health and social care

  • Created by: bearose99
  • Created on: 01-05-18 14:43

Aerobic Fitness

Aerobic fitness is the ability to endure or sustain endurance-type activities like swimming, cycling, running for long periods (over 12 minutes).

For aerobic fitness to occur it requires effective external respiration, oxygen transport from lungs to cells and oxygen use within the cell.

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VO2 max

VO2 max is a measure of aerobic fitness. It is a measurement of the maximum amount of oxygen that the body can take in and use per minute per kilogram of body weight (mls/min/kg).

VO2 max is the most accurate measure of aerobic fitness. It is performed in a sports science lab and measures the amount of oxygen consumption during maximal exercise. When oxygen consumption plateaus, this is defined as VO2 max. The higher the VO2 max score the fitter the individual.

However, there are problems with VO2 max testing, for example, its time consuming, expensive, impractical and a trained practitioner is needed.

Genetically men have higher VO2 max than females because males have a greater muscle mass and greater lung capacity. This is because mitochondria complete respiration and the majority of mitochondria are located in the muscle tissue.

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Short-Term Physiological Effects of Exersise

  • Stroke volume increases
  • Cardiac output increases
  • Increased blood flow to skeletal muscles
  • Increased ventilation 
  • Due to increased CO2 in blood
  • Sweating 
  • Redness of skin
  • Heart rate increases
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Long-Term Physiological Effects of Exercise

  • Resting stroke volume increases
  • Resting cardiac output increases
  • Artery wall elasticity will increase
  • Able to withstand greater blood pressure fluctuations 
  • Increased surface area of lungs
  • Number of capillaries in lungs increases 
  • More O2 can be diffused into the blood
  • The blood's O2 carrying capacity is increased
  • Lower resting heart rate
  • Muscles increase in size
  • Capillaries in muscles increase
  • VO2 max increases
  • Endurance increases
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The Training Effects of Aerobic Exercise

Short Term:

  • Increased heart rate
  • Increased ventilation
  • Increased cardiac output
  • Increased stroke volume 
  • More blood flow direct to skeletal muscles 
  • Less stress on heart

Long Term:

  • Skeletal muscles increase in size and become better at using oxygen
  • Increase in number of capillaries in lung/ skeletal muscles
  • Increase in surface area of lungs which increases oxygen diffusion into blood
  • Working capacity of heart increases which lowers heart rate
  • Increased elasticity of arterial walls
  • Endurance improves
  • Less stress on the heart
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Types and Sources of Carbohydrates

Types and sources:

  • Sugar (simple)
    • Chocolate, honey, jam, cakes, biscuits
  • Starches
    • Bread, rice, potatoes, pasta, breakfast cereals
  • Non-starch polysaccharides (NSP)
    • Bran products, wholemeal bread, peas, sweetcorn

NSPs:

  • These include substances such as fibre and cellulose
  • Some of these are insoluable and can not be broken down by digestion 
  • They pass through the body chemically unchanged therefore they have no nutritional value
  • Howevr they do have a number of functions:
    • it keeps the digestive system healthy
    • it can help lower heart disease 
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Functions and how Carbohydrates are Utilised

Functions:

  • Energy supply to the body 
  • They are used by the body for transport, protection, and recognition
  • Sugar and starch are the most efficient form
  • Starch is digested and stored as glycogen
  • Fats contain more energy but require more oxygen to break down

How they are Utilised:

They are eaten and then digested, which means glucose can enter into the blood stream. If glucose is not needed, it is stored as glycogen which are long chains of glucose molecules. These are stored in the muscles and the liver. When needed the glucose will combine with oxygen to make energy. 

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Excess and Lack of Carbohydrates

Excess:

  • Incresed body weight
    • when there is too much it is stored as fat, increasing body weight
  • Increase dental caries
    • the sugar will eat away at the tooths anamal

Lack:

  • Weight loss and lethargy 
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Source, Metabolism and Functions of Fat

Source:

  • Fat is found in many foods, especially from animal derivatives They can solid or liquid (oils) and they do not mix or dissolve in water
    • Dairy - milk, cheese, butter
    • Meat - bacon, sausages, less lean cuts of beef/pork

Metabolism:

Fat from food is broken down into fatty acids which travel in the blood. Then the fatty acids that are not needed staight away are packed into triglycerides and stored as fat cells.

Functiuons:

  • Helps body absorb vitamins A, D, E (which are fat soluable)
  • A source of energy / store of energy
  • Essential fatty acids
  • Helps maintain healthy skin as it is needed for membranes
  • Acts as insulation against heat loss
  • Protective layer
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Types of Fats

Satuated:

  • Bonded to as many hydrogens as possible (only single bonds)
  • Solid at room temperature
  • Raises level of cholesterol 

Monosaturated and Polyunsaturated: 

  • Mono contain one double carbon bond and poly contain multipul 
  • Found in olice oil and soft marge 
  • They help build cell membranes 

Transunsaturated:

  • They are oil that have had hydrogen added to them so they become solid
  • They raise LDL levels and lower your good HDL 
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Cholestrol

Cholestrol is carried in the blood as Low Density Lipoprotein and High Density Lipoprotein. HDLs are though to be positive and LDL to be negative.

Low Density Lipoprotein (LDL):

  • Carries cholesterol to cells that need it, if there is too much LDL it can build up in the arteries blocking them

High Density Lipoprotein (HDL):

  • Carries cholesterol away from cells and carries LDL cholesterol away from the arteries and back to the liver helping to remove excess cholestrol from the blood stream

Too much saturated fats can raise LDL in the blood this increases the risk of heart disease and stroke.

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Functions and Sources of Proteins

Proteins are made from long chains of amino acids, these long chains are folded into particular shapes.

Functions:

  • Growth
  • Hormones
  • Repair
  • Maintenance of muscles
  • Antibodies
  • Enzymes

Sources:

  • High Biological Value Proteins (HBV) contain all essential amino acids
    • meats, eggs, cheese, fish, milk, soya
  • Low Biological Value Proteins (LBV) contain some essential amino acids
    • Cereals, rice, wheat, oats, pulses
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Protein Metabolism and Deficiency

Metabolism:

  • Protease is made in the pancreas and is released into the duodenum to start breaking the protein into amino acids
  • More protease is then relised in the ileum and further digestion occurs
  • Amino acids are absorbed out of the ileum into the blood to nbe transported to the cells/muscles

Deficiency:

  • Kwashiorkor is a type of protein energy malnutrition 
  • Too muvh protein can cause high Cholesterol
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Muscular Fitness

Muscular Fitness

Having the strength and stamina to cope with the stresses of everyday life, e.g. the person's capacity to exert force.

Muscular Fitness is split into Maximum Strength and Dynamic Strength:

  • Maximum Strength is the greatest force the muscle can exert in a single contraction. E.g. weightlifting 
  • Dynamic Strenght is the ability of the Neuromuscular system to allow the muscle to contract at a speed whilst overcoming resistance e.g. running or biking

Muscular strength:

Force a muscle can exert to overcome resistance it envolves exercises like football, athletics, gymnastics.

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Flexibility

Flexibility: 

The range of movement possible by the whole body or parts of the body around a single joint, alonf with its muscles and tendons.

Without regular streching muscles and tendons become short and tight which limits movement.

Mobility:

Mobility = Speed + Balance + Endurance

The ability to move and change directions with speed, balance and endurance

  • Speed - The ability in which the body parts get into motion quickly or at the maximum rate to enable the person move over a specific directions
  • Balance - The maintenance of the center of mass over the base of support
  • Endurance - The ability to keep going or to sustain work without excessive fatigue (depends on muscular and aerobic fitness)
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Iron

Function:

  • Needed for production of red blood cells
  • Nutrient for growth & repair
  • Vital for transporting oxygen around the body
  • Helps energy production

Main Sources:

  • Liver
  • Spinach
  • Red meat
  • Leafy green veg

Deficiencies: 

  • Anaemia
  • Pale look
  • Fatigue
  • Short of breath
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Calcium

Functions:

  • Maintain healthy bones and teeth
  • Regulates muscle contractions
  • Ensures that blood clots normally

Sources:

  • Bread
  • Milk
  • Cheese
  • Green veg
  • Fish with edible bones (sardines)

Deficiencies:

  • Rickets in children
  • Low bone density
  • Osteoporosis
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Phosphorus

Functions:

  • Involved in reactions that turn chemical energy from food into work, and storing energy into muscles
  • Building and maintenance of teeth and bones

Sources:

  • Meat
  • Milk
  • Fish
  • Beans
  • Fruit

Deficiencies:

Although very rare, rickets in children, low bone density, and osteoporosis

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Iodine

Functions:

  • Produce hormones in thyroid gland that controls the rate of metabolism

Sources:

  • Sea food
  • Green veg
  • Milk

Deficiencies:

  • Swollen thyroid 
  • Hypothyroidism
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Zinc

Functions:

  • Sperm production
  • Growth
  • Healing of wounds
  • Blood Clotting

Sources:

  • Meat
  • Eggs
  • Peas
  • Beans

Dificiencies:

  • Delay in body growth
  • Loss of appetite
  • Weakened immune system
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Vitamin A (Fat soluble)

Functions:

  • Growth and maintenance of cells
  • Night vision improved
  • Aids development of cell structure, bones and teeth

Sources:

  • Liver
  • Eggs
  • Cheese
  • Milk
  • Carrots

Deficiencies:

  • Poor night vision
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Vitamin D (Fat soluble)

Functions:

  • Helps chemical reactions involved in absorbing calcium from food - helps build and maintain bones and teeth
  • Helps nerve tissue and muscles to work

Sources:

  • Oily fish
  • Margarine
  • Sunlight on skin

Deficiencies:

  • Rickets in children
  • Osteomalacia (softening of bones)
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Vitamin E (Fat soluble)

Functions:

  • Slows down damage to cells
  • Helps build red blood cells

Sources:

  • Vegetable oils
  • Nuts
  • Whole grain foods

Deficiencies:

  • Anaemia
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Vitamin K (Fat soluble)

Functions:

  • Helps produce blood clotting proteins

Sources:

  • Green leafy veg
  • Eggs
  • Pork

Deficiencies:

  • Failure of blood cloting
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Vitamin B1 (Water soluble)

Functions:

  • Function of Vitamin B1 Helps reaction that releases energy from carbs in muscles and nerve cells

Sources:

  • Liver
  • Kidney
  • Whole-grain foods
  • Peas
  • Beans
  • Cereals

Deficiencies:

  • Anxiety
  • Muscle cramps
  • Depression
  • Loss of appetite
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Vitamin B2 (Water soluble)

Functions:

  • Keeps skin, eyes and nervous system healthy

Sources:

  • Milk
  • Rice 
  • Eggs

Dificiencies:

  • Cracks and sores around mouth and nose
  • Visual problems
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Vitamin B3 (Water soluble)

Functions:

  • Releases energy from food 
  • Keeps nervous system and skin healthy

Sources:

  • Meat
  • Fish
  • Eggs

Deficiencies:

  • Pellagra, characterised by diarrhoea, dermatitis and dementia
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Vitamin B9 (Water soluble)

Functions:

  • Body forms healthy red blood clots
  • Helps build body cells
  • Helps build neucleic acid

Sources:

  • Green leafy veg
  • Liver
  • Chickpeas
  • Peas

Dificiencies:

  • Impaired cell division
  • Anaemia
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Vitamin B12 (Water soluble)

Functions:

  • Makes red blood cells
  • Keeps nervous system healthy
  • Releasing energy from food

Sources:

  • Meat
  • Fish
  • Eggs

Deficiencies:

  • Anaemia
  • Nerve damage
  • Weight loss
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Vitamin C (Water soluble)

Functions:

  • Helps keep cells healthy
  • Maintains healthy skin, blood vessels, teeth and bones
  • Helps heal wounds

Sources:

  • Citus fruit
  • Green leafy veg

Deficiency:

  • Muscle weakness
  • Easy Bruising
  • Scurvy
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Controlling Stress with Exercise

  • Reduce blood pressure 
  • Reduces chance of cardiac arrest
  • Improves concentration
  • Improves decision making
  • Help you cope better at work
  • Help you sleep better and feel lessn tired
  • Low anxiety levels so you can become calmer
  • The relese of endorphins/ serotonin can increase 
    • feel good factor
    • self-esteem
    • confidence
  • Less likey to have
    • indigestion
    • palpitations
    • muscular aches/ pains

It may add another burden/ demand by increased pressure to exersice

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Raising Self-esteem with Exercise

Exercise stimulates secretion of hormones (such as neurotransmitters like endorphins or serotonin). Neurotransmitters create 'feel good' factor which can mask the pain of exercise to feel good. Weight loss for exercise will raise self-esteem too, helping develop a good body image. This in turn develops self-confidence and help your sense of social belonging. These outcomes stimulates motivation and can help chage your mood as you achieve your goals/ targets. All this promotes positive mental attitude.

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Combating Aging with Exercise

  • Reduces blood pressure
  • Maintains metabolic rate
  • Clears mind reducing tension
  • Sleeping pattern improves
  • Concentration span increases
  • Delay muscle and fibre loss by reducing protein depletion
  • Maintains strenght
  • Slows body system deterioration
  • Ligaments and muscles are streched maintaining flexibility
  • Bone strenght preserved because calcium continues to be deposited into bones
  • Incidences of osteoporosis reduced
  • Risk of blood clots forming in arteries reduced 
  • Blood cholesterol levels decrease at risk of atherosclerosis is reduced
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Balanced Diet and Weight Control with Exercise 1

Exercise suppresses the appetite as it temporarily reduces and slows digestion. During exercise, the blood supply is directed towards the skeletal muscles rather than being used to digest food.

  • To maintain weight: energy input = energy output
  • To gain weight: energy input higher than energy output 
  • To lose weight: energy output higher than energy input 

Carbohydrates - Stored in the muscles and the liver as glycogen, then converted to glucose when needed for energy to fuel muscle contraction by respiration 

Fats - Main energy source from fat is triglycerides which are converted to free fatty acids for energy

Protein - Not a very significant energy provider, can be used when stored glycogen levels are low

It's very important for the diet to be balanced and to contain adequate amounts of nutrients to keep it balanced and to avoid deficiencies or excesses. Keeping a diet varied also makes it more appealing.

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Balanced Diet and Weight Control with Exercise 2

Having a balanced diet:

  • Maintains ideal weight
  • Reduces the risk of obesity, heart conditions and chronic diseases
  • Reduces the risk of under nutrition
  • Boosts energy
  • Promotes fitness and enhances fitness
  • Prevents disease and fights infection
  • Maintains cholesterol
  • Improves immunity
  • Provides the right combination of food and nutrients for optimum health
  • Avoid developing deficiencies/diseases
  • Helps promote mental health, reducing the risk of disorders
  • Improves concentration and memory
  • Helps the body to grow/maintain/repair

 

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Social Benefits with Exercise

Social:

  • Make new friendships or relationships, widening social circle
  • Meet new people with simular interests
  • Maintain existing friendships
  • Developing social skills and communication skills
  • Provides opportunities
  • It can give social support

Emotional:

  • Increases self-confidence/ self-esteem especially if they lose weight
  • Enhances mood/ development of 'feeling good' of feeling happy
  • Stimulates the release of chemicals e.g. serotonin or endorphins by nerve endings in the brain
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What is Heart Disease?

Diseases of the heart:

  • CHD
  • Angina
  • Heart attack
  • Congenital heart disease
  • Heart failure

All of these are caused by the gradual blocking/ narrowing of the arteries by deposits of fatty material. This build-up is called atherosclerosis.

Angina is when arteries narrow and not enough oxygen-rich blood gets to the heart.

If the build-up comes away it can cause a blood clot, if this clot blocks the coronary artery and therefore blocks the blood flow it can cause a heart attack

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How can Regular Exercise Prevent Heart Disease?

Heart disease cannot be cured, but treatment can help manage symptoms. Regular exercise will help you feel better and it will also help improve the functioning of your heart by reducing the workload and enabling it to beat more efficiently, helping improve symptoms.

Increased surface area of the lungs will allow for better gas exchange and better oxygen supply in the bloodstream to the body.

Exercise can:

  • Maintains arterial elasticity
  • Reduce the risk of plaque/ fatty build up/ atherosclerosis
  • Increased proportions of HDL to LDL
  • Overall cholesterol reduced
  • Reduces hypertension
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Exercise Programmes for Heart Disease

Exercise Programmes: 

  • Always speak to a healthcare professional before starting an exercise program to make sure you are not putting a strain on the heart. They will also be able to advise on which activities to avoid
  • It is wise to contact the local cardiac rehabilitation center and ask if they have any low-intensity training
  • Choose an activity you enjoy and that you preferably did prior to heart problems
  • Ask a friend to join with you
  • Understand what you can and can't do
  • Start lightly and listen to signs from the body
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What is a Stroke?

A stroke is when supply to part of the brain is cut off. A quick response is essential as the quicker a patient is dealt with the less damage is done.

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How can Regular Exercise Prevent a stroke?

  • Exercise can reduce your risk of having a stroke or transient ischaemic attack (TIA)
  • It reduces the risk of a number of conditions such as coronary heart disease, some cancers and type-2 diabetes
  • Lowers blood pressure and cholesterol level, helping control weight
  • Strengthens heart and lungs
  • Increases muscle strength and flexibility
  • Improves mood by increasing endorphins 
  • Improves immune system
  • Increases energy levels
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What is Type 2 Diabetes?

Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. this is known as insulin resistance.

It cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible to control your systems and minimise health problems developing later.

It is controlled by:

  • Medication
  • Healthy diet
  • Regular exercise
  • Losing weight
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How can Exercise Prevent Type 2 Diabetes?

  • Physical activity increases the amount of glucose used by the muscles for energy, so it may sometimes lower blood glucose levels
  • It will help you keep fit, losing weight to maintain a healthy weight and sharpen athletic skills
  • Being active helps the body use insulin more efficiently, and regular activity can help reduce the amount of insulin you have to take 
  • Losing any weight that may be necessary and maintaining a healthy weight will improve management of the condition
  • Being active strengthens your bones
  • Muscles which are working use more glucose than those that are resting 
  • You'll be more mobile, less out of breath and you'll sleep better
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What is Obesity and DAwO?

Obese is a term used to describe somebody who is very overweight with a high degree of body fat

  • BMI between 25 and 29 = overweight 
  • BMI between 30 and 40 = obese
  • BMI over 40 would be considered very obese

Being obese increases your risk of developing a number of serious and potentially life-threatening diseases, such as: 

  • Type 2 diabetes 
  • Heart disease
  • Some types of cancer, breast, and colon
  • Stroke
  • It can trigger depression
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How can Regular Exercise Prevent DAwO?

Reducing the number of calories in your diet will stop you putting on more weight, you have to combine a calorie-controlled diet with regular exercise.

GP or weight loss adviser will be able to provide an exercise plan suited to your circumstances, which will recommend so many hours of moderate-intensity physical activity a week.

Moderate-intensity physical activity is any activity that increases heart rate, breathing rate and may make you sweat, but you are still able to hold a normal conversation

  • Fast walking 
  • Jogging
  • Swimming
  • Tennis

Choose physical activities that you enjoy, as you are more likely to continue doing them.

You should aim to start gradually, possibly 15-20 minutes of exercise a day and then build up.

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Improvement of Type 1 Diabetes by Exercise 1

Can be referred to as insulin-dependent diabetes. The pancreas does not produce any insulin. If the amount of glucose in the blood is too high, it can seriously damage the body's organs.

Your blood glucose response to exercise will vary depending on:

  • your blood glucose before exercise

  • the intensity of the activity

  • the length of time you are active

  • changes you’ve made to insulin doses

Sometimes people experience a drop in blood glucose during or after exercise, so it is very important to monitor blood glucose, take proper precautions, and be prepared to treat hypoglycemia

To learn how different types of activity affect you, you should frequently check your blood glucose before, during, and after an exercise session.

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Improvement of Type 1 Diabetes by Exercise 2

During exercise:

  • The body will use up sugar during respiration, for energy, more than normal.
  • This reduces blood glucose levels which in turn prevents hyperglycemia, limiting the need for insulin injections
  • There is less pressure/stress put onto the body to convert the sugar to glycogen in the liver and muscles.
  • This limits the risk for excreting sugar in the urine which could cause hypoglycemia

Abnormally low blood sugar levels due to missing a meal, over-exercising or taking too much insulin.

  • The immediate treatment for hypoglycemia is to have some food or drink that contains sugar, such as dextrose tablets or fruit juice, to correct your blood glucose levels.
  • After having something sugary, you may need to have a longer-acting "starchy" carbohydrate food, such as a few biscuits or a sandwich.

Abnormally high blood sugar levels caused by an intake of excess sugary or starchy foods.

  • Treatment would be insulin injections
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Improvement of Hypertension by Exercise

Hypertension is otherwise known as high blood pressure. It rarely has obvious symptoms. If left untreated, high blood pressure increases your risk of a heart attack or stroke. The only way of knowing there is a problem is to have your blood pressure measured.

Blood pressure measures how strongly blood presses against the walls of your arteries as it is pumped around your body by your heart. If this pressure is too high it puts a strain on your arteries and your heart, which makes it more likely that you will suffer a heart attack, a stroke or kidney disease.

You can take effective steps to lower your blood pressure with changes to your lifestyle and by taking medication.

Exercise will:

  • Increase arterial elasticity
  • Increase cardiac output
  • Increase stroke volume
  • Reduce resting rate
  • Enable body to undergo fluctuations in blood pressure more easily
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Exercise Programs: Individuality

Genetics can play a large part in deciding how quickly a person will adapt to an exercise programme.

This means two individuals are unlikely to show the exact same response to the same programme.

Individual differences must be taken into account when designing exercise programmes.

Programmes must not be too easy or too hard but should encourage the person to stay with the programme.

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Exercise Programs: Specificity

Adaptations always depend on the type of activity undertaken and the intensity in which it is performed.

Specificity relates to the muscle groups involved and the energy sources used.

Training for one type of activity does not mean you are fit enough for all types of activity. E.g. a competent marathon runner would not be much good at the 100m sprint.

 

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Exercise Programs: Reversibility

The positive effects of training are reversible. If you do not adhere to regular physical activity then the benefits are lost.

“If you don’t use it, you lose it!”

All components of fitness can be affected by non-activity (e.g. aerobic capacity, strength, flexibility).

Once a level of fitness has been achieved, it can be maintained with less effort.

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Exercise Programs: Overload

To achieve a higher level of fitness you sometimes need to put the body systems under additional stress by pushing them beyond the level usually achieved.

If the greater level is not achieved, adaptation will not occur.

To avoid injury, illness, and lack of motivation it is important to progressively increase the training load.

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When Preparing a Training Programme…

…the right amount of exercise is needed to see improvements in the physical fitness components.

Programmes should be made to suit the individual or the sport/activity. Programmes should also consider:

  • Realistic fitness goals
  • Mode and form of training
  • How often it is to be undertaken
  • How long and at what intensity

Desired exercise goals have different health and well-being benefits:

  • Weight control
  • Muscle definition
  • Maintain flexibility
  • Disease prevention
  • Management of stress
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FITTA Principles

The FITTA principles say that all programmes should include:

Frequency – the number of times per week that the exercise is to be done.

Intensity – how hard to work (e.g. at 80% of heart rate max) or the amount of overload to be applied

Time – how long the activity is to take

Type – the mode of exercise to be performed

Adherence – the programme should produce the adaptations that the programme was designed for

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Programs to Control Weight 1

Your GP or weight loss adviser will be able to provide an exercise plan suited to your circumstances, which will probably recommend so many hours of moderate-intensity physical activity a week.

Reduce the energy intake from their diet by 600 calories a day. The best way to achieve this is to swap unhealthy and high energy food choices such as fast food, processed food and sugary drinks (including alcohol) for healthier choices. A healthy diet should consist of :

  • plenty of fruit and vegetables
  • plenty of potatoes, bread, rice, pasta and other starchy foods (ideally wholegrain varieties)
  • some milk and dairy foods
  • some meat, fish, eggs, beans and other non-dairy sources of protein
  • just small amounts of food and drinks that are high in fat and sugar 

Also avoid food that contains high levels of salt as this can raise your blood pressure, in particular, fast food and processed foods.

 

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Programs to Control Weight 2

You should avoid fad diets that recommend unsafe practices such as fasting or cutting out entire food groups such as meat, fish, wheat or dairy. These are not sustainable, can make you feel ill, and may cause unpleasant side effects such as bad breath, diarrhea, and headaches.

This is not to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well in some people. A responsible diet programme should:

  • educate you about issues such as portion size, making changes to behavior and healthy eating
  • not be overly restrictive in terms of the type of food you can eat
  • be based on achieving gradual sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last

A very low-calorie diet (VLCD) is where you consume less than 1,000 calories a day. This plan also assumes that you will be drinking water or diet drinks throughout the day, as most other popular drinks such as tea and coffee contain calories. You should only ever undertake a VLCD under the supervision of a suitably qualified healthcare professional

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Programs to Rehabilitate Following Illness

Physical therapy helps the patient restore the use of muscles, bones, and the nervous system. It seeks to relieve pain, improve strength and mobility, and train the patient to perform important everyday tasks. 

The duration of the physical therapy program varies depending on the injury/illness being treated and the patient's response to therapy.

Depending on the patient's condition, exercises may be performed by the patient alone or with the therapist's help, or with the therapist moving the patient's limbs.

Exercise equipment for physical therapy could include an exercise table or mat, a stationary bicycle, walking aids, a wheelchair, practice stairs, parallel bars, and pulleys and weights.

Exercise programs should always be started after advice from healthcare professionals.

And started slowly with low-intensity activities and gradually increasing the duration and intensity of the exercise

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Programs to Prevent and Regulate Disease

Regular physical activity can aid in the prevention and regulation of many diseases.

  • Walking
  • Swimming
  • Yoga
  • Jogging

They will improve the cardiac output, stroke volume, and arterial elasticity.

They will assist with weight loss.

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Programs to Combat Ageing

A patient will want to do some type of aerobic activity for at least 30 minutes on most days of the week.

Examples are walking, swimming and bicycling. You should also do resistance (also called strength training) 2 days per week.

Warm up for 5 minutes before each exercise session. Walking slowly and then stretching are good warm-up activities.

You should also warm-down with more stretching for 5 minutes when you finish exercising. warm-down longer in warmer weather.

Exercise is only good if a patent is feeling well.

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Barriers: Cost

Costs involved in sport and exercise activities can include buying suitable clothing, footwear, and equipment, transport to activity and entry/membership fees.

Why is this a problem?

  • Some more 'engaging/enticing' sport can be expensive e.g. wall climbing
  • Some gyms are expensive or charge a joining fee
  • Some gyms tie people into a contract for up to 12 months
  • Difficult for low-income families/ those with limited disposable income
  • Can de-motivate people

How can this barrier be overcome?

  • Some sports are free e.g. jogging and walking, the only cost will be buying fitness clothing
  • Fitness DVD's can be done at home
  • Local authority sports facilities are cheaper than commercial gyms, usually no joining fee, and often pay per session
  • Costs can be shared if starting exercise with someone else - a reduction of membership rates/transport costs and it helps  to motivate people
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Barriers: Fitness levels

Why is this a problem?

  • People with poor a fitness level often have poor body image
  • Exercise often requires exposing body e.g. shorts/swimming costume and can be embarrassed about excess body fat
  • Older people can find other people are younger and fitter
  • People with some medical conditions avoid exercising due to anxiety or discomfort e.g. angina sufferers

How can this barrier be overcome?

  • Use beginner classes as will be with like-minded people and sessions will be aimed at supporting those who are unfit
  • Start with small, light, regular exercise and increase in intensity and frequency 
  • Exercise with a friend for moral support
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Barriers: Skill levels

Why is this a problem?

  • Less rewarding for those with lower skills as activities and tasks will be less varied = boredom
  • More likely to lose in a competitive game
  • Embarrassment e.g. always dropping the ball

How can this be overcome?

  • Choose activities carefully - ones which do not involve competition
  • Activities like walking or beginners aerobics will help fitness and skill level (coordination)
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Barriers: Cultural Attitude

Why is this a problem:

People believe:

  • They will not enjoy it
  • It is a waste of money and time
  • Friends or family will not approve of it 
  • They don't know anyone else who takes exercise

These views come from social influence, our peers, cultural approaches towards exercise (this could include religious observance, beliefs, and dress) and our environment.

How can this barrier be overcome?

  • Change of social environment e.g. young people going to university or people starting work where people have a wider range of attitudes
  • Separate gym classes for those that are embarrassed or require it due to religious reasons
  • Exercise in the privacy of your own home
  • Join exercise classes with peers
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Barriers: Facility Locations

Why is this a problem?

  • People who live a long way away from amenities can have difficulty getting to facilities
  • Good sporting facilities are usually located in cities or large towns
  • Many facilities are now being closed down due to government cut-backs e.g. swimming pools
  • People who like doing outdoor activities such as sailing or canoeing can struggle to do these if they live in urban areas
  • High crime rate areas can also restrict people from accessing 'free' exercise like running in the street

How can this be overcome?

  • Exercise within the confines of your home e.g. fitness DVD/resistance training
  • Housework can be 'physically active'
  • Walk locally as access to exercise
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Barriers: Work and Family Commitments

What are these problems?

  • Work commitments generally increase as people age and juggling work/home life can be difficult. Exercise is the first thing to go 
  • Childcare arrangments in the evening are difficult and if people work during the day exercise may not be possible
  • Some exercise interests may require traveling e.g. hill walking and not always possible with a young family

How can this barrier be overcome?

  • Find an alternative exercise that can be done locally or from home e.g. fitness DVD
  • Some gyms have family membership/facilities
  • Find activities that can be done with the family e.g. walking or cycling
  • Exercise with work colleagues during lunch breaks
  • Use exercise as your mode of transport getting to and from work
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Safety: Medical Checks and Expert Advice

  • Prevent overexertion 
  • Prevent injury by establishing realistic fitness goals
  • To find any underlying medical problems and identify medical conditions
  • Evaluating current health status gives information on participant’s fitness, strengths, and weaknesses
  • Ask gym staff how to use exercise machines
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Safety:Appropriate Equipment and Clothing

Wear appropriate clothing/footwear

  • In order to prevent injury by not being too loose to catch in equipment
  • To keep warm/prevent overheating 
  • Allow sweating 
  • Comfort 
  • Freedom of movement 
  • Allowing sweat to evaporate

Use appropriate equipment

  • In order to prevent injury  
  • Avoid accidents 
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Safety: Warm-up programmes

Warming-up:

  • gradual/gentle warming up will make the body ready for exercise/by preventing injury eg. Muscle tears/sprain/strain  
  • warming up will prevent muscle soreness  
  • (gently) raising pulse  
  • gently raising cardiac output 
  • ventilation increases
  • increases O2 delivery to muscles  
  • helps reduce O2 deficit at start of exercise  
  • increases muscle  
  • increases temperature  
  • blood vessels in muscles dilate  
  • increases cellular respiration  
  • increases muscle flexibility 
  • mentally prepares the body to exercise/motivate
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Safety: Warm-down programmes

  • Preventing discomfort/soreness/stiffness/pain 
  • Maintaining elevated heart rate  
  • Reduce heart rate slowly/safely 
  • Reduce body temperature 
  • Lower pulse rate 
  • Allows lactic acid to be oxidised/metabolic rate maintained 
  • Reducing blood pooling in veins 
  • Prevents dizziness/feeling faint 
  • Allows muscle temperature to drop slowly 
  • Preventing muscle damage/strain/tears/injury 
  • Allows mental relaxation 
  • Gradually reduce ventilation rate 
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Safety: Correct use of Monitoring Equipment

  • should monitor heart rate and
  • Blood pressure when exercising
  • Used to inform what your personal exertion limits are 

 

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Safety: Drinking Water

  • avoid dehydration/stay hydrated 
  • essential for chemical reactions  
  • lubricant for joints and cells 
  • helps to regulate body temperature 
  • improve quality of workout/exercise/optimal performance 
  • reduce fatigue
  • reduce recovery time 
  • aids the digestion process to give you energy 
  •  

 

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BMI

For adults, the body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height.

  • BMI less than 18.5 0= underweight 
  • BMI 18.50 - 24.99 = healthy weight
  • BMI 25.00 - 29.99 = overweight
  • BMI 30 or more = obese

BMI allows for natural variations in body shape, giving a healthy weight range for a particular height.

The calculation divides the adult's weight in kilograms by their height in meters squared.

Not always an accurate measurement as it does not take into account the density of muscle, age or gender. It cannot distinguish between fat and muscle.

It is good because it creates standardised data, its good for showing a progression and its easy to measure

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Pulse Rate

Strengths :

  • Standardised data/can make comparisons
  • One of the best indicators of fitness
  • Easy to measure
  • Doesn’t require any equipment to measure 

Limitations:

  • More difficult to measure when moving
  • To record when moving requires equipment
  • Some people may find it hard to locate
  • Can be affected by other factors e.g. anxiety/health conditions
  • Shouldn’t be used as the sole measure of fitness 

Average pulse per minute is 60-80 beats per minute for a healthy adult. Lower = fitter

Increase in temperature, increase in exercise and intensity and intense emotion can all raise pulse rate.

 

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Lung Function Tests

Spirometry measures tidal volume = total volume of air that is inhaled or exhaled. Peak flow measures how fast you are able to breath out

Strength

  • simple/easy to use a peak flow meter
  • able to use standardised charts
  • portable
  • allows asthma sufferers to self-check their condition

Limitation

  • not a useful measure of fitness/lacks accuracy
  • human error 
  • only measures one aspect of lung function/fitness 
  • does not consider health conditions e.g. asthma 

The normal range is between 400 to 600

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Perceived Exertion Scales

Strenght

  • gives an overall perception of effort
  • shows progression in effort level
  • safety in exercise-lowers risk of overexertion 

Limitations

  • subjective measure
  • perceptions may vary
  • not good for comparisons between individuals
  • does not measure fitness 

6 - 10 = light

11 - 13 = normal/ middle range

14 - 20 = hard/ maximum effort

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Homeostasis

The maintenance and control of the internal environments.

It controls:

  • Body Temperature
  • Blood sugar levels
  • Water levels
  • Carbon dioxide levels

It works by using the endocrine and nervous system.

Homeostasis mechanisms use the principle of negative feedback.

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Thermoregulation

Body temperature is constantly monitored by the hypothalamus. It receives impulses along nerves from the temperature receptors in the skin as well as from receptors inside the body. If the body temperature changes the hypothalamus sends out a response to correct the change.

Below 37oC

  • Muscles contract and relax producing heat
  • Shivering
  • Pale skin as blood vessels constrict and become deeper in the skin to keep in heat
  • Hair becomes erect to trap a layer of air to the skin to keep heat in

Above 37oC

  • Skin becomes flushed blood vessels expand and move closer to surface to lose heat
  • Sweat forms on the skin to evaporate and cool body down
  • Hairs stay flat on the surface

This is an example of negative feedback. As a change in the body happens in one direction, mechanisms in the body, work to make it change in the opposite direction. This keeps conditions under control at the right level.

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Heart Rate

Electrical impulses from the heart muscle cause your heart to beat (contract). This electrical signal begins in the sinoatrial (SA) node, located in the right atrium. The SA node is sometimes called the heart's "natural pacemaker.“ The SA node is needed for the heart's contractions.

Adrenaline is a hormone released at moments of great anger or excitement. It has a slow but long lasting response on the body. Adrenaline can increase the rate of the heart by stimulating the adrenergic receptors on cells throughout your heart tissue. Adrenaline is released by the body to affect the heart if the heart has been damaged (heart disease/ angina) but this causes more damage.

Noradrenaline is also a hormone. Heart rate is also decreased with noradrenaline release but is a delayed effect. It interacts with alpha receptors in the arteries, thereby causing constriction of the blood vessel. Blood vessel constriction triggers a reflex pathway that causes the heart rate to slow down.

 

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Respiratory System

The respiratory system supplies oxygen and removes waste carbon dioxide.

The respiratory centre of the brain is in the medulla oblongata at the bottom of the brain cell.

The respiratory centre receives controlling signals of neural, chemical and hormonal nature.

It controls the rate and depth of respiratory movements of the diaphragm and other respiratory muscles.

Increased signals from the lungs during exercise will lead to the response of a quicker breathing rate in the lungs.

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