1
Q
What are the (4) poor lifestyle choices that contribute to chronic medical conditions?
A
- poor nutritional choices
- insufficient sleep
- smoking
- not enough activity and exercise
2
Q
What (4) psycho-social factors can many Canadians struggle with?
A
- poverty
- isolation
- lack of family/social support
- substance abuse
3
Q
What is the recommended amount of exercise for adults?
A
thirty (30) minutes of moderate-intensity exercise per day for at least 5 days per week
4
Q
What proportion of North American adults do not get the recommended amount of exercise?
A
more than half of all North American adults
5
Q
How can significant health benefits be obtained?
A
by engaging in moderate amounts of physical activity several times a week
6
Q
What type of fitness program approach elicits even greater benefits?
A
a progressive approach that gradually increases exercise intensity
7
Q
Who is the ideal person to set up appropriate programming for the deconditioned or exercise-adverse person?
A
the trained fitness instructor is the ideal person to set up appropriate programming for the deconditioned or exercise-adverse person
8
Q
Prescribed physical activity improves which (5) areas?
A
- cardiovascular,
- musculoskeletal,
- respiratory
- endocrine function,
- mental health
9
Q
What can regular exercise positively affect and control (related to chronic disease)?
Hint: Many of the ____________ and ____________ of ________, and in some cases, may ___________________________________________________.
A
many of the risk factors and complications of chronic disease, and in some cases, may prevent some of these diseases from ever developing
10
Q
Regular exercise has the greatest impact on which (7) conditions?
A
- coronary heart disease,
- hypertension,
- osteoporosis,
- colon cancer
- breast cancer and,
- Type 1 diabetes
- Type 2 diabetes
11
Q
What mental health effects can regular exercise have?
A
decrease the severity of depression and anxiety, and increase one’s sense of well-being
12
Q
Current Model of Medical Care in Canada — list the (9) issues
A
- many specialists – lack of integration / holistic perspective
- high rate of medical errors (primarily with medications)
- high rates of preventable re-admissions (20 - 40 percent are preventable – Naylor 2009)
- poor satisfaction with care – epidemic of unmet needs
- more and more increasingly complex interventions and surgeries are being performed
- high degree of government intervention and control
- government intervention policies often go against what is best for client/patient
- preoccupation with costs and performance – focus not on client/patient
- tremendous human and cost burden
13
Q
What is there a dramatic increase in (talking about a type of person)?
A
dramatic increase in the number of older adults and frail older adults
14
Q
One in how many baby boomers will develop dementia? (or what percentage)
A
one in 5 or 20%
15
Q
What is the #1 cause of all hospital admissions?
A
cardiovascular disease
16
Q
What percentage of ALL adults 65 years and older are diabetics?
A
10%
17
Q
According to JAMA 2009, what percentage of all diabetics in North America receive adequate care?
A
42%
18
Q
There is an increase in incidence of cancer among what age group?
A
older adults
19
Q
What does COPD stand for?
A
chronic obstructive pulmonary disease
20
Q
Instances of COPD are increasing. By 2020, COPD is expected to be the 3rd leading cause of what?
A
death
21
Q
Instances of COPD are increasing. By 2020, COPD is expected to be the 5th leading cause of what?
A
disability
22
Q
30% of those with COPD die from what?
A
heart disease
23
Q
What percentage of people with COPD die from heart disease?
A
30%
24
Q
According to Dajczman 2010, what percentage of all disability and dependency is caused by chronic disease?
A
87%
25
What percentage of all disability and dependency is caused by chronic disease?
87%
26
There is a significant increase in the ___ and ___ of prescription drugs.
number and volume
27
What are the (5) implications/complications for elevated blood pressure (hypertension)? Increased risk of…
1. heart attack
2. bypass surgery
3. stroke
4. kidney disease
5. dialysis
28
What is another word for elevated blood pressure?
hypertension
29
What are the (3) usual treatments for hypertension?
1. diuretics
2. CC blockers
3. beta blockers
(these can all cause adverse side effects)
30
How is hypertension affected by activity and exercise? (3)
1. decrease in resting blood pressure
2. better elasticity of blood vessels
3. resolution of stress hormones
31
What is another word for elevated cholesterol?
dyslipidemia
32
What are the (3) implications/complications for elevated cholesterol (dyslipidemia)? Increased risk of…
1. heart attack
2. stroke
3. vascular disease
33
What is the usual treatment for dyslipidemia?
statins (anti-cholesterol medications which can cause adverse side effects)
34
What are statins?
anti-cholesterol medications
35
How is elevated cholesterol affected by activity and exercise?
improved liver function stimulates higher production of 'good' cholesterol (HDLs)
36
What are the (6) implications/complications for high insulin resistance (pre-diabetes)? Increased risk of …
1. diabetes
2. heart attack
3. kidney disease
4. dialysis
5. blindness
6. amputation
37
What is another word for high insulin resistance?
pre-diabetes
38
What is the usual treatment for high insulin resistance (pre-diabetes)?
oral anti-diabetic medications – can cause adverse side effects
39
How is high insulin resistance (pre-diabetes) affected by activity and exercise?
exercise improves insulin sensitivity up to 48 hours after
40
What are the (5) implications/complications for clotting abnormalities? Increased risk of…
1. blood clots
2. heart attack
3. stroke
4. embolism
5. thrombosis
41
What is the usual treatment for clotting abnormalities?
baby aspirin, blood thinners – can increase risk of bleeding
42
How are clotting abnormalities affected by activity and exercise? (2)
1. helps lower viscosity of blood
2. aids in maintaining elasticity of blood vessel walls
43
What are the implications/complications for abdominal obesity? (3) visceral fat affects?…
1.function of liver
2. function of great vessels of heart and lungs
3. fatty liver disease
44
What is the usual treatment for abdominal obesity?
exercise and dietary adjustments usually recommended
45
What kind of exercise is effective to counter abdominal obesity?
higher intensity interval training (HIIT) very effective in targeting visceral or abdominal fat
46
What are the (3) implications/complications for osteoporosis (decreased bone density)?
increased risk of:
1. hip fractures
2. spinal fractures
3. pneumonia from prolonged bed rest
47
What is the usual treatments (3) for osteoporosis?
1. anti-resorptive medications,
2. hormones,
3. supplements:
can all cause adverse side effects
48
1. What (2) types of exercises or activities help with osteoporosis
2. How?
1. resistance training and weight-bearing activities
2. by stimulating increases in bone density
49
What are the (2) implications/complications for depression?
1. poor quality of life
2. increased risk of earlier death
50
What is the usual treatment for depression?
anti-depressants – can cause adverse side effects
51
How is depression affected by activity and exercise?
regular exercise has similar results to medications in mild to moderate depression
52
What are the (3) implications/complications for colon cancer?
1. multiple surgeries
2. side effects and complications of therapy
3. risk of recurrence
53
What are the (3) usual treatments for colon cancer?
1. colostomy
2. chemotherapy
3. radiation treatment
54
1. What kind of exercise confers the same or better benefits as chemotherapy in colon cancer?
2. And what does it lower?
1. regular higher-intensity exercise
2. lowers risk of re-occurrence
55
What are the (6) implications/complications for breast cancer?
1. surgery (and it's side effects and complications)
2. radiation
3. chemotherapy
4. lymphedema
5. frozen shoulder
6. risk of reoccurrence
56
What are the (5) usual treatments for breast cancer?
1. surgery
2. removal of lymph nodes
3. radiation
4. chemotherapy
5. long-term drug therapy
57
How is breast cancer affected by activity and exercise? (3)
1. regular higher-intensity exercise decreases risk of reoccurrence
2. can reduce severity of lymphedema
3. can reduce severity of shoulder problems
58
What percentage of North Americans do insufficient or no physical activity?
78 percent
59
What is the average amount of muscle tissue loss caused by inactivity per decade?
5–7 pounds per decade
60
What does muscle loss caused by inactivity lead to?
decrease in body’s metabolic activity
61
What are (5) consequences of inactivity related to weight and glucose?
1. gradual ....
2. decrease in
3. decrease in
4. increase in
5. increase in
1. gradual weight gain (fat)
2. decrease in glucose tolerance
3. decrease in HDL cholesterol
4. increase in resting heart rate and
5. blood pressure
62
What are (5) consequences of inactivity related to the cardiovascular system? Hint: decrease in...
1. decrease in contractility of ventricles
2. decrease in stroke volume
3. decrease in cardiac output
4. decrease in max VO2
5. decrease in total blood and plasma volume
63
What is the annual number of deaths directly linked to a sedentary lifestyle?
3.2 million deaths a year (WHO Global Database 2015)
64
What is experienced in the circulatory system during cardiovascular exercise (regarding diastolic phase)?
the circulatory system spends more time in diastolic phase, so a decrease in resting blood pressure is experienced
65
What are the (9) physiological adaptations to cardiovascular exercise?
Hint: 1 decrease and 8 increase...
1. decrease in resting blood pressure
2. increase in HDL cholesterol
3. increase in elasticity of blood vessel walls
4. increase in number of capillaries (increases O2 extraction potential)
5. increase in number, density and function of mitochondria
6. increase in oxidative enzymes (increases metabolism of energy from oxygen)
7. increase in hemoglobin content
8. increase in stroke volume at rest and during activity
9. increase in overall cardiac output
66
What is the effect of cardiovascular exercise on resting heart rate?
decrease in resting heart rate
67
What is the effect of cardiovascular exercise on lactate threshold?
elevation of anaerobic or lactate threshold (increases tolerance for activity)
68
What are the (10) physiological adaptations to resistance training?
1. increase in amount of muscle tissue
2. increase in metabolic activity (at rest, during exercise and post-exercise recovery)
3. increase in bone mineral density
4. decrease in body fat
5. increase in insulin sensitivity (improved glucose metabolism)
6. decrease in gastrointestinal transit time
7. increase in production of synovial fluid
8. reported decrease in arthritic pain
9. decrease in incidence of lower back pain
10. increase in ability of muscle to store glycogen
69
What are the (2) changes in energy use from resistance training?
1. increase in ability of body to use more fat as energy source
2. decrease in reliance on glycogen as energy source
70
What fraction of all deaths in Canada each year result from chronic illness?
two-thirds of all deaths each year in Canada result from four groups of chronic illnesses
71
What are the (4) chronic illnesses responsible for two-thirds of all deaths in Canada?
1.cardiovascular disease,
2.cancer,
3.Type 2 diabetes and
4.respiratory illness
72
What other urgent public health concern greatly contributes to the risk of chronic disease?
obesity
73
What has happened to the number of overweight and obese Canadians over the last 30 years?
it has risen steadily
74
In 2012, what fraction of Canadian adults was obese?
one in every four Canadian adults
75
In 2012, which groups were many of the obese Canadians?
many of them men and middle-aged individuals
76
What percentage of Canadian adults are considered overweight (in addition to those obese)?
37 percent
77
How many Canadian youths are defined as overweight or obese?
over a half-million
78
What has been identified as a significant contributor to the obesity epidemic in Canada?
physical inactivity
79
What is the textbook definition of obesity?
the excessive accumulation of body fat (Merck Manual 2002)
80
What is the simple mechanism that causes obesity?
consuming more calories than what is expended through activity, exercise and metabolism
81
What is true obesity defined as?
carrying 30 percent of one’s body weight as fat or adipose tissue
82
What is morbid obesity defined as?
carrying 40 percent or more of one’s weight as fat
83
What is BMI an acronym for?
Body Mass Index
84
How is BMI calculated?
dividing an individual’s weight in kilograms by the square of their height in meters
85
Among children and adolescents, how is overweight defined using BMI?
at or above the 95th percentile of the sex-specific BMI for age growth charts
86
Among adults, how is obesity defined using BMI?
a BMI score over 30
87
Among adults, how is extreme or morbid obesity defined using BMI?
a BMI score over 40
88
Why was BMI used initially?
because of its perceived correlation to an individual’s amount of body fat
89
Does BMI provide a final diagnosis of obesity?
no, BMI is only one screening tool in identifying possible weight problems
90
For a person 5'9'' tall, what weight is considered underweight?
124 lbs. or less
(below BMI 18.5)
91
For a person 5'9'' tall, what weight range is considered a healthy weight?
125 to 168 lbs. (BMI 18.5 to 24.9)
92
For a person 5'9'' tall, what weight range is considered overweight?
169 to 202 lbs. (BMI 25.0 to 29.9)
93
For a person 5'9'' tall, what weight is considered obese?
203 lbs. or more (BMI 30 or higher)
94
What is the BMI threshold for overweight in Caucasians?
25
95
What is the BMI threshold for overweight in Black African & Black Caribbean populations?
26.3
96
What is the BMI threshold for overweight in Ethiopians?
20.4
97
What is the BMI threshold for overweight in Chinese populations?
23.1
98
What is the BMI threshold for overweight in South Asians?
23
99
What is the BMI threshold for overweight in Indonesians?
21.8
100
What is the BMI threshold for overweight in Polynesians?
29.5
101
What is there continuing debate and research about regarding obesity definitions?
the validity of using current definitions of obesity for non-white ethnic groups
102
Why might different ethnic groups require revised BMI thresholds?
they have a varying range of body shape, size and composition, and may have differing physiological responses to the metabolism of fat
103
Which populations are now recommended to have revised BMI thresholds and standards?
Asian, South Asian, African and Hispanic populations
104
What waist circumference in women indicates the presence of excess abdominal fat?
more than 31.5 inches
105
What increased risks does a woman’s with a waist circumference greater than 31.5 inches have? (2)
increased risk of both heart disease and diabetes compared to extra weight carried elsewhere
106
What waist circumference in women indicates overweight or obesity and greatly increases disease risk?
greater than 35 inches
107
What waist circumference in men increases the risk of disease?
more than 34 inches
108
What waist circumference in men indicates overweight or obesity with much higher risk of chronic disease?
greater than 40 inches
109
What are 5 other more precise methods to measure body fat?
1. skinfold thickness measurements (with calipers)
2. underwater weighing
3. bioelectrical impedance
4. dual-energy x-ray absorptiometry (DXA)
5. computerized tomography (CAT scans)
110
What is a gynoid fat distribution pattern?
weight gain mostly in hips and buttocks, giving a 'pear-shaped' physique
111
What is an android fat distribution pattern?
weight gain mostly in the abdomen and trunk, giving an 'apple-shaped' physique
112
Which fat distribution pattern is at increased risk of chronic disease?
apple-shaped (android)
113
What (4) conditions are associated with having an apple-shaped rather than a pear-shaped body?
1. diabetes
2. heart disease
3. high blood pressure
4. elevated blood lipids
114
Why is visceral fat dangerous?
it lies in close proximity to the liver and coronary blood vessels, and can affect both
115
Are fat-distribution patterns controllable?
no, they are inherited
116
What can 'apple shapes' do to reduce their risk?
keep their weight at a healthy level and eat a balanced and nutritious diet
117
What is the BMI range for Class 1 Obesity?
30.0 – 34.9
118
What is the risk level for Class 1 Obesity if waist circumference is under 102 cm for men and 88 cm for women?
high
119
What is the risk level for Class 1 Obesity if waist circumference is over 102 cm for men and 88 cm for women?
very high
120
What is the BMI range for Class 2 Obesity?
35.0 – 39.9
121
What is the risk level for Class 2 Obesity if waist circumference is under 102 cm for men and 88 cm for women?
very high
122
What is the risk level for Class 2 Obesity if waist circumference is over 102 cm for men and 88 cm for women?
extremely high
123
What is the BMI for Class 3 Obesity?
40.0+
124
What is the risk level for Class 3 Obesity regardless of waist circumference?
extremely high
125
For a person 5'4'' tall, what weight corresponds to Class 1 Obesity?
174 lbs. / 79 kg
(30+ BMI)
126
For a person 5'4'' tall, what weight corresponds to Class 2 Obesity?
204 lbs. / 93 kg
(BMI of 35 - 39.9)
127
For a person 5'4'' tall, what weight corresponds to Class 3 Obesity?
232 lbs. / 105 kg
(40+ BMI)
128
For a person 5'9'' tall, what weight corresponds to Class 1 Obesity?
203 lbs. / 92 kg
(30 - 34.9 BMI)
129
For a person 5'9'' tall, what weight corresponds to Class 2 Obesity?
236 lbs. / 105 kg
(35 - 39.9 BMI)
130
For a person 5'9'' tall, what weight corresponds to Class 3 Obesity?
270 lbs. / 123 kg
(40+ BMI)
131
What technological trends (4) has decreased physical movement in daily life?
Iincreased presence and popularity of
1. televisions,
2. computers,
3. video games and
4. remote controls
132
Children between 2 and 17 years of age spend more than how many years of their lives watching television?
more than three years
133
What additional activities (3) increase screen time for children (beyond television)?
1.playing video games,
2.watching videos or
3.using a computer
134
Why are many schools dismantling playground stations?
fear of incurring injury lawsuits
135
What trend have governments followed despite scientific evidence about exercise benefits?
reducing funds allotted to recreation and physical activity organizations
136
What global trend reduces opportunities and accessibility for physical activity?
urbanization (less space)
137
What is another name for Type 1 Diabetes?
insulin-dependent diabetes
138
What type of disease is Type 1 Diabetes? What’s happening exactly?
a chronic disease that develops when the pancreas stop producing insulin
139
What organ is responsible for producing and secreting insulin?
the pancreas
140
What is the role of insulin?
transporting sugar (glucose) into the tissues of the body, where it is used for basic cell activity and energy
141
What happens to blood sugar without insulin?
it cannot enter the body’s tissues and blood sugar levels rise above safe limits
142
What can chronic high blood sugar levels damage?
blood vessels and nerves throughout the body
143
What (4) risks increase with chronic high blood sugar levels? Hint: diabetes is NOT one of the answers.
1. retinopathy (damage to eyes)
2. neuropathy (damage to nerve tissue)
3. cardiovascular disease
4. kidney disease
144
What percentage of diabetics are insulin-dependent or Type 1?
about 10 percent
145
What other forms of diabetes exist besides Type 1 and Type 2?
gestational diabetes and secondary diabetes
146
How does insulin work?
insulin is the key that unlocks the glucose channel, allowing glucose to enter the cell
147
What happens when the glucose channel is closed (without insulin)?
glucose cannot enter the cell
148
What is the most common type of diabetes?
Type 2 Diabetes
149
What percentage of diabetes cases are Type 2?
90 percent
150
What characterizes Type 2 Diabetes?
insulin resistance, when the body’s cells and tissues do not respond to and absorb insulin properly
151
Between 1990 and 2011, what was the percentage increase in Type 2 Diabetes in North America?
38 percent
152
What are two other names sometimes used for Type 2 Diabetes?
adult-onset or non–insulin-dependent diabetes
153
At what ages can Type 2 Diabetes develop?
at any age
154
What trend is occurring with Type 2 Diabetes in children?
the incidence is rising
155
What are (5) factors that can lead to insulin resistance?
1. obesity
2. increasing age
3. family history
4. decrease in muscle mass
5. chronically elevated blood sugar levels
156
What are 4 common symptoms of diabetes?
1.increased thirst,
2.increased urination,
3.weight loss, and
4.blurred vision
157
How do many people discover they are diabetic?
they do not experience symptoms and discover it through a medical check-up
158
What age group do symptoms of Type 1 Diabetes usually start in?
childhood or young adulthood
159
Why do people with Type 1 Diabetes often seek medical help?
they become seriously ill from sudden symptoms caused by high blood sugar
160
Before diagnosis, do people with Type 2 Diabetes usually have symptoms?
no, they may not have symptoms
161
At what age is Type 2 Diabetes usually discovered?
in adulthood
162
What trend is occurring in children with Type 2 Diabetes?
an increasing number of children are being diagnosed with the disease
163
Are episodes of low blood sugar (hypoglycemia) common in Type 1 Diabetes?
yes
164
Are episodes of low blood sugar common in Type 2 Diabetes?
no, unless taking insulin or certain oral diabetes medications
165
Can Type 1 Diabetes be prevented?
no
166
Can Type 2 Diabetes be prevented or delayed?
yes, with a healthy lifestyle including maintaining a healthy weight, eating sensibly, and exercising regularly
167
Both types of diabetes greatly increase the risk of what? Hint: general
serious complications and diseases
168
Although monitoring and management can prevent most complications, diabetes remains the leading cause of what (3)?
1. blindness
2. amputation
3. kidney failure in the Western world
169
Diabetes continues to be a critical risk factor for what (3)?
1. heart disease
2. stroke
3. foot or leg amputations
170
What is the normal pre-meal (fasting) glucose range in Canadian values?
4–6 mmol/L
171
What is the normal pre-meal (fasting) glucose range in American values?
< 110 mg/dl
172
What is the normal two hours post-meal glucose range in Canadian values?
5–8 mmol/L
173
What is the normal two hours post-meal glucose range in American values?
< 150 mg/dl
174
What is the target pre-meal (fasting) glucose range in Canadian values?
3.9–7.2 mmol/L
175
What is the target pre-meal (fasting) glucose range in American values?
70–130 mg/dl
176
What is the target two hours post-meal glucose range in Canadian values?
5–10 mmol/L
177
What is the target two hours post-meal glucose range in American values?
< 180 mg/dl
178
What is gestational diabetes?
a type of diabetes that develops during pregnancy when the body is unable to produce sufficient insulin to cope with the growth associated with carrying a baby
179
What is the risk of gestational diabetes for the baby?
increased risk of becoming overweight and even diabetic in the future
180
What percentage of women develop gestational diabetes?
between 5 and 20 percent
181
What usually happens to blood sugar levels after delivery in gestational diabetes?
they usually return to normal
182
Metabolic syndrome is a specific pattern of symptoms that result from … ?
insulin resistance
183
Who discovered and defined metabolic syndrome?
Dr. Claude Bouchard of Laval University
184
What can metabolic syndrome and its associated abnormalities lead to? (2)
1. cardiovascular disease and
2. premature death
185
What are the (6) characteristics of metabolic syndrome?
1. insulin resistance
2. hypertension
3. abnormalities of blood clotting
4. low HDL and high LDL cholesterol levels
5. high triglycerides levels
6. excess body fat carried as visceral/abdominal fat rather than subcutaneous fat
186
What does insulin resistance lead to in metabolic syndrome? Directly or indirectly to... (5)
directly or indirectly to the other metabolic abnormalities:
1. hypertension,
2. abnormalities of blood clotting,
3. low HDL and high LDL cholesterol levels,
4. high triglycerides levels,
5. excess body fat carried as visceral/abdominal fat rather than subcutaneous fat)
187
What often happens when insulin resistance is severe enough in metabolic syndrome?
individuals eventually develop full-blown type 2 diabetes
188
When diabetes develops in someone with metabolic syndrome, what happens to cardiovascular complications?
the high risk of cardiovascular complications increases even higher
189
How can metabolic syndrome most often be prevented?
with exercise and weight loss
190
Who should be evaluated for metabolic syndrome? (3)
1. any individual with a family history of type 2 diabetes
2. who is overweight and
3. sedentary
191
What blood pressure level is used as a diagnostic criterion for metabolic syndrome?
greater than 130/85 mm/Hg
192
What waist circumference is used as a diagnostic criterion for metabolic syndrome in men?
greater than 102 cm / 40 in
193
What waist circumference is used as a diagnostic criterion for metabolic syndrome in women?
greater than 88 cm (34.6 in)
194
What triglyceride level is used as a diagnostic criterion for metabolic syndrome?
greater than 150 mg/L (1.7 mmol/L)
195
What HDL-cholesterol level is used as a diagnostic criterion for metabolic syndrome in men?
less than 40 mg/L
196
What HDL-cholesterol level is used as a diagnostic criterion for metabolic syndrome in women?
less than 50 mg/L
197
What insulin resistance level is used as a diagnostic criterion for metabolic syndrome?
greater than 100 mg/dL
198
The coronary arteries supply _________ and _________ to the ________________?
oxygen and nutrients to the heart muscle
199
What is the clinical term for a heart attack?
myocardial infarction
200
What disease is the single largest killer of both Americans and Canadians?
coronary artery disease (CAD)
201
Do more North Americans die from heart disease or from all cancers combined?
more from heart disease
202
What is the buildup inside coronary arteries called?
atherosclerotic plaques, referred to as atherosclerosis
203
What happens to artery linings in atherosclerosis?
they become hardened and swollen with calcium deposits, fatty deposits and abnormal inflammatory cells
204
What can atherosclerotic plaques do to blood flow?
reduce blood flow to tissues, especially cardiac muscle tissue
205
What is arteriosclerosis?
the age-related decrease in elasticity of blood vessel walls
206
How does arteriosclerosis worsen atherosclerosis?
inelastic vessel walls further decrease blood flow to important tissues
207
What is the primary risk factor for coronary heart disease related to blood pressure?
hypertension
208
How does successfully managing hypertension affect risk of cardiovascular disease?
it substantially reduces the risk of cardiovascular disease and associated deaths
209
Which 2 conditions, when combined with hypertension, make blood pressure management even more important?
diabetes and/or elevated triglycerides
210
What does elevated cholesterol usually indicate?
that there is too much LDL in the bloodstream
211
Which lipoproteins are linked to the onset of atherosclerosis?
LDL and VLDL
212
How does smoking or second-hand smoke affect cardiovascular risk? It increases the risk of… (2)
1. developing heart disease and
2. stroke
213
How do tobacco by-products like tar and nicotine contribute to cardiovascular disease?
they contribute to plaque build-up in arteries and increase the risk of blood clots
214
How does smoking affect oxygen in the blood and blood pressure?
it reduces available oxygen and increases blood pressure
215
How much more at risk of a stroke are smokers?
nearly double
216
What lifestyle factor was recently added as a primary risk factor for coronary heart disease?
a sedentary lifestyle
217
What 3 primary risk factors dies a sedentary lifestyle increase?
1. obesity
2. diabetes, and
3. heart disease
218
What secondary risk factor for coronary heart disease is related to family history?
heredity
219
What age range are men at greatest risk for heart disease?
39 to 50 years
220
What age range are women at greatest risk for heart disease?
49 to 59 years
221
Why does menopause increase women’s risk for heart disease?
because it reduces estrogen, which is thought to have protective effects
222
What secondary risk factor for coronary heart disease is related to weight?
obesity
223
How does obesity increase cardiovascular risk? Hint: it raises risk of elevated ________, elevated ________ and ________, while also straining the _________.…
1. elevated blood pressure,
2. elevated blood lipids, and
3. diabetes,
4. while also straining the cardio-respiratory system
224
What secondary risk factor for coronary heart disease is related to blood sugar regulation?
diabetes
225
How does diabetes increase cardiovascular risk?
Hint: It causes damage to ____________. increasing ____________ and ____________.
1. the lining of blood vessel walls,
2. risk of plaque build-up
3. clot formation
226
What secondary risk factor for coronary heart disease is related to gender?
men are at slightly higher risk than women, but the gap is closing due to the greater number of female smokers
227
What is the #1 cause of death among North American women?
heart disease (cardiovascular disease)
228
Do more women die from cardiovascular disease or from all cancers combined?
more women die from cardiovascular disease
229
What is gout?
an acute and painful inflammation of the joints (most frequently the big toe and wrist) caused by high levels of uric acid in the blood
230
What diet factor is linked to gout?
a diet high in animal fats and purines
231
What foods high in purines should gout sufferers avoid? (4)
1. meat,
2. seafood,
3. chickpeas and
4. alcohol
232
Is gout considered dangerous on its own?
no, but it usually accompanies other risk factors
233
High levels of triglycerides usually accompany which other 2 risk factors?
1. elevated cholesterol and
2. insulin resistance
234
What are patients with elevated triglycerides advised to do?
1. Cut down on (2)
2. and to treat...
1. cut down on simple carbohydrates and alcohol, and
2. treat the other risk factors
235
What is metabolic syndrome in relation to coronary heart disease?
a condition where disorders of coagulation make it easier for blood clots to form within blood vessels
236
What cardiovascular event can blood clots in metabolic syndrome precipitate?
heart attacks
237
What therapy is generally recommended for patients with metabolic syndrome to help prevent clotting?
daily aspirin therapy
238
What are novel risk factors for cardiovascular disease? As in define what novel means...
newer findings in medical research that may soon overtake conventional risk factors
239
Why are novel risk factors important?
because predictive models based only on conventional risk factors have lower accuracy
240
Name (3) significant novel risk factors for cardiovascular disease.
1. insulin resistance
2. high levels of homocysteine
3. high levels of C-reactive protein
241
What is homocysteine?
a normal by-product of metabolism
242
What dietary factor is high homocysteine usually associated with?
a large dietary intake of meat
243
Why are high homocysteine levels dangerous?
they appear to increase the risk of heart disease
244
What is c-reactive protein?
a normal plasma protein found in the bloodstream
245
What do high levels of c-reactive protein usually indicate?
the result of inflammatory processes in the body
246
What do high levels of c-reactive protein signal? Hint: a high risk of...
a high risk of heart disease
247
What is hypertension?
elevated blood pressure
248
What 4 health conditions is hypertension associated with?
1. coronary artery disease,
2. stroke,
3. congestive heart failure, and
4. kidney failure
249
How many times does the risk of heart disease and stroke increase as blood pressure rises from 115/75 to 135/85?
risk doubles (x2)
250
How does risk of heart disease and stroke increase as blood pressure rises from 115/75 to 155/95?
risk quadruples (x4)
251
How does risk of heart disease and stroke increase as blood pressure rises from 115/75 to 175/105?
risk increases eightfold (x8)
252
What is the normal blood pressure reading?
less than 120/80 mm Hg
253
What is pre-hypertension blood pressure range?
120–139 systolic or 80–89 diastolic
254
What is Stage 1 Hypertension blood pressure range?
140–159 systolic or 90–99 diastolic
255
What is Stage 2 Hypertension blood pressure range?
160+ systolic or 100+ diastolic
256
What are (10) risk factors for hypertension? As in what factors increase your risk for developing hypertension?
1. a blood relative with high blood pressure (parent or sibling)
2. men over age 55 and women over age 65
3. diabetes
4. post-menopausal women
5. African Americans (especially women)
6. taking birth control pills
7. little or no regular physical activity
8. smoking
9. being overweight or obese
10. high total cholesterol
257
What are (5) complications of hypertension?
1. stroke
2. heart attack and heart failure
3. kidney failure
4. blindness
5. arteriosclerosis (blood vessel damage)
258
What happens 20 minutes after quitting smoking? (3)
1. blood pressure drops to resting levels,
2. pulse rate drops to resting levels, and
3. temperature of extremities returns to normal
259
What happens 8 hours after quitting smoking? (2)
1. carbon monoxide levels in blood drop to normal and
2. oxygen levels in blood increase to normal
260
What happens 24 hours after quitting smoking? (2)
1. chance of heart attack decreases and
2. chance of stroke decreases
261
What happens 48 hours after quitting smoking? (2)
1. ability to smell and taste is enhanced
2. walking becomes easier
262
What happens 2 to 12 weeks after quitting smoking? (2)
1. circulation improves and
2. lung function increases up to 30%
263
What happens 1 to 9 months after quitting smoking? (3)
1. cough and sinus congestion decrease,
2. fatigue decreases, and
3. shortness of breath decreases
264
What happens 1 year after quitting smoking? (2)
1. risk of chronic heart disease is half that of a smoker,
2. cilia regrow in lungs enhancing ability to breathe
265
What happens 5 years after quitting smoking? (2)
1. lung cancer death rate decreases by 50% and
2. stroke risk is reduced to that of a non-smoker
266
What happens 10 years after quitting smoking? (3)
1. lung cancer rates are similar to non-smokers,
2. pre-cancerous cells are replaced, and
3. risk of mouth, esophageal, bladder, and pancreatic cancers decreases
267
What happens 15 years after quitting smoking? (1)
heart disease risk is the same as a non-smoker
268
What is another name for a stroke?
cerebro-vascular accident
269
How is a stroke defined?
a sudden interruption of blood flow to the brain
270
What are the (2) main types of stroke?
1. ischemic stroke (blood clot causes a blockage)
2. hemorrhagic stroke (rupture of a blood vessel and bleeding into or around brain tissue)
271
What percentage of strokes are ischemic (caused by blood clots)?
about 80 percent
272
What percentage of strokes are hemorrhagic (bleeding from a vessel wall)?
about 20 percent
273
How many Canadians are living with complications of a stroke?
approximately 300,000
274
What percentage of individuals who suffer a stroke will experience complications such as sensory loss, memory loss, language problems, and depression?
more than 60 percent
275
What is the rank of stroke as a cause of death in Canada?
the third leading cause of death
276
What are some common misconceptions about stress?
that stress only comes from external sources such as death of a spouse, illness, divorce, or job loss
277
What is equally important to understand about stress?
that internal stressors trigger the same emotional and physiological responses as external events
278
What are (9) common external stressors?
1. death of a family member or spouse
2. illness (personal or a family member)
3. injury or disability
4. divorce
5. marriage
6. birth of child
7. loss of employment
8. start of new job or career or
9. moving
279
What are (6) common internal stressors?
1. negative personal beliefs
2. social beliefs and expectations
3. need to be 'always right'
4. rationalization
5. disillusionment
6. despair
280
What hormone levels are elevated in the blood during stress?
cortisol and adrenalin
281
What do cortisol and adrenalin do to the immune system?
they suppress the immune system
282
What can chronic elevation of cortisol disrupt?
the diurnal rhythm
283
What other hormones does cortisol stimulate the production of? (3)
1. glucocorticoids,
2. catecholamines and
3. prolactin
284
What hormone release do glucocorticoids inhibit?
thyroid-stimulating hormone (TSH)
285
How can glucocorticoids affect thyroid function?
they inhibit TSH release, which can impair thyroid function
286
What do catecholamines do during stress? (3)
1. increase cardiac output,
2. direct skeletal blood flow away from the digestive system, and
3. increase sodium retention
287
What reproductive hormones are suppressed during stress?
gonadotropins
288
How can stress affect reproductive function?
it suppresses gonadotropins, impairing reproductive function
289
What happens to insulin levels during severe stress responses?
they may decrease
290
What happens to antibodies in saliva during stress?
they decrease, increasing frequency of colds
291
What happens to lymphocytes such as interferon during stress?
they decrease, reducing immune responses
292
What brain wave pattern is associated with stress?
beta-rhythm ('orange alert')
293
What are some visible or physical signs of stress? (2)
1.goose bumps,
2.enlarged pupils
294
What happens to levels of free fatty acids during stress?
they increase
295
What happens to clotting agents during stress?
they increase
296
What happens to blood pressure and heart rate during stress?
they increase
297
What happens to respiration rate during stress?
it increases
298
What happens to blood flow to muscles during stress?
it increases
299
What is the vision of the Pan-Canadian Healthy Living Strategy Model?
a healthy nation in which all Canadians experience the conditions that support the attainment of good health
300
What are the (2) goals of the Pan-Canadian Healthy Living Strategy Model?
1. reduced health disparities
2. improved overall health outcomes
301
What does the Population Health Approach focus on?
1. determinants of health,
2. addressing health disparities,
3. targeting settings and key groups, and
4. taking intersectoral action
302
What are the (4) guiding principles of the Pan-Canadian Healthy Living Strategy Model?
1. priority to promotion and prevention
2. integration (vertical and horizontal)
3. partnership and shared responsibility
4. evidence-informed practice
303
What are the (4) sectors included in the Pan-Canadian Healthy Living strategy?
1. health (public health, clinical prevention, chronic disease management)
2. social (education, training, housing, social supports)
3. environment (land use planning, sustainable environmental management, recreation)
4. economic (industry, employment, transportation, finance)
304
What are the (4) strategies of the Pan-Canadian Healthy Living Strategy?
1. leadership and policy development
2. knowledge development and exchange
3. community development
4. public information
305
What are the (3) types of priorities in the Pan-Canadian Healthy Living Strategy?
1. build on existing priorities
2. address opportunities
3. assess emerging issues
306
What are 9 examples of existing priorities in the Pan-Canadian Healthy Living strategy?
1. physical activity,
2. healthy eating,
3. healthy weight,
4. tobacco control,
5. alcohol misuse
6. CVD (cardiovascular disease)
7. cancer,
8. diabetes,
9. chronic lung disease,
307
What are 3 examples of 'address opportunities' priorities in the Pan-Canadian Healthy Living Strategy?
1. mental health promotion,
2. injury prevention,
3. healthy weight
308
What is an example of an 'emerging issue' priority in the strategy?
musculo-skeletal disorders
309
Who provides current and evidence-based scientific information on disease prevention and health promotion?
The Public Health Agency of Canada
310
How does the Public Health Agency of Canada share information?
through a monthly publication
311
What is the National Wellness Institute definition of wellness?
a multidimensional concept that encompasses all aspects of the individual’s development and well-being
312
What are the (6) dimensions of wellness?
1. social
2. occupational
3. spiritual
4. physical
5. intellectual
6. emotional
313
What does the Social dimension of wellness encourage?
contributing to the human and physical environment for the common welfare of the community, emphasizing interdependence with others and nature, and harmony within one’s family
314
What benefits come from travelling the Social path of wellness?
power to enhance relationships, friendships, community, environment, and eventually the world
315
What is the Occupational dimension of wellness related to?
one’s attitude about one’s occupation and finding work that gives personal satisfaction and enrichment
316
What benefits come from travelling the Occupational path of wellness?
contributing unique skills, talents, and gifts to meaningful work and conveying values through paid or volunteer activities
317
What does the Spiritual dimension of wellness involve?
developing appreciation of life’s depth and natural forces, seeking meaning and purpose in human existence
318
What do individuals ask themselves when travelling the Spiritual path of wellness?
questions about who they are and what is meaningful in their life
319
What does the Physical dimension of wellness encourage? Hint: It encourages developing ________, knowledge about ____________, and discouraging ____________.
regular physical activity, knowledge about food and nutrition, and discouraging tobacco, drugs, and excessive alcohol
320
What benefits come from travelling the Physical path of wellness?
better understanding of nutrition and activity, immediate physical benefits, improved self-esteem, self-control, determination, and sense of direction
321
What does the Intellectual dimension of wellness encourage?
stimulating and creative mental activities to expand knowledge, skills, and potential
322
What benefits come from travelling the Intellectual path of wellness?
use of intellectual and cultural activities in and beyond the classroom, striving to expand and challenge the mind
323
What does the Emotional dimension of wellness emphasize?
awareness and acceptance of one’s feelings
324
What does Emotional wellness include?
capacity to feel positive and enthusiastic, manage feelings and behaviors, cope with stress, express feelings freely, and make personal decisions based on a healthy balance of thought and emotion
325
What additional (6) domains can help focus wellness dimensions in programs?
1. prevention
2. time span
3. wholeness
4. unity
5. age span
6. hardiness or resilience
326
What are the four elements connected in the Model of Relationships Between Health, Activity and Lifestyle?
1. heredity and genetic potential
2. physical activity (leisure, occupational, chores)
3. health-related fitness (morphological, neuromuscular, cardiorespiratory, metabolic)
4. health (wellness, morbidity, mortality)
327
What 4 factors influence health in the model? (The Model of Relationship Between Health, Activity, and Lifestyle)
1. lifestyle,
2. individual attributes,
3. physical environment, and
4. social environment
328
According to the model, what directly relates to physical fitness, health, and lifestyle?
how we live day-to-day
329
Why don’t traditional models of medical health intervention succeed in managing lifestyle-induced illnesses?
because they do not address day-to-day lifestyle choices
330
Why is understanding barriers to exercise important for fitness instructors?
because encouraging at-risk individuals to exercise is difficult without addressing barriers
331
What are the three categories of barriers to exercise?
1. personal
2. environmental
3. exercise-specific
332
What are personal barriers to exercise? Individuals' (4), regarding changes in ______________.
1. perceptions,
2. thoughts,
3. beliefs and
4. emotions
regarding changes in **exercise behavior**
333
What does temperament as a personal barrier refer to?
self-esteem and attitudes about health
334
Why might new exercisers feel intimidated in a fitness environment?
they may perceive themselves as inept with equipment setup and activities, and compare themselves negatively to others
335
What is social physique anxiety?
negative feelings triggered by others’ evaluation of one’s body, leading to avoidance of exercise
336
Why are individuals with low self-esteem less likely to exercise?
they do not feel good about themselves or believe they can exercise regularly
337
What is one of the most common personal barriers to exercise related to time?
exercise is not valued by the inactive individual; time spent exercising depends on the meaning and value they attach to it
338
Why do many parents have difficulty finding time to exercise?
they put the needs of their family ahead of their own
339
Why do many working individuals struggle to exercise?
work goals are often prioritized higher than activity goals
340
Why might retired individuals fail to use discretionary free time for exercise?
they often fill time with volunteering, caring for grandchildren, or being of service to others
341
What is a common personal barrier related to energy?
lack of energy, especially among working individuals and parents of young children
342
How can physical ailments act as a personal barrier?
chronic illness and chronic pain can interfere with regular physical activity
343
What personal barrier is related to fear?
fear of injury during exercise or knowing someone who has been injured while exercising
344
Why do older or frail individuals often avoid activity?
they fear falling while participating in physical activity
345
What is inertia as a barrier to exercise? Beliefs such as... (3)
beliefs such as 'I won’t like it,' 'I don’t know how,' or 'I’m too old'
346
Who are the least likely to start exercising, even with medical referral?
those accustomed to a sedentary lifestyle
347
Why might isolation be a barrier to exercise?
many adults do not want to exercise alone
348
Which adults (2) tend to participate less in exercise due to isolation?
adults who
1. have recently lost a spouse or
2. have mobility deficits
349
What is a barrier caused by misconceptions about exercise?
limited exposure, experience, and education about physical activity and exercise
350
What are environmental barriers to exercise?
social and environmental factors that impede an individual’s ability to change behavior toward exercise
351
What are (2) examples of access barriers to exercise?
1. lack of transport or safe access to and from fitness facilities
2. inability to afford fitness facility fees
352
Why is physician advice considered an environmental barrier?
many physicians neglect to ask about nutrition and activity levels, giving the impression they are not important
353
Why do most physicians fail to provide good fitness advice?
they do not have adequate knowledge in fitness and nutrition
354
Why is it concerning that health care providers themselves are a high-risk group?
they often have poor lifestyle habits and higher mortality rates
355
How has technology contributed to a less active population?
devices and machines now do many tasks that used to burn significant calories when performed by humans
356
How have smartphones, computer games, and social media affected children’s activity levels?
they have significantly reduced how much activity children participate in
357
What are (4) ways work can create barriers to exercise?
1. more entrepreneurs working longer hours
2. economic downturns/cutbacks causing fewer workers to do more work
3. commuting time cutting into leisure and exercise time
4. telecommuting encouraging more snacking and less leisure activity
358
What family trends create barriers to exercise? (4)
1. more dual-income families
2. more single-parent families
3. more women in the workforce
4. more children responsible for self-care
359
What are specific fitness environment barriers? Hint: barriers created by ________, ____, ____, or ____________.
barriers created by the physical environment, programming, staff, or climate of the fitness facility
360
What are 3 examples of physical environment barriers in a fitness facility?
1. large number of mirrors,
2. windows into exercise areas, and
3. equipment positioned close together
361
What are programming barriers in a fitness facility?
1. 'one size fits all' programming,
2. large group activities that intimidate sedentary individuals,
3. loud music, bright lights, and a busy atmosphere
362
How can staff members of a fitness facility unintentionally discourage new exercisers?
very fit staff may intimidate them, or a 'hard-core' military approach may discourage them
363
What are climate-related barriers to exercise?
inclement weather and unsafe outdoor conditions in northern climates, and high humidity or extreme heat in warm climates
364
How can exercise intensity itself be a barrier?
activity intensity may exceed the sedentary individual’s current fitness, energy, or functional capacity
365
How does lack of instruction act as a barrier?
without attention, instruction, and encouragement, sedentary individuals are further discouraged from exercising
366
What are the six fundamental components of physical fitness?
1. cardiovascular (cardiorespiratory) fitness
2. muscular strength
3. muscular endurance
4. flexibility and range of motion
5. body composition
6. muscular power
367
What is cardiovascular fitness also referred to as? (2)
aerobic fitness or cardiorespiratory capacity
368
How is cardiovascular fitness defined?
the ability of the heart and lungs to effectively deliver oxygen to working muscles for a prolonged period of time
369
How is cardiovascular fitness typically measured?
by the maximum volume of oxygen that can be delivered to one kilogram of body weight (Max VO2)
370
What other aspects are included in cardiovascular fitness? (4 types of training)
1. steady-state training
2. interval training,
3. anaerobic/lactate threshold, and
4. metabolic conditioning
371
How is muscular strength defined?
the maximal amount of force or tension generated in one contraction by one muscle or muscle group
372
Why is muscular strength important?
it is necessary to sustain movements in daily living and in sport and exercise
373
How is muscular endurance defined?
the ability of a muscle or muscle group to sustain muscular work over time at a submaximal load
374
Why is muscular endurance essential?
to maintain posture and alignment during activities
375
How is flexibility defined?
healthy mobility and ease of movement within a joint’s given range of motion
376
What factors affect flexibility and range of motion? (5)
1. genetics,
2. gender,
3. strength,
4. age, and
5. activity level
377
Why is body composition significant for health and fitness? More specifically
1. what does it measure?
2. what does it help reduce risks of (3)
1. it measures lean body weight (bone, muscle) and body fat,
2. helping reduce risks of
a) osteoporosis,
b) insulin resistance, and
c) obesity-related conditions
378
What is muscular power defined as?
the contractile velocity of a muscle or muscle group, requiring both speed and strength
379
How is muscular power measured?
as work or effort over time
380
How are strength and power related?
they are quantitatively related but are separate physical parameters of muscle fitness
381
What is another term for cardiovascular fitness?
aerobic fitness or cardiorespiratory capacity
382
How is cardiovascular fitness measured in detail?
by the maximum amount (volume) of oxygen delivered to one kilogram of body weight, known as Max VO2
383
What 4 additional factors are included in cardiovascular fitness assessment? Hint: 4 types of training
1. steady-state and
2. interval training,
3. anaerobic or lactate threshold, and
4. metabolic conditioning
384
How is muscular strength defined?
the maximal force or tension generated in one contraction by one muscle or muscle group
385
What does muscular strength reflect? Hint: How well the…
how well the nervous and muscular systems generate internal force to move an external force
386
Why is adequate muscular strength necessary?
to sustain movements in daily living, sport, and exercise
387
How is muscular endurance defined?
the ability of a muscle or muscle group to sustain work over time at a submaximal load
388
Why is muscular endurance essential?
to maintain posture and alignment during activities
389
How is flexibility defined?
healthy mobility and ease of movement within a joint’s range of motion
390
What 5 factors influence flexibility and range of motion?
1. genetics,
2. gender,
3. strength,
4. age,
5. activity level
391
Why is body composition an important measure?
1. It goes beyond ____,
2. affecting risks for (3)
1. it goes beyond aesthetics, reflecting lean body weight (bone, muscle) vs body fat,
2. affecting risks for
a) osteoporosis,
b) insulin resistance, and
c) obesity-related conditions
392
What are the health benefits of optimizing body composition? Reduced risk of (3)...
reduced risk of
1. osteoporosis,
2. insulin resistance, and
3. chronic diseases associated with obesity
393
How is muscular power defined?
Hint: It is the ________ of a muscle or group requiring both ____ and ____.
the contractile velocity of a muscle or group, requiring both speed and strength
394
How is muscular power measured?
as work or effort over time
395
What is the relationship between strength and power?
they are quantitatively related but remain distinct physical parameters
