Health Ed 110January 8, 2014 What is Health?Health is elusive to define Three leading approaches include The medical model The holistic model The wellness modelThe Medical Model of Health Dominant in North America in 20th century Emphasized treating specific physical diseases Doesnt accommodate mental or social problems well Being concerned with resolving health problems, de-emphasizes prevention Measures health by its absence (disease or death rates)The Holistic Model of Health Not merely the absence of disease, but a state of complete physical, mental, and social well-being (WHO, 1947) More than mortality statistics or morbidity rates Broadened the medical perspective Introduced idea of positive health The Wellness Model of Health Developed through the WHO health promotion initiative Health as a process or a force The extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the object of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities. Copenhagen, WHO, 1984January 10, 2014 Health ModelsThe Biopsychosocial Health Model The mind and body together determine health Fundamental assumption: health and illness are consequences of the interplay of biological, psychosocial, and social factors Macrolevel processes:___________________ Microlevel processes:___________________ Caused/influenced by multiple factors Mind and body cannot be distinguished in matters of health and illness Emphasizes both health and illness rather than regarding illness as a deviation from some steady stateJanuary 13, 2014 Health as Wellness Wellness puts the aspect of quality into health Implies there are levels to obtain in a number of categories To achieve a high level of wellness using positive health indicators How well one adapts and copes with the daily demands within each dimension of health Wellness is Purposeful, enjoyable living Deliberate lifestyle choice characterized by personal responsibility and optimal enhancement of physical, mental, and spiritual health Halbert Dunn (1950) Father of wellness movement Believed health care should be more than the treatment of disease Health: passive state of homeostasis or balance Wellness: dynamic process of continually moving toward ones potential for optimal functioning Dr. Bill Hettler (1970s) Co-founder of National Wellness Institute Believed that health care could be improved with health promotion activities and educational opportunities that encourage self care Developed the LAQ (lifestyle assessment questionnaire) Developed the Six Dimensions of Wellness Model Dr. John Travis Founded the first Wellness Resource Centre in the US (1975) Shifted focus from disease care to self-responsibility and prevention Created the Illness/Wellness Continuum Believed wellness is a choice and a lifestyle you design to reach your highest potential Wellness is dependent upon Direction and progress toward a higher potential of functioning The total individual, including physical, mental, emotional, social, and spiritual components Functioning and adapting for daily living and in times of crisis Health Promotion Efforts are made to enable people to increase control over and to improve their health To identify and realize aspirations, to satisfy needs, and to change or cope with the environment Requires Educational, organizational, environmental, and financial supports Assistance to help individuals and groups build positive health attitudes and behaviours and to change negative ones 3 Mechanisms to health promotion: Self care: decisions and sctions individuals take in the interest of their own health Mutual aid: actions people take to help each other cope Healthy environments: creation of conditions and surroundings conducive to health Prevention = taking action now Government money and our health care efforts have been traditionally & primarily allocated towards tertiary prevention Treatment rehabilitation after a person has become sick and prevent further progresson of the disease Considered by many to be more costly and less effective in promoting health Primary Prevention: There has been a considerable shift towards a focus on those actions that can be taken to prevent health problems: Immunizations Not smoking Practicing safe sex Nutrition and eating well Engaging in regular PA Regular medicals or checkups Self-examinations Common sense suggest health promotion dollars should focus on the primary & secondary prevention because 2/3 of deaths in Canada a result of chronic disease which share common preventable risk factors Secondary Prevention: Secondary: taking an education seminar to stop smoking; modifying diet or PA levels in response to a blood glucose or cholesterol test Early recognition of a health problem and intervening to eliminate or reduce it before more serious illness develops January 15, 2014 Gold Standards & Understanding Health Gold Standards of Health Constantly evolving recommendations guidelines keys to success programs guidance advice best practicesUnderstanding Health Behaviour Change is difficult Behaviours are complex and have multiple layers to them To make lasting beneficial changes it helps to understand the factors that shape behaviour The BioPsychoSocial Perspective Health and illness are caused by multiple factors and produce multiple effects Health is achieved through attention to: Biological needs Psychological needs Social needs Improving or diminishing health impacts individually: Biologically psychologically sociallySystems theory: approach to health and illness has been adopted to address this question maintains all levels of organization in any entity are linked to each other hierarchically change in any one level will effect change in all the other levels health, illness, and medical care are all interrelated processes involving interacting changes both within the individual and on the various levels Health Belief Model developed to help explain and predict health behaviour considers social, ecological and environmental factors that can influence our behaviour a model that explains how our attitudes and beliefs may influence behaviours attitudes and beliefs are predisposing influences on our capacity to change Belief Appraisal of the relationship between some object, action, or idea and some attribute of that object, action, or idea Direct experience or knowledge conveyed by others Attitude A relatively stable set of beliefs, feelings, and behavioural tendencies in relation to something or someone Several factors must support a belief in order for change to be likely Perceived susceptibility Perceived severity Perceived benefits Cues to action Psychosocial variables SDsOH (social determinants of health) Health is determined by complex interactions between our environment, our genetic makeup, and where we live and work Canada a world leader in research related to SDOH Growing inequality in social and economic status between groups of Canadians

Social Determinants of Health Public Health Agency of Canada lists 14 SDOH Income and income distribution Poverty is a major barrier to health and wellness Low income predisposes people to greater social deprivations Low income limits participation in recreational, educational, and cultural activities Education Higher education = better health and access to jobs Children of parents who do not have postsecondary education do not perform as well as children with well-educated parents Unemployment and job security Globalization: increased transnational movement of capital, goods, people, and political systems and a rapid turnover of ideas and images through new communication technology Can result in layoffs, increased part-time, casual, contract, and self-employment work situations Unemployment increases the likelihood of choosing unhealthy lifestyle choices Employment and working conditions Working hours, physical conditions at the workplace, time pressures, and unrealistic work demands can cause high levels of work stress Stress at work can lead to health issues or workplace injuries Early childhood development Children who have limited opportunities for learning at an early age are often at risk later in life due to cognitive and emotional immaturity Food insecurity Food is one of the most important social deteminants of health 1.1 million Canadian households experience food insecurity Housing Many Canadians spend more than 30% of their total income on rent or housing costs Results in money not being available for food, health care, recreation, etc Social exclusion Lack of opportunity to fully participate in society Based on gender, age, ability, sexual orientation, race, ethnicity, or religious beliefs Social safety net Programs, services, and benefits that help individuals and families during various life transitions or unexpected events Health services Rural vs. city access Low-income earners are more likely to have to wait for medical care or appointments with a physician as compared to high-income earners Low-income earners are less likely to fill prescriptions or access other treatments Aboriginal status: Average income is lower Chronic diseases and infection rates are much higher Gender Women are less to have full-time employment, less likely to be eligible for employment insurance, often have lower paying jobs, and take on more responsibilities with regard to child care Wages are not always equal Suicide rate among men is four times higher than that of women Race Canadians of color experience higher unemployment Economic returns for immigrants are not forthcoming Health status of recent immigrants appears to deteriorate over time once they settle in Canada Disability Canada provides the second to lowest compensations and benefits to citizens who are disabled Many employers are not willing to make modifications to the workplace to accommodate special needs Precede-Proceed Model for Health Think about our quality of life and health levels Assess our behaviour, lifestyle and environment Determine predisposing, reinforcing, and enabling factors for health Quality of Life Model 3 life domains: Being (physical psychological, spiritual) Belonging (physical, social, community) Becoming (practical, leisure, growth) Emphasizes: An individuals physical, psychological, and spiritual functioning The connections with his or her environment The opportunities for maintaining and enhancing skills January 17, 2014 Understanding Health Behaviour Social Cognitive Theory Behaviour influenced by both person & environment Reciprocal, triadic, and dynamic relationship Environment delineated as both external & internal Physical environment Social environment Situation (individuals perception of environment)According to the theory of reasoned action and the theory of planned behaviour, our behaviours result from our intentions to perform actions Intention is a result of Our attitude towards an action Our beliefs about what others want us to do Our perceived behavioural the more consistent and powerful your attitudes about an action, the more you influenced by others to take that action (subjective norm), and the greater your sense of ability to engage in the action the greater will be your stated intention to do so a behavioural intention is a written or stated commitment to perform an action Transtheoretical Model or Stages of Change Precontemplation: Not aware of a problem Contemplation: Aware of problem; considering making a change Preparation: Intend to change within a few months; planning Action: Modifying their behaviour according to their plan Maintenance Continue to work at changing their behaviour Termination Behaviour is deeply ingrained and has become habitual The College and University Student Demographic Over 1.15 million full or part-time university students in Canada One of the most diverse groups in Canada Students sometimes engage in behaviours that put them at risk for serious health problems The Living Environment of College and University Students Dormitories are breeding grounds for serious infectious diseases Second hand smoke is dangerous to smokers roommates Binge drinking imperils manyStudent Psychological Health College students report more distress than the general Canadian population, or those nor in college 1st year seems to take its greatest tollHealth Benefits of Education Influences lifestyle behaviours, problem-solving abilities, and values Positive attitudes about healthy living Access to preventative health services Join peer groups Higher self-esteem Increase understanding of components that influence quality of health Dimensions of Wellness Environmental Dimension Lifestyle respectful to environment Our ability to: Recognize our contribution to pollution Impact of interactions with nature Take action Protect yourself Minimize negative impact Make a positive impact Social Dimension Collectivist view of the world Helping others Interdependence between ourselves and our environment Actively seeking ways to enhance personal relationships Occupational Dimension (career path, education) Enrichment through work Consistent with personal values, interests, and beliefs Contribute your unique gifts, skills, and talents Healthy balance between work and life Spiritual Dimension Identifying our basic purpose Experience love, joy, peace, and fulfillment Achieve potential Transcendence, connectedness, a power, force, or energy Unites all wellness dimensions Stronger awareness of our inner selves Physical Dimension Proper nutrition Regular aerobic activity Strength training Stretching PA helps us maintain a healthy BMI Avoid harmful behaviours Intellectual Dimension Brain is the only organ capable of self-awareness Gather, process, and act on information Ability to think and learn from life experience Openness to new ideas Capacity to question and evaluate information Cherish intellectual growth and stimulation Emotional Dimension Positive and enthusiastic about oneself and life Awareness of wide range of feelings Express and manage feelings Make choices based upon the connection of feelings, thoughts, philosophies, and behaviours Ability to cope Understand the benefits of working interdependently with others January 20, 2014 Making Successful Change Approaches to Making Change: Shaping: Change in small steps Reward positive change over time and adapt Positive Visualization: Create a mental picture of a goal or a behaviour change and visual making that change Replay it over and over Modelling Observe others and emulate their behaviours Recognizing the power people can have Social and Cultural Norms Behaviours that are expected, accepted, or supported by a group Can make change harder Identify, learn to recognize, and think about these norms that dictate your behaviour Develop relationships with others that share similar goals and normsA General Process for Changing Unhealthy Behaviours Begin with self-assessment Start small with one behaviour you want to change Learn about your target behaviour Find help Build up your motivation and enhance your readiness to change Create a personalized plan Put your plan into action and stick with it Build Motivation through Self-Efficacy (Bandura, 1977) belief that you can and will succeed because you have the necessary skills those most likely to reach a goal are those who believe they can Locus of Control Figurative place a person designates as the source of responsibility for vents in his or her life Internal: belief that you are in control and your actions make a difference Reinforces motivation External: belief that factors beyond their control determine the course of their lives and play a greater role Can sabotage efforts If you believe youll succeed, youre on your way to wellness Reinforcements Positive = rewards & negative = punishments Short and long term benefits and costs Self-Talk Self-instructional methods Blocking negative thoughts Visualize yourself successfully engaging in a healthy behaviour Create a new self-image and imagine yourself Going for an afternoon run three days a week or no longer eating poorly Dealing with Relapse Not the same as failure Plan for relapse to avoid guilt Follow these steps: Forgive yourself Give yourself credit for the progress you have already made Reevaluate your goals and your strategy Move on Create a personalized plan: Monitor your behaviour (Gather data) Analyze the data (identify patterns) Set SMART goals that are Specific. Measurable. Attainable. Realistic. Time-frame specific. Devise your plan Sign a personal conflict

January 22, 2014 Making Successful Change Contd Epidemiological Perspective Epidemiology: Study of how often diseases occur in different groups of people and why Patterns, causes, and effects of health and disease conditions Information can be used for Identification Creation Evaluation Prevention Inference one cause one effectHealth Challenges Facing Canadians Cancer and heart disease are the two leading causes of death, Chronic lower respiratory diseases and type 2 diabetes Years of Potential Life Lost is greater if you live in northern Canada Hypertension affects 1 in 5 Canadians January 24, 2014 Psychosocial Health Psychosocial Health An adequate understanding of what keeps people healthy or makes them get well is impossible without knowledge of the psychological and social context within which health and illness are experienced. Taylor & Sirois, 2009 The result of a complex interaction of A persons history Unconscious and conscious thoughts about and interpretations of the past How we feel and think about ourselves, those around us, and our circumstances Can be enhanced by becoming aware of relevant attitudes and behaviours Factors Influencing Psychosocial Health External Factors include the influences of Family The wider environment Social bonds Internal Factors Influencing Psychosocial Health Heredity Hormonal function Physical health status Self-efficacy, personal control, and self esteem Belief in ones ability Sense of self-respect Learned helplessness vs. optimism Learned helplessness victim Learned optimism optimist Personality Unique mix of characteristics Influences: Heredity Culture Environment Healthy personality traits generally include: Extroversion Agreeableness Openness to experience Emotional stability Conscientiousness Measuring Psychosocial Health Determine whether these three fundamentals exist by asking Do you feel comfortable about yourself? Range of emotions Cope with these feelings in a healthy way Do you interact well with others? Concerned about others Build meaningful relationships Do you meet the demands of an adult life? Practise self-care Responsibility for ones actions Are you happy?Dimensions of Psychosocial Health Mental Health emotional and psychological well-being The Thinking You Our ability to: Perceive reality as it is Respond to challenges Carry out adult responsibilities Emotional Health The Feeling You Emotions Complex feelings Moods Emotions: a conscious mental reaction usually directed toward a specific object of person Four types of emotions: Result from loss, harm, or threats Result from benefits Borderline emotions Complex emotions Characteristics of an emotionally healthy person include: The self is not the centre of the universe Control over the mind and body High level of optimism Passion for work and play Social Health The Relating You Optimistic sense of trust in others Presence of strong social bonds & supports Supportive, constructive, and positive interactions Ability to form relationships Celebrating our diverse society by accepting differences Being open to new experiences Social support: the care and security that family, friends, colleagues, and professionals provide us Social bonds: the degree to which people are integrated into and attached to their families, communities, and society Spiritual Health Inner quest for well-being Basic purpose in life and to experience the fulfillment of achieving our full potential Does not have to be a religious doctrine Belief in higher power A search for meaning, purpose, connectedness, energy, and transcendence Themes of Spiritual Health Interconnectedness Sense of belonging and connection to oneself Transcendence Discovery of an external wisdom/power Mindfulness Fully present in the moment Living in Harmony Understanding our beliefs, values, and attitudes and their impact on those around you Altruism; giving of oneself our of genuine concern for others Daily Process of growth towards these themesJanuary 27, 2014 Psychological Health and Wellness Normality: psychological characteristics attributed to the majority of people in a population at a given time Growing Psychologically Eriksons Theory of Psychosocial Development Describes impact of social experience on individuals throughout their lifetime Carrying stages of development as we age Can set us up with a sense of mastery or a sense of inadequacy Responses to lifes challenges influence the development of our personality and identity Each stage builds on success of the previous stage Taking Steps Towards Enhancing Psychological Health Identifying Needs Range from survival needs to social, intellectual, and cultural needs What is the difference between want and need? Maslows Hierarchy of Needs Basic human needs at bottom Higher needs placed in ascending order on pyramid Striving towards self-actualization Self-actualized people share qualities such as: Realism The difference between what is real and what they want Cope with the world as it exists Know what can and cannot be changed Acceptance Psychologically healthy people accept themselves as they are Tolerant of your own imperfections Requires an appropriately high but realistic level of self-esteem Value themselves as people Autonomy Can direct themselves Internal locus of control High self-efficacy Authenticity Not afraid to be themselves Genuineness Not worried about being judged Capacity for intimacy Physically and emotionally Share feelings and thoughts without fear of rejection Open to pleasure of physical contact Creativity Continually look at the world with renewed appreciation Inform a persons creativity See more an dbe open to new experiences Dont fear the unknown or avoid uncertainty Clarifying Values Values: the criteria by which we evaluate things, people, events , and ourselves Instrumental Values: ways of thinking and acting that we hold important Terminal Values: goals, achievements, or ideal states that we strive toward Managing Mood Feelings: emotional responses that come and go within minutes Moods: sustained emotional state that colors our view of the world for hours or days Mood regulating strategies: Make a change Figure out what upset you and take action Strive for happiness Make an effort to sustain happiness Laugh Stimulates the heart, alters brain wave patterns and breathing rhythms, decreases stress Make a conscious decision to move Aerobic movements Non-aerobic workouts Get an appropriate amount of sleep Long-term effects of sleep loss include an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke Normal sleep from 5-10 hours Listen to your body and adjust sleep schedule

February 10, 2014 Physical Activity Jody Virr

Overload Principle Physiological systems of the body must be taxed using loads that are greater than those to which the individual is accustomed Why? Symmorphosis: the body will maintain its physiological capacity to meet normal demands Overload can be manipulated by FITT Frequency Workouts per week Total number of bouts/week Includes: Health related components of fitness Skill/performance related components of fitness Depends on: Present physical health and fitness status Physical fitness goals Time & intensity Motivation Guidelines Intensity Caloric expenditure rate (kcal/min) Rate of work or effort of work Specific to component of fitness Specific to TYPE of exercise Depends on: Present physical health & fitness status Physical fitness goals Motivation Guidelines Time/Interval Duration of exercise bouts Depends on: present physical health and fitness status physical fitness goals time leisure time schedule guidelines intensity Type (environment) Depends on: Personal preferences Skills Present physical health and fitness status Goals Time leisure time Guidelines Principle of Reversibility Positive changes in fitness and health due to effects of exercise and activity are reversible Exercise capacity dimisnishes Due to symmorphosis Dependent on component of fitness Consistency (reducing inconsistency) is critical to long term success. ACSM Guidelines Moderate intensity: Brisk walk Noticeable increased HR Accumulate bouts > 10 mins Vigorous Intensity Jogging Rapid breathing and substantial increased HR ACSM-AHA Guidelines Accumulated vs. continuous duration Shorts bouts versus continuous exercise (>30 min) There is similar effects from both types of workout bouts on risk factor profile In addition to routine activities of daily living (cooking, shopping) or bouts < 10 min (walking from parking lot) % of HR Max Determine HR max: 220-age Multiply prescribed intensity by HR max Eg. 20 year old male prescribed intensity of 80% HR max = 220 20 = 200 x .8 = 160 bpm Canadian Physical Activity Guidelines 5-11 and 12-17 years Accumulate at least 60 minutes of moderate-to-vigorous- intensity physical activity daily This should include: vigorous-intensity activities at least 3 days per week. Activities that strengthen muscle and bone at least 3 days per week More daily physical activity provides greater health benefits CPAG Adults (18-64 years) Accumulate at least 150 minutes of moderate-to-vigorous- intensity aerobic physical activity per week in bouts of 10 minutes or more It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week More daily physical activity provides greater health benefits CPAG (65 years and older) Accumulate at least 150 minutes of moderate-to-vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more Beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week. Those with poor mobility should perform physical activities to enhance balance and prevent falls More daily physical activity provides greater health benefits Vocab: Bone-strengthening activity: PA designed to increase strength of specific sites in bones that make up the skeletal system. Produce an impact or tension for on bones Weight-bearing activities Muscle Strengthening Activity strength training, resistance training, or muscular strength and endurance exercises that increases skeletal muscle strength, power, endurance, and mass Aerobic Physical Activity: large muscles move in a rhythmic manner for a sustained period of time Moderate-Intensity physical activity: On an absolute scale, Refers to the PA that is performed at 3.0-5.9 times the intensity of rest for adults On a scale relative to an individuals personal capacity, usually a 5 or 6 on a scale of 10 If you are doing moderate-intensity activity you can talk, but not sing your favorite song, during the activity You are working hard enough to raise your HR Vigorous-intensity PA Absolute scale: PA that is performed at 6.0 or more times the intensity of rest for adults Scale relative to an individuals personal capacity, vigorous-intensity PA is usually a 7 or 8 on a scale of 10 If you are doing vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath Your HR has increased quite a bit February 12, 2014 Physical Activity Physical Activity Any body movement produced by skeletal muscles that results in a substantial increase over resting energy expenditure Where you play, move around, and work up a sweat, breathe harder, use lots of your muscles, or get your heart beating fast (Grade 2 students (bayduza, 2012)) Canadian Physical Activity Guidelines Canadian Society for Exercise Physiology (CSEP) Voluntary organization composed of professionals interested and involved in the scientific study of exercise physiology, exercise biochemistry, fitness and health CSEP founded in 1967 Canadian Physical Activity and Sedentary Behaviour Guidelines Handbook http://www.csep.ca/CMFiles/Guidelines/CSEP_Guidelines_Handbook.pdf Active Healthy Kids Canada 2012 Report Card in Physical Activity for Children and Youth 46% of kids aged 6-11 got 3 hours or less of active play (unstructured PA) per week, including weekends 63% of Canadian kids free time after school and on weekends spent being sedentary Ages 6 and under spend 73-84% of their waking hours sedentary, and ages 6-19 spent 63% of their free time sedentary 2007-2008 Canadian Cimmunity Health Survey 48% of Canadian self-report being moderately active 15.4% of Canadians are shown to be moderately active based on accelerometer data 2013 Alberta Survey on PA 94% of Albertans agree that PA will keep them healthy Most Albertans (89%) agree that PA will reduce their chances of getting serious health problems About 74% of adult Albertans do some walking for leisure, transportation or work, but not enough to reach a moderate level of PA Only 59% of adult Albertans are physically active enough to gain health benefits This survey offered 3 key recommendations: Focus of PA at work , Identify ways to encourage older adults to be physically active Develop strategies to increase walking time by Albertans of all ages Factors influencing Albertans PA Levels The findings form the 2013 Alberta Survey on PA used broad determinants of health approach when developing PA policies and practices This survey found several sociodemographic, psychological, and environmental factors that were associated with and/or independently predictive of participation in PA: Sociodemographic factors: Age(% of active eALbertans decreases with age) Education (higher in those who complete high school) Annual Household Income (lowest in those with low income) Psychological Factors: Confidence in PA Participation (more efficacy the more active) General Self-Efficacy confidence in being able to participate in regular PA Coping self-efficacy confidence in being able to overcome potential barriers to PA such as bad weather, feeling tired or being in a bad mood. Scheduling self-efficacy confidence in being able to arrange ones schedule to participate in PA and overcome potential barriers, such as time constraints PA will Improve Health Health outcome expectations (the belief people have in benefits of PA; increase in expectation = higher proportion of active Albertans) Intentions to Participate in Regular PA PA Intentions (as the intention increases, so does the % of active Albertans) Perceived Behavioural Control (as erceived opportunities to participate in regular PA increase, so does the % if sufficiently active Albertans) Environmental Factors: Accessibility ( the proportion of sufficiently active Albertans rises with increases in perceptions about access to places for PA) Walking for Leisure, Transportation and Work Total amount of walking Albertans do (when combining all three modes of walking) resulted in an average of 693 MET-minutes/week among current walkers Minimum of 600 MET-minutes/week, is considered a moderate amount of PA Post-Secondary Students Three of the top four goals among students include increasing PA levels, improving diet, and gaining, losing, or maintaining weight (Greaney et al., 2009) Perceived barriers to achieving their PA and weight management goals include: Lack of discipline Social situations Time constraints Enabling environment (eg. Unhealthy food readily available) Positive factors: services supporting regular PA on campus, social support for healthy living choices, and healthy food choices in cafeterias. The Burden of Physical Inactivity (PIA) Self-responsibility: Considerable health consequences for those who remain inactive Requires and takes time, commitment, and energy to overcome Requires personal adjustment & change to increase daily PA levels Social responsibility(Katzmarzyk & Janssen, 2004) : Economic burden of PIA estimated at $5.3 billion $2.1 billion burden to health-care system ALONE $76 billion SAVINGS over the next 10 years if we could successfully deal with and improve upon the 5 major risk factors for heart disease (Thiriault et al., 2010): Smoking PIA Obesity High Blood Pressure Lack of fruit and vegetable consumptionFebruary 14, 2014 Components of Physical Fitness Components of Physical Fitness Cardiorespiratory/Aerobic Fitness Cardiorespiratory fitness: ability of the heart to pump blood through the body efficiently so a person can sustain prolonged rhythmic activity Aerobic exercise: any activity in which sufficient or excess oxygen is continually supplied to the body Brisk walking, jogging, swimming VO2 Max: maximum amount of oxygen that an individual is able to use during maximal exercise More energy used = more energy produced Influenced by Genetics, age, gender, and altitude Average for a sedentary individual is 35ml/kg/min Healthy aerobic exercise is working our strenuously without pushing to your VO2 max level Talk test Avoid gasping or shortness of breath Muscular Strength: refers to the force within muscles Measured by absolute max weight that a person can lift, push, or press in one effort Muscle mass increases with strength and helps to maintain a healthier body composition and metabolic rate Low reps, high weight, more rest Muscular Endurance: ability to perform repeated muscular effort Measured by counting how many times a person can lift, push, or press a given weight Assists in everyday movement requirements High reps, low weight Flexibility Range of motion around joints Depends onage, sex, posture, musculature, and body fat Children increase in flexibility until adolescence A gradual loss of joint mobility begins and continues through adulthood Muscles and connective tissue shorten and tighten because they are not used through their full range of motion Remember symmorphosis Body Composition Amount of fat (essential and stored) and lean tissue (bone,muscle, organs, water) in the body High proportion of body fathas serious health implications Increased incidence of heart disease High blood pressure Diabetes Stroke Gall bladder problems Back and joint problems Some forms of cancer Having an android body fat distribution is more dangerous than having gynoid body fat distribution. True or False? Fat located around the abdominal region or belly is more common in men and is often referred to as an android or apple body shape Fat distributed around the hips and thighs is more common in women and is called a gynoid or pear body shape Android fat distribution, sometimes called heart attack fat, presents greatest risk to health and is often linked to insulin resistance, which can lead to diabetes as well as cardiovascular and coronary heart disease (CHD) Android body shape is characterized by a large waist measurement which indicates fat is stored in the abdominal cavity, around the internal organs Hip-to-waist Ratio Provides a simple indicator of your degree of android fat accumulation and therefore your risk of obesity related to coronary heart disease To calculate, simply divide your waist measurement by your hip measurement A waist measurement is greater than your hip measurement present an increased risk of CHD Physical Conditioning (or training) Gradual building up of the body to enhance cardiorespiratory or aerobic fitness, muscular strength, muscular endurance, flexibility, and a healthy body composition Functional Fitness: the performance of daily activities PA that mimic job tasks or everday movements can improve an individuals balance, coordination, strength, and endurance Physical Activity and Athletic Performance Lifetime sport: leisure-time physical activities that are planned, structured, and competitive Improving skill-related fitness can help people enjoy a high level of success in lifetime sport Skill-related fitness includes: Agility Balance Coordination PowerFebruary 24, 2014 Designing a Personal PA/Exercise Program Physical Activity Pyramid Exercise for Health & Fitness Examples of Moderate Amounts of Physical Activity Summary of the FITT Principle for the Health-Related Components of Fitness February 26, 2014 Risk Taking Risk the potential that a chosen action or activity (including the choice of inaction) will lead to a loss. Implies that a choice exists, having an influence on the outcome Almost every human endeavor carries some risk, but some are more risky than others Risk Taking The GOOD Taking risks can be a healthy and positive way to: Have fun & give you an adrenaline rush Test your limits Teach you about others boundaries Learn new skills and experience new things Take on more independence and responsibility Risk Taking The BAD Some risks may affect your well-being and cause you harm Unprotected sex Drunk driving Drug or alcohol abuse Law breaking Self-harm Severe or excessive behaviours Unhealthy Risk Taking: The UGLY (problems & consequences) Engaging in risky behaviours can become a problem if it has a negative effect on your day-to-day life It can cause the inability to function as a successful member of society Consequences of Unhealthy Risk Taking Can have a wide variety of psychosocial and behavioural consequences Binge Drinking (alcohol abuse) Lower rates of educational attainment, antisocial/violent behaviour, DUI, and obesity Marijuana Lower educational performance, problems relating to family members, likelihood to use more illicit drugs in the future, and physical and psychological problems Why do we take unhealthy risks? Peer Pressure Have the respect of a peer groups or those whose opinions you find important To feel accepted or to be part of a group To prove to yourself or another that you are an adult that is responsible for their own actions Rebellion Get attention To deal with problems Using the behaviour as a way of managing a problem Unhealthy Risk Taking: A Pathway to Addiction addiction is often used to describe the compulsive use of a substance, loss of control, negative consequences, and denial Includes mood-altering behaviours or activities Addiction : a persistent, compulsive dependence on a behaviour or substance Addictive Behaviours Habits that have gotten out of control, with resulting negative effects on a persons health The Addictive Process Evolves over time Begins when a person repeatedly seeks the illusion of relief to avoid unpleasant feelings or situations Starts when a person does something to bring pleasure or avoid pain Person becomes dependent on the behaviour and tolerance may develop This pattern is known as nurturing through avoidance Maladaptive way of taking care of emotional needs (Johnson, 1986) What is addiction? Drug addiction : four important characteristics: the compulsive desire for a drug, the need to increase the dosage associated with psychological and physical dependence, harmful effects to the individual, and harm to society Drug habituation: the routine use of a substance, but without the level of compulsion or increasing need that characterized addiction Substance Use Dependence: Psychological: strong craving for a drug because it produces pleasurable feelings or relieves stress and anxiety Physical: when a person develops tolerance to the effects of a drug and needs larger and larger doses to achieve intoxication or another desired effect Abuse: User does not develop symptoms of tolerance and withdrawal, but use in ways that have a harmful effect Continued use of drugs despite awareness of persistent or repeated social, occupational, psychological, or physical problems related to drug use Drug Abuse and Dependence Substance Abuse Failure to fulfill major responsibilities Drug use in situations that are physically hazardous Drug-related legal problems Drug use despite persistent social or interpersonal problems Substance Dependence Develop tolerance/experience withdrawal Taking larger amounts over a longer period of time A desire to cut down/regulate use Spend time obtaining/using/recovering from use Giving up/reducing activity involvement Continued use despite recognizing it is a problem Indicators of Addiction Excessive use of a substance or behaviour Expression of a persistent desire, or makes unsuccessful efforts, to cut down or control use of substance or engagement in the activity Spends great amount of time getting or using substance or engaging in the behaviour or recovering from its effects and after-affects Frequently too intoxicated or incapacitated by the after-effects to fulfill major obligations Gives up regular activities to use the substance or engage in the behaviour Develops a physical tolerance to the substance Exhibits signs of withdrawal when not using the substance or engaging in the behaviour Uses the substance or engages in the behaviour to relieve or avoid symptoms of withdrawal The Physiology of Dependence All mental, emotional, and behavioural functions occur as a result of biochemical interactions between nerve cells in the body Biochemical messengers, called neurotransmitters, exert their influence at specific receptor sites on nerve cells Drug use and chronic stress can alter these receptor sites and cause the production and breakdown of these neurotransmitters What Causes Dependence & Abuse? Physiology or Dependence Certain mood altering substance and experiences trigger a rise in dopamine Brain chemical or neurotransmitter that is associated with feelings of satisfaction and euphoria Is one of the crucial messengers that link nerve cells in the brain Rises during any pleasurable experience According to this hypothesis, addicts do not specifically crave the substance but rather the rush of dopamine that these drugs produce Figure 14.1: Effect of cocaine on brain chemistry What Causes Dependence & Abuse? Psychology of Dependence Certain individuals may be at greater risk of dependence because of Difficulty controlling impulses Lack of values that may constrain drug use Low self-esteem, feeling of powerlessness Companions use drugs (peer pressure) Mental disorder (depression, anxiety, bipolar( DENIAL Will never lose control or suffer in any way Are stronger than and can control the drug The Drug Tradition Using drugs to alter consciousness is an ancient and universal pursuit Modern pharmacy, the art of compounding drugs, and pharmacology, the science and study of drugs, began in the 19th century In the early 1900s Canada passed harsh drug laws to regulate drug sales and manufacturing March 3, 2014 Substance Use Contd The Toll of Drugs Effects of Drugs can be Acute Resulting from single dose or series of doses Vary across different types of drugs Stimulants (cocaine) = unpredictable rage Opioids (heroin) = respiratory depression Chronic Resulting from long term use Chronic users may feel fatigued, cough constantly, lose weight, become malnourished, and ache from head to toe Risk of overdose rises steadily and they live with constant stress Substance Use Contd Withdrawal Development of symptoms that cause significant psychological and physical distress when an individual reduces or stops drug use Polyabuse Preference for a certain type of drug but use of several others as well Greater risk associated with more drug use Concurrent Disorders A person has both mental health and substance abuse problem Factors that influence students choice to use drugs Environment Peer influence, general attitudes towards drug use, availability and access, presence of deterrents, Alcohol Use Those who engage in unhealthy risk taking behaviours often engage in more than one Research has shown correlations between smoking, drinking, and drug use Those who report binge drinking more likely to report marijuana, cocaine, or other illegal drug use (Jones et al., 2001) Perception of risk Most likely to try substances they perceive as safe or low risk (of these top 4 are caffeine, alcohol, tobacco, marijuana) Possible health benefits of alcohol On average, light to moderate drinkers live longer than both abstainers or heavy users If you are 35 or younger, your odds of dying increase in direct proportion to the amount of alcohol you drink Moderate drinking (one drink per day for women; two drinks per day for men) May lower coronary heart disease Raises blood levels of HDL May lower risk of diabetes, high blood pressure, strokes, arterial blockages in the legs ,cognitive decline, and benign prostate enlargement Binge Drinking Pattern of alcohol use that brings a persons blood alcohol concentration up to .08 or above consumed within about two hours (4 men, 3 women ) Abuse vs Dependence Alcohol abuse is recurrent use that has negative consequences Alcohol dependence or alcoholism involves more extensive problems, usually involving tolerance and withdrawal Warning signs of alcohol dependency: Drinking alone Using deliberately and repeatedly Feeling uncomfortable when alcohol is not available Escalating consumption Consuming alcohol heavily in risky situations Getting drunk regularly Drinking in the morning or unusual times Figure 15.4 The Effects of Chronic Abuse Alcohol and how it affects you The proof of value of a drink is equal to twice the % of alcohol in a drink The number of pure ounces of alcohol in a drink is equal to the size of the drink multiplied by the % of alcohol it contains (2.5 x proof of drink x volume(size in oz) of drink) / body weight = time in hours per drink Treating Dependence & Abuse Pre-rehabilitative care Sever addictions where medical services are needed prior to any type of residential or community-based rehabilitation program Intervention Forced psychiatric, medical, or physical intervention, begun by friends and family of the user or addict Medically assisted detox Medical doctors and health professionals monitor the detox and treatment process of potentially fatal withdrawal symptoms Rapid detox Addict s put in a chemically induced coma so they do not have to endure the physical pain that occurs during the detoxification stage Buprenorphine and suboxone Use for opiate detoxification Block absorption of opiates and ease withdrawal symptoms In-patient rehabilitation Drug rehab facility (28 days to one year or more) Behaviour modification 12-step programs Dual diagnosis Assistance for addicts who have both an addiction disorder and a mental health disorder Religious or spiritual guidance Connection to church or spiritual based care and support Post-rehabilitative care Support groups for individuals who have completed detox and rehabilitation programs Family counselling Assist the family unit in dealing with addiction issues and challenges Out-patient rehabilitation Ongoing programs in which clients access counselling and medical services to prevent a relapse of addiction Abstinence: 12-Step Programs Precept is that members have been powerless when it comes to controlling their addictive behaviour on their own because addiction is a disease that must be managed Dont recruit members Desire to stop must come from the individual Held across Canadian cities Promote and maintain long-term abstinence Relapse prevention Relapses should be viewed as neither a mark of defeat nor evidence of moral weakness They do not erase the progress that has been achieved and ultimately may strengthen self-discovery and self-understanding Reminders of potential pitfalls to avoid in the future March 5, 2014 Harm Reduction contd and Nutrients Harm Reduction Strategies Utilize both psychoeducation and personalized feedback in the context of motivational interviewing (MI) A nonjudgmental and nonconfrontational therapeutic approach designed to build intrinsic motivation to change problematic behaviour (Arowitz & Westra 2009; Miller & Rollnick, 2002) Associated with transtheoretical model or stages of change model Those in action stage typically benefit most from cognitive-behavioural techniques, individuals in the precontemplation stage (not considering change) or contemplation stage (beginning to think about change) tend to benefit most from strategies that Enhance awareness Build motivation Move individual into preparation Most young people who drink heavily can be categorized as precontemplative or contemplative Substance Abuse: Why Harm Reduction as a treatment option? Harm reduction strategies do not demand abstinence and are designed to meet the individual where he or she is in the change process Information and education-only approaches, which often emphasizes abstinence, are typically ineffective with young people (Dejong, Larimer, Wood, & Hartman, 2009; National Institute on Alcohol Abuse and Alcoholism, 2002) Thus, it is important for clinical practitioners and school personnel to be familiar with the programs achieving documented success (i.e. BASICS intervention; Whiteside et al., 2010 article) Harm reduction can be an effective strategy because They meet students where they are in the change process and do not require abstinence Do not utilize scare-tactics that focus on the most severe (versus most likely) negative consequences Attempts to reach young people who may not perceive much harm in their current level of drinking Focus on an individuals personal experience with alcohol Serves to lessen resistance Increases openniess to considering change Nutrients Everyday out bodies need certain essential nutrients that it cannot manufacture itself To provide energy, build and repair body tissues, regulate body functions Six classes of essential nutrients: Water Macronutrients Protein Carbohydrates Fats Micronutrients Vitamins Minerals Micronutrients: nutrients that our bodies need in very small amounts Macronutrients: nutrients that are required by the human body in the greatest amounts Amount of macronutrients you need depends on: How much energy you expend Your sex, age, body-frame size, weight, percentage of body fat, and Basal metabolic rate: number of calories needed to sustain your body at rest Calories The measure of the amount of energy that can be derived from your food (macronutrients in particular); kcals For example: 9 calories per every gram of fat 4 calories per every gram of protein or carbohydrate Attempt to match our energy demands with appropriate amounts of energy derived from the macronutrients = calories Caloric Intake Current caloric recommendations: 45-65% from carbohydrates 20-35% from fat Childrens fat intake is slightly higher (25-40%) 10-35% from protein Activity level also affects caloric requirements EER (estimated energy requirement) Females & males 19 to 30 years (kcals): Sedentary level = F 1900 calories/day; M 2500 calories/day Low activity = F 2100 calories/day; M 2700 calories/day Active level = F 2350 calories/day; M 3000 calories/day Caloric Intake of the Average Canadian Adult 2358-2921 calories/day Influences on the foods we eat: Social pressures Emotional (brings back memories) or comforting Family traditions Culture Social events Religious beliefs Busy work/school/life schedules Attitudes and behaviours related to food How to get started: Making healthier eating choice Follow Eating Well with Canadas Food Guide To assist you in the recommended amount of food for your age, sex, and activity level To assist you in eating the right types of food To help you choose a variety of foods from all the food groups Utilize the Nutrition Facts table and the % daily value on the labels or packaging of the food you eat To help you compare and choose the healthier foods when shopping To help you limit foods and drinks that are high in calories, fat, sugar, and sodium Water Intake Essential/critical nutrient in our bodies for a host of reasons You lose 2 to 2.5 litres of waater/day (8 to 10 cups) Recommended intake is approx.. 2.7-3.7 litres, or 8 to 12 cups per day To prevent dehydration and to rehydrate Drink water, sports drinks, and unsweetened juices Avoid alcohol and caffeinated beverages May have a diuretic effect that can leave you less hydrates Protein Intake Form the basic framework for our muscles, bones, blood, hair, and fingernails Complete or high quality proteins Animal proteins (meat, fish, poultry, dairy) Incomplete proteins grains, legumes/dry beans, seeds, nuts, leafy greens/vegetables (broccoli) complementary protein combining incomplete proteins to ensure that the body gets sufficient protein eg. Rice and beans, peanut butter on whole wheat bread recommendations 0.8 grams per kilogram of body weight During pregnancy, additional 25 grams a day above non-pregnant intake Carbohydrates Organic compounds that provide our brain and body with glucose, their basic fuel Classifications: Monosaccharides: glucose, fructose, galactose Consists of one simple sugar unit Disaccharides: sucrose, lactose, maltose, table sugar Contain two sugar units linked by a chemical bond and must be broken down into simple sugars before out body can use them Polysaccharides: starch, glycogen More than 10 units of sugar and must be broken down to be used Simple Carbohydrates Include natural sugars and added sugars Complex carbohydrates Dietary starches Where we get most of our complex carbohydrates from: Grains Cereals Nuts Vegetables Beans Our bodies store starch in muscles and liver in the form of glycogen (polysaccharide) Glycogen is broken down into glucose when the body needs energy Carbohydrate Intake Recommendations 130 grams of digestible carbohydrate per day, for both children and adults 175 grams per day during pregnancy 210 grams per day for women who are breastfeeding Glycemic index Measures how much a carbohydrate-containing food is likely to raise your blood sugar Foods can be divided into high-, medium-, or low-glycemic values Low-glycemic index foods help prevent Type 2 diabetes, control blood sugar levels, and control blood cholesterol levels Pumpernickel, oatmeal, sweet potatoes High-glycemic index foods are found in the grain products food group Bread, cereal, pasta, rice, potatoes, Fibre Intake Dietary fibre: non-digestible form of carbohydrates occurring naturally in plant foods, such as leaves, stems, skins, seeds, and hulls Functional Fibre: isolated, non-digestible carbohydrates that may be added to foods and that provide beneficial effects in humans Total Fibre: sum of both Soluble Fibre: absorbs water, swells, forms gel, and traps nutrients sucha as glucose slow absorption process keeps food longer in the small intestine and causes you to feel full interferes with absorption of dietary fat and cholesterol, which lowers the risk of heart disease and stroke eg barley, oatmeal, fruits and vegetables insoluble Fibre: cellulose, lignin, hemicelluloses clings to water and helps prevent constipation and diverticulosis Recommendations: Men: 38 grams of total fibre Women: 25 grams of total fibre Older than 50 years old: Men = 30 grams of total fibre Women = 21 grams of total fibre Sudden increases in fibre intake can cause bloating and gas so gradually add more fibre to your diet Fat Intake Unsaturated Fats From plants and most vegetables Liquid at room temp Monounsaturated: improve blood cholesterol levels Eg. Peanut and olive oils Polyunsaturated: helps prevent blood clots and lowers triglycerides (eg. Cold-water fish, flaxseed, walnuts) Trans fatty acids: hydrogenated, unsaturated fatty acids found in some margarine products and in fried foods possible link between CVD risk & high trans fatty acids intake thought to be 2X as damaging as saturated fats increase LDL levels and decrease HDL levels no safe level for trans fatty acids Saturated Fats From animal fats &solid at room temp (eg butter) Linked to cholesterol Cholesterol: a form of fat manufactured by our bodies that circulates our blood Made in our liver (80%) & from foods we eat (20%) Made up of high-density lipoproteins (HDLs), low-density lipoproteins (LDLs), and very-low-density lipoproteins (VLDLs) HDLs are good cholesterol LDLs are bad cholesterol Diets high in saturated fats = rise in bad cholesterol (LDL) which increases risk of heart disease How much fat is okay? 20-35% of total calories is recommended Keep fat calories from saturated and trans ft below 10% of daily calories Olive oil is a good fat and has been correlated with lower incidence of heart disease, including strokes and heart attacks Choose reduced-fat snack and processed foods & lean meats and poultry Be careful of very low-fat diets because they can be unhealthy tooMarch 5, 2014 Eating Disorders Why do we eat? Our bodies need nutrients that it cannot manufacture on its own They provide energy, build and repair body tissues, and regulate body functions Unhealthy Eating behaviours The absence of healthy eating Known to be more prevalent in developed nations More widespread as wealth increases What could trigger unhealthy or disordered eating? Pressure to be thin Distorted body image Low self-esteem Fear of failure Stressful event or phase Low stress tolerance/weak coping mechanisms Specific athletic or cultural environments Vulnerable times The concept of minimal weight Lowest you can weigh before compromising FFM stores Males: about 3% essential body fat (marathon runners; gymnasts; jockeys; models, others) Females: includes about 12% essential body fat (gymnasts; skaters; swimmers;long distance runners, models, actors, etc) Anorexia Nervosa Psychological disorder in which refusal to eat and/or extreme loss of appetite leads to malnutrition, severe weight loss & possible death Reverse anorexia Bigorexia/muscle dysmorphia Psychological disorder where there is an excessive preoccupation with muscularity Characterized by: Body image distortion Excessive workout episodes Associated with inappropriate behaviours to increase muscle mass Bulimia Nervosa Episodic binge eating associated with inappropriate compensatory behaviours to prevent weight gain (eg purging, exercise, fasting, medication) Often normal weight Characterized by: Feeling lack of control over eating behaviour Preoccupation with body shape and weight Binge eating & inappropriate compensatory behaviours About 1-3% of people Binge Eating Disorder (BED) Rapid consumption of an abnormally large amount of food in a relatively short time Lack of control (2000 or more calories) Eating when not physically hungry Frequency of at least twice/week for 6 months Rapid eating, even after full Often eating alone to hide the behaviour No purging Eating Disorders Not Otherwise Specialized (EDNOS) All the criteria for AN except amenorrhea All the criteria for AN except the current weight is at a normal range All the criteria for BN except the binge eating and purging behaviour occur less frequently than for BN Regular use of purging in someone of normal weight after small amounts of food are ingested Chewing and spitting out, but not swallowing large amounts of food Compulsive overeating or extreme dieting Health Problems Associated with Eating Disorders Dehydration Kidney damage Electrolyte abnormalities Cardiovascular complications Gastric dilation (binge eating) Gastric rupture (binge eating) Menstrual dysfunction Decreased bone mineral density Tooth decay (purging) Decrease mental capacity Target populations Vast majority of anorexic and bulimic patients are females, aged 15-24, often from middle or upper class backgrounds Perfectionist tendencies Athletes and performers trying to enhance chances of success (female athlete triad) Depressive tendencies (~20-30%) Those who may start a severe, rigid diet Difficulty dealing with transition to independence or adulthood Very complex conditions, individual Treatment Multidisciplinary Improve energy balance by encouraging 250-300 kcal increase in calorie intake until estimated requirements are met Decrease training volume by 10-20%March 10, 2014 Food influences Table5.1 The six classes of essential nutrients Eating well with Canadas Food Guide Canadas first food guide was developed in 1942 Acknowledged wartime food rationing Guidelines were intended to assist in the prevention of nutritional deficiencies and improve the overall health of Canadians The current guidelines encompass basic recommendations to assist Canadians to consume a healthful variety of food and nutrients Guidelines continue to help people choose a healthy diet, avoid nutritional deficiencies, and reduce their risk of diet-related chronic diseases Key things: Variety Food guide serving sizes and quantities Make each food guide serving count Advice for different ages and stages Promotion of physical activity Basic Recommendations Canadas Food Guide is in constant evolution Basic Recommendations include however: Enjoy a variety of foods Choose leaner meats, poultry, and fish, as well as dried peas, beans, and lentils more often Emphasize cereals, breads, grain products, vegetables, and fruit Choose lower-fat dairy products and generally foods prepared with little or no fats Achieve and maintain a healthy weight by enjoying regular physical activity and healthy eating Limit salt, alcohol, and caffeine Serve size vs. portion size The size refers to the amount of food that all of the label information is based on In CFG, serving size refers to a recommended amount of food for one food guide serving cup of vegetables A portion size is the amount of food you put on your plate Serving sizes Grains 1 slice of bread, 1 small muffin, 1 cup ready-to-eat cereal flakes Vegetables c cooked or raw vegetables, 1 c raw leafy vegetables, c vegetable juice Fruit c fresh, canned, or frozen fruit, c 100% fruit juice, 1 small whole fruit, c dried fruit Milk and Alternatives 1 c milk or fortified soy beverage, 50 grams natural cheese, c yogurt Meat and Beans 75 grams cooked lean meat, poultry, or fish, c cooked dry beans or tofu, 2 eggs, 1 tbsp peanut butter, c nuts or seeds Discretionary calories, solid fats, and added sugars Dietary Diversity Different types of foods have nutritional benefits and potential drawbacks Majority of food guides of different countries recommend eating more carbohydrate-rich grains, vegetables, and fruits, and less high-protein meat and dairy Diet examples Content based Paleo, ketogenic, gluten free, vegetarian, vegan, organic, atkins, etc, Culturally based Canadian, Chinese, French, indian, Japanese, etc, Food availability 100 mile, meal exchange, communal garden The Fast Food Diet Meals typically only give you of your vitamin and mineral daily requirements One meal alone takes up a large percentage of your daily recommended caloric intake Almost of these calories come from fat in the meals Have high levels of sodium within themMarch 12, 2014 Weight Management Basic Concepts of Weight Management Energy Balance When energy in equals energy out, you maintain your current weight Body Composition Android versus gynoid body shapes The Energy Balance Equation Total Energy in Calories = total energy out To maintain your current weight, the total number of calories you eat must equal the number you burn To lose weight, you must decrease you calorie intake or increase the number of calories you burn The best approach for weight loss is combining an increase in physical activity with Body Mass Index (BMI) A ratio between weight and height Mathematical formula that correlates with body fat BMI = weight (kg)/ height (m2) Can be used to identify weight-related health risks in populations and individuals Not right for everyone May not be accurate in certain adults including: muscular athletes or individuals people under age 18 who have not reached full growth pregnant or lactating women adults over 65 years of age Guidelines Underweight: BMI under 18.5 Health risks include malnutrition, osteoporosis, and infertility Overweight: BMI of 25-29.9 Obese: BMI 30+ Health Risks of a BMI 25 or higher include TYPE 2 diabetes, hypertension, sleep apnea, cardiovascular disease, and certain cancers Weight Loss Depends on how overweight a person is For extreme obesity (BMI 40+), medical treatment can be performed Gastric bypass surgery or laproscopic gastric banding: reduce the volume of the stomac and tighten the passageway from the stomach to the intestine Gastric Bubble: a sac placed in the stomach to make a person feel full while following a low-calorie diet Risks associated with medical treatments For moderate obesity: 6 month trial of lifestyle therapy Initial goal: 10 percent reduction For overweight: But back moderately on food intake Concentrate on healthy eating and exercise habits Dietary Diversity Different types of foods have nutritional benefits and potential drawbacks Food guides vary in different countries Physical Activity: A Helpful Approach Exercise = adjusting/modifying caloric intake may be the most effective way of taking weight off, maintaining weight Exercise increases energy expenditure of the body by building up muscle tissue, burning off fat, and stimulating the immune system Once you start any type of nutritional plan, keep it up, the body like consistency Diet foods May be low in fat but high in sugar and calories olestra fat substitute Molecules are so large they cannot be digested, so dont leave calories behind Very Low-Calorie or Restrictive Diets Under 800 calories/day Promises to take pound off fast (DANGER!!) Rapid weight loss in linked with increased mortality Up to 50% of the weight you lose may be muscle Fad diets If it seems too good to be true, it probably is Quick and easy weight loss with no effort as part of the plan Cabbage soup diet Grapefruit diet Yo-yo syndrome On-an-off again dieting can be self-defeating and dangerous 95% of people who diet regain their pre-diet weight back within 5 years Can even change food preferences Symmorphosis Consistency Exercising can help overcome the negative effects of the yo-yo syndrome Preserves muscle tissue More muscle = higher metabolic rate To break out of this Re-focus from short term thinking to long-term thinking Be patient and give yourself time Set a target weight zone