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Introduction to the Fitness Spectrum. Today we will: Review the increase of heart disease in America Recognize the health implications of inactivity Describe.

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Presentation on theme: "Introduction to the Fitness Spectrum. Today we will: Review the increase of heart disease in America Recognize the health implications of inactivity Describe."— Presentation transcript:

1 Introduction to the Fitness Spectrum

2 Today we will: Review the increase of heart disease in America Recognize the health implications of inactivity Describe the Dr. Dean Ornish Program for Reversing Heart Disease Exercise Prescription Learn the benefits of the exercise guidelines Learn how to make exercise safe Discuss the integrated approach to success 2

3 US Cardiovascular Disease Mortality 1979-2004 3

4 Diabetes 20.8 million Americans have diabetes 30% are unaware Diabetes has doubled over the last 30 years. 65% of people with diabetes will die of heart disease or stroke 4

5 5 1999 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 54 person) 2008 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% 30%

6 The Epidemic of Obesity Number ONE modifiable risk factor for diseases such as: –Heart disease –Cancer –Diabetes –High blood pressure –High cholesterol 6

7 Heavy to Heavier 7

8 The Influence of Exercise Only 30% of adults engage in regular physical activity. 70% of Americans perform less than recommended levels of physical activity. 8 No Exercise Inconsistent Exercise Regular Exercise

9 Health Implications of Inactivity Coronary Artery Disease Obesity High Blood Pressure High Cholesterol Bone Loss Peripheral Artery Disease Asthma Stroke Cancer (colon, breast, prostate, lung) Diabetes Metabolic Syndrome Depression High Stress 9

10 The Risk of Inactivity The relative risk of heart disease associated with physical inactivity ranges from 1.5-2.4, an increase in risk comparable to that observed for high blood cholesterol, high blood pressure or cigarette smoking. –Source: JAMA 1995;273:402-407 10

11 Exercise and All-Cause Mortality Harvard Alumni Health Study 11

12 Age-Related Changes in Aerobic Capacity 12

13 Exercise and Obesity 22,000 participants were followed for 8 years and evaluated for fitness (treadmill testing) and body fat percentage. Lean men, who were fit, had 1/3 the incidence of cardiac related death as those who were lean and unfit. Fit obese men had lower death rates than unfit lean men. –Source: Lee et al. Am J of Clin Nutrition 1999; 69: 373 13

14 Benefits of Exercise Improves heart efficiency Improves oxygen carrying capacity of blood Lowers resting blood pressure Lowers triglycerides Increases HDL cholesterol Lowers blood glucose (sugar) Improves metabolism Prevents bone loss 14

15 Benefits of Exercise, cont. Decreases body fat Improves muscle mass and density Improves exercise capacity Decreases mortality rate Decreases stress level Decreases hostility Decreases depression Improves overall well-being 15

16 Exercise Prescription (Rx) 16

17 Exercise Guidelines Limit passive inactive pursuits. Add more activity into everyday life. Exercise aerobically for a minimum of 3 hours per week. Perform strength training activities a minimum of 2 times per week. 17

18 Exercise Components Flexibility / Stretching Aerobic / Cardiorespiratory Resistance / Strength Training 18

19 Format for Exercise Sessions Warm Up Phase (5-10 minutes): –Includes a low level cardiorespiratory component followed by flexibility exercises Stimulus or Conditioning Phase (30-60 minutes): –Cardiorespiratory component within your training range –Resistance training Cool Down Phase (5-10 minutes): –Same as warm-up period 19

20 Warm Up and Cool Down The warm up helps move the body from rest to exercise. The low level cardio activity increases blood flow to muscles and warms them up before stretching. Low intensity stretching before exercise may reduce the likelihood of musculoskeletal injuries. 20

21 Warm Up and Cool Down, cont. The cool down provides a recovery period to return the body (and heart rate and blood pressure) to the resting state. Helps maintain adequate venous return (reduces pooling of blood in lower extremities) and reduces the potential for hypotension (low blood pressure) and dizziness. Stretching after exercise helps to maintain flexibility. 21

22 F.I.T.T. Principle F = FrequencyHow often I = IntensityHow hard T = TimeHow long T = TypeWhat type 22

23 Flexibility 23

24 Guidelines for Flexibility Training F 3 to 7 days per week I To a mild tension, without discomfort T Hold each stretch for 15-30 seconds Repeat 2 to 4 times each stretch T Static stretches that involve the major muscle tendon units. May use yoga poses. 24 Warm up before stretching. Do not bounce when stretching.

25 Aerobic/Cardiorespiratory 25

26 Activity vs. Exercise Activity Stop and go activities 80% of maximal capacity Doesnt condition the cardiopulmonary system Exercise Continuous activity involving large muscle groups 45-80% of maximal intensity Conditions the cardiopulmonary system 26

27 Activity or Exercise? 27

28 Activity or Exercise? 28

29 Activity or Exercise? 29

30 Activity Versus Exercise Activity Gardening Golf Household Chores Shopping Cooking Doubles Tennis Basketball Dancing Exercise Hiking Aerobic dance Jogging Rowing Rollerblading 30

31 Exercise Monitoring: Heart Rate Target Heart Rates Based on the maximum heart rate achieved during an exercise test Pulse taking –Wrist – Neck 31

32 Exercise Monitoring: RPE 32 BORGS RATE OF PERCEIVED EXERTION (RPE) SCALE Borg RPE scale © Gunnar Borg, 1970, 1985, 1994, 1998 RATINGDESCRIPTION 6No Exertion 7Extremely Light 8 9Very Light 10Light 11 12 13Somewhat Hard 14 15Hard / Heavy 16 17Very Hard 18 19Extremely Hard 20Maxim

33 Program Guidelines: Aerobic Exercise F 3 to 6 days per week I 45-80% of maximal capacity T 30 to 60 minutes/session Accumulate at least 3 to 5 hours of exercise weekly T Activities using large muscles that are continuous and rhythmical in nature 33

34 Program Guidelines for Diabetes F Daily preferred I 45-80 % of maximal capacity Or RPE 11 to 14 T 20 to 60 minutes/session Accumulate at least 3 to 5 hours of exercise weekly T Activities using large muscles that are continuous and rhythmical in nature 34 Source: ACSM, 2000 Aerobic Exercise

35 Strength Training 35

36 Benefits of Strength Training fat mass Improves cholesterol blood pressure symptoms of depression Improves glucose utilization Improves self- confidence Improves bone density arthritis pain metabolism Can help break through a weight loss plateau 36

37 Program Guidelines: Strength Training F 2 to 3 days per week I RPE of 10 to 15 T 10-15 repetitions of 8 to 10 different exercises T Weights, resistance bands, body weight, household items, water resistance 37

38 Exercising Safely 38

39 General Exercise Guidelines Monitor your exercise response. Pace yourself. Have a regular exercise routine. Relax with stress management. Stay hydrated. 39

40 Exercise Guidelines for Diabetes Monitor glucose levels before, during and after exercise sessions. Do not exercise if blood glucose > 250 with urinary ketones or >300 if no ketones. Eat carbohydrate if blood glucose is < 100 mg/dL. Exercising at night may cause nocturnal hypoglycemia. 40

41 More Guidelines for Diabetes Exercise with caution in extreme hot/cold weather. Insulin, diabetes pills or other non-insulin injectables may have to be adjusted. Maintain good foot care and wear proper footwear for your activity. Exercise has an insulin-like response in the body. Exercise daily at the same time to prevent low blood sugar (hypoglycemia). Hypoglycemia can occur up to 6 hours after exercise. 41

42 Special Exercise Considerations Eating Alcohol Hot weather Cold weather Altitude Medications Illness Overexertion Carbon monoxide (smoking, smog) 42

43 Warning Signs Chest pressure/pain Severe breathlessness Excessive fatigue Poor recovery Irregular heart rate (palpitations) Sweating with cold, clammy skin Dizziness Nausea Fainting Confusion New or increased chest, jaw, back or arm pain that does not go away with rest or nitroglycerin 43

44 If You Have Chest Pain With Exercise… When you are exercising at Program sessions: –STOP exercise and let a staff member know. If you are exercising on your own: –STOP exercising, and follow your doctors instructions regarding calling 911, seeking immediate medical attention, taking nitroglycerin or other recommendations from your doctor. ALWAYS let your physician and Program staff know if you have had any angina symptoms when you have been exercising on your own especially if your symptoms are changing in intensity or frequency. 44

45 Musculoskeletal Injury RRest IIce the area for 20 minutes at a time CCompression (use an ACE bandage to hold the ice on the injured area) EElevate the injured area 45

46 Pathways to Success Buddies Clubs Classes Events Feelings Fun Time management Confidence Commitment 46

47 Integrated Approach 47 Love & Support Stress Management FitnessNutrition

48 Lifestyle Heart Trial Results Exercise adherence in combination with the other modalities is associated with: –Heart disease reversal –Improved blood lipids –Weight loss –Improved mood –More satisfaction and pleasure from life 48

49 Exercise and Stress Management Improved flexibility Increased awareness and ability to focus Improved breathing techniques Improved balance 49

50 Exercise and Group Support Decreased hostility Improved mood Increased satisfaction and pleasure from life Exercising with a partner or in a group can improve interpersonal relationships. 50

51 Exercise, Nutrition and Your Eating Plan Aids in weight loss and maintenance of weight loss Moderates appetite Helps curb binge eating 51

52 Upcoming Exercise Support and Training Well exercise twice weekly for the next 12 weeks. Well add strength training around week 6. Toward the completion of Stage I, you will have another stress test, and we will update your exercise prescription to reflect the new test. 52

53 Questions 53

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