NUTRITION AND PHYSICAL

FITNESSChapter 16

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NUTRITION AND PHYSICAL FITNESSNutrition and

physical fitness are essential interrelated parts of positive health promotion

Both reduce risks associate with chronic diseases

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NUTRITION AND PHYSICAL FITNESSBoth are important

therapies in dealing with already developed chronic diseases

Health care workers should provide their patients with sound guidelines for physical fitness AND practice these guidelines themselves!

NUTRITION AND PHYSICAL FITNESS

Objectives: Describe physical activity and

energy sourcesDescribe diet and exerciseDescribe the planning of a

personal exercise program

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NUTRITION AND PHYSICAL FITNESSKey Concepts:Healthy muscle structure and

function depend on appropriate energy fuels and tissue-building material, as well as oxygen and water

Different levels of physical activity and athletic performance draw on different body fuel sources

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NUTRITION AND PHYSICAL FITNESS A sedentary

lifestyle contribute to health problems. Regular physical activity is an important part of a healthy lifestyle.

A healthy personal exercise program combines both strengthening and aerobic activities

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

Guidelines and recommendations: Increased participation in physical

activity is a national health goal Physical Activity = bodily

movement that is produced by the contraction of muscle and that substantially increases energy expenditure. Should be in addition to ADL

Exercise = planned, structured, and repetitive bodily movement done to promote or maintain one or more components of physical fitness

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PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

Health Benefits – health problems may improve with moderate exercise

Coronary heart disease – exercise reduces risk by improving heart function, blood cholesterol levels, and oxygen transport Heart muscle function: aerobic

conditioning strengthens and enlarges this muscular organ, enabling it to pump more blood per beat

Blood cholesterol levels – raises blood levels of HDL, lowers blood levels of LDL

Oxygen-carrying capacity - increases

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PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITSHealth Benefits-Hypertension –

exercise is one of the most effective non-drug tx. for mild hypertension.

Exercise is an important adjuvant for those with higher BP along with medication

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PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITSDiabetes

For Type 2 DM – exercise increases glucose uptake in skeletal muscle despite insulin resistance.

For Type 1 DM – exercise must be balanced with food and insulin injections

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITSHealth Benefits cont.

Weight management – exercise helps: 1.) regulate appetite 2.) increase BMR 3.) reduces the genetic fat deposit set-point level

Bone disease – Weight-bearing exercises help strengthen bones. The weight-bearing load increases calcium deposits in bone increased bone density and reducing risk for osteoporosis

Mental health – exercise stimulates production of brain opiates – endorphins – which decrease pain and increase mood 12

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITSTypes of Physical Activity

A good fitness plan is a combination of different enjoyable activities that most effectively reduce the risk of several chronic diseases

Activities of daily living – incorporate exercise into daily routine and perform it consistently

Resistance training – creates and maintains muscle strength

Aerobic exercise – increases oxygenation to all cells. E.g. walking – start slow and gradually increase the pace and distance

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PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

Meeting personal needs – In planning a personal exercise program, first assess an individual’s health status, present level of fitness, personal needs, and resources necessary.Health status and personal gains – start

slowly, build gradually to avoid discouragement and injury. Moderation and regularity.

Achieving aerobic benefits – raise the pulse to within 60% to 90% of maximum heart rate. Maximum HR – subtract your age from 22015

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS

PHYSICAL ACTIVITY RECOMMENDATIONS AND BENEFITS Exercise preparation

and care – “warm up” Stretch muscles

to prevent stress or injury; cool down after exercise; don’t go beyond tolerance limits; rest when tired; stop when hurting; listen to your body!

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DIETARY NEEDS DURING EXERCISE Muscle action and fuel

Structure and function – special cells and fibers making up muscle mass are stimulated by nerve endings to produce controlled muscle contraction and relaxation

Fuel sources – Muscle action requires fuel to burn for energy. Basic energy nutrients (CHO, fat); their metabolic products – glucose, glycogen, and fatty acids – provide ready fuel for immediate, short- and long-term energy needs

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DIETARY NEEDS DURING EXERCISE Muscle action and fuel cont.

Oxygen – a person’s ability to deliver O2 to tissues for energy production determines how much exercise can be done.

“Aerobic capacity”– depends on: Body fitness and Body composition Aerobic capacity is the body’s ability

to deliver and use oxygen in sufficient quantities to meet the demands of increasing levels of exercise

Depends on the fitness of the lungs, heart, and blood vessels

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DIETARY NEEDS DURING EXERCISEAerobic capacity

cont. Body Composition –

a person’s aerobic capacity depends on the percentage of body fat and lean muscle mass. (Body tissues that use more O2 make up the “lean body mass”.)

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DIETARY NEEDS DURING EXERCISE

Fluid needs – more water is necessary for increased activity and exercise During exercise,

body temp rises and heat is released in sweat dehydration.

Water needs to be replaced as water or a glucose/salt drink

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DIETARY NEEDS DURING EXERCISE Nutrient stores –

with prolonged exercise, nutrient levels fall too low to sustain the body’s continued demands fatigue, exhaustion. CHO and fat are the fuels used to maintain these energy reserves

DIETARY NEEDS DURING EXERCISE Fluid and Energy needs cont.

Energy – physical activity requires energy in the form of kcalories Exercise is the only way to adjust an

individual’s internal genetic set-point which determines how much body fat the person will carry naturally

This body fat set-point is raised (e.g. more body fat is stored) when the person becomes more sedentary

This point is lowered by regular exercise

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MACRONUTRIENT AND MICRONUTRIENT RECOMMENDATIONS

Nutrient ratiosHighly active people and some

athletes have slightly increased protein requirements

CHO is the preferred fuel and is the critical food for an active person.Recommended ratios:

CHO 45-70 % total kcalsFat 15-25% total kcalsProtein 10-35% total kcals

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MACRONUTRIENT AND MICRONUTRIENT RECOMMENDATIONS

Carbohydrate – the major nutrient used for energy support during exercise Comes from 1.) circulating blood glucose

2.) glycogen stored in muscle

60-70% of daily energy intake for active persons should be from CHO

Complex CHO or starches are preferred because they breakdown more slowly and help maintain blood sugar levels more evenly, avoiding high and low blood sugar spikes

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MACRONUTRIENT AND MICRONUTRIENT RECOMMENDATIONS

MACRONUTRIENT AND MICRONUTRIENT RECOMMENDATIONS

Fat – in the presence of oxygen, fatty acids serve as a fuel source from stored fat tissue Total fat should not exceed 25-30% of

total daily energy intakeProtein – insignificant contribution to

energy No more than the usual adult

requirement is needed; approx 10%-35% of total daily kcals except for endurance and strength-trained athletes

Vitamins and minerals – cannot be used as fuel; exercise generally increases the body’s efficient use of vitamins and minerals Some special requirements for athletes

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ATHLETIC PERFORMANCE General training diet –

Athletes involved in heavy training are more susceptible to immunosuppression because of the extreme demands placed on the body.

A well-balanced diet with plenty of protein and CHO from a variety of foods helps prevent exercise-induced malnutrition and risk for injury and infection

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ATHLETIC PERFORMANCE Carbohydrate –

endurance athletes have higher needs

Fat – moderate amounts needed

Protein – 10-35% of total kcals

Total energy – Athletes need varying amounts of energy, depending on body size and the type of training or competition involved

ATHLETIC PERFORMANCECompetition

Carbohydrate loading – to prepare for an athletic event; a moderate, gradual tapering of exercise while total CHO intake is increased; usually a week before the event

Pregame meal – depends on the tolerance of the athlete; a light meal 3-4 hours before the event; high in complex CHOsThis gives the body time to digest,

absorb, and transform the meal into stored glycogen

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ATHLETIC PERFORMANCEHydration – fluid

needs depend on:The intensity and

duration of exerciseThe surrounding

temperature, altitude, and humidity

The level of fitnessThe pregame or

pre-exercise state of hydration

Athletes are advised (pregame) to drink more water than they think they need

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ATHLETIC PERFORMANCEErgogenic aids –

various substances that increase work or exercise capacity and output - e.g. use of steroids to increase muscle size, strength, and performance. (See p. 312 and 313 for list)Are dangerous with

serious physiologic side effects and psychological effects

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ATHLETIC PERFORMANCEMisinformation – manufacturers

sometimes make distorted for false claims for productsMyths and Superstitions

Electrolyte solutions are always needed during exercise

A pregame meal of steak and eggs ensures maximal performance

Drinking water during exercise causes cramps

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