ACE Health Coach Certification

How does exercise effect sleep?

- Increase the body's need for restorative sleep - Improve mood and reduce feelings of stress - Establish a regular sleep schedule - Increase exposure to natural light and darkness

What are the different types of cholesterol?

- Low-density lipoprotein: 60-70% of the body's total cholesterol. It's responsible for the early stages of atherosclerosis - Very LDL: Even larger than LDL, 10-15% of total cholesterol - Intermediate-density lipoproteins (IDL): Similar to LDL, transports triglycerides and cholesterol in the bloodstream and promote atherogenesis. - High-Density Lipoprotein (HDL): HDL transports lipids to the liver for recycling and removal - Non-HDL Cholesterol: Total cholesterol minus HDL

What are major treatments for those with depression?

- Medication, psychotherapies, and brain-stimulating therapies - Only 51% of people with depression are in treatment

What are the major treatments for anxiety and stress?

- Medication: antidepressants and benzodiazepines - Psychotherapies - Meditative therapies

What causes osteoporosis?

- Multiple types of health conditions - Being physically inactive - Inadequate calcium and vitamin D intake - High alcohl consumption - Smoking - Genetics and aging factors

What are some common alternative weight-loss approaches?

- Pharmacology approaches: There are drugs approved for short-term use and long-term use. Drugs should be taken alongside lifestyle medicine. - Bariatric surgery: It is typically for those who are extremely obese. Although the intervention is the most effective, it also has the most risks and downsides.

What are the major dietary strategies for weight loss?

- Reduce fat and/or carbohydrates - Portion control - Eat small meals throughout the day - Consume high nutrient-dense foods and low energy-dense foods - Calculate the resting-energy expenditure, and add onto it the exercise and physical activity

How can coaches help clients use their activity tracker?

- Support clients with set-up, syncing, and battery charging instruction - Help clients link their devices with a smart phone or computer - Provide trouble-shooting guidance and provide support resources - Provide info on adjusting behavior based on activity tracker info - Explore the various uses of the device - Assist with goal setting and reminders - Provide feedback and check-ins based on the client's desired accountability methods

What are 3 methods to establish accountability?

- Task completion: Clients establish a goal for them to complete between training sessions, the coach then asks for updates later on - Surveys: Asking people and the internet questions to survey all options - Research: Clients can get coaches to help them research new topics

What are ways coaches can help clients better manage stress?

-Mindset: A fixed mindset has been shown to promote more stress than a growth mindset - Resilience: Working towards wellness goals has been shown to create and build more resilience - Finding "flow": Creating challenges that are not too easy that they're boring, and not too hard that they're overwhelming - Self-regulation: Practicing health behaviors increases self-efficacy

What are the 6 skill-related components of fitness?

1. Agility 2. Coordination 3. Balance 4. Power 5. Reaction timing 6. Speed

What are the 3 stages of General Adaptation Syndrome?

1. Alarm: After a temporary drop in resistance to the stressor, the sympathetic nervous system is activated and the catecholamines are produced. At this stage, the HPA axis is activated resulting in the release of glucocorticoids 2. Resistance: If the stress continues, the body will continue to activate the HPA axis and release cortisol 3. Exhaustion: If the stress continues, the body will eventually deplete its resources, resulting in slower function of the organs and bodily systems

What are the 4 principles of ethics the client-coach relationship is based upon?

1. Autonomy: Client can act on their own free will and initiative 2. Non-maleficence: Reduce the amount of harm done as much as possible 3. Beneficence: Promote what is based on the best evidence 4. Justice: Treat people equally and equitably, displaying positive regard

What are practical strategies to meet the activity guidelines?

1. Create a consistent schedule 2. Choose enjoyable activities 3. Warm-up before exercising 4. Cool-down after exercising 5. Exercise safely 6. Create support networks

What are the 9 questions on the PHQ-9 (questionnaire for depression)?

1. Do you have little interest or pleasure in doing things? 2. Feeling down, depressed, or hopeless? 3. Trouble falling asleep, staying asleep, or sleeping too much? 4. Feeling tired or having little energy? 5. Poor appetite or overeating? 6. Feeling bad about yourself? 7. Trouble concentrating? 8. Moving around more or less than usual? 9. Thoughts that others would be better off if you were dead?

What are some major ways to make habits easier?

1. Don't make it too complicated at the beginning, do the simplest and easiest tasks first 2. Celebrate in some way every time you perform the new habit 3. What does the new behavior come after? What comes before the habit?

What is the elicit-provide-elicit approach to Motivational Interviewing?

1. Elicit by asking questions about their health, then continuing to ask deeper questions 2. Provide relevent info on the topic and help create a plan 3. Check with the client to see if they understood the info

What are the 4 major goals of the initial interview?

1. Establish the tone and direction of the client-coach relationship 2. Client's goals and future plans 3. Client's self-discovery 4. Enhance self-efficacy

What are the steps in cognitive restructing?

1. Examine the automatic thoughts that are negative 2. Identify cognitive distortions 3. Dispute automatic thoughts 4. Develop a rational rebuttal to automatic thoughts

What are the 5 major recommendations from the Dietary Guidelines for Americans?

1. Follow a healthy eating program across the lifespan 2. Focus on variety, nutrient density, and amount 3. Limit calories from added sugar and saturated fats, as ell as reduce sodium intake 4. Shift to healthier food and beverage choices 5. Support health eating patterns for all

What are the 3 aims of healthcare?

1. Improve the patient experience 2. Improve the health of populations 3. Reduce the per-capita cost of healthcare

What are the 3 major prevention methods for heart disease?

1. Primordial (prevention of risk factors) 2. Primary (treatment of risk factors) 3. Secondary (prevention of recurrent cardiovascular event)

What percentage of deaths are related to chronic disease?

70%

How common is alcohol use and misuse?

70% of people drank in the past year, 56% in the past month. 27% reported binge drinking in the past month

What is the Health Insurance Portability and Accountability Act?

A US law protecting client health info from being shared by individuals or corporations

What are nutrition strategies for arthritis?

A diet rich in omega-3, antioxidants, and phytochemicals for anti-inflammatory response

What is substance-use disorder?

A maladaptive pattern of substance use which leads to impairment or distress which includes at least 2 of the following: - Failure to fulfill major obligations - Repeated hazardous use of substance - Continued use of substance even though it is causing social or interpersonal problems - Development of tolerance - Withdrawal symptoms - Substance is taken in large amounts or for longer than intended - Efforts to reduce or eliminate use are unsuccessful - Large amounts of time are spent procuring or using the substance or recovering from substance use - Important activities are halted or given up - Craving or strong desire for substance use

What is a curious question?

A powerful open-ended question that gives the client the ability to explore

What is the GROW model?

A process to help clients turn their most important goals into actions. GROW stands for: - Goal: Help the client identify their goal with coaching techniques - Reality: The coach asks client's about their reality to explore the client's current situation and context - Options: Brainstorm with clients to develop and explore a list of options to achieve their goals - Will: Formulate specific goals and action plans with the help of the coach

What is the Acceptable Macronutrient Distribution Range (AMDR)?

A recommendation for the percentage of calories that come from carbohydrates (45-65% of calories), protein (10-35% of calories), and fat (20-35% of calories) for optimal performance

What is medical nutrition therapy?

A therapeutic approach to treating medical conditions through a specially tailored diet devised and monitored by a physician/RD

What % of the American diet is made up of added sugar? What is the recommended amount?

About 13% of the American diet is made up of added sugar, the recommendation is 10% or less

What is the definition of anxiety?

An emotion characterized by nervousness, tension, fear, and/or worry

What are standard measurements for drinks?

Beer: 12 oz Malt liquor: 8-9 oz Wine: 5 oz Spirits: 1.5 oz

What are behavior chains?

Behaviors that lead to other behaviors, for better or worse

What is Cognitive Behavioral Coaching (CBC)? What are the principles of CBC?

CBC is a guiding approach which helps coaches identify, examine, challenge and change unproductive thoughts and emotions in clients. The principles include: - Self-talk and automatic thoughts: CBC encourages clients to examine and pay attention to their inner thoughts and "mind-chatter." - Cognitive distortions and irrational beliefs are harmful thought patterns that interfere with a person's well-being. These could include: > Jumping to conclusions > Magnification or minimization of problems > Overgeneralizing: Seeing a single event as a pattern of defeat and disappointment > Labeling > All-or-nothing thinking > Personalization and blame: Taking full blame and responsibility for something that's outside of their control or not their fault

What are major dietary strategies to treat and prevent cardiovascular disease?

Consume more: - Fish and shellfish - White poultry and lean meat - Intact and minimally processed whole grains - Fruits - Vegetables - Nuts and legumes - Nonfat dairy products - Most vegetable oils - Egg whites - Foods rich in fiber - Water Limit or avoid... - Cheese and other dairy products - Egg yolks - Refined grains - Processed meats - Sugars, sweets, and diet sodas - Grain-based desserts and bakery goods - Fats, oils, or foods with trans fats - Tropical oils - Salt - Alcohol

How can coaches support clients suffering from withdrawal symptoms?

Discussions on behavior change, including a 12-step program

What is dyslipidemia? What is the prevalence of high cholesterol?

Dyslipidemia is high concentrations of cholesterols (especially LDL) in the blood. More than 28 million American adults are stimated to have total cholesterol levels above 240 mg/dL

What is eustress and distress?

Eustress: Positive stress. It's the righht amount of stimulation and discomfort to grow the individual Distress: Negative stress. Too much stress for one's capabilities.

How does exercise impact cancer treatment and recovery?

Exercise can help maintain and improve cardio conditioning, prevent musculoskeletal deterioration, reduce symptoms of nausea and fatigue, and improve the client's mental health. Regular activity of at least 150 mins/week of aerobics plus strength training

What is neuromotor exercise?

Exercise for older adults that combines balance, coordination, gait, and agility

What is the definition of health and wellness?

Health and wellness is more than the absence of disease, it is a state of physical, social and mental wellbeing.

How can coaches calculate target HR?

Hear rate reserve (max HR-resting HR) x % intensity + resting HR

What is the definition of hypertension? How prevalent is it?

Hypertension is chronic high blood pressure Hypertension affects 78 million US adults, with African Americans with the highest risk

What is the ABCDE system of Cognitive Behavioral Coaching?

Irrational beliefs and unreasonable concepts, often acquired by one's family or community. A- Activating Event: identify the event or situation that is associated with unproductive thinking B- Belief associated with the event needs to be viewed C- Consequences of unproductive thoughts need to be understood D- Disputing the negative thinking and trying to replace it with another one E- Effect of the new thought on emotions and actions

Why is self-monitoring important?

It is an individual's ability to recognize thoughts and feelings and how that affects their behavior, then to act on that knowledge

What is motivational interviewing?

It is different from most coaching, which takes a directing style, with the coach telling the client what to do. Motivational interviewing takes a guiding style, where the coach encourages, assists, and supports the client in the processes of change. This style encourages the client to talk themselves into making the change, rather than the coach.

What are the subclinical diseases for heart disease?

Left ventricular dysfunction, carotid stenosis, coronary calcification, endothelial dysfunction, autonomic dysfunction, myocardial ischemia, arrhythmias, plaque buildup, potential for thrombosis

What are major treatment options for hypertension?

Lifestyle modification: - Weight reduction - Adopt the DASH diet - Reduce sodium consumption - Increase physical activity - Decrease alcohol consumption Hypertension medications

What is a locus of control?

Locus of control is the extent to which people think things happen for internal vs external reasons

What are healthy and unhealthy ranges of triglycerides?

Normal: <150 - Borderline high: 150-199 - High: 200-499 - Very High: >500

What are the differences between osteoarthritis and rheumatoid arthritis? What is the prevalence of each?

Osteoarthritis: Protective cartilage that cushions the ends of your bones wears down. OA affects nearly 27 million Americans, women more than men, more obese than normal weight, and older populations. Rheumatoid arthritis: an autoimmune disease characterized by joint swelling, pain, and stiffness that can lead to severe motion impairment. Affects .5-1% of the population, most commonly those 40+. Exact cause is unknown

What are the components of a SMART goal?

Specific Measurable Attainable Relevant Time-bound

What is strengths-based coaching? How can coaches help clients with strengths-based coaching?

Stregnths-based coaching is working with clients to improve their habits and behaviors through their strengths, not by solving their problems. Coaches can help by: - Having a positive tone in all coaching sessions - Ask clients to identify their character strengths - Uncover clients' values - Take notes on progress towards goals

What is cognitive restructuring?

The process of replacing unproductive and unhealthy thinking with more productive thoughts. This can be done by: - Ask clients to keep a log of their negative thinking - Spend a session looking at and talking about these thoughts together - Suspend judgement and allow client to evaluate their thoughts on their own - Examine misconceptions about the negative thoughts - Empower clients to replace the negative thoughts and beliefs - Help clients anticipate and fight against their common unhelpful thoughts

What is positive psychology?

The scientific study of "valued subjective experiences: well-being satisfaction, and contentment (in the past); flow and happiness (in the present); and hope and optimism (in the future)

What causes lower-back pain?

Typically causes include trauma, spinal degeneration, disc rupture, but for most the underlying cause is unknown. This makes treatment very difficult.

What is ambivalence?

When a client wants to change and doesn't want to change at the same time

What are 5 categories of stressors?

- Acute time-limited stressors: Anxiety inducing situations that are short in duration (public speaking) - Brief naturalistic stressors: Real-world challenges that are over very quickly (interviewing for a job) - Stressful event sequences: An event that causes longer term and difficult consequences that will subside at some point (death of a loved one) - Chronic stressors: Multiple negative situations caused by life-changing circumstances with no end in sight (being a caregiver for a family member with Alzheimer's) - Distant stressors: Traumatic experiences that have negative ramifications for one's entire life (physical abuse as a child)

What are the 6 principles of adult learning?

- Adults need to know why they're learning something before they learn it - Self-directedness and autonomy of learning - Prior experiences provide a rich resource for learning - Adults are most likely to retain and act upon new info when they are ready to learn - Adults typically desire learning when they have a specific situation they need to learn for - The motivation for adult learners is typically internal, not external

What are the psychological and physical effects of chronic stress?

- Altered emotions: reduction in serotonin - Reproductive problems: Decreased testosterone and irregular mensuration - Increased risk of osteoporosis - Increased insulin resistance: increased cortisol can alter insulin activity - Chronic inflammation - Gastrointestinal issues: irritable bowel syndrome - Weight gain: increased visceral fat from overeating - Memory impairment: can lead to dementia and depression - Cardiovascular dysfunction: hypertension - Chronic pain: severe joint and muscle pain - Headaches: persistent muscle tension leads to headaches

How can coaches speak to clients about their sleeping habits?

- Ask clients about their levels of fatigue - Ask about caffeine and alcohol consumption - Encourage clients to notice whether they sleep better on exercise days - Explore simple relaxation exercises clients can explore at home - Encourage clients to address sources of stress that lead to poor sleep

What are the 3 directions client's answers can go?

- Clear direction: The client is open and clear about their intentions and goals with hiring a personal trainer - Choices in direction: The client is aware of some specific things that they should be doing to improve their health in a certain direction - Unclear direction: The client knows they want their life to change, but doesn't know how

What are the components of a coaching agreement?

- Clearly stated nature of the client-coach relationship - The type of coaching provided - The client's primary goal - The desired schedule and duration/commitment of coaching - An outline of the cost and fees - Policies for no-show, rescheduling, and/or cancelling - The process by which the coaching agreement can be terminated by either or both parties - Affirm client confidentiality

What are signs that a client is open to discussing their drug misuse?

- Client exposes concern about alcohol or drug use - The client's food records show a high intake of alcohol - The health coach is uneasy about the client's discussion of drug use - The client tells the coach they're struggling with an addiction - A client arrives to the session under the influence

How does the Dietary Guidelines suggest Americans to change their diet?

- Consume more veggies - Consume more fruit - Consume more whole grains - Consume fewer refined grains - Consume more dairy - Increase variety of protein choices - Choose more nutrient-dense foods - Men should consume less protein - Exchange solid fats for oils - Reduce added sugar consumption to less than 10% of calories - Reduce saturated fat intake to less than 10% fo calories - Reduce sodium intake

What are the components of a successful behavior-change program for those with substance misuse?

- Coping-skills training: People learn new responses to stressful stimuli - Cognitive-behavioral therpay (CBT): Becoming aware of the thought and behavior patterns that promote the substance misuse - Family therapy: Involving the family and its dynamics for treatment - Brief behavioral interventions: A few sessions may be helpful - Self-help programs: Books and educational materials - Social support - Structure and goal setting - Rewards, including rewarding positive activities - Normative models for behavior-change success - Improvements in self-efficacy - Development of coping skills

How does smoking affect cardiovascular disease?

- Decrease in smoking decreases heart disease risk - Second-hand smoke leads to about 8,500 deaths per year from heart attacks

What are 4 signs of discord in the client-coach relationship?

- Defending: Deflect blame, minimize situations, justify poor decisions - Squaring off: "you" statements - Interrupting: The client often interrupts the coach - Disengagement: Poor eye contact, distracted behavior

What are the 4 types of preparatory change talk?

- Desire: "I want..." - Ability: "I could/might..." - Reasons: "My life would be better if I..." - Need: "I need too/ I must..."

What is on the checklist for working with clients before the initial session?

- Develop a plan - Create answers to common client questions - Assemble a "welcome packet": > Welcome letter with info about the coach > Brief description of the coaching process > Forms to be completed prior to the initial session - Consider offering complimentary mini sessions - Contact the client several days before the session to remind them - Test any necessary equipment - Keep environment clean - Create a coaching agreement that can be completed during the session - Have copies of any needed forms with you

What is exercise's role in treating and preventing CVD?

- Each 1-MET increase in exercise is associated with a 15% reduction in cardiovascular mortality - Weekly walking distance and speed are predictors of mortality - Those who exercised the least were at the highest risk for heart disease and all-cause mortality - Those who exercised the most had a slightly increased risk of CVD compared to those who moderately exercised - Those with heart disease who do not regularly exercise should start exercising slow, and work up to a moderate to vigorous level of intensity

- What are the major exercise considerations for cardiovascular endurance?

- Frequency: 5+ days/week of moderate exercise, 3+ days/week of vigorous, or a combo of the 2 - Intensity: Moderate-vigorous activity is recommended - Time: 30-60 mins/day of moderate exercise, 20-60 mins/day of vigorous exercise - Type: Regular, purposeful, continuous exercise that involves major muscle groups - Volume: A target of 500-1000 MET-mins/week, 7000+ steps/day - Pattern: Can be performed in one session, one interval session, or multiple sessions - Progression: Adjusting exercise duration, frequency, and/or intensity for progress

What do doctors focus on when making a food prescription?

- Frequency: How often the person eats - Objective: The goal or reason to change diet - Options: How much and how to prepare the foods - Duration: How many times per day, week, or month

What are the major initial session questionnaires and their purpose?

- Health status questionnaire: Determine if the individual has physical or dietary restrictions - Par-Q: Figure out whether it's necessary to refer the person to a healthcare provider - Readiness to change questionnaire: Outline the client's motivation

What are some physiological effects of acute stress?

- Heart rate and blood pressure increase - Respiration rate increases - Increased muscular tension and pain - Blood glucose levels rise - Digestive issues - Skin and extremities are cold and clammy - The mouth and throat become dry - Heightened senses and increased alertness - A change in emotional state - The immune system releases pro-inflammatory cytokines

How can health coaches promote clients to sit less?

- Help them invest in a treadmill/standing desk - Stand up while taking phone calls - Walk to see colleagues - Have regular breaks in meetings where employees are allowed to stand and walk around - Go to the restroom on a different level, using the stairs - Walk to distant recycling bins and trash cans rather than using the items close to your desk - Take the stairs instead of the elevator

What does a positive nutrition change include for the client's environment?

- Home - School - Worksite - Community - Food retail

How can a health pro network and create relevant resources for clients?

- Identify government resources by visiting local city and country websites - Dial 211 - Use websites to identify pros in the area - Reach out to local businesses, no-profits, faith-based orgs - Become involved in coalitions, business meetings and conferences, volunteering in the community, and engage social network

What are the 3 goals of the exercise screening process?

- Identify who should receive medical clearance before exercise participation - Identify those with clinically significant diseases - Identify those with medical conditions who should not be exercising

What are dietary strategies for managing dyslipidemia?

- Consume more veggies, fruits, and whole grains. Limits sweets, sugar-sweetened drinks, and red meats - Aim for 5-6% of cals from saturated dat - Reduce the % of calories from saturated fat - Reduce or eliminate trans fat

What is outside the scope of a health coach?

- Counseling, therapy, and consulting - Nutrition prescription and meal planning - Exercise routines - Laboratory evaluation and analysis - Diagnosis of medical or mental health ailments - Recommendation, promotion, or sale of nutritional supplements - Other practices or activities where the coach doesn't have the requisite training or credentials

How can clients improve their quality of sleep/sleep hygiene?

- Create a relaxing sleep environment - Follow a consistent sleeping schedule - Follow a soothing bedtime routine - Limit exposure to bright light, especially blue light - Be exposed to natural light early in the day - Exercise daily - Stick to a consistent sleeping schedule - Avoid caffeine and alcohol - Avoid eating a large meal too close to bedtime

What are common negative body-language indicators?

- Cross arms: anger, defiance, disinterest - Feet pointed towards the door and checking watch: bored or anxious - Biting lip: tension or trepidation - Cracking knuckles: comforting habits - Use of barrier: personal space is invaded

What are nutrition strategies for improving osteoporosis?

- Eat enough calcium - Consume enough Vitamin D - Reduce alcohol consumption

What are 5 major causes of cancer?

- Environmental exposure - Lifestyle practices - Medical interventions - Viral infections - Genetic and aging traits

What are marks of a positive first impression?

- Greet the client and offer a comfortable place to sit - The physical environment is clean and organized - The coach should be on time and looking professional - Ensure privacy for the initial meeting

What are the most common sources of stress in America?

- Healthcare costs - The future of the nation - Health problems for an individual or their family members - Money problems - Work problems

How does exercise affect people's mood?

- More effective than a placebo, and its results in treating depression are equivalent to psychotherapy and medication is reducing symptoms - Not many mental health professionals view exercise as a viable treatment

What should health coaches do if their gym asks coaches to sell supplements?

- Obtain complete scientific understanding of the safety and efficacy of the product from qualified healthcare pros - Obtain legal info surrounding the use of the supplement and its ingredients - Obtain adequate insurance coverage should a problem arise

What are the 5 health-related components of fitness?

1. Cardiorespiratory endurance 2. Muscular endurance 3. Muscular strength 4. Flexibility 5. Body composition

What are the 7 things needed in a coaching agreement?

1. Coaching approach 2. Define partnership 3. Confidentiality 4. Coaching commitment 5. Coaching session procedures 6. Schedule/timeline/term of commitment and fees 7. Sign and date

What is an ecological perspective of health behavior?

An ecological perspective takes into account multiple overlapping ecological systems when considering health and illness. This includes: - Relationships with friends, family, and peers (interpersonal) - Rules, regulations and policies (organizational) - Community design, social networks, and belief systems (community) - Social and cultural norms, economic structures, public policies, laws, and regulations (societal)

What is the difference between minor and major depression?

Minor: sadness that resolves itself within 2 weeks Major: signs and symptoms of depression that last 2+ weeks with no end in sight

What is the purpose of screenings and assessments?

They are ways to provide qualitative and quantitative info on the client's health

How does smoking impact bone density?

Those who smoke for years have a larger affect of developing osteoporosis

What is the social cognitive theory?

When people are learning new factors that are influenced by 3 factors: - Cognitive factors: knowledge, outcome expectations, and attitudes - Environmental factors: social norms, community influences, behavior reinforcement, and observational learning - Behavioral factors: skills, practice, self-evaluation, and self-efficacy

What has exercise been shown to improve physiologically?

- Body composition - Lipoprotein profiles - Glucose homeostasis and insulin sensitivity - Blood pressure - Systemic inflammation - Blood coagulation - Endothelial function

Why are open-ended questions important in coaching?

- Breaks the ice of early meetings with clients to build rapport - Provides useful info - Nurtures autonomous motivation - Can lead to the development of personalized goals and plans

What signs warrant a referral to a health pro for stress?

- Changes in sleeping habits - A decline in professional/academic performance - Worsening physical symptoms - Inability to cope with demands of life - Engagement in dangerous or destructive behavior

How can coaches refer clients with drug misuse problems?

- Check-in with colleagues - Come prepared with a specific referral recommendation and a WHY - Meet with the client

What are the 4 classes of arthritis?

- Class 1: Completely able to perform functions of daily living - Class 2: Able to perform usual self-care and vocational activities, but leisure activities may be limited - Class 3: Able to perform self-care, but work and personal life suffer - Class 4: Limited in ability to perform daily functions

What are 4 situations where self-disclosure (sharing personal details) may be helpful?

- To promote trust in the client coach relationship - To model openness and extend the opportunity for the client to be open - To answer a client's direct question - To affirm the client's experience

How has the treatment of heart disease changed?

- Traditional view: Heart disease is just a plumbing problem, the more obstruction the bigger the problem - Modern view: the nature of cholesterol and plaque determines the inflammatory response and coronary events.

What are common symptoms of insomnia?

- Trouble falling asleep - Walking frequently during the night - Difficulty getting back to sleep - Waking too early in the morning - Daytime fatigue

How can coaches assist clients who have substance misuse with behavioral-change strategies?

- Use OARS (Open-ended questions, affirmations, reflective listening, and summarizing) - Tailor an approach to their stage of change - Apply the principles of self-determination theory - Help them build self-efficacy

What are the major facilitators of health behavior change?

- Use a confidence ruler: how likely does the client think that they will succeed by trying to achieve this goal? - Health literacy: Help client obtain, process, and understand basic health info

What are the major approaches for exploring client's values and visions?

- Values interview - Values card game

What is within a health coach's scope of practice with nutrition?

- We can share evidence-based dietary guidelines, including the Dietary Guidelines for Americans and the MyPlate recommendations - Principles of health nutrition and food preparation - Foods that can be included in a balanced diet - Essential nutrients that are needed by the body - Actions of nutrients in the body - Effects of deficiencies or excesses of nutrition - How nutrient requirements vary throughout the lifecycle - Information about nutrients contained in foods or supplements

What are the major health effects of sleep deficit and sleep disorder?

- Weight gain - Cognitive disorders and dementia - Depression and anxiety - Overtraining - Cardiovascular disease ad cardiometabolic disorders - Immune system effects

What is the NIH bodyweight planner?

A calorie calculator that accounts for an individual's changes in weight from weightloss, making it more accurate

How does exercise affect the prevention and management of hypertension?

Acute effect: There is a period where blood pressure significantly rises, then when exercise stops, BP is lower than it was before exercising for hours-days Long-term effect: Exercising 150+ mins/week has shown to have a positive effect on hypertension

What is the Healthy Vegetarian Eating Pattern?

Adapted from the healthy US Eating Pattern, but removes all meats and seafood and replace them with legumes, nuts, seeds, and soy products

What are the current physical-activity guidelines?

Adults should participate in at least 150 mins/week of moderate activity or 75 mins/week of vigorous activity

How does exercise impact high-cholesterol?

Aerobic exercise combined with weight-loss significantly reduces bad-cholesterols while improving HDL - Exercise lowers triglyceride levels for 12-36 hours after exercise

What is resilience?

A response to stressors where appropriate anticipation and engagement leads to the efficient sequence of allostatic response

What is the purpose of the PAR-Q+?

A self-guide questionnaire for the coach and client to understand the client's health problems that may impact exercise

What is a conflict of interest?

A situation where a professional has a personal or private interest which alters their effectiveness as a coach and/or health pro

What is sleep apnea?

A sleep disorder where breathing sporadically starts and stops. It can be fixed with Continuous positive airway pressure (CPAP) machines.

What are Health-based behavioral processes?

Action-oriented learning where clients take the behaviors that work for them Examples include: - Use cures to encourage change - Substitute healthy for unhealthy behaviors - Create social support systems - Create individualized rewards

Why is reframing problems and failures important?

If the view their lapses or poor behavior as failures that should be ashamed of, they can't improve. If they view them as challenges for them to become better, they will have an easier time succeeding

How does exercise impact arthritis?

Important part of treatment. Recommended 150+ mins/week, taking into consideration the client's activity level, pain, range of motion, and functional limitations.

What are the major stress management practices for hypertension?

Meditation was found to have a profound effect on BP, as well as yoga

What is a mindful and intuitive approach to eating?

Mindful: Clients slow down their eating and pay attention to the food sensations Intuitive: Only eating when hungry and listening to the body to determine what to eat

What are Health-based cognitive processes?

New ways of thinking about health to reinforce or change a client's motivations Examples include: - Recieving info on the benefits of specific changes - Having a change of heart - Considering their behaviors and how it affects others - Developing a self-image based on their goals - Connecting with social norms of like-minded people

What is the importance of verbal and nonverbal communication

Nonverbal: - Turn off the mind's chatter and really listen to the person who's speaking - Utilize body language that is open and inviting - Eye contact, facial expressions, and tone of voice should match the needs of the conversation Verbal: - Open-ended questions - Reflections: > Simple reflections: Repeating or rephrasing what the client has said in a brief and concise way > Complex reflections: Guessing at the underlying meaning of what the client has said > Straight reflections: A simple or complex reflection in response to a client talking about their desire to maintain the status quo > Amplified reflections: Providing a direct and more exaggerated form of what the client has stated > Double-sided reflections: Exploring the client's ambivalence by highlighting reasons he or she has given both for and against change

What is osteoporosis? Osteopenia? How prevalent?

Osteoporosis is low bone mass characterized by a bone mineral density of 2.5 SDs or more below the mean for young adults. Around 54 million Americans have low BMD. 1-in-2 women will develop osteoporosis over the age of 50 Osteopenia is defined as a BMD 1-2.5 SDs below the average

What is a peak experience? What are the 4 steps of achieving them?

Peak experiences are very positive experiences that help clients identify their strengths and act on them. The 4 steps are: 1. Identify 2-3 times when they have felt they acted their best 2. Invite clients to talk about their experience 3. Write down every 'positive strength' example they listed 4. Have the client write 4-5 areas of strength/characteristics that define them at their best

What is the self-determination theory?

People are naturally inclined to pursue activities and goals they are naturally interested in or from which they will receive the most benefits, and people act in response to external forces that put pressure on the individual. The 3 most important factors that influence motivation: 1. Autonomy: People act out of their own free will 2. Competence: As people become more competent with their actions, the more likely they are to do it 3. Relatedness: Adequate social support determines motivations

What is the health belief model?

People's pre-conceived notions of health, illness, and change will affect their ability to positively change

What are the ACE IFT model's phases?

Phase 1: function (Stability and mobility training) Phase 2: Health (movement training) Phase 3: Fitness (Load training) Phase 4: Performance (Performance Training)

What is the difference between physical activity, exercise, and physical fitness?

Physical activity: - Any bodily movement that contributes to energy expenditure - Positively associated with physical fitness Exercise: - Planned, structured, and repetitive body movement - Very positively associated with physical fitness - A subcategory of physical activity Physical fitness: - A set of physical attributes a person has or achieves - Health-related components (muscular strength, endurance, cardio, flexibility, etc.) - Skill-related components (agility, balance, speed, etc.)

What are the 10 processes of change?

They help a client move through the stages of change. 1. Consciousness raising: Learning new facts, ideas, and tips that support behavior change 2. Dramatic relief: Having negative emotions from the unhealthy habit, then feeling a sense of relief when deciding to change 3. Self-reevaluation: realizing that change is part of one's identity 4. Environmental reevaluation: Realizing how the behavior influences the person's environment 5. Self-liberation: Deciding to change and experiencing a belief in the ability to change 6. Helping relationships: Seeking and using social support for change 7. Counter-conditioning: Using healthy behaviors in place of unhealthy ones 8. Reinforcement management: Increase rewards for positive behaviors, decrease rewards for negative behaviors 9. Stimulus control: Removing negative cues and creating healthy cues 10. Social liberation: Spending time with people who model the healthy behavior

What is the difference between visceral and subcutaneous fat?

Visceral fat: Surrounds the internal organs Subcutaneous: Under the skin

What is learned helplessness?

When people believe they have no power or control over circumstances that they could have influence over

What did the results from experiments show were the major reasons that individuals lost weight?

- 98% modified their food intake/diet - 94% increased physical activity - 90% worked out about 1 hr/day - 75% weighed themselves weekly - 62% watched fewer than 10 hrs of TV per week - 55% lost weight with a weight-loss program

How can we characterize addiction?

- A compulsive drive to use an addictive substance or perform an addictive activity - A loss of control over the substance use or performance of the behavior - Harmful consequences - Distorted perceptions and denial concerning the addiction and its consequences

How does shame and stigma affect substance misuse?

- A feeling of shame from failing at quitting may make them hide their behavior - These feelings may cause people to continue abusing their substance

What are the main components of a healthy eating program?

- A variety of veggies from 5 different groups: dark green, red and orange, legumes, starch, and other - Fruit - Grains (whole grain) - Fat-free or low-fat dairy products - Limited amounts of saturated fats, trans fats, added sugars, alcohol, and sodium

What is inside the scope of a health coach?

- Apply effective communication skills, including open-ended questions, affirmations, reflective listening, and summarizing to increase a client's internal motivation to make a health-behavior change - Support clients in developing achievable and measurable goals, monitor their success, and motivate ongoing behavior change - Empower clients to develop and leverage their strengths to support successful behavioral changes

What are the 5 A's of working with client's with heart disease?

- Assess: Ask questions and learn about the client - Advise: Ask questions to evoke change - Agree: Co-create a program - Assist: Help them with their program (barriers, problem-solving, etc.) - Arrange: Arrange social support systems

What are the 5 A's of working with clients with heart disease?

- Assess: Explore the client's attitudes, beliefs, experiences, current behaviors, and knowledge of disease - Advise: Use coaching practices to evoke change - Agree: Co-create an action plan in alignment with the client's goals and vision - Assist: Identify barriers, social support, implement problem-solving strategies, and enhance self-management - Arrange: establish a system of accountability and method for self-monitoring, providing referrals and follow-up with other care providers

What are the 6 common traps of the "engaging" process?

- Assessment trap: The coach spends time asking the client a series of pre-written questions - Expert trap: Portraying yourself as the expert with all the answers from the beginning - Premature focus trap: Focusing on an area too quickly without enough knowledge - Labeling trap: The coach "names" the problem that needs to be fixed - Blaming trap: The coach blaming the client for the client's life failings - Chat trap: Spending too much time small-talking

What are the 4 major types of Cardiovascular disease (CVD)?

- Atherosclerotic coronary artery disease (CAD): Obstructed coronary arteries - Congestive heart failure (CHF): The heart's inability to pump properly, causing reduced blood flow to tissues - Stroke: A blockage of blood in the brain - Angina pectoris: Chest pain and pressure

What exercise can positively impact those with osteoporosis?

- Avoid excessive flexion, twisting and compression of the spine - Engage in weight-bearing activity - Incorporate activities that promote balance - Avoid movements or environments that could lead to a fall

What are some major types of psychotherpay?

- Behavioral activation - Cognitive behavioral therapy - Interpersonal therapy - Problem-solving therapy - Acceptance and commitment therapy - Self-control therapy

What impact does depression, anxiety, and stress have on health behaviors?

- Being depressed puts you at a higher risk of chronic illness, those with chronic illness are more likely to be depressed - Having depression and anxiety causes clients to have diminished willpower, making it difficult to work on wellness habits

What are the 4 major medications used to treat heart disease?

- Beta blockers: Slow the heart rate and lower blood pressure - ACE inhibitors/angiotensin 2 receptor blockers: dilate blood vessels, lowering blood pressure - Platelet inhibitors (blood thinners): Decreases inflammation in the arteries and prevent blood clots - Statins: Cholesterol-lowering drugs have dramatically prevented initial and recurrent heart attacks

What factors contribute to an individual's ability to handle stressors?

- Biological predisposition - Life experiences - Protective factors - Personality traits

Where are the major areas to measure pulse and monitor HR?

- Carotid pulse: Carotid artery in the neck - Radial pulse: radial artery in the wrist - Temporal pulse: left or right temple

What can coaches do to help clients improve their nutrition generally?

- Identify what the individual and their family typically consume, and what small changes can be made to improve that - Enhance self-efficacy by teaching gardening, cooking, meal-prepping, and nutrition label reading - Explore ways that individuals can model healthy eating patterns for friends and family - Create plans to help clients limit screen time and time spent being sedentary

How can clients avoid foodborne illnesses?

- Clean hands, contact surfaces, and fruits and veggies - Separate raw, cooked, and ready to eat foods while shopping - Cook foods to a safe temperature to kill microorganisms - Refrigerate perishable food right away - Avoid unpasteurized milk or any products made from unpasteurized milk, raw eggs, undercooked meat, or unpasteurized juice - Check produce for bulges, and smell for ripeness - Look for a "sell by" "use by" "expiration date" or "packaged date" - Make sure packaging is in tact - Separate fish and poultry from other purchases - Pick up refrigerated and frozen foods last

What are the major roles of a health coach?

- Client-coach relationship: Must understand how to express empathy and build rapport and trust - Coach presence and self-awareness: Must do the internal work to recognize and remove biases and bring a positive coaching experience to all clients - Health and wellness concepts: Have a solid foundation and understanding of health and wellness to bring to the client. They must also understand behavior change, motivation, and coaching therapy. - Ethics & Standards of practice: SHould have a strong understanding of the scope of practice and to safeguard their clients' confidentiality

What are the 4 elements of the "Spirit of Motivational Interviewing"?

- Collaboration: The client and coach work together without fighting - Acceptance: Unwavering acceptance, trust, respect, and empathy for the client - Compassion: Actions should be in the best interest of the client, not for coach's personal gain - Evocation: Coach helps the client call upon their own inner wisdom, telling themselves what they need

How can exercise be dangerous?

- Contact sports can cause orthopedic or brain related injuries - Rapid increases in intensity can lead to injury - Exercise and safety equipment should be properly made and maintained - The environment around the client is unsafe - Exercising on an unsafe area

How prevelant are mental health disorders in the US?

- Depression: 7% of American every year - Anxiety: 18% of Americans every year

How can health coaches educate clients on the sneaky tactics of supplement manufacturers?

- Dietary supplements are products that serve to support an already healthy diet - A product can be considered "adulterated" if it presents a significant or unreasonable risk of injury or illness - Supplement labels can't include that the product diagnoses, prevents, mitigates, treats, or cures specific diseases - Supplements must contain an ingredient label

What are general recommendations for those with OA and RA?

- During flare ups strenuous activity should be avoided but gentle movements should be performed. - Clients should be mindful of pain during exercise - Choose activities that do not exacerbate joint pain - Encourage clients to be physically active during the least painful time of day - Clients should wear shoes with good shock absorption and stability - Include exercises that improve functions of daily living

How can we tailor our approach to a client's stage of change on the transtheoretical model?

- During precontemplation the client should recieve a "nurturing style" from the coach - During contemplation the client should receive a "Socratic style" from the coach: essentially motivational interviewing - During preparation the client should receive an "expert" style from the coach: can work with the client to develop an action plan - During action and maintenance the client should recieve a "consultant" approach from the coach: can provide expert insight and tips

What are the major nutrition goals for those with diabetes?

- Eat less simple carbs and more complex carbs - Do not consume carbs in excess - Eat whole fruits and veggies - Lower processed meat consumption - Lower intake of unhealthy fats

What are major treatment strategies for diabetes?

- Exercise - Nutrition - Medication - Stress reduction

How can coaches understand their client's individual choices and motivations?

- Food access: Access to healthy, safe, and affordable food choices - Household food insecurity: When access to nutritious or safe food is limited or uncertain - Acculturation: The process of immigrants moving from a traditional healthier diet to an American diet

What are the 5 major goal catalysts?

- Goal commitment: The stronger the commitment to the goal, the more the goal will affect behavior change - Goal importance: The more importance the goal appears to be, the more motivational it is - Self-Efficacy: The higher the self-efficacy, the more likely the goal will be achieved - Feedback: When people receive specific feedback on the progress of their goal, the more likely they will be to continue doing it - Task complexity: As the complexity of the goals increase, clients will need more strategies for achieving the goal

How do they test for diabetes?

- Hemoglobin A1C Levels: Tests the average blood glucose levels over the past 2-3 months - Fasting plasma glucose: This measures the amount of glucose found in the plasma, or the clear part of the blood - Oral glucose tolerance: Measure glucose 2-3 hours after drinking 75 grams of glucose. If the blood glucose is too high for too long, it is called Impaired Glucose Tolerance (IGT)

What questions do the Prescription for Activity Task Force examine?

- How can the healthcare industry motivate individuals to exercise more, especially in areas who need it most? - What steps can healthcare take to pursue and achieve the goals of the leading authorities on fitness? - How can clinical care create a cultural shift to a healthier and more active culture?

How can coaches evaluate a diet for their clients?

- How does the diet cut calories? - What is the nutrient density of the diet? - Does the diet advocate for exercise? - Does it make common sense? - Where is the evidence? - Does it meet individual needs? - How much does it cost? - What kind of social support does the diet offer/the client have? - How easy is it to adhere to the diet?

How can you dissect a nutrition label?

1. Take a look at the serving size 2. Take a look at the total calories listed 3. Look at the listed nutrients 4. Look at the nutrient Percent Daily Value (PDV) 5. Look at the food allergens 6. Look at the ingredients if need be

Under what circumstances is medical clearance needed for exercise?

- If a client has cardiovascular, metabolic, or renal disease, or has signs that they do - If there is pain or discomfort in the neck, jaw, arms, or other areas that result from myocardial ischemia - Shortness of breath at rest, lying down, or sleeping - Dizziness or fainting - Ankle edema - Palpitations or tachycardia - Intermittent claudication (pain sensations or cramping in the lower extremities) - Known heart murmur - Unusual fatigue or shortness of breath with usual activities

When should coaches refer clients with stress, anxiety, and depression to mental health pros?

- If clients get particular scores on the PHQ-9 or Perceived Stress Scale test - Substance use problems - Illicit drugs - Alcohol dependency - Uncontrollable insomnia - Chronic anxiety

Why would a stress test be necessary for someone with diabetes?

- If they are currently sedentary - If they're planning on doing vigorous activitiy - If they're over 40 yrs old - If they're over 30 yrs old and have other chronic health conditions

What are 5 approaches to evoke change talk?

- Importance ruler: On a scale from 1-10, how important is it that you make this change?" - Querying extremes: Think about the best and worst case scenario of changing - Looking back: Think back to a time that you weren't thinking about change/hadn't changed - Looking forward: What life will be like once they've made a change - Exploring values: Explore their values

How can we classify individuals based on their physical activity?

- Inactive: No activity beyond baseline daily functions, receive no benefits - Insufficiently active: Activity fewer than 150 mins/week (75 mins vigorous activity), receiving some benefits - Active: 15-300 mins/week (75-150 mins vigorous activity), receiving substantial benefits - Highly active: more than 300 mins/week (150+ vigorous) receiving additional benefits

What has contributed to the lowered rates of tobacco use?

- Increased taxation on tobacco products - More laws surrounding second-hand smoke, prohibiting smoking in public venues - Laws against advertising tobacco - Legislation requiring health-risk labels - Increased enforcement of tobacco sales to minors - Health promotion in schools and offices advocating people to quit smoking - Increased communication with medical professionals to help the client quit smoking - Development of products to help quit smoking and reduce harmful effects

What are examples of actions outside the scope of practice of health coaches with nutriton?

- Individualized nutrition recommendations or meal planning - Nutritional supplements to determine nutritional needs - Specific recommendations or programming for nutrient or nutritional intake - Nutrition counseling, education, or advice aimed to prevent or treat disease - Any counseling regarding nutritional care standards or the nutrition care process - Promotion or identification as a "nutritionist" or "dietician"

What are the 6 types of motivation?

- Intrinsic motivation: The act of pursuing an action or activity because it is inherently enjoyable and/or rewarding - Integrated regulation: When a certain action or behavior is part of a person's sense of self - Identified regulation: Even though the individual does not enjoy the activity, the individual realizes the utility of the activity - Introjected regulation: People engage in an activity because they think they should, even though they don't want to - External regulation: People engage in an activity because of social pressure to avoid punishment and/or gain rewards - Amotivation: no motiation

What are healthy and unhealthy levels of LDL, HDL, and Total cholesterol?

- LDL:- Optimal: <100- Near optimal: 100-129- High: 160-189- Very high: >190 - HDL Cholesterol:- Low: <40- Normal: 41-59- High: >60 - Total Cholesterol:- Desirable: <200- High: >240

How can clients increase their self-efficacy?

- Mastery experiences: Experiencing successful accomplishment of a skill increases self-efficacy - Motivational models: When people see others who are successful at the behavior they want to complete, it increases self-efficacy - Persuasive messages: Receiving persuasive messages from others increases self-efficacy - Stress arousal: large amounts of stress is associated with decreased self-efficacy

What should be included in the client summary form?

- Measurements taken - Established goals - Homework - Any responsibilities of the coach - How to hold the client accountable - Date/time of the next training session

What factors determine the ideal intensity for clients?

- Medical history - Physical limitations - Threshold levels - Existing fitness levels

What are the types of professionals often recommended by health coaches?

- Mental Health Pros: Psychiatrists, psychologists, clinical social workers, licensed counselors, marriage and family therapists - Physicians - Nurses - Medical assistant - Registered Dietician - Exercise professionals - Physical therapists - Occupational therapists - Naturopathic doctor - Chiropractors

What are some major practices to help promote mindfulness in clients?

- Mindful movement - Meditation - Breathing exercises

What are some evidence-based mindfulness practices?

- Mindfulness-based stress reduction (MBSR): 8-week training that helps patients create mindful habits in their life - Mindfulness-based cognitive therapy (MBCT): 8-week training combining MBSR with meditation - Mindful self-compassion (MSC): 8-week training combining mindfulness and self-compassion by responding to difficult thoughts and emotions with kindness. - Breathing exercises: Counting up and down from 5 breathing in and out - Guided imagery: Imagine their life going well - Progressive muscle relaxation: Have the client tense their muscles, then relax them

What are the attitudinal factors of mindfulness?

- Non-judging: Becoming aware of thoughts as they arise and viewing them without judgement - Patience: Allowing things to emerge in their own time - Beginner's mindset: Being open to new and unique possibilities as they exist in the present - Trust: Honoring and trusting one's own feelings, experiences, wisdom, and intuition - Non-striving: Not striving to be one way or another, simply being aware of what is in the present - Acceptance: Embracing things as they truly are - Letting go: Choosing to embrace fluidity and dynamic nature of life moment by moment

How can we diagnose elevated blood pressure, stage 1 hypertension, and stage 2 hypertension?

- Normal: <120mmHg Systolic Blood Pressure (SBP) & <80mmHg Diastolic Blood Pressure (DBP) - Elevated: 120-129 mmHg SBP & <80mmHg DBP - Stage 1: 130-139 mmHg SBP & 80-89 mmHg DBP - Stage 2: >140 mmHg SBP & >90 mmHg DBP

What are the 8 dimensions of wellness?

- Occupational: Engaging with one's work in a way which feels enriching, rewarding, and meaningful - Physical: Physical activity, nutrition, and sleep - Social: Engaging one's interconnectedness with others for the betterment of the community - Intellectual: Activities that engage and stimulate mental activity - Spiritual: Aligning values with worldview to establish meaning and purpose - Emotional: Expression and management of one's feelings - Financial: Establishing healthy financial habits - Environmental: seeking surroundings that promote safety and wellness

What are the 4 core skills of motivational interviewing?

- Open-ended questions - Affirmations - Reflective listening - Clarifying points: > Encouraging: Short phrases that encourage the client to continue speaking (I see, interesting) > Paraphrasing: Putting into a clear and concise way what the client has already said > Reflecting emotional content: Confirm the emotional content of the client's story > Summarizing: At the end, pull together the most useful parts of the conversation

How can we determine a client's readiness to change?

- Open-ended questions - Scale of 1-10

What are the major myths about diabetes?

- People think that type 1 diabetes is juvenile diabetes because 75% of cases are reported in childhood. The truth is, Type 1 can affect anyone at any age - People think that if their blood glucose is higher or lower than usual, they must have done something wrong. The truth is, there are many factors outside of conscious control that determines blood glucose at any time. - People often believe that those who take insulin have a "worse" type of diabetes. The truth is, insulin is a regular type of treatment for all types of diabetes. - People often believe it is unsafe to exercise if you have diabetes. The truth is, if you are regulating your blood sugar during and after exercise, exercise is effective treatment.

What are common symptoms of depression?

- Persistent negative mood - Loss of pleasure and reduced interest in daily activates - Lack of concentration - Changes in sleep - Changes in appetite - Restlessness - Fatigue or loss of energy - Feelings of worthlessness or excessive guilt - Poor answers on the PHQ-9

What are effective interview skills?

- Practice high-quality non-verbal communication - Engage in active listening - Don't ask too many assessment questions and small talk, instead, ask open-ended questions and provide purposeful reflections

What are the 4 types of diabetes?

- Prediabetes - type 1 diabetes - Type 2 diabetes - Gestational diabetes

What are exercise strategies for improving lower-back pain?

- Prevent deconditioning of the muscles surrounding the spine - Avoid painful ranges of motion - Choose low or nonimpact activities - Focus on core function and fundamental movements

What are the major career opportunities for a health coach?

- Private in-person business or online practice - Fitness and wellness facilities - Workplace wellness - Health management systems - Cities and towns and municipalities - Non-profits - Integrated clinical care team

How can health coaches help clients reduce sodium intake?

- Read nutrition labels and pay attention to sodium content - Consume more fresh foods and fewer processed foods - Make home-prepared meals and don't add too much extra salt - When eating out, ask that salt not be added - Reduce calorie intake

What are the 4 reference values in the Dietary Reference Intake?

- Recommended Dietary Allowance (RDA): The level of intake of any particular nutrient that is at or above the adequate needs of the vast majority (98%) of the US population - Estimated Average Requirement (EAR): Adequate intake of any particular nutrient based on being 50% of that individual's age and gender specific group - Tolerance Upper Intake Level (UL): The maximal intake of any particular nutrient that is unlikely to cause adverse health effects to almost all individuals - Adequate Intake (AI): If the EAR or RDA is not able to be found, an AI is established. If a client exceeds the AI, they are very likely to meet their required needs

How can coaches deal with client-coach discord?

- Reflective listening - Apologizing when appropriate - Affirming the client's autonomy and resourcefulness - Shifting focus away from sensitive topics

What are the 2 major factors that determines whether a practice elicits relaxation?

- Repetition - Passive disregard

What are common medications for depression?

- Serotonin-reuptake inhibitors: increase levels of serotonin in the brain by blocking its reabsorption - Serotonin and norepinephrine reuptake inhibitors - Norepinephrine - Tricyclics - Monoamine oxidase inhibitors

What are the major causes and risk factors for hypertension?

- Stress: higher psychological stress was associated with a higher risk of hypertension - Body weight and body-fat: 70% of primary hypertension cases are associated with obesity. Higher BMI creates a higher risk of hypertension - Sleep: inadequate sleep in quantity and quality is associated with higher BP - Genetic factors: Hypertension is genetically based as well

What 3 techniques are needed for agenda mapping?

- Structuring: The coach asks the client permission to explore potential options for discussion - Considering options: The client and coach explore specific options - Zooming in: The coach and client choose an area of focus

What are the major components of a diet that positively affects hypertension?

- The Dietary Approaches to Stop Hypertension (DASH) eating plan is recommended. It advises eating high fiber and potassium foods - Overall, the biggest impact one can have on hypertension is increasing fruit and vegetable consumption and reducing sodium

Why is the National Commission for Certifying Agencies (NCCA) highly accredited?

- The exam process is fair and unbiased - The exam measures the minimum competence for the field, allowing only those most competent to be certified - The public is protected from ineffective and unqualified professionals - The organization has the means to support its professionals

What 3 factors are of greatest importance during an exercise health screening?

- The individual's current level of physical activity - Diagnosed cardio, metabolic, or renal disease - The desired exercise intensity

What are the major barriers of health behavior chnage?

- Time - Other people - Travel

What are nutrition interventions for cancer?

- getting enough macronutrients is critical - The goal for recovery is to maintain a healthy weight and nutrition plan - Eat plenty of veggies, fruits, and whole grains - Limit processed meat and red meat - Choose whole instead of refined grains - Limit consumption of alcohol to no more than 1-2 drinks/day

Who are those at the highest risk for vitamin D deficiency?

- those age 60+ - Those who acoid the sun or have difficult time getting outside - those who have medical conditions - People who have very dark skin - People with obesity

How prevalent is obesity?

-Americans: 38% - Women: 40.4% - Men: 35% - Children and adolescents: 18.4%

What are the 3 major components of a behavioral weight-loss plan?

1. Calorie reduction: Goals to promote 500-100 calorie deficit/week - Cut 50-100 calories per day - Practice portion control - Reduce consumption of calorie-dense foods - Increase consumption of nutrient-dense foods 2. Physical activity: increase moderate-intensity activities - Begin with 50 mins/week, and work up from there - Gradually increase to 150 mins/week - Gradually increase to 200-300 mins/week - Do strength training at least 2x per week - Increase non-exercise physical activity throughout the day 3. Behavioral Strategies: Increase adherence to exercise, nutrition, and health related goals - Practice self-monitoring - Avoid tempting situations - Spend more time with healthy individuals - Practice behavioral substitution - Set SMART goals to transform intentions to plans

What are the 4 processes of motivational interviewing?

1. Engaging: Engaging the clients with questions, plans, and talking about their interests 2. Focusing: Agenda setting, focusing on the specific areas the client deems the most relevant 3. Evoking: Discovering and discussing the client's own motivations for change 4. Planning: Marked by the client talking about how and when to change, rather than why

How can coaches help clients deal with negative thinking?

1. Explore what the client believes about his/her ability to develop a healthy lifestyle 2. Challenge any negative beliefs with evidence 3. Don't try to make your client think positively, help your client think realistically

What are the 10 questions on the Perceived Stress Scale?

1. How often have you been upset by something that happened unexpectedly? 2. How often do you feel unable to control the important things in life? 3. How often have u felt nervous or "stressed"? 4. How often have you felt confident about your ability to handle your personal problems? 5. How often have you felt that things were going your way? 6. How often have you found that you couldn't cope with all the things that you had to? 7. How often have you been able to control irritations in your life? 8. How often have you felt you were on top of things? 9. How often have you been angered by things outside your control? 10. How often have you felt problems were piling up so high that you could not overcome them?

What are the 5 stages of change in the transtheoretical model? What are the traits, goals, and strategies for each?

1. Precontemplation Traits: - Unaware or under aware of the problem, think it is unsolvable Goals: - Help the person become aware of the cons of not changing and the pros of changing - Make the conversation relevant to them - Let them start thinking about change Strategies: - Acknowledge their lack of readiness to change - Encourage reevaluation of current behavior and self-exploration - Explain and personalize the risks of complacency - Have extra reading and viewing material - Explore the client's values 2. Contemplation Traits: - Aware of the problem - Weighing the pros and cons of change - Have little understanding or ability to change Goals: - Collaborate and explore available options - Support the client with structured guidance when asked for it Strategies: - Acknowledge lack of readiness to change - Encourage evaluation of pros and cons to change - Identify and create new outcome expectations and boost self-confidence 3. Preparation Traits: - Looking for way to engage in the new behavior Goals: - Co-create an action plan with feedback and reinforcements for their progress Strategies: - Encourage the client by acknowledging their skills to change - Identify and assist with obstacles - Help the client create social support and establish SMART goals 4. Action Traits: - Desire for way to continue doing behavior - Change beliefs and attitudes about behavior - High risk for lapses Goals: - Establish the new behavior as a habit Strategies: - Help client build their social support and habits to promote behavior - Identify potential lapses and come up with solutions - Help clients create systems for accountability and self-monitoring 5. Maintenance Traits: - Desire a means to maintain adherence to the behavior - Can deal with lapses by themselves Goals: - Maintain support - Maintain interest and avoid boredom Strategies: - Reevaluate strategies currently in effect - Plan for lapses with social support - Help transition from external to internal rewards - Plan for lapses - Encourage reevaluation of goals and action plans if need be

What are the core competencies of coaching?

1. Setting the foundation - Meet ethical guidelines and professional standards - Establish the coaching agreement 2. Co-Creating the relationship - Establish trust and intimacy with the client - Be fully conscious and open 3. Communicating effectively - Active listening - Powerful questioning - Direct communication 4. Facilitating learning and results - Creating awareness - Designing actions - Planning and goal setting - Managing progress and accountability

What are the 3 major principles of training?

1. Specificity: What you specifically train will improve, but not necessarily other parts of your fitness 2. Progressive overload: In order to improve one's fitness, you need to challenge the body more than it's used to. Coaches need to have a balance between too much overload and safety 3. Reversibility: Lost it if you don't use it

What are the 8 principles of integrative medicine?

1. The patient and health pro are partners in the healing process 2. All factors that influence health and wellness are taken into consideration 3. Use of both conventional and traditional forms of medicine 4. Less invasive and more natural methods should be used as often as possible 5. No form of therapy or intervention is accepted uncritically 6. Good medicine is based in good science. It is inquiry driven and open to new paradigms 7. Along with treatment, health promotion and prevention are critical 8. Integrative medicine professionals should exemplify the principles and commit to self-exploration and personal-development

What role does genetics play in heart disease?

1. Those with genetic predisposition have nearly 2x the risk 2. Those with a genetic risk had a 50% reduction with lifestyle change 3. An unhealthy lifestyle erased 50% of the benefits of good genetics 4. Healthy lifestyle was associated with less plaque in the arteries in both groups 5. The biggest effect of whether someone would get heart disease is their lifestyle

How does your body's system react to stress?

1. When there is stress, it goes to the amygdala. The amygdala determines whether it does not pose a serious threat or if it should continue down the body 2. If it poses a threat, it is sent to the hypothalamus, where it is sent through the autonomic nervous system (ANS). The ANS is comprised of 2 parts: The sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). 3. When the hypothalamus receives the distress signal, it activates the SNS and turns off the PNS 4. The SNS signal the adrenal medulla to produce catecholamines, specifically epinephrine and norepinephrine. These hormones case vasodilation and vasoconstriction and other bodily functions to better react to the stressor. 5. If the stressor is still perceived as a threat, the hypothalamus activates the hypothalamus-pituitary-adrenal (HPA) axis. This releases corticotropin-releasing hormone (CRH), signaling the pituitary gland to release adrenocorticotropin hormone (ACTH). 6. This causes the release of glucocorticoids, including cortisol, which help regulate circadian rhythm, enhance glucose metabolism, and assist the SNS in releasing catecholamines.

What % of people don't get the adequate amount of sleep?

1/3 people

What is a normal range of cholesterol in the blood?

140-200 mg/dl

What is a normal range of triglycerides in the blood?

150 mg/dl or less

What % of Americans meet the physical activity guidelines?

21%

How can coaches calculate maximal HR?

220-client age

What is the Dietary Approaches to Stop Hypertension (DASH) eating plan?

A diet centered around lowering saturated fat, trans fat, cholesterol, and total fat. Red meat and sugar are limited. Moderate amount of fish, poultry, nuts, and other unsaturated fats. High in fruits, vegetables, legumes, and low-fat dairy.

What is the "personal values card game"?

A game with a list of a huge amount of values, and the client rates them on a scale from "not important to me" to "most important." Then, the client identifies the top 10 most important values

What is Appreciative Inquiry (AI)? What are the principles?

A style of coaching focused on the client's strengths, positives, dreams, and balancing that with realistic understanding. AI includes the 4-d cycle: - Discover: Understanding the client's strengths and best-self - Dream: Discover what creates joy and passion - Design: Setting goals and making plans - Deliver: Doing the work to achieve the dream The principles of AI include: - The positive principle: Positive questions and outlook leads to positive outcomes - The constructionist principle: The words of the client create their world - The narrative principle: The client's stories about their world determine their actions - The simultaneity principle: Just asking questions can begin the change process - The poetic principle: What people focus on influences the direction they take - The anticipatory principle: Positive ideas and images about the future elicit positive actions - The enactment principle: Act as the person or thing you want to become - The free-choice principle: Free-choice creates a sense of power - The awareness principle: Be aware of underlying assumptions

What does it mean when a coaching program is "client-centered"?

A style of coaching where the client is in charge: they determine their own goals, they seek their own assistance, and they overcome their own boundaries

What is a values interview?

A way for a coach to ask open-ended questions to the client, including: "What matters most to you?" "What would you say are the rules you live by?"

What is the illness-wellness continnum?

A way to understand how wellness can evolve and/or devolve in an individual

How prevalent is lower-back pain?

About 80% of individuals will experience lower-back pain in their lifetime, with the highest prevalence in those 45-65 yrs old.

How can coaches enhance the distress tolerance of depressed, anxious, and stressed clients?

Acceptance-based strategies: - Mindful awareness - Accepting discomfort as a way to grow and develop - Commitment to values: Acknowledging that escaping discomfort is not as rewarding as following a conscious healthy lifestyle.

What are the roles of physical activity and exercise in treating and preventing obesity?

Aerobic training: - Frequency: Be active at least 3-4 days/week - Intensity: Should be around 4 on the 0-10 scale - Time: Exercise 30-60 mins/day - Type: Low impact, rhythmic exercise using large muscle groups Resistance training: - Frequency: At least 2x per week - Intensity: Moderate, about 15 reps/set - Time: Full-body only requires 20-30 mins to complete - Type: Free weights, machines, or body-weight exercises How much exercise is needed? - 150-200 mins/week to prevent weight-gain. More than 250 mins/week is associated with significant weight loss.

What is allostasis and how is it related to homeostasis?

Allostasis: Adaptation to acute stress to restore homeostasis. It differs from homeostasis in that it's more preparatory than reactionary Allostatic load: When the stress response is inadequate for the stressors, "wear and tear" occurs

What is the US Healthy Eating Pattern?

Based on the types of foods Americans typically consume, but in smaller portions and nutrient-dense forms

What are the common screening and diagnostic tests used to detect coronary artery disease?

Basic tests: - Chest X-rays - Resting electrocardiogram (ECG) examines the heart's electrical impulses - Ultrasound - Abdominal aortic aneurysm - peripheral artery disease screening - Risk-factor profiling (questions on lifestyle and blood tests) Intermediate tests: - Exercise stress tests - How often and what level of exercise clients do - Pharmacological stress testing - Echocardiography (bounce ultrasound waves off the heart, creating images of the heart) Advanced tests: - Coronary angiography (putting dye into the blood to determine plaque buildup) Newer tests: - Computed tomography angiograms (CTAs) (images to determine plaque buildup) - CT and electron-beam CT scans (detect calcium in the coronary arteries, very accurate)

What is the Awareness-Choice-Execution (ACE) cycle of change?

Behavior change happens in phases, and the coach must tailor the client experience to their readiness to change. - Awareness: The client questions why there is a difference between a current behavior and a desired behavior - Choice: The client chooses the desired outcome, and the coach is there to support them - Execution: With well-defined goals, the coach and client can implement a personalized plan

What are the diagnoses for both overweight and obesity?

Body Mass Index: Calculating BMI is weight (lbs) divided by height (in)^2 x 703 - Underweight: Less than 18.5 - Normal Weight: 18.5-24.9 - Overweight: 25.0-29.9 - Obese: 30-39.9 - Extremely Obese: 40+ Waist Circumference: Measure the narrowest point of the torso. Above 35 for women and 40 for men is the risk-factor threshold Waist-to-hip ratio: Not only taking the measurement of the waist, but also taking the measurement at the widest part of the hip and comparing the 2. Body composition tests: There are multiple ways to test body-fat compared to muscle mass, including: skinfold tests, bioelectrical impedance analysis, hydrostatic weighing, magnetic resonance imaging, and dual-energy x-ray absorptiometry Fat distribution: Abdominal fat can be estimated by calculating the WHR

What is cancer? How prevalent is it?

Cancer is the uncontrolled division of cells that cause tumors. 1 in 6 people in the world develop cancer

How can you calculate a client's ideal weight based on current and target body fat %?

Current body weight x % current fat-free mass (FFM) = Current FFM Current FFM / % ideal FFM = Ideal weight

What is emotional intelligence? What are the 4 domains?

Emotional intelligence: Emotional competence, which is the ability to recognize, interpret, and manage emotions in oneself and others The 4 domains are: - Self-awareness: Can identify their own emotions and feelings, as well as the feelings of others - Self-management: The ability to use emotions to facilitate thinking. This means being able to focus without being distracted - Social awareness: The ability to understand emotions, emotional language, and the signals conveyed by emotions, especially empathy - Relationship management: The ability to manage one's emotions to attain certain social goals

What is the checklist for working with clients during the session?

Engaging: - Build rapport - Create/complete coaching agreement together - Client assessment Focusing: - Agenda mapping Evoking: - A discussion for or against change - Motivational interviewing Planning: - SMART goals Follow-up: - Determine plan for accountability - Determine plan for frequency of sessions - Determine mode of communication Documentation: - Complete summary form with client - Document visit for the benefit of referred health pros

What are the major factors that lead to obesity?

Environmental: - The availability, quantity, and energy density of foods - Availability of labor saving machines and devices Stress: More stress= more weight gain Genetics: Accounts for less than 5% of prevalence of obesity. Genetics play a factor in how much weight is gained or lost during dieting and exercise. Genetic predisposition can be reduced by about 40% by being active Hormones: - Leptin: Communicates with the hypothalamus to tell the body whether to eat more or less - adiponectin: Helps insulin by sending glucose into cells, increasing insulin sensitivity and glucose metabolism - Immune hormones: People with obesity release large amounts of cytokines because of their chronic inflammation - Appetite-regulating hormones: Includes ghrelin, which is secreted by the stomach and plays an important role in appetite regulation. The hormone Peptide YY and other hormones work with the central nervous system to regulate cessation and appetite. Sleep: About 58% of moderate-to-severe sleep apnea is caused by obesity Energy Balance: The primary reason for weight loss is a higher energy intake compared to energy expenditure

What are the 2 major types of stressors?

External: Outside events, situations, stimuli, and experiences Internal: Worries, feelings of uncertainty, lack of perceived control

What is the MyPlate daily food allowance?

It simplifies the Dietary Guidelines into a graphic that shows how much of the plate should be portioned with each type of food

How does heart develop physiologically?

It was believed that CVD was caused by a buildup of plaque on the walls of the arteries, but it is better understood now that inflammation is the cause of CVD, and inflammation is increased with more LDL cholesterol. In the blood there's a cell called a macrophage, which picks up debris in the cell and places it onto the artery wall

What are METs and what is the MET scale for light, moderate, and vigorous activity?

METS = Metabolic Equivalents. At rest, most people consume 3.5mL of oxygen per kg per minute. 3 METs is 3x the amount of oxygen consumed compared to being at rest. Light: Less than 3 METs Moderate: 3-5.9 METs Vigorous: 6+ METs

What is goal-setting theory?

Setting goals affect's people's performance and inspires behavior change. It does this because of 4 major reasons: - Directed attention: Goals help direct thoughts and behaviors toward the activities necessary to achieve the goal - Mobilized effort: Goals increase the amount of effort people will expend - Persistence: Specific goals help people persist longer - Strategy: Goal setting helps clients utilize strategies to achieve the goal

How can a coach effectively terminate the coaching agreement between themselves and a client?

Should end on a positive not: - Help te client reflect on the learning and growth they've had throughout the sessions - Explore ongoing sources of support - Celebrate the client and what they have achieved

What is the Healthy Mediterranean Style Eating Pattern?

Taken from the Healthy US Style Eating Pattern with modifications to more closely resemble the eating patterns of people with positive health outcomes who live in the Mediterranean. This means it contains more fruits and seafood, and less dairy and meats

What is the biopsychological model?

Taking into account biological, psychological, and sociological factors when understanding illness and wellness

What are the Values in Action (VIA) classifications?

The VIA is a strengths rating scale. This includes: - Wisdom: creativity, love-of-learning, curiosity, judgement, and perspective - Courage: Bravery, perseverance, honesty, zest - Humanity: kindness, social intelligence, love - Justice: Fairness, teamwork, leadership - Temperance: Forgiveness, prudence, humility, and self-regulation - Transcendence: Appeciation of beauty, hope, spirituality, gratitude, and humor

What is decisional balance?

The act of weighing the pros and cons of changing

What is self-efficacy?

The amount an individual believes he or she can successfully perform a behavior

What is the definition of coaching?

The art of communicating with individuals or groups to help them achieve self-directed goals. A great coach does this through a thought-provoking and creative process that inspires them to maximize their personal and professional potential

What is the attribution theory?

The coach may attribute the client's actions to their character traits, while the client will attribute it to the situation at hand

What does it mean when a coaching program is "partnership forming"?

The coaching must be: - Non-judgmental - Non-confrontational - Non-adversarial - Encourages change-talk

What is self-perception theory?

The idea that people's behaviors affect and reinforce their attitudes