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Transcript
Maintaining Energy Balance and a Healthy Weight Obesity Gene http://www.nlm.nih.gov/medlineplus/vide os/news/fighting_fat_112211.html Medline Plus Fit vs Fat There is a discussion about fitness and fatness. The fit vs fat argument states that fitness is more important than fatness. Fit vs Fat The point is that fatness is a symptom of bad nutrition and physical activity. It has been stated that by focusing on the obesity epidemic, we are causing people to get fatter. Fit vs Fat This occurs because people try to diet away the fat and end up getting fatter. Most people who try to lose weight (fat) are unsuccessful (98% failure rate). Fit vs Fat The recommendation is that by focusing on the behaviors of eating nutritiously and increasing physical activity, the person will be healthier even if he/she doesn’t lose any weight. Fit vs Fat The contention is that a fat person who eats well and is physically activity is healthier from a disease risk standpoint than a leaner person who does not practice these behaviors. Fit vs Fat Additionally, it has been stated that most risk factors of disease associated with obesity can be reduced by eating better and becoming more active. Fit vs Fat Thoughts? Maintaining Energy Balance and a Healthy Weight Regular physical activity along with a nutritious diet is key to maintaining a healthy weight. Balance calories consumed and calories expended. U.S. Department of Health and Human Services Maintaining Energy Balance and a Healthy Weight In most individuals, weight gain results from a combination of excess calorie consumption and inadequate physical activity. U.S. Department of Health and Human Services Maintaining Energy Balance and a Healthy Weight An individual’s physical activities may account for as much as 15 to 40 percent of the calories burned each day. While vigorous exercise uses calories at a higher rate, any physical activity will burn calories. U.S. Department of Health and Human Services Maintaining Energy Balance and a Healthy Weight A 140-pound person can burn 175 calories in 30 minutes of moderate bicycling, and 322 calories in 30 minutes of moderate jogging. The same person can also burn 105 calories by vacuuming or raking leaves for the same amount of time. U.S. Department of Health and Human Services Body Composition Overweight and obese individuals have incorporated patterns of overeating and physical inactivity into to their lifestyles, while others have developed food and/or exercise addictions. Body Composition Many are lured by fad diets and exercise gimmicks, and some resort to extreme behaviors such as avoiding food, bingeing and purging, and exercising compulsively. Body Composition Since reduction of body fatness is a need or goal of many exercise program participants, exercise programs should be designed to aid in accomplishing this objective, and doing so sanely and rationally. Factors Influencing Body Composition Energy intake Energy output Genetics Caloric Balance Body composition is determined by a complex set of genetic and behavioral factors. Caloric Balance Though the contributing variables are many, the fundamental determinant of body weight and body composition is caloric balance. Caloric Balance Caloric balance refers to the difference between caloric intake and caloric expenditure. Caloric Balance The First Law of Thermodynamics states that energy is neither created nor destroyed; therefore, body weight is lost when caloric expenditure exceeds caloric intake (negative balance) and weight is gained when the opposite situation exists. Fat Management Energy in = energy out = no change in Energy in > energy out = get fatter Energy in < energy out = lose fat fatness Caloric Balance One pound of fat is equivalent to approximately 3500 kcal of energy. Caloric Balance Shifts in caloric balance will be accompanied by changes in body weight. The nature of the weight change varies markedly with the specific behaviors that lead to the caloric imbalance. Caloric Balance Fasting and extreme caloric restriction (starvation and semi-starvation diets) cause substantial losses of water and fat-free tissue. Caloric Balance An exercise-induced negative caloric balance results in weight loss consisting primarily of fat. Caloric Balance High resistance exercise programs may lead to a gain in fat-free weight. Cardiorespiratory endurance training usually results in a maintenance of fatfree weight. Caloric Balance Both types of programs can contribute to a loss of body fat, although aerobic activity is more efficient because it involves a sustained, high rate of energy expenditure. Body Composition It is recommended that both an increase in caloric expenditure through exercise and a decrease in caloric intake be used to accomplish this goal. Body Composition Exercise also helps maintain resting metabolic rate and thus the rate of weight loss. Body Composition Programs Adoption of a physically active lifestyle. Adoption of dietary guidelines. Dietary Guidelines Eat a variety of foods. Balance activity. Choose the food you eat with physical a diet with plenty of grain products, vegetables, and fruits. Dietary Guidelines Choose a diet low in fat, saturated fat, and cholesterol. Choose Choose a diet moderate in sugars. a diet moderate in salt and sodium. Dietary Guidelines If you drink alcoholic beverages, do so in moderation. Body Composition Programs Behavior modification techniques can help people make these lifestyle changes. Behavior Modification Exercise specialists, nutritionists, and psychologists need to work together to help their clients, especially obesity prone individuals, modify their physical activity and eating attitudes and behaviors. Physical Activity The initial exercise program should be based on low intensity and progressively longer duration physical activity. Physical Activity Work toward increasing the intensity to bring the person into a target heart rate range suitable for cardiorespiratory conditioning. Physical Activity The higher intensity will allow for a shorter duration per session, or fewer sessions per week for the same weekly energy expenditure. Physical Activity The transition to higher intensity exercise will increase the number of opportunities to incorporate activities that naturally require a high rate of energy expenditure. Physical Activity For many (especially older) obese subjects, a walking or other low intensity exercise program may be all they desire, and movement toward a more intense program may not be warranted. Recommendations The first step is to gain an understanding of why the person is overfat/obese. Consider genetics, social factors, psychological factors, nutrition patterns, hormones, and activity levels. Recommendations Attempt to determine if you are dealing with hypertrophic obesity or hyperplasic obesity. Recommendations Once you understand the potential causes of the problem, then focus on behaviors which can be changed: Better nutritional patterns Increased physical activity Incidental PA Aerobic exercise Resistance training Recommendations The optimal approach to fat loss combines a mild caloric restriction with regular endurance exercise and avoids nutritional deficiencies. To maintain LBM, resistive training should also be included. Recommendations A desirable fat loss program is one that meets the following criteria: Recommendations 1. Provides intake not lower than 1220 kcal/day for normal adults and ensures a proper blend of foods to meet nutritional requirements. (Note: this requirement may not be appropriate for children, older individuals, and athletes). Recommendations 2. Includes foods acceptable to the dieter in terms of socio-cultural background, usual habits, taste, costs, and ease in acquisition and preparation. Recommendations 3. Provides a negative caloric balance (not to exceed 500 to 1000 kcal/day), resulting in gradual weight loss without metabolic derangement, such as ketosis. Recommendations 4. Results in a maximal weight loss of 1 kg/week. Recommendations 5. Includes the use of behavior modification techniques to identify and eliminate diet habits that contribute to malnutrition or overconsumption. Recommendations 6. Includes an exercise program that promotes a daily caloric expenditure of 300 or more kcal. For many participants, this may be best accomplished with low intensity, long duration exercise, such as walking. Recommendations 7. Provides that new eating and physical activity habits can be continued for life in order to maintain the achieved lower body weight. Portion control, low fat diet, minimize simple CHO and increase PA Caution The balance between intensity and duration of exercise should be manipulated to promote a high total caloric expenditure (300 to 500 kcal per session and 1000 to 2000 kcal per week for adults). Caution Obese individuals are at an increased relative risk for orthopedic injury, and this may require that the intensity recommended for improvement of cardiorespiratory endurance. Caution Non-weight bearing activities (and/or rotation of exercise modalities) may be necessary and frequent modifications in frequency and duration may also be required. Setting Goals A healthy body weight is based on the client’s present FFM and % BF goal. Computing Target Wt assuming all wt. Loss is fat 1 Fill in boxes with double lines and compute others minus Goal % Fat* Current % Fat* by X Current Body Wt minus Current Fat Wt Current LBM Goal % LBM* Target Body Wt * % is expressed as a decimal. Divide by 100 before entering the data. Reminder Data by Blair (1999) demonstrates that fitness level counteracts many of the negative impacts of obesity. Reminder Those obese individuals who are active may have greater protection against disease than those of normal fatness who are inactive. 1/3 of the obese will not have other risk factors for early death. Reminder Fat can be fit (at least from a cardiovascular standpoint) However, that does not mean that it is OK (medically) to be fat. ACSM recommends eat 250 less per day expend (walk = 250 more per day 2.5 miles) 500 kcal per day reduction ACSM recommends do this 7 days a week = 3500 kcal in a week = 52 lbs in a year