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CHAPTER OUTLINE The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Chapter 11 A Healthy Lifestyle The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer A Healthy Lifestyle Improving the quality, and most likely the length of life is a matter of personal choice Enhancing physical fitness alone is not sufficient to lower the risk for disease and ensure better health The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms Wellness: The constant and deliberate effort to stay healthy and achieve the highest potential for wellbeing; it integrates seven dimensions The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Wellness Lifestyle To enjoy a wellness lifestyle, a person has to practice behaviors that will lead to positive outcomes in the seven dimensions of wellness: physical, emotional, mental, social, environmental, occupational, and spiritual These dimensions are interrelated; one dimension frequently affects the others The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Lifestyle Habits to Live Healthier and Longer Be physically active Do not use tobacco Eat a healthy diet Maintain recommended body weight Sleep 7 to 8 hours each night Decrease stress levels Drink alcohol moderately or not at all Surround yourself with healthy relationships Be informed about the environment and avoid environmental risk factors Take personal safety measures The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Spiritual Well-Being Spirituality provides a sense of meaning and direction in life, a relationship to a higher being, freedom, prayer, faith, love, closeness to others, peace, joy, fulfillment, and altruism Prayer: sincere and humble communication with a higher power Altruism: true concern for and action on behalf of others (doing good for others is good for oneself, especially the immune system) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Causes of Death in the U.S. The leading causes of death in the U.S. are cardiovascular disease (38%), cancer (23%), chronic lower respiratory disease (5%), and accidents (4%) More than 60% are caused by cardiovascular disease and cancer and about 80% of these deaths are preventable through a healthy lifestyle program The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Actual Causes of Death in the U.S. Tobacco 435,000 Poor diet/inactivity 400,000 Alcohol 85,000 Microbial infections 75,000 Toxic agents 55,000 Motor vehicles 43,000 Firearms 29,000 Sexual behaviors 20,000 Drugs 17,000 Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer The top three causes of death in the U.S.— tobacco use, poor diet and inactivity, and alcohol abuse— are responsible for 920,000 deaths each year The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cardiovascular Diseases Any disease that affects the heart and the blood vessels Cardiovascular disease is the number one health problem in the U.S. About 20% of the U.S. population has some form of cardiovascular disease More than 60% of the people who die of heart disease die suddenly and unexpectedly The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Critical Thinking What are your feelings about your own risk for diseases of the cardiovascular system? Is this something that you need to concern yourself with at this point in your life? Why or why not? Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Coronary Heart Disease (CHD) The major form of cardiovascular disease In CHD the arteries that supply the heart with oxygen and nutrients are narrowed by fatty deposits such as cholesterol and triglycerides Narrowing of the coronary arteries diminishes blood supply to the heart muscle, which can precipitate a heart attack The Heart and Its Blood Vessels 11.5 The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Coronary Heart Disease (CHD) CHD accounts for 20% of all deaths and half of all cardiovascular deaths More than half of the people who died suddenly from CHD had no previous symptoms 80% of deaths from CHD in people under age 65 occur during the first heart attack The risk of death is greater in the least educated segment of the population Almost all risk factors are preventable and reversible The individual can reduce risk by participating in a healthy lifestyle program The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Major CHD Risk Factors Physical inactivity High blood pressure High body mass index Low HDL cholesterol High LDL cholesterol Elevated triglycerides Elevated homocysteine Inflammation Diabetes Abnormal electrocardiogram (ECG) Tobacco use Stress Personal and family history Age Gender The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Physical Inactivity Increasing physical activity reduces the overall risk for heart disease Improves aerobic endurance Decreases blood pressure Reduces body fat Lowers blood lipids Improves HDL cholesterol Helps control diabetes Increases and maintains good heart function Motivates toward smoking cessation Alleviates tension and stress Counteracts a personal history of heart disease The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms Blood pressure: A measure of the force exerted against the walls of the vessels by the blood flowing through them Systolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the forceful contraction (systole) of the heart; higher of the two numbers in blood pressure readings Diastolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the relaxation phase (diastole) of the heart; lower of the two numbers in blood pressure readings Hypertension: Chronically elevated blood pressure The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer High Blood Pressure The “silent killer” A blood pressure above 140/90 mm Hg Approximately 20% of Americans are hypertensive High blood pressure is a risk factor for CHD, congestive heart failure, strokes, kidney failure, and osteoporosis The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Treatment of High Blood Pressure Increase physical activity Weight control A low-salt/low-fat and high potassium/highcalcium diet Limit alcohol and caffeine intake Smoking cessation Stress management Medication The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Hypertension & Exercise Hypertensive people who are physically active have a lower risk of mortality from all causes than inactive individuals with normal blood pressure The death rates for unfit individuals with low systolic blood pressure are much higher than for highly fit people with high systolic blood pressure The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Effects of Aerobic Exercise on Blood Pressure An individual can expect exercise-induced reductions of approximately 3 to 5 mm Hg in resting systolic and diastolic blood pressures (both through aerobic exercise and strength training) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Excessive Body Fat (Obesity) Recognized as an independent risk factor for CHD A BMI of 30 or higher recognized as a major risk factor for coronary heart disease Risk factors such as high blood lipids, hypertension, and diabetes usually improve with weight loss and increased physical activity The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Abnormal Cholesterol Profile Blood lipids are carried in the bloodstream by molecules of protein known as High density lipoproteins (HDLs) Low density lipoproteins (LDLs) Very low density lipoproteins (VLDLs) Chylomicrons Standards for Blood Lipids 11.2 The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms High-density lipoproteins (HDLs): Cholesterol-transporting molecules in the blood (“good” cholesterol) that help clear cholesterol from the blood Low-density lipoproteins (LDLs): Cholesterol transporting molecules in the blood (“bad” cholesterol) that tend to increase blood cholesterol The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HDL Cholesterol HDL cholesterol acts as a “scavenger,” removing cholesterol from the body and preventing plaque from forming in the arteries For the most part, HDL cholesterol is determined genetically Generally, women have higher levels than men up to menopause (estrogen tends to raise HDL) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Ways to Increase HDL Cholesterol Habitual aerobic exercise (> 6 METs, 3 times/week for 20 min/session) Weight loss (if necessary) Niacin supplementation Quitting smoking Drug therapy The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer LDL Cholesterol Tends to release cholesterol, which then may penetrate the lining of the arteries and speed up the process of atherosclerosis The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Ways to Lower LDL Cholesterol Participate in a regular aerobic exercise program Lose body fat (if necessary) Choose a diet low in fat, saturated fat, and cholesterol Replace saturated with unsaturated fats (saturated fat consumption should be under 7% of the total daily caloric intake) Limit dietary cholesterol consumption to less than 200 mg per day Consume 25 to 38 grams of fiber per day, including a minimum of 10 grams of soluble fiber The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Ways to Lower LDL Cholesterol Consume 25 grams of soy protein a day Consume red meats fewer than three times per week, consume no organ meats (liver, kidneys) Eat fish instead of red meat Do not eat commercially baked foods Avoid foods that contain transfatty acids, hydrogenated fat, or partially hydrogenated vegetable oil Drink low-fat milk (1% or less) and choose low-fat dairy products The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Ways to Lower LDL Cholesterol Limit egg consumption to less than 3 eggs per week Bake, broil, grill, poach, or steam food instead of frying Refrigerate cooked meat before adding to other dishes; remove fat hardened in the refrigerator before mixing meat with other foods Avoid fatty sauces made with butter, cream, or cheese Consider drug therapy if the above fail to decrease LDL cholesterol The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Elevated Triglycerides Also known as free fatty acids Contribute to atherosclerosis Are carried in the bloodstream primarily by very low density lipoproteins (VLDLs) and chylomicrons Found in poultry skin, lunch meats, and shellfish Manufactured mainly in the liver, from refined sugars, starches, and alcohol The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Ways to Lower Triglycerides Cut down on high-triglyceride foods Decrease overall fat consumption Quit smoking Reduce weight (if necessary) Participate in aerobic exercise The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Homocysteine Clinical data indicates that many heart attack and stroke victims have normal cholesterol levels Homocysteine is an intermediate amino acid in the interconversion of two other amino acids: methionine and cysteine This interconversion requires the B vitamin folate (folic acid) and vitamins B6 and B12 The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Homocysteine Homocysteine accumulation may: Cause damage to the inner lining of the arteries Stimulate the proliferation of cells that contribute to plaque formation Encourage clotting, which may completely obstruct an artery The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Homocysteine A large number of people have high blood levels of homocysteine due to a Genetic inability to metabolize homocysteine Deficiency in the vitamins required for its conversion Five servings of fruits and vegetables daily can provide sufficient levels of folate and vitamin B6 to remove and clear homocysteine from blood The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Homocysteine Vitamin B12 is found primarily in animal flesh and animal products Vitamin B12 deficiency is rarely a problem (1 cup of milk or an egg provides the daily requirement) The body recycles most of this vitamin, thus, a deficiency takes years to develop The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Inflammation Scientists are looking at inflammation as a major risk factor for heart attacks Low-grade inflammation can occur in a variety of places throughout the body For years it has been known that Inflammation plays a role in CHD Inflammation hidden deep in the body is a common trigger of heart attacks, even when cholesterol levels are normal or low and arterial plaque is minimal The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer C-Reactive Protein (CRP) A protein whose blood levels increase with inflammation Physicians have turned to CRP to evaluate ongoing inflammation in the body People with elevated CRP are more prone to cardiovascular events The risk of a heart attack is even higher in people with both elevated CRP and cholesterol, resulting in an almost 9-fold increase in risk 11.3 Homocysteine Guidelines Relationships among C-Reactive Protein and Cholesterol and Risk of Cardiovascular Disease The hs-CRP (for high-sensitivity CRP) test is used to measure inflammation in the blood vessels 11.7 The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer C-Reactive Protein Levels decrease with statin drugs Also helpful are exercise, weight loss, proper nutrition, and aspirin Omega-3 fatty acids inhibit proteins that cause inflammation Excessive intake of alcohol and high protein diets increase CRP Aspirin therapy may also help control inflammation The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes A condition in which blood glucose is unable to enter the cells because The pancreas totally stops producing insulin The pancreas does not produce enough to meet the body’s needs The cells develop insulin resistance The role of insulin is to “unlock” the cell to escort glucose into the cell Diabetes affects more than 17 million people in the U.S. The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes People with chronically elevated blood glucose levels may have problems metabolizing fats, which can make them more susceptible to Atherosclerosis, coronary heart disease, heart attacks, high blood pressure, and strokes Diabetics also have lower HDL cholesterol and higher triglyceride levels The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes An 8-hour fasting blood glucose level above 126 mg/dl on two separate tests confirms a diagnosis of diabetes A level of 126 or higher should be brought to the attention of a physician The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms Type 1 Diabetes: Insulin-dependent diabetes (IDDM) Also called juvenile diabetes The pancreas produces little or no insulin Type 2 Diabetes: Noninsulin-dependent diabetes (NIDDM) The pancreas either does not produce sufficient insulin or it produces adequate amounts but cells become insulinresistant Accounts for 90 to 95% of all diabetes cases The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes Although diabetes has a genetic predisposition, type 2 is related to Overeating, obesity, and lack of physical activity Once limited primarily to overweight adults Now accounts for almost half of new cases in children More than 80% of all type 2 diabetics are overweight or have a history of excessive weight In most cases, type 2 can be corrected through Diet, weight loss, and regular exercise The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes Both moderate and vigorous physical activity are associated with increased insulin sensitivity and decreased risk for diabetes The key to increase and maintain proper insulin sensitivity is regularity of the exercise program The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Diabetes A healthy diet is beneficial High in complex carbohydrates and water-soluble fibers (found in fruits, vegetables, oats, and beans) Low in saturated fat and sugar Aggressive weight loss, especially if combined with exercise, often allows diabetic patients to normalize blood sugar level without the use of medication The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Metabolic Syndrome As cells resist insulin’s action, the pancreas releases even more insulin in an attempt to keep blood glucose from rising A chronic rise in insulin appears to trigger a series of abnormalities referred to as metabolic syndrome or syndrome X These abnormal conditions include Low HDL cholesterol, high triglycerides, an increased blood clotting mechanism, and high blood pressure The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Metabolic Syndrome Syndrome X people should distribute daily caloric intake so that 45% of the calories are derived from carbohydrates (primarily low-glycemic) 40% from fat (30 to 35% mono- and polyunsaturated fats, and 5 to 10% saturated fat) 15% from protein Syndrome X patients also benefit from Weight loss (if overweight) Exercise Smoking cessation Electrocardiogram (ECG): Provides a record of the electrical impulses that stimulate the heart to contract The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Stress Electrocardiogram Also known as a graded exercise stress test or a maximal exercise tolerance test A stress ECG reveals the tolerance of the heart to increased physical activity The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Stress ECG Guidelines Men over age 45 and women over age 55 A total cholesterol level above 200 mg/dl or an HDL cholesterol below 35 mg/dl Hypertensive and diabetic patients Cigarette smokers People with an abnormal resting ECG Individuals with a family history of CHD, syncope, or sudden death before age 60 All individuals with symptoms of chest discomfort, dysrhythmias (abnormal heartbeat), syncope, or chronotropic incompetence (heart rate that increases slowly during exercise and never reaches maximum) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Tobacco Use 48 million Americans smoke cigarettes Smoking causes between 430,000 and 440,000 annual deaths in the U.S. Some 37,000 yearly deaths from heart disease are attributed to secondhand smoke The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Smoking In relation to CHD Smoking speeds up the process of atherosclerosis Causes a threefold increase in the risk of sudden death following a myocardial infarction As far as the extra load on the heart is concerned, giving up one pack of cigarettes per day is the equivalent of losing between 50 and 75 pounds of excess body fat! The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Smoking Increases heart rate Raises blood pressure Irritates the heart, increasing the risk of fatal cardiac arrhythmias Decreases HDL cholesterol The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Critical Thinking Cigarette smoking is the largest preventable cause of premature illness and death in the United States. Do you think the government should outlaw the use of tobacco in all forms? Or does the individual have the right to engage in selfdestructive behavior? Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Stress People who are not able to relax have a constant low-level strain on the cardiovascular system that could manifest itself in heart disease Take control: examine and act upon the things that are most important, ignore less meaningful details One way is to identify the sources of stress and learn how to cope with them The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Stress The human body responds to stress by producing more catecholamines to prepare the body for fight or flight If the person fights or flees, the body metabolizes the higher levels of catecholamines and is able to return to a normal state Physical activity is one of the best ways to relieve stress When a person takes part in physical activity, the body metabolizes excess catecholamines and is able to return to a normal state The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Personal and Family History Individuals who have a personal or family history of cardiovascular problems are at higher risk for disease than those who have never had a problem People with such history should control other risk factors as much as they can Most risk factors are reversible, so they can greatly decrease the risk for future problems The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Age and Gender Age is a risk factor because of the higher incidence of heart disease in older people This tendency may be induced partly by other factors stemming from changes in lifestyle as we get older (less physical activity, poor nutrition, obesity) Earlier in life, men are at greater risk for cardiovascular disease Following menopause, the risk for women increases Risk factor management and positive lifestyle habits are the best means of slowing down the aging process and preventing cardiovascular disease Heart Disease The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms Cancer: Group of diseases characterized by uncontrolled growth and spread of abnormal cells Benign: Noncancerous Malignant: Cancerous Deoxyribonucleic acid (DNA): Genetic substance of which genes are made; molecule that contains cell’s genetic code Ribonucleic acid (RNA): Genetic material that guides the formation of cell proteins Angiogenesis: Formation of blood capillaries Metastasis: The movement of cells from one part of the body to another The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cancer Development More than 100 types of cancer can develop in the body Normally, the DNA molecule is duplicated perfectly during cell division Occasionally cells with defective DNA keep dividing and ultimately form a small tumor As more mutations occur, the altered cells continue to divide and can become malignant A decade or more can pass between carcinogenic exposure or mutations and the time cancer is diagnosed The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cancer Development To grow, a cancer tumor requires more oxygen In time, a few of the cancer cells start producing chemicals that enhance angiogenesis Through the new blood vessels, cells break away from a malignant tumor and migrate to other parts of the body (metastasis), where they can cause new cancer Although the immune system and the blood turbulence destroy most cancer cells, only one abnormal cell lodging elsewhere can start a new cancer Once cancer cells metastasize, treatment becomes more difficult The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cancer-Causing Factors As much as 80% of all human cancer is related to lifestyle or environmental factors Diet Obesity Tobacco use Sedentary lifestyle Excessive use of alcohol Exposure to occupational hazards The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Guidelines for Preventing Cancer Get proper nutrition Abstain from tobacco Avoid excessive sun exposure Monitor estrogen, radiation exposure, and potential occupational hazards Engage in physical activity Maintain recommended body weight Follow guidelines for cancer-related checkups (Table 11.5) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Dietary Guidelines Predominately a vegetarian diet (high in fiber and low in fat) Should include a variety of fruits and vegetables, in particular cruciferous vegetables The use of tea, soy products, calcium, and omega-3 fats is encouraged Adequate fiber intake is recommended (25 to 38 gr/day) Protein intake should be kept within the recommended guidelines Alcohol, if used at all, should be consumed in moderation (1 to 2 servings per day) Grilling of meats at high temperatures is discouraged The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Dietary Guidelines Consume ample amounts of fruits and vegetables which are high in antioxidants and phytochemicals Antioxidants seem to Absorb free radicals before they can cause damage Interrupt the sequence of reactions once damage has begun Phytochemicals (plant chemicals) seem to prevent cancer by blocking the formation of cancerous tumors and disrupting the process at almost every step of the way The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Abstain from Tobacco Use The biggest carcinogenic exposure in the workplace is cigarette smoke Of all cancers, at least 30% are tied to smoking, and 87% of lung cancers are tied to smoking Use of smokeless tobacco increases the risk for mouth, larynx, throat, and esophageal cancers The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Avoid Excessive Sun Excessive exposure to ultraviolet radiation (both UVB and UVA rays) contributes to skin cancer 1 in every 6 Americans will develop some type of skin cancer The most common sites of skin cancer are those areas exposed to the sun most often (face, neck, and back of the hands) Nearly 90% of the almost one million yearly cases of basal cell or squamous cell skin cancers in the U.S. could be prevented by protecting the skin from the sun Melanoma is the most deadly form of skin cancer, causing 7,600 yearly deaths The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Avoid Excessive Sun Tanning of the skin is the body’s natural reaction to permanent damage from too much sun Even small doses of sunlight add up to a greater risk for skin cancer and premature aging Avoid sun exposure between 10:00 am and 4:00 pm Sun lamps and tanning parlors provide mainly ultraviolet A rays (UVA) and have been linked to melanoma The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Avoid Excessive Sun Apply sunscreen lotion about 30 minutes before lengthy exposure to the sun A sun protection factor (SPF) of at least 15 is recommended When swimming or sweating, reapply waterproof sunscreens often (sunscreens lose strength when diluted) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Maintain Physical Activity An active lifestyle seems to have a protective effect against cancer Cancer mortality in active men and women is lower A daily 30-minute moderate-intensity exercise program lowers the risk for colon cancer and may lower the risk for cancers of the breast and reproductive system The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Warning Signals of Cancer Change in bowel or bladder habits Sore that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Critical Thinking You have learned about many of the risk factors for major cancer sites. How will this information affect your health choices in the future? Will it be valuable to you, or will you quickly forget all that you have learned and remain in a contemplation stage at the end of this course? Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Substance Abuse Chemical dependency presently encompasses some of the most self-destructive behaviors in society Almost anything can be addictive (work, shopping, television, the Internet, computer games, gambling, pornography, sex, exercise, food, drugs) The most serious types of chemical dependency include alcohol, tobacco, and illegal substances such as marijuana, cocaine, methamphetamine, MDMA (ecstasy), and heroin The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Alcohol Alcohol abuse is one of the most significant healthrelated drug problems in the U.S. Alcohol intake impedes peripheral vision, impairs the ability to see and hear, decreases reaction time, hinders concentration and motor performance, and causes impaired judgment of distance and speed of moving objects Alcohol use also lessens fear, increases risk-taking behaviors, stimulates urination, and induces sleep The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Health-Consequences of Alcohol Abuse Cirrhosis of the liver Oral, esophageal, and liver cancer Cardiomyopathy High blood pressure Increased risk for strokes Brain-cell damage Inflammation of the esophagus, stomach, small intestine, and pancreas Stomach ulcers Sexual impotence Malnutrition Depression, psychosis, and hallucinations The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Marijuana Most widely used illegal drug in the U.S. Low doses yield a sedative effect Larger doses produce physical and psychic changes Short-term effects include Tachycardia, difficulty in concentration, decreased coordination, memory impairment, confusion, increased heart attack risk Long-term effects include The amotivational syndrome, brain atrophy, brain damage, immune system dysfunction, chronic bronchitis, lung cancer, sterility, impotence The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cocaine 2.7 million people are chronic users and 3 million are occasional users 20% of first time users will become addicted Addiction becomes a lifetime nightmare Popularity based on the almost immediate feeling of euphoria Sustained cocaine snorting can lead to a constant runny nose, nasal congestion and inflammation, and perforation of the nasal septum The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Cocaine Long-term consequences of cocaine use in general include loss of appetite, digestive disorders, weight loss, malnutrition, insomnia, confusion, anxiety, and cocaine psychosis (characterized by paranoia and hallucinations) Large overdoses of cocaine can end in sudden death from respiratory paralysis, cardiac arrhythmias, and severe convulsions For individuals who lack an enzyme used in metabolizing cocaine, as few as two to three lines of cocaine may be fatal The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Methamphetamine Fastest growing drug problem in the U.S. A central nervous system stimulant Primary effect Produces a feeling of well-being and increased motor activity Decreases appetite, fatigue, and sleep Chronic users experience Inflammation of the heart lining, schizophrenia-like mental disorder, and brain-cell damage Users are frequently involved in violent crime, homicide, and suicide The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer MDMA (Ecstasy) Most common club drug in the U.S. A stimulant and hallucinogenic drug Promoted as a drug that increases energy, pleasure, and self-confidence Users may experience Faintness, blurred vision, chills, sweating, nausea, muscle tension, and teeth-grinding Long-term effects include Confusion, depression, sleep disorders, anxiety, aggression, paranoia, and verbal and visual memory impairment The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Heroin A sedative drug synthesized from morphine (opium) An extremely addictive and tolerance-developing drug Induces an almost immediate state of euphoria An overdose can cause convulsions, coma, and death Short-term use symptoms include Bone and muscle pains, muscle spasms and cramps, runny nose and eyes, drowsiness, slurred speech, nausea, and violent yawning Long-term symptoms include Hallucinations; nightmares; constipation; sexual difficulties; and increased risk for lung, liver, and cardiovascular disease SIDS is more frequently seen in children born to addicted mothers The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Treatment of Addiction Recognize that there is a problem Recovery almost always requires professional help Consult a physician, counseling center, or local mental health clinic Contact the National Center for Substance Abuse Treatment at 1-800-662-HELP for 24-hour substance abuse treatment centers in your area Successful treatment includes psychotherapy, medical care, and behavior modification The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Sexually Transmitted Diseases Have reached epidemic proportions in the U.S. 25% of all Americans will acquire at least one sexually transmitted disease (STD) in their lifetime Each year, more than 15 million people in the U.S. are newly infected with STDs More than 68 million Americans have an incurable STD The highest rate of STD infections are seen in young people between the ages of 16 and 24 The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Key Terms Acquired immunodeficiency syndrome (AIDS): Any of a number of diseases that arise when the body’s immune system is compromised by HIV Human immunodeficiency virus (HIV): Virus that leads to acquired immunodeficiency syndrome (AIDS) Opportunistic infections: Diseases that arise in the absence of a healthy immune system, which would fight them off in healthy people The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HIV and AIDS Upon infection, the HIV virus multiplies, attacks, and destroys white blood cells White blood cells are part of the immune system that fights infections and diseases As the number of white blood cells killed increases, the body’s immune system gradually breaks down or may be completely destroyed Without the immune system, a person becomes susceptible to various opportunistic diseases and cancers HIV infection is determined through an HIV antibody test The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HIV and AIDS HIV is a progressive disease At first, people who become infected with HIV might not know they are infected An incubation period of weeks, months, or years may pass during which no symptoms appear The virus may live in the body 10 years or longer before symptoms emerge The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HIV and AIDS As the infection progresses to the point at which certain diseases develop, the person is said to have AIDS HIV itself doesn’t kill, nor do people die of AIDS AIDS is the term designating the final stage of HIV infection Death is caused by a weakened immune system that is unable to fight off opportunistic diseases The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HIV and AIDS People do not get HIV because of who they are but because of what they do HIV and AIDS can threaten anyone, anywhere; nobody is immune to HIV The two most risky behaviors for HIV transmission are: Having unprotected vaginal, anal, or oral sex with an HIV-infected person Sharing hypodermic needles or other drug paraphernalia with someone who is infected The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer HIV and AIDS Treatment HIV infection and AIDS have no known cure The best advice is to take a preventive approach Medications are available that Delay the progress of infection and allow HIV-infected patients to live longer May keep some people from developing AIDS The sooner the treatment is initiated, the better the prognosis for a longer life Developing a vaccine to prevent HIV infection or AIDS seems highly unlikely within the next few years The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Risky Behaviors for STDs (including HIV) Multiple or anonymous sexual partners such as a pick-up or prostitute Anal sex with or without a condom Vaginal or oral sex with someone who shoots drugs or engages in anal sex Sex with someone you know has had several sex partners Unprotected sex (without a condom) with an infected person Sexual contact of any kind with anyone who has symptoms of AIDS or who is a member of a group at high risk for AIDS Sharing toothbrushes, razors, or other implements that could become contaminated with blood with anyone who is, or might be, infected with the HIV virus The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Quackery & Fraud The conscious promotion of unproven claims for profit The rapid growth of the fitness and wellness industry during the last three decades has spurred the promotion of fraudulent products that deceive consumers into “miraculous,” quick, and easy ways to achieve total well-being The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Guidelines to Select a Health/Fitness Facility Make sure the facility complies with the standards established by the American College of Sports Medicine (ACSM) for health and fitness facilities Examine all exercise options in your community Health clubs/spas, YMCAs, gyms, colleges, schools, community centers, senior centers Check to see if the facility’s atmosphere is pleasurable and nonthreatening to you Analyze costs versus facilities, equipment, and programs The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Guidelines to Select a Health/Fitness Facility Find out what types of facilities are available Walking/running track, basketball/tennis/racquetball courts, aerobic exercise room, strength training room, pool, locker rooms, saunas, hot tubs, facility access Check the aerobic and strength-training equipment available Consider the location Is the facility close to your home? Check on times the facility is accessible Work out at the facility several times before becoming a member The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Guidelines to Select a Health/Fitness Facility Inquire about the instructor’s qualifications Consider the facility’s approach to fitness Does it include all healthrelated components of fitness? Ask about supplementary services Fitness assessments, blood chemistry analysis, health/wellness seminars The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Personal Trainer An exercise specialist who works one-on-one with an individual and is typically paid by the hour or exercise session Exercise sessions are usually conducted at a health/fitness facility or at the client’s own home Currently, anyone who prescribes exercise can call him/herself a personal trainer without proof of education, experience, or certification Personal trainers should have an undergraduate degree in a fitness-related area and certification from a reputable health/fitness organization (ACSM, IDEA, NSCA) The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Purchasing Exercise Equipment Do not buy equipment for purported benefits if you do not enjoy the activity Try it out several times before making the purchase Consider quality Look for signs of wear and tear on similar units Consider maintenance costs (cheaper units may not be a wise investment) Exercise equipment is valuable for people who prefer to exercise indoors Watch out for expensive gadgets Monitors that provide exercise heart rate, work output, caloric expenditure, speed, grade, and distance may help motivate you But monitors are expensive, need repairs, and do not enhance the actual fitness benefits of the workout 11.10 Relationships among Physical Work Capacity, Aging, and Lifestyle Habits The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Critical Thinking Are there people around you that you admire and would like to emulate for their wellness lifestyle? What behaviors do these people exhibit that would help you adopt a healthier lifestyle? What keeps you from emulating these behaviors, and how can you overcome these barriers? Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Lifetime Fitness & Wellness The real challenge: a lifetime commitment to fitness and wellness The Seven Dimensions of Wellness “ Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer For every runner who tours the world running marathons, there are thousands who run to hear the leaves and listen to the rain, and look to the day when it is all suddenly as easy as a bird in flight. For them, sport is not a test but a therapy, not a trial but a reward, not a question but an answer.” The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases An Educated Fitness/Wellness Consumer Lifetime Fitness & Wellness Fitness and wellness is a process that requires a constant and deliberate effort to achieve and maintain a higher quality of life Improving the quality of your life, and most likely your longevity, is in your hands Only you can take control of your lifestyle and thereby reap the benefits of wellness Thank You