Your Complete Solution for Health Online Personal Change Labs Personalized Learning Plans CengageNOW provides access to the activities, surveys, and self- CengageNOW allows you to gauge your own unique study needs assessment tools from Fitness and Wellness in an online, interactive using diagnostic pre-tests that generate Personalized Learning Plans format. Some diverse examples include “Are You Ready to Become that contain links for the resources you need, including sections from More Active?,” “How Healthful is Your Diet?,” “Body Composition the eBook, video clips, and interactive exercises. Click through these Assessment and Recommended Body Weight Determination” and resources to master the concepts, and then take the post-test to “Designing Your Strength Training Program.” measure your improvement. The program’s unique diagnostic quizzes and study plan will help you get the most out of your study time and succeed in the course! Behavior Change Planner Pedometer Activities! The CengageNOW Behavior Change Planner is a fun, Even small steps can move you toward better health interactive, and easy way to complete a course assignment while using practical tools for making healthy change. Track your daily number of steps, set activity goals, and see your progress over time! The program’s Health/Lifestyle Survey will show you the overall The CengageNOW Behavior Change Planner includes four picture of how active you are. The easy-to-use “how to” tool will help you main components: measure your stride length to determine the distance you travel during a day. This can be a great motivator . . . and a great help to reaching your • A Wellness Inventory that asks you a series of questions fitness goals. related to the wellness categories of Physical Activity, Tobacco, Drugs and Alcohol, Safety, Sexuality, Weight Management, Nutrition, and Stress. The scores on the wellness inventory help to identify areas where change is most needed. • A Behavior Change Contract that guides you into targeting an area that needs improvement, setting a goal, and formulating a committed plan for change. • A Change Tracker for recording progress toward the goal of the Behavior Change Contract • A Change Journal for reflection and comments on the process of working toward the behavior change goal Easy to Order and Use Log on to CengageNOW™ by using the access code packaged with the text. With its simple, browser-based interface, CengageNOW is as easy to use as surfing the web. Just a click of the mouse allows you to enter and explore the system at any point with no instructor setup necessary. Alternatively, you can purchase access at www.cengagebrain.com if access was not ordered with the text.
Fitness and Wellness
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NINTH EDITION Fitness and Wellness WERNER W.K. HOEGER Professor Emeritus (Active) Department of Kinesiology Boise State University and SHARON A. HOEGER Fitness & Wellness, Inc. Boise, Idaho Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States
Fitness and Wellness, Ninth Edition © 2011, 2009 Wadsworth, Cengage Learning Werner W.K. Hoeger and Sharon A. Hoeger ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form Publisher/Executive Editor: Yolanda Cossio or by any means, graphic, electronic, or mechanical, including but Acquisitions Editor: Laura Pople not limited to photocopying, recording, scanning, digitizing, taping, Developmental Editor: Anna Lustig Web distribution, information networks, or information storage and Assistant Editor: Samantha Arvin retrieval systems, except as permitted under Section 107 or 108 of the Editorial Assistant: Kristina Chiapella 1976 United States Copyright Act, without the prior written permis- Media Editor: Miriam Meyers sion of the publisher. Marketing Manager: Laura McGinn Marketing Assistant: Elizabeth Wong For product information and technology assistance, contact us at Marketing Communications Manager: Cengage Learning Customer & Sales Support, 1-800-354-9706 Belinda Krohmer Content Project Manager: For permission to use material from this text or product, Charlene M. Carpentier submit all requests online at www.cengage.com/permissions Creative Director: Rob Hugel Art Director: John Walker Further permissions questions can be e-mailed to Print Buyer: Paula Vang [email protected] Rights Acquisitions Account Manager, Text: Bob Kauser Library of Congress Control Number: 2009937503 Rights Acquisitions Account Manager, Image: Dean Dauphinais ISBN-13: 978-0-538-73749-4 Production Service: Graphic World Inc. Text Designer: Ellen Pettengell ISBN-10: 0-538-73749-2 Photo Researcher: Bill Smith Group Copy Editor: Graphic World Inc. Wadsworth Cover Designer: Yvo Riezebos 20 Davis Drive Cover Image: Shutterstock/Vladimir Nikulin Belmont, CA 94002-3098 Compositor: Graphic World Inc. USA Cengage Learning is a leading provider of customized learning solu- tions with office locations around the globe, including Singapore, the United Kingdom, Australia, Mexico, Brazil, and Japan. Locate your local office at www.cengage.com/global. Cengage Learning products are represented in Canada by Nelson Education, Ltd. To learn more about Wadsworth, visit www.cengage.com/wadsworth. Purchase any of our products at your local college store or at our preferred online store www.CengageBrain.com. Printed in the United States of America 1 2 3 4 5 6 7 14 13 12 11 10
BRIEF CONTENTS CHAPTER 1 Introduction to Physical Fitness and Wellness 1 CHAPTER 2 Assessment of Physical Fitness 29 CHAPTER 3 Exercise Prescription 61 CHAPTER 4 Evaluating Fitness Activities 101 CHAPTER 5 Nutrition for Wellness 121 CHAPTER 6 Weight Management 147 CHAPTER 7 Stress Management 173 CHAPTER 8 A Healthy Lifestyle Approach 197 CHAPTER 9 Relevant Fitness and Wellness Issues 229 APPENDIX A Strength-Training Exercises 262 APPENDIX B Flexibility Exercises 270 APPENDIX C Exercises for the Prevention and Rehabilitation of Low Back Pain 273 APPENDIX D Contraindicated Exercises 276 APPENDIX E Selective Nutrient Content of Common Foods 279 Notes 293 Answer Key 298 Glossary 299 Index 305 v
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CONTENTS CHAPTER 1 Behavior Modification 14 Changing Behavior 14 Introduction to Physical Fitness and Motivation and Locus of Control 17 Wellness 1 Behavior Modification Principles 19 Lifestyle, Health, and Quality of Life 4 Self-Analysis 19 Importance of Increased Physical Activity 6 Behavior Analysis 19 2008 Federal Guidelines for Physical Activity 7 Goal Setting 19 Wellness 8 Social Support 19 Physical Fitness 9 Monitoring 19 A Positive Outlook 19 Health-Related Fitness 9 Reinforcement 20 Skill-Related Fitness 9 Benefits of Fitness and Wellness 10 SMART Goals 20 National Health Objectives for the Year 2010 13 Goal Evaluation 21 Path to Fitness and Wellness 14 A Word of Caution Before You Start Exercise 21 Web Interactive 22 Assess Your Behavior 22 Assess Your Knowledge 22 Ty Milford/Masterfile CHAPTER 2 Assessment of Physical Fitness 29 Responders Versus Nonresponders 31 Fitness Assessment Battery 31 Health Fitness Standard 31 Physical Fitness Standard 32 Cardiorespiratory Endurance 33 Assessing Cardiorespiratory Endurance 34 Muscular Strength and Endurance 37 Muscular Strength and Muscular Endurance 37 Determining Strength 38 Muscular Flexibility 41 Assessing Flexibility 42 Modified Sit-and-Reach Test 42 Finger Touch Test 43 Overall Flexibility Fitness 44 Body Composition 44 Assessing Body Composition 46 Effects of Exercise and Diet on Body Composition 53 Web Interactive 54 Assess Your Behavior 54 Assess Your Knowledge 54 vii
viii Contents CHAPTER 3 Exercise Prescription 61 Monitoring Daily Physical Activity 62 Readiness for Exercise 63 Exercise Prescriptions 65 Cardiorespiratory Endurance 65 Cardiorespiratory Exercise Prescription 65 Muscular Strength and Endurance 71 78 Overload Principle 71 Specificity of Training 71 Muscular Strength-Training Prescription 72 Strength-Training Exercises 76 Strength-Training Exercise Guidelines 76 Core Strength Training 77 Designing Your Own Strength-Training Program 77 Dietary Recommendations for Strength Development Flexibility 78 Muscular Flexibility Prescription 78 Designing a Flexibility Program 81 Pilates Exercise System 81 Preventing and Rehabilitating Low Back Pain 82 Contraindicated Exercises 84 Getting Started 84 JupiterImages Setting Fitness Goals 85 Web Interactive 87 Assess Your Behavior 87 Rating the Fitness Benefits of Aerobic Activities 113 Skill-Related Fitness 113 Assess Your Knowledge 87 Team Sports 116 Tips to Enhance Your Aerobic Workout 116 CHAPTER 4 Web Interactive 117 Assess Your Behavior 118 Evaluating Fitness Activities 101 Assess Your Knowledge 118 Aerobic Activities 102 Walking 102 Hiking 103 CHAPTER 5 Jogging 104 Nutrition for Wellness Aerobics 105 121 Swimming 106 Essential Nutrients 122 Water Aerobics 106 112 Carbohydrates 123 Cycling 107 Fats 124 Spinning® 109 Proteins 126 Cross-Training 110 Vitamins 126 Rope Skipping 110 Minerals 126 Cross-Country Skiing 110 Water 126 In-Line Skating 111 Rowing 112 Nutrition Standards 126 Stair Climbing/Elliptical Training Dietary Reference Intakes 126 Racquet Sports 112 Daily Values 127
Contents ix Dietary Guidelines 129 Web Interactive 165 Assess Your Behavior 165 Determining Fat Content in the Diet 130 Assess Your Knowledge 165 Balancing the Diet 130 Nutrient Analysis 132 Vegetarianism 132 CHAPTER 7 Nutrient Supplementation 133 Stress Management 173 Antioxidants 134 Multivitamins 136 The Mind/Body Connection 174 Vitamin D 136 Sleep and Wellness 175 Folate 137 Stress 176 The Body’s Reaction to Stress 176 Benefits of Foods 137 Adaptation to Stress 177 Probiotics 138 Fish 138 Alarm Reaction 177 Resistance 177 Eating Disorders 139 Exhaustion/Recovery 177 Anorexia Nervosa 140 Behavior Patterns 178 Bulimia Nervosa 140 Vulnerability to Stress 180 Binge-Eating Disorder 141 Sources of Stress 181 Treatment 141 Coping with Stress 184 2005 Dietary Guidelines for Americans 142 Lifetime Commitment to Wellness 142 Web Interactive 143 Assess Your Behavior 143 Assess Your Knowledge 143 CHAPTER 6 Weight Management 147 Tolerable Weight 150 Fad Dieting 151 Principles of Weight Management 153 Image copyright Phil Date, 2009. Used under license from Shutterstock.com Energy-Balancing Equation 153 Diet and Metabolism 153 Recommendation 154 Sleep and Weight Management 155 Exercise: The Key to Successful Weight Management 156 Myth of Spot-Reducing 157 Exercise Safety 158 Light-Intensity Versus Vigorous-Intensity Exercise for Weight Loss 158 Designing Your Own Weight Loss Program 159 Estimating Your Caloric Intake 159 Monitoring Your Diet Through Daily Food Logs 161 Using Low-Fat Entrees 162 Behavior Modification and Adherence to a Lifetime Weight Management Program 162 You Can Do It! 165
x Contents Types of Cardiovascular Disease and Their Prevalence 200 Risk Factors for CHD 201 Time Management 185 Relaxing Techniques 187 Cancer 212 Guidelines for Preventing Cancer 213 Physical Activity 187 Abstaining from Tobacco 216 Progressive Muscle Relaxation 188 Avoiding Excessive Sun Exposure 216 Breathing Techniques 189 Monitoring Estrogen, Radiation Exposure, and Potential Occupational Sighing 190 Hazards 217 Meditation 190 Physical Activity 217 Yoga 190 Other Risk Factors for Cancer 217 Visual Imagery 192 Early Detection 218 Which Technique Is Best? 192 Web Interactive 193 Chronic Lower Respiratory Disease 218 Assess Your Behavior 193 Assess Your Knowledge 193 Accidents 218 CHAPTER 8 197 Substance Abuse 219 221 Alcohol 219 A Healthy Lifestyle Approach Illegal Drugs 219 Treatment for Chemical Dependency A Wellness Lifestyle 198 Spiritual Well-being 198 Sexually Transmitted Infections 221 HIV/AIDS 222 Causes of Death 199 Guidelines for Preventing STIs 222 Diseases of the Cardiovascular System 200 Web Interactive 224 Assess Your Behavior 224 Assess Your Knowledge 224 CHAPTER 9 Relevant Fitness and Wellness Issues 229 Wellness Behavior Modification Issues 230 Safety of Exercise Participation and Injury Prevention 231 Special Considerations for Women 239 Hormone Replacement Therapy 245 Nutrition and Weight Control 246 Exercise and Aging 249 Fitness/Wellness Consumer Issues 250 What’s Next? 255 Web Interactive 256 Assess Your Behavior 256 Assess Your Knowledge 257 Dennis Welsh/JupiterImages APPENDIX A Strength-Training Exercises 262
Contents xi APPENDIX B APPENDIX E Flexibility Exercises 270 Selective Nutrient Content of Common Foods 279 APPENDIX C Notes 293 Exercises for the Prevention and Answer Key 298 Rehabilitation of Low Back Pain 273 Glossary 299 Index 305 APPENDIX D Contraindicated Exercises 276
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P R E FA C E Most people go to college to learn how to make a What the Book Covers living. Making a good living, however, won’t help them unless they live an active lifestyle that will al- As you study this book and complete the various low them to enjoy what they have. Unfortunately, activities, you will learn to: the 21st-century American lifestyle does not provide the human body with sufficient physical activity to • Determine whether medical clearance is needed achieve or maintain adequate health. for your safe participation in exercise. Many of the behaviors we adopt in life are prod- • Conduct nutrient analyses and follow the recom- ucts of our environment. Currently, we live in a mendations for adequate nutrition. “toxic” health and fitness environment. We are so habituated to our modern-day environment that we • Develop sound diet and weight-control programs. miss the subtle ways it influences our behaviors, • Assess the health-related components of fitness personal lifestyle, and health each day. The epidemic of physical inactivity and obesity that is sweeping (cardiorespiratory endurance, muscular strength across America is so harmful to health that it actu- and endurance, muscular flexibility, and body ally increases the deterioration rate of the human composition). body and leads to premature aging, illness, and • Write exercise prescriptions for cardiorespiratory death. endurance, muscular strength and endurance, and muscular flexibility. About one half of the adults in the United States • Understand stress, lessen your vulnerability to do not achieve the recommended amount of daily stress, and implement a stress-management pro- physical activity. Among those who do, most do not gram if necessary. reap the full benefits because they simply do not • Implement a cardiovascular disease risk- know how to implement and stay with a sound pro- reduction program. gram that will yield the desired results. • Follow guidelines to reduce your personal risk of developing cancer. The good news is that lifetime wellness is within • Implement a smoking cessation program, if the grasp of most people. We know that most chronic applicable. and debilitating conditions are largely preventable. • Understand the health consequences of chemical Scientific evidence has shown that improving the dependency and irresponsible sexual behaviors quality—and most likely the length—of our lives is and learn guidelines for preventing sexually a matter of personal choice. transmitted infections. • Discern between myths and facts concerning ex- This book offers you the necessary information to ercise and health-related concepts. start on your path to fitness and wellness by adher- • Learn behavior-modification techniques to help ing to a healthy lifestyle. The information in the fol- you adhere to a lifetime fitness and wellness lowing chapters and the subsequent activities at the program. end of each chapter will enable you to develop a personal program that promotes lifetime fitness, New in the Ninth Edition preventive health care, and personal wellness. The emphasis throughout the book is on teaching you All chapters in the ninth edition of Fitness and Wellness how to take control of your lifestyle habits so you have been revised and updated according to recent can do what is necessary to stay healthy and realize advances published in the scientific literature and in- your optimum well-being. xiii
xiv Preface formation reported at professional health, physical • The ever-increasing importance of vitamin D is education, and sports medicine conferences. examined in Chapter 5, “Nutrition for Wellness,” with an expanded discussion on the benefits of A new feature added to this edition is individual this vitamin and how to obtain an adequate sup- Real Life Stories presented at the start of each chapter. ply. Additional information is also included on Students can relate to these accounts as many en- probiotics and multivitamin supplements. counter similar situations in their own lives. In addi- tion to the individual chapter updates listed below, • Chapter 6, “Weight Management,” has been re- several new graphs and photographs is included in vised to conform with the new Position Stand: this new edition. Following are the most significant Appropriate Physical Activity Intervention Strategies chapter updates: for Weight Loss and Prevention of Weight Regain for Adults released in 2009 by the American College • In Chapter 1, “Introduction to Physical Fitness of Sports Medicine. Revised figures on the inci- and Wellness,” all pertinent statistics related to dence of overweight, along with discussion of the prevalence of physical activity, life expec- obesity trends in the United States and the tancy, and the leading causes of death in the health consequences of obesity and its impact on United States have been brought up to date. Also life expectancy, are provided. A new section on included are the newly released Federal Guide- the role of sleep deprivation on weight manage- lines for Physical Activity for children, adults, ment and weight loss and the importance of so- older adults, and pregnant and postpartum cial support to enhance proper weight manage- women. These guidelines supplement the land- ment were added as well. mark 1996 Surgeon General’s Report on Physical Activity and Health as well as the 2007 American • A new section on Sleep and Wellness has been College of Sports Medicine and American Heart As- added to Chapter 7, “Stress Management.” This sociation Physical Activity and Public Health Recom- section addresses the problem of chronic sleep mendations. Additional information is also pre- deprivation among college students. sented on the benefits of vigorous-intensity versus moderate-intensity aerobic activity. • In Chapter 8, “A Healthy Lifestyle Approach,” all statistics on the incidence and prevalence of • In Chapter 2, “Assessment of Physical Fitness,” cardiovascular disease, cancer, addictive behav- the muscular strength and flexibility tables have ior, and sexually transmitted infections have been simplified so that students can more read- been updated. The guidelines for a graded exer- ily determine personal test results and their re- cise stress electrocardiogram have been revised spective fitness categories. To further facilitate and new information is provided on the effects the assessment of flexibility fitness, the Total of statin drugs on inflammation and the role of Body Rotation Test has been replaced with the “safe sun exposure” on cancer prevention. Finger Touch Test. The latter test is used to de- termine shoulder flexibility and does not require • Several questions in Chapter 9, “Relevant Fitness equipment other than a cloth measuring tape. and Wellness Issues,” have been updated. New questions related to fitness and wellness issues • The topic of Chapter 3, “Exercise Prescription,” have been added to the chapter, including infor- has been extensively updated to conform with mation on training order between cardiorespira- the newly released American College of Sports tory endurance and strength training, energy Medicine Guidelines for Exercise Testing and Pre- drinks and performance, and the effectiveness of scription and the Federal Guidelines for Physical diet plans. Activity. All three prescription guidelines— cardiorespiratory endurance, muscular strength, Ancillaries and muscular flexibility—have been revised. A new and more accurate maximal heart rate equa- • CengageNOW™ with eBook 1-Semester Instant Ac- tion is now used in place of the traditional cess Code. ISBN-10: 0-538-49451-4. Get instant “220 Ϫ age” equation. access to CengageNOW™! This exciting online resource is a powerful learning companion that • Updates and revisions have been made to the helps students gauge their unique study needs— descriptions of selected aerobic activity choices and provides them with a Personalized Change discussed in Chapter 4, “Evaluating Fitness Plan that enhances their problem-solving skills Activities.”
Preface xv and conceptual understanding. A click of the • Instant Access Code for Diet Analysis 9.0. mouse allows students to enter and explore the ISBN-10: 0-495-38786-X. Diet Analysis 9.0 is the system whenever they choose, with no instructor market-leading software with a database of over setup necessary. The Personalized Change Plan- 20,000 foods that enables students to track their ner guides students through a behavior-change diet, generate reports, complete assignments, process tailored specifically to their needs and and gain a better understanding of how nutri- personal motivation. An excellent tool to give as tion relates to their personal health goals. The a project, this plan is easy to assign, track, and new 9.0 version has been enhanced with new ro- grade, even for large sections. bust features, easy navigation, custom reports, • CengageNOW™ with eBook Printed Access Code. and new critical-thinking assignments. ISBN-10: 0-538-49452-2. Get instant access to CengageNOW™! This exciting online resource is • Printed Access Code for Diet Analysis 9.0. a powerful learning companion that helps stu- ISBN-10: 0-495-38788-6. Diet Analysis 9.0 is the dents gauge their unique study needs—and pro- market-leading software with a database of over vides them with a Personalized Change Plan 20,000 foods that enables students to track their that enhances their problem-solving skills and diet, generate reports, complete assignments, conceptual understanding. A click of the mouse and gain a better understanding of how nutri- allows students to enter and explore the system tion relates to their personal health goals. The whenever they choose, with no instructor setup new 9.0 version has been enhanced with new ro- necessary. The Personalized Change Planner bust features, easy navigation, custom reports, guides students through a behavior-change pro- and new critical-thinking assignments. cess tailored specifically to their needs and per- sonal motivation. An excellent tool to give as a • Behavior Change Workbook. ISBN-10: project, this plan is easy to assign, track, and 0-495-01145-2. The Behavior Change Workbook grade, even for large sections. This section also includes a brief discussion of the current theories includes a complete, interactive eBook! behind making positive lifestyle changes, along • Website (http://www.cengage.com/health/hoeger/ with exercises to help students make those fw9e). When you adopt Fitness and Wellness, ninth changes in their everyday lives. edition, you and your students will have access to a rich array of teaching and learning resources • Careers in Health, Physical Education, and Sports, 2e. that you won’t find anywhere else. Resources in- ISBN-10: 0-495-38839-4. This unique booklet clude a downloadable study guide for students, takes students through the complicated process Web links, flash cards, and more. of picking the type of career they want to pur- • Online Instructor’s Manual with Test Bank. sue; explains how to prepare for the transition ISBN-10: 0-538-49441-7. This comprehensive re- into the working world; and provides insight source provides learning objectives, detailed into different career paths, education require- chapter outlines, classroom activities integrated ments, and reasonable salary expectations. A with critical-thinking questions, and teaching designated chapter discusses some of the legal strategies. The Test Bank provides matching, issues that surround the workplace, including true/false, multiple-choice, and short-answer discrimination and harassment. This supplement questions. is complete with personal-development activities • PowerLecture CD-ROM with ExamView® Computer- designed to encourage students to focus on and ized Testing. ISBN-10: 0-538-49440-9. Designed to develop better insight into their future. make lecture preparation easier, this CD-ROM in- cludes over 500 customizable PowerPoint® pre- • Walk4Life® Pedometer. ISBN-10: 0-495-01315-3. sentation slides with images from the text, new Provided through an alliance with Walk4Life, ABC video clips, and electronic versions of the In- the Walk4Life Elite Model pedometer tracks structor’s Manual and Test Bank. Also included is steps, elapsed time, and distance. A calorie coun- the ExamView® Computerized Test Bank, which ter and a clock are included in this excellent allows you to create, deliver, and customize tests class activity and tool to encourage students to (both print and online) in minutes with this easy- track their steps and walk toward better fitness to-use assessment and tutorial system. awareness. • Readings for a Healthy Lifestyle. ISBN-10: 0-759-35944-X. This reader features 12 articles written by author Dianne Hales and published in PARADE magazine. Readings include “Take
xvi Preface Your Meds—The Right Way,” “You Can Think © Fitness & Wellness, Inc. Award for Research and Scholarship in the College Yourself Thin,” “Getting Yourself Back on of Education at Boise State University. In 2008, he Track,” “Too Tough to Seek Help,” and “The Best was asked to be the keynote speaker at the VII Medical Help Online.” Iberoamerican Congress of Sports Medicine and Ap- • TestWell Online Assessment Access Card. ISBN-10: plied Sciences in Mérida, Venezuela and was pre- 0-495-01264-5. This Web-based assessment tool sented with the Distinguished Guest of the City allows students to answer 100 questions specific recognition. to their health status in relation to the six dimen- sions of wellness. Students are provided a 10- Dr. Hoeger uses his knowledge and personal ex- Step Behavior Change Guide for long-term posi- periences to write engaging, informative books that tive behavior modifications. It can be used as a thoroughly address today’s fitness and wellness is- pre-test or a post-test to assess students’ health sues in a format accessible to students. Since 1990, he status, and it can provide a venue for learning has been the most widely read fitness and wellness about the different dimensions of wellness. It ex- college textbook author in the United States. He has ecutes immediate feedback based on students’ published a total of 49 editions of his 9 fitness and responses and can contribute to classroom par- wellness-related titles. Among the textbooks written ticipation and overall learning assessment. Test- for Wadsworth Cengage Learning are Principles and Well offers a fun and easy Web-based activity for Labs for Fitness and Wellness, eleventh edition; Life- student enrichment. time Physical Fitness and Wellness: A Personalized Pro- gram, eleventh edition, Principles and Labs for Physical Brief Author Biographies Fitness, seventh edition; Wellness: Guidelines for a Healthy Lifestyle, fourth edition; and Water Aerobics Werner W.K. Hoeger is a professor emeritus of the for Fitness and Wellness, third edition (with Terry- Department of Kinesiology at Boise State University. Ann Spitzer Gibson). He remains active in research and continues to lec- ture in the areas of exercise physiology, physical fit- Dr. Hoeger was the first author to write a college ness, and wellness. fitness textbook that incorporated the “wellness” concept. In 1986, with the release of the first edition Dr. Hoeger completed his undergraduate and of Lifetime Physical Fitness and Wellness, he intro- master’s degrees in physical education at the age of duced the principle that to truly improve fitness, 20 and received his Doctorate degree with an em- health, and quality of life and achieve wellness, a phasis in exercise physiology at the age of 24. He is person needed to go beyond the basic health-related a Fellow of the American College of Sports Medicine components of physical fitness. His work was so and also of the Research Consortium of the Ameri- well received that every fitness author immediately can Alliance for Health, Physical Education, Recre- followed his lead in the field. ation, and Dance. In 2002, he was recognized as the Outstanding Alumnus from the College of Health As an innovator in the field, Dr. Hoeger has de- and Human Performance at Brigham Young Univer- veloped many fitness and wellness assessment tools; sity. He is the recipient of the 2004 first Presidential including fitness tests such as the Modified Sit-and- Reach, Total Body Rotation, Shoulder Rotation, Mus- cular Endurance, Muscular Strength and Endurance, and Soda Pop Coordination tests. Proving that he “practices what he preaches,” at 48, he was the old- est male competitor in the 2002 Winter Olympics in Salt Lake City, Utah. He raced in the sport of luge along with his then-17-year-old son Christopher. It was the first time in Winter Olympics history that father and son competed in the same event. In 2006, at the age of 52, he was the oldest competitor at the Winter Olympics in Turin, Italy. Sharon A. Hoeger is vice-president of Fitness & Wellness, Inc. of Boise, Idaho. Sharon received her degree in computer science from Brigham Young University. She is extensively involved in the re- search process used in retrieving the most current scientific information that goes into the revision of
Preface xvii each textbook. She is also the author of the software together, stay together.” She also served as Chef de that accompanies all of the Fitness and Wellness text- Mission (Head of Delegation) for the Venezuelan books. Her innovations in this area since the publi- Olympic Team at the 2006 Olympic Winter Games in cation of the first edition of Lifetime Physical Fitness & Turin, Italy. Wellness set the standard for fitness and wellness computer software used in this market today. Acknowledgments © Fitness & Wellness, Inc. The ninth edition of Fitness and Wellness was made possible through the contributions of many indi- Sharon is a coauthor in five of the seven Fitness viduals. In particular we would like to express our and Wellness titles. Husband and wife have been gratitude to the reviewers of the ninth edition. Their jogging and strength training together for over valuable comments and suggestions are most sin- 32 years. They are the proud parents of five children, cerely appreciated. all of whom are involved in sports and lifetime fit- ness activities. Their motto: “Families that exercise John Acquavivia, Northern Virginia Community College Leslie K. Hickcox, Portland Community College Rebecca Kujawa, Mother McAuley High School Robin Kurotori, Ohlone College Cathy McMillan, Western Illinois University Jeff Meeker, Cornell College Holly J. Molella, Dutchess Community College Charles Pelitera, Canisius College Marc Postiglione, Union County College Andrea Pate Willis, Abraham Baldwin College Sharon Woodard, Wake Forest University
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Fitness and Wellness
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Introduction to Physical Fitness and Wellness There is no drug in current or prospective use that holds as much promise for sustained health as a lifetime program of physical exercise.1 Chapter 1 Ty Milford/Masterfile OBJECTIVES ▶ LEARN motivational and behav- Log on to CengageNOW at www.cengage.com/login ▶ UNDERSTAND the importance ior modification techniques to en- hance compliance with a healthy to find innovative study tools—including of lifetime fitness and wellness. lifestyle program. pre- and post-tests, personalized study plans, activities, labs, and the personal change ▶ LEARN the recommended ▶ LEARN to write SMART goals to planner. guidelines for weekly physical aid with the process of change. activity. ▶ DETERMINE whether medical ▶ DEFINE physical fitness and list clearance is required for safe par- components of health-related ticipation in exercise. and skill-related fitness. ▶ UNDERSTAND the benefits of a comprehensive fitness and wellness program. 1
2 Fitness and Wellness REAL LIFE STORY Jordan’s Experience prescription.” I even © EugeneF, 2009. Used under license stretched once in a while and from Shutterstock.com Last year as a freshman in college I was advised to started to eat better. As I be- enroll in a general education fitness and wellness came more fit, I started to course. I played high school sports and thought I feel better about myself, I knew all there was to know about being fit and in lost weight, I toned up, I had shape. As the course started, I realized I didn’t really so much more energy, and I know how important it was to exercise regularly and actually started to enjoy ex- take good care of myself. It quickly became my favor- ercise. It is fun to work out! I now know that how ite class and I couldn’t wait to try what I was learn- well I will live the rest of my life has a lot to do with ing. I started cardio and strength workouts according wellness choices I make. My goal is to never stop ex- to an exercise prescription I wrote myself. I didn’t ercising and take good care of myself. even know there was such a thing as an “exercise Most people believe school will teach them how to dence linking increased physical activity and positive make a better living. A fitness and wellness course lifestyle habits to better health and improved quality will teach you how to live better—how to truly live of life. Even though a few individuals live long be- your life to its fullest potential. Real success is about cause of favorable genetic factors, for most people, more than money: Making a good living will not the quality of life during middle age and the “golden help you unless you live a wellness lifestyle that will years” is more often related to wise choices initiated allow you to enjoy what you have. Your lifestyle is during youth and continued throughout life. the most important factor affecting your personal well-being, but most people don’t know how to Based on the abundance of scientific research on make the right choices to live their best life. physical activity and exercise, a clear distinction has been established between the two. Physical activity During the last three decades, the benefits of phys- is defined as bodily movement produced by skeletal ical activity have been substantiated by scientific evi- muscles that requires the expenditure of energy and Photos © Fitness & Wellness, Inc. Physical activity and exercise lead to less disease, a longer life, and enhanced quality of life.
Chapter 1 Introduction to Physical Fitness and Wellness 3 Figure 1.1 U.S. prevalence of recommended physical activity.* WA MT ND MN ME WY OR SD WI NY VT ID NE IA PA NH MA NV UT KS IL MI CA OK MO IN OH CT RI CO TX AR WV VA NC DC NJ AZ NM KY DE TN SC MD AL GA > 55% LA MS 50–54.9% 45–49.9% FL 40–44.9% < 40% AK HI Guam Puerto Rico Virgin Islands *Moderate-intensity physical activity at least 5 days a week for 30 minutes a day or vigorous-intensity physical activity 3 days a week for 20 minutes a day. SOURCE: Centers for Disease Control and Prevention, Atlanta, 2005. produces progressive health benefits. Examples of mendation of 30 minutes of moderate physical activ- physical activity are walking to and from work and ity at least 5 days per week.2 Furthermore, data from the store, taking the stairs instead of elevators and the Centers for Disease Control and Prevention escalators, gardening, doing household chores, (CDC) indicate that 16 percent are completely inac- dancing, and washing the car by hand. Physical in- tive (that is, spending less than 10 minutes per week activity, by contrast, implies a level of activity that is in moderate- or vigorous-intensity physical activ- lower than that required to maintain good health. ity). The prevalence of physical activity by state in the United States is displayed in Figure 1.1. Exercise is considered a type of physical activity that requires planned, structured, and repetitive Even though most people in the United States bodily movement to improve or maintain one or believe that a positive lifestyle has a great impact more components of physical fitness. Walking, jog- on health and longevity, most do not know how to ging, cycling, aerobics, swimming, strength training, implement a fitness and wellness program that will and stretching are all examples of exercise that can yield the desired results. Patty Neavill is an exam- be conducted as a regular weekly program. ple of someone who frequently tried to change her life but was unable to do so because she did not Unfortunately, the current way of life in most know how to implement a sound exercise and developed nations does not provide the human body with sufficient physical exercise to maintain KEY TERMS adequate health. Furthermore, many lifestyle pat- terns are such a serious threat to health that they Physical activity Bodily movement produced by skeletal mus- actually speed up deterioration of the human body. cles that requires energy expenditure and produces progressive In a few short years, lack of wellness leads to loss of health benefits. vitality and gusto for life, as well as premature mor- bidity and mortality. Exercise A type of physical activity that requires planned, struc- tured, and repetitive bodily movement done to improve or main- The typical North American is not a good role tain one or more components of physical fitness. model in terms of physical fitness. Currently, only about half of U.S. adults meet the minimal recom-
4 Fitness and Wellness weight control program. At age 24, Patty, a college mostly to changes in lean tissue lost during the © Fitness & Wellness, Inc. sophomore, was discouraged over her weight, level weight-reduction phase. Despite only a slight drop of fitness, self-image, and quality of life in general. in weight during the second year following the calo- rie-restricted diet, Patty’s 2-year follow-up revealed She had struggled with weight most of her life. a further decrease in body fat, to 19.5 percent. Patty Like thousands of other people, she had made many understands the new quality of life reaped through unsuccessful attempts to lose weight. Patty put aside a sound fitness program. her fears and decided to enroll in a fitness course. As part of the course requirement, she took a battery of Lifestyle, Health, and Quality fitness tests at the beginning of the semester. Patty’s of Life cardiorespiratory fitness and strength ratings were poor, her flexibility classification was average, she Research findings have shown that physical inactiv- weighed more than 200 pounds, and she had 41 per- ity and negative lifestyle habits pose a serious threat cent body fat. to health. Movement and physical activity are basic functions for which the human organism was cre- Following the initial fitness assessment, Patty met ated. Advances in modern technology, however, with her course instructor, who prescribed an exer- have all but eliminated the need for physical activity cise and nutrition program such as the one presented in daily life. Physical activity no longer is a natural in this book. Patty fully committed to carry out the part of our existence. This epidemic of physical inac- prescription. She walked or jogged five times a week, tivity is the second greatest threat to U.S. public worked out with weights twice a week, and played health and has been termed Sedentary Death Syn- volleyball or basketball two to four times each week. drome, or SeDS. (The number-one threat is tobacco Her daily caloric intake was set in the range of 1,500 use—the largest cause of preventable deaths.) to 1,700 calories. She took care to meet the minimum required amounts from the basic food groups each Today we live in an automated society. Most of the day, which contributed about 1,200 calories to her activities that used to require strenuous physical exer- diet. The remainder of the calories came primarily tion can be accomplished by machines with the simple from complex carbohydrates. At the end of the pull of a handle or push of a button. If people go to a 16-week semester, Patty’s cardiorespiratory fitness, store that is only a couple of blocks away, most drive strength, and flexibility ratings had all improved to their automobiles and then spend a couple of minutes the “good” category, she had lost 50 pounds, and her driving around the parking lot to find a spot 10 yards percent body fat had dropped to 22.5! The epitome of physical inactivity is to drive around a A thank-you note from Patty to the course in- parking lot for several minutes in search of a parking spot structor at the end of the semester read: 10 to 20 yards closer to the store’s entrance. Thank you for making me a new person. I truly ap- preciate the time you spent with me. Without your kindness and motivation, I would have never made it. It’s great to be fit and trim. I’ve never had this feeling before and I wish everyone could feel like this once in their life. Thank you, Your trim Patty! Patty never had been taught the principles gov- erning a sound weight loss program. She needed this knowledge and, like most Americans who never have experienced the process of becoming physi- cally fit, she needed to be in a structured exercise setting to truly feel the joy of fitness. Of even greater significance, Patty maintained her aerobic and strength-training programs. A year after ending her calorie-restricted diet, her weight actually increased by 10 pounds—but her body fat decreased from 22.5 percent to 21.2 percent. As dis- cussed in Chapter 6, the weight increase is related
Chapter 1 Introduction to Physical Fitness and Wellness 5 closer to the store’s entrance. During a visit to a multi- Figure 1.2 Leading causes of death in the United level shopping mall, nearly everyone chooses to ride States: 2006. the escalators instead of taking the stairs. Cardiovascular Cancer Automobiles, elevators, escalators, cell phones, diseases 23.0% intercoms, remote controls, electric garage door openers—all are modern-day commodities that min- 31.7% imize the amount of movement and effort required of the human body. Others CLRD* 35.2% 5.1% One of the most significant detrimental effects of modern-day technology has been an increase in *Chronic Lower Accidents chronic diseases related to a lack of physical activity. Respiratory Disease 5.0% These include hypertension (high blood pressure), heart disease, chronic low back pain, and obesity, SOURCE: U.S. Department of Health and Human Services, Centers for Disease among others. They sometimes are referred to as hy- Control and Prevention, National Center for Health Statistics, National Vital pokinetic diseases. (“Hypo” means low or little, and Statistics reports, Deaths: Final Data for 2006, 57:14 (April 2009). “kinetic” implies motion.) Lack of adequate physical activity is a fact of modern life that most people can disease and quality of life. The data also indicate avoid no longer. According to the World Health Orga- that 83 percent of deaths that occur before age 65 nization (WHO), chronic diseases account for 60 per- are preventable. In essence, most people in the cent of all deaths worldwide.3 If we want to enjoy United States are threatened by the very lives they contemporary commodities and still expect to live life lead today.5 to its fullest, a personalized lifetime exercise program must become a part of our daily lives. Based on 2009 government data, the average life expectancy in the United States is now 75.1 years for With the developments in technology, three ad- men and 80.2 years for women. Unlike previous life ditional factors have changed our lives significantly expectancy calculations, the WHO has calculated and have had a negative effect on human health: healthy life expectancy (HLE) estimates for 191 na- nutrition, stress, and environment. Fatty foods, tions. The United States ranks 24th in this report, sweets, alcohol, tobacco, excessive stress, and envi- with an HLE of 70 years. Japan is first, with an HLE ronmental hazards (such as wastes, noise, and air of 74.5 years (see Figure 1.3). pollution) have detrimental effects on people’s health. The ranking for the United States is a major sur- prise for a developed country with one of the best The leading causes of death in the United States medical care systems in the world. The rating indi- today (see Figure 1.2) are lifestyle related. About cates that Americans die earlier and spend more 55 percent of all deaths in the United States are caused by cardiovascular disease and cancer.4 Al- KEY TERMS most 80 percent of these deaths could be prevented by adhering to a healthy lifestyle. The third leading Sedentary Death Syndrome (SeDS) Deaths that are attrib- cause of death—chronic lower respiratory (lung) uted to a lack of regular physical activity. disease—is related largely to tobacco use. Accidents Chronic diseases Illnesses that develop and last over a long are the fourth leading cause of death. Even though time. not all accidents are preventable, many are. Fatal ac- Hypokinetic diseases Diseases related to a lack of physical cidents often are related to abusing drugs and not activity. wearing seat belts. Life expectancy Number of years a person is expected to live based on the person’s birth year. According to Dr. David Satcher, former U.S. Sur- Healthy life expectancy (HLE) Number of years a person is ex- geon General, more than 50 percent of the people pected to live in good health; this number is obtained by subtract- who die in the United States each year die because ing ill-health years from overall life expectancy. of what they do. Estimates indicate that more than half of disease is lifestyle related, a fifth is attrib- uted to environmental factors, and a tenth is influ- enced by the health care the individual receives. Only 16 percent is related to genetic factors. Thus, the individual controls as much as 84 percent of
6 Fitness and Wellness Figure 1.3 Healthy life expectancy for selected span may decrease by as much as 5 years. This de- countries. crease in life expectancy will be related primarily to the growing epidemic of obesity. More than 32 per- Ireland 69.6 cent of the adult population in the United States is USA obese. Additional information on the obesity epi- Germany 70.0 demic and its detrimental health consequences is Austria given in Chapter 5. Belgium 70.4 United Kingdom Importance of Increased Norway 71.6 Netherlands Physical Activity Canada 71.6 Greece The U.S. Surgeon General has stated that poor health Switzerland 71.7 as a result of lack of physical activity is a serious Italy public health problem that must be met head-on at Spain 71.7 once. Regular moderate physical activity provides Sweden substantial benefits in health and well-being for the France 72.0 vast majority of people who are not physically ac- Japan tive. For those who are already moderately active, 60 65 72.0 even greater health benefits can be achieved by in- creasing the level of physical activity. 72.5 Among the benefits of regular physical activity 72.5 and exercise are significantly reduced risks for de- veloping or dying from heart disease, stroke, type 2 72.7 diabetes, colon and breast cancers, high blood pres- sure, and osteoporotic fractures.6 Regular physical 72.8 activity also is important for the health of muscles, bones, and joints, and it seems to reduce symptoms 73.0 of depression and anxiety, improve mood, and en- hance one’s ability to perform daily tasks through- 73.1 out life. It also can help control health care costs and maintain a high quality of life into old age. 74.5 Moderate physical activity has been defined as 70 75 80 any activity that requires an energy expenditure of Years 150 calories per day, or 1,000 calories per week. The general health recommendation is that people strive SOURCE: World Health Organization, http://www.who.int/inf-pr-2000/en/ to accumulate at least 30 minutes of physical activity pr2000-life.html. Retrieved Nov. 24, 2007. a minimum of 5 days per week. Whereas 30 minutes of continuous activity is preferred, on days when time disabled than people in most other advanced time is limited, three activity sessions of at least countries. The WHO points to several factors that 10 minutes each provide about half the aerobic ben- may account for this unexpected finding: efits. Examples of moderate physical activity are walking, cycling, playing basketball or volleyball, 1. The extremely poor health of some groups, such swimming, water aerobics, dancing fast, pushing a as Native Americans, rural African Americans, stroller, raking leaves, shoveling snow, washing or and the inner-city poor. Their health status is waxing a car, washing windows or floors, and even more characteristic of poor, developing nations gardening. than a rich industrialized country. Because of the ever-growing epidemic of obesity 2. The HIV epidemic, which causes more deaths in the United States, a 2002 guideline by American and disability than in other developed nations and Canadian scientists from the Institute of Medi- cine of the National Academy of Sciences increased 3. The high use of tobacco products the recommendation to 60 minutes of moderate- 4. A high incidence of coronary heart disease 5. Fairly high levels of violence, notably homi- cides, compared with other developed countries Although life expectancy in the United States gradually increased by 30 years over the last cen- tury, scientists from the National Institute of Aging believe that in the coming decades the average life-
Chapter 1 Introduction to Physical Fitness and Wellness 7 intensity physical activity every day.7 This recom- 30 minutes and high-intensity activity for mendation was based on evidence indicating that 20 minutes on another 2 days. Aerobic activity people who maintain healthy weight typically ac- should be performed in episodes of at least cumulate one hour of daily physical activity. 10 minutes long each, preferably spread throughout the week. Subsequently, the 2005 Dietary Guidelines for • Additional health benefits are provided by increas- Americans released by the U.S. Department of Health ing to 5 hours (300 minutes) a week of moderate- and Human Services (DHHS) and the Department of intensity aerobic physical activity, 2 hours and Agriculture say that up to 60 minutes of moderate- to 30 minutes a week of vigorous-intensity physical vigorous-intensity physical activity per day may be activity, or an equivalent combination of both. necessary to prevent weight gain, and between 60 • Adults should also do muscle-strengthening ac- and 90 minutes of moderate-intensity physical activ- tivities that involve all major muscle groups, ity daily is recommended to sustain weight loss for performed on 2 or more days per week. previously overweight people.8 Older Adults (ages 65 and Older) • Older adults should follow the adult guidelines. In sum, although health benefits are derived with If this is not possible due to limiting chronic con- 30 minutes per day, people with a tendency to gain ditions, older adults should be as physically ac- weight need to be physically active daily for an hour tive as their abilities allow. They should avoid to an hour and a half to prevent weight gain. And 60 inactivity. Older adults should do exercises that to 90 minutes of activity per day provides additional maintain or improve balance if they are at risk health benefits, including a lower risk for cardiovas- for falling. cular disease and diabetes. Children 6 Years of Age and Older and Adolescents 2008 Federal Guidelines • Children and adolescents should do 1 hour (60 minutes) or more of physical activity for Physical Activity every day. • Most of the 1 hour or more a day should be ei- Because of the importance of physical activity to our ther moderate- or vigorous-intensity aerobic health, in October 2008 the DHHS issued Federal physical activity. Physical Activity Guidelines for Americans for the • As part of their daily physical activity, children first time. These guidelines complement the Dietary and adolescents should do vigorous-intensity ac- Guidelines for Americans published in 2005 (see tivity on at least 3 days per week. They also Chapter 5, page 142) and further substantiate previ- should do muscle-strengthening and bone- ous recommendations issued by the American Col- strengthening activities on at least 3 days per lege of Sports Medicine (ACSM) and the American week. Heart Association (AHA) in 2007,9 and the U.S. Sur- Pregnant and Postpartum Women geon General in 1996.10 The federal guidelines pro- • Healthy women who are not already doing vig- vide science-based guidance on the importance of orous-intensity physical activity should get at being physically active and eating a healthy diet to least 2 hours and 30 minutes (150 minutes) of promote health and reduce the risk for chronic dis- moderate-intensity aerobic activity a week. Pref- eases. The federal guidelines include the following erably, this activity should be spread throughout recommendations:11 the week. Women who regularly engage in vig- orous-intensity aerobic activity or high amounts Adults Between 18 and 64 Years of Age of activity can continue their activity provided • Adults should do 2 hours and 30 minutes a KEY TERMS week of moderate-intensity aerobic (cardiore- spiratory) physical activity, 1 hour and 15 min- Moderate-intensity aerobic physical activity Defined as the utes (75 minutes) a week of vigorous-intensity equivalent of a brisk walk that noticeably increases the heart rate. aerobic physical activity, or an equivalent com- bination of moderate- and vigorous-intensity Vigorous-intensity aerobic physical activity Defined as an aerobic physical activity (also see Chapter 3). activity similar to jogging that causes rapid breathing and a sub- When combining moderate- and vigorous- stantial increase in heart rate. intensity activities, a person could participate in moderate-intensity activity twice a week for
8 Fitness and Wellness that their condition remains unchanged and they weights regularly, participate in stretching exercises, talk to their health care provider about their ac- and watch their body weight can be classified as tivity level throughout their pregnancy. having good or excellent fitness. If these same peo- ple, however, have high blood pressure, smoke, are In a 2007 report, the ACSM and AHA also re- under constant stress, consume too much alcohol, leased a joint statement on physical activity recom- and eat too many fatty foods, they are exposing mendations for healthy adults.12 The report states themselves to risk factors for disease of which they that a greater amount of physical activity that ex- may not be aware. ceeds the minimum recommendations given above for adults between 18 and 64 years of age provides Good health no longer is viewed as simply the even greater benefits and is recommended for indi- absence of disease. The notion of good health has viduals who wish to further improve personal fit- evolved notably in the last few years and continues ness, reduce the risk for chronic disease and dis- to change as scientists learn more about lifestyle fac- abilities, prevent premature mortality, or prevent tors that bring on illness and affect wellness. Once unhealthy weight gain. the idea took hold that fitness by itself would not necessarily decrease the risk for disease and ensure The ACSM/AHA report also states that only better health, the wellness concept developed in the 49 percent of the U.S. adult population meets the 1980s. recommendations. College graduates are more likely to adhere to the recommendations (about 53 percent Wellness is an all-inclusive umbrella covering a of them), followed by individuals with some college variety of health-related factors. A wellness lifestyle education, then high school graduates; and the least requires the implementation of positive programs to likely to meet the recommendations are those with change behavior and thereby improve health and less than a high school diploma (37.8 percent). quality of life, prolong life, and achieve total well- being. To enjoy a wellness lifestyle, a person has to In conjunction with the above report, the ACSM practice behaviors that will lead to positive out- and the American Medical Association (AMA) have comes in seven dimensions of wellness: physical, launched a nationwide Exercise Is Medicine pro- emotional, intellectual, social, environmental, spiri- gram.13 The goal of this initiative is to help improve tual, and occupational (see Figure 1.4). These dimen- the health and wellness of the nation through exer- sions are interrelated; one frequently affects the cise prescriptions from physicians and health care others. For example, a person who is “emotionally providers: “Exercise is medicine and it’s free.” All down” often has no desire to exercise, study, go to physicians should be prescribing exercise to all pa- work, socialize with friends, or attend church. tients and participate in exercise themselves. Exer- cise is considered to be the much needed vaccine of The concept behind the seven dimensions of well- our time to prevent chronic diseases. Physical activ- ness shows that high-level wellness clearly goes be- ity and exercise are powerful tools for both the treat- yond optimum fitness and the absence of disease. ment and the prevention of chronic diseases and premature death. Figure 1.4 Dimensions of wellness. CRITICAL THINKING Social Do you consciously incorporate physical activity into Occupational Physical your daily lifestyle? ● Can you provide examples? ● Do you think you get sufficient daily Wellness physical activity to maintain good health? Emotional Spiritual Wellness Mental Environmental After the initial fitness boom swept across the United States in the 1970s, it became clear that improving physical fitness alone was not always enough to lower the risk for disease and ensure better health. For example, individuals who run 3 miles a day, lift
Chapter 1 Introduction to Physical Fitness and Wellness 9 Wellness incorporates fitness, proper nutrition, stress Figure 1.5 Health-related components management, disease prevention, social support, of physical fitness. self-worth, nurturance (a sense of being needed), spirituality, personal safety, substance control and Muscular Cardiorespiratory not smoking, regular physical examinations, health flexibility endurance education, and environmental support. Body For a wellness way of life, individuals must be composition physically fit and manifest no signs of disease, and they also must avoid all risk factors for disease Muscular strength (such as physical inactivity, hypertension, abnormal & endurance cholesterol levels, cigarette smoking, excessive stress, faulty nutrition, or careless sex). Even though Health-Related Fitness an individual tested in a fitness center might dem- onstrate adequate or even excellent fitness, indul- Health-related fitness has four components: cardio- gence in unhealthy lifestyle behaviors will increase respiratory endurance, muscular strength and en- the risk for chronic diseases and decrease the per- durance, muscular flexibility, and body composition son’s well-being. Additional information on well- (see Figure 1.5): ness and how to implement a wellness program is given in Chapter 8. 1. Cardiorespiratory endurance: the ability of the heart, lungs, and blood vessels to supply oxy- Unhealthy behaviors contribute to the staggering gen to the cells to meet the demands of pro- U.S. health care costs. Risk factors for disease carry a longed physical activity (also referred to as aer- heavy price tag. Health care costs in the United obic exercise). States rose from $12 billion in 1950 to $2 trillion in 2005, or about 16 percent of the gross domestic prod- 2. Muscular strength and endurance: the ability of uct (GDP). In 1980, health care costs represented the muscles to generate force. 8.8 percent of the GDP, and they are projected to reach about 20 percent by the year 2015. Based 3. Muscular flexibility: the achievable range of mo- on estimates, 1 percent of Americans account for tion at a joint or group of joints without caus- 30 percent of these costs. Half of the people use up ing injury. about 97 percent of the health care dollars. 4. Body composition: the amount of lean body mass In terms of yearly health care costs per person, and adipose tissue (fat mass) in the human the United States spends more per person than any body. other industrialized nation. In 2006, U.S. health care costs per capita were about $7,026; they are Skill-Related Fitness expected to reach almost $9,000 in 2010. Yet, over- all, the U.S. health care system ranks only 37th in Fitness in motor skills is essential in activities such the world. as basketball, racquetball, golf, hiking, soccer, and water skiing. Good skill-related fitness also enhances One of the reasons for the low overall ranking is overall quality of life by helping people cope more the overemphasis on state-of-the-art cures instead of prevention programs. The United States is the best KEY TERMS place in the world to treat people once they are sick, but the system does a poor job of keeping people Risk factors Characteristics that predict the chances for develop- healthy in the first place. ing a certain disease. Wellness The constant and deliberate effort to stay healthy and Physical Fitness achieve the highest potential for well-being. Physical fitness The general capacity to adapt and respond fa- Individuals are physically fit when they can meet vorably to physical effort. both the ordinary and the unusual demands of daily Health-related fitness A physical state encompassing cardio re- life safely and effectively without being overly fa- spiratory endurance, muscular strength and endurance, muscular tigued and still have energy left for leisure and rec- flexibility, and body composition. reational activities. Physical fitness can be classified into health-related and skill-related fitness.
10 Fitness and Wellness Figure 1.6 Motor-skill-related components of physical fitness. Agility Coordination Speed Balance Power Reaction time effectively in emergency situations (see Chapter 4). © Fitness & Wellness, Inc. The components of skill-related fitness are agility, balance, coordination, power, reaction time, and Good skill-related fitness enhances success in sports speed (see Figure 1.6): performance. 1. Agility: the ability to change body position and 6. Speed: the ability to propel the body or a part of direction quickly and efficiently. Agility is im- the body rapidly from one point to another. Ex- portant in sports such as basketball, soccer, and amples of activities that require good speed for racquetball, in which the participant must success are soccer, basketball, stealing a base in change direction rapidly and at the same time baseball, and sprints in track. maintain proper body control. In terms of preventive medicine, the main em- 2. Balance: the ability to maintain the body in phasis of fitness programs should be on the health- equilibrium. Balance is vital in activities such related components. Skill-related fitness is crucial as gymnastics, diving, ice skating, skiing, for success in sports and athletics, and it also and even football and wrestling, in which contributes to wellness. Improving skill-related fit- the athlete attempts to upset the opponent’s ness affords an individual more enjoyment and equilibrium. success in lifetime sports, and regular participa- tion in skill-related fitness activities also helps de- 3. Coordination: integration of the nervous system velop health-related fitness. Further, total fitness is and the muscular system to produce correct, achieved by taking part in specific programs to graceful, and harmonious body movements. This improve health-related and skill-related compo- component is important in a wide variety of mo- nents alike. tor activities such as golf, baseball, karate, soccer, and racquetball, in which hand/eye or foot/eye Benefits of Fitness and Wellness movements, or both, must be integrated. The benefits to be enjoyed from participating in a 4. Power: the ability to produce maximum force in regular fitness and wellness program are many. In the shortest time. The two components of addition to a longer life (see Figures 1.7 and 1.8), the power are muscle speed and force (strength). greatest benefit of all is that physically fit people An effective combination of these two compo- who lead a positive lifestyle have a healthier and nents allows a person to produce explosive better quality of life. These people live life to its full- movements such as required in jumping; put- est and have fewer health problems than inactive ting the shot; and spiking, throwing, and hit- individuals who also indulge in negative lifestyle ting a ball. habits. 5. Reaction time: the time required to initiate a re- Compiling an all-inclusive list of the benefits to sponse to a given stimulus. Good reaction time be reaped through participation in a fitness and is important for starts in track and swimming; for quick reactions when playing tennis at the net; and in sports such as ping-pong, boxing, and karate.
Chapter 1 Introduction to Physical Fitness and Wellness 11 wellness program is a challenge, but the following In addition to the benefits listed, epidemiological list summarizes many of these benefits: research studies linking physical activity habits and mortality rates have shown lower premature mortal- • Improves and strengthens the cardiorespiratory ity rates in physically active people. Pioneer work in system this area demonstrated that as the amount of weekly physical activity increased, the risk for cardiovascu- • Promotes better muscle tone, muscular strength, lar deaths decreased.14 In this study, conducted and endurance among 16,936 Harvard alumni, the greatest decrease in cardiovascular deaths was observed in alumni • Improves muscular flexibility who burned more than 2,000 calories per week • Enhances athletic performance through physical activity. • Helps maintain recommended body weight • Helps preserve lean body mass A landmark study subsequently upheld the find- • Increases resting metabolic rate ings of the Harvard alumni study.15 Based on data • Improves the body’s ability to use fat during from 13,344 individuals who were followed over an average of 8 years, the results confirmed that the level physical activity of cardiorespiratory fitness is related to mortality from • Improves posture and physical appearance all causes. These findings showed a graded and con- • Improves functioning of the immune system sistent inverse relationship between physical fitness • Lowers the risk for chronic diseases and illness and mortality, regardless of age and other risk factors. (such as cardiovascular diseases and cancer) In essence, the higher the level of cardiorespira- • Decreases the mortality rate from chronic tory fitness, the longer the life (see Figure 1.7). The death rate from all causes for the low-fit men was diseases 3.4 times higher than for the high-fit men. For the • Thins the blood so it doesn’t clot as readily low-fit women, the death rate was 4.6 times higher than for the high-fit women. The study also reported (thereby decreasing the risk for coronary heart a greatly reduced rate of premature deaths, even at disease and strokes) moderate fitness levels, which most adults can • Helps the body manage cholesterol more achieve easily. People gain further protection when effectively they combine higher fitness levels with reduction in • Prevents or delays the development of high other risk factors such as hypertension, elevated cho- blood pressure and lowers blood pressure in lesterol, cigarette smoking, and excessive body fat. people with hypertension • Helps prevent and control diabetes Additional research that looked at changes in fit- • Helps achieve peak bone mass in young adults ness and mortality found a substantial (44 percent) and maintain bone mass later in life, thereby de- reduction in mortality risk when the study partici- creasing the risk for osteoporosis pants abandoned a sedentary lifestyle and became • Helps people sleep better moderately fit.16 The lowest death rate was found in • Helps prevent chronic back pain people who were fit and remained fit, and the high- • Relieves tension and helps in coping with life est rate was found in men who remained unfit (see stresses Figure 1.8). • Raises levels of energy and job productivity • Extends longevity and slows the aging process Further research in this area substantiated the pre- • Promotes psychological well-being through bet- vious findings and also indicated that primarily vig- ter morale, self-image, and self-esteem orous activities are associated with greater longev- • Reduces feelings of depression and anxiety ity.17,18 Vigorous activity was defined as activity that • Motivates a person toward positive lifestyle requires a MET level equal to or greater than 6 METs changes (improving nutrition, quitting smoking, (see Chapter 4, Table 4.1, page 114). This level repre- controlling alcohol and drug use) • Speeds recovery time following physical KEY TERMS exertion • Speeds recovery following injury or disease Skill-related fitness Components of fitness important for suc- • Regulates and improves overall body cessful motor performance in athletic events and in lifetime sports functions and activities. • Helps maintain independent living, especially in older adults Epidemiological The study of epidemic diseases. • Enhances quality of life: People feel better and live a healthier and happier life.
12 Fitness and Wellness Figure 1.7 Death rates by physical fitness levels. 64.0 39.5 70 40 60 35 50 30 40 26.3 24.6 25 20 16.4 16.3 30 20.3 20.3 15 9.7 7.4 20 10 7.8 7.3 4.8 10 7.4 3.9 3.1 5.8 1.0 2.9 1.0 4.7 Fitness 5.4 category Men Fitness category Low oderate M High of death Cause Low oderate M High of death Cause AClal rcdaiuosveassculaCr aAnccecrident All cauCsCaearsdnicoevrascAuclacrident .8 1.8 Women Numbers on top of the bars are all-cause death rates per 10,000 person-years of follow-up for each cell; 1 person-year indicates one person who was followed up 1 year later. SOURCE: Based on data from S. N. Blair, H. W. Kohl III, R. S. Paffenbarger, Jr., D. G. Clark, K. H. Cooper, and L. W. Gibbons, “Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy Men and Women,” Journal of the American Medical Association 262 (1989): 2395–2401. Figure 1.8 Effects of fitness changes ball, tennis, and shoveling snow. Results also indi- on mortality rates. cated that vigorous exercise is as important as main- taining recommended weight and not smoking. 125 122.0 While it is clear that moderate-intensity exercise Death 105 67.7 does provide substantial health benefits, the research rate 85 39.6 data shows a dose-response relationship between from 65 physical activity and health. That is, greater health all and fitness benefits occur at higher duration and/or causes* intensity of physical activity. 45 Vigorous activity are preferable to the extent of one’s capabilities because they are most clearly asso- 25 ciated with better health and longer life. As compared with prolonged moderate-intensity activity, vigorous- 5 intensity has been shown to provide the best im- provements in aerobic capacity, coronary heart dis- Initial assessment Unfit Unfit Fit ease risk reduction, blood pressure, blood glucose 5-year follow-up Unfit Fit Fit control, and overall cardiovascular health.19,20 SOURCE: S. N. Blair et al., “Changes in Physical Fitness and All-Cause Mortal- A word of caution, however, is in order. Vigorous ity: A Prospective Study of Healthy Men and Women,” Journal of the American exercise should be reserved for healthy individuals Medical Association 273 (1995): 1193–1198. who have been cleared to do it (see Activity 1.2 at the end of the chapter) and who have been participating sents exercising at an energy level of 6 times the rest- regularly in at least moderate-intensity activities. ing energy requirement. Examples of vigorous ac- tivities used in the previous study include brisk The results of the previously discussed studies walking, jogging, swimming laps, squash, racquet- indicate clearly that fitness improves wellness, qual- ity of life, and longevity. If people are able, vigorous exercise is preferable because it is associated most closely with longer life.
Chapter 1 Introduction to Physical Fitness and Wellness 13 Figure 1.9 Selected national health objectives for the year 2010. 1. Increase quality and years of 7. Promote health for all people 16. Promote health and prevent healthy life. through a healthy environment. secondary conditions among persons with disabilities. 2. Eliminate health disparities. 8. Reduce the incidence and 3. Improve the health, fitness, and severity of injuries from un- 17. Enhance the cardiovascular intentional causes, as well as health and quality of life of all quality of life of all Americans violence and abuse. Americans through prevention through the adoption and main- and control of risk factors, and tenance of regular, daily physical 9. Promote worker health and promotion of healthy lifestyle activity. safety through prevention. behaviors. 4. Promote health and reduce chronic disease risk, disease 10. Improve access to comprehen- 18. Prevent HIV transmission progression, debilitation, and sive, high-quality health care. and associated morbidity and premature death associated with mortality. dietary factors and nutritional 11. Ensure that every pregnancy in status among all people in the the United States is intended. 19. Improve the mental health of United States. all Americans. 5. Reduce disease, disability, and 12. Improve maternal and preg- death related to tobacco use and nancy outcomes and reduce 20. Raise the public’s awareness of exposure to secondhand smoke. rates of disability in infants. the signs and symptoms of lung 6. Increase the quality, availability, disease. and effectiveness of educational 13. Improve the quality of health- and community-based programs related decisions through 21. Increase awareness of healthy designed to prevent disease and effective communication. sexual relationships and prevent improve the health and quality all forms of sexually transmitted of life of the American people. 14. Decrease the incidence of infections. functional limitations due to arthritis, osteoporosis, and 22. Reduce the incidence of chronic back conditions. substance abuse by all people, especially children. 15. Decrease cancer incidence, morbidity, and mortality. SOURCE: U.S. Department of Health and Human Services. National Health Objectives health to all people is crucial to the health of the nation. for the Year 2010 3. Health promotion and disease prevention. A shift from treatment to preventive techniques will Every 10 years, the U.S. Department of Health and drastically cut health care costs and help all Human Services releases a list of objectives for pre- Americans achieve a better quality of life. venting disease and promoting health. From its onset in 1980, this 10-year plan has helped instill a new Development of these health objectives involves sense of purpose and focus for public health and pre- more than 10,000 people representing 300 national ventive medicine. These national health objectives are organizations, including the Institute of Medicine of intended as realistic goals to improve the health of all the National Academy of Sciences, all state health Americans as we go into the second decade of the departments, and the federal Office of Disease new millennium. Two unique goals of the 2010 objec- Prevention and Health Promotion. A summary of tives are that they emphasize increased quality and key 2010 objectives is provided in Figure 1.9. Living years of healthy life, and they seek to eliminate health according to the fitness and wellness principles disparities among all groups of people. The objectives provided in this book will enhance the quality of address three important points:21 KEY TERMS 1. Personal responsibility. Individuals need to be- come ever more health-conscious. Responsible MET Short for metabolic equivalent, represents the rate of energy and informed behaviors are the key to good expenditure while sitting quietly at rest. This energy expenditure is health. approximately 3.5 milliliters of oxygen per kilogram of body weight per minute (mL/kg/min) or 1.2 calories per minute for a 70 kilo- 2. Health benefits for all people. Lower socioeco- gram person. A 3-MET activity requires three times the energy ex- nomic conditions and poor health often are penditure of sitting quietly at rest. interrelated. Extending the benefits of good
14 Fitness and Wellness your life and also will allow you to be an active Healthy Lifestyle Habits participant in achieving the Healthy People 2010 Objectives. Research indicates that adherence to the following 12 lifestyle habits will significantly improve health Path to Fitness and Wellness and extend life: Current scientific data and the fitness movement that 1. Participate in a lifetime physical activity began more than three decades ago in the United program. States have led many people to see the advantages of participating in fitness programs that will improve 2. Do not smoke cigarettes. and maintain health. Because fitness and wellness 3. Eat right. needs vary from one person to another, exercise and 4. Avoid snacking. wellness prescriptions must be personalized for best 5. Maintain recommended body weight through results. This book provides the necessary guidelines for developing a lifetime program to improve fitness adequate nutrition and exercise. and promote preventive health care and personal 6. Sleep 7 to 8 hours each night. wellness. As you study the book and complete the 7. Lower your stress levels. assignments in each chapter, you will learn to: 8. Drink alcohol moderately or not at all. 9. Surround yourself with healthy friendships. • Determine whether medical clearance is required 10. Seek to live and work in a healthy for you to participate safely in exercise. environment. • Assess your overall level of physical fitness, in- 11. Use the mind: Keep your brain engaged cluding cardiorespiratory endurance, muscular strength and endurance, muscular flexibility, and throughout life to maintain cognitive function. body composition. 12. Take personal safety measures to lessen the • Prescribe personal programs for total fitness risk for avoidable accidents. development. Try It Look at the list above and indicate which • Learn behavior modification techniques that will habits are already a part of your lifestyle. What allow you to change unhealthy lifestyle patterns. changes could you make to incorporate additional healthy habits into your daily life? • Develop sound diet and weight-control programs. • Implement a healthy lifestyle program that in- simply fulfilment of a college requirement. They sign up for the course, participate for a few months, cludes prevention of cardiovascular diseases and finish the course—and stop exercising! Various ex- cancer, stress management, and smoking cessa- cuses are offered: too busy, no one to exercise with, tion, if applicable. already have the grade, inconvenient open-gym • Discern myths from facts pertaining to exercise hours, or job conflicts. A few months later, they real- and health-related concepts. ize once again that exercise is vital and repeat the cycle (see Figure 1.10). Behavior Modification The information in this book will be of little value Scientific evidence of the benefits derived from living to you if you are unable to abandon negative habits a healthy lifestyle continues to mount each day. Al- and adopt and maintain new, healthy behaviors. though the data are impressive, most people still don’t Before looking at the physical fitness and wellness adhere to a healthy lifestyle. To understand why this guidelines, you will need to take a critical look at is so, one has to examine what motivates people and your behaviors and lifestyle—and most likely make what actions are required to make permanent changes some permanent changes to promote your overall in behavior, called behavior modification. health and wellness. Let’s look at an all-too-common occurrence on Changing Behavior college campuses. Most students understand that they should be exercising. They contemplate enroll- The very first step in addressing behavioral change ing in a fitness course. The motivating factor might is to recognize that indeed a problem exists. Five be enhanced physical appearance, health benefits, or
Chapter 1 Introduction to Physical Fitness and Wellness 15 Figure 1.10 Exercise-exercise dropout cycle. A sixth stage of change, termination/adoption, was subsequently added to this model. Contemplate exercise After years of study, researchers found that apply- ing specific behavior-change techniques during each Find Realize need stage of the model increases the rate of success for excuses for not for exercise change. Understanding each stage of this model will help you determine where you are in relation to your exercising personal healthy lifestyle behaviors. It also will help you identify techniques to make successful changes. Stop Consider exercising fitness course Precontemplation People in the precontemplation stage are not con- Course Enroll in sidering or do not want to change a specific behav- ends fitness course ior. They typically deny having a problem and pres- ently do not intend to change. These people are Participate usually unaware or underaware of the problem. in exercise Other people around them, including family, friends, health care practitioners, and coworkers, however, general categories of behaviors are addressed in the identify the problem quite clearly. process of willful change: Precontemplators do not care about the problem 1. Stopping a negative behavior behavior and might even avoid information and 2. Preventing relapse of a negative behavior materials that address the issue. They avoid free 3. Developing a positive behavior screenings and workshops that could help identify 4. Strengthening a positive behavior and change the problem, even if they receive finan- 5. Maintaining a positive behavior cial incentives for attending. Frequently these people actively resist change and seem resigned to accept Changing chronic, unhealthy behaviors to stable, the unhealthy behavior as their “fate.” healthy behaviors is often challenging. Change usu- ally does not happen all at once but, rather, is a Precontemplators are the most difficult people to lengthy process with several stages. reach for behavioral change. They often think that change isn’t even a possibility. Educating them about The simplest model of change is the two-stage the problem behavior is critical to helping them start model of unhealthy behavior and healthy behavior. contemplating the process of change. It is said that This model states that either you do it or you don’t. knowledge is power, and the challenge is to find Most people who use this model attempt self-change ways to help them realize that they will be ulti- but end up asking themselves why they’re unsuc- mately responsible for the consequences of their be- cessful: They just can’t do it (start and adhere to ex- havior. Sometimes they initiate change only when ercise or quit smoking, for example). Their intention under pressure from others. to change may be good, but to accomplish it, they need knowledge about how to achieve change. The Contemplation following discussion may help. In the contemplation stage, people acknowledge that they have a problem and begin to think seri- To aid in this process, psychologists James ously about overcoming it. Although they are not Prochaska, John Norcross, and Carlo DiClemente de- veloped a behavioral change model.22 The model’s KEY TERMS five stages are important to understanding the process of willful change. The stages of change describe un- Behavior modification The process used to permanently derlying processes that people go through to change change negative behaviors in favor of positive behaviors that will most problem behaviors and adopt healthy behaviors. lead to better health and well-being. Most frequently, the model is used to change health- related behaviors such as physical inactivity, smoking, Precontemplation stage Stage of change in which people are nutrition, weight control, stress, and alcohol abuse. unwilling to change their behavior. The five stages of change are precontemplation, Contemplation stage Stage of change in which people are con- contemplation, preparation, action, and maintenance. sidering changing behavior in the next 6 months.
16 Fitness and Wellness quite ready for change yet, they are weighing the times per week according to exercise prescription pros and cons. People may remain in this stage for guidelines (see Chapter 3), or is maintaining a years, but in their mind they are planning to take healthy diet. some action within the next 6 months or so. Educa- tion and peer support are valuable during this Relapse, in which the individual regresses to a stage. previous stage, is common during this stage. Once people maintain the action stage for 6 consecutive Preparation months, they move into the maintenance stage. In the preparation stage, people are seriously con- sidering and planning to change a behavior within Maintenance the next month. They are taking initial steps for During the maintenance stage, the person continues change and may even try it for a short while, such as to adhere to the behavior change for up to 5 years. stopping smoking for a day or exercising a few times The maintenance phase requires continually adher- during this month. In this stage, people define a ing to the specific guidelines that govern the target general goal for behavior change (say, to quit smok- behavior (for example, complete smoking cessation, ing by the last day of the month) and write specific aerobic exercise three times per week, or proper objectives to accomplish this goal (see the discussion stress management techniques). At this time, a per- on SMART Goals, pages 20–21). Continued peer and son works to reinforce the gains made through the environmental support are recommended during various stages of change and strives to prevent the preparation phase. lapses and relapses. Action © Fitness & Wellness, Inc. Termination/Adoption The action stage requires the most commitment of time and energy by the individual. Here people are Once a person has maintained a behavior more than actively doing things to change or modify the prob- 5 years, he or she enters the termination/adoption lem behavior or to adopt a new health behavior. stage without fear of relapse. In the case of negative The action stage requires that the person follow the behaviors that have been terminated, this stage of specific guidelines set forth for that specific behav- change is referred to as termination. If the person ior. For example, a person has actually stopped has adopted a positive behavior for more than 5 smoking completely, is exercising aerobically three years, this stage is designated the adoption stage. Many experts believe that after this period of time, Many people refrain from physical activity because they any former addictions, problems, or lack of compli- lack the necessary skills to enjoy and reap the benefits of ance with healthy behaviors no longer present an regular participation. obstacle in the quest for wellness. The change has become a part of one’s lifestyle. This phase is the ultimate goal for everyone who seeks a healthier lifestyle. Use the form provided in Figure 1.11 to deter- mine where you stand in respect to behaviors that you want to change or new ones that you wish to adopt. As you fill out this form, you will realize that you are at different stages for different behav- iors. For instance, you may be in the termination stage for aerobic exercise and smoking, in the ac- tion stage for strength training, but only in the contemplation stage for a healthy diet. Realizing where you are at with respect to different behaviors will help you design a better action plan for a healthy lifestyle. Using the form provided in Activity 1.1, pages 25–26, select two or three behaviors that you have targeted for the next 3 months. Developing new be- havioral patterns takes time, and trying to work on too many components at once most likely will lower
Chapter 1 Introduction to Physical Fitness and Wellness 17 Figure 1.11 Identifying your current stage of change. Please indicate which response most accurately describes your current ______________________________________ behavior (in the blank space identify the behavior: smoking, physical activity, stress, nutrition, weight control, etc.). Next, select the statement below (select only one) that best represents your current behavior pattern. To select the most appropriate statement, fill in the blank for one of the first three statements if your current behavior is a problem behavior. (For example, you might say, “I currently smoke, and I do not intend to change in the foreseeable future,” or “I currently do not exercise, but I am contemplating changing in the next 6 months.”) If you have already started to make changes, fill in the blank in one of the last three statements. (In this case, you might say: “I currently eat a low-fat diet, but I have done so only within the last 6 months,” or “I currently practice adequate stress management techniques, and I have done so for more than 6 months.”) As you can see, you may use this form to identify your stage of change for any type of health-related behavior. 1. I currently __________________________________, and I do not intend to change in the foreseeable future. 2. I currently __________________________________, but I am contemplating changing in the next 6 months. 3. I currently _______________________________________ regularly but intend to change in the next month. 4. I currently ________________________________________, but I have done so only within the last 6 months. 5. I currently ____________________________________________, and I have done so for more than 6 months. 6. I currently ______________________________________________, and I have done so for more than 5 years. STAGES OF CHANGE 1 = Precontemplation 4 = Action 2 = Contemplation 5 = Maintenance 3 = Preparation 6 = Termination/Adoption your chances for success. Start with components factors and is unrelated to their behavior. The latter in which you think you will have a high chance for group often has difficulty getting out of the precon- success. templation or contemplation stages. CRITICAL THINKING People with an internal locus of control are apt to be healthier and have an easier time initiating and What factors do you think keep you from participating in a regular exercise program? ● How about factors KEY TERMS that keep you from managing your daily caloric intake? Preparation stage Stage of change in which people are getting Motivation and Locus of Control ready to make a change within the coming month. Action stage Stage of change in which people are actively Motivation often explains why some people suc- changing a negative behavior or adopting a new, healthy behavior. ceed and others do not. Although motivation comes Relapse Slipping or falling back into unhealthy behavior(s) or fail- from within, external factors are what trigger the in- ing to maintain healthy behaviors. ner desire to accomplish a given task. These external Maintenance stage Stage of change in which people maintain factors, then, control behavior. behavioral change for up to 5 years. Termination/adoption stage Stage of change in which people Understanding locus of control is helpful to the have eliminated an undesirable behavior or maintained a positive study of motivation. People who believe they have behavior for more than 5 years. control over events in their lives are said to have an Motivation The desire and will to do something. internal locus of control. People with an external lo- Locus of control The extent to which a person believes he or cus of control, by contrast, believe that what hap- she can influence the external environment. pens to them is a result of chance or environmental
18 Fitness and Wellness tion and action stages. Once she mastered the skills, she was able to achieve and maintain her adhering to a wellness program than those who per- goal. ceive that they have little control and think of them- 2. Problems of confidence. Problems with confidence selves as powerless and vulnerable. The latter people arise when you have the skills but you don’t also are at greater risk for illness. When illness does believe you can get it done. Fear and feelings of strike, restoring a sense of control is vital to regain- inadequacy often interfere with the ability to ing health. perform the task. Few people have either a completely external or a Don’t talk yourself out of something until completely internal locus of control. They fall some- you have given it a fair try. If the skills are where along a continuum. The more external, the there, the sky is the limit. Initially, try to visual- greater is the challenge in changing and adhering to ize yourself doing the task and getting it done. exercise and other healthy lifestyle behaviors. Fortu- Repeat this several times, then actually give it a nately, a person can develop a more internal locus of try. You will surprise yourself. control. Understanding that most events in life are not determined genetically or environmentally helps Sometimes, lack of confidence sets in when people pursue goals and gain control over their the task seems to be insurmountable. In these lives. Three impediments, however, can keep people situations, dividing a goal into smaller, realistic from entering the preparation or action stages: prob- objectives helps to accomplish the task. You lems of competence, confidence, and motivation. may know how to swim, but the goal of swim- ming a continuous mile could take you several 1. Problems of competence. Lacking the skills to get weeks to accomplish. Set up your training pro- a given task done leads to less competence. If gram so you swim a little farther each day until your friends play basketball regularly but you you are able to swim the entire mile. If you don’t know how to play, you might not be in- don’t meet your objective on a given day, try it clined to participate. The solution to this prob- again, reevaluate, cut back a little, and, most lem of competence is to master the skills you important, don’t give up. need for participation. Most people are not 3. Problems of motivation. With problems of moti- born with all-inclusive natural abilities, includ- vation, both the competence and the confidence ing playing sports. are there but individuals are unwilling to A college professor continuously watched a change because the reasons for change are not group of students play an entertaining game of important to them. For example, a person be- basketball every Friday at noon. Having no gins contemplating a smoking cessation pro- basketball skills, he was reluctant to play (con- gram when the reasons for quitting outweigh templation stage). Eventually, however, the de- the reasons for smoking. sire to join in the fun was strong enough that he enrolled in a beginning course at the college The lack of knowledge and lack of goals are so he would learn to play the game (prepara- the primary causes of unwillingness to change tion stage). To his surprise, most of the students (precontemplators). Knowledge often deter- were impressed that he was willing to do this. mines goals, and goals determine motivation. Now, with greater competence, he is able to How badly you want something dictates how join in on Friday’s pick-up games (action hard you’ll work at it. Many people are un- phase). aware of the magnitude of the benefits of a Another alternative is to select an activity in wellness program. When it comes to a healthy which you are skilled. It may not be basketball, lifestyle, however, there may not be a second but it well could be aerobics. And don’t be chance. A stroke, a heart attack, or cancer can afraid to try new activities. Similarly, if your have irreparable or fatal consequences. Greater body weight is a problem, you could learn to understanding of what leads to disease may be cook low-fat meals. Try different recipes until all that is needed to initiate change. you find foods you like. Patty’s story at the beginning of this chapter Also, feeling physically fit is difficult to ex- exemplifies a lack of competence. Patty was plain unless you have experienced it yourself. motivated and knew she could do it, but she What Patty expressed to her instructor—fitness, lacked the skills to reach her goal. All along, self-esteem, confidence, health, and quality of Patty was fluctuating between the contempla- life—cannot be conveyed to someone who is constrained by sedentary living. In a way, well-
Chapter 1 Introduction to Physical Fitness and Wellness 19 ness is like reaching the top of a mountain. The chapter, SMART Goals, will help you write goals quiet, the clean air, the lush vegetation, the flow- and prepare an action plan to achieve those goals. ing water in the river, the wildlife, and the majes- This will aid with behavior modification. tic valley below are difficult to explain to some- one who has spent a lifetime within city limits. Social Support Behavior Modification Surrounding yourself with people who will work Principles toward a common goal with you or will encourage you along the way will be helpful. Attempting to Over the course of many years, we all develop habits quit smoking, for instance, is easier when the per- that we would like to change at some point. The ad- son is around others who are trying to quit as well. age “old habits die hard” comes to mind. Acquiring The person also may get help from friends who positive behaviors that will lead to better health and have quit already. Peer support is a strong incentive well-being requires continual effort. When wellness for behavior change. During this process, people is concerned, the sooner we implement a healthy who will not be supportive should be avoided. lifestyle program, the greater are the health benefits Friends who have no desire to quit smoking may and quality of life that lie ahead. Adopting the fol- tempt the person to smoke and encourage relapse. lowing behavior modification principles can help People who achieved the same goal earlier might change behavior. not be supportive either. For instance, someone might say, “I can do six consecutive miles.” The re- Self-Analysis sponse should be, “I’m proud that I can jog three consecutive miles.” The first step in modifying behavior is a decisive de- sire to do so. If you have no interest in changing a be- Monitoring havior, you won’t do it (precontemplator). A person who has no intention of quitting smoking will not During the action and maintenance stages, continu- quit, regardless of what anyone says or how strong the ous behavior monitoring increases awareness of the evidence is against it. As part of your self-analysis, desired outcome. Sometimes this principle in itself is you may want to prepare a list of reasons for continu- sufficient to cause change. For example, keeping ing or discontinuing the behavior. When the reasons track of daily food intake reveals sources of fat in the for changing outweigh the reasons for not changing, diet. This can help a person cut down gradually or you are ready for the next step (contemplation stage). completely eliminate some high-fat foods before consuming them. If the goal is to increase daily in- Behavior Analysis take of fruit and vegetables, keeping track of the number of servings eaten each day raises awareness Now you have to determine the frequency, circum- and may help increase their intake. stances, and consequences of the behavior to be al- tered or implemented. If the desired outcome is to A Positive Outlook consume less fat, you first must find out what foods in your diet are high in fat, when you eat them, and Having a positive outlook means taking an optimis- when you don’t eat them (preparation stage). Know- tic approach from the beginning and believing in ing when you don’t eat fatty foods points to circum- yourself. Following the guidelines in this chapter stances under which you exert control of your diet will help you pace yourself so you can work toward and will help as you set goals. change. Also, you may become motivated by look- ing at the outcomes—how much healthier you will Goal Setting be, how much better you will look, or how much farther you can jog. A goal motivates change in behavior. The stronger the goal, or desire, the more motivated you will be KEY TERMS either to change unwanted behaviors or to imple- ment new healthy behaviors. The final topic of this Goal The ultimate aim toward which effort is directed.
20 Fitness and Wellness © Fitness & Wellness, Inc. accomplish. For example, if you are overweight at 150 pounds and at 27 percent body fat, sim- Social support enhances regular participation and the pro- ply stating “I will lose weight” is not a specific cess of behavior modification. goal. Instead, rewrite your goal to state “I will reduce my body fat to 20 percent body fat Reinforcement (137 pounds) in 12 weeks.” People tend to repeat behaviors that are rewarded Be sure to write down your goals. An un- and disregard those that are not rewarded or are written goal is simply a wish. A written goal, punished. If you have successfully cut down your in essence, becomes a contract with yourself. fat intake during the week, reward yourself by going Show this goal to a friend or an instructor and to a show or buying a new pair of shoes. Do not re- have him or her witness the contract you made inforce yourself with destructive behaviors such as with yourself by signing alongside your eating a high-fat dinner. If you fail to change a de- signature. sired behavior (or to implement a new one), you may want to put off buying those new shoes. When Once you have identified and written down a positive behavior becomes habitual, give yourself a specific goal, write the specific objectives that an even better reward. Treat yourself to a weekend will help you reach that goal. These objectives away from home, buy a new bike, or get that tennis are the necessary steps required to reach your racket you always wanted. goal. For example, a goal might be to achieve recommended body weight. Several specific SMART Goals objectives could be to a. lose an average of 1 pound (or 1 fat percent- Only a well-conceived action plan will help you at- tain goals. Determining what you want to accom- age point) per week, plish is the starting point, but to reach your goal you b. monitor body weight before breakfast every need to write SMART goals. The SMART acronym means that goals are specific, measurable, accept- morning, able, realistic, and time-specific. c. assess body composition every 3 weeks, 1. Specific. When writing goals, state exactly and d. limit fat intake to less than 25 percent of to- in a positive manner what you would like to tal daily caloric intake, e. eliminate all pastries from the diet during this time, and f. walk/jog in the proper target zone for 60 minutes, six times per week. 2. Measurable. Whenever possible, goals and ob- jectives should be measurable. For example, “I will lose weight” is not measurable, but “I will reduce body fat to 20 percent” is measur- able. Also note that all of the sample specific objectives (a) through (f) in Item 1 are measur- able. For instance, you can figure out easily whether you are losing a pound or a percent- age point per week; you can conduct a nutrient analysis to assess your average fat intake; or you can monitor your weekly exercise sessions to make sure you are meeting this specific objective. 3. Acceptable. Goals that you set for yourself are more motivational than goals that someone else sets for you. These goals will motivate and challenge you and should be consistent with other goals that you have. As you set an accept- able goal, ask yourself: Do I have the time, commitment, and necessary skills to accom- plish this goal? If not, you need to restate your goal so that it is acceptable to you.
Chapter 1 Introduction to Physical Fitness and Wellness 21 In instances where successful completion of Goal Evaluation a goal involves others, such as an athletic team or an organization, an acceptable goal must be In addition to the SMART guidelines provided, you compatible with those of the other people in- should conduct periodic evaluations of your goals. volved. If a team’s practice schedule is set Reevaluations are vital for success. You may find Monday through Friday from 4:00 to 6:00 p.m., that after you have fully committed and put all your it is unacceptable for you to train only three effort into a goal, that goal may be unreachable. If so, times per week or at a different time of the day. reassess the goal. Acceptable goals are also embraced with Recognize that you will face obstacles and that you positive thoughts. Visualize and believe in your will not always meet your goals. Use your setbacks success. As difficult as some tasks may seem, and learn from them. Rewrite your goal and create a where there’s a will, there’s a way. A plan of ac- plan that will help you get around self-defeating be- tion, prepared according to the guidelines in haviors in the future. Once you achieve a goal, set a this chapter, will help you achieve your goals. new one to improve upon or maintain what you have 4. Realistic. Goals should be within reach. If you achieved. Goals keep you motivated. currently weigh 190 pounds and your target weight (at 20 percent body fat) is 140 pounds, In addition to previously discussed guidelines, setting a goal to lose 50 pounds in a month throughout this book you will find information on would be unsound, if not impossible. Such a behavioral change. For example, Chapter 3 includes goal does not allow for the implementation of the Exercise Readiness Questionnaire, tips to start adequate behavior modification techniques or and adhere to an exercise program, and how to set ensure weight maintenance at the target your fitness goals; Chapter 4 offers tips to enhance weight. Unattainable goals only set you up for your aerobic workout; Chapter 6 gives suggestions failure, discouragement, and loss of interest. on how to adhere to a lifetime weight management program; Chapter 7 sets forth stress management On the other hand, do not write goals that techniques; and Chapter 8 outlines a six-step smok- are too easy to achieve and do not challenge ing cessation plan. you. If a goal is too easy, you may lose interest and stop working toward it. A Word of Caution Before You Start Exercise At times, problems arise even with realistic goals. Try to anticipate potential difficulties as Even though exercise testing and participation is rela- much as possible, and plan for ways to deal tively safe for most apparently healthy individuals, a with them. If your goal is to jog for 30 minutes small but real risk exists for exercise-induced abnor- on 6 consecutive days, what are the alternatives malities in people with a history of cardiovascular if the weather turns bad? Possible solutions are problems and those who are at higher risk for disease. to jog in the rain, find an indoor track, jog at a These people should be screened before initiating or different time of day when the weather is bet- increasing the intensity of an exercise program. ter, or participate in a different aerobic activity such as stationary cycling, swimming, or step Before you start an exercise program or participate aerobics. in any exercise testing, you should fill out the health history questionnaire provided in Activity 1.2. A “yes” Monitoring your progress as you move to- answer to any of these questions may signal the need ward a goal also reinforces behavior. Keeping for a physician’s approval before you participate. If an exercise log or doing a body composition as- you don’t have any “yes” responses, you may proceed sessment periodically enables you to determine to Chapter 2 to assess your current level of fitness. your progress at any given time. 5. Time-specific. A goal always should have a spe- KEY TERMS cific date set for completion. The above exam- ple to reach 20 percent body fat in 12 weeks is SMART An acronym for specific, measurable, attainable, realistic, time-specific. The chosen date should be realis- and time-specific goals. tic but not too distant in the future. Allow yourself enough time to achieve the goal, but Objectives Steps required to reach a goal. not too much time, as this could affect your performance. With a deadline, a task is much easier to work toward.
22 Fitness and Wellness Web Interactive LifeScan will help you learn more about the health risks sults, and height/weight results. Your ranking among you might be taking each day. Take the health question- the top ten causes of death is provided, as well as sug- naire to determine your personal lifestyle risks. Your re- gestions on how to improve. sults provide a score for general results, nutrition re- http://wellness.uwsp.edu/other/lifescan/ Assess Your Behavior Log on to http://www.cengage.com/login 3. Do you participate in vigorous-intensity physical and take a wellness inventory to assess activity a minimum of two times per week? the behaviors that might benefit most from healthy change. 4. Do you make a constant and deliberate effort to 1. Are you aware of lifestyle factors that may nega- stay healthy and achieve the highest potential for tively affect your health? well-being? 2. Do you accumulate at least 30 minutes of moderate- intensity physical activity five days per week? Assess Your Knowledge Log on to http://www.cengage.com/login c. chronic lower respiratory disease. to assess your understanding of this d. diseases of the cardiovascular system. chapter’s topics by taking the Student Practice Test and e. drug-related illness. exploring the modules recommended in your Personal- 4. The constant and deliberate effort to stay healthy ized Study Plan. and achieve the highest potential for well-being is 1. Bodily movement produced by skeletal muscles is defined as called a. health. a. physical activity. b. physical fitness. b. kinesiology. c. wellness. c. exercise. d. health-related fitness. d. aerobic exercise. e. metabolic fitness. e. muscle strength. 5. Which of the following is not a component of 2. The 2008 Federal Guidelines for Physical Activity health-related fitness? state that adults between 18 and 64 years of age a. Cardiorespiratory endurance should do b. Body composition a. 2 hours and 30 minutes a week of moderate- c. Agility intensity aerobic physical activity. d. Muscular strength and endurance b. 1 hour and 15 minutes (75 minutes) a week of e. Muscular flexibility vigorous-intensity aerobic physical activity. 6. Research on the effects of fitness on mortality indi- c. an equivalent combination of moderate- and cates that the largest drop in premature mortality is vigorous-intensity aerobic physical activity seen between listed under choices a. and b. above. a. the average and excellent fitness groups. d. muscle-strengthening activities that involve all b. the least fit and moderately fit groups. major muscle groups on 2 or more days per c. the good and high fitness groups. week. d. the moderately fit and good fitness groups. e. All of the above choices are correct. e. The drop is similar between all fitness groups. 3. The leading cause of death in the United States is 7. What is the greatest benefit of being physically fit? a. cancer. a. Absence of disease b. accidents. b. A higher quality of life
Chapter 1 Introduction to Physical Fitness and Wellness 23 c. Improved sports performance c. is preparing for change in the next 30 days. d. Better personal appearance d. willingly adopts healthy behaviors. e. Maintenance of ideal body weight e. is talking to a therapist to overcome a problem 8. Which of the following is a stage in the behavioral modification model? behavior. a. Recognition 10. A SMART goal is effective when it is b. Motivation c. Relapse a. realistic. d. Preparation b. measurable. e. Goal setting c. specific. 9. A precontemplator is a person who d. acceptable. a. has no desire to change a behavior. e. All are correct choices. b. is looking to make a change in the next six Correct answers can be found at the back of the book. months.
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ACTIVITY 1.1 Behavior Modification: Stages of Change Name Date Course Section Instructions If you have already started to make changes, fill in the blank in one of the last three statements. (In this case, you might say: Please indicate which response most accurately describes your “I currently eat a low-fat diet but I have done so only within the stage of change for three different behaviors (in the blank space last 6 months,” or “I currently practice adequate stress manage- identify the behavior: smoking, physical activity, stress, nutrition, ment techniques and I have done so for more than 6 months.”) weight control, etc.). Next, select the statement (select only one) You may use this technique to identify your stage of change for that best represents your current behavior pattern. To select the any type of health-related behavior. most appropriate statement, fill in the blank for one of the first three statements if your current behavior is a problem behavior. Now write SMART goals (see pages 19–20) and indentify (For example, you might say, “I currrently smoke and I do not in- three behavior modification principles (pages 18–19) that will tend to change in the foreseeable future.” or “I currently do not aid you with the process of change. exercise but I am contemplating changing in the next 6 months.” Behavior 1: 1. I currently , and I do not intend to change in the foreseeable future. 2. I currently , but I am contemplating changing in the next 6 months. 3. I currently regularly but intend to change in the next month. 4. I currently , but I have done so only within the last 6 months. 5. I currently , and I have done so for more than 6 months. 6. I currently , and I have done so for more than 5 years. Stage of change: (see Figure 1.11, page 17). Specific goal and date to be accomplished: Principles of behavior modification to be used: Behavior 2: 1. I currently , and I do not intend to change in the foreseeable future. 2. I currently , but I am contemplating changing in the next 6 months. 3. I currently regularly but intend to change in the next month. 4. I currently , but I have done so only within the last 6 months. 5. I currently , and I have done so for more than 6 months. 6. I currently , and I have done so for more than 5 years. Chapter 1 Introduction to Physical Fitness and Wellness 25
ACTIVITY 1.1 Behavior Modification: Stages of Change (continued) Stage of change: (see Figure 1.11, page 17). Specific goal and date to be accomplished: Principles of behavior modification to be used: Behavior 3: 1. I currently , and I do not intend to change in the foreseeable future. 2. I currently , but I am contemplating changing in the next 6 months. 3. I currently regularly but intend to change in the next month. 4. I currently , but I have done so only within the last 6 months. 5. I currently , and I have done so for more than 6 months. 6. I currently , and I have done so for more than 5 years. Stage of change: (see Figure 1.11, page 17). Specific goal and date to be accomplished: Principles of behavior modification to be used: Stages of Change 1 Precontemplation 4 Action 2 Contemplation 5 Maintenance 3 Preparation 6 Termination/Adoption Self-Reflection In your own words, indicate barriers (what may keep you from changing) that you may encounter during the process of change and how can you best prepare to overcome these barriers.
ACTIVITY 1.2 Clearance for Exercise Participation Name Date Course Section I. Health History pation. These changes include abnormal blood pressure, irregular heart rhythm, fainting, and in rare instances a heart Even though participation in exercise is relatively safe for attack or cardiac arrest. Therefore, you must provide honest most apparently healthy individuals, the reaction of the cardio- answers to this questionnaire. vascular system to increased levels of physical activity cannot always be totally predicted. Consequently, there is a small but real risk of certain changes occurring during exercise partici- Have you ever had or do you now have any of the following conditions? Yes No 1. Cardiovascular disease (any type of heart or blood vessel disease, including strokes) Yes No 2. Elevated blood lipids (cholesterol and triglycerides) Yes No 3. Chest pain at rest or during exertion Yes No 4. Shortness of breath or other respiratory problems Yes No 5. Uneven, irregular, or skipped heartbeats (including a racing or fluttering heart) Yes No 6. Elevated blood pressure Yes No 7. Often feel faint or have spells of severe dizziness Yes No 8. Obesity (BMI of 30 or above) Yes No 9. Diabetes Yes No 10. Any joint, bone, or muscle problems (e.g., arthritis, low back pain, rheumatism) Yes No 11. An eating disorder (anorexia nervosa, bulimia, binge-eating) Yes No 12. Any other concern regarding your ability to participate safely in an exercise program? If so, explain: Indicate if any of the following two conditions apply: Yes No 13. Do you smoke cigarettes? Yes No 14. Men—Are you age 45 or older? Yes No 15. Women—Are you age 55 or older? Exercise may not be recommended under some of the conditions listed above; others may simply indicate special consideration. If any of the conditions apply, you should consult your physician before participating in an exercise program. You also should promptly report to your instructor any exercise-related abnormalities you experienced during the course of the semester. Student’s Signature: Date: Chapter 1 Introduction to Physical Fitness and Wellness 27
ACTIVITY 1.2 Clearance for Exercise Participation (continued) II. Do you feel that it is safe for you to proceed with an exercise program? Explain any concerns or limitations that you may have regarding your safe participation in a comprehensive exercise program to improve cardiorespiratory endurance, muscu- lar strength and endurance, and muscular flexibility. III. In a few words, describe your previous experiences with sports participation, whether you have taken part in a structured ex- ercise program, and express your own feelings about exercise participation.
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