1. Option C: Physical Activity & Health

2. Learning Objectives
Define various disease that are related to physical inactivity
C.2.1 Outline the coronary circulation
C.2.2 Outline what is meant by the term atherosclerosis.
C.4.1 Compare type 1 and type 2 diabetes.
C.5.5 Discuss the relationship between physical activity and
bone health.
C.5.1 Outline how bone density changes from birth to old age.

3. Learning Objectives
2. What are useful Diagnostic Tools and what does Maturation mean to our Health
C.3.1 Describe how obesity is determined.

4. Learning Objectives
3. What effects does Exercise have on our Health and Wellness
C.6.1 Outline physical activity guidelines for the promotion of
good health
C.6.2 Describe the aims of exercise in individuals with a
hypokinetic disease
C.6.3 Discuss the potential barriers to physical activity
C.7.6 Describe strategies for enhancing adherence to exercise.
C.7.7 Outline the possible negative aspects of exercise
adherence.

5. Define Various Diseases that are RELATED to Physical Activity

6. Left coronary artery supplies the left side of the heart.
C Outline the coronary circulation
Blood supply to the heart provided by the (left and right) coronary arteries.
Left coronary artery supplies the left side of the heart.
Right Coronary artery supplies the right side of the heart.
Left coronary artery divides into circumflex artery and left anterior descending/ intraventricular artery.

7. Narrowing of arteries as plaque and cholesterol build up over time.
C Outline what is meant by the term atherosclerosis.
Narrowing of arteries as plaque and cholesterol build up over
time.
Can become blocked (thrombus) with cholesterol.
Can cause tissues to die (myocardial infarction)

8. Type 1 is insulin dependent whereas Type 2 is insulin resistant.
C Compare type 1 and type 2 diabetes.
Type 1 generally has a sudden onset during childhood or young adulthood whereas the onset of type 2 is more gradual.
Type 1 may be treated with insulin whereas type 2 responds well to diet, exercise., oral med & or insulin.
Type 1 is insulin dependent whereas Type 2 is insulin resistant.
The primary function of a beta cell is to store and release insulin. Insulin is a hormone that brings about effects which reduce blood glucose concentration. Beta cells can respond quickly to spikes in blood glucose concentrations by secreting some of their stored insulin while simultaneously producing more.
Type I – autoimmune, childhood onset, insulin dependent
Type II – lifestyle related though genetic factors,obesity, old age and is insulin resistant.
10% of the world population, mostly Type II
Result of – obesity, inactivity, ethnicity, diet
Consequences – CVA, retinopathy, CHD, nephropathy, neuropathy, amputation
Role of physical activity in lowering blood sugar
Type 1 is normally inherited whereas type 2 is often acquired via lifestyle.
Type 1 involves destruction of the β-cells in the pancreas whereas type 2 is characterised by impaired glucose tolerance because of insulin resistance.

9. Weight-bearing physical activity is essential for bone health.
C Discuss the relationship between physical activity and bone health.
Weight-bearing physical activity helps prevent osteoporosis by increasing bone mass. There is some evidence to suggest that exercise-induced gains in bone mass in children are maintained into adulthood.
Bones must be compressed or pushed up to promote optimal bone mass. Weight-bearing physical activity compresses bones.
Weight-bearing physical activity is essential for bone health.
Smaller bodies, less muscle, possibly less physical activity
Greater loss in old age among females because of estrogen effect
Exercise increases bone mass, strengthens muscles around the bones, improved balance to reduce risk of falling
During physical activity contracting muscles that cross a joint compress bones to maintain and enhance bone health.

10. C.5.5 Discuss the relationship between physical activity and bone health.
Non weight-bearing physical activity (e.g. swimming) is less effective in maintaining bone health compared to weight-bearing physical activity.
However
Weight- bearing training/activity (running) is associated with a higher bone mineral content/ bone health than non-weight-bearing training activity (e.g. cycling).
Resistance training/ activity is associated with higher bone mineral content/ bone health rather than a weight-bearing training/ activity such as running.
Smaller bodies, less muscle, possibly less physical activity
Greater loss in old age among females because of estrogen effect
Exercise increases bone mass, strengthens muscles around the bones, improved balance to reduce risk of falling
Changes in bone mineral density are site specific with the mode of activity (e.g. Olympic style lifts compared to arm curls e.g. dominant arm sports e.g. runners compared to cyclists);

11. Bone density changes over lifetime.
C Outline how bone density changes from birth to old age.
Bone density changes over lifetime.
Peak in mid 30’s-40’s and then decreases.
Females typically lower bone mass. Why?
Lower Bone Mass Density lead to osteoporosis.

12. Define Diagnostic Tools/ Technologies

13. High waist girth values determine abdominal obesity.
C Describe how obesity is determined.
Obesity is by definition an excess of body fat, but in reality it is determined using indirect measurements of body, for example body fat index BMI and waist girth.
High waist girth values determine abdominal obesity.
Childhood obesity-> associated with social stigmatization and bullying- (This raises an ethical issue around the routine)
Health consequences – diabetes, cvd, hbp, osteoarthritis, some cancer (bowel, breast, prostate)
BMI a measurements of body fat, calculated by dividing weight in kilograms by height in meters squared = indirect assessment of body fat percentage,
A BMI > 25.kg.m-2 -> overweight  A BMI > 30 kg m-2 -> obese 
Values can be often misleading - bodybuilders weightlifters, large muscles, high mass but not obese.

14. What effects does Exercise have on our Health and Wellness

15. Exercise is one of the most effective ways to alleviate a bad
C Outline physical activity guidelines for the promotion of good health
Exercise is one of the most effective ways to alleviate a bad
mood. How? Why?
Shown in healthy
& diseased
Individuals
Research:
Can exercise treat
clin. depression?
Consider World Health Organization (WHO) recommendations for minimal levels of physical activity in the promotion of good health.
State of emotional or affective arousal; non-permanent but not momentary either (different than disposition or personality which is more permanent)
Different from emotion per se – which is more associated with a given event; mood is longer lasting than a given emotion.
How exercise improves mood? – thermogenic hypothesis (incr temp), blood flow to brain, production of endorphins, increase in serotonin, increase in noradrenalin, improved feelings of self-worth/esteem/body image – stress management (be able to name some physical and some psych effects)

16. C.6.1 Outline physical activity guidelines for the promotion of good health
Children and youth aged 5–17 should accumulate at least 60 minutes total of moderate- to vigorous-intensity physical activity daily.
Most of the daily physical activity should be aerobic. Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least 3 times per week.
Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
Older adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.

17. Types of Hypokinetic Conditions
C Describe the aims of exercise in individuals with a Hypokinetic disease
To make the most of limited functional capacities.
To alleviate or provide relief from symptoms.
To reduce the need for medication.
To reduce the risk of disease reoccurrence (secondary prevention)
To help overcome social problems and psychological distress.
Types of Hypokinetic Conditions
Cardiovascular Disease
Obesity
Cancer
Diabetes
Low Back Pain
Osteoporosis

18. Hazards of exercise (for example, cycle and swimming accidents)
C Discuss the potential barriers to physical activity
Uncontrolled disease state (unstable angina, poorly controlled diabetes, uncontrolled hypertension)
Hazards of exercise (for example, cycle and swimming accidents)
Musculoskeletal injuries
Triggering of other health issues (for example, heart attack, respiratory tract infections).
Too old, too fat, injury
Shyness, embarrassment, fear
Lack of energy, lack of confidence, don’t enjoy exercise
Work and family life
Lack of equipment, safe place to exercise, people to exercise with
Incr adherence – contract, prompt, rewards, social support, counseling, goal setting
Can be addicted – withdrawl, fear of not exercising, see it displacing other activities, interfering with relationships, taking physical toll, causing OCD

19. Environmental approaches- prompts, contracting, perceived choice.
C Describe strategies for enhancing adherence to exercise.
Social support approaches- role of significant others (spouse, family members, friends). Include joining in, adjusting routines, transportation, providing equipment.
Goal setting and cognitive approaches- associative versus dissociative focus during exercise.
Environmental approaches- prompts, contracting, perceived choice.
Associative thoughts are based on the race or performance itself. While running, Schomer (1987) states these thoughts could include monitoring of bodily sensations such as respiration or muscle pain. Associative thoughts also include internal commands or instructions, such as "surge to that next person" or "relax the shoulders". An athlete in an associative state may also consider their present emotional state and have a thought such as "I feel light and fast today" or "I'm really mad that coach put me in the 10k and I have 15 more laps to go". Finally, according to Schomer (1987), association can also include thoughts about pace. The bottom line is that athletes who associate are focused on the task at hand and this only.
Athletes who dissociate, however, may think about things unrelated to the task at hand as a means of distraction. These dissociative thoughts, according to Schomer (1987) could include reflection on past events and planning for future events. Athletes who focus on the environment (looking at the trees or the pretty girls in the stands) or listen to music while running are also dissociating.
Reinforcement approaches- rewards for attendance and participation, external feedback, self-monitoring.

20. Negative exercise addiction to exercise – life choices and
C Outline the possible negative aspects of exercise adherence.
Negative exercise addiction to exercise – life choices and
relationship issues.
What does this mean……
Exercise addiction can occur independently or in conjunction with another disorder, such as anorexia nervosa or bulimia.
Detrimental social consequences.
Disturbed psychological functioning.
Exercising despite medical contraindications.
Interference with relationships or work.
Withdrawal symptoms such as agitation, anxiety, or restlessness after not exercising for a time.

21. 2. Symptoms of negative exercise
C Outline the possible negative aspects of exercise adherence.
2. Symptoms of negative exercise
Stereotyped pattern with a regular schedule of once or more daily
Increased priority of exercise
Negative mood affect with withdrawal
Increased tolerance to exercise
Subjective awareness of compulsion to exercise
What does this mean……

22. C.7.7 Outline the possible negative aspects of exercise adherence.
Such things as…..
Loss of control: inability to control the urge to exercise or to stop exercising for a significant time, especially in the presence of an injury that requires time to heal.
Continuance: continuing to exercise even in the presence of injuries, physical problems, psychological issues, or interpersonal problems.
Intention effects: going beyond the original intended duration, frequency, or intensity of exercise without meaning to do so.
Time: spending a great deal of time engaging in, planning for, thinking about, or recovering from exercise.
Reduction in other activities: spending less time in social, occupational, or other situations as a direct result of exercise.
Tolerance: needing to exercise more often, for longer durations, or at higher intensity to feel the desired effect than you originally did.
Withdrawal: feelings of irritability, restlessness, or anxiety after a period without exercise.