Health Promo Test 1 Flashcards

(285 cards)

1
Q

CNS and fatigue

A

Fiber recruitment has conscious aspect:
Stress of exhaustive exercise may be too much
Subconscious or conscious unwillingness to endure more pain
Discomfort of fatigue = warning sign
Elite athletes learn proper pacing, tolerate fatigue

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2
Q

Time to fatigue changes with ambient temperatures

A

11C (52 F) time to exhaustion longest
31C (88 F) time to exhaustion shortest
Muscle precooling prolongs exercise

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3
Q

Systematic reduction of training duration and intensity combined with an increased emphasis on improving technique and nutritional intervention prior to competition

A

Tapering

Objective is to attain peak performance at the time of competition

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4
Q

Fartlek training

A
Combined methods of training 
Easy running (~70% VO2 max) combined with hills or short fast bursts (~85-90% VO2 max) 

Can be adapted for running or swimming

Benefits:
Enhance VO2 max
Increase lactate threshold
Improved running economy and fuel utilization

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5
Q

High prevalence of inadequate intake of ____ in all subgroups.

All over age 2, mean intakes of ___ are below the DRI.

A

inadequate intake:
Vitamin E
Magnesium

Below DRI:
Fiber
Potassium

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6
Q

Ideally the majority of carbs consumed. Complex carb. High nutrition. Slow digestion

A

Polysaccharides

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7
Q

Several studies have shown that an athlete’s ___ appears to be a better indicator of his/her aerobic endurance performance than ____

A

Lactate threshold better indicator than VO2 max

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8
Q

Ranks carbohydrates on speed of digestion and absorption

A

Glycemic index

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9
Q

Fat soluble vitamins

A

A- vision and bone health
D- maintain calcium levels
E- antioxidant
K- essential for blood clotting

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10
Q

Adult guidelines for activity - for substantial benefits

A

At least 150 minutes a week of moderate intensity OR 75 minutes vigorous intensity Aerobic OR a combo

Aerobic activity should be performed in episodes of at least 10 minutes and should be spread throughout week.

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11
Q

Vitamins that are not stored in the body

A

Water soluble

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12
Q

Moderate exercise

A

70-80% VO2 max or HR reserve

80-90% HR max

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13
Q

One of the most commonly measured adaptations to aerobic endurance training is

A

An increase in maximal oxygen uptake associated with an increase in maximal cardiac output

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14
Q

Carb recommendations for exercise intensity/duration

A

Low intensity training:
3-5 g/kg per day

> 60 min low, 60 min moderate, or < 30 min vigorous:
5-7 g/kg per day

1-3 hours per day moderate to high intensity:
6-10 g/kg per day

4-5 hours per day moderate to high intensity:
8-12 g/kg per day

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15
Q

Phosphorus…

A

Transports lipids

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16
Q

The average daily nutrient intake level considered sufficient to meet the needs of half of the healthy population within each life stage and sex

A

EAR: estimated average requirement

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17
Q

Hyperhydration signs/symptoms

A
Confusion
Inattentiveness
Blurred vision 
Muscle cramps/twitching 
Poor coordination 
Nausea/Vomiting 
Rapid breathing 
Weakness 
Acute weight gain
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18
Q

HIIT

A

Repeated high intensity bouts interspersed with brief recovery periods
Need to spend several minutes above 90% VO2 max for optimal stimulus
May be effective for improving running economy and running speed

Ex: Long-interval HIIT 2-3 min at 90% VO2 max withrelief bouts of = or < 2 min

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19
Q

___ of the top 10 causes of death in 2010 were chronic diseases.
___ and ____ combined accounted for nearly 48% of all deaths

A

7 of the top 10

Heart disease and cancer (48%)

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20
Q

Basic guidelines of TLC diet

A

Cholesterol intake kept below 200 mg day
Sodium limited to 2400 mg day
25-35% total calories should come from fat intake
Caloric intake should be level to maintain healthy weight
Physical activity must be maintained regularly (at least 30 min daily)

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21
Q

Aerobic exercise is recommended ___ per week
Significant improvements occur with ___
Plateau in improvements with..,

A

3-5 days per week
Significant improvements with > 3 days per week
Plateau with > 5 days with vigorous intensity and the same mode

Modifying intensity and mode will allow for daily training for some adults

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22
Q

DRI components (4 of the 6)

A

RDA: recommended dietary allowance
AI: adequate intake
UL: tolerable upper intake level
AMDR: acceptable macronutrient distribution range

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23
Q

Lactic acid accumulates during brief, high intensity exercise

A

If not cleared immediately, converts to lactate H ion
H ion accumulation causes decreased muscle pH (acidosis)

Buffers help pH but not enough

pH < 6.9 inhibits glycolytic enzymes, ATP synthesis
pH = 6.4 prevents glycogen breakdown

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24
Q

1 MET is = to ___ oxygen consumption

A

3.5 mL/kg x min

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25
Fat burning zone
50-65% max HR
26
Glycogen depletion in muscle groups
Activity-specific muscles deplete first | Recruited earliest and longest for given task
27
Copper..
Iron metabolism
28
___ is a high energy substrate for prolonged, less intense exercise. ___ ATP yield ___ ATP production
Fat High net ATP yield Slow ATP production- must be broken down in FFA and glycerol Only FFAs are used to make ATP.
29
Water soluble vitamins
C- immune system and collagen formation | B- convert food to energy
30
It takes ___ hours to restore normal hydration following heavy sweating
24-48 hours
31
Children and adolescents should do ___ or more physical activity DAILY. And include... weekly
60 minutes or more daily Aerobic activity for most of the 60 min; moderate or vigorous. Vigorous at least 3x week. Muscle-strengthening part of daily; at least 3x week Bone-strengthening part of daily; at least 3x week
32
Astrand and rhyming bicycle test
Submaximal test 6 minutes Primary measure is HR BP also measured for determination of response to test VO2 max estimated by plotting HR on nomogram
33
Primary functions of minerals
Structural components of bone, nails and teeth Regulate fluid balance Blood Congo Muscle contraction Regulate nerve impulses Maintain acid-base balance in blood Components of enzymes that facilitate a wide variety of metabolic functions
34
Activity that burns ___ METs is considered vigorous-intensity
> 6 METs
35
Benefits of fat in diet
``` Healthy cell membranes Brain and CNS development Healthy hair and skin Thyroid and adrenal function Hormone production Regulates BP and liver Regulates blood clotting Transport cholesterol ```
36
6 dimensions of wellness
``` Social Occupational Spiritual Physical Intellectual Emotional ```
37
Common for ___% loss of total body water during intense exercise Water loss of ___% of total body weight can be fatal
1-6% total body water loss during intense exercise (homeostatic response is yo reduce blood flow to kidneys during exercise to conserve water) Water loss of 9-12% of total body weight can be fatal
38
Iron...
Produce hemoglobin/ myoglobin
39
Factors related to aerobic endurance performance
VO2 max Lactate threshold Exercise economy
40
A positive outcome that is meaningful for people and for many sectors of society, because it tells us that people perceive that their lives are going well
Well-being
41
AMDR for protein
Children (1-3 yo) 5-30% total calories Children (4-18 yo) 10-30% total calories Adults (19-60 yo) 10-35% total calories
42
Homeostatic functions of water
1. Biochemical reactions 2. Maintain blood volume 3. Transport nutrients 4. Remove waste products 5. Regulate body temp 6. Optimal health
43
Target heart rate zone
65- 85% max HR
44
Foods to avoid- MIND diet
``` Red meat >4 servings per week Butter and margarine > Tbsp daily Cheese > serving a week Pastries and sweets> 5 servings a week Fried or fast food > 1 serving per week ```
45
____ affect enzyme activity
Co-factors (vitamins)
46
Certain rate of muscle glycogenolysis required to maintain...
NADH production in Kreb’s Electron transport chain No glycogen = inhibited substrate oxidation
47
Hyponatremia may occur...
From high water intake without electrolytes | Can occur during event or up to 24 hours after
48
Benefits of protein
``` Bone volume Energy Calcium absorption Satiety Thermal effect Growth repair body tissues ```
49
Energy from carbs and amount stored
4.1 kcal/g | ~ 2500 kcal stored in body
50
Karvonen method - target HR calculations
APMHR: age predicted max HR APMHR = 220 - age HRR: heart rate reserve HRR = APMHR - RHR Target HR = (HRR x %intensity) + RHR (Calc twice for upper/lower limits of range)
51
6 minute walk test
To determine CRF in older adults Can predict mortality and morbidity Need to be conducted on measured track/distance Formula to estimate VO2 max Distance measure also useful
52
3 main categories of lipids
Triglycerides Sterols Phospholipids
53
Types of maximal exercise tests
Treadmill tests - Bruce Storer stationary bike test. Timed tests: 1.5 mile run
54
2 classes of vitamins
Fat soluble | Water soluble
55
Chromium...
Enhances insulin action
56
Selenium...
Regulates thyroid hormone
57
___% adults obese and __% overweight or obese in 2011-2012 | ___% Children/teens were obese, ___% either overweight or obese
Adults: 34. 9% 68. 6% Kids/teens: 17% 31.8%
58
What patient is appropriate for maximal exercise testing?
High risk for disease. (Physician and crash cart to be present) Moderate risk for disease that intend to begin a vigorous intensity exercise program NOT recommended for patients with low risk for disease- regardless of intensity of exercise program they intend to begin
59
Daily water intake by gender
Women: 2.7 L, 11.4 cups, 91.3 fluid ounces Men: 3.7 L, 15.6 cups, 125 fluid ounces
60
The exercise intensity at which maximal lactate production is equal to maximal lactate clearance in the body
Maximal lactate steady state
61
Adaptations associated with aerobic endurance training
``` Increased: Max oxygen uptake Running economy Respiratory capacity Mitochondrial and capillary density Enzyme activity ``` Reduced: Body fat Blood lactate concentrations at submax exercise
62
Postseason
Active rest | Focus on revering from season while maintaining sufficient fitness
63
3 groups of carbs
Monosaccharides Disaccharides Polysaccharides
64
Signs/symptoms of severe hypohydration
``` Increased core body temp Sunken eyes Dry wrinkled skin Decreased BP Rapid breathing Fast HR Dizziness Irritability Confusion/Delerium Lack of urination Reduced SV and cardiac output Reduced blood flow to muscles Muscle cramping Exertional rhabdo ```
65
Eating after event..
Glycogen replenish 5-7% per hour 20-24 hours needed to fully restore Carbs 1-1.5 g/kg body weight (1.2 g/kg optimal) Repeat every 15-20 min for 4-6 hours or until goal achieved
66
Carb that is rapid source of energy
Monosaccharides
67
AMDR fat
20-35% Children (1-3) 30-40% Children (4-18) 25-35% Adults 20-35%
68
In a study comparing LSD to HIIT on s treadmill...
Both effective | HIIT resulted in significant improvements beyond LSD
69
Hydration risks for older adults
Less sensitive thirst mechanism Kidney function changes- low water conservation Side effects from medication
70
PCr Depletion
Phosphorus-Creatine energy system Coincides with fatigue PCr used for short-term, high intensity effort PCr depletes more quickly than total ATP P(i) - inorganic phosphate- accumulation may be potential cause Pacing helps defer PCr depletion Common for Creatine monohydrate supplementation to reduce fatigue and speed up recovery
71
Treating hypertension early to reduce risk of cardiac arrest is an example of ____ prevention
Secondary
72
During the first ___ after training, muscles ____
45 minutes after training | Muscles rapidly absorb carbs resulting in rapid resynthesis of glycogen
73
Frequency of training depends on
Interaction of exercise intensity and duration Training status of athlete Specific sport season
74
Key factor in sport drink effectiveness
Carb concentration <6% reported to improve performance (High carb concentrations delays gastric emptying and can interfere with performance)
75
Protein quality determined by _____
Amino acid content and digestibility
76
As of 2012 ____ of all US adults had one or more chronic health conditions, and ___ have two or more.
Nearly half of all adults (117 million) have one or more chronic health condition, 25% have two or more.
77
Water makes up ___% total body weight for men and ___% for women
60% men | 50% women
78
Failure may occur at neuromuscular junction, preventing muscle activation
Decreased ACh synthesis and release Altered ACh breakdown in synapse Increase in muscle fiber stimulus threshold Altered muscle resting membrane potential Fatigue may inhibit calcium release from SR
79
Hypohydration effects
Increase cortisol Increase norepinephrine 2% decline strength/performance 3% decline power 10% decline muscular endurance Decline in recovery
80
Interval training
Exercise at intensity close to VO2 max for intervals of 3-5 minutes Work: Rest ration 1:1 Increases VO2 max and enhances anaerobic metabolism Allows athletes to train at intensity close to VO2 max for greater amount of time Interval training should be used sparingly, and only when training athletes with a firm aerobic endurance base
81
Takes into account the total caloric intake and also the amount of nutrition needed to reduce the risk of chronic disease
AMDR: acceptable macronutrient distribution range
82
Amount of oxygen consumed by body’s tissues
VO2 Oxygen uptake Expressed L/min or mL/kg/min
83
Resistance training benefits to aerobic endurance training
Improvement in short term exercise performance Faster recovery from injuries Prevention of overuse injuries and reduction of muscle imbalance
84
Energy from fat and amount stored
9.4 kcal/g | ~ 70,000 kcal stored
85
The total effect of individual and environmental factors on function and health status
Health related quality of life (HRQOL)
86
All vitamins are essential and generally act...
As coenzymes to facilitate numerous reactions in the body
87
12 min walk/run
Distance measured and converted to meters | Plug into formula to estimate VO2 max
88
Resistance training can increase muscle sensitivity to ___ for ___.
Amino acids for up to 48 hours after activity
89
The health outcome of a group of individuals, including the distribution of such outcomes within the group
Population health
90
Uncompensated loss of body water
Hypohydration
91
Benefits of carbs
Rapid breakdown and availability for energy. Allow for sparing protein as a source of fuel. Dietary fiber for improved gastric motility. Reduces risk for colon cancer. Helps control body weight when consumed in proper amounts and including fruits and vegetables
92
Inflammatory foods
``` Fried food Soda Refined carbs Lard Processed meat Processed foods Hydrogenated and trans fats Sweeteners- white sugar and artificial Iodized salt Food additives Dairy Meat Wheat and gluten grains Alcohol ```
93
Current dietary guidelines on unsaturated fat intake
Do not limit unsaturated fat intake
94
Magnesium...
Works with calcium
95
Hydration after exercise
Athletes should aim to consume 125-150% of fluid deficit (20-24 oz per lb of body weight) If sodium not consumed with beverage then much of fluid consumed will lead to increased urine output
96
Aerobic exercise with conventional therapy has been shown to ..
Increase pain threshold | Improve quality of life relating to pain, discomfort, physical role deficit, PF, and overall health perception
97
Diabetes is leading cause of..
Kidney failure Lower-limb amputations (other than injury) New cases of adult blindness
98
5 major fatigue causes
1. Dehydration 2. Inadequate energy delivery/metabolism 3. Accumulation of metabolic by-products 4. Failure of muscle contractile mechanism 5. Altered neural control of muscle contraction
99
Lower activation energy for a chemical reaction
Enzymes
100
Resting - typically energy comes from... Short exercise- typically energy comes from... Long exercise- typically energy comes from....
Resting: 50% carb, 50% fat Short exercise: more carbs Long exercise: carbs and fat
101
Potassium..
Maintain steady HR
102
Too much vitamin K..
Can result in blood clots
103
10 food groups of MIND diet
1. Green leafy veggies- at least 6 servings per week 2. Other veggies- at least 1 a day 3. Nuts- 5 servings per week 4. Berries- 2 or more servings per week 5. Beans- at least 3 servings per week 6. Whole grains- 3 or more servings daily 7. Fish- once week 8. Poultry- 2x week 9. Olive oil- use as main oil 10. Wine- 1 glass daily
104
RDA for protein for adult men and women
0.80 g per Kg of body weight per day of high quality protein
105
Calcium ...
Bone formation and muscle contraction
106
Reported benefits of a diet with low GL
Reduces insulin sensitivity in older, obese adults | Reduces inflammatory markers
107
Losing body water
Dehydration
108
Symptoms of hypohydration
``` Thirst/dry mouth Dry and cool skin Headache Muscle cramp Low urine production Dark urine ```
109
The most frequently used method for prescribing aerobic exercise intensity
HR
110
There is a high correlation between ___ and performance in aerobic endurance events
VO2 max
111
Primary function of protein
Tissue repair and regeneration May be energy source at end of long duration event Endurance athletes should consume 1.2-2.0 g/kg body weight. Higher range for ultra endurance activities. Can be on low end of range depending on duration and intensity.
112
Foods with a high glycemic index will produce...
High and rapid increase in blood glucose and trigger a high insulin release
113
Occurs when athlete reduces training duration or intensity or stops training altogether due to break in training program, injury, or illness
Detraining Athlete experiences loss of physiological adaptations brought about by training
114
An improvement in exercise economy can enhance...
Maximal aerobic power (VO2 max) and lactate threshold
115
Anti-Inflammatory Diets AKA Healing Foods Diet
Structured to be eating plan for life Many major diseases have been linked to chronic inflammation: cancer, heart disease, diabetes, arthritis, depression and Alzheimer’s Components of food/beverages may have anti-inflammatory effects Recommended by arthritis foundation.
116
Factors that can affect exercise economy - running economy
``` Form/technique Environment Topography of training Neurophysiological changes Biomechanical factors Humeral factors ```
117
Anaerobic/high intensity zone
85-100% max HR
118
Eggs, meat, soybeans and quinoa are high in ___
Essential amino acids
119
Measurements taken during exercise testing
Measures needed for VO2 HR, BP, workload, RPE Other subjective indices: Dyspnea, Angina
120
Intensity can be set as a range if either
HR max or VO2 max
121
Anabolic window for protein consumption
Trained athletes: within 1 hour after event Untrained: can delay 3 hours or more
122
4 major health risk behaviors
Inadequate physical activity Poor nutrition Tobacco use Alcohol/drug use
123
Maximal effort objective indicators
RER + or > 1.1 (respiratory exchange ratio..more CO2 out than O2 in) Plateau in VO2 Achievement of age-predicted Max HR Rating if perceived exertion near max
124
Hyponatremia signs/symptoms
``` Core body temp < 104 Nausea/Vomiting Swelling hands/feet Lower blood sodium levels Progressive headache Apathy Altered state of consciousness Pulmonary edema Cerebral edema Rhabdomyolosis Seizures Confusion Lethargy Coma ```
125
Heavy exercise
> 80% VO2 max or HR reserve | > 90% HR max
126
Adult activity guidelines for more extensive health benefits
300 min week moderate intensive aerobic activity OR 150 min week vigorous intensity aerobic activity OR combo Muscle-strengthening activity moderate or high intensity and involves all major muscle groups on 2 or more days per week
127
Fats AMDR, endurance athletes
AMDR 20-35% total energy intake Endurance athletes should consume 1-2 g/kg body weight Higher range for longer duration activities Low fat diets can lead to less than optimal training adaptations as well as performance- should be limited to time point close to event.
128
One of the most important factors in improving and maintaining aerobic power
Intensity of training
129
A state of being that incorporates all facets and dimensions of human existence, including physical health, emotional health, spirituality and social connectivity. An active process through which people become aware of, and make choices toward, a more successful existence
Wellness
130
MIND
Mediterranean-DASH intervention for neurodegenerative delay Developed to reduce mental decline and Alzheimer’s Combo of DASH and Mediterranean diets Lowers risk of Alzheimer’s by 53% with close adherence Choose from wide variety of food groups
131
Maximal aerobic power
VO2 max
132
Major minerals
``` Calcium Magnesium Phosphorus Potassium Chloride Sodium ```
133
5 A model for building self-efficacy (Counseling and motivational interviewing)
``` Address agenda Assess Advise Assist Arrange follow up ```
134
A mode of training that can be used to maintain general conditioning in athletes during periods of reduced training due to injury or during recovery from a training cycle
Cross-training
135
A measure of the energy cost of activity at a given exercise velocity
Exercise economy
136
Zinc...
Immune function, nutrients/fluid absorption from intestines
137
A measure of the glycemic response if calculated in portion size
Glycemic load
138
Sodium..
Muscle contraction and sending nerve impulses
139
Too much Vitamin A can lead to...
Liver damage
140
Pace/tempo training
Intensity at or slightly above competition intensity, corresponding to lactate threshold Intent is to improve lactate threshold and improve tolerance for lactate buildup 20-30 min of continuous training at lactate threshold (Borg 15-16) Avoid high intensity or end up exceeding lactate threshold
141
In-season training
Designed around competition | Low-intensity and short-duration training just before race days
142
HRQOL
Health related quality of life
143
The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Health literacy
144
Rockport 1 mile walk
Patients with low fitness or unable to run Record time takes to complete 1 mile walking (as fast as can but walking only- no running) Immediately following, take pulse x15 sec, multiply by 4 Plug into formula to estimate VO2 max
145
Most athletes can maintain adequate hydration by consuming ___ fluid per hour
0.4-0.8 L (13-27 oz) per hour Carb concentrations of 6-8% are ideal - higher concentrations can result in delayed gastric emptying
146
5 leading causes of death in US. Which account for ___% of all US deaths
``` Heart disease Cancer Chronic lower respiratory diseases Stroke Unintentional injuries 63% ```
147
The best dietary recommendations are from ___
Dietary reference intakes (DRI)
148
Top 3 diets
DASH: dietary approaches to stop hypertension MIND: Mediterranean intervention for neurodegenerative delay TLC: therapeutic lifestyle changes
149
Too much vitamin E..
Acts as anticoagulant
150
Most adults should exercise ___ per week and include ____ moderate intensity per session, ___ vigorous intensity per session. Exercise should be ___ min per session
Adults should exercise 150 minutes or more per week 30-60 min moderate per session 20-60 min vigorous per session Should be 10 or more minutes per session
151
There are __ calories per gram of fat. Therefore if you have a 2000 calorie diet you need ___ grams of fat each day. Keep total intake of saturated fats to ___% of total caloric intake
9 calories 44-77 grams per day <10% of total caloric intake
152
Anti-inflammatory eating like the ___ diet, significantly decreases in mortality from ____, and out performs ___ for controlling cholesterol levels.
Mediterranean diet Heart disease, diabetes, Alzheimer’s and Parkinson’s Out performs statins.
153
Amino acids account for approximately __ total energy (endurance)
2-5%
154
Glycogen depletion and blood glucose
Muscle glycogen insufficient for prolonged exercise Liver glycogen-> glucose in blood As muscle glycogen decreases, liver glycogenolysis increases Muscle glycogen depletion + hypoglycemia = fatigue
155
Warm-up/cool-down zone
50% or less max HR
156
___ focuses on treating disease and injury that is already present in an effort to reduce disability and assist individuals in gaining a higher level of functioning
Tertiary prevention
157
Increasing exercise intensity may benefit skeletal muscle adaptations by
Affecting muscle fiber recruitment
158
Key recommendations for managing fluid levels
1. 2 hours before exercise, consume 14-22 oz water 2. During exercise, consume fluid to minimize water losses to <2% of body weight 3. After exercise, consume enough water to replace sweat losses occurring from exercise 4. Sport drinks containing 4-8% carb concentration and Na concentration 0.5-0.7 g/L 5. Consume food with high sodium content during recovery period 6. Track performance and alter fluid consumption to prevent water loss >2% body weight
159
Rating of perceived exertion scale
``` 1- nothing (lying down) 2- extremely little 3- very easy 4- easy (could go this all day) 5- moderate 6- somewhat hard (starting to feel it) 7- hard 8- very hard (making effort to keep up) 9- very very hard 10- maximum effort (can’t go any further) ```
160
Maximal oxygen uptake range is expressed as ____ METs
7.1 - 22.9 METs
161
Trace minerals
``` Iron Chromium Iodine Copper Manganese Fluoride Selenium Molybdenum Zinc ```
162
___ is considered to be a better indicator than lactate threshold and VO2 max
Maximal lactate steady state
163
A measure of the energy (oxygen) used by the body
MET | Metabolic equivalent
164
Preseason training
Focus on increasing intensity, maintaining or reducing duration, and incorporating all types of training
165
Mass action effect
Substrate availability affects metabolic rate More available substrate = higher pathway activity Excess of given substrate = cells rely on that energy substrate more than others
166
Cognitive-behavioral approaches to promote exercise
``` Reinforcement Goal setting Social support Relapse prevention Affect regulation Association vs Disassociation ```
167
Being physically inactive is responsible for ___% deaths in US adults ___% of American adults don’t meet physical activity recommendations ___% of adults are not sufficiently active to achieve health benefits
10% deaths 80% don’t meet recommendations 60% not active enough to achieve health benefits
168
The DRI guidelines are established to reduce ___
Reduce the risk of developing chronic diseases. | Previous guidelines were based on preventing deficiencies.
169
Substrate fatigue
Develops from inability to produce ATP from any source | Can be prevented with proper diet before/during event
170
Contributing to the growth and development of health
Health promotion
171
A state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity
Health
172
Muscle glycogen synthesis stages
1. Insulin-independent stage 30-60 min after activity | 2. Insulin-dependent stage 1-2 hours to 48 hours after activity
173
Glycogen depletion and FFA
With glycogen depletion, FFA metabolism increases | But FFA oxidation too slow, may be unable to supply sufficient ATP for given intensity
174
Average US consumption is higher than recommended for ____ and lower than recommend for ____
Higher intake than recommended for protein (meat, eggs and nuts) and grains. Lower than recommended for veggies, dairy and fruit.
175
Protein yields ___ energy | It must be converted to ___
4.1 kcal/g Must be converted into glucose (gluconeogenesis) Can also convert into FFAs (lipogenesis) - for energy storage and cellular energy substrate
176
Iodine...
Production of thyroid hormone
177
4 core measures of health
1. Our behaviors (lifestyle) 2. Policies sand practices of our healthcare, government and other prevention systems 3. Medical care we receive 4. The environment and community we live in
178
Chronic adaptations to aerobic exercise
Cardiovascular: Increases in: max cardiac output, SV, and fiber capillary density Increased parasympathetic tone = decreas in resting/submaximal exercise HR Respiratory: Ventilatory- highly specific to type of exercise Increased tidal volume and breathing frequency with max exercise Neural: Efficiency increased, fatigue of contractile mechanisms delayed Muscular: Increase in aerobic capacity of trained musculature- allows absolute intensity with greater ease Bone/connective tissue: Tendons, ligaments and cartilage grow and strengthen proportional to stimulus Endocrine: Increase- hormonal circulation and receptor changes
179
General indications to stop a test
Onset of angina or angina-like Drop in SBP > or = 10 mmHg with increased work rate Excessive rise in BP (SBP > 250 mmHg and/or DBP > 115 mmHg) SoB, wheezing, leg cramps, or claudication Signs of poor perfusion, lightheaded, confusion, ataxia, pallor, cyanosis, nausea, cold/clammy skin Failure of HR to increase with increased exercise intensity Noticeable change in heart rhythm Physical/verbal signs of severe fatigue Subject requests to stop Failure of test equipment
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Energy system used to supply ATP is dependent on... | Low intensity exercise, primary fuel is _____. High intensity ____. Endurance ____.
Rate ATP needed, availability of oxygen, and intensity of activity Fats for low intensity Carbs for high intensity Amino acids for endurance (after fats and carbs depleted)
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Protein can provide ___ of total energy needed during prolonged exercise
3-18% | Results in release of nitrogen and leads to rapid onset of fatigue
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YMCA 3 minute step test
Step height 12” Step rate: metronome set to 96 bpm Take radial pulse x 1 min after completion Compare HR to normative table
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Pre-event eating (resistance)
``` Within hour.. Hydration Top off glycogen Decrease hunger Balance protein consumption for athletes who have high daily protein intake requirements ```
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Very light exercise
45-55% VO2 max or HR reserve | 60-70% max HR
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Keys to nutrient intake for resistance training performance and recovery
Eating right foods | Eating at right time
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The general physical, mental or spiritual condition of the body
Health
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Submaximal exercise testing
Primary purpose: Estimate VO2 max OR Determine functional response to exercise Modes: Field test, treadmills, cycle ergometers, step testing Select mode based on fitness program for patient; musculoskeletal limitations
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A broad multidimensional concept that usually includes self-reported measures of physical and mental health
Health-related quality of life
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Off-season training
Base training | Begin with long duration and low intensity. Gradually increase intensity and to a lesser extent duration
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____ are primary energy substrates used during resistance training
Muscle glycogen and blood glucose
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When should exercise test be conducted
Determine CRF level and tolerance for functional activity Determine CRF level prior to beginning exercise program Establish baseline- reassess to monitor progress Results can be used in goal setting Readiness for return to sport
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Research is ____ on effectiveness of supplementation to improve health or treat disease. Absorption of supplements is ___ naturally through the foods we eat.
Insufficient or inconclusive | Absorption of supplements is poor vs consuming vitamins and minerals naturally through food
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Number of training sessions conducted per day or per week
Training frequency
194
Dietary guidelines for resistance athletes
RDA Carbs 5-6 g/kg Protein 1.4-1.7 g/kg
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Frequency, intensity or duration should not increase by more than ...
10% each week
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Eating during event...
Choose carbs wisely- low fiber, low residue Consuming during event can prevent substrate fatigue and improve performance Consume 30-90 g per hour (not based on body weight) Limiting factor is rate of absorption across intestinal wall. Glucose absorption 60g per hour Fructose absorption 30g per hour
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Signs/symptoms of mineral deficiencies
Mouth ulcers or cracks in corners of mouth Poor night vision and white growths on eyes Brittle hair and nails Scaly patches and dandruff hair loss Red or white bumps on skin Restless leg syndrome
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In 2011, __% adults (18+ years old) did not meet recommendations for aerobic exercise or physical activity and ___% did not meet recommendations for muscle strengthening
52% aerobic exercise/physical activity | 76% muscle strengthening
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Acclimation to altitude may occur between ___ but can take up to __.
12-14 days at moderate altitudes Can take up to several months In order to see an ergogenic effect, athletes need a hypoxic dose =or > 12 hours daily for minimum of 3 weeks at moderate altitude
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Metabolic by-products and fatigue
P(i) - inorganic phosphate- from rapid breakdown from PCr, ATP Heat: retained by body, core temp increase Lactic acid... H ions, pH drops, acidosis
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Energy is released at a controlled rate depending on ___.
Enzyme activity in a metabolic pathway Enzymes do NOT start chemical reactions or set ATP yield Enzymes facilitate breakdown (catabolism) of substrates More enzyme activity = more product
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Glycogen depletion
Glycogen reserves limited and deplete quickly Depletion correlated with fatigue Related to total glycogen depletion Unrelated to rate of glycogen depletion Depletes faster with high intensity Depletes faster during first few minutes of exercise vs later stages
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Ratings of perceived exertion scales uses..
Can be used to regulate intensity of aerobic endurance training across changes in fitness level May be influenced by external environmental factors
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Maximal exercise testing
AKA graded exercise tests (GXT) or stress tests Test design is to use gradual increase workload until peak exertion is achieved ``` Purpose: Screen for presence of disease Diag disease when symptoms are present Establish a prognosis Treatment planning ```
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Functions of water for athletics
Maintain body temperature BP Circulation of metabolites
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Recommended daily intake of carbs
Sedentary adults 45-65% total calories Aerobic training 8-10g per Kg body weight Anaerobic training 5-6g per Kg body weight
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Foods with high GI
Baked russet potato Sugary foods Breads with bleached white flour
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Considered more accurate measure of glycemic response
GL: glycemic load
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Light exercise
55-70% of VO2 max or HR reserve | 70-80% HR max
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Drinking too much alcohol is responsible for ___ deaths each year, more than half due to ___
88,000 | Binge drinking
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Every gram of carbohydrate retains ____
3-4 g water
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US food consumption as % of calories
12% plant 25% animal 63% processed foods
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A state of good health
Wellness
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Foods with low GI
Complex carbs Soy beans Hummus
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Hydration assessment
``` Plasma/urine osmolality USG: urine specific gravity test Sweat patches placed in skin Bio electric impedance analysis Body weight pre and post Urine color ```
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___ aims to detect disease at an early stage when signs and symptoms are not evident so that disease can be controlled and it’s effects limited
Secondary prevention
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Lower quality proteins are found in ___
Plants
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___ is most common cause of disability
Arthritis
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More than ___ adults, close to ___% smoke. Smoking accounts for ____ deaths each year
42 million adults ~20% More than 480,000 annual deaths
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___ involves actions that avert the onset of disease or injury through intervention strategies such as reducing risk factor levels.
Primary prevention
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____ METs considered moderate intensity activity
3-6 METs
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A ___% decrease in body weight due to dehydration results in declining performance
2%
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Average person loses ___ L per hour through perspiration while sedentary During training....
0. 3 L per hour sedentary | 0. 3-1.4 L per hour training
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Maximum daily intake unlikely to cause adverse health effects
UL: Tolerable upper intake level
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Muscle fiber type and recruitment patterns
Fibers recruited first or most frequently deplete fastest Type I fibers depleted after moderate endurance exercise Recruitment depends on exercise intensity Type I recruit fist (light/moderate) Type IIa next (moderate/high) Type IIx last (maximal intensity)
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CRF (cardiorespiratory fitness) is considered a health related component due to..,
1. Low levels of CRF linked to development of chronic diseases as well as increased all-cause mortality 2. Higher levels of CRF linked to decrease in all-cause mortality 3. High levels of CRF associated with increased frequency of activity resulting in numerous health benefits and increased HRQOL
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The art and science dealing with the protection and improvement of community health by organized community effort and including preventative medicine and sanitary and social science
Public health
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Molybdenum
Produce RBC
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Dietary fat is comprised primarily of ____
Triglycerides
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Participants in endurance events are at risk for hyperhydration if...
They only consume water
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To calculate the GL...
Multiply glycemic index by number of grams of carbs per serving of food
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LSD
Long slow distance training Intensity at < 20% normal training intensity Program based on time rather than distance- progress by time (1-2x month) rather than distance Recommended for marathon training programs Adaptations: enhances oxygen delivery to muscles and therefore improves ability to clear lactate Causes eventual shift of type 2x fibers to type 1 Increased use of fat as energy source
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____ are effective in maintaining HR during endurance exercise
Either water or saline
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6 groups of nutrients
``` Minerals Carbohydrates Fats Vitamins Water Proteins ```
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___% loss total body weight can increase core body temp and significantly affect performance ___% loss reduces blood flow to muscles ___% loss cause decrease in cardiac output, sweat production and blood flow to skin and muscles
1-3% 4% 6-10%
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Wrapping up the fitness test
Share results with patient Help patient establish goals for fitness program Schedule a follow up time to assess performance Modify fitness program as needed
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RDA for fat for adult men and women
Children (1-3 yo) 30-40% total calories Children (4-18 yo) 25-35% total calories Adults (19-79 to) 20-35% total calories
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Any effort taken to allow an individual, group or community to achieve awareness of- and empowerment to pursue- prevention and wellness
Health promotion
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Too much vitamin D can lead to..
Heart arrhythmias and blood vessel calcification
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Chloride...
Balances fluid in body
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External and individual factors influencing adaptations to aerobic endurance training
Altitude- Body must compensate for lower atmospheric pressure Initial response is increase respiratory rate and HR Acclimation expect to occur after 10-14 days due to increased RBC production Smoking- Increased airway resistance Paralysis of cilia CO binding to hemoglobin Genetic potential- Upper limit of genetic potential dictates absolute magnitude of adaptation Age and sex- Max aerobic power decreases with age Power of women 73-85% of male values
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Fitness is the ability to perform physical work that requires...
``` Cardiorespiratory function Muscular strength Endurance Flexibility Optimum body composition ```
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Omega 3 and 6 are ___
Polyunsaturated | Essential fatty acids
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1 MET is
The energy (oxygen) used by the body at rest
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Length of time of training session
Duration
246
Anti-Inflammation foods
``` Tomato Fruit Nuts Olive oil Leafy greens Fatty fish ```
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The practice of preventing disease and promoting good health by providing the resources and creating environments that help people stay healthy
Public health
248
Energy substrates
Carbs, fats, protein Breakdown of these macronutrients provide fuel and are broken down to release the energy stored in bonds between molecules
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Exercise mode is _____.
The specific activity performed by the athlete
250
Vitamins that are dissolved and stores in fat cells
Fat soluble
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Anti- inflammatory diets are recommended by
``` Arthritis foundation American heart association American cancer society Hepatitis central American diabetes association ```
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2 definitions of fatigue
1. Decrements in muscular performance with continued effort, accompanied by sensations of tiredness 2. Inability to maintain required power output to continue muscular work at a given time
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RDA for fats
20-35% of total caloric intake
254
Fluoride...
Bone formation
255
DASH
Dietary approaches to stop hypertension Lower BP in just 14 days 3 plans: original, weight loss and vegetarian Lowers risk of several cancers, heart disease and failure, stroke, kidney stones, reduced risk of diabetes, can slow progression of kidney disease
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Heat alters metabolic rate
Increases carb utilization Hastens glycogen depletion High muscle temp may impair muscle function
257
TLC diet
Therapeutic lifestyle changes Not designed for weight loss, intended to lower cholesterol levels Targets saturated fat intake and promotes foods high in unsaturated fatty acids Intake of saturated fat should be kept below 7% total caloric intake
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Submaximal Field tests
Rockport 1 mike walk 6 minute walk test 12 minute walk/run
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Sodium losses range from ___ per liter of sweat
230-2277 mg of sodium per liter of sweat
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High intensity aerobic endurance training augments the absolute secretion rates of
Many hormones in response to maximal exercise
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High quality proteins are ____ and contain ___.
Highly digestible and contain all 9 of the essential amino acids
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Barriers to treatment adherence in PT outpatient clinics
1. Low levels of physical activity at baseline or in previous weeks 2. Low in-treatment adherence with exercise 3. Low self-efficacy 4. Anxiety 5. Depression 6. Helplessness 7. Poor social support or activity 8. Greater perceived number of barriers to exercise 9. Increased pain levels during exercise
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Manganese...
Regulates blood sugar
264
Health and fitness programs are example of ____ prevention
Primary
265
Estimated that ___% US adults are obese
42%
266
Grains are
Polysaccharides
267
Basic functions of vitamins
Organ and immune functioning Metabolism and facilitating energy production Supporting muscle contraction and relaxation Oxygen transport Building and repairing body tissues Protection from cellular damage Vision
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Children have ___ sweat rate, ___ skin temp, and...
Lower sweat rate Higher skin temp Need more time to acclimate to high temps Lower sodium concentration in sweat (one factor that benefits children)
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There are ___ calories per gram of carbohydrates. | Adequate intake if fiber ___ g per 1000 kcal.
4 calories per gram of carb | Fiber intake: 4g per 1000 kcal
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Established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy
AI: adequate intake
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The average daily level of intake sufficient to meet nutrient requirements of nearly all healthy people (97-98%)
RDA: recommended dietary allowance
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Adding aerobic exercise to PT for chronic MSK resulted in .... (compared to PT without)
Improved pain pressure threshold
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RER of 1.1:1 | What higher?
RER (respiratory exchange rate) is CO2 to O2 ratio 1.1:1 means CO2 output higher At VO2 max (and lactate threshold)
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There are ___ calories per gram of fat. | For a 2000 calorie diet... ___ grams of fat per day
9 44-77 g daily
275
RDA fat
20-35% total caloric intake | <10% total caloric intake of saturated fats
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Overtraining is a process that can result in ____ overreaching
Functional overreaching (intentional) Nonfunctional overreaching
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Functional overreaching
Intentional overtraining to stimulate supercompensative environment
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Nonfunctional overreaching
Overtraining Gradual onset resulting in declines of performance May require weeks or months to fully recover
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Cardiovascular overtraining responses
Greater volumes of training affect HR while resting BP generally do not change
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Overtraining- biochemical response
High training volume results in increased levels of creatine kinase, indicating muscle damage Muscle glycogen decreases with prolonged periods of overtraining
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Overtraining- endocrine response
May result in decreased testosterone-to-cortisol ratio, decreases secretion of GH, and catecholamine levels Decrease: insulin and testosterone Increase: adrenaline, noradrenaline, ACTH, cortisol and glucagon
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Potential markets of aerobic overtraining
``` Decreased: Performance % body fat Maximal oxygen uptake Muscle glycogen ``` ``` Altered BP Increased muscle soreness Altered RHR Increased submax exercise HR Change in mood ```
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Heart rate zones
50% or less - recovery 50-65% - fat burning 65- 85% - target HR zone 85-100% - anaerobic
284
Aerobic training design for client classification
Beginner: 2-3 days week/ 20-40 min Intermediate: 4-5 days week/ 30-60 min Advanced: 5+ days/ varies
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HR max ranges
``` Very light. < 57% Light 57-63% Moderate 64-76% Vigorous 77-94% Near-max + or > 95% ```