Health Ed 110

January 8, 2014 What is Health?

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

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

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









February 10, 2014 Physical Activity Jody Virr

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