits

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Q

Planning a Healthy Diet
Knowing what to eat can be a challenge
Dietary Guidelines for Americans and the Dietary Reference Intakes (DRIs)
MyPlate: http://www.choosemyplate.gov,
U.S. Department of Agriculture (USDA) food plan that aims to be a simple reminder for healthy eating
DASH (Dietary Approaches to Stop Hypertension)

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With all the contradictory information out there, how can I know what to eat and what to avoid?

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FIGURE 9-1 USDA’S MYPLATE
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Q

USDA’s MyPlate
MyPlate helps to determine the amount of food to consume from each food group
How much you eat depends on:
Your current body weight
Your desire to change or maintain weight
Your level of physical activity

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What exactly is a portion size?
More…

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USDA’s MyPlate
Your diet should be based on these principles:
Choosing nutrient-rich foods
Staying within the limit for empty calories
Watching your portion sizes
Most people significantly underestimate their
food intake

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FIGURE 9-2 MYPLATE FOOD INTAKE PATTERNS BASED ON DAILY CALORIE INTAKE
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TABLE 9-1 TYPICAL AMERICAN DIET VERSUS MYPLATE, ADJUSTED TO A 2,000-CALORIE/DAY DIET FOR COMPARISON
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FIGURE 9-3 VISUAL GUIDE TO PORTION SIZES
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Q

USDA’s MyPlate
Check the ingredient list
If it is a whole grain it will be first on the list
Recommended amount of grains: six 1-ounce equivalents per day
Make half your grains whole
More fiber, vitamins, minerals, and phytochemicals
Nutrient-rich

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How do I know whether I am eating whole grains?

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Q

USDA’s MyPlate
In most cases, canned and frozen vegetables are as good a choice as fresh
Especially if no salt has been added
Recommended amount of vegetables:
2½ cups per day
Vary your veggies
Dark-green, orange, and red vegetables; legumes;
starchy vegetables

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Canned or frozen, which veggies are better?

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Q

USDA’s MyPlate
It must be 100% fruit juice to be labeled juice
Fruit juice drink, fruit punch, fruit cocktail, or fruit-aide have something in them besides juice
Added sugar
Recommended amount of fruit: 2 cups per day
100% juice can count, but it is best to consume whole fruits because they are lower-calorie and contain fiber

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Is a fruit “drink” the same thing as fruit juice?

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Q

USDA’s MyPlate
Plant proteins and animal proteins:
Animal is the more complete protein source
More saturated fat
Go lean with protein
Recommended amount of protein: 5½ ounce equivalents per day
Lean meats; fish; nuts; seeds; soy; legumes (could also count as vegetable)

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How can hamburger and pinto beans count as the same thing?

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Q

USDA’s MyPlate
You do not want milk calories to displace other important calories
Recommended amount of dairy: 3 cups of milk or the equivalent per day
Get your calcium-rich foods
Do not use ice cream as the primary dairy product—it is high in fat and sugar
Lactose-free products are also available
Calcium-fortified beverages like orange juice and soy milk
Lack nutrients that are typically found in dairy products

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I love milk. Can I drink too much of it?

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Q

USDA’s MyPlate
Recognize and choose healthy fats
DO NOT ELIMINATE OIL FROM YOUR DIET!!
Choose fats that are low in saturated and trans fats
Recommended amount of oils: 27 grams or about 6 teaspoons per day
The daily requirement for oils is easy to meet
but also easy to exceed, especially with
unhealthy fats

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Is it a good idea to eliminate oil since
it’s pure fat?

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TABLE 9-2 OIL CONTENT OF COMMON FOODS
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Q

USDA’s MyPlate
The best way to assess your eating pattern is to do an analysis
The more days you track, the more accurate the dietary information

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What’s the easiest way to know if I’m eating well?

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Q

USDA’s MyPlate
You should eat 300–500 calories of healthy food within 2 hours of waking
Skipping breakfast leads to poor nutritional choices later in the day and affects concentration

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Why is skipping breakfast so bad?

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Q

USDA’s MyPlate
Whole gain crackers
Low-fat microwave popcorn
Fruit
Nonfat yogurt
Nuts and seeds
Cup of vegetable soup
Homemade trail mixes

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What are some healthy snacks?

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Q

Vegetarian Diets
Most food planning sites contain options for all types of eaters
Vegans: eat only plant foods and avoid all animal products
Lacto-vegetarians: eat plant foods and dairy products
Lacto-ovo-vegetarians: eat plant foods, dairy products, and eggs

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I’m a vegetarian. Can I still use online food planners?
More…

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Vegetarian Diets
Many people follow a partial vegetarian diet
Vegetarian diets tend to be lower in saturated fat and cholesterol and higher in fiber, potassium, folate, and other micronutrients and phytochemicals
May lead to lower rates of heart disease, hypertension, and type 2 diabetes

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Q

DASH and Other Dietary Plans
The 2010 Dietary Guidelines for Americans recommends two eating patterns:
DASH diet
Mediterranean diet
Both diets can help reduce chronic disease risk, help control body weight, and provide an abundance of nutrient-rich choices

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Are any diets healthy?

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DASH and Other Dietary Plans
The DASH diet was developed to help people reduce blood pressure
Significantly reduces blood pressure, improves heart function and cognition, reduces insulin sensitivity, and improves cholesterol levels
Emphasizes: potassium-rich vegetables, fruits, low-fat dairy, whole grains, poultry, fish, nuts
Limits: sodium, red meat, added sugars

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DASH and Other Dietary Plans
The Mediterranean diet is a pattern of eating associated with cultures bordering the Mediterranean Sea
Primarily plant-based
Linked with lower rates of several chronic diseases
Staples include: unrefined grains, vegetables, legumes, fruits, nuts, seeds, fish, olive oil
Limits: saturated fat, meat, full-fat dairy products

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FIGURE 9-4 MEDITERRANEAN DIET PYRAMID
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Q

Meal Planning and Preparation
When planning a meal, think about your goals
Breakfast: whole-grain cereal, fruit, milk, yogurt
Two servings of vegetables at lunch and dinner
Snack on fruit
Go for lean proteins
Pay attention to nutrition labels on convenience foods
Start collecting recipes

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What am I supposed to do if I don’t know how to cook? Help!

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Q

Meal Planning and Preparation
Fast foods are high in calories and fat and low in fiber and micronutrients
Opt for salads, grilled chicken, fresh fruit
Beware: even salads can pack a caloric punch
Look for calorie totals, now provided

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What are the best fast-food choices?

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Q

Meal Planning and Preparation
Check menus online in advance
Avoid buffets and all-you-can-eat deals
Choose “light” or “diet” options
Eat a light snack beforehand so you don’t overindulge

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What are some good restaurants to
eat at?

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Q

Food Safety and Technology
Foodborne illness: a sickness caused by contaminated foods or beverages
Pathogens: viruses, bacteria, and other disease-causing microorganisms
Each year, affect more than 75 million Americans
325,000 hospitalizations; about 5,200 deaths
Most cases of food poisoning or stomach flu last only a few days and are characterized by nausea, vomiting, diarrhea, and fever

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Is food safety a worry at home?

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Food Safety and Technology
The most common causes of foodborne illness:
Salmonella
Campylobacter
E. coli O157:H7
Norovirus
Four steps for food safety:
Clean
Separate
Cook
Chill

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FIGURE 9-5 FOUR BASIC STEPS FOR FOOD SAFETY
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Q

Food Safety and Technology
Refrigeration is key for leftovers
Check your refrigerator’s temperature: the risk for foodborne illness rises if it is more than 40°F

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What about leftovers—can I still eat the pizza from Friday night?

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Q

Food Safety and Technology
The only safe method of determining when meat is safe to eat is to use a meat thermometer

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My mom checks a roast with a meat thermometer, but I don’t have one. Is it really necessary?

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TABLE 9-3 SAFE REFRIGERATOR AND FREEZER STORAGE FOR FOODS
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Q

Food Safety and Technology
Allergens are substances that are capable of producing an allergic reaction in the body’s immune system
Food intolerances have different underlying causes such as an absence of an enzyme or sensitivity to a substance

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So, is everyone allergic to peanuts these days?
More…

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Food Safety and Technology
Symptoms of food allergies include:
Coughing or wheezing
Flushed skin, rash, or hives
Tingling or itching in mouth
Swelling of lips or tongue
Nausea, abdominal cramps, diarrhea
Anaphylaxis
Medical emergency
EpiPen

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Q

Food Safety and Technology
Some fish contain mercury
You must balance the risk of mercury against the benefits of consuming fish
High-quality protein
Low in saturated fat
Heart-healthy omega-3 fatty acids

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Fish is supposed to be healthy, but doesn’t it contain mercury?
More…

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Food Safety and Technology
For women who are or will become pregnant, for nursing mothers, and for young children:
Do not consume shark, swordfish, king mackerel, or tilefish
Limit consumption of albacore tuna to no more than
6 oz./week
Eat up to 12 oz. of lower-mercury types of fish
Check consumption guidelines for locally-caught fish

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Q

Food Safety and Technology
Organic refers to how the food is produced
Advantages:
Conservation of resources
Recycling of animal waste
Release of fewer chemicals
Improved soil fertility
Promotion of crop diversity

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Are organic foods better than regular foods?
More…

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Food Safety and Technology
Other benefits to choosing organic foods:
Nutrition: research findings are mixed
Chemical residues: fewer pesticides
Foodborne illness: research findings are mixed
Taste: research findings are mixed
Organic foods often cost more and may have a shorter shelf life

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More…

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Food Safety and Technology
Organic foods are labeled in three different categories:
100% Organic
Organic—must contain at least 95% organic
Made with Organic—foods made with at least 70% organic ingredients
Foods in the first two categories can display the USDA Organic seal

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Q

Food Safety and Technology
These are crop plants that have been modified in the laboratory to enhance desired traits
Genetically engineered “GE” plants are plants that have been modified using modern biotechnology
60–70% of processed foods in the U.S. have GE ingredients
Food companies aren’t required by law to label GE foods

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What are genetically modified foods?
More…

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Food Safety and Technology
Risk of GE foods
Introduction of allergens and toxins to food
Accidental contamination between GE and non-GE foods
Antibiotic resistance
Adverse changes to nutrient content of a crop
Creation of “super” weeds and other environmental risks

Benefits of GE foods
Increased pest and disease resistance
Drought tolerance
Increased food supply

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Q

Making Changes for the Better
Applying basic techniques of behavior change along with sound nutrition principles is the best way to change for the better
Assess your diet
Start with a SMART goal
Start on the path to change with interim goals

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What are the best ways to break bad eating habits?

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Healthy Weight Loss
and Maintenance
Focus on energy balance
Neutral energy balance
Calories in = Calories out
Positive energy balance
Calories in > Calories out
Negative energy balance
Calories in < Calories out Fundamentally, changes in weight result from changes on one or both sides of the energy balance equation Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Focus on Energy Balance You will put weight on over time, normally about 1–2 pounds each year starting in your early twenties The DRI recommends a decrease of 7–10 calories per day for each year starting around the mid twenties Your level of physical activity will influence calorie output Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * My weight’s fine right now, so why should I worry? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Focus on Energy Balance Weight gain results from a positive energy balance A pound of body weight is equivalent to 3,500 calories, so to lose a pound, you need to create a negative energy balance of 3,500 calories Lose 1–2 pounds per week It is best to make the calorie deficit small and reasonable until weight-loss goals are met Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How many calories does it take to lose weight? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Focus on Energy Balance Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What about cutting calories or cutting carbs? In general, cutting calories causes weight loss, and being more active sustains the weight loss Moderation is key Too drastic a cut in calories is not recommended The lowest daily calorie intake recommended is 1,200 calories for women and 1,500 calories for men Checking the calorie content of food and keeping track of it is a great weight-management strategy Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Focus on Energy Balance One important weight-management issue is that we often eat for reasons other than hunger Tracking food habits and motivations will help Makes you more mindful of your eating habits Gain control over your food environment Stock your kitchen with healthy snacks Steer clear of less-healthy alternatives Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How can I not eat junk when I’m stressed out? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Focus on Energy Balance It is not uncommon for the rate of weight loss to slow down over time At first, you may quickly lose fluid weight After the first few weeks, you start to lose body fat Your metabolic rate drops (if you have lost 10 lbs. you will use 80 calories less per day) The more you lose, the harder it becomes to lose more The goal should be a balanced state of weight management Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Why does weight seem to plateau? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Focus on Energy Balance Any exercise you will keep doing Include both aerobic exercise and strength training Aerobic exercise helps burn calories How much time is necessary? 300 minutes a week (moderate intensity) 150 minutes a week (vigorous intensity) Greater durations and/or intensities are needed for weight loss and weight-loss management Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the best exercise for weight loss? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Weight-Loss Plans, Products, and Procedures Evaluate all diet plans critically Avoid extreme or gimmicky eating patterns No weight-loss supplement has been proven safe and effective for weight loss Potentially harmful Multiple side effects Not safe for women who are pregnant or may become pregnant Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the best diet book? Which weight-loss supplements are best? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Weight-Loss Plans, Products, and Procedures Gastric bypass is one type of bariatric surgery Surgical procedures for the morbidly obese Restrictive surgeries reduce or restrict the size of the stomach and slow digestion Malabsorptive/restrictive surgeries are more invasive; they restrict stomach size and bypass part of the digestive tract Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the difference between gastric bypass and liposuction? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Weight-Loss Plans, Products, and Procedures Liposuction is a cosmetic procedure that removes small bulges of fat Used to reshape certain areas New non-invasive procedure: cryolipolysis Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Weight Gain Increase caloric intake from healthy, nutrient-rich foods Eat five or six times a day Add concentrated sources of calories Eat more for breakfast Top salads with legumes or seeds Eat larger portions for dinner Eat good snacks Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I need to gain some weight but I don’t want flab. Do I just eat more? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Weight Gain Exercise is critical for healthy weight gain Resistance training is more important to increase muscle size, but you should do both Apply the overload principle Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What kind of workout should I do to gain weight? Avoid cardio? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Eating Disorders Eating disorder: a severe disturbance in eating patterns and behavior involving insufficient or excessive food intake Eating disorders are relatively common, but the underlying factors are complex Individuals usually have low self-esteem, feelings of inadequacy, and a negative body image Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How can I tell whether a friend has an eating disorder? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Eating Disorders Three main types of eating disorders: Anorexia nervosa Extreme thinness; fear of gaining weight One of highest death rates of any psychological disorder Bulimia nervosa Binge eating followed by purging or excessive exercise Binge-eating disorder Binge eating without compensatory purging Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Eating Disorders Eating disorders are not permanent, but they are not easy to treat Professional health care is required Treatment depends on the symptoms and physical problems experienced Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Are eating disorders permanent? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 9-4 EATING DISORDERS: CHARACTERISTICS AND RISKS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * CHAPTER 10 STRESS AND ITS SOURCES Questions and Answers: A Guide to Fitness and Wellness 3rd Edition * COMING UP IN THIS CHAPTER Discover the physiology of stress and relaxation Know the factors that affect your experience of stress Recognize the effects of stress on your health and performance Identify the sources of stress in your life Develop personalized strategies for managing stress * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Stress and the Stress Response Stress is the collective physical and emotional changes experienced in response to a stressor A stressor is a specific event that triggers stress A physical or emotional demand from your internal or external environment Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What is stress really? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Stress Response: Fight or Flight Any response to stress can be normal Homeostasis: a stable state of physiological functioning The stress response prepares the body for a physical reaction to a threat, whether real or imagined The brain activates the autonomic nervous system (ANS), which provides unconscious controls of critical internal body processes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * When I get stressed, I sweat a lot. Is this normal? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * The Stress Response: Fight or Flight Sympathetic nervous system Generates the fight-or-flight response, an acute state of stress Releases adrenaline and cortisol Initially beneficial, but can have negative health effects in the long term Parasympathetic nervous system Returns the body to homeostasis after the threat has passed Oxytocin helps suppress the stress response Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 10-1 THE FIGHT-OR-FLIGHT RESPONSE * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Stress Emotions: Anger and Fear Anger is a natural response to a perceived threat (i.e., injustice, jealousy), real or imagined Harmful manifestations of anger: Shouting; using violent words Inability to deal with difficult situations without anger Using or being tempted to use aggression or violence Using anger to make you feel better Being recognized as an angry person Avoiding situations because you fear your own temper Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s wrong with getting angry? Everybody does it. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Stress Emotions: Anger and Fear Suppressing anger can lead to passive-aggressive behavior Ask yourself three questions: Is this situation important enough to get angry about? Am I justified in getting angry? Will expressing my anger make a positive difference? If the answer to all three questions is yes, a calm expression of anger is appropriate If no to any, find a way to calm yourself Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the best way to deal with my anger? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q The Stress Emotions: Anger and Fear Fear is often used interchangeably with the word anxiety: a persistent state of worry, unease, and nervousness not directed at any particular threat Fear or anxiety can be categorized as rational (useful) or irrational (useless) Rational: reactions to real events in order to survive or avoid danger Irrational: unreasonable or excessive fear or anxiety Phobia Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the difference between fear and anxiety? Is either good? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * The Stress Emotions: Anger and Fear The fear response is altered in people who have post-traumatic stress disorder (PTSD) Those with PTSD have fear and stress when there is no danger; they may be constantly on edge and experience nightmares The difference between ordered and disordered anxiety is frequency and the effect on everyday functioning Generalized anxiety disorder: constant anxiety that interferes with your ability to function and relax Can cause physical problems like body aches, insomnia, and exhaustion Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Stress Emotions: Anger and Fear Psychosocial techniques for worriers: Self-monitoring: familiarize yourself with your patterns of worry and adjust your thinking Cognitive therapy: reappraise worrying by making thought patterns more positive Worry exposure: being presented with ideas that create worry in order to become used to the worry Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What can I do to stop worrying so much? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Factors Affecting the Experience of Stress Stress is an individualized experience Factors that play a role in an individual’s response to stress: Personality Gender and biological sex Cognitive factors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Personality Researchers in the 1950s developed a model of personality based on two patterns of behavior: Type A personality: rushed, ambitious, impatient , time conscious, goal driven, competitive, aggressive, quick to anger; having difficulty relaxing Type B personality: patient, easygoing, and adaptable to changing circumstances The model has been criticized as oversimplified Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What personality types experience the most stress? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Personality Additional types (equally controversial) Type C: introverted, respectful, eager to please, compliant Type D: increased levels of anxiety, irritation, and depressed mood, along with elevated levels of cortisol Threefold increased risk for future cardiovascular problems Personality is a result of heredity and social, psychological, and behavioral factors Personality traits fall within five broad domains: openness, conscientiousness, extraversion, agreeableness, neuroticism Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Gender and Biological Sex Hormonal and evolutionary differences cause men and women to handle stress differently Women are more likely to nurture and reach out Men are more likely to initiate confrontations or withdraw Cultural differences may also play a role Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Do guys and girls handle stress differently? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Gender and Biological Sex There is also a biological component: oxytocin Oxytocin is produced in both men and women, but in men, its effects are diminished by testosterone This could help explain different responses between the sexes These differences may have evolutionary roots Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Ways of Thinking: Cognitive Strategies Theories about stress responses: The transactional model of stress outlines how we assess and approach a stressful situation Primary appraisal Secondary appraisal Coping Reappraisal Attribution theory focuses on how we assess success or failure after a stressful event Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Why does it seem my friends handle stress better than I do? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Stress and Performance Yerkes-Dodson law (inverted U hypothesis) Some stress is good Too much is not Too much or too little stress, and performance will suffer Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I’d rather drop a class than give a presentation in it. Why does stress make public speaking so much worse for me? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 10-2 YERKES-DODSON LAW: STRESS AND PERFORMANCE * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Acute Versus Chronic Stress Acute stress is usually temporary but can cause: Muscle tension Headache Heartburn Dry mouth Short term memory loss Chronic stress can be more serious and long-lasting Especially if corticosteroid levels remain elevated Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Can stress really make me sick? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Acute Versus Chronic Stress General adaptation syndrome (GAS) Selye’s three-stage model of how chronic stress affects health Alarm reaction: acute reaction (fight or flight) Resistance: body’s attempt to adapt to the demands of a persistent stressor Exhaustion: state of impaired functioning if persistent stressor exhausts body’s resources for coping Distinguishes between positive (eustress) and negative stressors (distress) * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Acute Versus Chronic Stress Recent research focuses on allostatic load Cumulative physical damage of chronic exposure to stress hormones Increase in circulating blood corticosteroid levels When allostatic load exceeds one’s ability to adapt and cope, the risk for health problems increases * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 10-3 STRESS WARNING SIGNALS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * TABLE 10-1 STRESS-RELATED HEALTH PROBLEMS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sources of Stress Major underlying causes of stress: Change Fear of the unknown Sources of stress: Life experiences, large and small Job and financial pressures Relationships and families Social and environmental stressors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Life Experiences Large and Small Big life changes that are unexpected can cause stress So can routine aspects of daily life “Little” things outside our control These can add up over time * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Job and Financial Pressures The top stressors are money and work Chronic workplace stress is linked to cardiovascular disease and premature mortality For college students: money, academics, roommates, and relationships are top stressors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What causes the most stress? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 10-2 TOP STRESSORS REPORTED BY AMERICAN ADULTS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Relationships and Families Homesickness is a common experience for those leaving home for the first time “Friendsick” Find a support group Focus on developing new friendships Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I really miss my friends back home. How do I deal with being so homesick? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Relationships and Families Nontraditional students typically have a myriad of life responsibilities Such students need: Creative time management A realistic course load The support of family and coworkers Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What about dealing with stress when you’re not 19, single, and living in the dorms? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Social and Environmental Stressors Social stressors Interacting with new people Facing tough competition or discrimination Using English if it isn’t your first language Environmental stressors Crowded or loud residences Poor public transit Extreme weather Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Social and Environmental Stressors Communication and respect are key to living with someone new Common courtesy Learn about each other Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I’ve never shared a bedroom before. How am I supposed to live with someone I’ve never met? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Managing Stress Once you’ve identified your major stressors, it’s time to think about coping strategies More than 90 percent of Americans report trying some form of stress-management technique Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * TABLE 10-3 AMERICAN ADULTS’ STRESS-MANAGEMENT TECHNIQUES * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Time Management Set online time limits, stick to the original task, and plan web destinations before logging on Other time management strategies: Prioritize, schedule, make to-do lists, and stay on task Use your planner Effective use of time is crucial to accomplishing one’s personal and professional goals Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I thought computers were supposed to make me use my time better, but every time I log on, I waste tons of time! What can I do? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Cognitive Strategies Engage in realistic self-talk Strategies for dealing with negative self-talk: Problem-focused coping Attempt to do something practical and constructive about the stressor Emotion-focused coping Attempt to regulate emotions elicited by the stressful event Positive self-talk, talking with others, journaling Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does positive thinking really stop me from worrying? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Cognitive Strategies One way to restructure more positive self-talk: the ABCDE model A—adversity: I lost my car B—belief: I can’t get to school C—consequence: have to drop out D—dispute the belief: car pool or bus E—re-energize: stay in school Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Cognitive Strategies Focus on the present; don’t stress about yesterday or tomorrow Setting realistic goals is key Develop problem solving skills: Identify the problem Brainstorm possible solutions Consider positives and negatives; select best approach Evaluate the effectiveness of the solution tried Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I just can’t seem to get over my bad quiz grade. How can I move on? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Healthy Relationships and Social Support Meet new people, and make time for your friends Be a good listener Ask people about their feelings and really pay attention to what they say Reflect back what you hear, so the other person knows you genuinely understand Focus your questions, comments, and attention on the other person Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I can’t seem to make any new friends. Any advice? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Relationships and Social Support Examine your patterns of communication Passive communication: failing to express feelings, thoughts, and beliefs honestly Aggressive communication: directly standing up for personal rights and expressing thoughts, feelings, and beliefs in a way that is emotionally honest but may make others feel humiliated, degraded, belittled, or intimidated Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I get the feeling some people think I’m rude. What can I do to change that? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Healthy Relationships and Social Support Assertive communication will help you maintain relationships while still expressing yourself Assertive communication: standing up for personal rights and expressing thoughts, ideas, feelings, needs, and beliefs in direct, honest, and appropriate ways that are sensitive to others Tips for communicating assertively: Use confident body language Use a firm and pleasant tone Don’t assume that you know what other people are going to say or do Think win-win Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Healthy Relationships and Social Support Try to surround yourself with positive, sharing people Not everything goes perfectly in any relationship Relationship violence is NEVER OK Don’t compromise when it comes to your own safety Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How do you know whether a friendship is worth it? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Healthy Lifestyle Choices: Activity, Diet, and Sleep Physical activity is a proven stress buster Any amount of physical activity will help Exercise bouts as short as 10 minutes have been shown to elevate people’s moods Good stress-relieving activities include: Yoga T’ai chi Pilates Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does working out really relieve stress? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Lifestyle Choices: Activity, Diet, and Sleep Eating habits can affect your stress level for better and for worse Good eating habits counteract stress by supporting your immune system and controlling blood pressure Limit caffeine intake Too much can make you jittery and anxious Fried and fatty foods may make falling asleep difficult Pay attention to sugar and salt intake Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does what I eat affect my stress level? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Lifestyle Choices: Activity, Diet, and Sleep Sleep is essential for optimal wellness 6–8 hours for an adult Lack of sleep may lead to problems in the short term (colds) and the long term (high blood pressure, blood glucose abnormalities, abdominal fat accumulation) You will function at a higher mental and physical level Persistent snoring may be linked to obstructive sleep apnea Can cause daytime sleepiness, cardiovascular problems Requires medical care Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Why do I need sleep? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Healthy Lifestyle Choices: Activity, Diet, and Sleep Insomnia is characterized by persistent difficulty falling asleep or staying asleep Emotional stress is the primary cause Stress management techniques should be used Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I just can’t seem to get to sleep. How can I turn my brain off? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Healthy Lifestyle Choices: Activity, Diet, and Sleep Power naps can restore alertness, enhance performance, decrease stress, reduce mistakes Keep to 20–30 minutes Be consistent Keep warm and turn off the lights Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Is there really such a thing as a power nap? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Spiritual Wellness Spirituality has three general components: Feeling a connectedness to ourselves and to others Developing a system of personal beliefs and values Finding meaning and purpose in life Spirituality does not necessarily mean religion Spirituality is personal and subjective Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Will spirituality make me more or less stressed? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Spiritual Wellness Steps to develop spiritually include: Improve your self-esteem Engage in meaningful activities Foster relationships with the people who are important to you Help others Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Relaxation Techniques The relaxation response: a physiological state of deep rest that reverses the body’s responses to stress Breathing and posture Progressive muscle relaxation Meditation Visualization and mental imagery Many other strategies Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What are some good relaxation techniques? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Relaxation Techniques Breathing and posture Diaphragmatic breathing relaxes muscles, quiets the mind, and gets oxygen to the blood Good posture radiates ease and confidence and can make you feel better about yourself Progressive muscle relaxation (PMR) Tense your muscles and then actively reduce tension while your concentration is on the body, not stressors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Relaxation Techniques Meditation is an internal state of relaxed awareness Exclusive meditation Inclusive meditation (mindfulness meditation) Prayer Repeating a mantra Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How does meditation reduce stress? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Relaxation Techniques Other strategies for relaxation: Music Journaling Reading Massage Spending time with a pet Laughter Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I like to listen to music when I’m upset. Does that reduce stress? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Relaxation Techniques Visualization/mental imagery: Visualization is a technique using all the senses to imagine a place or scene that is comfortable, soothing, and relaxing Temporarily removes us from reality Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q When Stress Becomes Too Much: Getting Help Stress becomes dangerous when it interferes with your ability to live normally It is important to recognize signs of depression Realize that feelings of exhaustion and helplessness are part of the illness Don’t be scared or ashamed to seek help Virtually all colleges and universities provide free counseling Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the difference between stress and depression? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q When Stress Becomes Too Much: Getting Help If someone appears suicidal, take action If the threat seems imminent, call 911 If you’re not sure, call the suicide prevention hotline If the threat is not imminent, talk to your friend Listen, show empathy, and do not judge Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What should I do about a friend who seems depressed or suicidal? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 10-4 SYMPTOMS OF DEPRESSION AND RISK FACTORS FOR SUICIDE * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter 11 chronic diseases Questions and Answers: A Guide to Fitness and Wellness 3rd Edition 1 COMING UP IN THIS CHAPTER Identify the major types of cardiovascular disease, cancer, and diabetes Assess your personal risk factors for these chronic diseases Understand screening, diagnosis, and treatment options Plan steps to reduce your risk for these diseases 2 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 2 Table 11-1 Estimated Prevalence and Annual Mortality from Cardiovascular Disease, Cancer, and Diabetes 3 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 3 Cardiovascular Disease Cardiovascular disease (CVD) is a broad collection of many diseases that affect the heart (cardio) or blood vessels (vascular), or both Deaths due to CVD have declined in the last 20 years Still responsible for one in every three U.S. deaths By 2030, over 40 percent of the U.S. population is projected to have some form of CVD Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 4 What is cardiovascular disease? How many people die from it? Q 4 Types of Cardiovascular Disease CVD is group of diseases that affects the heart and/or blood vessels Heart attacks, strokes, coronary artery disease, hypertension, heart failure, and peripheral artery disease Strokes are one of the most common forms of CVD Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 5 Heart attacks and strokes affect different parts of the body, so why are they always lumped together? Q 5 Figure 11-1 Percentage breakdown of U.S. deaths from cardiovascular disease 6 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Types of Cardiovascular Disease Coronary artery disease (CAD) Usually caused by atherosclerosis Buildup of plaque creating an occlusion Can lead to arteriosclerosis When atherosclerosis occurs in coronary arteries, CAD results In artery leading to brain—stroke In artery to a limb—peripheral artery disease Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 7 What type of cardiovascular disease kills the most people? Q 7 Types of Cardiovascular Disease CAD often has no symptoms as it develops Once developed, it may reveal itself as: Angina pectoris: chest pain as result of reduced blood supply to heart Heart attack, or myocardial infraction (MI) Blood supply in a coronary artery is blocked, depriving the heart of oxygen Arrhythmia: a change in the normal pattern of the heartbeat Cardiac arrest: sudden loss of responsiveness, pulse, and blood pressure 8 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Figure 11-2 Atherosclerosis and heart attack 9 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 9 Types of Cardiovascular Disease Stroke: when the blood (and oxygen) supply to a part of the brain is suddenly interrupted Two major types: Ischemic stroke: caused by a blocked artery Hemorrhagic stroke: caused by a burst blood vessel Transient ischemic attacks (TIAs) “Mini-strokes”; caused by temporary blockage and typically do not cause lasting damage Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 10 Is stroke caused by a blocked artery or burst artery? Q 10 Figure 11-3 Stroke 11 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 11 Thrombus- a clot that forms in and occludes an artery to the brain Embolus- a clot that forms elsewhere and travels to a cerebral artery Cerebral hemorrhage- a blood vessel in the brain that bursts Aneurysm- a weak spot in the blood vessel that forms a pouch that is subject to rupturing Types of Cardiovascular Disease Peripheral artery disease (PAD) occurs in the limbs, most commonly the legs It may cause leg pain when walking, leg numbness or weakness, and coldness or paleness of the limb Unless treated, it may lead to infections and amputation of the affected limb Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 12 Can I really get CVD in my arms and legs? Q 12 Types of Cardiovascular Disease Temporary increases in blood pressure are OK Sustained high blood pressure (hypertension) is not OK Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 13 If my blood pressure goes up naturally when I exercise, why is high blood pressure so bad? More… Q 13 Types of Cardiovascular Disease Blood pressure is the force of blood pumping against blood vessel walls Systolic blood pressure (top number) Force produced when the heart contracts Diastolic blood pressure (bottom number) Force between beats when the heart is at rest Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 14 14 Types of Cardiovascular Disease The recommended blood pressure is less than 120/80 Hypotension: low blood pressure Less common Systolic pressure below 90 or diastolic pressure below 60, or both Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15 For blood pressure, how high is too high? Q 15 Table 11-2 Blood Pressure Classification for Adults Age 18 and Older 16 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 16 Types of Cardiovascular Disease Heart attack can lead to heart failure The heart is unable to pump a sufficient volume of blood Often causes shortness of breath, fatigue, and fluid buildup May compromise the ability of the kidneys to eliminate fluid Heart failure complicated by fluid buildup is referred to as congestive heart failure Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 17 Is heart failure the same as a heart attack? Q 17 Types of Cardiovascular Disease Heart murmur refers to a variety of conditions Most have no ill effects, and no treatment is needed Result of inherited defects, infections, heart disease May be related to heart valve function Mitral valve prolapse (MVP) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18 What can be done to eliminate a heart murmur? Q 18 Types of Cardiovascular Disease Varicose veins are a product of improper valve function Blood accumulation, twisting, and enlargement of affected veins Caused by aging, hereditary, hormone changes The best prevention is exercise and avoidance of excess weight Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 19 What causes varicose veins, and how can I avoid them? Q Assessing Your Risk for Cardiovascular Disease: Factors You Cannot Control You can’t reverse your familial predisposition to CVD, and some risks factors are not modifiable Important to know family health history/ genetic predispositions CVD that may be caused by inherited traits include certain forms of cardiomyopathy; arrhythmia; aneurysm; and Marfan’s syndrome Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 20 Is there any way you can reverse genetically predisposed heart problems? Q 20 Assessing Your Risk for Cardiovascular Disease: Factors You Cannot Control The prevalence of CVD rises with age This is due to the wear and tear on the heart and blood vessels Leads to structural and functional alternations, i.e. hypertension Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 21 Why does getting older make a person more likely to have CVD? Q 21 Figure 11-4 Prevalence of high blood pressure among adults age 20 and over by age and sex 22 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 22 Assessing Your Risk for Cardiovascular Disease: Factors You Cannot Control Men are more likely to develop and die from CVD at a younger age There is no clear reason for the difference Women are more likely to die from a heart attack On the horizon: studies that examine heart physiology and rhythms, and hormone fluctuations Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 23 Why do more men have heart attacks than women? Q 23 Figure 11-5 Incidence of cardiovascular disease among adults age 20 and over, by age and sex 24 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 24 Assessing Your Risk for Cardiovascular Disease: Factors You Cannot Control Studies have found different rates of CVD and associated risk factors among different ethnic groups The reasons are complex but include socioeconomic and biological factors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 25 How does ethnicity affect cardiovascular disease? What group or groups are most at risk? More… Q 25 Assessing Your Risk for Cardiovascular Disease: Factors You Cannot Control African Americans Higher prevalence of CVD, hypertension, and stroke Asian Americans and Latinos Lower prevalence of heart disease than other groups American Indians and Alaska Natives Highest prevalence of stroke as a group Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 26 26 Cardiovascular Disease Prevention Some CVD risk factors are modifiable Avoid tobacco Keep alcohol use moderate and avoid drugs Manage stress in healthy ways Have regular screenings Reduce elevated blood pressure Maintain healthy cholesterol and triglyceride levels Control diabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 27 Cardiovascular Disease Prevention Body weight and food choices are only part of what affects CVD risk Genes, age, biological sex, and ethnicity also count Physical activity is an important factor in reducing one’s risk Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 28 Are people who can eat all they want and not gain weight still at risk for cardiovascular disease? Q 28 Cardiovascular Disease Prevention Many factors must be looked at to assess CVD risk Among the factors: age, sex, smoking and drinking habits, eating patterns You are a sum of your risk factors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 29 If you have excellent cardiovascular fitness but CVD runs in your family, do you have a greater risk than someone with no family history of CVD? Q Cardiovascular Disease Prevention The best food plan for CVD prevention is balanced and moderate Fiber-rich foods, low-fat dairy products, and seafood Limit excess calorie intake from added sugars, fats, and processed foods Keep alcohol intake moderate Limit salt intake Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 30 What types of food should I avoid and eat to help prevent cardiovascular disease? Q 30 Cardiovascular Disease Prevention Added weight puts stress on the heart People with excessive body fat are more likely to develop CVD even with no other risk factors Increased physical activity and a balanced diet are key Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 31 If I’m overweight is my risk a lot higher? Q Cardiovascular Disease Prevention Avoid tobacco Smoking not only raises cancer risk but also significantly increases risk for cardiovascular disease Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 32 Smoking causes cancer, not cardiovascular disease—right? More… Q 32 Two issues must be addressed in order to quit smoking, the nicotine addiction and psychological dependence. One-third of all cigarette smokers try to quit each year, but less than 10% succeed. Cigarette smoking is responsible for one out of ever five deaths in the U.S. annually. Cardiovascular Disease Prevention Smoking: Affects fatty buildup (HDL and LDL levels) Increases heart rate Contributes to arrhythmias Elevates blood pressure, reduces the oxygen level in the blood, and may trigger blood clots The body slowly begins to heal as soon as someone quits The risk of CVD falls by 50 percent just 1 year after quitting Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 33 33 Two issues must be addressed in order to quit smoking, the nicotine addiction and psychological dependence. One-third of all cigarette smokers try to quit each year, but less than 10% succeed. Cigarette smoking is responsible for one out of ever five deaths in the U.S. annually. Cardiovascular Disease Prevention Keep alcohol use moderate, and avoid drugs No more than 2 drinks per day for men or 1 drink per day for women The effects of alcohol use can be positive or negative Alcohol use is associated with a small increase in HDL and reduced clot formation Excessive drinking can lead to high blood pressure, arrhythmia, stroke, sudden cardiac death, and obesity Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 34 Does alcohol affect cardiovascular disease? What about other drugs? Q 34 Two issues must be addressed in order to quit smoking, the nicotine addiction and psychological dependence. One-third of all cigarette smokers try to quit each year, but less than 10% succeed. Cigarette smoking is responsible for one out of ever five deaths in the U.S. annually. Table 11-3 Drugs and Related Cardiovascular Disease Complications 35 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 35 Two issues must be addressed in order to quit smoking, the nicotine addiction and psychological dependence. One-third of all cigarette smokers try to quit each year, but less than 10% succeed. Cigarette smoking is responsible for one out of ever five deaths in the U.S. annually. Cardiovascular Disease Prevention Manage stress in healthy ways There is a likely connection between stress and cardiovascular disease The acute stress response is associated with elevated blood pressure and heart rhythms Over time, the hormones associated with uncontrolled stress may alter glucose and blood fat levels Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 36 Is stress a major factor in cardiovascular disease? Q 36 Cardiovascular Disease Prevention Have regular screenings for: Blood pressure Cholesterol and triglycerides Triglycerides Diabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 37 How often do I have to get my blood pressure and cholesterol checked? Q 37 Cardiovascular Disease Prevention Reduce elevated blood pressure Hypertension is a type of cardiovascular disease that is a risk factor for other types of CVD Keeping your blood pressure in check can help prevent CVD and complications from many conditions Eat a balanced, low-sodium diet, engage in physical activity, maintain healthy weight, limit alcohol, and avoid smoking Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 38 What can I do to lower my blood pressure? Q 38 Cardiovascular Disease Prevention The connection between the foods you eat and the fats (lipids) in your blood are complex Cholesterol is a waxy substance that occurs naturally in all cells of the body Low-density lipoprotein (LDL)—bad cholesterol High-density lipoprotein (HDL)—good cholesterol Triglycerides High levels are closely associated with CVD Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 39 How does the fat in the foods I eat affect my cholesterol? Q 39 Table 11-4 Cholesterol and Triglyceride Classification 40 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 40 Cardiovascular Disease Prevention People with diabetes are two to four times more likely to develop cardiovascular disease Elevated blood glucose levels can harm cardiovascular system Metabolic syndrome: the cluster of conditions that puts people at risk for both heart disease and type 2 diabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 41 Why does diabetes affect the heart? Q 41 Table 11-5 Metabolic Syndrome 42 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 42 Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Some forms of CVD have no visible symptoms Testing is required Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 43 Would I know if I had CVD? Q 43 Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Symptoms vary depending on the type of CVD Signs to watch out for: Chest pain Fatigue Shortness of breath Leg pain Palpitations Light-headedness and fainting Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 44 Does cardiovascular disease hurt? Would it affect my everyday activities? Q Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Look for signs Chest and upper body discomfort (including jaw, neck, arms, back, stomach) Shortness of breath Cold sweat, nausea, light-headedness Prompt treatment is crucial Call 911 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 45 How can you tell if a person is having a heart attack or a stroke? Q Table 11-6 Warning Signs of Heart Attack and Stroke 46 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 46 Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Cardiopulmonary resuscitation (CPR) Artificial blood circulation and respiration For victims of cardiac arrest Doesn’t usually restart the heart but can temporarily maintain circulation Resuscitation usually requires defibrillation AEDs Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 47 When are you supposed to use CPR? Q Table 11-7 Tests for Diagnosing and Monitoring Cardiovascular Disease 48 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 48 Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Lifestyle changes are the first line of defense Other treatments include: Medications Coronary angioplasty and the placement of a stent Coronary bypass surgery Pacemakers Heart valve repair or replacement Heart transplant Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 49 What kinds of medicine and help are available? Q Symptoms, Diagnosis, and Treatment of Cardiovascular Disease Many forms of CVD are treatable It is necessary to learn to manage CVD Prevention is best Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 50 How likely is it that someone will survive and recover from CVD? Is there a cure for it? Q Cancer Cancer is a broad category of disease, characterized by the uncontrolled growth of cells Tumors are abnormal clumps of cells Benign means noncancerous Polyps Malignant tumors are known as cancer Metastasize: spread Primary tumor and secondary tumors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 51 What is cancer? What is the difference between malignant and benign tumors? Q 51 Figure 11-6 Normal cell division versus cancer cell division 52 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 52 Cancer About 13.7 million Americans with a history of cancer are alive today Each year: 1.66 million new diagnoses 586,000 deaths The number of new cases occurring each year has begun to decline slightly Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 53 How many Americans have cancer? Q Types of Cancer There are hundreds of types of cancer, most falling into one of these general groupings: Carcinoma: in the skin or tissue lining or covering 80–90% of all cases Sarcoma: in connective or supportive tissue Lymphoma and myeloma: in the immune system Leukemia: in blood-forming tissues Central nervous system cancers: in the tissues of the brain or spinal cord Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 54 54 Types of Cancer The most frequently diagnosed cancers in the U.S. are basal cell carcinoma and squamous cell carcinoma Noninvasive and highly curable Lung cancer is the leading cause of cancer death Lung, liver, and pancreatic cancers have poor survival rate Diagnosis typically doesn’t happen until advanced Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 55 What is the most common type of cancer? Which type is most severe? Q Table 11-8 Most Frequently Diagnosed Cancers in the U. S., 2012 estimates 56 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 56 Assessing Your Risk for Cancer Cancer risk is viewed in two ways: Lifetime risk: probability of dying from cancer in your lifetime Relative risk: extent of the relationship between a risk factor and a specific kind of cancer Specific risk factors: heredity/genetics; age; gender; ethnicity; exposure to cancer-causing agents Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 57 What are my chances of getting cancer? Q 57 Assessing Your Risk for Cancer Heredity/genetics: All cancers involve genetic mutation (damage) Most are random Only 5–10% are linked to inherited mutations In evaluating your own risk, consider: How many family members have had a particular type of cancer Whether any were diagnosed at a young age Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 58 If someone in my family has cancer, am I likely to get it too? Q 58 Assessing Your Risk for Cancer The likelihood of being diagnosed with cancer rises with age Genetic mutations and environmental factors build up Increased exposure/decreased ability to repair damaged cells Testicular cancer is an exception Although uncommon, it is more prevalent in men aged 15–34 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 59 Is cancer common in young adults? What types of cancer should I worry about now, when I’m 20? Q 59 Assessing Your Risk for Cancer Men are more likely to develop cancer Half of all men will develop cancer at some point in their life; one-third of all women Data are inconclusive as to why Lifestyle factors Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 60 Are men or women more likely to get cancer? Q Assessing Your Risk for Cancer Cancer is more common in African Americans Other ethnicities have lower overall cancer rates but higher rates of specific cancers Many factors contribute Low incomes; limited access to health care, insurance Cultural dietary factors and preferences for early marriage and childbirth Genetics Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 61 What groups are most at risk for cancer? Q 61 Assessing Your Risk for Cancer A carcinogen is any substance that causes cancer Radiation: X-rays, radon, sunlight, and tanning beds Certain hormones and viruses Asbestos Tobacco Solvents Pesticides Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 62 What’s a carcinogen? Q 62 Cancer Prevention Avoid tobacco Pay attention to your diet, physical activity, and body weight One-third of all cancer deaths are due to poor nutrition and physical activity and/or excess body weight Drink alcohol in moderation Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 63 Is there a way to keep from getting cancer? More… Q 63 Cancer Prevention Be aware of infectious agents Prevent with vaccination, antibiotic treatments, and lifestyle choices Avoid unnecessary radiation X-rays, radioactive substances, sunlight Be cautious with sunlight, and avoid tanning lamps and booths UV rays can lead to melanoma Minimize stress Be careful about chemical exposure Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 64 Symptoms, Diagnosis, and Treatment of Cancer Early cancer screening is critical Screening tests performed before any symptoms appear can help find cancer in its earliest and most treatable stage Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 65 When am I supposed to get all those cancer tests—and does everyone really need them? Q 65 Table 11-9 Cancer Screening Guidelines for the Early Detection of Cancer in Average-Risk Asymptomatic People 66 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 66 Symptoms, Diagnosis, and Treatment of Cancer General symptoms to watch for: CAUTION Changes in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 67 What are symptoms of cancer? Q 67 Figure 11-7 ABCDEs of melanoma 68 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 68 Symptoms, Diagnosis, and Treatment of Cancer There is no single test to diagnose cancer Possible tests include: Biopsy Imaging procedures Tumor marker or lab tests Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 69 What tests will a doctor do to figure out if a symptom really means cancer? Q 69 Symptoms, Diagnosis, and Treatment of Cancer When someone is diagnosed with cancer, the type of cancer and stage of development will be identified Stage: I–IV (stage I, early; stage IV, advanced cancer that has spread) In situ—found only in the layer of cells where it began Prognosis Typically decreases as stage increases Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 70 What does it mean when they say that someone has stage IV cancer? Q Figure 11-8 Stages and spread of cancer 71 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 71 Symptoms, Diagnosis, and Treatment of Cancer Chemotherapy: drugs to kill cancer cells or inhibit their growth Radiation therapy: use of high-energy rays to kill or damage cancer cells in an attempt to keep them from growing and/or spreading Local rather than a systemic treatment Surgery: removal of malignant tissue Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 72 Once someone has cancer, what’s the best way to treat it? Q 72 Diabetes Diabetes mellitus is a metabolic disorder characterized by problems with the body’s production or use of insulin Causes glucose to build up in the blood stream, resulting in high blood sugar, or hyperglycemia Because cells can’t obtain sufficient glucose, body loses main source of energy Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 73 What is diabetes? Q 73 Diabetes Prolonged hyperglycemia can cause damage to nerves, blood vessels, and other organs Untreated, it can lead to ketoacidosis Long-term complications include higher rates of CVD and lower life expectancy Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 74 What’s bad about high blood sugar? Q Figure 11-9 Possible complications of diabetes 75 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 75 Diabetes Hypoglycemia or low blood sugar occurs when glucose levels in the blood are low Relatively rare Danger is to the brain because without glucose, brain cells die Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 76 Can blood sugar be too low? Q Diabetes Diabetes is more common in older adults The number of cases among children and teens is growing An estimated 79 million American adults have prediabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 77 Who is most likely to develop diabetes? Q Types of Diabetes There are three primary types of diabetes: Type 1 diabetes: an autoimmune disease attacking and destroying the insulin-producing cells of the pancreas Type 2 diabetes: the pancreas produces insulin, but cells don’t respond properly to the insulin Insulin resistance Gestational diabetes: high glucose levels during pregnancy Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 78 Are some kinds of diabetes more dangerous than others? Q 78 Types of Diabetes Before developing type 2 diabetes, people often develop prediabetes, impaired glucose tolerance Higher than normal glucose, but not high enough to be classified as diabetes Can suffer the same complications as those with diabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 79 Can you have high blood sugar without having diabetes? Q Figure 11-10 Normal glucose metabolism, type 1 diabetes, and type 2 diabetes 80 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 80 Assessing Your Risk for Diabetes Different types have different causes Type I: autoimmune condition Genetic and viral factors are suspected to be the primary trigger The exact cause is unknown Develops most often in children Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 81 What causes diabetes? More… Q Assessing Your Risk for Diabetes Type II: causes unknown; risk factors include: Age 45 or older BMI over 25; not physically active A family history of diabetes High blood pressure or high cholesterol Gestational diabetes Blood glucose levels that are higher than normal African American, American Indian, Asian American, Pacific Islander, or Hispanic/Latino genetic heritage Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 82 More… 82 Assessing Your Risk for Diabetes Type II: causes unknown; risk factors include: Polycystic ovary syndrome Dark, thick, velvety skin around the neck or in the armpits Blood vessel problems affecting the heart, brain, or legs Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 83 83 Figure 11-11 Lifetime risk of diabetes by BMI at age 18 84 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 84 Assessing Your Risk for Diabetes A family history of diabetes is a risk factor in the disease Positive lifestyle choices can delay or prevent the onset of diabetes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 85 If both my dad and my grandfather have diabetes, will I get it too? Q Assessing Your Risk for Diabetes As a nation, we are getting fatter, and obesity is a key risk factor for type 2 diabetes The risk is greater for those who are overweight at a young age Lifestyle choices related to diet and exercise are key to prevention Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 86 I keep hearing that more and more people are getting diabetes. Why is that? Q Diabetes Prevention Eating anything in excess can cause obesity, a key risk factor Sugar itself does not directly cause diabetes Diabetes is related to genetics and lifestyle choices Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 87 Does eating too much sugar cause diabetes? Q 87 Symptoms, Diagnosis, and Treatment of Diabetes Symptoms to watch for: Increased thirst Increased hunger after eating Dry mouth Frequent urination Unexplained weight loss or weight gain Fatigue Blurred or decreased vision Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 88 How would I know if I had diabetes? More… Q 88 Symptoms, Diagnosis, and Treatment of Diabetes Symptoms to watch for: Numbness or tingling in hands or feet Slow-healing sores or cuts Itching of the skin, most often around the vaginal or groin area Frequent yeast infections Impotency Loss of consciousness (in rare cases) 89 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 89 Symptoms, Diagnosis, and Treatment of Diabetes Adults over age of 45 should be tested every 3 years If at high risk, early and more frequent testing required A1C test Fasting plasma glucose test (FPG) Oral glucose tolerance test (OGTT) Urinalysis Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 90 Do I need to be tested for diabetes even if I don’t have any symptoms? Q 90 Figure 11-2 Criteria for diagnosing diabetes 91 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Symptoms, Diagnosis, and Treatment of Diabetes Type 1: requires daily doses of insulin Self-injections Pumps Type 2: oral medication and lifestyle strategies Gestational: lifestyle strategies and insulin in some cases Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 92 I have a friend who has to give herself shots. Does everyone with diabetes have to do this? Q 92 Symptoms, Diagnosis, and Treatment of Diabetes Self-management of diabetes is crucial Learn how to self-test glucose levels Understand signs of diabetes complications Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 93 What about those ads for diabetes supplies? Besides taking medication, what does someone with diabetes have to do? Q Putting it All Together for Chronic Disease Prevention Get regular physical activity Eat a balanced diet Don’t smoke, or stop if you do Consume alcohol only in moderation Give your health history to your health care provider Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 94 94 Table 11-10 Top Lifestyle Choices for Preventing Chronic Disease 95 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 95 CHAPTER 12 INFECTIOUS DISEASES Questions and Answers: A Guide to Fitness and Wellness 3rd Edition * COMING UP IN THIS CHAPTER Discover the major types of infectious organisms and your body’s defenses against disease Learn about common infections—means of transmission, symptoms, and treatments Understand common sexually transmitted infections Take steps to prevent infections and limit their impact * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Infections and Immunity Infectious diseases: diseases that can be passed to or among people Colds Flu Bronchitis Mononucleosis Sexually transmissible infections Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Pathogens Infections are caused by pathogens: disease-causing agents that can be passed among people The most prevalent type of pathogens are bacteria and viruses Microbes or microorganisms Infections can also be caused by larger organisms like lice or parasitic worms Infestations Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What causes infectious diseases? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Pathogens Many microbes live in a healthy human body and are needed to keep the body functioning normally They can cause illness if they gain entry into a part of the body that is normally microbe-free Staphylococcus aureus Thrush Infection versus disease Symptoms or asymptomatic Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Pathogens Pathogens vary in their virulence: the ability to cause intense or severe symptoms They affect different parts of the body i.e., small area of skin vs. in bloodstream The amount of pathogen initially exposed to can have an influence The health status of the person is also significant Strength of immune system Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Why are some infections more serious than others? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 12-1 PATHOGENS, EFFECTS, AND ASSOCIATED DISEASES * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Cycle of Infection The pathogen must gain entry into the host’s body and start to replicate and cause symptoms Transmission requires: A source of pathogens A susceptible host A mode of transmission Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How do you actually catch an infectious disease? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * The Cycle of Infection Source of pathogens: Infectious agents can come from another person, an animal, water, or even soil Reservoir: body of individual already affected Susceptible host: People are more susceptible to infection if: Their immune system is weak Children, elderly, those with underlying health issues A natural physical defense is compromised A cut in the skin Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Cycle of Infection Mode of transmission: Different pathogens have different modes of transmission Directly, indirectly: cold virus Airborne: flu Vector: malaria, Lyme disease Transmitted through insects or animals Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q The Body’s Defenses We are each born with a specific capacity to resist certain diseases There is little consistency from one person to the next Built-in defenses: The skin The mouth, nostrils, eyelids, lungs, and genitals are all lined with mucous membranes Chemical barriers, including those in the acids, proteins, and enzymes of the digestive tract Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How do I get my resistance to disease? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q The Immune System The immune system responds and defends the body from disease-causing agents Immune cells recognize foreign substances Antigens Trigger immune response when recognizing a pathogen Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How do I develop my immunity? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * The Immune System Some immune cells move to the site of infection and “eat” invading microbes May cause pain and swelling If infection persists, the immune system produces antibodies A low-grade fever (100°F or less) may develop to fight infection Makes host less hospitable for the pathogen Specialized “memory” cells may be produced to provide immunity to that pathogen Immunity can also be acquired through vaccination Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Immune System One sign of the immune response is swollen lymph glands or nodes Lymphatic system Network of vessels and organs Return fluid lost from capillaries to circulatory system Plays key role in defense against invading pathogens Activates and transports infection-fighting cells Swollen lymph glands indicate an active response to an infection Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 12-2 THE LYMPHATIC SYSTEM * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q The Role of Immunizations Vaccines strengthen the immune system by preparing the body to fight infection They create immunity against infections you have not previously had Made from killed, weakened, or incomplete pathogens No vaccine is completely effective Boosters may be needed Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Can vaccines weaken my immune system? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 12-3 RECOMMENDED IMMUNIZATIONS FOR ADULTS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Stages and Patterns of Infectious Diseases Acute infections are most likely to cure on their own or cure quickly with treatment They are characterized by a short duration and a typical series of stages: Incubation: time between infection and symptoms Prodrome: general appearance of symptoms Illness: symptoms become more severe Convalescence: recovery Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Can infections be cured? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Stages and Patterns of Infectious Diseases Infections can also follow other patterns Chronic infection Illness persists or recurs over a long period Latent infection Pathogen lies dormant but retains the ability to replicate Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 12-4 STAGES AND PATTERNS OF INFECTIONS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Prevention and Treatment of Infectious Diseases Keep pathogens out of your body Wash hands often! Avoid people who are sneezing and coughing; cover your mouth and nose when sneezing or coughing Maintain a strong immune system Eat a healthy diet; get plenty of sleep and exercise Avoid smoking and excessive drinking Control stress and maintain mental health Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How can I keep from getting sick? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 12-5 HAND-WASHING GUIDELINES * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 12-6 MENTAL HEALTH AND RISK OF INFECTIOUS DISEASE IN COLLEGE STUDENTS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Prevention and Treatment of Infectious Diseases Antibiotics primarily fight bacterial infections but may be prescribed to fight certain fungi and parasites They do not work against infections caused by viruses Bacteria can develop resistance to a drug’s effects The more you take antibiotics, the more you increase the chance of resistance They can have side effects Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * I’m confused about antibiotics—when do they really work? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Prevention and Treatment of Infectious Diseases This depends on the type of pathogen, the severity of the infection, and the person’s underlying health status Some don’t need to be treated Symptoms can be treated Over-the-counter medications Antimicrobials, antibiotics Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How are infections treated? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Infectious Diseases on Campus: Colds and Influenza Colds and influenza Caused by viruses and have similar symptoms Influenza is the more serious disease; colds are more common Hundreds of viruses can cause the common cold Transmitted primarily by indirect contact Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How do you tell if you have a cold or the flu? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Infectious Diseases on Campus: Colds and Influenza Influenza viruses are more likely to be transmitted through respiratory droplets Symptoms usually come on quickly and include: Fever Body aches Severe fatigue Influenza carries a greater risk of serious complications Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 12-1 IS IT A COLD OR THE FLU? * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Infectious Diseases on Campus: Colds and Influenza College students benefit from the influenza vaccine The influenza infection can spread easily in a campus setting It is important to take a type-specific vaccine The vaccination is reformulated each year to target strains most likely to be circulating Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does getting a flu shot really help prevent the flu? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Infectious Diseases on Campus: Infectious Mononucleosis Mononucleosis (“mono”) is caused by the Epstein-Barr virus (EBV), a member of the herpes family of viruses Transmitted through saliva: “kissing disease” Symptoms: fever, sore throat, swollen glands, and fatigue EBV is a Latent infection Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does mono only come from kissing? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Infectious Diseases on Campus: Meningitis Meningitis is an inflammation of the membranes that surround the brain and spinal cord Symptoms: high fever, severe headache, stiff neck, sensitivity to bright light Two kinds: Viral: resolves on own in 7–10 days Bacterial: very serious; can cause disability or death Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What is that serious infection that causes a stiff neck? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Infectious Diseases on Campus: Bacterial Skin Infections MRSA is a type of staph bacteria that is resistant to many antibiotics It is a major agent of skin infections Risk factors: crowded living conditions; contaminated items and surfaces Dorms, athletic facilities, military barracks, daycares Symptoms: red, swollen, painful lumps that look like boils or insect bites May spread: swollen glands, fever Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What is MRSA? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 12-2 COMMON INFECTIONS: SYMPTOMS AND TREATMENTS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * TABLE 12-2 COMMON INFECTIONS: SYMPTOMS AND TREATMENTS (CONTINUED) * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections Sexually transmitted infections (STIs) are among the most common types of infections in the United States Spread through person-to-person sexual contact Half of all new infections in people aged 15–24 Some can be treated and cured, others are chronic, incurable, and even life threatening All are preventable Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections Women are more likely to have STIs and experience complications from them Women’s cervix is covered with cells that are particularly susceptible STIs cause more serious problems in women, including infertility Many STIs are asymptomatic Anyone who is sexually active can have an STI Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Do women get more STIs than men? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Q Sexually Transmitted Infections: HPV Human Papillomavirus (HPV)—genital warts Most common STI in U.S.; asymptomatic in many Complications can still develop; and it can still be transmitted to sexual partners Warts can be treated, but there is no treatment for the underlying viral infection Primary complication is cervical cancer Detected through Pap tests Two vaccines: Cervarix and Gardasil Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What’s the most common sexually transmitted infection? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections: Chlamydia Chlamydia is a bacterial infection transmitted during sex or from an infected mother to the baby during birth About 70% of infected people have no symptoms Symptoms: painful urination and abnormal discharge If untreated can cause serious infections of the fallopian tubes in women and the urethra and epididymis in men Those 25 and younger who are sexually active should be checked annually Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How often should I get checked for chlamydia? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections: PID Pelvic inflammatory disease (PID)—an infection and inflammation of the uterus, ovaries, fallopian tubes, and reproductive organs in women Usually the result of chlamydia or gonorrhea May be asymptomatic or have severe symptoms like fever and pain Early antibiotic treatment is crucial Can cause damage to reproductive organs, infertility Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * If I have chlamydia, does that mean I also have PID? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections: Syphilis Syphilis is a bacterial infection transmitted through infected skin and mucous membranes in the genitals, lips, mouth, and anus It can be passed from mother to infant during pregnancy: congenital syphilis Multistage STD Primary, secondary, latent, tertiary Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How many stages of syphilis are there? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections: Syphilis Primary syphilis: painless sore (chancre) that disappears within 3–6 weeks Full of bacteria that can be spread, but can go unnoticed Secondary syphilis: develops in 2–10 weeks Most common symptom: non-itchy skin rash on palms of hands and soles of feet Other symptoms include: swollen glands, headache, fatigue, sore throat, and hair loss Symptoms usually disappear without treatment, but may recur * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Sexually Transmitted Infections: Syphilis Latent syphilis: develops in untreated cases Symptoms disappear, but bacteria remains in the body Can still infect others, but risk fades over time Tertiary syphilis: develops in a small percentage of cases Syphilis bacteria cause organ damage, mental illness, heart disease, blindness, and death * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections: Herpes Not everyone has herpes, but it is common Genital herpes can be caused by: Herpes simplex virus type 1 (HSV 1) Generally infects the lips and mouth, producing cold sores, can cause genital herpes if transmitted through oral sex Herpes simplex virus type 2 (HSV 2) Responsible for genital herpes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Does everyone have herpes? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections: Herpes Herpes symptoms: Sores at the site of entry into the body Herpes is a latent viral infection There is no treatment or cure for genital herpes Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * TABLE 12-4 PREVALENCE OF HERPES SIMPLEX VIRUS TYPE 2 AS MEASURED BY BLOOD TESTS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections: Viral Hepatitis Viral hepatitis: inflammation of the liver caused by infection with one of the hepatitis viruses Hepatitis A virus: transmitted through food and water Usually resolves on its own A vaccine is available Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Are herpes and HIV the only incurable STIs? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections: Viral Hepatitis Hepatitis B virus: transmitted through sexual contact, blood, and saliva Acute symptoms include jaundice Chronic hepatitis may have no symptoms It may cause liver damage, cancer There is a vaccine available Hepatitis C virus: primarily transmitted through blood Most new infections caused by injection drug use Can become chronic Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections: HIV Infection and AIDS HIV is very prevalent in the United States and worldwide In the U.S., someone is infected with HIV every 10 minutes, and someone dies from HIV/AIDS every 45 minutes Worldwide, 7,400 people are infected every day, half of them under age 25 HIV is not equally distributed across the U.S. population Higher rates among man and African Americans * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * FIGURE 12-7 ESTIMATED RATES OF DIAGNOSIS OF HIV INFECTION AMONG U.S. ADULTS AND ADOLESCENTS BY SEX AND RACE/ETHNICITY * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections The human immunodeficiency virus (HIV) is the infectious agent that causes acquired immune deficiency syndrome (AIDS) HIV is a pathogen Destroys CD4+ T cells, which are critical for fighting infection AIDS is late stage of HIV infection Diagnosed when an opportunistic infection develops Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Is there a difference between HIV and AIDS? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections Condom use does not completely eliminate risk, but it greatly reduces HIV transmission HIV is spread by: Unprotected sex Having multiple sex partners The presence of other sexually transmitted infections Sharing needles or other equipment used to prepare illicit drugs or injections Being born to an infected mother Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Do condoms help prevent HIV infection? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FIGURE 12-8 TRANSMISSION ROUTES AMONG U.S. ADULTS AND ADOLESCENTS DIAGNOSED WITH AIDS * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections Symptoms during the acute phase may include fever, headache, fatigue, muscle aches, and enlarged lymph nodes Typically resolve with no treatment and may be attributed to something else HIV in the acute phase is highly infectious Following the acute phase, HIV is asymptomatic Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * What are symptoms of HIV and AIDS? More… Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Sexually Transmitted Infections The late stages of HIV infection are characterized by: Rapid weight loss Extreme fatigue Sores in the mouth or genitals Neurological disorders Opportunistic infections of full-blown AIDS include pneumonia, liver disease, cancer, and unusual infections Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections Blood tests detect antibodies within 2–8 weeks of infection 97% of infections can be detected within 3 months OraQuick over-the-counter test can yield results in a few minutes Federal guidelines recommend routine HIV testing for Americans aged 13–64 For high risk persons, annual testing is recommended Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How long do you have to wait to find out if you have HIV? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * Q Sexually Transmitted Infections With treatment, people can survive many years or even decades with an HIV infection Antiviral drugs can suppress the virus The development of a vaccine is challenging HIV attacks the immune system, the cells that need to be activated by a vaccine Microbicides kill microbes or reduce their ability to cause infection Vaginal application Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. * How long until someone with HIV dies? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 12-3 STIs IN THE UNITED STATES: A SNAPSHOT * Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. *




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