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Chapter 1Lecture Slides

Introduction

• Two main focal points of this text

– The role nutrition, complemented by physical activity and exercise, may play in determining one’s health status

– The role nutrition may play in the enhancement of fitness and sports performance

Health Status

• Genetics and Lifestyle• Six of ten leading causes of death

– 80 percent of all deaths• Diseases of the heart• Cancer• Stroke• Chronic lung diseases• Diabetes• Chronic liver diseases and cirrhosis

• Preventable

Genetics and Lifestyle

• Genetics– May account for 30 percent of life expectancy

• Lifestyle choices and environmental factors– Diet– Physical activity– Medicine

Risk Factors

• A health behavior associated with a given disease– Family history– Cigarette smoking– Excessive alcohol consumption– Poor dietary habits– Physical inactivity

• Nutrigenomics and exercisenomics

Cool Website

www.hhs.gov/familyhistoryCreate your own family health history.

Sport and Exercise Performance

• Genetics– Stature– Body composition– VO2max– Vision

• Training– Optimal physiological,

psychological and biomechanical training

Physical Fitness

• A set of abilities an individual possesses to perform specific types of physical activity– Sports-related fitness– Health-related fitness

What Is Health-Related Fitness?Health related fitness

– Healthy body weight and body composition – Cardio-respiratory fitness– Adequate muscular strength and endurance– Adequate flexibility– Other measures

• Blood pressure

• Bone strength• Postural control and balance

• Markers of carbohydrate and lipid metabolism

Physical Activity

• General definition of physical activity is any movement caused by muscle contraction that results in caloric expenditure

• Unstructured physical activity– Activities of Daily Living (ADL)

• Leisurely walking

• Structured physical activity– Planned exercise programs

• Brisk, aerobic walking

What are the basic principles of exercise training

• Principle of overload• Principle of progression• Principle of specificity• Principle of recuperation• Principle of individuality• Principle of reversibility• Principle of overuse

Principle of Overload

• Intensity of exercise– % of heart rate or maximal oxygen uptake– % or repetition maximal (RM)

• Duration of exercise– Time of exercise session

• Frequency of exercise– Number of sessions per week

Principle of Progression

• Gradual increase in overload with training – Faster speed of running– More weight lifted

Principle of Specificity

• Hans Selye SAID principle• Specific Adaptations to Imposed Demands

– Endurance training• Running• Cycling• Swimming

– Strength training• Muscular strength, power and muscle mass• Muscular endurance

Principle of Recuperation

• Recovery and rest– Within exercise session– Between exercise sessions

Principle of Individuality

• Individual responses to exercise training– Blood pressure

• Responders – Blood pressure is lowered• Nonresponders – No change in blood pressure

Principle of Reversibility

• Use it or lose it– Health gains gradually disappear in detraining

• Single exercise bouts– May induce beneficial effects

• Lowered blood pressure• Decreased blood sugar response

• Chronic exercise training– Needed to maximize health benefits

Principle of Overuse

• Excessive exercise may induce adverse health effects– Muscle injuries– Stress fractures

What is the role of exercise in health promotion?

• Sedentary Death Syndrome (SeDS)– Health problems with physical inactivity– Frank Booth – University of Missouri

• Short-term costs– Metabolic deterioration and weight gain

• Intermediate-term costs– Type 2 diabetes

• Long-term costs– Increased rate of premature mortality

What is the role of exercise in health promotion?

• Physical inactivity– 45% increased risk of coronary artery disease– 60% increased risk of stroke– 30% increased risk of hypertension– 59% increased risk of osteoporosis

U. S. Centers for Disease Control and Prevention

Health Benefits of Exercise

Health Benefits of Exercise

• Prevent predisease conditions– Increased body weight (abdominal fat)– Elevated blood glucose– Type 2 diabetes

• Diabesity

• Type 2 diabetes– 171 million worldwide in 2000– 366 million worldwide in 2030 (projection)

How does exercise enhance health?• Specific mechanisms not completely

understood• Physical inactivity

– Impaired gene function– Cytokines may induce gene expression

• Fewer glucose receptors in fat cells

• Exercise may cause the expression of genes with favorable health effects– Cytokines induce beneficial gene expression

• More glucose receptors in fat cells

How does exercise enhance health?

• Local inflammation recognized as a risk factor for major chronic diseases

• Exercise produces an anti-inflammatory cytokine to help cool inflammation

• Some healthful adaptations with a single bout of exercise– Improved blood lipid profile– Reduced blood pressure– Improved insulin sensitivity

Do most of us exercise enough?

• In general, NO. • Most adults are not getting enough physical

activity• About 40-50% of college students are

physically inactive• Children and adolescents more physically

active, but many not obtaining adequate amounts– Increased type 2 diabetes in children related to

physical inactivity

How much physical activity is enough for health benefits?

How much physical activity is enough for health benefits?

• Comprehensive program of physical activity– Aerobic exercise– Resistance exercise– Flexibility exercise

Moderate and vigorousphysical activity

• Moderate physical activity– 40-50% of aerobic capacity

• Heart rate monitoring (Chapter 11)

– 5-6 on 10-point RPE scale– Talk test – carry on a conversation

• Vigorous physical activity– 60% or more of aerobic capacity– 7-8 on the RPE scale– Talk test – difficult to talk in complete sentences

What are some general guidelines for exercise programs for someone who wants to become

more physically active?

Recent Guidelines• American College of Sports Medicine and the

American Heart Association (2007)– www.acsm.org/physicalactivity

• Department of Health and Human Services (2008)– http://www.health.gov/paguidelines

General Exercise Guidelines for Adults and Older Adults

• Aerobic exercise– 30 minutes of moderate-intensity 5 days a week

or– 20 minutes of vigorous-intensity 3 days a week

or– 2 days of moderate and 2 days of vigorous

– May be done as exercise snacks• 3 bouts of 10 minutes (total 30 minutes)

General Exercise Guidelines for Adults and Older Adults

• Resistance exercise– 8-10 exercises that stress the major muscle

groups of the body– 8-12 repetitions of each exercise at least twice a

week on nonconsecutive days– May use weights, machines, or body resistance

such as push-ups and pull-ups

General Exercise Guidelines for Adults and Older Adults

• Flexibility and balance exercise– Older adults should perform activities that

maintain or improve flexibility on at least 2 days a w3ek for at least 10 minutes daily

– Older adults should also perform exercises that help maintain or improve balance about 3 times a week

General Exercise Guidelines for Adults and Older Adults

• Individualization– Exercise programs, especially for older adults,

should be individualized based on physical fitness and health status

– One key component is simply to reduce the amount of daily sedentary activity.

– Leisurely walking may be adequate physical activity for elderly individuals or those with compromised health status

General Exercise Guidelines for Adults and Older Adults

• More is Better– For substantial health benefits, adults should do

at least 150 minutes of moderate intensity, or 75 minutes of vigorous intensity aerobic physical activity, or an equivalent combination of moderate and vigorous per week

– For additional and more extensive health benefits, adults should increase their weekly aerobic physical activity to 300 minutes of moderate or 150 minutes of vigorous, or an equivalent combination

One model of the Physical Activity Pyramid

• Level I: 30 minutes daily: low-intensity• Level II: 3-5 days/week, > 30 minutes of

moderate, 20 minutes of vigorous, or combination of moderate and vigorous

• Level III: 3-7 days/week stretching to fitness• Level IV: 2-3 days/week resistance activities• Level V: Limit physical inactivity (e.g. TV

watching

General Exercise Guidelines for Children and Adolescents

• Should do 60 minutes or more of physical activity daily– Most of the 60 or more minutes should be either

moderate or vigorous intensity aerobic exercise– As part of their 60 or more minutes daily, muscle-

strengthening exercises should be performed on at least 3 days per week

– As part of their 60 or more minutes daily, bone-strengthening exercises should be performed on at least 3 days per week

General Exercise Guidelines for Children and Adolescents

• It is important to encourage young people to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety.

2008 Physical Activity Guidelines for Americans

Cool Websites• www.smallstep.gov

• www.Americaonthemove.org• www.fitness.gov

• Consult these Websites for information on fitness and starting an exercise program for most individuals.

www.choosetomove.org• Choose to Move is a free, 12-week physical

activity program for women developed by the American Heart Association.

Cool Websites

www.Kidnetic.comwww.nick.com/myworld/letsjustplay

www.whatmovesu.comwww.verbnow.com

• These Websites provide games and activities to help children become more physically active and promote overall good health. The What Moves U Website was developed jointly by the National Football League and American Heart Association, and has activity kits for use by school teachers.

Can too much exercise be harmful to my health?

• Some possible health problems associated with excessive or improper exercise– Orthopedic problems– Impaired immune function– Exercise-induced asthma– Osteoporosis– Heat illness and kidney failure– Heart attack

Nutrition and Health-Related Fitness

• Overall definition of nutrition: Sum total of processes involved in intake and utilization of food substances by living organisms, including ingestion, digestion, absorption, transport, and metabolism of nutrients in food

Six Classes of Nutrients

• Carbohydrates (Macronutrient)• Fats or Lipids (Macronutrient)• Proteins (Macronutrient)• Vitamins (Micronutrient)• Minerals (Micronutrient)• Water

Major functions of nutrients In food

What is the role of nutrition in health promotion?

• Food is Medicine– Hippocrates: Let food be your medicine and

medicine be your food.

• Role of nutrients– Promoters: Lead to progression of chronic diseases– Antipromoters: Deter initiation or progression of

chronic diseases

• Healthful nutrition reduces the risk of numerous chronic diseases

Proposed health roles of nutrients

• Inactivate carcinogens or kill bacteria that cause cancer• Increase insulin sensitivity• Relax blood vessels and improve blood flow• Reduce blood pressure• Optimize serum lipid levels• Reduce inflammation• Inhibit blood clotting• Enhance immune system functions• Speed up digestive processes• Prevent damaging oxidative processes• Reduce body fat

Do we eat right?• As a nation, we eat

– Too many Calories– Too much fat and saturated fat– Too much sugar and other sweeteners– Too much salt– Too much meat and cheese– Too few fruits and vegetables– Too few fiber-rich foods– In general, more than we need and less of what

we need more

What are some general guidelines for healthy eating?

• Nutrition and Your Health: Dietary Guidelines for Americans– Every 5 years. Current, 2005.

• Health Professional Organizations– American Heart Association– American Cancer Society– American Diabetes Association

What are some general guidelines for healthy eating?

• Examples of recommended diets– Mediterranean diet– Harvard Healthy Eating Diet plan– Optimal Macronutrient Intake diet plan

• OmniHeart Diet

– Dietary Approaches to Stop Hypertension diet• DASH diet

The Prudent Healthy Diet

• Based on current recommendations from major health professional organizations and government health agencies.

The Prudent Healthy Diet

1. Balance the food you eat with physical activity to maintain or improve your weight.

The Prudent Healthy Diet

2. Eat a nutritionally adequate diet consisting of a wide variety of nutrient-rich foods.

The Prudent Healthy Diet

3. Choose a diet moderate in total fat, but low in saturated and trans fat and cholesterol.

The Prudent Healthy Diet

4. Choose a diet with plenty of fruits and vegetables, whole grain products, and legumes.

The Prudent Healthy Diet

• 5. Choose beverages and foods that moderate or reduce your intake of sugars.

The Prudent Healthy Diet

• 6. Choose and prepare foods with less salt and sodium.

The Prudent Healthy Diet

• 7. If you drink alcoholic beverages, do so in moderation.

The Prudent Healthy Diet

• 8. Maintain protein intake at a moderate, yet adequate level, obtaining much of your daily protein from plant sources, complemented by smaller amounts of fish, skinless poultry and lean meat.

The Prudent Healthy Diet

• 9. Choose a diet adequate in calcium and iron. Individuals susceptible to tooth decay should obtain adequate fluoride.

The Prudent Healthy Diet

• 10. Practice food safety, including proper food storage, preservation and preparation.

The Prudent Healthy Diet

• 11. Avoid excess intake of questionable food additives and dietary supplements.

The Prudent Healthy Diet

• 12. Enjoy your food. Eat what you like but balance it within your overall healthful diet.

Am I eating right?

• Take the quiz in the Application Exercises section at the end of this chapter to rate your current diet.

• You may also obtain a detailed analysis of your diet, and physical activity, by accessing the MyTracker link on www.MyPyramid.gov.

Are there additional health benefits when both exercise and diet habits are improved?

• A poor diet and physical inactivity are individual risk factors for a number of chronic diseases. Collectively they may pose additional risks.

• A healthy diet and increased physical activity may exert complementary effects to help prevent several chronic diseases.– Diabetes– Heart disease– Cancer

Sports-Related Fitness:Exercise and Nutrition

• What makes a champion?– Genetics

• Genetic factors determine 20 to 80 percent of the variation in a wide variety of traits relevant to athletic performance

– Training• Optimal training can maximize an athlete’s genetic

potential

– Nutrition• Some specific nutritional practices may benefit athletes

Sports-related fitness

Sports-related fitness:• Strength• Power• Speed • Endurance• Sport-specific neuromuscular motor skills

Sports-related fitness:Energy demands and control

• Explosive power sports– Olympic weight lifting

• Very high-intensity sports– 100-meter dash

• High-intensity, short duration sports– 5,000-meter run

• Intermittent high-intensity sports– Soccer

Sports-related fitness:Energy demands and control

• Endurance sports– Marathon running (26.2 miles; 42.2 kilometers)

• Low-endurance, precision skill sports– Golf

• Weight-control and body-image sports– Bodybuilding

Sports fitness

• Training of elite athletes: United States Olympic Training Center– Physical power

• Physiological energy systems

– Mental strength• Psychological processes

– Mechanical edge• Biomechanical skills

What is sports nutrition?

• The application of nutritional principles to enhance sports performance.– To promote good health– To promote adaptations to training– To recover quickly after each training session– To perform optimally during competition

Louise Burke, Australian Institute of Sport

Is sports nutrition a profession?

• Professional associations– SCAN, American Dietetic Association– International Society of Sports Nutrition

• Certification programs– Specialty in Sports Dietetics (SCAN)

• Research productivity– International Journal of Sport Nutrition (1991)

• Consensus statements and position stands– Nutrition and athletic performance

(ACSM,ADA,DC)

Are athletes today receiving adequate nutrition?

• Dietary survey research– Underreporting– Nutrient intake versus clinical deficiency

• Individual variability• Weight-control sports

– Eating disorders

• Young athletes• Athletes not meeting recommendations• Source of nutrition information

How does nutrition affect athletic performance?

• Role of nutrients– Provide energy– Regulate metabolic processes– Promote growth and development

• Malnutrition– Undernutrition– Overnutrition

What should athletes eat to help optimize sports performance?

• Depends on a variety of factors– Gender– Age– Body weight status– Eating and lifestyle patterns– Climatic conditions– Type of sport and training

• Viewpoints– Nutrient supplements are needed by all athletes– No athlete needs nutrient supplements– Some athletes may benefit from nutrient supplements

Ergogenic Aids and Sports Performance

• Genetics• Training• Ergogenic aids – Beyond training

What is an ergogenic aid?

• Ergogenic– Defined as a means to increase potential for work output– Performance-enhancing techniques– Performance-enhancing substances

• Classes of ergogenic aids– Mechanical aids– Psychological aids– Physiological aids– Pharmacological aids– Nutritional aids

Why are nutritional ergogenics so popular?

• Use of drugs is illegal– Doping– World Anti-Doping Agency (WADA)

• Dietary supplements– Sports supplements

• Popularity– Belief in magical properties of some supplements– Recommended by coaches and fellow athletes– Shrewd advertising and marketing

• Endorsement by star athletes

Are nutritional ergogenics effective?

• Research suggests a few are but most are not• Supplements are found in each nutrient class

– Carbohydrates: Specific forms such as ribose– Fats: Specific fatty acids such as omega-3– Protein: Specific nitrogen compounds such as creatine– Vitamins: Specific vitamins such as B12

– Minerals: Specific minerals such as phosphate salts– Water: Special oxygenated waters– Others: Food drugs like caffeine and herbals like ginseng

Are nutritional ergogenics safe?

• Most over-the-counter (OTC) dietary supplements are safe taken as directed

• Potential problems– Product may not contain substances as per the

Supplement Facts label– Athletes may use the concept “If one is good, ten

is better”• Young athletes

Are nutritional ergogenics legal?

• Legality or permissibility in sports (Doping)• Some dietary supplements banned in sports

– Anabolics such as androstenedione– Stimulants such as ephedrine

• Intentional or inadvertent contamination– Intentional inclusion of banned substance– Processed in factory that produces banned substances

Nutritional Quackery in Health and Sports

• Thousands of foods and supplements marketed to enhance health and physical performance

What is nutritional quackery?

• Misinformation– Promotion of worthless product– Glitzy brochures; Infomercials

• Supplements are big business– Estimated $25 billion annual sales

• To be discussed in chapter 2– Dietary Supplements Health and Education Act– Supplement Facts label

• Statement to the effect that the FDA has not evaluated the effectiveness of this product

Why is nutritional quackery so prevalent in athletics?

• Attempts to gain a competitive edge• Possible factors promoting quackery in sports

– Eating behaviors of star athletes– Advice from coaches– Misinformation in sports magazines and books– Direct advertising to the athlete

Cool Website

www.supplementwatch.com• Click on Product Review, and then Sports & Fitness.

Provides a review of specific sports supplements.

How do I recognize nutritional quackery in health and sports?

• Some questions to ask about products:– Does it promise quick improvement in health or sports?– Does it contain some magical ingredient or formula?– Is it marketed by popular personalities or sports stars?– Does it exaggerate a single truth about an ingredient?– Does it question the integrity of the scientific or medical

establishment?– Does the person or magazine who recommends it also sell

it?– Is its claim too good to be true?

Where can I get sound nutritional information to combat quackery in health and sports?

• High quality research– Scientific books– Government, professional, educational, consumer groups

• Websites: .gov; .edu; org; use caution with .com sites

– Scientific journals– Popular magazines– Consultants

• American Dietetic Association (www.eatright.org)– SCAN: Certified Specialist in Sports Nutrition (CSSD)

Research and Prudent Recommendations

• Research in the past– Identify nutrients in foods – Determine functions of specific nutrients

• Current research with foods and nutrients– Health benefits– Performance-enhancing effects

• Evidence-based recommendations– Data base– Nature of research and possible limitations

What types of research provide valid information?

• Epidemiological research (Observational research)– Study large populations to find relationships between two

variables, for example diet and heart disease– Retrospective techniques

• Compare diets of those with heart disease to a similar group (cohort) of those without heart disease

– Prospective techniques• Diets of individuals without heart disease are studied for years and

then related to those who do and do not develop heart disease

Epidemiological research

• Epidemiological research– Helps scientists identify important relationships between

diet and health• 1950s research – Dietary fat

– Does not determine cause and effect relationship– Causality may be inferred if relationship is very strong

• Relative risk (RR) or odds ratio (OR)• RR of 1.0 is normal probability; 2.0 is twice and 0.5 is half

Experimental research

• Experimental research– Essential to establishing a cause and effect relationship– Randomized controlled trials (RCTs)– Cause and effect

• Independent variable – cause (Diet)• Dependent variable – effect (Heart disease)

Experimental research

• Experimental research– Populations

• Small groups (University laboratory research)• Large groups (National or International studies)

– Conditions• Randomization of subjects

– Matching of subjects

• Control or placebo condition• Double blind procedure

– Gold standard • RCTs with large populations

Experimental research and sports performance

• Mostly laboratory studies; some designed to mimic actual sports performance. However, few studies with actual competition.

Experimental research: Supplements and sports performance

• Methodological considerations for laboratory studies– Logical rationale– Appropriate subjects– Valid performance tests– Placebo control (Note nocebo effect)– Random assignment of subjects

• Matched subjects• Crossover design

– Double-blind protocol– Control of extraneous factors– Appropriate data analysis (statistics)

Why do we often hear contradictory advice about the effects of nutrition on health or physical performance?

• Media exaggeration or oversimplification• Quality of the study

– Limited number of subjects in RCT

• Peer-reviewed or presentation at a conference• Funding sources• Findings put in proper context

What is the basis for the dietary recommendations presented in this book?

• Evidence-based research• Individual studies• Reviews of RCTs and epidemiological studies• Meta-analyses of RCTs• Position statements and position stands

– American College of Sports Medicine– American Dietetic Association– American Institute of Cancer Research’– American Heart Association

• Prudent recommendations

How does all this relate to me?

• Individuality• Responders and non-responders

– Salt sensitivity– Carbohydrates and gastrointestinal distress

• Seek appropriate guidance for supplements or other nutritional strategies for medical applications or performance enhancement strategies

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