NCSF Personal Trainer Reference Guide-2

LESSON FIVE BODY COMPOSITION Perform your conversion for the Metric formula below: _________ lbs ÷ 2.2 = _________ kg _________ inches x .0254 = _______ m Step 3 Calculate your subject’s BMI using one of the following formulas. English Formula: BMI = {Weight (lbs) ÷ Height (inches)2} x 703 Metric Formula: BMI = Weight (kg) ÷ Height (meters) 2 Example One (English) Example Two (Metric) 5”10 in. 150 lbs. female 5”10 in. 150 lbs. female BMI = {150 lbs ÷ (70 inches)2} x 703 1.778 m 68 kg female BMI = (150 ÷ 4900) x 703 BMI = 68 ÷ (1.788)2 BMI = 0.0306 x 703 BMI = 68 ÷ 3.196 BMI = 21.5 BMI = 21.3 Perform your calculation below by selecting one of the two calculation methods: BMI = {________ lbs. ÷ (______ inches)2 } x 703 BMI = _________ kg ÷ (______ m)2 BMI = _________ kg ÷ ________ BMI = (_________ lbs. ÷ ________) x 703 Or BMI = _________ BMI = _________ Step 4 Reference the BMI tables on page 174 of the course textbook to interpret your results. 46

BODY COMPOSITION LESSON FIVE Waist Circumference • High predictability for metabolic disease and obesity related low-grade inflammation • Correlates to behavior-related fat storage Highest Risk Values – Males >40 inches, Females >35 inches Waist-to-Hip Ratio • Predictability for disease based on difference between measures • Risk increases as value increases, values above 0.9 for males and 0.8 for females have greatest risk • Waist circumference alone is a better predictor of metabolic disease risk as large waist measures reduce the value Calculate Waist-to-Hip Ratio Waist measurement _________________ Hip measurement _________________ Waist value __________ ÷ Hip value ___________ = _____________ Ratio Value Direct Measures Clinical Assessments • Hydrostatic Weighing • Air Displacement Plethysmography • Dual X-ray Absorptiometry Field Assessments • Circumference Measurements • Skinfold Measurements • Bioelectrical Impedance • Near-infrared scan 47

LESSON FIVE BODY COMPOSITION Clinical Measures • Hydrostatic Weighing – calculates body density based on Archimedes principle of buoyancy • Air Displacement Plethysmography – based on the inverse relationship of pressure and volume using Boyles Law • Dual X-ray Absorptiometry – assesses multiple compartments using the attenuation of X-rays by the body’s tissues Circumference Measurements Measure the circumference of designated locations which are equated to predict body density based on the positive linear relationship between the measured values. Reference values for individual body size are often the neck or wrist. Advantages • Non-invasive – low psychological impact • Desirable method for obese individuals • Provides regional fat storage information • Easy methodology • Limited expertise required Disadvantages • Reduced accuracy for lean individuals • Over-predicts muscular individuals Girth Estimation of Body Fat Procedures Follow the directions below to compute the 2-3 Girth estimation of body fat using a volunteer subject. Step 1 Anthropometric data collection. Measure the appropriate anatomical locations of the subject and record the value in the space provided (reference p294 in Chapter 14 of your textbook for a detailed overview). All circumference measurements should be taken over the subject’s skin where applicable. Tight fitting clothing should be worn when skin contact is not appropriate. Men • Abdominal measurement – measure the circumference of the abdomen by aligning the tape so that it passes over the navel. • Neck – measure the circumference of the neck just inferior to the larynx (Adam’s apple). • Record your results. Abdominal circumference _______________in. Neck circumference _______________in. Height ______________in. 48

BODY COMPOSITION LESSON FIVE Women • Upper abdominal measurement – measure the circumference of the upper abdomen by aligning the tape so that it is between the distal aspect of the rib cage and the navel • Hip – measure the circumference of the hip in the center of the gluteals at the level of the greater trochanter, or curvilinear apex, of the hip (widest points) • Neck – measure the circumference of the neck just inferior to the larynx. • Record your results Upper abdominal circumference _______________in. Hip circumference _______________in. Neck circumference _______________in. Height _______________in. Step 2 Calculate subject’s derived circumference value. The 2-3 Girth model utilizes a derived circumference value to ascertain the subject’s estimated body fat. From the data collected in Step 3 Step 1, find the subject’s derived circumference value by utilizing the following gender Step 4 specific equation. Men: Abdominal – Neck = Circumference value Women: ___________ – ___________ = ____________ Upper abdominal + Hip – Neck = Circumference value ___________ + ___________ – ___________ = ____________ Find subject’s estimated 2-3 Girth percent body fat. The charts in Chapter 14 contain the estimated body fat percentages according to the 2-3 Girth model. To find your subject’s estimated body fat you must first refer to the correct gender table (Table A for men and Table B for women). You must then match the subject’s calculated circumference value from Step 2 with the subject’s height in inches. The derived circumference values are located in the left hand column and the height values are located across the top of the table. Record data. Record the subject’s estimated 2-3 Girth percent body fat value. ________ Body fat percentage Step 5 Interpret the data. Compare the subject’s predicted body fat measurement with the body fat percentage chart on p182 in Chapter 10. 49

LESSON FIVE BODY COMPOSITION Skinfold Measures Skinfolds at specific sites are measured and the values in millimeters are entered into regression equations to predict body density. Advantages • Increased accuracy for lean subjects (3.5% SEE) • Limited equipment needs • Can be performed anywhere, quickly Disadvantages • Accurate for leaner individual • Technician expertise required • Equations are site specific • Difficult with obese individual • Skinfold compressiveness varies Skinfold Locations • Abdomen – vertical fold • Chest – diagonal fold • Thigh – vertical fold • Triceps – vertical fold • Suprailiac – diagonal fold • Midaxillay – vertical fold • Subscapular – diagonal fold • Medial calf – vertical fold Skinfold Measurements Procedures Follow the description below to calculate the percent body fat for a sample subject using the 3-site skinfold method. Answer the corresponding activity questions at the end of the section. Step 1 Locate the correct gender-specific anatomical location(s). The following chart and illustrations on p288-290 in Chapter 14 provide a detailed description of the 3-site Jackson and Pollock model. Refer to these when locating the correct gender specific skinfold locations. Once the site has been identified, mark the site with an erasable marker so that you can return to the exact location for subsequent measurements. This will also allow you to become more proficient at site identification and increase test reliability. Note: You may need to wipe the area dry of oils, sweat, or lotions before marking the site. Jackson and Pollock Gender-Specific Skinfold Sites • Men – Chest, Abdominal, Thigh • Women – Tricep, Suprailiac, Thigh 50

BODY COMPOSITION LESSON FIVE Step 2 Hand placement. Place the caliper in the right hand with the index finger in a position to open the caliper. Slightly pronate the right hand so that the caliper can be easily read from above. Pronate the left hand to a point at which the thumb of the left hand is pointing downward. A simplified description is to have the tester place both arms out in front of him/her and rotate both arms inward so that both thumbs are pointing downward, with the caliper in the right hand. With the thumb and fore-finger facing downward, place the thumb and finger perpendicular to the marked site of the skinfold. Step 3 Pinching of skinfold. Using a pinch width of approximately two inches wide, firmly pinch Step 4 the skinfold between the thumb and first two fingers, lifting the subcutaneous fat and skin from the underlying muscle tissue. Placement of calipers. Once the tester has successfully separated the subcutaneous fat and skin from the underlying muscle belly, the caliper should be placed on the fold. The pinchers of the caliper should be placed across the long axis of the skinfold at the designated site. Using a 1 cm separation between the technician’s fingers and the calipers should prevent the skinfold dimension from being affected by the pressure from the tester’s fingers. 51

LESSON FIVE BODY COMPOSITION Step 5 The depth of caliper placement is about half the distance between the base of the normal skin Step 6 perimeter and the top of the skinfold. Place the jaws of the calipers perpendicular to the skinfold site approximately 1 cm below the fingers. This will allow the caliper reading to be done approximately halfway between the bottom and top of the fold. Reading of calipers. Calipers have a compression tension of 10 g · mm2. In order to get an accurate reading and prevent compression of the fat by the caliper, the tester must read the caliper to the closest half millimeter within 2 seconds of applying the caliper jaws to the fold. Measure each site and record the assessment values on the Data Recording Sheet. The measurements should be repeated two times allowing at least 15 seconds between subsequent measurements. If the measurements differ by more than 2 millimeters, a third measurement should be taken and an average of the three measurements used. In non-obese individuals, the skinfolds should not differ by more than two millimeters. The median values of the three trials are used for evaluation and prediction. Record results. Record the individual site measurements on the provided Data Recording Form. The measurements will be used to compare future assessment results. 3-Site Skinfold Body Composition Estimation Data Recording Form Men: Trial 1 Chest ______ Abdominal _______ Thigh ______ Trial 2 Chest ______ Abdominal _______ Thigh ______ Trial 3 Chest ______ Abdominal _______ Thigh ______ Average _______ Average ______ Average ______ Sum of the Three Averages _____________ Women: Trial 1 Tricep ______ Suprailiac _______ Thigh ______ Trial 2 Tricep ______ Suprailiac _______ Thigh ______ Trial 3 Tricep ______ Suprailiac _______ Thigh ______ Average _______ Average ______ Average ______ Step 7 Sum of the three averages _____________ Computation of results. Once the data has been recorded on the provided Data Recording Sheet, the tester should add the three skinfolds together to obtain the sum of skinfolds in millimeters. The sum of the skinfolds is then charted or used in a body density equation to determine the estimated body fat of the individual. The charts on p291-292 in Chapter 14 contain the estimated age-adjusted body composition computed by the Siri Equation. Find your subject’s estimated body fat by referencing the gender-specific table by matching the sum of the skinfolds in the left hand column with the subject’s age on the top row. Estimated Body Fat _____________ % 52

BODY COMPOSITION LESSON FIVE Step 8 Interpretation of results. After the subject has been classified by estimated value, the results can be used to establish goals and develop weight management strategies. Listed below are general classifications for body fat. Bioelectrical Impedance Based on the water content of tissue. Fat has a lower water content than connective tissues. A weak electrical current is run through the body to identify the speed of conductivity or level of impedance. Advantages • Easy to use • Limited tester expertise • Rapid assessment • Can be used across populations Disadvantages • Non-clinical assessment methods using field devices have questionable accuracy • Accuracy affected by hydration, ambient temperature, skin permeability, skin temperature, equation used Near Infrared Light Interactance Based on light absorption and reflection. Body fat absorbs light, while lean mass reflects it. Advantages • Easy methodology • Can be performed anywhere Disadvantages • Questionable accuracy • Expensive equipment 53

LESSON FIVE BODY COMPOSITION Body Composition Continuum Males Essential Optimal Increased Risk Obesity 3-5% 11-19% 20-24% >25% Females 11-14% 16-25% 26-30% >32% Target Body Weight Formula Fat free mass divided by the value (one) minus the desired percentage expressed as a decimal. Assumes weight loss is from fat mass without loss in lean tissue. Calculating Lean Mass & Target Body Weight Activity Description Differentiating the tissue compartments by mass is useful in determining the necessary changes for optimal health and goal setting for weight loss or gain. Using the percentage of body fat determined via body composition analysis, personal trainers can identify the relative quantity of lean and fat mass on the body. These values can then be used to calculate target weight for appropriate adjustments in body composition. Procedures Following the instructions below, enter the appropriate data to calculate lean mass and target body weight. Use the examples provided for guidance. Calculating Lean Mass Bodyweight x Body fat percentage = Fat mass Bodyweight – Fat mass = Lean mass Example 200 lb. male 20% body fat 200 lbs. x 0.20 = 40 lbs. Fat mass = 40 lbs. 200 lbs – 40 lbs. = 160 lbs. Lean mass = 160 lbs. Step 1 Enter estimated body fat __________% Enter bodyweight __________ lbs. 54

BODY COMPOSITION LESSON FIVE Step 2 Enter the values from Step 1 into the formula. Step 3 Estimated body fat ( ________% ÷ 100 ) x bodyweight _________ lbs. = ________ Fat mass Calculate lean mass by subtracting the fat mass, in pounds, from the total body weight. Bodyweight _______ lbs. – Fat mass ________ lbs. = Lean mass __________ lbs. Calculating Target Bodyweight Using the formula provided, calculate the Target Bodyweight for a volunteer subject or the sample subject below. The formula will identify the weight of the individual at the selected body fat percentage assuming the weight lost is fat mass and not lean mass. Lean Mass ÷ {1 - (desired body fat percent ÷ 100)} = Target Bodyweight Example 200 lb man 20% body fat Lean Mass 160 lbs. New desired body fat 18% 160 lbs. ÷ {1 - (18% ÷ 100)} = Target Bodyweight 160 lbs. ÷ {1 - (.18)} = Target Bodyweight 160 lbs. ÷ (.82) = 195 lbs. 200 lbs. – 195 lbs. = 5 lbs. weight loss Procedures Using the sample subject below or a volunteer subject, calculate the desired bodyweight for a 3% reduction in body fat. Sample Subject: Jennifer is 32 years old and weighs 145 lbs. Her current body composition is 28%. Her short-term goal is 25%. Step 1 Calculate Fat Mass using the formula below. Enter Current Bodyweight _________ lbs. Enter Current Body Fat _________ % Current body fat ( ________% ÷ 100 ) x Bodyweight _________ lbs. = ________ Fat mass Step 2 Calculate lean mass by subtracting the fat mass in pounds from the total bodyweight. Bodyweight _______ lbs. – Fat mass ________ lbs. = Lean mass __________ lbs. Enter Lean Mass _________ lbs. 55

LESSON FIVE BODY COMPOSITION Step 3 Select a new Desired Body Fat _________ % Step 4 Enter the values from Step 1 and Step 2 into the formula below to calculate the Target Body- weight. Hint: Do not convert the body fat percentage into a decimal before inserting the value. Lean Mass _______ lbs. ÷ {1 - (desired body fat percent _______ ÷ 100)} = Target Bodyweight Lean Mass _______ lbs. ÷ {1 - ( _______ )} = Target Bodyweight Lean Mass _______ lbs. ÷ ________ = ________ Target Bodyweight Step 5 Subtract the Target Bodyweight from the initial bodyweight to identify the weight loss goals. Current bodyweight ______ – Target Bodyweight _______ = Weight loss goal _______ lbs. Once the initial short-term goal has been attained, the personal trainer must then re-compute the target body- weight based on new desired body fat goals. Homework for Next Class Page 190 Textbook Read Chapter 11 Weight Management 56



LESSON SIX WEIGHT MANAGEMENT Lesson Six Weight Management Trends • Obesity is increasing by 1% per year • More than 60% of people are overweight • 17% of children are overweight or obese • Obese individuals costs 6x more in health care • Physical activity is decreasing among all population segments Factors Affecting Weight • Social Factors – Cultural behaviors, eating and physical activity patterns of a wealthy country • Economic Factors – Low price convenience food, economic relationship to weight • Physiological Factors – Effects of hunger on meal portioning; energy nutrient dynamics • Psychological Factors – Learned eating patterns, effects of appetite Energy Balance Equation Energy = calories in – calories out Energy entering the body has four options: 1) Stored as glycogen 2) Stored as fat 3) Used to synthesize molecules 4) Used to facilitate actions of the body Caloric Restriction • Protein sparing mechanism is lost when caloric intake is too low to support carbohydrate sparing • Meal skipping or prolonged restriction cause metabolic shifts towards catabolic activity and fat- sparing due to low blood glucose levels • 1200 kcal is the minimum recommended caloric intake, and for most people is too low to support metabolic homeostasis 57

WEIGHT MANAGEMENT LESSON SIX Identifying Intakes • Caloric intake is half of the energy balance equation • Determining intakes requires identifying the type and quantity of food and drink • Most commonly assessed using food logs or recall • Measurement accuracy and food knowledge are factors to estimation validity • Dietary Recalls/Logs Dietary Recalls/Logs Common Errors • Incorrect serving/portion size • Falsifying data (embarrassed) • Forgotten items (recall) • Temporarily changing eating habits • Limited knowledge of mixed food contents/eating out • Overlooking condiment use • Forgetting drinks Improving Accuracy • Review serving sizes and portions • Record foods as consumed • Identify what has been added to the food during preparation • Clearly explain that the diet will not be judged and inaccuracies make the evaluation invalid Key Nutrients for Dietary Evaluation Energy Nutrients • Total Carbohydrates • Sugars • Fiber • Total Fats • Saturated Fat • Cholesterol • Protein Non-Energy Yielding • Sodium • Potassium • Calcium • Iron • Water 58

LESSON SIX WEIGHT MANAGEMENT Food Energy Protein Carbohydrates Fat Saturated Cholesterol Calcium Iron Sodium Fiber Plain bagel (Kcals) 7 38 13 2.7 229 0 Fat 27 .5 2 0 195 10 0 8 oz Orange Juice 112 2 26 00 0 2 tbsp Cream 104 2 2 10 6.6 32 24 .4 44 0 cheese 118 3 16 5 2 0 175 1.62 78 1 10 31 22 2.7 30 Granola bar 1 25 10 3 120 1 3 00 0 Chicken salad pita 366 0 103 0 0 0 76 2.2 483 2 Potato chips 190 7 5 14 2 0 27 .3 255 1 Dill pickle 15 0 0 00 0 6 .4 833 1 22 66 18 8.4 48 32 oz Coke 412 5 34 18 4 60 15 .75 110 0 163 0 81 0 0 0 25 .5 121 3 Single size bag 8 30 2 0 2 0 0 00 Peanuts 0 20 oz water 0 0 68 g 292mg Beef and Bean 510 106 5.2 1340 6 burrito 320 Nachos and salsa 303 300 6.3 1780 3 24 oz Lemonade 21 1.2 21 0 Bowl of low fat 156 260 .5 106 0 ice cream 0 0 0 0 0 00 0 12 oz Water 2964 kcal 100g 28.7g 1075 mg 22.22 mg 5402 mg 17 g Total 460g Total Sugar 294g 59

WEIGHT MANAGEMENT LESSON SIX Calculate Food Log Recommended < 30 of dietary intake Total Calories ________ kcal < 10% of dietary intake 55-60% of dietary intake Total Fat ________ g x 9 kcal/g = ______ kcals <10% of dietary intake 10-15% of dietary intake Saturated Fat ________ g x 9 kcal/g = ______ kcals < 300 mg per day 20-35 g per day Total Carbohydrates ________ g x 4 kcal/g = ______ kcals 2400 mg Sugar ________ g x 4 kcal/g = ______ kcals M: 8 mg, F: 18mg 1000 mg Total Protein ________ g x 4 kcal/g = ______ kcals 64 oz Cholesterol ________ mg Dietary Fiber ________ g Sodium ________ mg Iron ________ mg Calcium ________ mg Water ________ oz Identifying Output • Energy expenditure is a factor of involuntary metabolism and voluntary metabolism • Physical activity and nutrient intake represent voluntary controls • Most estimation errors occur in the prediction of metabolism and physical activity Components of Metabolism • Resting Metabolic Rate – 60-70% of expenditure • Physical Activity – 25-35% • Thermic Effect of Food – up to 10% Resting Metabolic Rate • Based on body size, gender, body composition, and genetic predisposition • Affected by illness, stress, starvation, recovery from exertion, and malnutrition • Represents 60-70% of daily energy expenditure 60

LESSON SIX WEIGHT MANAGEMENT Thermic Effect of Food • Reflects all energy used in the process of eating, digestion, absorption, and elimination of food • Affected by energy content, carbon chain complexity and diversity, quantity of food consumed • Represents 5-10% of energy expenditure • Diets high in fat, sugar, and processed foods have lower thermic dynamics • Diets high in complex carbohydrates, lean meats, and fiber have higher TEF Calculating Metabolic Rate Equations do not identify genetic factors or activity related adjustments • Revised Harris-Benedict Equation – based on age, gender, height, weight • Cunningham Lean Mass Equation – based on fat-free mass Daily Need • Daily need is the product of metabolism and physical activity • Activity multipliers are used to account for physical activity and the thermic effect of food • Inaccuracies in activity prediction may under or over predict caloric need • Slow progression of fat gain associated with a decline in metabolic activity from age and decreased physical activity without adjustments in caloric intake • Continuous yearly positive caloric balance can add weight progressively to obesity in the second half of life Lean Mass Estimation of RMR The amount of lean mass a person carries influences RMR. It is widely accepted that muscle is more metabolically active than fat, even during resting conditions. This suggests that if two individuals weigh the same, the person with the higher amount of fat-free mass (FFM), or greater lean body weight (LBW), should have a higher RMR than the person with a higher amount of fat mass (FM). This further supports the need for a resistance training component in a fitness program aimed at weight loss. Following the steps below, calculate the RMR value for your test subject. Use their body fat results from Lab 4.2 or 4.3 to calculate RMR using the lean mass equation. Step 1 Determine lean mass value of subject using body composition analysis. Test Subject’s weight in pounds __________ Test Subject’s body fat percentage __________ _________Percent body fat x __________ weight in pounds = __________ Fat mass _________Weight in pounds – __________ Fat mass = __________ Fat-free mass 61

WEIGHT MANAGEMENT LESSON SIX Step 2 Determine Fat-free mass in kilograms. Step 3 Fat-free mass in lbs. ________ ÷ 2.2 = __________ Fat-free mass in kilograms Calculate RMR from Fat-free mass using the following formula. RMR (kcal/day) = 370 + (21.6 x fat-free mass in kg) RMR (kcal/day) = 370 + (21.6 x ______ kg) Step 4 RMR (kcal/day) = 370 + ( ________ ) RMR = __________ Compare Lean Mass RMR value to the Harris-Benedict RMR Predication Equation value. Predicted RMR ______________ Estimation of Daily Caloric Need Procedures Calculate your test subject’s Daily Caloric Need by multiplying the RMR value from either the Harris- Benedict Equation or the Lean Mass Equation by the correct corresponding Activity Multiplier (see following table). RMR (kcal) x Activity Multiplier (see below) = Daily Caloric Need RMR _______ kcal x Activity multiplier _______ = Daily Caloric Need __________ calories Use Chart on Next Page to Identify Activity Multiplier 62

LESSON SIX WEIGHT MANAGEMENT It is quite obvious from the table that the more active an individual is, the higher the activity multiplier used will be. The activity multiplier can be adjusted to half-numbers (i.e. 1.45). You can use the table to “classify” your client’s fitness level, but be aware that it is not uncommon for individuals to overestimate their activity level. For a personal trainer working with a client who has weight loss as the primary goal, it is recommended to use the lowest reasonable activity multiplier to best meet the caloric restriction requirements needed for weight loss. 63

WEIGHT MANAGEMENT LESSON SIX Metabolic Factors of Influence • Total oxygen utilization – increase total physical activity • Excess Post-Exercise Oxygen Consumption – increase intensity of exercise – high intensity anaerobic exercise has the greatest effect • Lean Mass – resistance training aimed at hypertrophy • Thermic Effect of Food – increase fiber, complex carbohydrates, and lean protein Creeping Obesity Slow progressive weight gain often increases rate over the final four decades of lifespan. Example: Sun Mon Tues Wed Thur Fri Sat + 2550 2730 2205 2640 2460 3205 3100 - 2450 2305 2330 2550 2200 2460 2720 Weekly Intake +18890 Weekly Expenditure - 17015 Weekly Net + 1875 Avg. Positive Balance + 268 per day Monthly Net + 7500 Potential Weight Gain + 2 lbs/month Net Weight Gain +.75 lbs/month due to metabolic compensation Weight Loss Strategies 1. Be realistic – 0.5 lbs of weight loss a week 2. Make small progressive changes 3. Make a plan with milestones 4. Provide behavior and nutritional education 5. Teach portion sizes 6. Increase meal frequency and reduce meal size 7. Advocate moderation not restriction 8. Focus on the long term – diet should reflect a lifestyle not an acute change in eating 9. Emphasize daily movement 10. Add resistance training 64

LESSON SIX WEIGHT MANAGEMENT Dietary Behavior Recommendations • Plan and prepare food • Avoid eating out • Take small portions instead of filling the plate • Eat before going out • Snack on fruits • Focus on fiber intake • Avoid convenience eating • Be conscious of drink calories • Avoid easy access to food Physical Activity • Physical activity is the key to successful long-term weight loss • Diet alone is ineffective long-term • Combining aerobic exercise with anaerobic exercise provides the greatest impact on body composition • Emphasis should be on caloric expenditure regardless of the energy system used Spot Reduction • The body does not comply with selective lipolysis • Fat loss is related to genetically defined receptor activity and endocrine response • Localized spot reduction does not occur Fad Diets • Fad diets represent short-term adjustments to the diet • No single fad diet has proven to provide long-term results • Dietary changes without exercise have not shown to be effective long-term • Most fad diets are accompanied by purported dramatic results in short periods of time Weight Gain • Effective weight gain requires exercise • Increased caloric intake 150-200 kcal from protein in conjunction with resistance training • If weight gain is difficult 500-700 kcal increase per day from protein and nutritious carbohydrate sources • Protein synthesis is a slow process; excess calories are stored as fat • 1 lb of lean mass equates to 2500 kcal 65

WEIGHT MANAGEMENT LESSON SIX Homework for Next Class Page 207 Page 235 Textbook Read Chapter 12 Physical Fitness & Health Read Chapter 13 Pre-Exercise Screening & Test Consideration Reference Guide Page 66 Complete Activity Heart Disease Risk Factors Activity: Heart Disease Risk Factors Activity Description Heart disease is the leading killer in the United States. It is well documented that a sedentary lifestyle, obesity, and poor nutritional habits accelerate the development of the disease. Personal trainers should be well-versed in the risk factors for heart disease and the behaviors linked to them. Exercise and routine physical activity along with healthy dietary habits and reduced stress exposure can help prevent the premature development of heart disease and thwart the cascade of events that may lead to a myocardial infarction or stroke. Procedures Connect the risk factors for heart disease with the resultant effect each has in the development of Coronary Artery Disease (CAD). There may be more than one negative effect for each risk factor. You may reference Chapter 12 for assistance if necessary. Risk Factor for CAD Negative Consequences ________High Blood Pressure A. Increased LDL Cholesterol ________Low Grade Inflammation B. Reduced HDL Cholesterol ________High Fat Diet C. Reduced Adiponectin ________Saturated Fat D. Increased Triglycerides ________Psychological Stress E. Increased Platelet Adhesion ________Smoking F. Endothelial Dysfunction/Damage ________Oxidative Stress (free radicals) G. Endothelial Lesions ________Physical Inactivity ________Visceral Fat 66

LESSON SEVEN PRE-EXERCISE SCREENING Lesson Seven Pre-Exercise Screening Benefits of Screening • Educates participants to health risks associated with lifestyle, behaviors, and heredity • Identifies current health status compared to recommended ranges • Provides data for the development of a needs analysis and subsequent exercise prescription • Helps in the establishment of starting points • Identifies interests, aptitudes, and limitations Screening Documents • Informed Consent • Par-Q • Health Risk Appraisal • Medical History Questionnaire • Health Status Questionnaire Informed Consent Legally defensible document used to acquire consent for participation. Included in the Informed Consent • Purpose and rationale for activity or testing • Assumed risk of participation • Expected benefits • Explanation of procedures • Physiological expectations • Opportunity for inquiry • Right of refusal • Right of confidentiality Complete the Informed Consent Par-Q • General clearance form for physical activity • Self-reported assessment of health information • Provides seven red flag indicators • If “yes” is answered to any of the questions, medical referral is recommended • Provides limited data for programming 67

PRE-EXERCISE SCREENING LESSON SEVEN Medical History Questionnaire • Provides information pertaining to previous medical findings • May be limited by diagnosis • Ideally provides information that presents criteria to establish risk • Best when the documents include recent medical findings or evaluations Health Status Questionnaire • Most comprehensive screening tool • Include evaluative questions for activity participation • Sectioned into general information, medical history, current medical information, self-reported health and physical fitness information, and self-reported mental health status based on perceived stress • Probing questions are designed to extract additional information • Should be orally administered and professional notes based on additional information should be documented • Provides quality data for program decision making and exercise prescription Behavior Questionnaire • Identifies positive and negative behaviors • Used to identify correlating factors • Used to ascertain current affects of eating behaviors, physical activity participation, alcohol intake, and sleep • Negative behaviors should be fully explained as to relevance and documented for modification What to Look For • Diagnosed disease or health problems • Signs and symptoms indicative of disease or health problems • Factors and behaviors that increase risk for disease or health problems • Correlation between behaviors and risk factors • Previous injury • Current medications or prescriptions Review HSQ and Behavior Questionnaire 68

LESSON SEVEN PRE-EXERCISE SCREENING HEALTH STATUS QUESTIONNAIRE SECTION ONE - GENERAL INFORMATION 1. Date: 7/6/2010 2. Name: John Delaney 3. Mailing Address: 15 Elm St. Merribel, PA 18623 Phone (H): 555-347-2830 Phone (W): Email: [email protected] Phone: 4. EI Personal Physician: Dr. Vincent Fax: Physician Address: 5. EI Person to contact in case of emergency: Mary Delaney Phone: Same 6. Gender (circle one): Female Male RF 7. RF Date of birth: 06/23/65 8. Height: 5’10” Weight: 205 9. Number of hours worked per week: Less than 20 20-40 41-50 over 50 10. SLA More than 25% of the time at your job is spent (circle all that apply): Sitting at desk Lifting loads Standing Walking Driving SECTION TWO - CURRENT MEDICAL INFORMATION 11. Date of last medical physical exam: 03/14/2010 12. Circle all medicine taken or prescribed within the last 6 months: Blood thinner MC Epilepsy medication SEP Nitroglycerin MC Diabetic MC Heart rhythm medication MC Other_____________________ Digitalis MC High blood pressure medication MC Diuretic MC Insulin MC 13. Please list any orthopedic conditions. Include any injuries in the last six months. ACL tear in High School – Surgically repaired 69

PRE-EXERCISE SCREENING LESSON SEVEN 14. Any of these health symptoms that occur frequently (two or more times/month) require medical attention. Please check any that apply. a. ___ Cough up blood MC g. ___ Swollen joints MC b. ___ Abdominal pain MC h. ___ Feel faint MC c. ___ Low-back pain MC i. ___ Dizziness MC d. ___ Leg pain MC j. ___ Breathlessness with slight exertion MC e. ___ Arm or shoulder pain MC k. ___ Palpitation or fast heart beat MC f. ___ Chest pain RF MC l. ___ Unusual fatigue with normal activity MC Other________________________________________________________________ SECTION THREE - MEDICAL HISTORY 15. Please circle any of the following for which you have been diagnosed or treated by a physician or health professional: Alcoholism SEP Diabetes SEP Kidney problem MC Anemia, sickle cell SEP Emphysema SEP Mental illness SEP Anemia, other SEP Epilepsy SEP Neck strain SLA Asthma SEP Eye problems SLA Obesity RF Back strain SLA Gout SLA Phlebitis MC Bleeding trait SEP Hearing loss SLA Rheumatoid arthritis SLA Bronchitis, chronic SEP Heart problems MC Stress RF Stroke MC Cancer SEP High blood pressure MC Thyroid problem SEP Cirrhosis MC HIV SEP Ulcer SEP Concussion MC Hypoglycemia SEP Congenital defect SEP Hyperlipidemia RF Other_____________________ 16. Circle any operations that you have had: Back SLA Heart MC Kidneys SLA Eyes SLA Joints SLA Neck SLA Ears SLA Hernia SLA Lungs SLA Other________________________________ 17. RF Circle any who died from a heart attack before age 55: Father Brother Son 18. RF Circle any who died from a heart attack before age 65: Mother Sister Daughter 70

LESSON SEVEN PRE-EXERCISE SCREENING SECTION FOUR - HEALTH-RELATED BEHAVIORS 19. Have you ever smoked? Yes No 20. RF Do you currently smoke? Yes No 21. RF If you are a smoker, indicate the number smoked per day: Cigarettes: 40 or more 20-39 10-19 1-9 Cigars or pipes only: less than 5 5 or more 22. RF Do you exercise regularly? Yes No 23. Last physical fitness test: High School 24. How many days a week do you accumulate 30 minutes of moderate activity? 01 2 3 4 5 6 7 25. How many days per week do you normally spend at least 20 minutes in vigorous exercise? 012 3 4 5 6 7 26. What activities do you engage in a least once per week? Golf 27. Weight now: 205 lbs. One year ago: 200 lbs. Age 21: 170 lbs. SECTION FIVE - HEALTH-RELATED ATTITUDES 28. These are traits that have been associated with coronary-prone behavior. Circle the number that corresponds to how you feel toward the following statement: I am an impatient, time-conscious, hard-driving individual. Circle the number that best describes how you feel: 6= Strongly agree 3= Slightly disagree 5= Moderately agree 2= Moderately disagree 4= Slightly agree 1= Strongly disagree 71

PRE-EXERCISE SCREENING LESSON SEVEN 29. How often do you experience “negative” stress from each of the following? Never _____ Work: Always Usually Frequently Rarely _____ Home or family: _____ _____ X _____ _____ Financial pressure: _____ _____ _____ Social pressure: _____ _____ _____ X _____ Personal health: _____ _____ _____ X _____ _____ _____ X _____ X 30. List everything not included on this questionnaire that may cause you problems in a fitness test or fitness program. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Action Codes EI = Emergency Information - must be readily available. MC = Medical Clearance needed - do not allow exercise without physician’s permission. SEP = Special Emergency Procedures needed - do not let participant exercise alone; make sure the person’s exercise partner knows what to do in case of an emergency. RF = Risk Factor of CHD (educational materials and workshops needed). SLA = Special or Limited Activities may be needed - you may need to include or exclude specific exercises. Other (not marked) = Personal information that may be helpful for files or research. 72

LESSON SEVEN PRE-EXERCISE SCREENING BEHAVIOR QUESTIONNAIRE 1. How many servings of fruits and vegetables do you eat per day? 0 1 2 3+ 2. How many caffeinated drinks (coffee, tea, cocoa, soft drinks) do you drink per day? 0 1-2 3-4 5+ 3. How many glasses (8 ounces) of water do you drink per day? 8+ 0-3 4-5 6-7 4. How many meals do you consume per day? 1-2 3-4 5-6 7+ 5. I cook with and eat fats: ___ Nearly always cook/eat high fat foods (fried foods, shortening, butter, creams) ___ Cook/eat mostly high fat X Cook/eat both high and low fat foods ___ Cook/eat mostly low fat ___ Cook/eat only low fat 6. My bread/grain eating habit is: ___ Nearly always eat refined (white bread, grains, rolls, crackers, cereal) ___ Eat mostly refined grain products X Eat a mixture of refined and whole grain products ___ Eat primarily whole grain products ___ Eat only whole grain products 7. How often do you eat out: X I eat out nearly every day ___ I eat out several times each week ___ I eat out a few times each month ___ I seldom or never eat out 8. My salty food habit is: (check all that apply) ___ I rarely eat salty foods (chips, pickles, soups, added salt) X Occasionally I eat salty foods ___ I regularly eat salty food ___ I add salt to the foods I eat 9. During the past 30 days, did you diet to lose weight or to keep from gaining weight? Yes No If Yes Explain:_______________________________________________________________ 10. My high fat snack eating habit is: ___ I eat high fat snack foods (potato chips) 3 or more times daily ___ I eat high fat snacks once or twice daily X I eat high fat snacks a few times each week ___ I rarely or never eat high fat snacks 73

PRE-EXERCISE SCREENING LESSON SEVEN 11. How often do you eat red meat? ___ I eat red meat nearly every day X I eat red meat several times each week ___ I eat red meat a few times each month ___ I seldom or never eat red meat 12. How often do you eat cookies, cakes, sweets? ___ I eat cookies, cakes, sweets nearly every day ___ I eat cookies, cakes, sweets several times each week X I eat cookies, cakes, sweets a few times each month ___ I seldom or never eat cookies, cakes, sweets 13. How many alcoholic beverages do you consume per week? 8+ 0-3 4-5 6-7 14. On average, I sleep ____ hours a night. 3-4 5-6 7-8 8+ 15. Outside of work, what physical and/or social activities do you engage in? Play golf, go boating and fishing. Data Collection • List all diagnosed diseases and health problems • List all risk factors • List the behaviors that correlate to increased risk • Rank the listings by relevance • Initial development of the Needs Analysis • Initial Program decisions: medical referral, restricted program, or unrestricted participation Resting Battery Pre-exercise Evaluations • Height and Weight • Resting Heart Rate • Resting Blood Pressure • Body Composition • Waist Girth • Blood Lipid Profile 74

LESSON SEVEN PRE-EXERCISE SCREENING Medical Referral Values BMI >35 Resting Heart Rate >100 bpm Resting Blood Pressure >160 mmHg Systolic >100 mmHg Diastolic Body Fat >30% Males >40% Females Waist Girth >40 inches Males >35 inches Females Lipid Profile >135 mg/dl LDL <40 mg/dl HDL >240 mg/dl Total Cholesterol >5 Cholesterol Ratio >200 mg/dl Triglycerides Medical Clearance Form • Form used to provide physician clearance for exercise • Physician may define recommendations and restrictions • Significantly reduces risk for liability when adhered to in the exercise prescription Exercise Testing Rationale for Testing 1. Identifying baseline data of physical measures 2. Identification of strengths and weaknesses 3. Defines level or readiness for activity participation 4. Used to establish program criteria and track progression 5. To determine reasonableness of goals 6. Educates participants to current level of fitness 75

PRE-EXERCISE SCREENING LESSON SEVEN Test Selection Criteria • Test purpose • Test’s validity, reliability, and objectiveness • Test relationship to training • Test prediction capabilities • Consistency with the goals of the training • Appropriateness for the individual being tested • Safety • Does the test present psychological barriers, create anxiety, or make the participant uncomfortable • Participant benefit Methods to Improve Test Validity • Ensure the protocol is valid • The tester must be skillful, knowledgeable, and experienced in the test protocol • The client must be proficient in the test actions • Strict discrimination in measurement • Client is mentally prepared and appropriately motivated for the test • The environment is safe and ideal for the test • The equipment has been calibrated and tested • No outside variable can affect the outcome • Clearly define the scoring system • Record results as they occur Methods to Improve Test Reliability • Duplicate the exact conditions • Strict adherence to protocol • Use consistent pretest factors – pretest checklist • Use the exact same scoring system • Use the same tester • Use the same test instrumentation Testing Order For multiple tests on the same day order should be consistent with energy system utilization and fatigue. Ideally, tests should be split into different days. 1. Resting Tests – body composition, balance 2. Strength and Power Tests – max rep tests, anaerobic power 3. Endurance Tests – push-ups, curl-ups 4. Anaerobic Capacity Tests – one minute squat, 400 m run 5. Aerobic Tests – 12-min run, Step tests 76

LESSON SEVEN PRE-EXERCISE SCREENING Test Interpretation • Review test scores for relevance and define the course of action • Classify the scores based on relative parameters • Participants should be educated about what scores mean • Tact in communication of poor scores requires emphasis on ability to change or improve in a select component of fitness Needs Analysis • All the data collected from the screening and evaluation should be listed • Relevant findings should be ranked in the order of importance (ex. disease prevention management, documented health problems, primary risk factors etc…) • Test findings from the resting battery and exercise testing should be summarized and ordered by significance • Exercise tests results should be listed by low level of fitness to acceptable or higher levels • The needs analysis is used to create the program components by creating the remedies to the defined needs Homework for Next Class Textbook Page 323 Read Chapter 16 Flexibility Assessment and Programming Study Guide Page 87 Complete Lesson 16 Flexibility Assessment and Programming Viewing Flexibility Training Considerations Concepts of Training CD-ROM Flexibility Training Training Technique & Assessment DVD Video 77



LESSON EIGHT FLEXIBILITY LAB Class Eight Flexibility Lab Procedure The following static stretches are presented in Chapter 16 of your course textbook. Following the performance of an adequate warm-up, perform the designated movements and identify the soft tissue structures being stretched with each exercise. Each exercise should be held for a minimum of 15 seconds. Example Butterfly Stretch Muscles involved: Hip adductors Movement performed: Hip abduction, partial hip external rotation 78

FLEXIBILITY LAB LESSON EIGHT Supine Trunk Rotator Stretch Muscles involved: ________________________________________________________________________ Movement performed: _____________________________________________________________________ Seated Trunk Rotator Stretch Muscles involved: ________________________________________________________________________ Movement performed: _____________________________________________________________________ 79

LESSON EIGHT FLEXIBILITY LAB Latissimus Dorsi Stretch from the Floor Muscles involved: ________________________________________________________________________ Movement performed: _____________________________________________________________________ Standing Hip Adductor Stretch Muscles involved: ________________________________________________________________________ Movement performed: _____________________________________________________________________ 80

FLEXIBILITY LAB LESSON EIGHT Hip Flexor Stretch Muscles involved: ________________________________________________________________________ Movement performed: _____________________________________________________________________ 81

LESSON EIGHT FLEXIBILITY LAB Active-Assisted Stretching Procedure Select a partner or test subject to perform the following flexibility activities and have them perform an adequate warm-up activity prior to performing the designated exercises. Upon completion of the activity, identify the structures that were involved in the exercise and document any observed limitations. In some cases, the flexibility technique will address a particular structure, whereas in others, more than one muscle group is being stretched. The stretches can be referenced in Chapter 16 of your course textbook. Partner-Assisted Piriformis Stretch Muscles involved: ____________________________________________________________________ Observed limitations: __________________________________________________________________ 82

FLEXIBILITY LAB LESSON EIGHT Partner-Assisted Quadriceps Stretch Muscles involved: ____________________________________________________________________ Observed limitations: __________________________________________________________________ Partner-Assisted Glute Stretch Muscles involved: ____________________________________________________________________ Observed limitations: __________________________________________________________________ 83

LESSON EIGHT FLEXIBILITY LAB Partner-Assisted Gastrocnemius Stretch Muscles involved: ____________________________________________________________________ Observed limitations: __________________________________________________________________ 84

FLEXIBILITY LAB LESSON EIGHT Dynamic Flexibility Procedures Review the following illustrations and descriptions to ascertain proper exercise technique for each dynamic flexibility activity. Once the information has been reviewed, perform a general warm-up. Following the warm-up, perform the movements using the illustrations and descriptions as a guide. Identify the muscles involved and the joint actions. In some cases, the dynamic flexibility techniques can serve as both flexibility and strengthening exercises, saving time while providing for an efficient training response. Lunge to High Knee Standing in an upright posture with feet located under the hips, take a broad step backward, flexing both the front and back knee to the fullest range of motion. Once the hip has reached its greatest attainable range of motion, the back leg will be lifted forward and upward bringing the knee as high as possible toward the chest while balancing on the contralateral foot. Following the completion of the designated number of repetitions, the action should be switched to the other side. Muscles being stretched: _______________________________________________________________________ Joint actions: ________________________________________________________________________________ 85

LESSON EIGHT FLEXIBILITY LAB Wide Squat to Reach Starting with the widest attainable stance, reach both arms forward and downward while flexing the hips and knees. Once the fullest range of motion has been attained, the arms should be extended forward and upward as a standing posture is attained. The arms should attempt to reach above the body to the highest possible point. Muscles being stretched: ______________________________________________________________________ Joint actions: ________________________________________________________________________________ Alternating Toe Reach Standing in an upright position, step backward with one leg while simultaneously reaching the contralateral arm upward and backward to a full range of motion. Once the fullest range of motion has been attained by both limbs, stabilize the body and move the limbs forward in the sagittal plane contacting the contralateral limbs at the furthest attainable point in front of the body. After completing the designated number of repetitions, switch to the other side. Muscles being stretched: __________________________________________________________________________ Joint actions: ____________________________________________________________________________________ 86

FLEXIBILITY LAB LESSON EIGHT Scorpions Lying in a prone position, reach one leg backward, upward, and across the body; flexing the knee so the toe makes contact with the floor. The arms should be extended forward against the ground and remain in that position during the activity. Once the leg has reached its fullest range of motion it should return to the start position as the contralateral leg follows the same movement across the body. Some trunk rotation will occur during the movement. Muscles being stretched: __________________________________________________________________________ Joint actions: ____________________________________________________________________________________ Lateral Tucks to High Knee Standing in an upright posture with feet located under the hips; lift the step leg up to the highest attainable range of motion while bringing the knee toward the chest. Step laterally to the widest open-leg stance while descending into a low tuck position, flexing both knees and hips to the fullest range of motion. Once the lowest point has been reached, stand upwards while drawing the contralateral leg toward the chest, establishing a balanced position. Repeat the movement back toward the start position tucking downward on each repetition. Muscles being stretched: __________________________________________________________________________ Joint actions: ____________________________________________________________________________________ 87

LESSON EIGHT FLEXIBILITY LAB Opposite Heel Touch Standing in an upright posture with feet under the hips; lift one leg backwards and across the body while simultaneously reaching with the contralateral arm to touch the heel of the lifted foot. Stabilize at the fullest attainable range of motion before alternating to the other side. Muscles being stretched: __________________________________________________________________________ Joint actions: ____________________________________________________________________________________ Homework for Next Class Page 353 Textbook Read Chapter 17 Programming for Cardiovascular Fitness 88



LESSON NINE CARDIOVASCULAR TRAINING Lesson Nine Cardiovascular Training Assessing CRF Considerations for Testing • Client characteristics • Goals of the data • Test protocol experience • Available equipment • Time • Comparable population norms • Motivation Test Comparisons • Step Tests – easy to implement, requires limited equipment, pace negates motivation factor, predicts VO2 in multiple populations, over-predicts fit individuals • Run Tests – requires high motivation, ideal for fit populations with running experience, measured distance is a factor, track required • Walk/Jog Tests – easy to implement, limited equipment, motivation and exercise tolerance are factors, over-predicts fit populations • Bike Tests – requires technical expertise, validity is high and viable for multiple populations, can be paced, fitness level and fatigue are factors Calculating Max Heart Rate Heart Rate Max Formula Max HR = 220 – age Multifactor Formula Males Max HR = 203.9 – (0.812 x age) + (0.276 x RHR) – (0.084 x kg) – (4.5 x smoking code) Females Max HR = 204.8 – (0.718 x age) + (0.162 x RHR) – (0.105 x kg) – (6.2 x smoking code) Max HR for Obese Populations Max HR = 200 – (0.5 x age) 89

CARDIOVASCULAR TRAINING LESSON NINE Older Adults Max HR = 208 – (0.7 x age) Max Heart Rate Example: 20 year old 220 – age = Max Heart Rate 220 – 20 years = 200 beats · min-1 Problems with the prediction 1) Standard Deviation (SD) = 10-12 beats 1 SD range = 188 to 212 beats 2 SD range = 176 to 224 beats 2) Based on Bell Curve Theory – 32% of the population will have incorrect predictions by some level. 3) The formula suggests that all individuals of the same age would have the same training zones regardless of fitness level Heart Rate Training Zones Max Heart Rate Method Max Heart Rate x Training Intensity Percentage Heart Rate Reserve Formula Max Heart Rate – Resting Heart Rate = Heart Rate Reserve Heart Rate Reserve Method – Karvonen Heart Rate Reserve x (Training Intensity Percentage) + Resting Heart Rate Heart Rate Max Method Example: 20 year old Max HR – Age 220 – 20 = 200 beats 200 beats x (0.75) = 150 beats 200 beats x (0.9) = 180 beats Heart Rate Training Zone = 150 beats to 180 beats 90

LESSON NINE CARDIOVASCULAR TRAINING Heart Rate Reserve Method Example: 20 year old, Resting HR 60 beats Max HR – Age 220 – 20 = 200 beats Max HR – Resting Heart Rate = Heart Rate Reserve 200 – 60 = 140 Heart Rate Reserve x (Training Intensity Percentage) + Resting HR (140 x 0.6) + 60 = 144 beats (140 x 0.8) + 60 = 172 beats Heart Rate Training Zone = 144 to 172 beats Calculating Max Heart Rate and Training Intensities Procedures This activity requires the calculation of a subject’s training intensities using two different methods (you have the option of calculating your own). Once the target heart rate zone (THRZ) has been established, you will have the subject exercise until a steady-state HR within the zone is reached. RPE will then be used to validate the calculations. Be sure to read through the entire lab activity prior to performing the procedures. Step 1 Assess the resting heart rate and record base information. Resting Heart Rate of subject ______________ beats • min-1 Age of subject _________________ Step 2 Calculate Maximum Heart Rate for your subject using the Indirect Method. 220 – Age = predicted Max Heart Rate 220 – ______ subject’s age = _______ predicted Max Heart Rate Record subject’s predicted Max Heart Rate value _________ beats • min-1 91

CARDIOVASCULAR TRAINING LESSON NINE Step 3 Calculate subject’s Target Heart Rate Zone using Max Heart Rate Method and the recommended (75%-90%) training intensities. Sample Subject: 45 year-old male with a resting heart rate of 77 beats • min-1 Find the predicted max heart rate. 220 – 45 = 175 beats • min-1 Find the recommended training zones using the Max Heart Rate Method and corresponding intensity ranges. 175 beats • min-1 x .75 = 130 beats • min-1 (Low-end) 175 beats • min-1 x .90 = 158 beats • min-1 (High-end) Target Heart Rate Zone = 130 beats • min-1 to 158 beats • min-1 Enter the predicted max heart rate of the subject from Step 2 and calculate the Target Heart Zone using the intensities provided. _________ Max HR x (.75) = _________ (L) _________ Max HR x (.90) = _________ (H) Record the low end and high end of the training zone. Target Heart Rate Zone = (L) __________ to (H) __________ beats • min-1 Step 4 Calculate subject’s Target Heart Rate Zone using the Heart Rate Reserve (HRR) method and recommended corresponding training intensities (60%-80%) for use with the Karvonen Formula. Karvonen Formula/Heart Rate Reserve Method Max HR – Resting HR (RHR) = Heart Rate Reserve (HRR) {HRR x (training intensity)} + RHR = Target Heart Rate Sample Subject: 45 year-old male with a resting heart rate of 77 beats • min-1 Find the Max Heart Rate. 220 – 45 = 175 beats • min-1 Find recommended training zones using HRR method and corresponding intensity ranges. Max Heart Rate – Resting Heart Rate = Heart Rate Reserve 175 beats • min-1 – 77 beats • min-1 = 98 beats • min-1 Heart Rate Reserve = 98 beats • min-1 92