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Cause of chronic Disease/ Hypokinetic Disease

sedentary lifestyle and poor diet

Physical Inactivity

automated society and leisure time is filled with sedentary behaviors.


Nutrient deficiencies and excess of nutrients

Life expectancy for men and women

men - 75.1 years
women - 80.2 years

Healthy life expectancy (HLE)

70 years, US ranked 24th by international World Health Organization (WHO).

Government Health Organizations

Department of Health and Human Services (HHS)
Centers for Disease Control and Prevention (CDC)
National Institutes of Health (NIH)

Reports of the Surgeon General US Public Health Service

1979 -> Healthy People
1988 -> Nutrition + Health
1996 -> Physical Activity and Health

Healthy People 2020 Topics and Objectives

updated every 10 years

HP 2020 Nutrition

-Healthier food access
-health care and worksite settings
-weight status
-food insecurity
-food and nutrient consumption
-iron deficiency.

HP 2020 Physical Activity

-Leisure time (PA increase)
- Aerobic and muscle strengthening activity (increase)
- PE and recess (increase)
- Screen time (reduce)
- Access to PA facilities
- Healthcare and worksite settings
- Active transportation (bike)
- Build environment


study of movement.
PA knowledge comes from:
- experience (watching or doing)
- scholarship (learning or studying)
- Professional practice (training or teaching)

Physical Activity

-bodily movement that is produced by skeletal muscles and substantially increases energy expenditure.
- limited to voluntary movement

Classifying Physical Activity

-Exercise: Training, health-related, therapeutic
-Skilled Movement: Sport, Developmental skills (crawl, walk, etc.)

Classifying Scholarly Study of Physical Activity

-Physiology of physical activity
-Philosophy of physical activity
-History of physical activity
-Sociology of physical activity
-Motor behavior
-Psychology of sport and exercise
-Biomechanics of physical activity

Classifying Professional Practice

-Health and fitness
-Sport Management
-Coaching and sport education
-Teaching physical education
-Therapeutic exercise

PA Guidelines for Adults

>150 min of moderate intensity or 75 min of vigorous intensity per week.
-time depends on intensity
-can be a combo
-episodes should be at least 10 min, at least 3x a week
-greater health benefits if doubled
Muscle strengthening activities on > 2 days a week that work all muscle growth.
-9-12 reps per muscle group

PA Guidelines for children (6-17)

> 60 min every day
-mostly moderate or vigorous intensity
vigorous intensity > 3 days/week
muscle and bone strengthening activity > 3 days/week

PA Guidelines for Older Adults (>65 years)

-follow adult guidelines if able
-include balance exercises
-strength and flexibility training are most important

PA Guidelines for Pregnant and Postpartum women

-follow moderate intensity guidelines, unless already doing vigorous activity
-spread throughout week
-do not do exercises laying on back

Tips for meeting guidelines

-short workouts (even just 10 min, take stairs)
-mix it up
-set year schedule
-gym isn't necessity
-make it a family affair
-choose exercises you enjoy
-join a league or team

Physical Activity Assessment

pedometers, questionnaires, and PA records

Physical Fitness Assessment

2 types of physical fitness
- health-related
-sport/skilled related

Health-related physical fitness assessment

-cardiorespiratory endurance (ability of heart/lungs)
-muscular strength (ability of muscles to provide force)
-muscular endurance (# of repetitions muscles can do)
-flexibility (range of motion)
-body composition (% of fat, muscle, and water)

Sport/Skill related physical fitness assessment

-agility (ability to quickly and easily change directions)
-balance (maintain equilibrium)
-coordination (coordinating senses to movement)
-power (strength and speed)
-speed (ability to move quickly)
-reaction time (responding to stimulus)

Fundamental principles of assessment

- fitness and functional capacity testing
- diagnostic testing
• the gold standard: definitive measure, most accurate
• error of measurement: should be recorded in results

Pre- Assessment Screening (Informed consent)

• purpose of assessment
• procedures
• potential risks/discomforts
• potential benefits
• alternative (if any)
• responsibilities of client
• encouragement of questions
• confidentiality
• client can stop any time

Pre- Assessment Screening (health history questionnaire)

• risk stratification
• recommendation for medical exam
• constraints for exercise

Cardiorespiratory Endurance - Assessing

-resting heart rate
-VO2 max
• gold standard - maximal exercise test
• submax test
• step test
• one mile walking test
• 1.5 mile running test

Assessing Muscular Strength and Endurance

• gold standard - one repetition maximum (I-RM)
• grip strength using dynamometer
• 20 - RM tests
• YMCA sub-maximal bench press test
• partial curl up test
• push-up test

Assessing Flexibility

-Gold standard - assess ROM using goniometer
-shoulder flexibility test
-sit and reach test
• excellent (reached well past toes)
• good (reached to toes)
• fair (up to 4" from toes)
• poor (more than 4" from toes)

Assessing Body Composition

-Body Composition
• fat mass: - essential fat, - storage fat (excess)
• fat-free mass: -bone, muscle, water, organs
-Bod Pod
-Gold Standard (DXA)
• lowest margin of error
-Skin-fold Testing
• quick, cheap, and easy
-Underwater Weighing
• fat lighter than muscle
• breathe out and submerge
-Bioelectrical Impedance
• sends electrical current through body
• depends on hydration status

Food + Nutrition: Experience

- Growing food (or know where it comes from)
- Selecting and purchasing food (what and when to purchase it)
- Preparing food
- Serving food (make it appealing)
- Consuming food

Food + Nutrition: scholarly study -> Nutrition

- Basic Nutrition
- Advanced Nutrition
- Lifespan Nutrition
- Medical Nutrition Therapy
- Community Nutrition

Food + Nutrition: scholarly study -> Foods

-Food Science
• Food preparation
• Food chemistry and microbiology
• Food technology
-Food Service
• Food production
• Food systems management

Registered Dietician (RD)

nationally recognized title for nutrition expert that requires:
-academic training
-supervised practice
-national credential exam


no requirements

Areas of professional practice for RDs

Clinical (56%)
- acute care/inpatient (hospital) - 30%
- ambulatory care (check ups) - 17%
- long-term care (rehabilitation) - 9%
Food and Nutrition Management (12%)
Community (11%)
Consultant and Business (8%)
Education and Research (7%)

RDs Salary

median annual income: $58,000

Becoming a Professional (RD)

-Undergraduate degree
-Mastery of specialized professional education
• Field work/volunteer work
• Internships
• License/Certification
-Graduate degree

Nutritional Assessment

Anthropometry - bone density, skin folds, etc.
Biochemical Indicators - measurements of nutrient values
Clinical Evaluation - signs and symptoms
Dietary Assessment - analysis software of diet

Dietary Assessment

• Gold standard: weighed food record
• Written food record: write down as you are consuming
• 24 Hour Recall - Interview person what they ate in the last 24 hours (low validity = only one day).
• Food Frequency Questionnaire - how often you eat certain foods

Dietary Guidelines for Americans: Overarching Concepts

- Maintain calorie balance
- Focus on nutrient-dense foods
- Meet nutrient needs (primarily through foods)

Dietary Guidelines for Americans: Foods/Nutrients to Reduce

• sodium: <2,300 mg/d
• Trans Fat (AVOID)
• Saturated Fat: <10% of calories
• Cholesterol: <300 mg/d
• Empty calories - solid fats and added sugars
• Refined grains - White bread
• Alcohol in moderation: 1 drink/day for women, 2 drinks/day for men.

Dietary Guidelines for Americans: Nutrients to increase

• fiber - 25-38g
• calcium
• vitamin D
• potassium - 4,700mg

Dietary Guidelines for Americans: Foods to increase

• Fruits and Vegetables
• Whole grains
• low-fat dairy products
• lean protein foods
• seafood
• oils to replace solid fats


- carbohydrate 45-65%
- fat 20-35%
- protein 10-35%


- Grains: "Make half your grains whole"
- Protein Foods: "Go lean w/ protein"
- Vegetables: "Vary your veggies"
- Fruits: "Focus on fruits"
- Dairy: "Get your calcium rich foods"
- Oils: "Know your limits on fats"
- Empty Calories: "Limit to 260 calories"

Diet Analysis Program: MyPyramid Tracker

• Online, links to resources, can track physical activity/energy balance, and simplicity
• Small database, can't add foods, recommendations based on 2005 guidelines, incomplete micronutrient info, and can't display nutrients for individual foods.

Diet Analysis Program: Nutrition Analysis Tool

• online, mobile access, provides info about nutrient functions/sources, and energy calculator
• small database, can't add foods, general recommendations based on age range/gender, incomplete micronutrient info, and only displays one report.

Diet Analysis Program: Fit Day

• online, large database, mobile access, can track physical activity, weight, mood, and measurements, can create custom foods
• incomplete nutrient info

Diet Analysis Program: The Food Processor 5QL

• Large database (35,000 foods, >150 nutrients), can add new foods, online version- food prodigy, nutrient search, and can track physical activity.
• have to purchase software

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