1 / 50

Health-Enhancing Behaviors

Health-Enhancing Behaviors. Exercise. Types of Exercise. Aerobic Exercise Elevated heart rate and respiration Weight training Resistance important for development of lean muscle mass Increased activity Increasing daily movement to improve fitness. Benefits of Exercise - Physiological.

kquillen
Download Presentation

Health-Enhancing Behaviors

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Health-Enhancing Behaviors

  2. Exercise

  3. Types of Exercise • Aerobic Exercise • Elevated heart rate and respiration • Weight training • Resistance important for development of lean muscle mass • Increased activity • Increasing daily movement to improve fitness

  4. Benefits of Exercise - Physiological • Increases in cardiovascular fitness and endurance • 30-minute/day decreases the risk of chronic disease • Improved circulation • Strengthens bones and increases joint flexibility • Improves digestion and fat metabolism • Increases muscle strength and tone • Increased longevity • by age 80, the amount of additional life attributable to aerobic exercise is between 1 and 2 years

  5. Benefits of Exercise - Psychological • Psychological Effects of Exercise • Improved mood • Exercise as effective as therapy for depression for most people • Decreased anxiety • May decrease stress and protect against effect of stressors • Exercise addiction?

  6. Exercise: Determinants of Regular Exercise • Exercise schedules are usually erratic • Lack of time and stress undermine good intentions • About 50% of people who initiate a voluntary exercise program are still doing it after 6 months • Individual Characteristics • Gender, weight, social support, self-efficacy predict exercise adherence • Characteristics of the Setting • Convenient and accessible settings predict adherence

  7. Exercise: Characteristics of Interventions • Strategies • Stages of Change model helps understand levels of motivation • Cognitive-behavioral strategies promote adherence • Telephone and mail reminders are effective in relapse prevention • Individualized Exercise Programs • Understanding motivation and attitudes aids in development of a program of activities that are liked and are convenient

  8. Diet

  9. Maintaining a Healthy Diet:Overview • Controllable risk for many causes of death • 35% of U.S. population gets 5 servings of fruit and vegetables each day • Unhealthy eating contributes to 300,000+ deaths per year • Dietary change is critical for those at risk for • Coronary artery disease, hypertension • Diabetes • Cancer

  10. Prevalence of Overweight and Obese Americans

  11. Weight Gain/Loss Formula Wt +/- = cal absorbed through food ------------------------------------- cal spent through metab. & activity

  12. Basal Metabolic Rate and Caloric Intake • Basal Metabolic Rate (BMR) • Body’s base rate of energy expenditure • Influenced by heredity, age (higher in younger people), activity level, and body composition (fat tissue has a lower metabolic rate) • Calorie • amount of energy needed to raise the temperature of 1 g of water 1 degree Celsius

  13. Weight Regulation • The Search for Hunger/Satiety Signals • Feelings of hunger rise and fall with levels of glucose and insulin • Possible link to the number of fat cells in the body • Lateral Hypothalamus (LH) • Stimulation leads to hunger • Lesioning leads to self-starvation • Ventromedial Hypothalamus (VMH) • VMH lesioning leads to hunger • VMH stimulation causes an animal to stop eating

  14. Short-Term Appetite Regulation • Pancreas hormone insulin helps convert glucose into fat • When glucose levels fall, insulin productions increases and we feel hungry • Cholecystokinin (CCK) — satiety hormone produced by the intestine • Ghrelin — appetite stimulant produced by stomach

  15. Long-Term Weight Regulation • Laboratory mice with a defective gene for regulating the hormone leptin become obese • Leptin levels increase with body fat • Neurons in the arcuate nucleus (ARC) of the hypothalamus contain many receptors for leptin

  16. Obesity: Some Basic Facts • Measuring Obesity • Body mass index (BMI) — measure of obesity calculated by dividing body weight by the square of a person’s height

  17. Two Weight Extremes

  18. Mortality Rates and BMI • Generally speaking, thinner people live longer; however, very thin people do not have the lowest mortality rates

  19. Weight Control: Why Obesity is a Health Risk • Links with other risk factors, i.e., blood pressure • Increases risks during surgery, anesthesia administration, and childbearing • Chief cause of disability • number of people aged 30-49 who cannot care for themselves has jumped by 50% • Problems with health care • May not fit in standard wheelchairs • X-rays may not penetrate far enough • Blood pressure cuffs may not fit

  20. Hazards of Obesity • Male-pattern obesity linked to atherosclerosis, hypertension, diabetes • Complications after surgery • Increased risk of several cancers • Increased mortality rates from all causes • Impact on psychological well-being • Metabolic syndrome • Weight cycling — repeated weight gains and losses through repeated dieting

  21. Obesity Theories • Set-Point Hypothesis • The point at which an individual’s “weight thermostat” is supposedly set • When the body falls below this weight, an increase in hunger and a lowered metabolic rate may act to restore the lost weight • Positive Incentive Model • Food tastes good and is a powerful reinforcer for eating behavior • Social factors and other pleasurable aspects of eating are part of what is reinforcing.

  22. The Biopsychosocial Model of Obesity - Biology • Heredity • Genes thought to contribute approximately 50%to the likelihood of obesity • 60% of obese people had obese biological parents • Body weights of adopted children correlate more strongly with weights of biological parents • Body weights of adopted siblings weakly correlated

  23. The Biopsychosocial Model - Psychology • Stress has a direct effect on eating • Especially true for adolescents • Greater stress tied to • Eating more fatty foods • Eating less fruit and vegetables • Skipping breakfast • More between-meals snacks

  24. Weight Control: Stress and Eating • 50% eat more when under stress • Women more likely to eat more under stress • Stress removes self-control in dieters/obese • Choose foods containing more water, “chewier” • Choose salty, low calorie foods • Negative emotions – sweet, high-fat foods • 50% eat less when under stress • Men, compared to women, eat less under stress • Non-dieting, non-obese suppress hunger cues

  25. The Biopsychosocial Model - Social • 1975: 47% of Americans are overweight or obese • 2006: 65% are overweight or obese • More prevalent among African-Americans, Hispanic-Americans, Native Americans • Inversely related to socioeconomic status

  26. The Biopsychosocial Model - Social • Cultural variation in ideal body image • African-Americans may be less preoccupied with thinness than European Americans • Acculturation of dietary customs • Japanese-American men are 3 times as likely to be obese as men living in Japan

  27. Weight Control: Factors Associated with Obesity • Particular risk to “apples” rather than “pears” (fat localized in abdomen) • More psychologically reactive to stress • Greater cardiovascular reactivity • Yo-Yo dieting • Loss and regain • Affects abdominal fat

  28. Weight Control: Factors Associated with Obesity • Obesity and Dieting as Risk Factors • Obesity is a risk factor for obesity • High basal insulin levels prompt overeating due to increased hunger • Obese have larger fat cells • Cycles of dieting lower metabolic rate

  29. Dieting • Dieting • Successful weight loss is often defined as at least a 10% reduction of initial weight that is maintained for one year • 72% of women and 44% of men report having dieted at some point • Why Diets Fail • People are not accurate at estimating calorie needs • Dieters underestimate consumption • People find diets hard to stick with

  30. Diet and Disease • Body expends only 3 calories to turn 100 calories of fat in food into body fat • Body expends 25 calories to turn 100 calories of carbohydrate into body fat • Humans have a natural craving for fat (a legacy from our evolutionary past when food was not plentiful?) • Typical Western diet: 40%–45% of total calories are from fats • Poor diet (especially saturated fat) is implicated in one-third of all cancer deaths in the United States

  31. Weight Control: Treatment of Obesity • Amazon.com has 140,000 titles about dieting • Obese individuals attempt to lose weight because • It is considered unattractive (a primary reason) • It carries a social stigma (a primary reason) • They perceive that it is a health risk • It is coupled with psychological distress • Obese - often blamed for their weight • Few health practitioners advise losing weight

  32. Maintaining a Healthy Diet:Interventions to Modify Diet • Individual interventions • In response to specific health risk • Education and self-monitoring are key • Cognitive-behavioral interventions • Transtheoretical Model of Change - Different interventions are required for each stage • Precontemplation • Contemplation • Preparation • Action • Maintenance

  33. Weight Control: Treatment of Obesity • Dieting • Small losses, rarely maintained for long • Risk of yo-yo dieting to CHD > than risk of obesity alone • Formal investigation of low-carb diets does not suggest they are more effective than other kinds of diets • Fasting – usually employed with other techniques • Surgery – stomach stapled to reduce capacity • Appetite-Suppressing drugs • The multimodal approach • Screening, self-monitoring, control over eating, exercise • Controlling self-talk, social support, relapse prevention

  34. Behavioral and Cognitive Therapy • Most behavior modification programs include the following components: • Stimulus control • Self-control • Contingency contracts • Social support • Careful self-monitoring • Cognitive behavior therapies (CBT) — focus on interdependence of feelings, thoughts, behavior, consequences, social context, and physiology

  35. Weight Control: Evaluation of Cognitive-Behavioral Techniques • Efforts are somewhat successful • Losing 2 pounds/ week for 20 weeks • Maintenance for 2 years • Programs emphasize self-direction, exercise, and relapse prevention • Health psychologists suggest • Sensible eating and exercise • Rather than specific weight reduction techniques

  36. Stepped Care for Obesity

  37. Eating Disorders

  38. Eating Disorders: Anorexia Nervosa • DSM-IV Criteria • Self-starvation • BMI chronically < 18 • Intense fear of weight gain • Disturbance of body image • Amenorrhea for at least three months

  39. Health Hazards of Anorexia • Slowed thyroid function • Heart arrhythmias • Low blood pressure • Dry and yellowed skin • Anemia • Brittle bones

  40. Bulimia Nervosa • DSM-IV criteria • At least two bulimic (binge-purge) episodes a week for at least 3 months • Lack of control over eating • Behavior designed to avoid weight gain • Persistent, exaggerated concern about weight

  41. History and Demographics • Strong gender bias: 10 to 1 ratio of women to men • Prevalence • Anorexia nervosa: 0.5% to 1.0% of young adult and adolescent females • Bulimia nervosa: 1.0% to 3.0%

  42. Biological Factors in Eating Disorders • Hypothalamic-pituitary-adrenal Axis (HPA) • HPA abnormalities that may promote depression are linked with both anorexia and bulimia • HPA abnormalities return to normal when disordered eating stops

  43. Heredity and Eating Disorders? • Bulimia and identical twins (75% concordance rate) • Bulimia and fraternal twins (27% rate) • The chances that a young adult woman will be diagnosed with a clinical eating disorder are much greater if she has a female relative who has anorexia • Family history of major depression, obsessive-compulsive disorder (OCD), and anxiety

  44. Psychological Factors • Competitive, semiclosed environments of some families, athletic teams, and sororities may foster disordered eating • Families of anorexics • High achieving • Competitive • Overprotective • Intense interactions • Poor conflict resolution

  45. Psychological Factors • Families of bulimia patients • Above-average incidence of alcoholism, substance abuse, obesity, and depression • Anorexic and bulimic daughters rate their relationships with their parents as disengaged, unfriendly, and even hostile • Less accepted by their parents, who are perceived as overly critical, neglectful, and poor communicators

  46. Sociocultural View • Dieting/disordered eating viewed as responses to social roles, cultural ideals • Shown photographs of ultra-thin actresses and models, they respond with increased shame, depression, and dissatisfaction with their own bodies

  47. Body Image and the Media • Media representation of “ideal” female weight has decreased to that of the thinnest 5% to 10% of American women

  48. Treatment of Eating Disorders • A range of treatments • Behavioral treatments have been used, from force-feeding to family therapy • Restoring body weight is the first priority • Drug therapy (antidepressants, appetite suppressants, opiate antagonists) is controversial

  49. Cognitive Behavioral Treatments • Exposure-Response Prevention • A behavioral treatment of bulimia nervosa that attempts to prevent purging (and therefore reinforcement) following binge eating

  50. How Effective Are Treatments for Eating Disorders? • Most therapies result in some short-term success, but poor long-term outcome • Cognitive behavior therapy is fairly effective as a primary prevention for binge eating in high-risk women • Some degree of disordered eating may be normative for college women; reduction of disordered eating after graduation is also normative

More Related