Chapter 13: Diet and Exercise for Lifelong Fitness and Health Overarching Concepts 1. Humans are designed to be physically active. 2. Proper diet and exercise are important for lifelong fitness and health. 3. Diet and exercise are fundamental to the prevention, delay, and treatment of many chronic diseases. 4. Techniques have been developed for the general population to assess chronic disease risk. 5. A better understanding of how and why people change their behavior is needed. Learning Objectives LO 13.1 Identify reasons why energy expenditure may decline and weight may be gained as individuals age, and compare and contrast general diet and physical activity recommendations published by various organizations. LO 13.2 Explain the relationships among body weight, fat distribution, and chronic disease risk; discuss the factors that regulate body weight, food intake, and energy expenditure; and compare and contrast popular weight-loss programs. LO 13.3 Discuss the following chronic diseases—obesity, cardiovascular disease, hypertension, type 2 diabetes, metabolic syndrome, lifestyle-related cancers, and osteoporosis—and explain how diet and physical activity influence each. Chapter Outline I. Introduction A. Pre-test assessment B. Introduction to lifelong fitness 1. “Everyone is an athlete” 2. Few athletes remain competitive in their sports over a lifetime 3. It is important to be physically active at all ages 4. It is important to consume a nutritious diet at all ages 5. Poor diet and lack of exercise promote chronic diseases 6. Proper diet and exercise prevent or slow the progression of chronic diseases II. 13.1 The lifelong athlete • All people should be physically active throughout their lives. • Proper nutrition is important across the life cycle. • The Dietary Guidelines and other nutrition- and exercise-related recommendations outline a general plan for good health. A. Most collegiate athletes do not become professional athletes and must adjust to reduced exercise training 1. Most collegiate athletes do not become professional athletes 2. Must adjust dietary intake to lower activity level 3. Many former athletes gain body fat over their lifetimes 4. Weight gain in former athletes is not inevitable 5. Declining physical activity associated with age a. Amount of physical activity declines with age b. Intensity and duration of activity also decrease c. Result is a decline in physical functionality B. Various nutrition and exercise guidelines are remarkably similar, although there are some differences 1. Nutrition guidelines a. Dietary Guidelines for Americans, 2010 1. Public domain 2. Use with the general population 3. Basic diet guidelines b. Other nutrition guidelines 1. American Heart Association 2. Mediterranean diet 3. American Cancer Association c. Despite some differences, guidelines are remarkably similar 2. Exercise guidelines a. Physical Activity Guidelines for Americans, 2008 1. Public domain 2. Use with the general population 3. Exercise guidelines for specific situations a. Minimum amount b. Amount necessary to prevent weight gain c. Amount necessary to prevent weight re-gain b. American College of Sports Medicine (ACSM) guidelines 1. Specific guidelines a. Cardiorespiratory fitness b. Muscular strength and endurance c. Flexibility c. Basic message is regular, lifelong exercise Question for discussion: What is meant by the opening quote of this chapter?—“Everyone is an athlete. The only difference is that some of us are in training, and some are not.” III. 13.2 The impact of overweight and obesity on chronic diseases • Chronic diseases often begin in childhood and progress throughout the life cycle. • Lifestyle, particularly diet and exercise, is closely tied to many chronic diseases. • Overweight and obesity affect many chronic diseases. • American society is “obesogenic.” • The regulation of body weight is complex. • To lose weight, eat less and exercise more. • No one weight-loss diet is the “best.” A. General characteristics of chronic diseases 1. Disease lasting 3 months or more that can be treated but not cured 2. In the U.S., 70% of all deaths are related to chronic diseases 3. Poor diet and lack of exercise are major contributing factors B. The majority of Americans are overweight or obese 1. BMI 25-29.9 = overweight, BMI >30 = obese 2. Prevalence: Majority of adult population 3. Cause is energy imbalance 4. Excessive kcal intake and lack of physical activity are major factors 5. Prevention a. Match caloric intake with caloric expenditure b. Eat predominantly because of physical hunger c. Appropriate portion sizes d. Routine physical activity 6. Weight gain and aging – Not an inevitable consequence of aging or pregnancy C. Regulation of body weight is a complex process that is not completely understood 1. Multiple physiological & psychological inputs affect behaviors related to weight 2. Hypothalamus – hunger or satiety 3. Ghrelin – hormone that stimulates appetite/food intake by causing secretion of Neuropeptide Y (NPY) 4, Peptide YY (PYY) decreases drive to eat 5. Cholecystokinin (CCK) & stomach distention signal satiety 6. Leptin – hormone produced by fat cells that helps regulate weight long term 7. Energy expenditure affected by many factors, primarily resting metabolic rate, thermic effect of food, and physical activity D. The treatment of overweight and obesity involves long-term changes to established food and exercise patterns 1. Popular weight-loss diets a. Atkins diet 1. Very low CHO, moderate to high protein and fat 2. Low fiber 3. Caloric intake not “counted” but likely to be less than usual 4. Appetite suppression due to ketosis 5. Considers degree of insulin resistance b. Zone diet (40/30/30) 1. Low CHO (40%), high protein (30%), moderate fat (30%) 2. Emphasis on monounsaturated fats; moderate fiber 3. Caloric intake not “counted” but ≈1,000-1,600 kcal daily 4. Number of CHO, protein, and fat “blocks” limited 5. Considers glucose and insulin responses to CHO foods c. Ornish diet 1. High CHO, moderate protein, very low fat 2. Emphasis on plant foods; high fiber 3. Caloric intake not “counted” but likely to be less than usual 4. Goal is to prevent and reverse heart disease 5. Weight loss may be a consequence of diet d. Weight Watchers 1. Moderate CHO and protein, low fat 2. Moderate to high fiber 3. Caloric intake not “counted” but “points” system limits intake 4. Known for its support network e. Comparing the effectiveness of various weight-loss diets 1. No single weight-loss plan has been proven to be most effective 2. Regardless of the plan, after one year ≈5-7 lb are lost 3. Weight loss is ≈3% of body weight 4. Restriction of total caloric intake is most important factor, not CHO, protein, and fat distribution 5. Weight loss and the maintenance of lost weight are very difficult 6. Restricted-fat or -CHO weight-loss plans compared a. Restricted-fat weight-loss diets 1. Advantages a. Limits most caloric-dense nutrient b. Limits an easy-to-overconsume nutrient c. Plan has been successful for some people d. Reduces total cholesterol and LDL-C 2. Disadvantages a. May increase blood triglycerides b. May decrease HDL-C b. Restricted-CHO weight-loss diets 1. Advantages a. Includes high-fat/protein foods that are tasty b. Reduces appetite (due to ketosis) c. Plan has been successful for some people d. Higher protein helps to preserve LBM e. Alters insulin response f. Reduces blood triglycerides, cholesterol, and insulin g. Increases HDL-C 2. Disadvantages a. No long-term data on safety or effectiveness g. Risk for some medical conditions may be increased Question for discussion: Why is it so difficult for humans to lose weight and maintain the weight loss? III. 13.3 Diet, exercise, and chronic disease • Hypertension, diabetes, cardiovascular disease, metabolic syndrome, osteoporosis, and lifestyle-related cancers are greatly affected by diet and exercise habits. • Body Mass Index, waist circumference, and bone mineral density tests are helpful screening tools. • Cardiovascular fitness is important regardless of one’s weight. • Individual and collective behavior change is needed to prevent and treat chronic diseases. A. Diet and exercise are important components of prevention and treatment strategies for hypertension 1. High blood pressure 2. Prevalence: 1 in 3 adults 3. No distinct symptoms 4. Cause is unknown in most cases 5. Prevention a. Maintain or achieve healthy body weight b. Nutritious diet 1. Some people are sodium sensitive c. Physical activity 1. Endurance training reduces risk 2. Lifelong physical activity reduces risk B. Diabetes is a group of diseases characterized by a high blood glucose level 1. Impaired CHO metabolism 2. Type 1 diabetes results from an inability to manufacture insulin 3. Type 2 diabetes is more common a. Characterized by insulin resistance b. Prevalence: ≈21 million in U.S.; ≈57 million are prediabetic c. Prevention 1. Maintain a healthy weight 2. Consume a healthy diet 3. Routine physical activity C. Cardiovascular disease is the major cause of death in the United States 1. Diseases of the heart and vessels 2. Atherosclerosis (hardening and narrowing of the arteries) a. Process begins in childhood/adolescence b. Prevalence: ≈17 million in U.S. (≈26% of deaths) c. Symptoms: Typically none while developing d. Blockage can lead to chest pain, heart attack, stroke e. Prevention 1. Maintain or achieve a healthy weight 2. Consume a healthy diet 3. Maintain or progress to a minimum of 150 minutes of moderate-intensity exercise each week f. Major risk factors 1. Age 2. Cigarette smoking 3. Family history of early heart disease 4. HDL-C 60 is protective) 5. Hypertension 6. Diabetes g. Contributing risk factors 1. Elevated total cholesterol (may be affected by diet) 2. Excess body fat (involves diet and exercise) 3. Physical inactivity 4. Excess alcohol intake 5. Unhealthful responses to stress h. Laboratory tests 1. Total cholesterol is a screening tool 2. Relative amount of lipoproteins is more important than total amount of cholesterol 3. LDL-C is best predictor of heart disease risk a. Referred to as “bad” cholesterol because elevated LDL-C is undesirable b. Diets high in saturated and trans fats increase LDL-C c. Other kinds of fats reduce the risk for heart disease 4. HDL-C referred to as “good” cholesterol a. Elevated HDL-C is desirable and protective 3. The role of diet and exercise – Recommendations for prevention are to: a. Reduce trans fats as much as possible b. Reduce dietary cholesterol c. Choose healthy fats (omega-3, poly-, monounsaturated) d. Limit saturated fats e. Limit added sugars f. Consume a moderate amount of (or no) alcohol g. Exercise regularly – beneficial, mostly as an aid to weight loss or maintenance D. Metabolic syndrome is a cluster of metabolic disorders strongly associated with abdominal obesity and insulin resistance 1. Cluster of risk factors a. Obesity b. Hypertension c. Dyslipidemia d. Glucose intolerance e. Insulin resistance 2. Underlying factors a. Obesity and insulin resistance 1. Upper body obesity 2. Visceral fat is easily mobilized 3. Physical activity has a direct and independent positive effect 4. Prevention a. Routine physical activity b. Maintain or achieve a healthy weight c. Consume a healthy diet E. Osteoporosis is characterized by low mineral density 1. Bone mineral density more than 2.5 standard deviations below normal 2. Caused by loss of bone mineral 3. Prevalence: ≈10 million adults, mostly women 4. Prevention a. Weight-bearing activity on a near-daily basis beginning in childhood b. Adequate calcium and vitamin D intakes across the life cycle 5. Assessing bone mineral density (BMD) a. BMD is best predictor of fracture risk b. Normal c. Osteopenia (low BMD) d. Osteoporosis (low BMD + structural deterioration) e. Calcium supplementation after peak bone mass has been achieved may be prudent but its effects are limited F. Many cancers are related to lifestyle 1. Cancer is characterized by uncontrolled cell growth 2. Poor diet and inactivity are contributors to some types of cancer 3. Prevention a. Maintain or achieve a healthy weight b. Routine physical activity c. Consume a healthy diet, with an emphasis on plant foods d. Limit alcohol consumption G. Chronic disease risk can be assessed with a number of screening tools 1. Body Mass Index (BMI) a. Chronic disease risk screening tool b. More predictive when used with waist circumference c. Associations among body weight, chronic disease risk, and mortality 1. Cardiovascular fitness is a strong influence 2. Body fat distribution is a strong influence 3. Disease risk is associated with increasing BMI 4. No BMI category is disease free 5. Increasing BMI has greatest impact on risk for hypertension H. Physical activity and fitness may reduce the adverse impact of over fatness on health 1. Obesity-related deaths in the U.S. are ≈112,000 yearly 2. Being physically active has health benefits regardless of body weight 3. Becoming physically active has some immediate positive health benefits I. The Health at Every Size movement emphasizes improved metabolic health over weight and fat loss 1. “Nondiet” approach 2. Emphasis is on: a. Consuming a healthy diet b. Normalizing eating habits c. Moderate physical activity 3. Weight loss is not an expectation but may be a consequence 4. Success is defined as improved: a. Metabolic fitness (e.g., blood pressure) b. Eating behaviors (e.g., less disordered eating) c. Well-being (e.g., less depression, increased self-esteem) J. Behavior change is needed to prevent and treat lifestyle-related chronic diseases 1. Behavior change models a. Knowledge-Attitude-Behavior (KAB) 1. Knowledge is driving force 2. Most people do not change behavior based on knowledge alone b. Health Belief Model (HBM) 1. Potential for health problems is driving force 2. Limited success c. Social cognitive theory (SCT) 1. Expected outcome is the driving force 2. Skill and confidence are also critical 3. Some SCT-based diet and exercise programs report success d. Stages of Change Model 1. One aspect is stages of change a. Precontemplation b. Contemplation c. Preparation d. Action e. Maintenance 2. There is no “correct” or “best” approach 2. Environmental and policy changes a. Population-level changes make it easier for individuals to begin & continue health-promoting behaviors b. E.g., CDC strategies include ensuring healthful foods are affordable & more readily available in public places than unhealthful ones, & making the built environment exercise friendly Question for discussion: How can you, your family, your community, and your country become “health genic” rather than “obesogenic”? IV. Summary and review A. Chapter summary B. Post-test assessment C. Review questions D. References Supplementary Teaching Materials and Classroom Activities Note: The text chapter includes an application exercise requiring the formulation of a weekly physical activity and exercise program to help Freddy (from the Spotlight) improve his fitness and reduce his disease risk (p. 512). Activity 13-1 Take a voluntary survey of students to determine how many have a family history of the chronic diseases covered in the chapter—hypertension, overweight or obesity, type 2 diabetes, heart disease, metabolic syndrome, lifestyle-related cancers, and osteoporosis. Some students may want to share stories of family members who have experienced medical complications, such as amputations due to uncontrolled diabetes. Activity 13-2 Survey students to determine which weight-loss plan they would choose if they had a choice of only two—Atkins or Ornish. What do students see as the advantages or disadvantages of each? Broaden the discussion by including any weight-loss plan that students may be familiar with. Have each student prepare a meal or a day’s food intake following the guidelines of two different weight-loss diet programs. Students can volunteer to share the menu created with the entire class, who can share their opinions about their personal preferences for the foods selected. Activity 13-3 Guest speakers who have experience with lifelong struggles with weight loss can provide insight for students, many of whom have never gained large amounts of body fat or tried to lose a substantial amount of weight. For example, students are often fascinated by the experiences of those who have undergone successful gastric bypass surgery or those who are advocates of the Health at Every Size approach. Such speakers are usually comfortable with any questions that students may ask, but it is important to set some ground rules. It may be helpful to remind students that personal questions should be asked respectfully. Similarly, speakers should be reminded that they may choose to not answer a question. Activity 13-4 Have students evaluate websites associated with health-prevention organizations. This can be an in-class demonstration with websites pre-selected by the instructor or an out of class assignment. Student Assignment The purpose of the assignment is to evaluate the content material of the website of a non-profit or government agency that offers information about diet- and exercise-related chronic diseases. Focus on the information related to prevention rather than treatment of the disease. Answer the following questions about the website. 1. What is the URL of the website? 2. Describe the mission of the organization. 3. Summarize the factual information found on the site. Was this information easy to find? Would consumers find it easy to understand? 4. Describe any interactive features. 5. In your opinion, what are the best features of this website? What suggestions do you have for improvements? 6. Write a one-paragraph summary of this website. Crossword Puzzle Answer Key 1. dyslipidemia 2. hypertension 3. osteoarthritis 4. masters athletes 5. platelet 6. leptin 7. eicosanoid 8. sleep apnea 9. ghrelin 10. A: overweight; D: obese 11. endocrine 12. inverse Word Find Puzzle Answer Key • 5 common chronic diseases: cardiovascular disease, cancer, diabetes, osteoporosis, obesity • 3 lifestyle factors that influence death risk: tobacco, diet, exercise • 2 dietary minerals related to blood pressure: sodium, potassium • 4 harmful conditions associated with obesity: hypertension, dyslipidemia, osteoarthritis, sleep apnea • 4 popular weight-loss plans: Atkins, Zone, Weight Watchers, Ornish • 4 important blood lipid values: total cholesterol, LDL-C, HDL-C, triglycerides • 2 nutrients involved in maintaining bone density: calcium, vitamin D A E M T D N I M A T I V C O C L D L U S B S S T W Y T M A E O N I A Z S A G A T K I N S T R I G L Y C E R I D E S Y G O E C I E S K D P R E T D U E S L D N C W O R M E S U S P I S I P M R E L O R E T S E L O H C L A T O T U E E O S S I T S L X A O T D Y E V E I B P B T L G H T L E E L O N T U A H C M A O E I H S E N U T S N A I Q S T L U P N O S T E O P O R O S I S T C G A N N E A A W Z R E Q R D O D E R U N C T E R R T A U D I E T I M C B A L I R A A A T G T R C T R A U D T O B A C C O S E H N C O E H U I M S N C P R L U G C W R I H T S S S E S S E S A D L G A A S I S E D Y S L I P I D E M I A N N W A T A R T A N O H N E I F E S C I I I K I H S T R O Y Y A R C O L E L F S C C S C O N U I E M K R O S R A U D S L A I P H A O H Y P E R T E N S I O N D S E T E B A I D S A G S N Z E P N E H Chapter 13 Crossword Puzzle Across Down 2. Blood pressure chronically elevated above normal resting levels. 5. A cell found in the blood that assists with blood clotting. 7. Member of a class of compounds manufactured from polyunsaturated fatty acids that are involved in cellular activity, including mediating inflammation. 8. Condition marked by brief periods during sleep when breathing stops. 9. A protein-based hormone secreted by the cells of the stomach and associated with appetite stimulation. 10. Having a body mass index of 25–29.9. 11. Relating to glands that secrete hormones. 12. In a(n) _____ relationship, when one variable increases the other decreases, and vice versa. 1. Abnormal concentration of blood fats (e.g., cholesterol, lipoproteins, triglycerides). 3. Degenerative joint disease characterized by pain and stiffness. 4. A separate division created by a sports-governing body for athletes older than a certain age. 6. A hormone produced in adipose tissue that suppresses appetite. 10. Having a body mass index greater than 30. Chapter 13 Word Find Puzzle A E M T D N I M A T I V C O C L D L U S B S S T W Y T M A E O N I A Z S A G A T K I N S T R I G L Y C E R I D E S Y G O E C I E S K D P R E T D U E S L D N C W O R M E S U S P I S I P M R E L O R E T S E L O H C L A T O T U E E O S S I T S L X A O T D Y E V E I B P B T L G H T L E E L O N T U A H C M A O E I H S E N U T S N A I Q S T L U P N O S T E O P O R O S I S T C G A N N E A A W Z R E Q R D O D E R U N C T E R R T A U D I E T I M C B A L I R A A A T G T R C T R A U D T O B A C C O S E H N C O E H U I M S N C P R L U G C W R I H T S S S E S S E S A D L G A A S I S E D Y S L I P I D E M I A N N W A T A R T A N O H N E I F E S C I I I K I H S T R O Y Y A R C O L E L F S C C S C O N U I E M K R O S R A U D S L A I P H A O H Y P E R T E N S I O N D S E T E B A I D S A G S N Z E P N E H Instructions: In the grid above, find the following words or phrases, and then write them beside each clue. • 5 common chronic diseases: • 3 lifestyle factors that influence death risk: • 2 dietary minerals related to blood pressure: • 4 harmful conditions associated with obesity: • 4 popular weight-loss plans: • 4 important blood lipid values: • 2 nutrients involved in maintaining bone density: 1 Crossword and word find contributed by Elesha Feldman Instructor Manual for Nutrition for Sport and Exercise Marie Dunford, J. Andrew Doyle 9781285752495
Download
Close
Close
