EE from physical activity = exercise + NEAT ~150-500 kcal/d most variable, up to 2000 kcal!

Physical Activity Flashcards by S S

Fitness v.
Activity v.
Exercise

-measurable state
-any mvt
-planned

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Muscle fiber types I&II
-mito
-E source
-duration

I: slow-twitch
-↑↑ mito
-E from ox metab
-fatigue resistant, long activities

II: fast-twitch
-E from glycolysis
-forceful, sprinting

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TDEE =
(%’s)

REE (BMR) + TEM (TEF) + EEPA
(60-75%) + 10% +15-35%

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EEPA =

EE from physical activity
= exercise + NEAT
~150-500 kcal/d

most variable, up to 2000 kcal!

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NEAT sources

occupational
transportation
leisure
fidgeting

*often most variable btw ppl

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VO2
-def
-units

= volume of O2 consumed per minute
- L/min or mL/kg/min

measure of “aerobic fitness”

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Predicted VO2 max based on:

1 mile walk test
3 min step test

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MET
-def
-1 MET =
-2 MET =

= metabolic equivalent of task (i.e. E “cost”)

-estimates EE for PA

1 MET = avg resting O2 consumption (RMR)
= 3.5 mL/kg/min

2 MET = 2x RMR

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MET categories

<3: Light (driving = 2)

3-6: Mod (e.g brisk walk = 5… 4 mph)

> 6: Vig (25-49 lbs up stairs)

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Resting VO2 & age, BMI

VO2 ↓ with:
↑ age or ↑ BMI

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Lean body mass % and breakdown

widely variable btw indivuals (genetics, gender, race, age, nutrition, and PA)

75% of total body mass:
-40% muscle
-25% organs
-10% bone
-also water, ligs/tends

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LBM vs. FFM

Both include h2o, minerals, protein, and glycogen

FFM:
DXA measures fat, soft tissue, bone
FFM = total mass - fat mass

*LBM also includes essential fat in organs, CNS, marrow

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Sarcopenic obesity
-onset of mm loss
-contributors

*skeletal mm begins decline at age 30 yo, >65, >80
*factors: ↓ PA, ↓ BMR of adipose
*eccentric mvmts beneficial for strength and ↓ IM fat = “negs”, contract while lengthening

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Obesity and walking

-source of biomechanical load linking obesity to OA, esp knee
-↑ ground rxn forces (GRF) with ↑ bw
-consider SLOWER speeds with WIDER stance

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Exercise Rx

Freq
Int
Type
Timing
Enjoyment

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Freq

-# days/wk is NOT DEFINED, except 2+ days of strength training

-choose something safe and realistic for individual

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Int Recs

Mod:
150-300 min/wk
-starting to get challenging
-conversation more effort

Vig:
-75 min/wk
-hard work
-conversation difficult

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Int by HR

Mod:
-HR: 64-76% x (220-age)
~70%

Vig:
-HR: 77-93% x (220-age)
~85%

Int by Borg scale

*preferred for pts taking rx affecting HR

6-20:
…6 = no exertion
…12-14 = moderate
…20 = max effort

x10 = HR (highly correlated)

Time

Mod: 150-300 min
Vig: 75-150 min
Strength: 2+/wk

Low risk aerobic options:

aqua classes, water walking
recumbent bike
elliptical
walking
chair aerobics

-20-30 min/day
-can divide into 5-10 min sessions

Resistance training

-2-3 d/wk nonconsec days
-2-4 sets x 8-12 reps w 2-3 min rest between
-6-10 exercises in 20-30 min session
-bw, bands, wts, machines

Kids: prevention of wt gain

-Screen < 2 hrs/day
-60-90 min play
-Routine physical activity
-Sedentary behavior assessment

Kids: structured wt mgmt

-Screen < 1 hr/d
-planned supervised play for 60 mins
-activity log
-consider ex physio

For substantial weight loss

>300 min/wk may be required (vs. 150 min to maintain)

Cals to prevent wt regain

?900/d for women 1500-2000/wk

% of US adults meeting PA guidelines

1 in 5!! (20%) highest in Western states

Stress test before starting exercise routine?

Non-exercisers with: -CV, metab, or renal dz -or S/S of such All others, NOT NEEDED

Absolute contraindications to exercise

NONE

Conditions that require close supervision

recent MI unstable angina VT or other arrythmia Dissecting aneurysm acute CHF severe AS Myo/pericarditis Thrombophlebitis Intracardiac thrombus Systemic or pulm emb Acute infxn

Other conditions that require close supervision

-Untx / uncontrolled severe HTN -Mod AS -Sev subAoS -Supraventrivular arrhythmias -Vent an -Freq / complex vent ectopy -Cardiomyopathy -Uncontrolled metab dz (DM, thyroid, etc) -Electrolyte abnL -Chronic / recurrent infxn (malaria, hepatitis) -NM, MSK, or Rhuematoid dz exacerbated by exercise -Complicated preg

Chronic conditions or Disabilities

-if unable to meet guidelines, do what they can according to abilities -start low, go slow -consult a healthcare professional or physical activity specialist

Exercise is Medicine

Rx in right "dosage" is effective for prev, tx, and mgmt of 40+ most common conditions Encourage PA as vital sign, give rx @ each visit

Factors that play role in browning of white adipose tissue

-BF activated by cold -↓ Brown fat w ↑ BMI Exercise increases: IL-6 FGF21 Irisin Meteorin-like Glucagon Catechol

PA health benefits

CV Endo Pulm & sleep CA Ortho & rheum Neuro & psych

Aerobic activity & CV fxn

↑ TBVol V compliance Venous return Myo contractility EDV EF SV CO Effectiveness of CO distribution Peripheral blood flow Flow to active mm ↓ resting HR

↑ Fitness & mortality

↓ CV death ↓ overall mortality

STRRIDE -VO2 -HDL

↑ VO2 w ex ↑ HDL

Exercise and DM

↓ glucose rx needs IR wt control BP LDL TG mm & bone strength General well-being ↑ HDL anxiety

Exercise in bariatric surg

ciritcal to maintain wt loss & lasting DM2 remission

Muscle protein synthesis

-sensitve to changes in mech load & nutritional status *LBM strong predctor of longevity and health

Exercise and visceral fat

Vig ex & HIIT ↑ visceral fat loss

Exercise and appetite

In response to mod-vig ex: ↓ Ghrelin ↑ PYY & other sat hormones ↓ appetite during & after PA, but highly variable

Physical Inactivity

>= 6 hrs sitting per day Includes screen time * Men w med-high sedentary behav had 65-&^% risk of met synd >= 7.5 in college women, 10x ↑ tisk of ob