Wellness: the new health goal
• Generations of people have viewed health simply as the absence of disease
• Health – typically refers to the overall condition of a person’s body or mind and to the presence or absence of illness or injury
• Wellness – beyond the simple presence or absence of disease, wellness refers to optimal health and vitality – to living life to its fullest
• There are two differences between health and wellness: o Health – or some aspects of it – can be determined or influenced by factors beyond your control, such as your genes, age and family history (for example, family history of heart disease or cancer) o Wellness is largely determined by the decisions you make about how you live. For example, eating sensibly, exercising and having regular screening tests.
 Enhanced wellness, therefore, involves making conscious decisions to control risk factors that contribute to disease or injury. (age and family history are risk factors that cannot be controlled. Behaviours such as smoking, exercising and eating healthy are factors you can control)
The dimensions of wellness
• Experts have defined six dimensions of wellness: o Physical o Emotional o Intellectual o Interpersonal o Spiritual o Environmental
• These dimensions are interrelated; each has an effect on the others
• The process of achieving wellness is constant and dynamic, involving change and growth
• Wellness is not static; ignoring any dimension of wellness can have harmful effects on your life
Physical wellness
• Your physical wellness includes not just your body’s overall condition and the absence of disease but your fitness level and your ability to care for yourself
• The higher your fitness level, the higher your level of physical wellness will be
• As you develop the ability to take care of your own physical needs, you ensure a greater level of physical wellness
• To achieve optimum physical wellness you need to make choices that will help you avoid illnesses and injuries
Emotional wellness
• Your emotional wellness reflects your ability to understand and deal with your feelings
• Emotional wellness involves attending to your own thoughts and feelings, monitoring your reactions and identifying obstacles to emotional stability
• Achieving this type of wellness means finding solutions to emotional problems
Intellectual wellness
• Those who enjoy intellectual wellness (mental) constantly challenge their minds
• An active mind is essential to wellness because it detects problems, finds solutions and directs behaviour
• These people never stop learning; they seek out and relish new experiences and challenges
Interpersonal wellness
• Your interpersonal (or social) wellness is defined by your ability to develop and maintain satisfying and supportive relationships
• These relationships are essential to physical and emotional health
• Social wellness requires participating in and contributing to your community, country and world
Spiritual wellness
• To enjoy spiritual health is to possess a set of guiding beliefs, principles or values that give meaning and purpose to your life, especially during difficult times
• The spiritually well person focuses on the positive aspects of life and finds spirituality to be an antidote for negative feelings such as cynicism, anger and pessimism
Environmental wellness
• Your environmental wellness is defined by the livability of your surroundings
• Personal health depends on the health of the planet
• Your physical environment either supports your wellness or diminishes it
New opportunities, new responsibilities
• in 1900, many people died as a result of common infectious diseases and poor environmental conditions
• since 1900, the development of vaccines and antibiotics to prevent and fight infectious diseases and to public health campaigns to improve environmental conditions
• infectious diseases – a diseases that can spread from one person to another; caused by microorganisms such as bacteria and viruses
• heart diseases, cancer and strokes are three of the leading causes of death in north America today
• chronic diseases – a disease that develops and continues over a long period of time; usually caused by a variety of factors, including lifestyle factors
• people make choices everyday that either increase or decrease their risk for these diseases – lifestyle choices involving behaviour such as exercise, diet, smoking and drinking
Behaviours that contribute to wellness
• a lifestyle based on good choices and healthy behaviours maximizes the quality of life. It helps people avoid disease, remain strong and fit, and maintain their physical and mental health as long as they live
• the most important behaviours and habits are listed below o be physically active
 human body is designed to work best when it is active
 physical fitness – a set of physical attributes that allows the body to respond or adapt to the demands and stress of physical effort
 the more we ask of our bodies, the more fit they become
 benefits of being physically active are both physical and mental, immediate and long term
• in the term being physically fit makes it easier to do everyday tasks, provides reserve strength for emergencies and helps people look and feel good
• in the long term, being physically fit confers protection against chronic diseases and lowers the risk of dying prematurely o choose a healthy diet
 many Canadians have a diet that is too high in calories, unhealthy fats, added sugar, and too low in fibre, complex carbohydrates, fruits and vegetables
 this diet is linked to a number of chronic diseases
 a healthy diet promotes wellness in both the short and long term
 it provides the necessary nutrients and sufficient energy without also providing too much of the dietary substances linked to diseases o maintain a healthy body weight
 overweight and obesity are strongly associated with a number of disabling and potentially fatal conditions and diseases
 healthy body weight is an important part of wellness – but short term dieting is not part of a fit and well lifestyle
 maintaining a healthy body weight requires a lifelong commitment to regular exercise, healthy diet and effective stress management o manage stress effectively
 inappropriate stress management can lead to fatigue, sleep disturbances and other unpleasant symptoms
 over long periods of time, poor stress management can lead to less efficient functioning of the immune system and increased susceptibility to disease o avoid tobacco and drug use and limit alcohol consumption
 alcohol and drug intoxication is an especially notable factor in the death and disability of young people, particularly through unintentional injuries and violence o protect yourself from disease and injury
 most effective way of dealing with disease and injury is to prevent them o take other steps toward wellness
 developing meaningful relationships
 planning for successful aging
 learning about the health care system
 acting responsibly toward the environment
National wellness goals
• the Canadian government first began to recognize the importance of health promotion with the 1986 ottawa charter for health promotion. The charter not only indentified resources and strategies for health promotion but ultimately lead to a challenge of “health for all” by the year 2000
• of additional impact has been the action statement for health promotion (1996) which refocused attention onto the need for Canadians to value health. Seven specific strategies for development were outlined: o see page 8
• in order to increase physical activity levels by 10% in the year 2010 the Canadian government in conjunction with the Canadian society for exercise physiology has created Canada’s physical activity guide to healthy active living. These tools are intended to start Canadians of all ages on a path to wellness
Reaching wellness through lifestyle management
• behaviour change – a lifestyle management process that involves cultivating healthy behaviours and working to overcome unhealthy ones
Getting serious about your health
• before you can start changing a wellness related behaviour, you have to know that the behaviour is problematic and that you can change it
• to make good decisions, you need information about relevant topics and issues, including what resources are available to help you change o examining your current health habits o choosing a target behaviour
 changing any behaviour can be demanding. That is why its a good idea to start small, by choosing one behaviour you want to change (called a target behaviour) and working on it until you succeed
 target behaviour – the specific behaviour or habit selected by an individual who intends to develop a program to change/improve this particular behaviour o learn about your target behaviour
 how is your target behaviour affecting your level of wellness today?
 What diseases or conditions does this behaviour place you at risk for?
 What effect would changing your behaviour have on your health? o Find help
Building motivation to change
• To succeed at behaviour change, you need strong motivation
• Examining the pros and cons of change o For successful behaviour change, you must believe that the benefits of changing outweigh the costs o Carefully examine the pros and cons of continuing your current behaviour and of changing to a healthier one o Focus on the effects that are most meaningful to you, including those that are tied to your personal identify and values o To complete your analysis, ask friends and family members about the effects of your behaviour on them o The short term benefits of behaviour change can be an important motivating force o People are likely to be moved to action by shorter-term, more personal goals (feeling better, doing better in school, improving at sports, reducing stress, increases self-esteem) o You can further strengthen your motivation by raising your consciousness about your problem behaviour o This enables you to focus on the negatives of the behaviour and imagine the consequences if you don’t make a change. At the same time, you can visualize the positive results of changing your behaviour o Social pressure can also increase the motivation to make changes
• Boosting self-efficacy o When you start thinking about changing a health behaviour, a big factor in your eventual success is whether you have confidence in yourself and your ability to change o Self-efficacy – the belief in ones ability to take action and perform specific behaviour o Strategies for boosting self-efficacy include
 Locus of control
• Locus of control – the figurative “place” a person designates as the source of responsibility for the events in his life
• People who believe they are in control of their own lives are said to have an internal locus of control
• Thos who believe that factors beyond their control (the environment, fate, luck, other outside sources) are more important in determining the events of their lives are said to have an external locus of control
• For lifestyle management, an internal locus of control is an advantage because it reinforces motivation and commitment
 Visualization and self talk
• Visualize yourself successfully engaging in a new, healthier behaviour
• Visualize yourself enjoying all the short term and long term benefits that your lifestyle change will bring
• You can also use self talk, the internal dialogue you carry on with yourself, to increase your confidence in your ability to change
 Role models and other supportive individuals
• Social support can make a big difference in your motivation level and chances of succeeding
• Find a role model (someone who achieved the goals you are striving for)
• Find a buddy who wants to make the same changes you do and who can take an active role in your behaviour change program
 Identifying and overcoming key barriers to change
Enhancing your readiness to change
1. Pre-contemplation – do not think there is a problem and have no intention of changing their behaviour. Believe there are more reasons or more important reasons not to change than there are reasons to change
2. Contemplation – know they have a problem and intend to take action within 6 months
3. Preparation –plan to take action within a month or may already have begun to make small changes in their behaviour
4. Action – people outwardly modify their behaviour and their environment. This stage usually requires the greatest commitment of time and energy. People are at risk for reverting to old, unhealthy patterns of behaviour
5. Maintenance –maintained their new, healthier lifestyle for at least 6 months
6. Termination – exited the cycle of change and are no longer tempted to lapse back into their old behaviour. New self image and total self efficacy with regard to their target behaviour
Dealing with relapse
• When you experience relapse, follow these steps: o Forgive yourself o Give yourself credit for the progress you have already made o Move on
Developing skills for change: creating a personalized plan
1. Monitor your behaviour and gather data
a. Keep a record of your target behaviour and the circumstances surrounding it
b. Record each occurrence of your behaviour noting the following
i. What the activity was ii. When and where it happened iii. What you were doing iv. How you felt at that time
2. Analyze the data and identify patterns
a. After data has been collected on the behaviour, analyze the data and identify patterns
3. Be “SMART” about setting goals
a. Experts suggest that your goals meet the “SMART” criteria, that is your goals should be:
i. Specific ii. Measurable: progress is easier to track if goals are quantifiable iii. Attainable: set goals within your physical limits iv. Realistic: manage expectations when setting goals
v. Time frame specific: give reasonable amount of time to reach goal
4. Devise a plan of action
a. Develop strategy that supports your day to day efforts at behaviour change. Plan of action should include:
i. Get what you need ii. Modify your environment iii. Control related habits iv. Reward yourself
v. Involve people around you vi. Plan for challenges
5. Make a personal contract
a. A serious personal contract (one that commits you to your word) can result in higher chance of follow through than a casual, off hand promise
b. Contract should include:
i. The date you will start ii. The steps you will need to measure your progress iii. The strategies you plan to use to promote change iv. The date you expect to reach your final goal
c. Have someone sign the contract as a witness
Putting your plan into action
• This stage require commitment, the resolve to stick with the plan no matter what temptations you encounter
• Strategies from behaviour change plan
• Belief that you are the boss
• Change-friendly environment
• Support
• Rewards
• Congratulate yourself
Staying with it
If your program is grinding to a halt, identify what is blocking your progress. It may come from one of the following sources:
• Social influences
• Levels of motivation
• Choice of techniques and level of effort
• Stress barriers
• Procrastinating, rationalizing, blaming
• Being fit and well for life o First attempts may only involve the planning stage o Need to develop certain skills (intellectual, behavioural, emotional) o Do not expect to master everything quickly and with ease – be patient with yourself
Chapter 2 – basic principles of physical fitness
Physical activity and exercise for health and fitness
• 51% of Canadians (over age 20) are physically inactive, meaning that their daily energy expenditure is less than the equivalent of walking for half an hour
• 2005 physical activity monitors report that factors such as gender, age, and income level may impact our level of physical activity o Women are more likely to be physically inactive than men o Those with higher incomes report being more active than those with lower incomes
Physical activity on a continuum
• Physical activity – any body movement carried out by the skeletal muscles and requiring energy
• These movements can include participation in sport-based, leisure or work related activities
• Different types of physical activity can be arranged on a continuum based on the amount of energy they require
• Exercise – refers to a subset of physical activity – planned, structured, repetitive movement of the body designed specifically to improve or maintain physical fitness
• To develop fitness, a person must perform enough physical activity to stress the body and cause long term physiological changes
• Physical activity is essential to health and confers wide ranging health benefits, but exercise is necessary to significantly improve physical fitness
Lifestyle physical activity for health promotion
• Health Canada recommends that Canadian adults expend an average of 3.0 kcal/kg/day for optimal health benefits
• Health Canada suggests that this average expenditure can be accomplished by engaging in endurance, flexibility and strength activities
• By increasing lifestyle physical activity, people can expect to significantly improve their health and wellness
How much physical activity is enough?
• The amount of activity needed depends on an individual’s health status and goals
• People should exercise long and intensely enough to improve physical fitness
• Regular physical activity, regardless of the intensity, makes you healthier and can help protect you from many chronic diseases
• Although you get many health benefits of exercise simply by being more active, you obtain even more benefits when you are physically fit
• In addition to long term health benefits, fitness also significantly contributes to quality of life
Health related components of physical fitness
• Some components of fitness are related to specific activities, and others related to general health
• Health related fitness – physical capacities that contribute to health, these include o Cardiorespiratory endurance o Muscular strength o Muscular endurance o Flexibility o Body composition
• Health related fitness contributes to your capacity to enjoy life, helps your body withstand physical and psychological challenges, and protects you from chronic disease
Cardiorespiratory endurance
• Cardiorespiratory endurance – the ability of the body to perform prolonged, large muscle, dynamic exercise at moderate to high levels of intensity
• It depends on such factors as the ability of the lungs to deliver oxygen from the environment to the bloodstream, the hearts capacity to pump blood, the ability of the nervous system and blood vessels to regulate blood flow, and the capability of the body’s chemical systems to use oxygen and process fuels for exercise
• When Cardiorespiratory fitness is low, heart has to work very hard during normal daily activities and may not be able to sustain high intensity physical activities in an emergency
• When cardiorespiratory fitness improves, related physical functions also improve o The heart pumps more blood per beat, resting heart rate slows, blood volume increases, blood supply to tissues improves, the body can cool itself better, resting blood pressure decreases
• Cardiorespiratory endurance is a central component of health related fitness because the functioning of the heart and lungs is so essential to overall good health
• Low levels of cardiorespiratory fitness are linked to heart disease
• Cardiorespiratory endurance exercise further benefits quality of life by improving self image, mood, cognitive functioning and the ability to manage stress
Muscular strength
• Muscular strength – the amount of force a muscle can produce with a single maximum effort
• It depends of such factors as the size of muscle cells and the ability of nerves to activate muscle cells
• Strong muscles are important for everyday activities. They help keep the skeleton in proper alignment, preventing back and leg pain and providing the support necessary for good posture
• Muscle tissue if an important element of overall body composition
• Greater muscle mass means a higher rate of metabolism and faster energy use
• Metabolism – the sum of all the vital processes by which food energy and nutrients are made available to and used by the body
• Maintaining strength and muscle mass is vital for healthy ageing
• Older people tend to lose both number and size of muscle cells – condition called sarcopenia
Muscular endurance
• Muscular endurance – the ability of a muscle or group of muscles to remain contracted or to contract repeatedly for a long period of time
• Depends on such factors as the size of muscle cells, the ability of muscles to store fuel and the blood supply to muscles
• Important for good posture and for injury prevention
Flexibility
• Flexibility – the range of motion in a joint or group of joints, flexibility is related to muscle length
• Depends on joint structure, the length and elasticity of connective tissue and nervous system activity
• Flexible, pain free joints are important for good health and well being
Body composition
• Body composition – the proportion of fat and fat-free mass (muscle, bone and water) in the body
• Healthy body composition involves a high proportion of fat free mass and an acceptably low level of body fat, adjusted for age and gender
• A person with excessive body fat – especially when located in the abdomen – is more likely to experience a variety of health problems (heart disease, insulin resistance, high blood pressure, stroke, joint problems, type 2 diabetes, gallbladder disease, some types of cancer and back pain
• Best way to lose fat – sensible diet and exercise
• Best way to add muscle mass – resistance training
• Large changes in body composition aren’t necessary to improve health; small increases in physical activity and a small decrease in body fat can lead to substantial health improvements
• Cardiorespiratory fitness may be more important than body composition in determining overall health status
Skill related components of fitness
• Skill related fitness – physical capacities that contribute to performance in a sport or activity o Speed – the ability to perform a movement in a short period of time o Power – the ability to exert force rapidly, based on a combination of strength and speed o Agility – ability to change the position of the body quickly and accurately o Balance – ability to maintain equilibrium while moving or while stationary o Coordination – ability to perform motor tasks accurately and smoothly using body movements and the senses o Reaction time – ability to respond or react quickly to a stimulus
Principles of physical training: adaptation to stress
• Physical training – the performance of different types of activities that cause the body to adapt and improve its level of fitness
• Particular types and amounts of exercise are most effective in developing the various components of fitness
• To put together an effective exercise program, you should first understand the basic principles of physical training, including the following o Specificity o Progressive overload o Reversibility o Individual differences o All of these rest on the larger principle of adaptation
Specificity – adapting to type of training
• To develop a particular fitness component, exercises must be performed that are specifically designed for that component
• This is the principle of specificity – the training principle that the body adapts to the particular the and amount of stress placed on it
• Specificity training relies on the application of the specific adaptation imposed demands (SAID) principle which suggests that specific gains are seen when we challenge relevant energy systems employed during training
Progressive overload – adapting to amount of training and the FITT principle
• When the amount of exercise is progressively increased, fitness continues to improve because of the adaptations that the body undergoes
• This is the principle of progressive overload – the training principle that placing increasing amounts of stress on the body causes adaptations that improve fitness
• Amount of overload is very important. Too little exercise will have no effect, but too much can cause injury and problems with the body’s immune system and hormone levels
• For every exercise, there is a training threshold at which fitness benefits begin to occur, a zone within which maximum fitness benefits occur, and an upper limit of safe training
• The amount of exercise needed depends on the individual’s current level of fitness, fitness goals and component being developed
• Amount of overload needed to maintain or improve level of fitness for a particular fitness component is determined through four dimensions (FITT) o Frequency – how often o Intensity – how hard o Time – how long (duration) o Type – mode of activity
Reversibility – adapting to a reduction in training
• Fitness is a reversible adaptation
• The body adjusts to lower levels of physical activity the same way it adjusts to higher levels
• This is the principle of reversibility – the training principle that fitness improvements are lost when demands on the body are lowered
• If you stop exercising, up to 50% if fitness improvements are lost within 2 months
• Skill components and techniques tend to remain but may later need refinement – will be affected by disuse, lack of practice, and reduced fitness
Individual differences
• Everyone is not created equal from a physical standpoint
• There are large individual differences in ability to improve fitness, body composition and sports skills
Designing your own exercise program
• Planning for physical fitness consists of assessing how fit you are now, determining where you want to be, and choosing the right activities to help you get there
Assessment
• First step in creating successful fitness program is to assess your current level of physical activity and fitness for each of the five health related fitness components
Getting medical clearance
• People of any age who are not at high risk for serious health problems can safely exercise at moderate intensity (60% or less of max heart rate) without a prior medical evaluation
• Canadian society for exercise physiology (CSEP) has developed the physical activity readiness questionnaire (PAR-Q) to help evaluate exercise safety
• Exercise stress test – a test usually administered on a treadmill or cycle ergometer that involves analysis of the changes in electrical activity in the heart from an electrocardiogram taken during exercise. Used to determine if any heart disease is present and to assess current fitness level
• Graded exercise test (GXT) – an exercise test that starts at an easy intensity and progresses to maximum capacity
Setting goals
• See chapter 1
Choosing activities for a balanced program
• An ideal fitness program combines a physically active lifestyle with a systematic exercise program to develop and maintain physical fitness
• Choose activities that you enjoy, that suit your needs and that you will be able to continue with over time
• A balanced program includes activities to develop all the health related components of fitness
• Cardiorespiratory endurance is developed by continuous rhythmic movements of large muscle groups in activities such as walking, jogging, cycling, swimming and aerobic dance and other forms of group exercise
• Muscular strength and endurance can be developed through resistance training
• Flexibility is developed by stretching the major muscle groups, regularly and with proper technique
• Healthy body composition can be developed through a sensible diet and a program of regular exercise
Guidelines for training
• The following guidelines will make your exercise program more effective and successful o Train the way you want your body to change
 Stress your body such that it adapts in the desired direction o Train regularly
 Consistency is the key to improving fitness o Start slowly and get in shape gradually
 Exercise program can be divided into three phases:
• Beginning phase – the body adjusts to the new type and level of activity
• Making progress phase – fitness increases
• Maintenance phase – the targeted level of fitness is sustained over the long term
 Overtraining – a condition caused by training too much or too intensely, characterized by lack of energy, decreased physical performance, fatigue, depression, aching muscles and joints, and susceptibility to injury o Warm up before exercise
 Decreases risk of injury
 Warm up should include low intensity, whole body movements similar to those used in the activity that will follow o Cool down after exercise o Exercise safely
 Working muscles too hard can lead to injury o Listen to your body and get adequate rest o Cycle the volume and intensity of your workouts o Vary your activities
 Change exercise program from time to time to keep things fresh and help develop a higher degree of fitness o Train with a partner o Train your mind and emotions o Fuel your activity appropriately o Have fun o Keep your exercise program in perspective

Chapter 3 – cardiorespiratory endurance
Basic physiology of cardiorespiratory endurance exercise
The cardiorespiratory system
• The cardiorespiratory system consists of the heart, the blood vessels and the respiratory system
• It also picks up and transports oxygen, nutrients and other key substances to the organs and tissues that need them; it also picks up waste products and carries them to where they can be used or expelled
The heart
• Four-chambered, fist sized muscle located beneath the ribs under the sternum
• Its role is to pump oxygen-poor blood to the lungs and oxygenated blood to the rest of the body
• Blood travels through two separate circulatory systems: o The right side pumps blood to the lungs in what is called pulmonary circulation
 The part of the circulatory system that moves blood between the heart and the lungs; controlled by the right side of the heart o The left side pumps blood through the rest of the body in systematic circulation
 The part of the circulatory system that moves blood between the heart and the rest of the body; controlled by the left side
• Steps describing the path of blood through the cardiorespiratory system: o See page 56
 Atria – the two upper chambers of the heart in which blood collects before passing to the ventricles; also called auricles
 Venae cavae – the large veins through which blood is returned to the right atrium of the heart
 Ventricles – the two lower chambers of the heart from which blood flows through arteries to the lungs and other parts of the body
 Aorta – the large artery that receives blood from the left ventricle and distributes it to the body
Blood pressure
• Blood pressure – the force exerted by the blood on the walls of the blood vessels; created by pumping action of the heart. Blood pressure increases during systole and decreases during diastole
• Period of the hearts contraction is called systole
• The period of relaxation is called diastole
• Normal systolic blood pressure for a young, healthy male is approx. 120 mm Hg; diastole blood pressure is approx 80 mm Hg (women 10-20 mm Hg below men)
• Blood pressure is higher in taller individuals
• During systole, atria contract first, pumping blood into the ventricles; the ventricles contract, pumping blood into the lungs and body
• During diastole, blood flows into the heart and blood pressure is at its lowest during this phase
• Blood pressure is measured using a sphygmomanometer
• Heart beat (the split second sequence of contractions of the hearts four chambers) is controlled by nerve impulses
The blood vessels
• Blood vessel are classified by size and function
• Veins – vessels that carry blood to the heart
• Arteries – vessels that carry blood away from the heart
• Veins have thin wall; arteries have thick elastic walls that enable them to expand and relax with the volume of blood being pumped through them
• Capillaries – very small blood vessels that distribute blood to all parts of the body
• Capillaries deliver oxygen and nutrient rich blood to the tissues and pass on oxygen poor, waste carrying blood
• Two large vessels, the right and left coronary arteries, branch off the aorta and supply the heart muscle with oxygenated blood. Blockage of this artery is the leading cause of heart attack
The respiratory system
• Respiratory system – the lungs, air passages, and breathing muscles; supplies oxygen to the body and carries off carbon dioxide
• Air passes through lungs due to contraction and relaxation of the diaphragm and rib muscles
• The lungs expand and contract about 12-20 times a minute
• Alveoli – tiny air sacs in the lungs through whose walls gases such as oxygen and carbon dioxide diffuse in and out of blood
• Carbon dioxide passes from blood cells into the alveoli, where it is carried up and out of the lungs (exhaled)
• Oxygen from inhaled air is passed from the alveoli into blood cells; returned to the heart and pumped throughout the body
• Oxygen is an important part of the body’s energy producing system, so the cardiorespiratory systems ability to pick up and deliver oxygen is critical for the functioning of the body
The cardiorespiratory system at rest and during exercise
• At rest and light activity, cardiorespiratory system functions at a fairly steady pace o Heart beats about 50-90 beats per minute o Take about 12-20 breaths per minute o Blood pressure is 110 systolic and 70 diastolic (measured in millimeters of mercury) o Cardiac output is 4.5-6 liters per minute o Blood distributed to muscles is about 15-20%
• During exercise, demand on cardiorespiratory system increase. Body cells, particularly working muscles need to obtain more oxygen and fuel to eliminate more waste products. o Heart rate increases, up to 170-210 beats per minute o Hearts stoke volume (the amount of blood the heart circulates with each beat) increases o Cardiac output increases to 18-23 liters per minute
 Cardiac output – the amount of blood pumped by the heart each minute; function of heart rate and stoke volume (the amount of blood pumped during each beat o Blood flow changes, as much as 85-90% of blood may be delivered to working muscles o Blood pressure is 175 systolic and 65 diastolic o To oxygenate increased blood flow, you take up to 40-60 breaths per minute
• All these changes are controlled and coordinated by special centers in the brain, which uses the nervous system and chemical messengers to control the process
Energy production
• Metabolism – the sum of all chemical processes necessary to maintain the body
• The rate at which your body uses energy (its metabolic rate) depends on your level of activity
Energy from food
• Body converts chemical energy from food into substances that cells can use as fuel
• Can be used immediately or stored for later
• Three classes of energy containing nutrients in food are carbohydrates, fats and proteins
• During digestion, most carbs are broken down into the simple sugar glucose
• Glucose – a simple sugar that circulates in the blood and can be used by cells to fuel adenosine triphosphate
• Glucose may also be converted to glycogen and stored in the liver, muscles and kidneys
• Glycogen – a complex carbohydrate stored principally in the liver and skeletal muscles; the major fuel source during most forms of intense exercise. Glycogen is the storage form of glucose
• If glycogen stores are full and the body’s immediate need for energy is met, the remain glucose is converted to fat and stored in the body’s fatty tissues. Excess energy from dietary fat is also stored as body fat
• Protein in the diet is used primarily to build new tissue, but it can be broken down for energy or incorporated into fat stores
ATP: the energy currency of cells
• Adenosine triphosphate (ATP) energy source for cellular processes
Exercise and the three energy systems
See table 3.1 and terms on page 59-61
Benefits of cardiorespiratory endurance exercise
• cardiorespiratory endurance exercise helps body become more efficient and better able to cope with physical challenges. Lowers risk for many chronic diseases improved cardiorespiratory functioning
• when performed regularly, endurance exercise leads to permanent adaptations in the cardiorespiratory system
• endurance exercise enhances the heart’s health by: o maintaining or increasing heart’s own blood and oxygen supply o increasing the heart’s muscle function, so it pumps more blood per beat (keeps heart rate lower both at rest and during exercise o strengthening hearts contractions o increasing hearts cavity size (in young adults) o increasing blood volume so heart pushes more blood into the circulatory system during each contraction o reducing blood pressure improved cellular metabolism
• regular endurance exercise also improves metabolism at the cellular level by enhancing your ability to produce and use energy efficiently
• cardiorespiratory training improves metabolism by doing the following: o see page 63
• regular exercise may also help protect your cells from chemical damage caused by agents called free radicals – highly reactive compounds that can damage cells by taking electrons from key cellular components such as DNA or the cell membrane; produced by normal metabolic processes and through exposure to environmental factors, including sunlight reduced risk of chronic disease cardiovascular disease
• sedentary living is a key contributor to cardiovascular disease – disease of the heart and blood vessels
• cardiorespiratory endurance exercise lowers your risk of CVD by doing the following: o see page 63
• reduced risk of chronic diseases such as: o cancer o type 2 diabetes o osteoporosis o deaths from all causes better control of body fat
• too much body fat is linked to a variety of health diseases, including, CVD, cancer and type 2 diabetes improved immune function
• moderate endurance exercise boosts immune function, whereas training (overtraining) depreses it
• physically fit people get few colds and upper respiratory tract infections than people who are not fit
• exercise affects immune function by influencing levels of specialized cells and chemicals involved in the immune response
• in addition, immune system can be strengthened by eating a well balanced diet, managing stress and getting 7-8 hours of sleep every night improved psychological and emotional wellbeing
• most people who participate in regular endurance exercise experience social, psychological and emotional benefits
• performing physical activities provides proof of skill mastery and self control, thus enhancing self image
• recreational sports provide an opportunity to socialize, have fun and strive to excel
• endurance exercise lessens anxiety, depression, stress, anger, and hostility, thereby improving mood and boosting cardiovascular health.
• Regular exercise also improves sleep
• As cardiorespiratory fitness is developed, these benefits translate into both physical and emotional wellbeing and a much lower risk of chronic disease
Assessing cardiorespiratory fitness
• Body’s ability to maintain level of exertion (exercise) for extended period of time is a direct reflection of cardiorespiratory fitness. Determined by the body’s ability to take up, distribute and use oxygen during physical activity
Choosing an assessment test
• Assessment test provide reasonably good estimates of maximal oxygen consumption
• The four commonly used tests are: o The 1.6 Km walk test – estimates level of cardiorespiratory fitness (maximal oxygen consumption) based on amount of time it takes to complete 1.6 km of brisk walking and exercise heart rate at end of walk o The 3 minute step test – pulse returns to normal after exercise is a good measure of cardiorespiratory fitness. Heart rate remains lows and recovers faster in people who are more physically fit o The 2.4 km run-walk test – oxygen consumption increases with speed in distance running o Leger’s 20 meter shuttle run – capacity to efficiently use oxygen over time will be reflected in those who reach higher stages of this test
Monitoring your heart rate
• Heart rate can be used to assess maximal oxygen consumption as well as monitor exercise intensity during workout
• Two most common sites for monitoring heart rate are the carotid artery in the neck and the radial artery in the wrist
• Heart rates are assessed in beats per minute
• Best to do a short count (10 seconds) then multiply by 6 to get heart rate for full minute because heart rate slows rapidly
• You can also use a heart rate monitor to record heart rate for you
Developing a cardiorespiratory endurance program
• Cardiorespiratory endurance exercise are best for developing the type of fitness associated with good health
Setting goals
• Goal should be high enough to ensure healthy cardiorespiratory system, but not so high that it will be impossible to achieve
• Though endurance training, you may be able to improve maximal oxygen consumption (VO2max) by about 10-30%, depending on age, health status, initial fitness level
• Resting heart rate may decrease by as much as 10-15 beats per minute due to endurance training
• Changes may be noticeable after about 4-6 weeks
Applying the FITT equation
• FITT = frequency, intensity, time (duration) and type of activity
Frequency of training
• To build cardiorespiratory endurance you should exercise 3-5 time per week
• Beginners start with 3 and work up to 5
• Moderate physical activity such as walking can be done everyday
• Training less than 3 days can make it difficult to improve fitness or use exercise to lose weight
Intensity of training
• Most important factor in achieving training effects
• Must exercise intensely enough to stress body so that cardiovascular fitness improves
• 2 ways to monitor intensity
Target heart rate zone
• Necessary to exercise at maximum heart rate to improve maximal oxygen consumption
• Target heart rate zone –the range of heart rates that should be reached and maintained during cardiorespiratory endurance exercise to obtain training effects. Between 65-90% of maximum heart rate
• To calculate target heart rate zone, follow these steps: o Subtract your age from 220 to estimate your maximum heart rate (MHR) o Multiply your MHR by 65 and 90% to calculate your target heart rate zone (55% if unfit)
• Alternative way to calculate heart rate range uses heart rate reserve – the difference between maximum heart rate and resting heart rate; used in one method for calculating target heart rate range
• You can achieve significant health benefits by exercising at the bottom of your target range, so dont feel pressured into exercising at an unnecessarily intense level
Ratings of perceived exertion
• Another way to monitor intensity is to monitor perceived level of exertion
• Ratings of perceived exertion (RPE) – a system of monitoring exercise intensity based on assigning a number to the subjective perception of target intensity
Talk test
• You should not work out so intensely that you cannot speak
Time (duration) of training
• A total duration of 30-60 minutes is recommended
• Can take place in a single session or in multiple sessions lasting 10 or more minutes
• Different intensity levels require different durations for comparable stress
• High intensity activity = 20 minutes
• Low-to-moderate intensity activity = 45-60 minutes
Type of activity
• Cardiorespiratory endurance exercises include activities that involve rhythmic use of large muscle groups for an extended period of time, such as jogging, walking, cycling, aerobic dancing and swimming
• Having fun is a strong motivator as well as exercising with a friend
Warming up and cooling down
• Warming up (5-10 min) o Muscles work better when warmed up o Increase heart rate gradually, raise body temperature o Redirect blood flow to working muscles o Spread synovial fluid within joints
• Cooling down (5-10 min) o Blood flow and respiration return to normal o Relaxation for muscles
Building cardiorespiratory fitness
• Rate of improvement will depend on your age, health status, initial level of fitness and motivation
• Fitness improves when you overload your body
• For the initial phase of you program, which may last 3-6 weeks, exercise at the low end of your target heart rate zone o 3-4 days per week o 12-15 if unfit, 20 if sedentary but healthy and 30-40 minutes if experienced exerciser
• The next phase if the improvement phase o Lasts 4 to 6 months o Slowly and gradually increase amount of overload until you reach target level of fitness o Increase duration 5-10 minutes every 2-3 weeks o 3-5 days per week, middle to upper end of target HR zone, 25-40 minute duration o Signs of too rapid progession in overload include muscles aches and pains, lack of usual interest in exercise, extreme fatigue, and inability to complete a workout
Maintaining cardiorespiratory fitness
• Continue to exercise at the same intensity on 3 non-consecutive days per week
• If you have to stop, start the program again at a lower level
• Cross-training maintains motivation and reduces injury (+ expands specific and general physical benefits and activity skills)
• Cross-training – alternating two or more activities to improve a single component of fitness
• Interval training – adding relatively more intense training sessions to less intense sessions. Each more intense repetition should be followed by rest period of an equal time length
• Fartlek training – incorporating relatively more intense training into a less intense session. Using existing environmental conditions (hills and stairs, and plan the training session to include them on the running/jogging route
Exercise safety and injury prevention
Read slides 31-37
Chapter 9 – putting together a complete fitness program
Developing a personal fitness program
Steps to developing a personal fitness plan
1. Set goals – based on formal + informal assessment
2. Select activities (effective, convenient, enjoyable)
3. Set a target frequency, intensity and time for each activity (work up to this target over time)
4. Set up a system of mini goals and rewards
5. Include lifestyle physical activity in your program
6. Develop tools for monitoring your progress
7. Make a commitment
Set goals
• Develop different types of goals – general and specific, long term and short term
• General and long term goals might include lowering risk for chronic disease, improving posture, having more energy and improving the fit of clothes
• Good idea to have specific, short term goals based on measurable factors
• Specific goals (SMART goals) allow you to track progress
• Break specific goals into several smaller steps (mini-goals)
• Easier to stick to program if goals are both important to you and realistic
• Fitness improves most quickly during first 6 months
Select activities
• It is best to include exercises to develop each of the health related components of fitness o Cardiorespiratory endurance – developed by activities such as walking, cycling, aerobic dance that involve continuous rhythmic movements of large muscle groups like those in the legs o Muscular strength and endurance – developed by training against resistance o Flexibility – developed by stretching major muscle groups o Healthy body composition – developed by combining sensible diet and a program of regular exercise
• One strategy is to select one activity for each component of fitness
• Another strategy applies the principle of cross training – alternating two or more activities to improve a single component of fitness
• Selecting activities that support you commitment rather than activities that turn exercise into a chore, will make the right program its own incentive for continuing
• Consider the following factors when making your choices: o Fun and interesting – program is more likely to be successful if you choose activities you enjoy doing o Your current skill and fitness level
 Some sports and activities require moderate level of skill to obtain fitness benefits
 Current fitness level may limit the activities that are appropriate for your program o Time and convenience – unless exercise fits easily into your daily schedule, you are unlikely to maintain your program over the long term o Cost – some sports and activities require equipment, fees or members o Special health needs – if you have special exercise needs, choose activities that will conform to your needs and enhance ability to cope
Set a target frequency, intensity and time (duration) for each activity
Cardiorespiratory endurance exercise
• 3-5 times per week at target heart rate or RPE
• Total workout time should be about 20-60 minutes, depending on the intensity of the activity (shorter durations are appropriate for high intensity activities, longer durations for moderate intensity)
• Single session or multiple sessions of 10 or more minutes
• One way to check whether the total duration you’ve set is appropriate is to use the calorie costs (calories per minute, per kg of body weight)
• Calorie cost – the amount of energy used to perform a particular activity, usually expressed in calories per minute per body weight
• Goal should be to work up to burning 300 calories per work out (beginners should start with 100-150 calories per workout)
Muscular strength and endurance training
• At least 2 non-consecutive days per week
• 1 or more sets of 8-12 repetitions of 8-10 exercises that work all major muscle groups
• For intensity, choose weight that is heavy enough to fatigue muscles but not so heavy you cannot complete the full number of repetitions with proper form
Flexibility training
• Stretches should be performed at least 2-3 days per week when muscles are warm (preferably 5-7)
• Should be performed for all major muscle groups
• Stretch to point of slight tension or mild discomfort, hold for 15-30 seconds; 2-4 repetitions each exercise
Set up a system of mini goals and rewards
• Break specific goals into several step, set target date for each step
• Allow several weeks between mini goals
• Reaching a series on mini goals is more satisfying than working towards a single, more challenging goal
• Realistic goals, broken down into achievable mini goals, increases your chances of success
Include lifestyle physical activity in your program
• Be more active during daily routine
• Find ways to integrate walking, climbing, running, stretching, etc. Into your day
• Use your health journal to track your activities
Develop tools for monitoring your progress
• A record that tracks your daily progress will help remind you of your ongoing commitment to your program and give you a sense of accomplishment o Program logs o Charts
Make a commitment
• Make a commitment by signing a contract
• Find a witness for your contract
Putting your plan into action
Strategies that help people succeed in sticking with an exercise program:
• Start slow and increase fitness gradually o First step is to break your established pattern of inactivity. Be patient and realistic
• Find an exercise buddy o Working out with a friend makes exercise more enjoyable and increases chances of sticking with your program. Find partners with same goals and general fitness. Extra motivation
• Ask for support from others
• Vary your activities o Cross training can help you develop balanced, total body fitness o Can be done by choosing different activities on different days or by altering activities within a single workout
• Cycle the duration and intensity of your workouts
• Adapt to changing environments and schedules
• Expect fluctuations and lapses
• Choose other healthy lifestyle behaviours o Choose a nutritious diet, avoid harmful habits like smoking and overconsumption of alcohol exercise guidelines for people with special health concerns arthritis • Begin exercise program as early as possible in the course of the disease
• Warm up thoroughly before each workout to loosen still muscles and lower risk of injury
• For cardiorespiratory endurance exercise, avoid high impact activities that may damage arthritic joints
• Strength train the whole body; pay special attention to muscles that support and protect affect joints. Start with small loads and build intensity gradually
• Perform flexibility exercises regularly to maintain joint mobility
Heart disease and hypertension
• Check with physician about exercise safety before increasing activity level
• Exercise at moderate level rather than high intensity. Keep heart rate below level at which abnormalities appear on exercise stress test
• Warm up and cool down session should be gradual and last at least 10 min
• Monitor heart rate during exercise, stop if you experience dizziness or chest pain
• If prescribed, carry nitroglycerin with you during exercise. If taking beta-blockers (reduces heart rate) for hypertension, use RPE rather than heart rate to monitor intensity. Exercise at RPE level of “somewhat hard”; breathing should be unlaboured, should be able to talk
• Don’t hold breath when exercising (could cause steep increase in blood pressure)
• Take special care during weight training; don’t lift extremely heavy loads. Exhale during exertion phase of lifts
• Increase exercise frequency, intensity and time very gradually
Obesity
• For max benefit and min risk, begin by choosing low-to-moderate intensity activities. Increase intensity slowly as your fitness improves
• People who want to lose weight or maintain weight loss should exercise moderately 60 or more every day
• Choose non or low weight bearing activities such as swimming, water exercise, cycling or walking. Low impact activities are less likely to lead to joint problems or injuries
• Stay alert for heart related problems during exercise
• Ease into exercise program and increase overload gradually. Increase time and frequency of exercise before increasing intensity
• Include strength training in fitness program to build or maintain muscle mass
• Try to include as much lifestyle physical activity in daily routine as possible
Exercise guidelines for life stages
Pregnant women
• Pregnant women should consider these guidelines when exercising: o See physician about possible modifications needed for particular pregnancy o Continue mild to moderate exercise routines (100-160 beats per minute) at least 3 times a week. avoid exercising vigorously or to exhaustion, especially in 3rd trimester o Monitor intensity by assessing how you feel rather than heart rate; RPE levels of 11-13 are appropriate o Favor non or low weight bearing exercises such as swimming or cycling over weight bearing exercises, which can carry increased risk of injury o Avoid exercise in supine position – lying on your back – after first trimester. Avoid prolonged periods of motionless standing o Avoid exercise that could cause loss of balance, especially in third trimester, and exercise that might injure the abdomen, stress the joints or carry risk of falling o Avoid activities involving extremes in barometric pressure, such as scuba diving and mountain climbing o Especially during first trimester, drink plenty of fluids and exercise in well ventilated areas to avoid heat stress o 3-5 sets of kegel exercises daily. Involve tightening the muscles of the pelvic floor for 5-15 seconds. Kegel exercise are thought to help prevent incontinence (involuntary loss of urine) and speed recovery after giving birth o After giving birth, resume prepregnancy exercise routines gradually, depending on how you feel
Older adults
• General exercise principles are the same as for younger people, but some specific guidelines apply: o Include three basic types of exercise – resistance, endurance and flexibility o For strength training, it is recommended that older adults use a lighter weight and perform more repetitions (10-15) than recommended for young adults o Drink plenty of water and avoid exercising in excessively hot or cold environments o Warm up slowly and carefully. Increase intensity and duration of exercise gradually o Cool down slowly, continuing very light exercise until heart rate is below 100 beats per minute o To help prevent soft tissue pain, do static stretching after a normal workout