Health and Fitness for Life PDF

Health and Fitness for Life  Health and Fitness for Life MHCC - HPE295 DAWN MARKELL AND DIANE PETERSON MHCC LIBRARY PRESS GRESHAM, OR Health and Fitness for Life by Dawn Markell and Diane Peterson is licensed under a Creative Commons Attribution 4.0 Internationa...

Health and Fitness for Life  Health and Fitness for Life MHCC - HPE295 DAWN MARKELL AND DIANE PETERSON MHCC LIBRARY PRESS GRESHAM, OR Health and Fitness for Life by Dawn Markell and Diane Peterson is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Contents Attribution and OER Revision Statement ix MARC Record x Chapter 1 - Healthy Behaviors and Wellness Why Study Wellness? 2 Dimensions of Wellness 3 Health Problems in the United States 7 Behaviors That Promote Wellness 8 Behavior Modification 9 Lifestyle Modification Barriers 13 Fostering Wellness in Your Life 15 Start with “Why?” 18 Test Your Knowledge 19 Chapter 2 - Fitness Principles Exercise: Not a Passing Fad 23 What are Physical Activity and Exercise? 26 Components of Health-Related Fitness 27 Principles of Adaptation to Stress 29 FITT 31 Specificity 34 Rest, Recovery, and Periodization 36 Reversibility 38 Individual Differences 39 Creating a Successful Fitness Plan 41 Additional Safety Concerns 51 Test Your Knowledge 56 Chapter 3 - Cardiorespiratory Fitness What are the cardiovascular and respiratory systems? 61 The CR System and Energy Production 64 Changes in the CR System 68 Measuring Heart Rate 70 Measuring Intensity 72 Cardiorespiratory Fitness Assessment 77 Test Your Knowledge 78 Chapter 4 - Muscular Strength and Endurance Muscular Physiology 82 Muscle Fiber Types 88 Resistance Exercise Programing 92 Supplements 101 Test Your Knowledge 102 Chapter 5 - Flexibility What is Flexibility? 106 Benefits of Flexibility and Stretching 108 Improving Range of Motion 111 Improving Flexibility 115 Creating an Effective Stretching Program 119 Assessing Your Flexibility 122 Test Your Knowledge 123 Chapter 6 - Body Composition Body Weight versus Body Composition 127 Diseases Associated with Excessive Body Fat 129 Body Fat Distribution 133 Body Mass Index 135 How to Measure Body Composition 137 Weighing in on the U.S. 141 Low Body Composition 143 Test Your Knowledge 145 Chapter 7 - Nutrition The Basics 149 Carbohydrates 151 Proteins 153 Fats (Lipids) 154 Vitamins 156 Minerals 157 Calories (Food Energy) 158 Test Your Knowledge 161 Chapter 8 - Weight Management Weight Management Through Diet 164 The Importance of Physical Activity in Maintaining a 169 Healthy Weight Keeping the Weight Off 173 Health Risks of Being Underweight 177 Test Your Knowledge 181 Chapter 9 - Stress What Is Stress and How Does It Affect Wellness? 184 What Are the Strategies for Managing Stress? 187 Assess Your Stress Level 190 Test Your Knowledge 191 Chapter 10 - Cardiovascular Disease and Stroke Heart Disease 195 Different types of CVD 197 Test Your Knowledge 201 References 203 Attribution and OER Revision Statement “Health and Fitness for Life” by Dawn Markell and Diane Peterson is licensed under CC BY 4.0 / A derivative from the original work, except where otherwise noted. This open textbook is a modified version of “Concepts of Fitness and Wellness” from Georgia Highlands College (also found in the Open Textbook Library). It includes only chapters 1-10 of the original 13, to better accommodate a 10 week length course (quarter system) at Mt Hood Community College. Proprietary links were either updated or removed. Terminology lists were relocated to the beginning of each chapter, just after the original list of Objectives. The primary focus of this revised version is on assessment and development of functional goals in fitness training, nutrition, and stress management. Publication and descriptive metadata was added to facilitate library cataloging: MARC record freely available. Attribution and OER Revision Statement | ix MARC Record [provide link to.mrc file hosted on libguides?] x | MARC Record CHAPTER 1 - HEALTHY BEHAVIORS AND WELLNESS Objectives 1. Define the nine dimensions of wellness 2. Identify health problems in the United States 3. Identify the behaviors that promote wellness 4. Behavior Modification: how change occurs, barriers to change, and how to successfully overcome barriers and make lasting lifestyle changes Terminology Health – Absence of Disease Wellness – optimal state of mind and body Behavior Modification – the alteration of behavioral patterns through specific techniques Goal Setting – the process of identifying something you want to accomplish and establishing measurable goals and timeframes Barriers – something that stands in the way of you achieving your goals Chapter 1 - Healthy Behaviors and Wellness | 1 Why Study Wellness? As most college students do, you have probably set goals. Obviously, your individual goals differ from those of your fellow classmates, but everyone’s goals share one common attribute: their intention to improve individual wellbeing. However, there are as many ideas about how to do that as there are individuals. Do your goals involve making more money, achieving better health, improving your relationships? Holistic wellness involves all those aspects of life and more. This chapter explains the importance of overall wellness, which is about more than being physically and mentally healthy, free from illness and disease. In fact, the study of wellness incorporates all aspects of life. Achieving overall wellness means living actively and fully. People in this state exude confidence, optimism, and self- efficacy; they have the energy reserves to do what needs to be done today and to plan for a better tomorrow. The most effective and transformative goals are those designed to achieve the highest level of personal wellness. 2 | Why Study Wellness? Dimensions of Wellness Wellness is a familiar term, but what is its true definition? Is it simply the absence of disease? This chapter will define all the components of holistic wellness and describe the factors that contribute to not only a person’s physical and mental health, but also their ability to develop, thrive, succeed, enjoy life, and meet challenges head on with confidence and resolve. To achieve this type of overall wellness, a person must be healthy in nine interconnected dimensions of wellness: physical, emotional, intellectual, spiritual, social, environmental, occupational, financial, and cultural. A description of each dimension follows. The Nine Dimensions of Wellness 1. Physical Wellness People who are physically well actively make healthy decisions on a daily basis. They eat a nutritionally balanced diet; they try to get an adequate amount of sleep, and they visit the doctor routinely. They make a habit of exercising three to five times per week; they have the ability to identify their personal needs and are aware of their body’s limitations. They maintain positive interpersonal relationships and make healthy sexual decisions that are consistent with their personal values and beliefs. Dimensions of Wellness | 3 2. Emotional Wellness An emotionally well person successfully expresses and manages an entire range of feelings, including anger, doubt, hope, joy, desire, fear, and many others. People who are emotionally well maintain a high level of self-esteem. They have a positive body-image and the ability to regulate their feelings. They know where to seek support and help regarding their mental health, including but not limited to, seeking professional counseling services. 3. Intellectual Wellness Those who enjoy intellectual wellness engage in lifelong learning. They seek knowledge and activities that further develop their critical thinking and heighten global awareness. They engage in activities associated with the arts, philosophy, and reasoning. 4. Spiritual Wellness People who can be described as spiritually well have identified a core set of beliefs that guide their decision making, and other faith- based endeavors. While firm in their spiritual beliefs, they understand others may have a distinctly different set of guiding principles. They recognize the relationship between spirituality and identity in all individuals. 5. Social Wellness A socially well person builds healthy relationships based on 4 | Dimensions of Wellness interdependence, trust, and respect. Those who are socially well have a keen awareness of the feelings of others. They develop a network of friends and co-workers who share a common purpose, and who provide support and validation. 6. Environmental Wellness An environmentally well person appreciates the external cues and stimuli that an environment can provide. People who have achieved environmental wellness recognize the limits to controlling an environment and seek to understand the role an individual plays in the environment. 7. Occupational Wellness An occupationally well person enjoys the pursuit of a career which is fulfilling on a variety of levels. This person finds satisfaction and enrichment in work, while always in pursuit of opportunities to reach the next level of professional success. 8. Financial Wellness Those who are financially well are fully aware of their current financial state. They set long- and short-term goals regarding finances that will allow them to reach their personal goals and achieve self-defined financial success. Dimensions of Wellness | 5 9. Cultural Wellness Culturally well people are aware of their own cultural background, as well as the diversity and richness present in other cultural backgrounds. Cultural wellness implies understanding, awareness and intrinsic respect for aspects of diversity. A culturally well person acknowledges and accepts the impact of these aspects of diversity on sexual orientation, religion, gender, racial and ethnic backgrounds, age groups, and disabilities.1 For more information on the nine dimensions of wellness, click on the link below: Nine Dimensions of Wellness To watch a video about the nine dimensions of wellness, click on the following link: Video on the Nine Dimensions of Wellness 6 | Dimensions of Wellness Health Problems in the United States Americans today experience health problems that people who lived 100 years ago did not encounter. What are the factors that account for these health problems that have arisen over the past 100 years? Most health problems faced by people in the U.S. are chronic diseases that are preventable and caused by everyday choices and unhealthy lifestyles. The link below provides more information about the leading causes of death in the United States: Leading Causes of Death To see a 2014 chart that shows the leading cause of death by age group, click on the link below: Leading Cause of Death by Age Group In the video linked below, you will learn about the determinants of health as outlined by Healthy People 2020. Healthy People 2020 is a federal advisory committee comprised of non-federal, independent subject matter experts who gather data and provide advice on how to promote health and prevent disease in America: Healthy People 2020 and Determinants of Health Health Problems in the United States | 7 Behaviors That Promote Wellness Bad habits are hard to break, but choosing to eat healthier and exercise more provides benefits that go far beyond a more ideal body weight and shape. Being physically fit can stave off many of the diseases and medical conditions discussed in the previous section, including heart disease, the number 1 killer in America. Exercise reduces stress and eases depression. Healthier employees are also more productive. Being physically fit nurtures the mind, body, and spirit and is the cornerstone of wellness. The links below provide information about behaviors within your control that contribute to an improved quality of life and increased wellness. Six Behaviors That Contribute to Wellness Lifestyle Choices and Their Effect on Wellbeing Behaviors that Contribute to Wellness Presentation 8 | Behaviors That Promote Wellness Behavior Modification Making permanent lifestyle changes is one of the greatest challenges a person can face. This section will explore how changes to behavior occur, the psychological barriers that hamper efforts to change, and tips for making lasting change. How Changes in Behavior Occur The Transtheoretical Model, also called the Stages of Change Model, was developed by James Prochaska and Carlo DiClemente in the late 1970s. Considered the dominant model for describing how behavior changes occur, it evolved through studies examining the experiences of smokers who quit on their own and comparing them with the experiences of those requiring further treatment. The goal of those studies was to understand why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change. The TTM operates on the assumption that people do not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a cyclical process. The TTM is not a theory but a model; different behavioral theories and constructs can be applied to various stages of the model where they may be most effective. The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Termination was not part of the original model and is less often used in application of stages of change for health-related behaviors. For each stage of change, Behavior Modification | 9 different intervention strategies are most effective at moving the person to the next stage of change and subsequently through the model to maintenance, the ideal stage of behavior. Six Stages of Change: Stage 1: Precontemplation In this stage, people do not intend to take action in the foreseeable future (defined as within the next 6 months). People are often unaware that their behavior is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behavior and place too much emphasis on the cons of changing behavior. 10 | Behavior Modification Stage 2: Contemplation In this stage, people are intending to start the healthy behavior in the foreseeable future (defined as within the next 6 months). People recognize that their behavior may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behavior takes place, with equal emphasis placed on both. Even with this recognition, people may still feel ambivalent toward changing their behavior. Stage 3: Preparation (Determination) In this stage, people are ready to take action within the next 30 days. People start to take small steps toward the behavior change, and they believe changing their behavior can lead to a healthier life. Behavior Modification | 11 Stage 4: Action In this stage, people have recently changed their behavior (defined as within the last 6 months) and intend to keep moving forward with that behavior change. People may exhibit this by modifying their problem behavior or acquiring new healthy behaviors. Stage 5: Maintenance In this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages. Stage 6: Termination In this stage, people have no desire to return to their unhealthy behaviors and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs. Goal Setting: One of the most effective tools for changing behavior is goal setting. The link below provides information on how to set goals effectively to achieve greater success in goal attainment. Video on S.M.A.R.T. Goals 12 | Behavior Modification Lifestyle Modification Barriers Dr. James M. Olson, a psychology professor at the University of Western Ontario, London, has identified several psychological barriers that commonly prevent people from taking action, even when inaction poses a threat to their health. These barriers occur during 3 stages of behavior modification: admission of the problem, initial attempts to change, and long-term change as outlined below: Barriers to Admission of the problem The first step in lasting change is admitting a problem exists. People often fail to change behavior that poses a risk to their health because they deny a risk exists, trivialize their personal risk, feel invulnerable, make a faulty conceptualization, (i.e., they attribute early warning signs to a benign cause), or experience debilitating emotions when contemplating preventative measures. Barriers to Initial Attempts to Change At this stage, people acknowledge the need to change but struggle to accomplish their goals. This failure is a result of lack of knowledge, low self-efficacy (the belief in one’s own ability to succeed at change), and dysfunctional attitudes. Lifestyle Modification Barriers | 13 Barriers to long-term change Just because a person has experienced success in changing a behavior, that doesn’t mean the change is permanent. Barriers to long-term change include cognitive and motivational drift (diminishing enthusiasm for the need to change), lack of perceived improvement, lack of social support, and lapses. To read more about these barriers to change, including strategies for overcoming these barriers, read Dr. Olson’s article linked below: Psychological Barriers to Behavior Change A presentation on overcoming barriers to change by the National Institute for Health and Clinical Excellence (NHS) is linked below: Overcoming Barriers to Change 14 | Lifestyle Modification Barriers Fostering Wellness in Your Life You are once again feeling motivated to eat better, exercise more, drink less caffeine or make any number of the positive lifestyle changes you have been telling yourself you want to make. You have tried before—probably declaring another attempt as a New Year’s resolution—but without experiencing much success. Making a lifestyle change is challenging, especially when you want to transform many things at once. This time, think of those changes not as a resolution, but as an evolution. Lifestyle changes are a process that take time and require support. Once you are ready to make a change, the difficult part is committing and following through. So do your research and make a plan that will prepare you for success. Careful planning means setting small goals and taking things one step at a time. Here are five tips from the American Psychological Association (APA) that will assist you in making lasting, positive lifestyle and behavior changes: Make a plan that will stick. Your plan is a map that will guide you on this journey of change. You can even think of it as an adventure. When making your plan, be specific. Want to exercise more? Detail the time of day when you can take walks and how long you will walk. Write everything down, and ask yourself if you are confident that these activities and goals are Fostering Wellness in Your Life | 15  realistic for you. If not, start with smaller steps. Post your plan where you will most often see it as a reminder. Start small. After you’ve identified realistic short-term and long-term goals, break down your goals into small, manageable steps that are specifically defined and can be measured. Is your long-term goal to lose 20 pounds within the next five months? A good weekly goal would be to lose one pound a week. If you would like to eat healthier, consider as a goal for the week replacing dessert with a healthier option, like fruit or yogurt. At the end of the week, you will feel successful knowing you met your goal. Change one behavior at a time. Unhealthy behaviors develop over the course of time, so replacing unhealthy behaviors with healthy ones requires time. Many people run into problems when they try to change too much too fast. To improve your success, focus on one goal or change at a time. As new healthy behaviors become a habit, try to add another goal that works toward the overall change you are striving for. Involve a buddy. Whether it be a friend, co-worker or family member, someone else on your journey will keep you motivated and 16 | Fostering Wellness in Your Life  accountable. Perhaps it can be someone who will go to the gym with you or someone who is also trying to stop smoking. Talk about what you are doing. Consider joining a support group. Having someone with whom to share your struggles and successes makes the work easier and the mission less intimidating. Ask for support. Accepting help from those who care about you and will listen strengthens your resilience and commitment. If you feel overwhelmed or unable to meet your goals on your own, consider seeking help from a psychologist. Psychologists are uniquely trained to understand the connection between the mind and body, as well as the factors that promote behavior change. Asking for help does not mean a lifetime of therapy; even just a few sessions can help you examine and set attainable goals or address the emotional issues that may be getting in your way. Fostering Wellness in Your Life | 17 Start with “Why?” Making changes in habitual behavior requires a deep and abiding belief that change is needed. Your desire to change may be motivated by personal goals, or it may be the result of the impact your improved wellness will have on those you love. Nietzsche said, “He who has a strong enough why can bear almost any how.” Once you have a compelling reason to change, develop a plan and commit to that plan. If you experience a moment of weakness, do not waste time on self-condemnation. Revisit your compelling reason and reaffirm your commitment to change. The health, peace, and sense of wellbeing inherent in the highest level of your own personal wellness is more than worth the effort required to change 18 | Start with “Why?” Test Your Knowledge 1. Health is defined as a. Having health insurance b. Absence or presences of disease or injury c. Absence or presence of optimal wellness d. Not having to see a doctor 2. Health and Wellness mean the same thing a. True b. False 3. Which of the following is the least likely to affect a college student’s wellness? a. Retirement income b. School c. Screen time d. Drugs 4. Before changing your behavior, what must you do first? a. Find help b. Learn where resources are located that will help you change your behavior c. Nothing you just start changing your behavior d. Pick a behavior that you want to change Test Your Knowledge | 19 5. Visualization is a. Picturing a pro-con list b. Seeing yourself laying on the beach c. Seeing yourself accomplish a goal d. Picturing yourself falling asleep 6. What is the first step in the transtheoretical model? a. Relapse b. Precontemplation c. Action d. Preparation Answers: 1.B, 2.B, 3.A, 4.D, 5.C, 6.B 20 | Test Your Knowledge CHAPTER 2 - FITNESS PRINCIPLES Objectives 1. Describe the origins of exercise 2. Define physical activity and exercise 3. Discuss principles of adaptation to stress 4. Provide guidelines for creating a successful fitness program 5. Identify safety concerns Terminology Physical activity – any activity that requires skeletal muscle and requires energy aimed at improving health. Exercise – a subset of physical activity that is planned and structured aimed at improving fitness. Health related components of fitness – types of activities dedicated to improving physical fitness categorized as cardiorespiratory endurance, muscular strength and endurance, flexibility, and body composition. Skills related components of fitness – types of activities dedicated to improving physical skills categorized as speed, agility, coordination, balance, power, and reaction time. Principles of adaptations to stress – guidelines related to managing the application of stress during physical activity/ exercise. Overload Principle – a principle of adaptation to stress Chapter 2 - Fitness Principles | 21  suggesting the amount of stress applied during exercise must exceed a threshold level to stimulate adaptation. Volume – the term used to describe “how much” stress is being applied by combining the duration and frequency of exercise. Progression principle – a principle relating to how much additional stress that can safely be introduced to gradually improve fitness without risking injury or overuse. Specificity – the principle of stress suggesting activities should be closely centered around the primary outcome goal, i.e. train the way you want to adapt. Reversibility – the principle that adaptations to stress can be lost over time if training is modified or stopped. Principle of rest and recovery – the concept that adaptation not only requires overload but also requires rest to avoid overstressing the body. Periodization – a method of organizing workouts into blocks or periods. These cycles consist of work/stress periods and rest periods. Overtraining syndrome – a condition of chronic stress from physical activity affecting the physical and psychological states of an individual or athlete. Detraining – the act of no longer training at all or decreasing the amount of training. 22 | Chapter 2 - Fitness Principles Exercise: Not a Passing Fad The benefits of physical activity and exercise are universally recognized—and have been for far longer than one might think. Our Paleolithic ancestors regularly engaged in physical activity to survive. Rather than chasing after a soccer ball to win a game or taking a leisurely stroll down a tree-lined path, they “worked out” by chasing after their next meal. For them, no exercise meant no food. How’s that for a health benefit! With the advent of sedentary agriculture some 10,000 years ago, that same level of peak performance was no longer necessary. As our ancestors continued to devise more advanced means of acquiring food, physical activity declined. It wasn’t until the fourth century BCE, that the Greek physician Herodicus, recognized the importance of being physically active outside of a hunter-gatherer society. He practiced gymnastic medicine, a branch of Greek medicine that relied on vigorous exercise as a treatment. During that same time period, Hippocrates, who is often referred to as the Father of Modern Medicine, asserted, “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” In the 12 century CE, the Jewish philosopher Rabbi Moses ben Maimon, a physician to the Sultan of Egypt, stated, ”Anyone who lives a sedentary life and does not exercise, even if he eats good foods and takes care of himself according to proper medical principles, all his days will be painful ones and his strength will wane.” The 15th century theologian and scholar Robert Burton went so far as to declare that not exercising, or “idleness” as he referred to it in his widely read tome, The Anatomy of Melancholy, was the “bane of body and mind.” Burton also warned that the lack of exercise was the sole cause of melancholy (the name given depression at that time) and “many other maladies.” Burton claimed that idleness was one of the seven deadly sins, as well as “the Exercise: Not a Passing Fad | 23 nurse of naughtiness,” and the “chief author of mischief.” For Burton, exercise was not only essential for good health, but a means of avoiding eternal damnation. By the 16th century, the benefits of exercise were widely accepted, at least among the wealthy and the educated, who had access to leisure. During this time period, H. Mercuralis defined exercise as “the deliberate and planned movement of the human frame, accompanied by breathlessness, and undertaken for the sake of health or fitness.” This definition is still widely used today. Beyond the physical health benefits, there are affective benefits associated with group games and activities. Ancient Mayans organized the first team game called the Ball Game. It consisted of two teams trying to get a ball through a hoop mounted approximately 23 feet on a wall. The rules were to get the ball through the hoop using certain parts of the body. In some cases the captain of the losing team gave himself as a human sacrifice to the winning team, an act that was believed by the Mayans to be a vital part of prosperity. American Indians are thought to have founded the modern game of lacrosse, as well as other stick games. Lacrosse, which received its name from French settlers, was more than a form of recreation. It was a cultural event used to settle disputes between tribes. Figure 1. Ball Players. George Catlin. Date unknown. 24 | Exercise: Not a Passing Fad  The outcome of the game, as well as the choosing of teams, was thought to be controlled supernaturally. As such, game venues and equipment were prepared ritualistically. From Ancient History to Modern Times In retrospect, the perceived benefits of exercise have changed very little since Herodicus or the American Indians. Mounting research supports historical assertions that exercise is vital to sustaining health and quality of life. Culturally, sports play a huge role in growth and development of youth and adults. Physically, there is indisputable evidence that regular exercise promotes healthy functioning of the brain, heart, and the skeletal and muscular systems. Exercise also reduces risk for chronic diseases, such as cancer, diabetes, and obesity. Regular exercise can even improve emotional health and overall wellbeing. Exercise: Not a Passing Fad | 25 What are Physical Activity and Exercise? Physical activity is defined as any movement carried out by skeletal muscle that requires energy and is focused on building health. Health benefits include improved blood pressure, blood-lipid profile, and heart health. Acceptable physical activity includes yard work, house cleaning, walking the dog, or taking the stairs instead of the elevator. Physical activity does not have to be done all it once. It can be accumulated through various activities throughout the day. Although typing on a phone or laptop or playing video games does involve skeletal muscle and requires a minimal amount of energy, the amount required is not sufficient to improve health. Despite the common knowledge that physical activity is tremendously beneficial to one’s health, rates of activity among Americans continue to be below what is needed. According to the Center for Disease Control (CDC), only 1 in 5 (21%) of American adults meet the recommended physical activity guidelines from the Surgeon General. Less than 3 in 10 high school students get 60 minutes or more of physical activity per day. Non-Hispanic whites (26%) are more active than their Hispanic (16%) and Black counterparts (18%) as is the case for males (54%) and females (46%). Those with more education and those whose household income is higher than poverty level are more likely to be physically active.1 The word exercise, although often used interchangeably with the phrase physical activity, denotes a sub-category of physical activity. Exercise is a planned, structured, and repetitive movement pattern intended to improve fitness. As a positive side-effect, it significantly improves health as well. Fitness improvements include the heart’s ability to pump blood, increased muscle size, and improved flexibility. 26 | What are Physical Activity and Exercise? Components of Health-Related Fitness In order to carry out daily activities without being physically overwhelmed, a minimal level of fitness is required. To perform daily activities without fatigue, it is necessary to maintain health in five areas: cardiorespiratory endurance, muscular strength and endurance, flexibility, and body composition. These five areas are called the components of health-related fitness. Development of these areas will improve your quality of life, reduce your risk of chronic disease, and optimize your health and well-being. Each of these 5 areas will be explored in depth at a later time. Below is a brief description of each. 1. Cardiorespiratory endurance is the ability to carry out prolonged, large muscle, dynamic movements at a moderate to high level of intensity. This relates to your heart’s ability to pump blood and your lungs’ ability to take in oxygen. 2. Muscular strength is the ability of the muscles to exert force over a single or maximal effort. 3. Muscular endurance is the ability to exert a force over a period of time or repetitions. 4. Flexibility is the ability to move your joints through a full range of motion. 5. Body Composition is the relative amount of fat mass to fat-free mass. Components of Health-Related Fitness | 27  As previously stated, these areas are significant in that they influence your quality of life and overall health and wellness. Skill-Related Components of Fitness In addition to the 5 health-related components, there are 6 skill- related components that assist in developing optimal fitness: speed, agility, coordination, balance, power, and reaction time. Although important, these areas do not directly affect a person’s health. A person’s ability to perform ladder drills (also known as agility drills) is not related to his/her long term heart health. However, coordination of muscle movements may be helpful in developing muscular strength through resistance training. As such, they may indirectly affect the 5 areas associated with health-related fitness. Skill-related components are more often associated with sports performance and skill development. 28 | Components of Health-Related Fitness Principles of Adaptation to Stress The human body adapts well when exposed to stress. The term stress, within the context of exercise, is defined as an exertion above the normal, everyday functioning. The specific activities that result in stress vary for each individual and depend on a person’s level of fitness. For example, a secretary who sits at a desk all day may push his/her cardiorespiratory system to its limits simply by walking up several flights of stairs. For an avid runner, resistance training may expose the runner’s muscles to muscular contractions the athlete is not accustomed to feeling. Although stress is relative to each individual, there are guiding principles in exercise that can help individuals manage how much stress they experience to avoid injury and optimize their body’s capacity to adapt. Knowing a little about these principles provides valuable insights needed for organizing an effective fitness plan. Overload Principle Consider the old saying, “No pain, no gain.” Does exercise really have to be painful, as this adage implies, to be beneficial? Absolutely not. If that were true, exercise would be a lot less enjoyable. Perhaps a better way to relay the same message would be to say that improvements are driven by stress. Physical stress, such as walking at a brisk pace or jogging, places increased stress on the regulatory systems that manage increased heart rate and blood pressure, increased energy production, increased breathing, and even increased sweating for temperature regulation. As these subsequent adaptations occur, the stress previously experienced during the Principles of Adaptation to Stress | 29 same activity, feels less stressful in future sessions. As a result of the adaptation, more stress must be applied to the system in order to stimulate improvements, a principle known as the overload principle. For example, a beginning weightlifter performs squats with 10 repetitions at 50 pounds. After 2 weeks of lifting this weight, the lifter notices the 50 pounds feels easier during the lift and afterwards causes less fatigue. The lifter adds 10 pounds and continues with the newly established stress of 70 pounds. The lifter will continue to get stronger until his/her maximum capacity has been reached, or the stress stays the same, at which point the lifter’s strength will simply plateau. This same principle can be applied, not only to gain muscular strength, but also to gain flexibility, muscular endurance, and cardiorespiratory endurance. 30 | Principles of Adaptation to Stress FITT In exercise, the amount of stress placed on the body can be controlled by four variables: Frequency, Intensity, Time (duration), and Type, better known as FITT. The FITT principle, as outlined by the American College of Sports Medicine (ACSM) falls under the larger principle of overload. Frequency and Time Each variable can be used independently or in combination with other variables to impose new stress and stimulate adaptation. Such is the case for frequency and time. Frequency relates to how often exercises are performed over a period of time. In most cases, the number of walking or jogging sessions would be determined over the course of a week. A beginner may determine that 2–3 exercise sessions a week are sufficient enough to stimulate improvements. On the other hand, a seasoned veteran may find that 2–3 days is not enough to adequately stress the system. According to the overload principle, as fitness improves, so must the stress to ensure continued gains and to avoid plateauing. The duration of exercise, or time, also contributes to the amount of stress experienced during a workout. Certainly, a 30-minute brisk walk is less stressful on the body than a 4-hour marathon. Although independent of one another, frequency and time are often combined into the blanket term, volume. The idea is that volume more accurately reflects the amount of stress experienced. This can be connected to the progression principle. For example, when attempting to create a jogging plan, you may organize 2 weeks like this: FITT | 31  Week 1: three days a week at 30 minutes per session Week 2: four days a week at 45 minutes per session At first glance, this might appear to be a good progression of frequency and time. However, when calculated in terms of volume, the aggressive nature of the progression is revealed. In week 1, three days at 30 minutes per session equals 90 minutes of total exercise. In week two, this amount was doubled with four days at 45 minutes, equaling 180 minutes of total exercise. Doing too much, too soon, will almost certainly lead to burnout, severe fatigue, and injury. The progression principle relates to an optimal overload of the body by finding an amount that will drive adaptation without compromising safety. Intensity Intensity, the degree of difficulty at which the exercise is carried out, is the most important variable of FITT. More than any of the other components, intensity drives adaptation. Because of its importance, it is imperative for those beginning a fitness program to quantify intensity, as opposed to estimating it as hard, easy, or somewhere in between. Not only will this numeric value provide a better understanding of the effort level during the exercise session, but it will also help in designing sessions that accommodate individual goals. How then can intensity be measured? Heart rate is one of the best ways to measure a person’s effort level for cardiorespiratory fitness. Using a percentage of maximum lifting capacity would be the measure used for resistance training. 32 | FITT Type of Exercise Simply put, the type of exercise performed should reflect a person’s goals. In cardiorespiratory fitness, the objective of the exercise is to stimulate the cardiorespiratory system. Other activities that accomplish the same objective include swimming, biking, dancing, cross country skiing, aerobic classes, and much more. As such, these activities can be used to build lung capacity and improve cellular and heart function. FITT | 33 Specificity The more specific the exercise to individual training goals, the better. While vigorous ballroom dancing will certainly help develop the cardiorespiratory system, it will unlikely improve a person’s 10k time. To improve performance in a 10k, athletes spend the majority of their time training by running, as they will have to do in the actual 10k. Cyclists training for the Tour de France, spend up to six hours a day in the saddle, peddling feverishly. These athletes know the importance of training the way they want their body to adapt. This concept, called the principle of specificity, should be taken into consideration when creating a training plan. In this discussion of the principle of specificity, a few additional items should be considered. Stress, as it relates to exercise, is very specific. There are multiple types of stress. The three main stressors are metabolic stress, force stress, and environmental stress. Keep in mind, the body will adapt based on the type of stress being placed on it. Metabolic stress results from exercise sessions when the energy systems of the body are taxed. For example, sprinting short distances requires near maximum intensity and requires energy (ATP) to be produced primarily through anaerobic pathways, that is, pathways not requiring oxygen to produce ATP. Anaerobic energy production can only be supported for a very limited time (10 seconds to 2 minutes). However, distance running at steady paces requires aerobic energy production, which can last for hours. As a result, the training strategy for the distance runner must be different than the training plan of a sprinter, so the energy systems will adequately adapt. Likewise, force stress accounts for the amount of force required during an activity. In weightlifting, significant force production is required to lift heavy loads. The type of muscles being developed, fast-twitch muscle fibers, must be recruited to support the activity. 34 | Specificity In walking and jogging, the forces being absorbed come from the body weight combined with forward momentum. Slow twitch fibers, which are unable to generate as much force as the fast twitch fibers, are the type of muscle fibers primarily recruited in this activity. Because the force requirements differ, the training strategies must also vary to develop the right kind of musculature. Environmental stress, such as exercising in the heat, places a tremendous amount of stress on the thermoregulatory systems. As an adaptation to the heat, the amount of sweating increases as does plasma volume, making it much easier to keep the body at a normal temperature during exercise. The only way to adapt is through heat exposure, which can take days to weeks to properly adapt. In summary, to improve performance, being specific in your training, or training the way you want to adapt, is paramount. Specificity | 35 Rest, Recovery, and Periodization For hundreds of years, athletes have been challenged to balance their exercise efforts with performance improvements and adequate rest. The principle of rest and recovery (or principle of recuperation) suggests that rest and recovery from the stress of exercise must take place in proportionate amounts to avoid too much stress. One systematic approach to rest and recovery has led exercise scientists and athletes alike to divide the progressive fitness training phases into blocks, or periods. As a result, optimal rest and recovery can be achieved without overstressing the athlete. This training principle, called periodization, is especially important to serious athletes but can be applied to most exercise plans as well. The principle of periodization suggests that training plans incorporate phases of stress followed by phases of rest. Training phases can be organized on a daily, weekly, monthly, and even multi-annual cycles, called micro-, meso-, and macrocycles, respectively. An example of this might be: Week Frequency Intensity Time Type 1 3 days 40% HRR 25 min walk 2 4 days 40% HRR 30 min walk 3 4 days 50% HRR 35 min walk 4 2 days 30% HRR 30 min other As this table shows, the volume and intensity changes from week 1 to week 3. But, in week 4, the volume and intensity drops significantly to accommodate a designated rest week. If the chart were continued, weeks 5-7 would be “stress” weeks and week 8 36 | Rest, Recovery, and Periodization would be another rest week. This pattern could be followed for several months. Without periodization, the stress from exercise would continue indefinitely eventually leading to fatigue, possible injury, and even a condition known as overtraining syndrome. Overtraining syndrome is not well understood. However, experts agree that a decline in performance resulting from psychological and physiological factors cannot be fixed by a few days’ rest. Instead, weeks, months, and sometimes even years are required to overcome the symptoms of overtraining syndrome. Symptoms include the following:weight loss loss of motivationinability to concentrate or focusfeelings of depressionlack of enjoyment in activities normally considered enjoyablesleep disturbanceschange in appetite. Rest, Recovery, and Periodization | 37 Reversibility Chronic adaptations are not permanent. As the saying goes, “Use it or lose it.” The principle of reversibility suggests that activity must continue at the same level to keep the same level of adaptation. As activity declines, called detraining, adaptations will recede. In cardiorespiratory endurance, key areas, such as VO2max, stroke volume, and cardiac output all declined with detraining while submaximal heat rate increased. In one study, trained subjects were given bed rest for 20 days. At the end of the bed rest phase, VO2max had fallen by 27% and stroke volume and cardiac output had fallen by 25%. The most well-trained subjects in the study had to train for nearly 40 days following bed rest to get back into pre-rest condition. In a study of collegiate swimmers, lactic acid in the blood after a 2-minute swim more than doubled after 4 weeks of detraining, showing the ability to buffer lactic acid was dramatically affected.2 Not only is endurance training affected, but muscular strength, muscular endurance, and flexibility all show similar results after a period of detraining. 38 | Reversibility Individual Differences While the principles of adaptation to stress can be applied to everyone, not everyone responds to stress in the same way. In the HERITAGE Family study, families of 5 (father, mother, and 3 children) participated in a training program for 20 weeks. They exercised 3 times per week, at 75% of their VO2max, increasing their time to 50 minutes by the end of week 14. By the end of the study, a wide variation in responses to the same exercise regimen was seen by individuals and families. Those who saw the most improvements saw similar percentage improvements across the family and vice versa. Along with other studies, this has led researchers to believe individual differences in exercise response are genetic. Some experts estimate genes to contribute as much as 47% to the outcome of training. In addition to genes, other factors can affect the degree of adaptation, such as a person’s age, gender, and training status at the start of a program. As one might expect, rapid improvement is experienced by those with a background that includes less training, whereas those who are well trained improve at a slower rate. Activity Guidelines Below is a link to the physical activity guidelines provided by the US Department of Health and Human Services. As you review these recommendations, notice how closely they follow the FITT pattern described earlier in the chapter. NIH Recommendations for Physical Activity Individual Differences | 39 Fitness Guidelines The recommendations linked above pertain to physical activity only. While they can be applied to fitness, more specific guidelines have been set to develop fitness. As stated previously, physical activity is aimed at improving health; exercise is aimed at improving health and fitness. These guidelines will be referenced often as each health-related component of fitness is discussed. 40 | Individual Differences Creating a Successful Fitness Plan Often, the hardest step in beginning a new routine is simply starting the new routine. Old habits, insufficient motivation, lack of support, and time constraints all represent common challenges when attempting to begin a new exercise program. Success, in this case, is measured by a person’s ability to consistently participate in a fitness program and reap the fitness benefits associated with a long-term commitment. Think Lifestyle Beginning a fitness program is a daunting task. To illustrate the concept of lifestyle, consider attendance at fitness centers during the month of January. Attendance increases dramatically, driven by the number 1 New Year’s resolution in America: losing weight. Unfortunately, as time marches on, most of these new converts do not. By some estimates, as many as 80% have stopped coming by the second week in February. As February and March approach, attendance continues to decline, eventually falling back to pre- January levels. Why does this occur? Why aren’t these new customers able to persist and achieve their goal of a healthier, leaner body? One possible explanation: patrons fail to view their fitness program as a lifestyle. The beginning of a new year inspires people to make resolutions, set goals, as they envision a new and improved version of themselves. Unfortunately, most of them expect this transformation to occur in a short period of time. When this does not happen, they become discouraged and give up. Creating a Successful Fitness Plan | 41  Returning to teen level weight and/or fitness may be an alluring, well-intended goal, but one that is simply unrealistic for most adults. The physical demands and time constraints of adulthood must be taken into consideration for any fitness program to be successful. Otherwise, any new fitness program will soon be abandoned and dreams of physical perfection fade, at least until next January. Like any other lifestyle habit, optimal health and fitness do not occur overnight. Time and, more importantly, consistency, drive successful health and fitness outcomes. The very term lifestyle refers to changes that are long term and become incorporated into a person’s daily routine. Unlike many fad diets and quick fixes advertised on television, successful lifestyle changes are also balanced and reasonable. They do not leave you feeling depressed and deprived after a few days. Find a balance between what you want to achieve and what you are realistically able to do. Finally, you must do more than simply change your behaviors. You must also modify your mental perception to promote long-term health. Find a compelling reason for incorporating healthier behaviors into your daily routine. The steps below will guide you through this process. Before beginning a fitness program, you should understand the safety concerns associated with exercise. Safety First: Assessing Your Risk The physical challenges of beginning a new exercise program increase the risk of injury, illness, or even death. Results from various studies suggest vigorous activity increases the risk of acute cardiac heart attacks and/or sudden cardiac death.3 While that cautionary information appears contradictory to the previously identified benefits of exercise, the long-term benefits of exercise unequivocally outweigh its risks. In active young adults (younger 42 | Creating a Successful Fitness Plan than 35), incidence of cardiac events are still rare, affecting 1 in 133,000 in men and 1 in 769,000 in women. In older individuals, 1 in 18,000 experience a cardiac event. 4 Of those rare cardiac incidents that do occur, the presence of preexisting heart disease is the common thread, specifically, atherosclerosis. Atherosclerosis causes arteries to harden and become clogged with plaque, which can break apart, move to other parts of the body, and clog smaller blood vessels. As such, it is important to screen individuals for risk factors associated with heart disease before they begin an exercise program. The American College of Sports Medicine recommends a thorough pre-screening to identify any risk of heart disease. The 7 major risk factors associated with increased risk of heart disease are identified below.5 1. Family history – Having a father or first-degree male relative who has experienced a cardiac event before the age of 55, or a mother or first-degree female relative who has experienced a cardiac event before age 65, could indicate a genetic predisposition to heart disease. 2. Cigarette smoking – The risk of heart disease is increased for those who smoke or have quit in the past 6 months. 3. Hypertension – Having blood pressure at or above 140 mm/ HG systolic, 90 mm/Hg diastolic is associated with increased risk of heart disease. 4. Dyslipidemia – Having cholesterol levels that exceed recommendations (LDL above 130 mg/dL, HDL below 40 mg/ dL), or total cholesterol of greater than 200 mg/dL increases risk. 5. Impaired fasting glucose (diabetes) – Blood sugar should be within the recommended ranges. 6. Obesity – Body mass index greater than 30, waist circumference of larger than 102 cm (40”) for men and larger than 88 cm (34.5”) for women, or waist to hip ratio of less than 0.95 men, or less than 0.86 women increases risk of heart Creating a Successful Fitness Plan | 43  disease. 7. Sedentary lifestyle – Persons not meeting physical activity guidelines set by US Surgeon General’s Report have an increased risk of heart disease. In addition to identifying your risk factors, you should also complete a Physical Activity Readiness Questionnaire (PAR-Q) before beginning an exercise program. The PAR-Q asks yes or no questions about symptoms associated with heart disease. Based on your responses on the PAR-Q, you will be placed into a risk category: low, moderate, high. Low risk persons include men younger than 45, and women younger than 55, who answer no to all of the PAR-Q questions and have one or no risk factors. Although further screening is a good idea, such as getting physician’s approval, it isn’t necessary. Moderate risk persons are men of or greater than 45, women 55 or those who have two or more risk factors. Because of the connection between cardiac disease, the seven risk factors, and risk during exercise, it is recommended you get a physician’s approval before beginning an exercise program. High risk persons answer yes to one or more of the questions on the PAR-Q. Physician’s approval is required before beginning a program. Once you have determined your ability to safely exercise, you are ready to take the next steps in beginning your program. Additional safety concerns, such as where you walk and jog, how to be safe during your workout, and environmental conditions, will be addressed at a later time. As you review the remaining steps, a simple analogy may help to better conceptualize the process. Imagine you are looking at a map because you are traveling to a particular location and you would like to determine the best route 44 | Creating a Successful Fitness Plan for your journey. To get there, you must first determine your current location and then find the roads that will take you to your desired location. You must also consider roads that will present the least amount of resistance, provide a reasonably direct route, and do not contain any safety hazards along the way. Of course, planning the trip, while extremely important, is only the first step. To arrive at your destination, you must actually drive the route, monitoring your car for fuel and/or malfunction, and be prepared to reroute should obstacles arise. Preparing yourself for an exercise program and ultimately, adopting a healthier lifestyle, requires similar preparation. You will need to complete the following steps: 1. Assess your current fitness: Where are you on the map? 2. Set goals: What is your destination’s location? 3. Create a plan: What route will you choose? 4. Follow through: Start driving! Assess Your Condition To adequately prepare, you will need to take a hard look at your current level of fitness. With multiple methods of assessing your fitness, you should select the one that most closely applies to you. Obtaining a good estimate will provide you a one-time glance at your baseline fitness and health and provide a baseline measurement for gauging the efficacy of your fitness program in subsequent reassessments. Assessments are specific to each health-related component of fitness. You will have the opportunity to assess each one in the near future. Creating a Successful Fitness Plan | 45 Set Goals Using the map analogy, now that you know your current location, you must determine your destination and the best route for getting there. You can start by setting goals. In his bestselling book, The 7 Habits of Highly Effective People, author Stephen Covey suggests you should “Begin with the end in mind.”7 While Covey’s words may not be directly aimed at those seeking to complete a fitness program, his advice is useful to anyone making a significant lifestyle change. To be successful, you must develop a clear vision of your destination. Setting specific goals about how you want to feel and look, increases your chances of success. Without specific goals to measure the success of your efforts, you could possibly exceed your target and believe you failed. The art of setting goals includes stating them in a clearly defined and measurable way. Consider exactly what you would like to accomplish, make certain your goals can be measured, and establish a reasonable timeframe in which to achieve your goals. Goals that meet these guidelines are referred to as S.M.A.R.T. goals. Specific: Be as specific and detailed as possible in creating your goal. Measurable: If your goal cannot be measured, you will not know when you have successfully completed the goal. Attainable: Consider whether you have the resources—such as time, family support, and financial means—to obtain your goal. Realistic: While your goal should be challenging, it should not exceed reasonable expectations. Timeframe: Set a deadline to accomplish your goal. Well-Stated Goals A well-stated goal contains all of the SMART components 46 | Creating a Successful Fitness Plan  listed above. Take a look at the well-stated example: I will improve my 12-minute distance by 10% within 2 months of the first assessment. Note, all the ingredients of a well-stated goal are present. It is specific (improve 12-minute distance by 10%), measurable (10% improvement), attainable and realistic (the degree of improvement is reasonable in that time frame), and includes a time frame (a clear deadline of 2 months). Less Effective Goals Less effective goals would be stated like this: I will run farther next time I assess my fitness; I want to jog faster; I will lose weight. And a common one: I will exercise 3 days a week at 60% max heart rate for 45 minutes per session for 2 months. At a closer glance, none of these examples contain all of the ingredients of a well-stated goal. How can “faster” be measured? “Farther” is not specific enough, nor is “lose weight.” In the last example, this is not a goal at all. It is a plan to achieve a goal that has not been stated. In the end, setting up well-stated goals will give you the best chance to convert good intentions into a healthier lifestyle. To complete this step, write down 2-3 personal goals, stated in the SMART format, and put them in a place you will see them frequently. Create a Plan Once you know exactly what you want to achieve, generate a strategy that will help you reach your goals. As you strategize, your Creating a Successful Fitness Plan | 47 goal is to determine the frequency, the intensity, and the duration of your exercise sessions. While doing this, it is imperative to keep in mind a few key principles. First, use your goals as the foundation for your program. If your goal is related to weight loss, this should drive the frequency, duration, and intensity of your daily workouts as these variables will influence your body’s use of fat for fuel and the number of calories burned. If you feel more interested in improving your speed, you will need to dedicate more workout time to achieving those results. Another key principle is the importance of safety. The importance of designing a program that is safe and effective cannot be overstated. You can minimize any risks by relying on the expert recommendations of the US Department of Health and Human Services previously outlined and linked here. These highly reputable organizations have conducted extensive research to discover the optimal frequency, intensity, and duration for exercise. Follow Through Once you have assessed your current fitness levels, set goals using the SMART guidelines, and created your personalized fitness plan, you should feel very proud of yourself! You have made significant progress toward achieving a healthier lifestyle. Now is when the “rubber hits the road.” (Literally so, if your plan includes walking or jogging.) Now that you have invested time and energy to develop a thoughtful, well-designed fitness program, it is time to reap the returns of good execution. The assessment, planning and preparation are really the hardest parts. Once you know what to do and how to do it, success is simply a matter of doing it. Unfortunately, the ability to stick with a program proves difficult for most. To prevent getting derailed from your program, identify barriers that may prevent you from consistently following through. One of the most common challenges cited is a shortage of time. 48 | Creating a Successful Fitness Plan Work schedules, school, child care, and the activities of daily living can leave you with little time to pursue your goals. Make a list of the items that prevent you from regularly exercising and then analyze your schedule and find a time for squeezing in your exercise routine. Regardless of when you schedule your exercise, be certain to exercise consistently. Below are a few additional tips for achieving consistency in your daily fitness program: Think long term; think lifestyle. The goal is to make exercise an activity you enjoy every day throughout your life. Cultivating a love for exercise will not occur overnight and developing your ideal routine will take time. Begin with this knowledge in mind and be patient as you work through the challenges of making exercise a consistent part of your life. Start out slowly. Again, you are in this for the long haul. No need to overdo it in the first week. Plan for low intensity activity, for 2–3 days per week, and for realistic periods of time (20–30 minutes per session). Begin with low Intensity/low volume. As fitness improves, you will want to gradually increase your efforts in terms of quantity and quality. You can do this with more time and frequency (called volume) or you can increase your intensity. In beginning a program, do not change both at the same time. Keep track. Results from a program often occur slowly, subtly, and in a very anti-climactic way. As a result, participants become discouraged when immediate improvements are not visible. Keeping track of your consistent efforts, body composition, and fitness test results and seeing those subtle improvements will encourage and motivate you to continue. Seek support. Look for friends, family members, clubs, or even virtual support using apps and other online forums. Support is Creating a Successful Fitness Plan | 49  imperative as it provides motivation, accountability, encouragement, and people who share a common interest, all of which are factors in your ability to persist in your fitness program. Vary your activities from time to time. Your overall goals are to be consistent, build your fitness, and reap the health benefits associated with your fitness program. Varying your activities occasionally will prevent boredom. Instead of walking, play basketball or ride a bike. Vary the location of your workout by discovering new hiking trails, parks or walking paths. Have fun. If you enjoy your activities, you are far more likely to achieve a lasting lifestyle change. While you cannot expect to be exhilarated about exercising every day, you should not dread your daily exercise regimen. If you do, consider varying your activities more, or finding a new routine you find more enjoyable. Eat healthier. Nothing can be more frustrating than being consistent in your efforts without seeing the results on the scale. Eating a balanced diet will accelerate your results and allow you to feel more successful throughout your activities. 50 | Creating a Successful Fitness Plan Additional Safety Concerns As activity rates among Americans increase, specifically outdoor activities, safety concerns also rise. Unfortunately, the physical infrastructure of many American cities does not accommodate active lifestyles. Limited financial resources and de-emphasis on public health means local and state governments are unlikely to allocate funds for building roads with sidewalks, creating walking trails that surround parks, or adding bike lanes. In addition, time constraints and inconvenience make it challenging for participants to travel to areas where these amenities are available. As a result, exercise participants share roads and use isolated trails/pathways, inherently increasing the safety risks of being active. A key principle in outdoor safety is to recognize and avoid the extremes. For example, avoid roads that experience heavy traffic or are extremely isolated. Avoid heavy populated areas as well as places where no one is around. Do not exercise in the early morning or late at night, during extreme cold or extreme heat. To minimize safety risks during these types of environmental conditions, do not use headphones that could prevent you from hearing well and remaining alert, do not exercise alone, prepare for adequate hydration in the heat, and use warm clothing in extreme cold to avoid frostbite. Extreme conditions require extra vigilance on your part. A second key principle, whether outdoor or indoor, is to simply use common sense. While this caveat seems obvious, it gets ignored far too often. Always remember the purpose of your exercise is for enjoyment and improved health. If these objectives could be compromised by going for a run at noon in 95-degree heat, or lifting large amounts of weight without a spotter, you should reconsider your plan. Before exercising in what could be risky conditions, ask yourself, “Is there a safer option available?” Lastly, be aware of the terrain and weather conditions. Walking Additional Safety Concerns | 51 or jogging on trails is a wonderful way to enjoy nature, but exposed roots and rocks present a hazard for staying upright. Wet, muddy, or icy conditions are additional variables to avoid in order to complete your exercise session without an accident. Environmental Conditions When exercising outdoors, you must consider the elements and other factors that could place you at increased risk of injury or illness. Heat-Related Illness Heat-related illnesses, such as heat cramps, heat exhaustion, and heat stroke, contributed to 7,233 deaths in the United States between 1999 and 2009. A 2013 report released by the Center for Disease Control stated that about 658 deaths from heat-related illnesses occurred every year which account for more deaths than tornadoes, hurricanes, and lightning combined. Of those deaths, most were male, older adults.8 The number one risk factor associated with heat-related illness is hydration, the starting point of all heat-related illness. Unfortunately, sweat loss can occur at a faster rate than a person can replace with fluids during exercise, especially at high intensities. Even when trying to hydrate, ingestion of large amounts of fluids during exercise can lead to stomach discomfort. What does this mean? Hydration must begin before exercise and must become part of your daily routine. Several practical methods of monitoring hydration levels can assist in preventing illness. One simple method, while not fool proof, is to simply monitor the color of your urine. In a hydrated state, 52 | Additional Safety Concerns urination will occur frequently (every 2–3 hours) and urine will have very little color. In a dehydrated state, urination occurs infrequently in low volume and will become more yellow in color. Another simple method involves weighing yourself before and after a workout. This is a great way to see firsthand how much water weight is lost during an exercise session primarily as a result of sweat. Your goal is to maintain your pre- and post-body weight by drinking fluids during and after the workout to restore what was lost. This method, when combined with urine-monitoring, can provide a fairly accurate assessment of hydration levels. The best preventative measure for maintaining a hydrated state is simply drinking plenty of water throughout the day. In previous years, recommendations for the amount of water to drink were a one size fits all of about 48–64 oz. per day, per person. In an effort to individualize hydration, experts now recommend basing fluid intake on individual size, gender, activity levels, and climate. Generally, half an ounce (fluid ounces) to 1 ounce per pound of body weight is recommended.9 For a 150-pound individual, this would mean 75–150 ounces of water per day (½ gallon to one gallon)! While there is still considerable debate over the exact amounts, no one disputes the importance of continually monitoring your hydration using one of the techniques described previously. Insufficient hydration leads to poor performance, poor health, and potentially serious illness. It should be noted that electrolyte “sport” drinks, such as Gatorade and PowerAde, are often used to maintain hydration. While they can be effective, these types of drinks were designed to replace electrolytes (potassium, sodium, chloride) that are lost through sweating during physical activity. In addition, they contain carbohydrates to assist in maintaining energy during activities of long duration. If the activity planned is shorter than 60 minutes in duration, water is still the recommended fluid. For activities beyond 60 minutes, a sports drink should be used. Additional Safety Concerns | 53 Cold-Related Illnesses Much like extremely hot environmental conditions, cold weather can create conditions equally as dangerous if you fail to take proper precautions. To minimize the risk of cold-related illness, you must prevent the loss of too much body heat. The three major concerns related to cold-related illnesses are hypothermia, frost-nip, and frost bite. As with heat-related illness, the objective of preventing cold- related illness is to maintain the proper body temperature of between 98.6 and 99.9 degrees Fahrenheit. If body temperature falls below 98.6 F, multiple symptoms may appear, indicating the need to take action. Some of those symptoms include: shivering numbness and stiffness of joints and appendages loss of dexterity and/or poor coordination peeling or blistering of skin, especially to exposed areas discoloration of the skin in the extremities When walking or jogging in the cold, it is important to take the necessary steps to avoid problems that can arise from the environmental conditions. Hydration is key. Cold air is usually drier air, which leads to moisture loss through breathing and evaporation. Staying hydrated is key in maintaining blood flow and regulating temperature. Stay dry. Heat loss occurs 25x faster in water than on dry land. As such, keeping shoes and socks dry and clothing from accumulating too much sweat will allow for more effective body temperature regulation. Dress appropriately. Because of the movement involved, the body will produce heat during the exercise session. Therefore, the key point is to direct moisture (sweat) away from the skin. 54 | Additional Safety Concerns  This is controlled most effectively by layering your clothing. A base layer of moisture-wicking fabric should be used against the skin while additional layers should be breathable. This will channel moisture away from the skin, and any additional layers of clothing, without it becoming saturated in sweat. If exercising on a windy day, use clothing that protects from the wind and is adjustable so you can breathe. Cover the extremities. Those parts of the body farthest away from the heart (toes, fingers, and ears) tend to get coldest first. Take the appropriate steps to cover those areas by using gloves, moisture-wicking socks, and a winter cap to cover your head. Additional Safety Concerns | 55 Test Your Knowledge 1. The term exercise refers to physical activity that is: a. Discontinuous and unplanned but designed to improve fitness b. Planned, structured, and repetitive designed to improve fitness c. Not a contributor to physical fitness d. Random and unstructured 2. Which of the following is NOT considered a skill-related fitness component? a. Coordination b. Flexibility c. Balance d. Agility 3. During the initial phase of an exercise program, a beginner should: a. Begin slowly, exercising at a low intensity and gradually increasing volume b. Keep intensity high, exercise at the high end of the target heart rate range c. Perform short but intense bouts of activity d. Exercise 5-7 days per week 56 | Test Your Knowledge 4. The body’s ability to adapt to gradual increases in the amount of exercise is the principle of: a. Overload b. Specificity c. Reversibility d. Assessment 5. The amount of overload needed to maintain or improve one’s fitness level is NOT determined by: a. Time (duration) b. Intensity c. Frequency d. Specificity 6. Another term used for organizing your training into phases or cycles is: a. Specificity b. Skill training c. Periodization d. Overload Answers: 1. B, 2. B, 3. A, 4. A, 5. D, 6. C Test Your Knowledge | 57 CHAPTER 3 - CARDIORESPIRATORY FITNESS Objectives 1. Define the cardiovascular and respiratory system 2. Describe how the cardiorespiratory system works 3. Identify the benefits of cardiorespiratory fitness 4. What is the importance of this system? 5. Identify methods for assessing and improving the CR system Terminology Cardiorespiratory system: The term used to describe the relationship between the cardiovascular system (heart and blood vessels) and respiratory system (lungs). Calorie: A term used to describe food energy. Scientifically, it is the amount of energy needed to raise one kilogram of water, 1 degree Celsius. More accurately, it is one kilocalorie. Adenosine Triphosphate (ATP): The basic unit of energy used by the cells. Aerobic energy system: The term used to describe the way cells produce ATP. In this case, the cells require oxygen to assist in ATP production. Mitochondria: The area (organelle) of the cell where ATP is produced. 58 | Chapter 3 - Cardiorespiratory Fitness  Creatine phosphate: a compound found in the cells and used by the immediate energy system that can be used to produce ATP. Non-oxidative energy system: a term used to describe the way cells produce ATP. In this case, cells do not require oxygen to produce ATP. Glucose: The simplest form of sugars found in the blood. Tidal volume: The amount of air measured during inspiration or expiration. Diffusion capacity: The amount of air that is transferred from the lungs to the blood. Areterial-vein difference (aVO2diff): The difference between the oxygen found in arterial blood and venous blood. Principle of Reversibility: The fitness principle describing how fitness is lost while detraining. Maximal oxygen consumption (VO2max): The maximum amount of oxygen the body can take in and utilize. Specificity: A fitness principle describing how fitness improvements or adaptations to exercise stress are specific to the type of training that is performed. Overload: The fitness principle describing how adaption to exercise stress is driven by progressively increasing the workload during training. Target Heart Rate (THR): A term describing heart rate zones that represent an intensity range—a low end heart rate and a high end rate—used as a guide for exercise intensity. Max heart rate (MHR): The maximum number of beats per minute the heart can contract. Resting Heart Rate (RHR): The minimum number of beats per minute the heart contracts. Heart Rate Reserve (HRR): The difference between the maximum heart rate and the resting heart rate. This term is also used to describe a method for calculating target heart rate. Rating of Perceived Exertion (RPE): A self-assessment used Chapter 3 - Cardiorespiratory Fitness | 59  during exercise used to estimate the intensity of the work being performed. The scale used, called the Borg Scale, ranges from 6 to 20. Talk-test: A self-assessment used during exercise to estimate the intensity of the work being performed. The assessment is based on the degree of breathlessness observed while attempting to talk during exercise. 60 | Chapter 3 - Cardiorespiratory Fitness What are the cardiovascular and respiratory systems? Imagine for a moment climbing to the top of Mt. Everest, a challenging feat very few have accomplished. In the process, you gradually ascend from base camp, which sits at about 17,500 feet above sea level, to the peak at over 29,000 feet. At this elevation, the pressure of oxygen is so low, you struggle to take in a satisfying breath. Although you strive to breathe deeply, you are unable to get enough air. Your heart rate increases and you might even develop nausea and a headache. Unless your body has a chance to acclimate itself to higher elevations or you gain access to supplemental oxygen, your symptoms will persist or worsen. These are the sensations many people with cardiovascular or respiratory illnesses, such as asthma, chronic bronchitis, or mild cardiovascular disease, experience on a daily basis. Climbing up a flight of steps may leave them gasping for air, as would walking briskly or even breathing in cold air. Regardless of the cause, being unable to take in sufficient air can create a sense of panic and cause serious physical discomfort. From this simple example, hopefully, you feel an appreciation for the simple act of breathing and ensuing satisfaction that comes with each life-sustaining breath. For most people, unless they engage in strenuous physical activity sufficient to get them breathing hard, their cardiovascular and respiratory system (heart, blood vessels, and lungs) operates efficiently enough to go relatively unnoticed. However, does that mean their cardiorespiratory (CR) system is functioning at optimal capacity? Or, could it be operating at a minimum level and experiencing problems that go undetected? This chapter defines cardiorespiratory fitness, examines the benefits of a healthy CR system, and explores how to effectively assess and improve the CR system. What are the cardiovascular and respiratory systems? | 61 The Benefits of Good Cardiorespiratory Health The link below provides a list of specific benefits: Benefits of Cardiorespiratory Fitness The article linked below describes how exercise protects against Cardiovascular Disease (CVD): Preventing CVD How the CR System Works The cardiorespiratory system operates to obtain and circulate vital compounds throughout the body—specifically, oxygen and nutrients, such as food energy, vitamins, and minerals. Both oxygen and nutrients, which are imperative for cellular energy production, must be taken in from the lungs and digestive system. Because the heart and lungs are so interlocked in this process, the two systems are often labeled together as the cardiorespiratory system. Without a healthy respiratory system, the body would struggle to bring in enough oxygen, release carbon dioxide (the chemical waste product of cellular metabolism) and eliminate unwanted particles that enter the respiratory tract when inhaling. Without a healthy heart, transporting oxygen from the lungs and nutrients from the digestive system to the body’s cells would be impossible. If the health of the CR system were compromised enough, survival would be impossible. Additionally, both must be healthy or the function of one or the other will be compromised. Below are several videos explaining how the cardiovascular and respiratory systems operate and function together: The CR System and Exercise 62 | What are the cardiovascular and respiratory systems?  Effects of exercise on the circulatory and respiratory systems Circulatory & Respiratory Systems The circulatory system The respiratory system What are the cardiovascular and respiratory systems? | 63 The CR System and Energy Production Clearly the cardiovascular and respiratory systems function as one, but why is the CR system so important? What makes the distribution of oxygen throughout the body so vital to existence? The answer is simple: ENERGY. While oxygen in and of itself does not contain any energy (calories), it does combine with fuel extracted from food once it has been introduced into the cell to help produce adenosine triphosphate (ATP). ATP is the basic form of cellular energy found in the body. Because the body stores very little ATP, it must constantly be regenerated. For this reason, people must continue eating and breathing to live. Within the context of fitness, the purpose of the cardiorespiratory system is not only to produce energy but to also adapt in a way so that energy production can be optimized. For example, a high school cross country runner wants to be fit enough to compete in the state cross country meet. Unfortunately, this athlete’s current mile times are 6 minutes per mile. In other words, that is the maximum work rate possible for this athlete. However, the goal is to improve to 5 minutes per mile, or improve the maximum work rate. To do so, more energy must be produced. According to the principles of adaptation, it is possible for this athlete to become more efficient at producing energy, enabling him to run a mile in less time. An example of this adaptation comes from the world record mile time of 3 minutes and 43 seconds. The world record marathon time (26.2 miles) is 2 hours, 1 minutes, and 39 seconds. That equates to 4 minutes and 38 seconds per mile over the 26-mile course. That is some serious ATP production! 64 | The CR System and Energy Production Oxidative Energy System (Aerobic) As oxygen and nutrients are delivered to the cells, they are utilized to produce ATP. The workhorses of the cell for oxidative metabolism are the mitochondria. This form of energy production is contingent on the ability of the CR system to deliver oxygen and nutrients and the cell’s ability to process that oxygen. Because of the importance of oxygen in this particular energy-producing pathway, it is called the oxidative energy system, or aerobic system. Oxidative energy production is the primary means of ATP production during rest and for activities that last for 2 minutes or longer. Although other forms of energy production assist in ATP production at any given time, long duration exercise sessions rely on this aerobic pathway. Also, in contrast to other forms of ATP production, the oxidative energy system uses both carbohydrates and fats for fuel sources. To consider: What activities would emphasize development of this energy pathway? Immediate/Explosive Energy System While the oxidative system is the primary source of ATP production, it does require a few minutes for the system to begin operating at full capacity during exercise. How then could the body immediately produce enough energy to perform a strenuous activity, such as sprinting 50 meters? Clearly, another energy system must drive ATP production. The immediate or explosive energy system utilizes the storage of creatine phosphate (CP) and the storage of adenosine diphosphate, which is stored in very small amounts, to generate ATP. When needed, this energy system provides enough ATP to sustain a short-duration, explosive activity, approximately 10–20 The CR System and Energy Production | 65 seconds or less. Once CP is depleted, other energy systems must assist in the ATP generating process. Non-Oxidative or Anaerobic Energy System As the name implies, the non-oxidative energy system does not require oxygen to generate ATP. Instead, the cells where the ATP is produced require glucose (carbohydrates that have been broken down) as the fuel source. Like the immediate energy system, this system is associated with high intensity and short duration movements. While it is possible for some elite athletes to maintain exercise at “anaerobic” levels for several minutes, even they will eventually fatigue as a result of the non-oxidative system’s ability to sustain ATP production for events lasting longer than approximately 2 minutes. As glucose is processed to produce ATP, the natural byproduct of this process, lactic acid, also begins to accumulate. The result of excessive lactic acid accumulation contributes to muscle fatigue, making it impossible to continue exercise at a high intensity. Energy Systems Combine It is important to understand that energy systems do not operate in a compartmental fashion, but rather operate simultaneously, each carrying some of the burden of ATP production. For example, a professional soccer player would spend most of the match “cruising” at a light/moderate intensity level, thus primarily utilizing the oxidative energy system. However, during the match, he or she may sprint for several hundred meters, utilizing the explosive and non-oxidative system, or he or she may jump, requiring use of the explosive system. Thus, both energy systems are utilized 66 | The CR System and Energy Production simultaneously throughout the match. To improve performance, this player would need to develop the energy system which is utilized the most during the match. Here’s a video that goes over all 3 systems, but with a slightly different nomenclature for the Immediate Energy System (ATP-PCR Sytem) and the Non-Oxidative System (Glycolitic System): Energy Systems The CR System and Energy Production | 67 Changes in the CR System An improvement in CR functioning, or fitness level, requires adaptation of the system. Remember, the point is to more effectively generate ATP so more work can be accomplished. In order to process more oxygen and deliver more oxygenated blood to the cells, the overall system must undergo changes to make this possible. Here is a list of adaptations that occur to the CR system as a result of consistent aerobic exercise: Resting heart rate may decrease. The average resting heart rate hovers around 70–75 beats per minute. Elite athletes may have resting heart rates in the high 30s. Generally, resting heart rate may decrease by approximately 10 beats per minute with chronic exercise. Pulmonary adaptations, such as increased tidal volume (the amount of oxygen entering the lungs with each breath) and increased diffusion capacity (the amount of oxygen that enters the blood stream from the lungs). This allows for more oxygen to enter the pulmonary circulation en route to the left side of the heart. The heart muscles, specifically the left side of the heart, increase in size making it possible to contract more forcefully. As a result, more blood can be pumped with each beat meaning more oxygen can be routed to the systemic circulation. More oxygen is delivered and transported into the cells where ATP production can occur. This is called the arterial-vein difference (a-VO2diff) These changes in the system are not permanent due to the principle of reversibility. Following a period of inactivity, the benefits from chronic aerobic exercise will be reversed. 68 | Changes in the CR System Assessing CR Fitness To adequately prepare for starting a personal fitness program, it is important to first assess your current level of fitness. There are multiple methods for assessing a person’s level of fitness. Each of the walking/jogging assessments discussed here attempts to estimate a key physiological marker of the heart’s and lungs’ functioning capacity and maximal oxygen consumption. Maximal oxygen consumption, or VO2 max, measures the body’s maximum ability to take in and utilize oxygen, which directly correlates to overall health and fitness. A good estimate of VO2 max provides a one-time glance at a person’s health and fitness level and a baseline measurement for reassessment at future dates to gauge improvements. Some of the most common walking/jogging assessments used to estimate VO2 max include the 12-Minute Walk, 1.5-Mile Run/Walk Test, 3-Minute Step Test, and 1-Mile Walk Test. Unfortunately, these field assessments, although practical and inexpensive, only provide estimations. More accurate assessments require a lab-based VO2 max test using equipment that measures the volume of oxygen and carbon dioxide being moved in and out of the air passages during exercise. Although this test is more accurate, the expense and availability make it impractical for most. Unlike the lab test, the field assessments are relatively cost free, user-friendly and require very little expertise to conduct or perform. In addition, the key point of the assessment is measuring differences rather than absolute values, and the field tests accurately meet that objective. Information on how to safely perform these assessments will be provided at the end of this chapter. Changes in the CR System | 69 Measuring Heart Rate Those starting the VO2 max assessments must first measure their heart rate, an important component used in the calculations. Here is a video describing how to determine heart rate: How to Check Your Pulse Creating a Plan to Develop CR Fitness Once the assessments have been completed, the next step is to develop a plan for maintaining or improving your current level of fitness. This fitness plan should include activities that are safe and adapted to meet your personal goals. Once these fitness goals have been identified, the principles of adaptation to change can be utilized to achieve those goals. These principles include specificity, targeting specific areas in a workout, and overload, the practice of increasing exertion as the body adapts to ensure continued gains in fitness levels. Specifically, you need to apply the FITT principle (Fitness, Intensity, Time, and Type) described in detail in the previous chapter, “Fitness Principles”: Frequency: 3–5 days per week for healthy adults. Intensity: moderate to vigorous intensity, which equals 40–85% of heart rate reserve, or 55–90% of percentage of max heart rate. (More information about intensity will be provided later.) Time/duration: 20–60 minutes per session or accumulation of 150 minutes per week. Sessions must be continuous for 10 minutes or more. Type/mode: Use large muscle groups and exercises specific to cardiorespiratory exercise. 70 | Measuring Heart Rate Click on the link below for ACSM’s latest recommendations on the quantity and quality of exercise for adults: ACSM’s Official News Release Measuring Heart Rate | 71 Measuring Intensity Intensity may be the most important aspect of the FITT principle. Engaging in a “cardio” program that does not stress the CR system to the recommended levels will be ineffective. Engaging in a program that overstresses the system can lead to injury and pose unnecessary risks. So how do you know if you are in the right range? Heart rate is one of the best ways to measure effort level. Walking and jogging increase a person’s heart rate. Based on the function of the heart, this is no surprise. The heart rate directly correlates with the amount of oxygen being taken in by the lungs. As activity increases in intensity, oxygen demands increase and so does heart rate. Because of this relationship, heart rate can be used in the design of an effective walking and jogging program by creating target heart rate zones. Heart rate zones represent an intensity range—a low end heart rate and a high end rate—within which a person’s heart rate would fall during a walking or jogging session. The first step in determining your target heart rate (THR), is to determine your maximum heart rate (MHR), both measured in beats per minute (bpm). Generally, MHR is estimated to be your age subtracted from 220 beats per minute. In other words, your heart rate should theoretically stop increasing once it reaches the calculated maximum. While helpful, it is not uncommon to see variances in the laboratory tested maximum heart rate versus the calculated method. The next step in calculating THR is to calculate a specific percentage of your MHR. This is done using two different methods. Ke