HES 3573 FINAL
What are sanctions designed to do? Be able to recognize examples.
Laws or policies designed to discourage unhealthy behavior
What are incentives designed to do? Be able to recognize examples.
Laws or policies designed to encourage healthy behavior
Must we choose between PA and academic achievement?
"Active kids learn better" - the positive effects of physical activity on brain function are well documented with a number of studies showing that aerobic activity improves cognition and performance
How should you address food addiction?
"This may be the one circumstance where you would completely eliminate a food or foods from a patient's diet" - identify and eliminate the foods that trigger overeating/binge eating and replace them with: - psychosocial assessment and treatment - cognitive behavioral therapy
According to the AHA, what are the general recommendations for infants?
- "Breast-feeding is ideal nutrition and sufficient to support optimal growth and development for about the first 4-6 months after birth but should be maintained when possible for at least 12 months." - "Transition to other sources of nutrients should begin at about 4-6 months of age to ensure sufficient micronutrients in the diet." - "Don't overfeed infants and young children — they can usually self-regulate the amount of calories they need each day."
For which direct comorbidity associated with obesity does excessive alcohol consumption increase your risk?
- Alcohol consumption not only increases caloric intake but is also associated with obesity in epidemiological studies as well as in experimental studies. (Suter & Tremblay, 2005). • Alcohol provides unneeded calories and displaces more nutritious foods. (DHHS, 2015) - Excessive Alcohol consumption increases the risk for NAFLD, MetS, CVD and Diabetes • Promotes systemic inflammation and a prothrombotic state (Mahli & Hellerbrand, 2016) - Light Alcohol consumption (1 drink/day) was recently found to increase the risk for colorectal, breast and esophageal cancers
With regard to choosing nutrient dense foods, what are the tips for success?
- Be sure to include a nutrient dense protein and high fiber food source in each meal an snack to prolong satiety - Choose whole grains high in fiber to promote satiety and reduce risk for obesity comorbidities - Avoid triggering set point resistance by - Not skipping a meal or going more than 4 hours without eating - Not dropping below the lower caloric limits recommend by the NHLBI guidelines
What are the benefits of using a daily food diary to track your calories?
- Can allow patients to self-monitor daily dietary intake rather than recall past dietary intake - Allows for tracking dietary triggers as well as actual intake - Excellent tool for patient self-awareness and motivation
What are the benefits of flexibility training specific to overweight or obese adults?
- Can improve postural alignment and muscular balance - Can decrease pain in joints stressed by excess weight
How does the Table Time Model for meal-time structure and feeding communication promote healthier eating patterns among children? The FIT intervention model
- Central to the Table Time Model is the acronym "FIT" • Food- the parent prepares foods from balanced food groups and family style serving. During the meal, the parent places all the food at the center of the table for the child to choose. • Intuitive Eating- The parent to models eating to satiety or satisfaction and uses mealtime manners. • Table Talk- The parent engages in enthusiastic non-food related conversation with their child. - During an 8 week Table Time intervention, the children of parents who received real-time coaching (promoted the use of FIT and how to avoid using ABCDE feeding styles) saw a cessation of weight gain as compared to the children of parents who received usual care in a clinical setting.
What are some examples of partnerships?
- Coalition: an alliance of political groups formed to oppose a common foe or pursue a common goal - Organization: an organized body of people with a particular purpose - Alliance: a union or association formed for mutual benefit with or without a formal agreement - Network: a group of people or organizations that are closely connected and that work with each other
What did Steven Blair mean when he stated in his article, "In essence, physical activity is the common denominator for the clinical treatment of low fitness and excess weight, making the "fitness vs fatness" debate largely academic"? What did he say we should be focused on?
- Common denominator: solution to both is fitness and working towards it - We should focus on how to get sedentary individuals to become active
What are the quality of life benefits of regular physical activity for overweight and obese adults?
- Enhances ability to live and function independently • Optimal performance in = ADL's = work = recreational activities • Improves perception of health, wellness and self
What are the determinants of a child's eating behaviors?
- Family and Peer influences • Modeling- food preferences, portion sizes - Family Influences • feeding style • mealtime structure • parent attitudes and behaviors - Environmental Influences • Food availability- type and quantity • Food accessibility- ease of access - Socioeconomic influences • knowledge, accessibility, - Cultural influences • acceptability
What are the differential effects of lower fat/higher carbohydrate diets?
- Greater reduction in LDL-C - Lesser reduction in serum triglycerides - Lesser increases in HDL-C
How do you assess a client's self-efficacy?
- Have they ever had successful or unsuccessful attempts at weight management? • What factors were involved in previous attempts? -How do family, friends, and co-workers influence their choices? motivation? • Who will be possible supporters and how confident is the patient that they can recruit this support? • Who will be possible antagonists to their efforts and how will the patient overcome their influence? - Do they have readily available resources for weight management therapy? • Time = Is the patient able and willing to commit their time to a weight loss and maintenance program? a.) Are there competing needs? b.) Can they fit treatment into their life? • Cost = Is the patient able and willing to pay for treatment? a.) This may include travel expenses to treatment facilities, purchase of healthy foods and/or exercise equipment, paying for professional counseling that may not be covered by insurance, etc. - Assessing support network
How do you assess a client's self-efficacy involving a support network?
- Have they made their support aware of their goals? Do they care about the patient's success? - Will they assist the patient in structuring the environment to enhance success? - Are they willing to assist to assist with problem-solving to overcome obstacles to change? - Are they a good role model?
What are the benefits of a community health assessment?
- Improved organizational and community coordination and collaboration - Increased knowledge about public health and the interconnectedness of activities - Strengthened partnerships within state and local public health systems - Identified strengths and weaknesses to address in quality improvement efforts - Baselines on performance to use in preparing for accreditation - Benchmarks for public health practice improvements
How should we encourage PA in all sedentary adults?
- Increase lifestyle PA: • Functional walking, manual household chores, taking the stairs instead of the escalator, parking in 1 spot/further away, deliver office messages in person - Adopt the habit of moving a minimum of 5-10 minutes every few hours - Identify leisure activities they enjoy that can increase self-efficacy: • fishing, pool activities, gardening, after dinner stroll
What perceptions influence motivation? How do these perceptions influence self-efficacy?
- Internal locus of control • A person's perception that the outcomes of their life are determined by their own personal actions (Reflects a strong sense of self-control and emotional self- regulation and may be a precursor to success) - External locus of control • A person's perception that the outcomes of their life are determined by other people's actions, external events, or chance. (Reflects low self-value and self-control and may indicate other psychosocial challenges, perceptions and attitudes such as learned helplessness, competing needs, and issues with their relationship with food)
What are the beverage intake recommendations for infants?
- Juice should not be introduced into the diet of infants before 6 months of age. - Infants should not be given juice at bedtime and never from bottles or easily transportable covered cups
What are the limitations of using a daily food diary to track your calories?
- Measurements not readily quantifiable so not a useful tool for accurately estimating current total Kcal intake - Susceptible to responder bias
What are DIRECT method assessments of physical activity?
- Pedometers- can be used to assess a small event - Accelerometers - New technology: fitness apps, fitbits, etc. - Questionnaires. . .
According to the committee for the dietary guidelines for Americans, what are the general recommendations for children and adolescents?
- Plant-based foods, especially vegetables and fruits - Foods low in saturated fat - carbohydrate intake that is primarily from high fiber, complex carbohydrates, such as those found in whole grains - A focus on low-fat and non-fat dairy products - Choosing lean sources of high quality protein
What are the consequences of children consuming an energy dense, nutrient poor diet and irregular meals?
- Poorer mental health - Poor concentration and ability to focus at school - Small reductions in IQ
What are the risks of exercise participation for overweight or obese individuals?
- Possible Injuries • Heel cracks • Joint discomfort • Obese/morbidly obese: Increased risk for fracture •Rubbing injuries = Skin sores OBSERVE APPROPRIATE PROGRESSION AND ALLOW FOR APPROPRIATE REST TIME
How does the Table Time Model for meal-time structure and feeding communication promote healthier eating patterns among children? authoritarian feeding style
- Promote the use of an Authoritative style - Develop parent education classes that focus on reasons and rationales for why children should eat more fruits and vegetables. • Contributes to the effective use of an authoritarian feeding style • Allows parents to become better role models
How can Resistance Training help prevent Musculoskeletal Disorders in overweight and obese individuals?
- Promoting the growth and/or increases in the structural integrity of ligaments, tendons, tendon to bone and ligament to bone junction strength, joint cartilage and the connective tissue sheaths within muscle • damaged tendons and ligaments regain strength at a faster rate when RT is performed after the damage has occurred - Correcting muscular imbalances, especially important in weight-bearing joints - Facilitating coordinated muscular contractions that are capable of smoothly decelerating joint motions, even if the muscles themselves are relatively weak
What are the limitations of using nutrition analysis software to track your calories?
- Quality and operating features vary - If the food list is limited, then substitutions must be used, lowering the accuracy of the analysis. - Accuracy of information dependant upon accuracy of individual • Estimation of Portions • responder bias
Where do most excess calories come from in the American diet?
- Soda pop • the leading source of carbohydrate calories in the American diet. = On average, Americans drink 55 gallons per year per person. = Most soft drinks contain HFCS - Fruit Juice • Although thought to be healthier, juice still remains overconsumed by Americans = Children should only consume 4oz of juice per day. Many consume 3-4 times this amount - Gatorade • Only necessary after 60 minutes of vigorous exercise. Water is more appropriate for most exercise - Sugar sweetened energy drinks • Replaces nutritious energy sources and water
What are the limitations of flexibility training specific to overweight or obese adults?
- Some exercise positions are not possible or are very uncomfortable both physically and psychologically for overweight/obese patients - Stretching hypermobile joints can increase laxity in already stretched tendons and ligaments
What are the physicians committee for responsible medicine recommendations for promoting healthy eating among children?
- Teach children that food is fuel for health and fitness rather than a comfort, friend, enemy, or boredom reliever. - Don't restrict a child's daily caloric intake; Do reduce or limit the number of daily calories that come from "empty calorie" sources • Processed and fast foods that are high in added sodium, sugar and saturated fat - Parents should encourage their child to: • eat a healthy breakfast every day • GO TO BED at an hour that is appropriate to their age and sleep needs (Why?) - Parents should learn what their child is eating at and after school • Review school menus together ahead of time to "rehearse" healthy choices • Advocate for healthier school meals and the removal of food venders from school property
What is the problem with "filling up" on beverages?
- The volume of large portions of any type of beverage can exert satiety, but ONLY short term: • Activation of the vagal stretch and tension mechanoreceptors in the stomach triggers chemical and hormonal satiety signals and digestive factors • The rapid emptying of liquid from the stomach (especially carbonated liquids), and rapid digestion of carbohydrates, cannot maintain the sense of satiety for very long
Why join or form a partnership?
- To learn the extend of a common issue - To learn about evidence-based interventions to address a common issue - To pool resources - To contribute to the formulation of educated recommendations - To advocate for change - Why is inclusivity key
Based on the information in each of the slides with this title, how do you enhance motivation to enhance success? (Implies you understand the types of motivation discussed, how motivation impacts the value of change and how to leverage that)
- To leverage outcome expectations, set small, achievable weight management goals • How do you eat an elephant? = Target a behavior the patient is highly motivated to change = set realistic goal(s) 1 behavior at a time = Monitor progress and assist patients in: a. overcoming challenges whenever they arise b. connecting their successes to enhancing their core values - "Those with more modest absolute weight loss goals were more likely to achieve their goals and more likely to maintain weight loss 2.5 years after starting a program." (Teixeira, et. al., 2004) - To leverage outcome expectancies, help the patient connect the positive outcomes of the behavior itself to their core values as often as possible: • Prevention/management of co-morbidities • Enhanced quality of life • Higher self-esteem/self-value/emotional health • More self-awareness, self-control and self-efficacy - At first it may be easier to assist patients in leveraging extrinsic motivation and outcome expectations. . . • "I love how all my co-workers are complementing me on how good I look!" • "I was so happy I was able to move my belt buckle over one notch today when I got dressed this morning!" . . .while continuing to assist them in connecting to the more sustainable outcome expectancies and intrinsic motivators • "I love having more energy throughout my day!" • "I love having some personal time while walking and how clearheaded and upbeat I feel after I go for my walks." - Vital to long-term success is helping clients connect and reconnect healthy behaviors to deeply felt core values and beliefs.
When is an INDIRECT assessment of physical activity most appropriate?
- Your objective and strategy focus on increasing a component of fitness (CRE, muscular strength, endurance, or flexibility, body composition) - Your vehicle of delivery is a program
What are the health risks associated with too much added sugar?
- increased risk of obesity, hypertension, stroke, and coronary heart disease (CHD) in adults and obesity in children - Observational and intervention studies indicate a consistent relationship between higher added sugar intake and higher blood pressure and serum triglycerides.
What are the advantages to using indirect measures of physical activity?
- provides an objective, reproducible estimate of recent PA - can verify positive changes (↑ CRF) as a result of PA participation over time - CRF levels are directly related to the health benefits acquired from PA participation
Health Impact Assessment is a systematic process that:
- uses an array of data sources and analytic methods - considers input from stakeholders - provides practical recommendations for how to minimize negative health effects and maximize beneficial health effects.
When is a DIRECT assessment of physical activity most appropriate?
- your objective and strategy focus on increasing PA behavior or increasing access to PA opportunities - Your vehicle of delivery is a program
What are the benefits of including high fiber foods in obesity treatment?
- ↓ the risk of comorbidities associated with obesity and overweight (DHHS, 2015) • Heart disease: fiber is believed to reduce atherogenic dyslipidemia and chronic inflammation • Cancer: directly reduces the risk for colon and esophageal cancers • Diabetes: Fiber slows the increase of blood sugar after eating - May facilitate weight loss (Harvard School of Public Health, 2017) : • The fiber in whole grains takes longer to chew/digest and increases satiety by delaying gastric emptying • swelling and lingering in stomach makes you feel fuller longer • TEF is enhanced when breaking down high-fiber
What are the 4 methods members of the national weight control registry reported using to keep off the weight they lost?
1. 78% eat breakfast everyday 2. 75% weigh themselves at least once per week 3. 62% watch less than 10 hours of TV per week 4. 90% exercise, on average, about 1 hour per day
What are the 5 steps to developing public health policy? Be able to discuss the process of 1 of these steps.
1. Problem Identification 2. Policy Analysis 3. Strategy and Policy Development 4. Policy Enactment 5. Policy Implementation
What were Dr. Klein's and Yolanda Neil's 5 Tips for Weight Loss?
1. Start with small steps 2. Make realistic goals 3. Seek support 4. Keep portions under control 5. Track your caloric intake
With regard to healthy eating, what are the 4 main goals recommended by the IOM?
1. promote the consumption of nutritious foods, and encourage and support breast feeding during infancy 2. help adults increase physical activity and decrease sedentary behavior in young children 3. help adult's increase children's healthy eating 4. Create a healthful eating environment that is responsive to children's hunger and fullness cues.
Why is it important to assess physical fitness?
1. to assess current fitness levels in relation to age and sex 2. to identify areas of health and injury risk 3. to identify it ad referral to a healthcare professional if needed 4. to aid in the development of exercise prescriptions - realistic, attainable goals - evaluate suitability of program to person 5. To educate participant about physical fitness
What is Acceptance and commitment therapy?
3rd generation cognitive behavioral therapy
What are the NHLBI behavior therapy recommendations for a comprehensive-lifestyle intervention?
All 3 components should be included: 1. prescription of a moderately-reduced calorie diet; 2. a program of increased physical activity 3. the use of behavioral strategies to facilitate adherence to diet and activity recommendations.
What type of risk assessment US Preventative Services Task Force recommend for children and adolescents 6 years of age and older?
Although all children and adolescents are at risk for obesity and should be screened, there are several specific risk factors, including parental obesity, poor nutrition, low levels of physical activity, inadequate sleep, sedentary behaviors, and low family income.3 Risk factors associated with obesity in younger children include maternal diabetes, maternal smoking, gestational weight gain, and rapid infant growth. A decrease in physical activity in young children is a risk factor for obesity later in adolescence. Obesity rates continue to increase in some racial/ethnic minority populations. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (e.g., socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom).3 The prevalence of obesity is approximately 21% to 25% among African American and Hispanic children 6 years and older.2, 3 In contrast, the prevalence of obesity ranges from 3.7% among Asian girls aged 6 to 11 years to 20.9% among non-Hispanic white adolescent girls.
What is an example of a sanction?
Arkansas soft drink tax
What is the DIRECT measure of PA?
Attempts to characterize the actual type, duration and intensity of movement during a period of PA - PA logs, recalls and motion sensors collect PA info while (or immediately after) an individual engages in various activities
What are the average number of calories Children ages 2 to 18 years consume through beverages?
Average of 400 calories per day
Based on our class discussion, why is using a commercial diet or weight loss program to lose weight either ineffective or unsustainable?
Because those who use it will just end up re-gaining the weight die to "demonizing" a certain food group
Which is more important: losing weight or being fit?
Being fit and having a good diet is more important. You need to be active rather than being sedentary and thin.
What type of screening tests does the US Preventative Services Task Force recommend for children and adolescents 6 years of age and older?
Body mass index measurement is the recommended screening test for obesity. Body mass index percentile is plotted on growth charts, such as those developed by the CDC, which are based on US-specific, population-based norms for children 2 years and older.10 Obesity is defined as an age- and sex-specific BMI in the 95th percentile or greater.
What is an example of an incentive?
Certified Healthy Business program (stakeholders) began a plan to recognize businesses that were working to improve employee health. They decided that one way to recognize businesses would be through an online certification process. They will then be honored at an awards ceremony. There's no money incentive, but they get a decal, a certificate and standard "winning trophy"
What are the benefits of using nutrition analysis software or a food diary to track your calories?
Can estimate current Kcal intake with relative accuracy • Can be adapted to evaluate disease risk, special needs, etc. • Lists most foods people consume
What is the benefits and limitations of this nutrition assessment method: food frequency questionnaire?
Capture a person's food consumption over a period of time (1 week to 1 month). Once a food is chosen, the person then reports how much and how often the food was consumed. - Benefits • Flexibility: Self-report or by interview • Uses a preformatted list of foods that act as a memory prompt • Inexpensive form of quantitative analysis - Limitations • Patient's long-term memory may not be reliable • Food lists may not be culturally sensitive • Patient's inability to accurately estimate portion sizes • Preformatted list may miss a patient's food preferences or encourage biased reporting
What is crucial for a client to identify if cognitive defusion is to be helpful?
Commitment to move in a valued direction, even in the face of uncomfortable and painful feelings and thoughts
When discussing levels of prevention, the Institute for Work and Health authors stated, "Fix the hole in the bridge so people stop falling through and drowning downstream." What did they mean by this?
Compromised quality of life, less productive to society - think of people in the primary, secondary, and tertiary categories - Ultimate goal: to stop it before it even occurs
Which type of motivation do overweight or obese people tend to better identify with? Why?
Extrinsic motivation
Know the ACSM guidelines regarding frequency, intensity, time and type.
FITT - Frequency: how many times per week - Intensity: imposed demand or overload • CRF training = % of THR OR % of VO2max • Muscular strength or endurance = % of 1RM - Time: length of each exercise session • CRF training = time/distance • Muscular strength or endurance = # of reps/sets - Type: specific modality for desired outcome • CRF fitness: activities that require repetitive movements of large muscle groups • Muscular strength and endurance: exercises that target all major muscle groups to promote an increase in capacity • Muscular flexibility: exercises that target all major muscle groups to promote a safe increase in ROM
In the 5 steps to developing public health policy, what is policy enactment and its process?
Follow internal or external procedures for getting policy enacted or passed: - Enact law (measures, resolutions, propositions), regulation, procedure, administrative action, incentive, disincentive or voluntary practice
In the 5 steps to developing public health policy, what is strategy and policy development and its process?
Identify the strategy for getting the policy adopted and how the policy will operate. - Identify how the policy will operate and what is needed for policy enactment and implementation (e.g., understand jurisdictional context and identify information and capacity needs) - Define strategy for engaging stakeholders and policy actors (who might they be?) - Possibly draft the policy (law, regulation, procedures, actions, etc.)
What are the weight loss maintenance benefits of muscular strength and endurance training to overweight or obese adults?
Increases lean body mass and Kcal expenditure at rest > Counters decreases in RMR associated with weight loss - Important for continued loss of body fat during caloric restriction phase of program and for maintaining weight loss during maintenance phase of program
What is a Community Health Assessment or community health needs assessment?
It gives organizations comprehensive information about the community's current health status, needs, and issues. This information can help develop a community health improvement plan by justifying how and where resources should be allocated to best meet community needs.
Are weight loss supplements generally considered safe? Effective? Why or why not?
It is not safe because it is dangerous and ineffective. It throws off the rest of our systems and may result in hormone imbalances.
What is an example of a nutrition analysis software?
MyFitnessPal
Should youth train with maximal weights? Why or why not?
No, because they should be body weight, age and developmentally appropriate
Is there a method of delivery of a comprehensive weight loss intervention that includes personalized feedback from a trained interventionist that works better than any other?
No, it is relatively equal (~ 5-8kg weight loss) regardless of the method of delivery
What are the challenges to policy enactment?
Opposition to Systemic Change: - The beverage industry spent nearly $10 million in television ad time pouncing on these measures because they instill a "general" tax, which requires a simple majority and doesn't stipulate how the revenue is spent. - They also called it a "grocery tax," arguing business owners will be forced to raise prices on other items to spread the cost. The tax is on distributors and is not paid by customers who buy the drinks or store-owners who sell the drinks
What is an example of a DIRECT measure of PA?
Pedometers: measures total steps for the time worn Fitbits, GPS trackers
What is the benefits and limitations of this nutrition assessment method: 24 hour foods recall?
Person is asked by an interviewer to recall everything they have eaten or drank within the last 24 hours - Benefits - Can be done for a single day or multiple days - Conducted by interview so clarifications can be made during assessment - The interviewer must be thorough in their questioning - They must report food and portion sizes - Limitations - The accuracy of the recall is dependent upon the patient's memory and ability to accurately estimate portion sizes - Lack of experience by an interviewer/interviewer bias - A 1-day recall may not be indicative of general dietary habits
Based on behavior therapy techniques and physiology content covered in class, how would you respond to the client statements given on slide #59?
Relate, reframe, talk about what they like to do and incorporate workouts with it. "60-90 min is too overwhelming and boring!" -- I am with you on that! I find it so hard to workout during long period of times as well, but it really helped me when I incorporated something I like to do. What do you like to do?
In the 5 steps to developing public health policy, what is policy analysis and its process?
Research and Identify different policy options to address the problem/issue and use quantitative and qualitative methods to evaluate and the policy options to determine the most effective, efficient, and feasible option. Describe: a) how the policy will impact morbidity and mortality (health impact) b) the costs to implement the policy and how the costs compare with the benefits (economic and budgetary impacts) c) the political and operational factors associated with adoption and implementation (feasibility) Assess and prioritize policy options
When it comes to forming a partnership, why is inclusivity key to a successful partnership?
The diversity of the committee promoted strong cross-sector participation in planning, implementing and evaluation of community health efforts.
What did the author mean when he said, "We must give Americans permission to be fat and still be healthy"?
This is possible and the way to do it is by getting them more active and whether or not they lose weight may not be that important - give them permission to be bigger (focus more on their behavior) do not ridicule them
What are the summary guidelines from the NHLBI regarding the appropriate energy deficit for women and men, appropriate caloric restriction to achieve weight loss?
To achieve weight loss, an energy deficit is required: - for women: usually 1,200-1,500 kcal/day - for men: usually 1,500-1,800 kcal/day Estimation of individual energy requirements according to expert guidelines and prescription of an energy deficit of 500 kcal/day or 750 kcal/day or 30% energy deficit
In the 5 steps to developing public health policy, what is problem identification and its process?
To clarify and frame the problem or issue in terms of the effect on population health. - Collect, summarize, and interpret information relevant to a problem or issue (e.g., nature of the problem, causes of the problem) - Define the characteristics (e.g., frequency, severity, scope, economic and budgetary impacts) of the problem or issue - Identify gaps in the data - Frame the problem or issue in a way that lends itself to potential policy solutions
In the 5 steps to developing public health policy, what is policy implementation and its process?
Translate the enacted policy into action, monitor uptake, and ensure full implementation. - Translate policy into operational practice and define implementation standards - Implement regulations, guidelines, recommendations, directives and organizational policies - Identify indicators and metrics to evaluate implementation and impact of the policy - Coordinate resources and build capacity of personnel to implement policy - Assess implementation and ensure compliance with policy - Support post-implementation sustainability of policy
What is the INDIRECT measure of PA?
Used to acquire substitute measures of PA. Estimates of PWC and EE are based on current fitness level - PWC: obese almost always suffer from low physical working capacity - EE: habitual levels of PA are closely related to cardiorespiratory fitness, so low CRF = low PA levels
Can children and adolescents obtain the same health benefits as adults from consuming the same diet?
Yes
Can an individual be healthy at every size?
Yes, it is more about the athletic level and diet
What is a partnership?
a cooperative pact or agreement among individuals or groups to take joint action for a common cause.
What is self-efficacy?
an individual's confidence they can engage in and sustain a health behavior even in the face of dynamic and challenging environmental factors; it drives motivation and readiness to change
Know the different risk factors related to CVD and be able to use ACSM's risk stratification method and chart to determine: an individual's level of CVD risk when starting a CRF exercise program
an individuals level of CVD risk when starting a CRF exercise program
What were the most effective interventions reported by the USPSTF? (Know number of sessions and types of behavioral management activities used.)
comprehensive and were of high intensity - 12 to 26 sessions in a year - used group/individual sessions, weight-loss goals, improving diet and nutrition
What is an example of INDIRECT measure of PA?
cycle ergometer, supported and bolted elliptical machines
What type of interventions does the US Preventative Services Task Force recommend for children and adolescents 6 years of age and older?
he USPSTF recognizes the challenges that children and their families encounter in having limited access to effective, intensive behavioral interventions for obesity. Identifying obesity in children and how to address it are important steps in helping children and families obtain the support they need. The USPSTF found that comprehensive, intensive behavioral interventions with a total of 26 contact hours or more over a period of 2 to 12 months resulted in weight loss (Table 1).3, 4 Behavioral interventions with a total of 52 contact hours or more demonstrated greater weight loss and some improvements in cardiovascular and metabolic risk factors. These effective, higher-intensity (≥26 contact hours) behavioral interventions consisted of multiple components.3, 4 Although these components varied across interventions, they frequently included sessions targeting both the parent and child (separately, together, or both); offered individual sessions (both family and group); provided information about healthy eating, safe exercising, and reading food labels; encouraged the use of stimulus control (e.g., limiting access to tempting foods and limiting screen time), goal setting, self-monitoring, contingent rewards, and problem solving; and included supervised physical activity sessions. Intensive interventions involving 52 or more contact hours rarely took place in primary care settings but rather in settings to which primary care clinicians could refer patients. These types of interventions were often delivered by multidisciplinary teams, including pediatricians, exercise physiologists or physical therapists, dieticians or diet assistants, psychologists or social workers, or other behavioral specialists. Adherence to interventions can change their effectiveness. In the included trials, 68% to 95% of participants completed all of the sessions. Lower adherence in clinical practice could decrease the overall benefit of these interventions.
What is the ultimate goal of a community health assessment?
is to develop strategies to address the community's health needs and identified issues
What is an environmental impact assessment?
is the process of identifying, predicting, evaluating and mitigating the biophysical, social, and other relevant effects of proposed developments prior to major decisions being made. EIAs are currently a requirement in most countries
What is a health impact assessment (HIA)?
is used to evaluate the public health consequences of proposed decisions in non-health sectors. It is meant to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and whether the health effects are distributed evenly within the population.
What is cognitive restructuring?
it seeks to modify the content of thoughts
What is the benefit of using circuit resistance training with overweight or obese exercisers?
maximizes caloric expenditure while increasing CR and muscular endurance
What does Acceptance and Commitment Therapy promote?
psychological flexibility rather than experiential avoidance
What is cognitive defusion?
viewing uncomfortable and painful feelings and thoughts from a detached perspective as what they are, data
Know the different risk factors related to CVD and be able to use ACSM's risk stratification method and chart to determine: whether a physician must be present during a submax or max test.
whether a physician must be present during the test
Know the different risk factors related to CVD and be able to use ACSM's risk stratification method and chart to determine: whether a submax or max test is recommended
whether sub-max or max tests are recommended