Chapter 1

1. ChapterOutline PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Chapter 1 Physical Fitness and Wellness .

2. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Humans: Created to move • Physical inactivity leads to disease and premature death • Physically active people live longer • Technological advances have greatly reduced required daily physical activity • 400,000 deaths in the U.S. were attributed to poor diet and physical inactivity in the year 2000

3. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Life expectancy • Beginning of the 20th century • Life expectancy was 47 years • Major life threats were infectious diseases: tuberculosis, diphtheria, influenza, polio, etc. • Late 20th century • Infectious diseases eliminated with medical breakthroughs • Life expectancy increased to 76.9 years but living the so-called “good life” encouraged chronic diseases:hypertension, coronary heart disease, diabetes, cancer, etc.

4. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Fitness & wellness movement • The fitness and wellness movement resulted from the need to combat chronic disease • Focus became disease prevention through a healthy lifestyle

5. Figure 1.1 Physical inactivity and poor lifestyle habits have caused an increase in the incidence of chronic diseases

6. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Healthy life expectancy in U.S. • Average life expectancy in the U.S. is 76.9 years • Healthy life expectancy is defined as the years of illness subtracted from life expectancy • The World Health Organization (WHO) calculated in 2000 that the healthy life expectancy of the U.S. was 24th in the world

7. Figure 1.2 Healthy life expectancy in the United States lags behind other countries

8. Physical Activity: Bodily movement produced by skeletal muscles; requires expenditure of energy and produces progressive health benefits Exercise: A type of physical activity that requires planned, structured, and repetitive bodily movement with the intent of improving or maintaining one or more components of physical fitness PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Key terms

9. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach 1996 surgeon general’s report • Poor health because of lack of physical activity is a serious public health problem • More than 60% of adults do not achieve the recommended amount of physical activity • 25% are not physically active at all • Almost half of all people between 12 and 21 years of age are not vigorously active on a regular basis

10. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach 1996 surgeon general’s report • Physical inactivity is more prevalent in • Women than men • African Americans and Hispanic Americans than whites • Older than younger adults • Less affluent than more affluent people • Less educated than more educated adults

11. Table 1.1 The 1996 report became a nationwide call to action

12. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Critical thinking • Do you consciously incorporate physical activity into your daily lifestyle? • Can you provide examples? • Do you feel that you get sufficient daily physical activity to maintain good health?

13. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Moderate physical activity • Provides benefits through regular participation • Can prevent premature death, unnecessary illness, and disability • For people who are not physically active: • Can provide substantial benefits in health and well-being • For people who are already moderately active: • Greater health and fitness benefits can be obtained when intensity of physical activity is increased

14. Moderate physical activity: Activity that uses 150 calories of energy per day, or 1,000 calories per week Vigorous activity: Any exercise that requires a MET level equal to or greater than 6 METs or 21 ml/kg/min (1 MET = energy expenditure at rest or the equivalent of 3.5 ml/kg/min) PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Key terms

15. Physical fitness: The ability to meet the ordinary as well as the unusual demands of daily life safely and effectively without being overly fatigued and still have energy left for leisure and recreational activities Health-related fitness: Fitness programs that are prescribed to improve the overall health of the individual PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Key terms

16. Skill-related fitness:Fitness components important for success in skillful activities and athletic events; encompasses agility, balance, coordination, power, reaction time, and speed Metabolic fitness:Improvements in the metabolic profile through a moderate-intensity exercise program in spite of little or no improvement in physical fitness measures PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Key terms

17. Health and fitness benefits according to lifestyle and physical activity program Figure 1.10 • Attaining the health fitness standard requires only moderate physical activity • For high physical fitness, a high intensity exercise program is required

18. Physical activity vs. mortality Figure 1.5 Studies show an inverse relationship between physical activity and premature mortality rates

19. Although greater improvements in fitness yield a slightly lower risk for premature death, the largest drop is between the low fit and the moderate fit groups Figure 1.6 Fitness levels vs. mortality

20. Figure 1.7 Effects of fitness changes on mortality rates Even greater protection is attained by combining higher fitness levels with reduction in other risk factors

21. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Health-related fitness Cardiorespiratory endurance Muscular flexibility Body composition Muscular strength and endurance

22. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Motor skill–related fitness

23. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Critical thinking • What role do the four health-related components of physical fitness play in your life? • Can you rank in order of importance to you and explain your rationale in doing so?

24. Health fitness standard Minimum fitness values required for disease prevention and health Physical fitness standard Higher standard required to achieve good or excellent physical fitness Physical fitness standard Requires more intense exercise to allow people of all ages the freedom to enjoy life’s daily and recreational activities to their fullest potential Current health fitness standards are not enough to achieve these objectives PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Two fitness standards

25. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Key terms • Wellness: The constant and deliberate effort to stay healthy and achieve the highest potential for well-being; It integrates seven dimensions

26. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Wellness continuum • Although an individual may demonstrate adequate or excellent fitness, indulgence in unhealthy lifestyle behaviors will increase risk for chronic diseases and diminish wellness

27. Leading Causes of Death in the United States Figure 1.11

28. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach “ Lifestyle as a health problem Almost 80% of deaths in the U.S. today could be prevented through a healthy lifestyle program.”

29. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Actual causes of death in the U.S. • 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 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 Updated figures from JAMA 291:1238–1245, 2004

30. Figure 1.13 Health care costs in the U.S. for selected years

31. Figure 1.14 • U.S. spends more on yearly health care per person than any other industrialized nation Yet U.S. health care ranks 37th in the world One reason for low ranking is overemphasis on state-of-the art cures instead of prevention

32. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Lifestyle as a health problem • Over 50% of people who die in U.S. die because of what they do • More than half of disease is lifestyle-related • A fifth is attributed to the environment • A tenth is influenced by the health care the individual receives • Only 16% is related to genetics • The individual controls as much as 84% of vulnerability to disease and quality of life • 83% of deaths before age 65 are preventable

33. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach “ Lifestyle as a health problem In essence, most people in the United States are threatened by the verylives they lead today.”

34. Participate in a lifetime physical activity program Do not smoke cigarettes Eat three nutritious meals each day Avoid meaningless snacking Maintain healthy weight Get enough sleep PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Healthy lifestyle habits

35. Control stress Be wary of alcohol Surround yourself with healthy friendships Be informed about the environment Increase education Take personal safety measures PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Healthy lifestyle habits

36. 2010 National Health Objectives Figure 1.15 Two unique goals of the 2010 national health objectives emphasize increased quality and years of healthy life and seek to eliminate health disparities among all groups of people

37. PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach Critical thinking • What are your feelings about lifestyle habits that enhance health and longevity? • How important are they to you? • What obstacles keep you from adhering to such habits or incorporating new ones into your life?

38. Implement motivational and behavior modification techniques for wellness Determine whether medical clearance is needed for exercise participation Conduct a nutrient analysis and follow recommendations for adequate nutrition Write your own nutrition and weight-control programs PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach A personalized approachIn this course you will learn to

39. Assess your health-related components of fitness Write exercise prescriptions for cardiorespiratory endurance, muscular strength and endurance, and muscular flexibility Understand the relationship between fitness and aging Determine your levels of tension and stress, lessen your vulnerability to stress, and implement a stress management program if necessary PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach A personalized approachIn this course you will learn to

40. Follow a cancer risk–reduction program Implement a smoking cessation program, if applicable Avoid chemical dependency and know where to find assistance if needed Learn health consequences of sexually transmitted diseases PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach A personalized approachIn this course you will learn to

41. Write objectives to improve your fitness and wellness and learn how to chart a wellness program for the future Differentiate myths and facts about exercise and health-related concepts PhysicalActivity vs. Exercise SurgeonGeneral’s Report A WellnessLifestyle Wellness,Fitness, &Longevity Types ofPhysicalFitness Leading U.S. Health Problems ComprehensiveWellness Program Wellness Challenge of 21st Century A Personalized Approach A personalized approachIn this course you will learn to

42. End of Chapter