KHS Final CH. 10-18

Food Allergies and Food Intolerances

Food allergies: adverse reactions of the body's immune system to a food ingredient. 90% of food allergies are due to eight foods: •Cow's milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. Food intolerances: adverse reactions that don't involve the immune system. The problem usually lies with metabolism.

Cardiorespiratory Endurance

Cardiorespiratory endurance: the ability to perform prolonged, large-muscle, dynamic exercise at moderate to high intensity. Cardiorespiratory endurance training conditions of the heart and metabolism. •Related physical functions improve. •Functioning of the body's chemical systems also improves.

Binge-Eating Disorder

Binge-eating disorder: incontrollable eating followed by feelings of guilt and shame about weight gain. •Characterized by very rapid eating, eating until uncomfortably full, eating when not hungry, and preferring to eat alone. Often, eating is a way of coping. Likely to be obese. High rates of depression and anxiety.

Estimating Body Composition

Bioelectrical impedance analysis (BIA). Skinfold measurement. Scanning procedures. •CT scan. •MRI. •Dual-energy X-ray absorptiometry (DEXA). •Dual-photon absorptiometry.

Evaluating Body Weight and Body Composition

Body composition: Bodies are composed of fat-free mass and body fat. Fat-free mass: non-fat tissues. Body fat includes: •Essential fat. •Fat stored in fat cells (adipose tissue). •Fat located in subcutaneous fat (under the skin) and around major organs (visceral fat). Percent body fat: the proportion of the body's total weight that is fat.

Allergy: A Case of Mistaken Identity

Allergies result from a hypersensitive and overactive immune system. Reaction to a harmless substance as if it were a harmful pathogen. Allergens elicit an exaggerated immune response. •Pollen. •Animal dander. •Dust mites and cockroaches. •Molds and mildew. •Foods. •Insect stings. Allergic response: Part of the body's response is to release large amounts of histamine, a chemical involved in some cases of inflammation as well as allergy. In some people, an allergen can trigger an asthma attack. •Causes wheezing, shortness of breath, and coughing. Most serious kind of allergic reaction is anaphylaxis, characterized by difficulty breathing, low blood pressure, heart arrhythmia, seizure, and sometimes death. •Treatment requires immediate injection of epinephrine. Climate change and allergies: •Likely to exacerbate allergies. Dealing with allergies: •Avoidance. •Medication. •Immunotherapy—desensitizing "allergy shots."

Anorexia Nervosa

Anorexia nervosa involves a refusal to eat enough food to maintain a reasonable body weight. Characteristics: •Fear of gaining weight or becoming fat. •Distorted self-image. •Compulsive behaviors and rituals. •Excessive exercise. •Some may also binge and purge. Health risks of anorexia nervosa: •Amenorrhea. •Cold intolerance. •Low blood pressure and heart rate. •Dry skin, and swelling of the hands and feet. •Medical complications, including disorders of the cardiovascular, gastrointestinal, endocrine, and skeletal systems. •Depression and suicide.

Other Substances in Food

Antioxidants: substances that can reduce the breakdown of food or body constituents by free radicals. •Free radical: an electron-seeking compound that can react with fats, proteins, and DNA, damaging cell membranes and mutating genes. •Free radicals have been implicated in aging, cancer, cardiovascular disease, and other degenerative diseases. Some antioxidants: vitamins C and E; selenium; and the carotenoids found in yellow, orange, and deep green vegetables. Phytochemicals: substances found in plant foods that may help prevent chronic disease. •Soy foods may help lower cholesterol levels. •Cruciferous vegetables such as broccoli render some carcinogenic compounds harmless. •Allyl sulfides (garlic and onions) boost cancer-fighting immune cells. •Carotenoids in green vegetables may preserve eyesight. Phytochemicals found in whole grains are associated with a reduced risk of cardiovascular disease, diabetes, and cancer

Major Forms Of Cardiovascular Disease

Atherosclerosis Coronary artery disease and heart attack. Stroke. Peripheral arterial disease. Congestive heart failure. Congenital heart defects. Rheumatic heart disease. Heart valve disorders.

Designing your exercise program

Best exercise program: •Promotes health. •Is fun to do. Start slow and move up the physical activity pyramid.

The Immune System: Cells, Tissues, and Organs

Beyond surface barriers, the immune system operates through a network of billions of white blood cells. •Actually two interacting systems: the innate immune system (first to respond) and the adaptive immune system. Cells of the innate immune system: •Neutrophils. •Eosinophils. •Macrophages. •Natural killer cells. •Dendritic cells, which engulf pathogens. Cells of the adaptive immune system: Lymphocytes: two main types of white blood cells capable of exquisite specificity and immunological memory—T cells and B cells. •Have receptors that allow it to recognize one specific antigen. •B cells proliferate and become plasma cells that secrete antibodies. •T cells differentiate into helper T cells, killer T cells, or suppressor T cells. •Some B and T cells become memory B and T cells that respond rapidly when they encounter a known invader. Antigens: substances that trigger the immune response. Antibodies: specialized proteins that can recognize specific antigens. Inflammatory response: Macrophages engulf the invading microbe and convey danger to other immune system cells. •Resulting response causes blood vessels to dilate and fluid to flow out of capillaries into the injured tissue. •Pus—dead white blood cells and debris—may collect at the site of infection. Immune response: Phase 1, recognition: dendritic cells are drawn to the site. Phase 2, proliferation: helper T cells multiply. •Production of killer T and B cells. •Cytokines: chemical messengers. Phase 3, elimination: killer T cells strike. •Cell-mediated immune response. •Antibody-mediated immune response. Phase 4, slowdown: Some memory T and B cells remain. Immunity: •Usually, after an infection, a person has immunity to the same pathogen. •Memory T and B cells continue to circulate in the blood and lymphatic system. •Adaptive immunity: immunity to infection acquired by the activation of antigen-specific lymphocytes in response to infection or immunization. Lymphatic system: Vessels that carry lymph; and certain organs and structures. •Spleen, lymph nodes. Vessels pick up excess fluid from body tissues and clear it of debris and pathogens. As the immune response progresses, a lymph node actively involved in fighting infection may fill with cells and swell—thus physicians use the location of swollen lymph nodes as a clue to an infection's location.

Body Composition

Body composition: the proportion of fat and fat-free mass (muscle, bone, and water) in the body. •Healthy body composition has a high proportion of fat-free mass and a low level of body fat, adjusted for age and sex. Best way to lose fat is through a lifestyle that includes a sensible diet and exercise. Best way to add muscle mass is through resistance training such as weight training.

Body Image and Eating Disorders

Body image: the mental representation a person holds about his or her body, consisting of perceptions, images, thoughts, attitudes, and emotions. Severe body image problems: Body dysmorphic disorder (BDD). •Constant preoccupation with body imperfections. •Related to obsessive-compulsive disorder. Muscle dysmorphia. Eating disorders are psychological disorders, characterized by severe disturbances in body image, eating patterns, and eating-related behaviors. •Anorexia. •Bulimia. •Binge-eating disorder. •Other specified feeding or eating disorder (OSFED). Heredity and environment both play roles, as do turning points in life. •Coping with stresses.

Body Mass Index

Body mass index (BMI) is useful for classifying the health risks of body weight. •Correlated with but does not directly measure body fat. Body weight (in kilograms) divided by the square of height (in meters). •Alternatively, the weight in pounds divided by the square of height in inches, multiplied by 703 (the conversion factor). Standards set by the NIH: •Between 18.5 and 24.9 is healthy. •Greater than 25 is overweight. •Greater than 30 is obese. •Under 17.5 is sometimes used as a diagnostic criterion for anorexia nervosa. BMI is not helpful for determining body composition because it does not distinguish between fat weight and fat-free weight. •Can be inaccurate for shorter people, muscular athletes, and older adults.

What is the Right Weight for you?

Body weight and body shape are influenced by heredity. Changes should be lifestyle changes. Let a healthy lifestyle determine your weight.

Bulimia Nervosa

Bulimia nervosa is characterized by recurring episodes of binge eating followed by purging. Characteristics: •Rapid consumption of food, followed by purging. •Eating in secret. •After a binge, feeling ashamed, disgusted, and physically and emotional drained. Health risks of bulimia nervosa: •Eroded tooth enamel. •Deficient calorie intake. •Liver and kidney damage. •Cardiac arrhythmia. •Chronic hoarseness. •Esophageal tearing. •Rupture of the stomach. •Menstrual problems. •Depression.

Basic Facts About Cancer

Cancer is an abnormal and uncontrollable multiplication of cells or tissue that can lead to death if untreated. •Tumor: a mass of tissue that serves no purpose. •Benign tumor: a mass of cells enclosed in a membrane that prevents their penetration into other tissues. •Malignant tumor: can invade surrounding tissues, including blood vessels, the lymphatic system, and nerves. Every case of cancer begins as a change in a cell that allows it to grow and divide when it should not. Once there is a suspicion of cancer, a patient will have a biopsy—the removal of tissue to allow for microscopic examination. Metastasis is the spread of cancer cells from one part of the body to another. •Cancer cells move away from the primary tumor. •New tumors are called secondary tumors or metastases.

Common Types of Cancer

Cancers are classified according to the types of cells that give rise to them. •Carcinomas—the most common—arise from the epithelial tissue that covers body surfaces (linings, tubes, cavities, and secretion glands). •Sarcomas arise in connective and fibrous tissues (bone, muscle, cartilage, and membranes covering muscle or fat). •Lymphomas: cancers of the lymph nodes. •Leukemias: cancers of the blood-forming cells, chiefly in bone marrow. Cancers vary greatly in how easily they can be detected and how well they respond to treatment. In general, it is difficult for an oncologist or hematologist to predict how a specific cancer will behave. •Oncologist: a specialist in the diagnosis and treatment of cancer. •Hematologist: a specialist in the diagnosis and treatment of blood disorders, including cancers such as leukemia and lymphoma.

Carbohydrates- An important source of energy

Carbohydrates supply energy for body cells. Simple carbohydrates: •Monosaccharides: single sugar molecule. •Glucose, fructose, galactose. •Disaccharides: pairs of single sugars. •Sucrose, maltose or malt sugar, and lactose. Complex carbohydrates: multiple sugar units. •Starches and fiber. During digestion, carbohydrates are broken down into glucose for absorption. •Glycogen: starch stored in liver and muscles. Refined carbohydrates versus whole grains: All grains are whole grains before processing. •Inner layer: germ. •Middle layer: endosperm. •Outer layer: bran. During processing, the germ and bran are removed, leaving just the starch of the endosperm. These refined carbohydrates are lower in fiber, vitamins, minerals, and other beneficial compounds. Added sugars refers to white sugar, brown sugar, high-fructose corn syrup, and other sweeteners added to most processed foods. •Foods that tend to be high in calories and low in essential nutrients and fiber. •High intake is associated with dental cavities, excess weight, and type 2 diabetes. Sugars in your diet should come mainly from whole fruits and from low-fat milk and other dairy products. Recommended carbohydrate intake: •On average, Americans consume 200 to 300 grams daily. •130 grams are needed to meet the body's requirements for essential carbohydrates. •AMDR: 45 to 65% of total daily calories, or 225 to 325 grams. •Focus should be on consuming a diet rich in complex carbohydrates, especially whole grains. •Athletes can benefit from high-carbohydrate diets.

Cardiovascular Diseases

Cardiovascular disease (CVD) refers to the development of diseases that affect the heart and blood vessels. •Heart disease, heart attack, stroke, angina, blood vessel diseases, arrhythmias, congenital heart defects, and other conditions. CVD is the leading cause of death in the United States. •Affects more than 92 million Americans. •Claims about 2300 American lives ever day. •CVD results largely from our way of life.

Disease Prevention and Management

Cardiovascular disease: Sedentary life is one of six major risk factors of CVD. Exercise specifically lowers risk of: •Coronary heart disease. •Stroke. Regular physical activity also reduces risk of: •Cancer. •Type 2 diabetes.

Cardiovascular System

Cardiovascular system (CVS) consists of the heart and blood vessels—both arteries and veins. •Transport blood through the body. When lungs are included, the system is known as the cardiorespiratory or cardiopulmonary system. Heart is a four-chambered muscle, fist-sized muscle. •Pumps deoxygenated blood to the lungs and oxygenated blood to the rest of the body. Pulmonary circulation: right side of the heart pumps blood to the lungs. Systemic circulation: left side of the heart pumps blood through the rest of the body. Path of blood flow: •Superior vena cava and inferior vena cava. •Right atrium. •Right ventricle. •Pulmonary arteries to the lungs. •Pulmonary veins to the left atrium. •Left ventricle. •Aorta. Each heartbeat consists of two basic parts: •Systole: heart's contraction. •Diastole: period of relaxation. Blood pressure: force exerted by the blood on the walls of blood vessels. •Created by the pumping action of the heart and the resistance of the blood vessels. Veins carry blood to the heart. •Thin walls. Arteries carry blood away from the heart. •Thick elastic walls that expand and relax with the volume of blood. •Smallest arteries are capillaries. •Coronary arteries: the two large vessels, right and left, that supply blood to the heart.

Preventing and Managing Athletic Injuries

Care for injuries that may occur: •R-I-C-E principle: Rest-Ice-Compression-Elevation. Six basic guidelines: •Stay in condition. •Warm up thoroughly before exercising. •Use proper body mechanics. •Do not exercise when ill or overtrained. •Use the proper equipment. •Do not return to normal exercise program until the injury has healed.

Cancers of the Female Reproductive Tract

Cervical cancer: Sexually transmitted infection or disease. •HPV virus. Smoking, immunosuppression, prolonged use of oral contraceptives. Screening: Pap test. HPV vaccines have been approved by the FDA. Treatment: surgery, chemotherapy, radiation. Uterine, or endometrial, cancer: Most often occurs after 55. Risk factors similar to those of breast cancer. Treatment is surgery. •Hysterectomy, or removal of the uterus. Five-year relative survival rate: 84% for white women, 62% for Black women. Ovarian cancer: •Difficult to detect and diagnose; no warning signs. •Risk factors: age, genetics, higher number of ovulations. •Treatment is surgical removal of the ovaries, the fallopian tubes, and the uterus. •Radiation and chemotherapy are sometimes used. •Survival rate after five years is over 90% for localized tumor but is only 47% for all stages.

Dietary Challenges for Various Population Groups

College students. Pregnant and breastfeeding women. Older adults. Athletes. People with special health concerns

Congestive heart failure.

Congestive heart failure or cardiomyopathy results from damage to the heart's pumping mechanism. •Cannot maintain regular pumping; fluid backs up. •Pulmonary edema: fluid accumulates in the lungs. Controlled by: •Reducing the workload on the heart. •Modifying fluid and salt intake. •Drugs that help the body eliminate excess fluid.

Spread of Disease: Symptoms and Contagion

First phase of infection: the incubation period. •May not have symptoms; may be contagious. Second and third phases: may "feel a cold coming on." •Symptoms first appear during the prodromal period. Many symptoms are due to the immune response. You may be contagious before you have symptoms. You may continue to have symptoms when no longer contagious.

Increasing Physical Activity and Exercise

Current guidelines for weekly exercise: •At least 150 minutes of moderate-intensity aerobic physical activity, or 75 minutes of vigorous-intensity aerobic activity. •For more extensive health benefits, increase activity to 300 minutes of moderate-intensity activity or 150 minutes of vigorous-intensity activity. •Adults should do muscle-strengthening activities of moderate or high intensity that involve all major muscle groups on two or more days a week. •Everyone should avoid inactivity. Reducing sedentary time: •Regardless of whether physical activity goals are met, too much time sitting is detrimental to health.

Dietary Guideline for Americans

Designed to encourage improved nutrition and physical activity. Major themes expected to influence the 2020-2025 Dietary Guidelines: •Approach food choices from a full lifespan perspective. •Focus on dietary patterns. •Shift to healthier food and beverage choices. •Limit calories from red and processed meats, sugar-sweetened foods and beverages, and refined grains. Support healthy eating patterns for all. Eating pattern: result of choices on multiple eating occasions over time. Three healthy eating patterns: •Healthy U.S.-Style Pattern. •Healthy Vegetarian Pattern. •Healthy Mediterranean-Style Pattern. All three emphasize whole fruits, vegetables, whole grains, beans and peas, fat-free and low-fat milk and milk products, and healthy oils. Less red meat; more seafood. Making shifts to align with healthy eating patterns: •Most Americans need to make changes to their current food and beverage choices. Supporting healthy eating patterns: •People are more likely to shift their eating patterns if we make a collaborative effort.

Detecting, Diagnosing, and Treating Cancer

Detecting cancer: •Self-monitoring and routine cancer checkups. Diagnosing cancer: •Biopsy. •Magnetic resonance imaging (MRI); computed tomography (CT); ultrasonography. Treating cancer: •Surgery. •Chemotherapy: use of medications to kill cancer cells. •Radiation.

Diabetes

Diabetes mellitus causes a disruption of normal metabolism. Type 1 diabetes: •Immune system destroys insulin-producing cells in the pancreas. Type 2 diabetes: •Strongly associated with excess body fat. •Pancreas does not produce enough insulin, body cells have become resistant, or both. Gestational diabetes. Prediabetes.

DASH Eating Plan

Dietary Approaches to Stop Hypertension (DASH) eating plan was developed to help people control high blood pressure. Tailored with special attention to sodium, potassium, and other nutrients that affect blood pressure.

Fiber - A closer look

Dietary fiber: nondigestible carbohydrate that is present naturally. •Soluble (viscous) fiber such as in oat bran or legumes. •Insoluble fiber. Functional fiber: nondigestible carbohydrate that has been isolated or synthesized. Total fiber is the sum of both dietary fiber and functional fiber. High-fiber diet can help reduce risk of type 2 diabetes, heart disease, and pulmonary disease and is linked to numerous other health benefits. Sources of fiber: •All plant foods. Recommended fiber intake: •38 grams for adult men. •25 grams for adult women. •Needs to come from foods, not supplements.

Approaches to Overcoming a Weight Problem

Doing it yourself: Set reasonable goals. •Loss of 1 to 2 pounds per week recommended. Develop a plan that you can maintain over the long term. Diet media: •Reject gimmicks. •Seek books that advocate a balanced approach. Dietary supplements and diet aids: •Formula drinks and food bars, herbal supplements, and others: claims are often false. Weight loss programs: •Noncommercial: TOPS (Take Off Pounds Sensibly); OA (Overeaters Anonymous). •Commercial: Weight Watchers. •Commitment and a plan for maintenance are important. •Online diet websites combine self-help with group support. •Clinical weight loss programs are medically supervised. Prescription drugs: •Appetite suppressants. •All have potential side effects. •Work best in conjunction with behavior modification. •Once drugs are stopped, most individuals return to their original heavy weight. •Good option for the very obese who need help getting started. Surgery: Severe obesity is a medical condition. •NIH recommends gastric bypass for individuals with a BMI of 40, or greater than 35 with an obesity-related illness.

Skin Cancer

Easily detectable; and the most common forms are highly curable. Risk factors: •Exposure to ultraviolet (UV) radiation. •Sunburns and suntans, especially in childhood. •Fair skin. •Depleted ozone. •Moles. •Spending time at high altitudes. •Family history. •Basal cell carcinoma and squamous cell carcinoma. •Melanoma is the most dangerous form. Prevention: •Avoid long-term overexposure to sunlight. •Protection from sun: sunscreen and clothing. Detection and treatment: •Signs in skin lesions: ABCDE.

Protecting Yourself Against Cardiovascular Disease

Eat heart-healthy. •Decrease saturated and trans fat intake. •Eat a high-fiber diet. •Reduce sodium intake and increase potassium intake. •Avoid excessive alcohol consumption. •Eat foods rich in omega-3 fatty acids. Additional dietary options: •Plant stanols and sterols. •Folic acid, vitamin B-6, and vitamin B-12. •Calcium. •Vitamin D. •Soy protein. •Healthy carbohydrates. •Reduced daily caloric intake. DASH: Dietary Approaches to Stop Hypertension Exercise regularly. Avoid tobacco products. Know and manage your blood pressure. Know and manage your cholesterol levels. Develop effective ways to handle stress and anger.

How Did I Get to Be My Weight

Energy balance is key to maintaining healthy body weight and keeping a healthy ratio of fat to fat-free mass. Body takes in energy (calories) and uses energy (calories) to maintain vital body functions. To change weight, the balance must be tipped. •Positive energy balance. •Negative energy balance. Carbohydrate-insulin model argues that the primary cause of obesity is overeating refined carbohydrates Multi-factor model suggests that genetic, metabolic, psychological, cultural, and socioeconomic factors are all involved. Genetic factors: •Influence body size and shape, body fat distribution, and metabolic rate. •Affect the ease with which weight is gained and where on the body it is added. •Set point theory suggests our bodies are designed to maintain a stable "set point." Fat cells: •Amount of fat (adipose tissue) the body can store is a function of the number and size of fat (adipose) cells. •Overeating in childhood can create more fat cells. Metabolism: •Resting metabolic rate (RMR): energy (calories) required while the body is at rest. •Genetics affects metabolic rate. •Exercise can have a modest positive effect on RMR. Hormones: •Especially in women, play a role in the accumulation of fat. •Insulin, leptin, and ghrelin are all thought to be linked to obesity. Gut microbiota: •Intestinal flora help digest foods and produce some vitamins. •Lean people differ from overweight people in the composition of their intestinal flora. •Diets high in processed foods have been linked to less diverse intestinal flora. Psychology, culture, and behavior: •Many people use foods as a means of coping. •Binge eating and other unhealthy patterns can develop. •Prevalence of obesity goes down as family income goes up. Sleep: •Short sleep duration and sleep debt are associated with increased BMI and abdominal obesity. Food marketing and public policy: •"Obesogenic" environments encourage overconsumption and discourage physical activity.

Fats- another essential nutrient

Fats (lipids) are the most concentrated source of energy. •Store energy; provide insulation and support. •Major fuel during rest and light activity. Nine calories of energy per gram. Linoleic acid and alpha-linolenic acid are essential. Triglycerides: most fats in foods. Types: saturated or unsaturated; monounsaturated; polyunsaturated. Hydrogenation and trans fats: •Hydrogenation changes some unsaturated fatty acids in trans fatty acids. •Trans fats are associated with increased low-density lipoprotein cholesterol (LDL, the "bad" cholesterol) and decreased high-density lipoprotein cholesterol ( HDL, the "good" cholesterol). Recommended fat intake: •Limit unhealthy fats. •AMDR for fats is 25 to 35% of total daily calories.

Other Patterns of Disordered Eating

Feeding or eating disorders that do not meet the diagnostic criteria for anorexia, bulimia, or binge-eating disorder may be classified as other specified feeding or eating disorders (OSFED). •Atypical anorexia nervosa. •Bulimia nervosa with limited duration. •Purging disorder. •Night eating syndrome. •Avoidant restrictive food intake disorder (ARFID). •Orthorexia.

Food Biotechnology

Food irradiation kills potentially harmful pathogens. •There are few irradiated foods on the market due to consumer skepticism. Genetically modified (GM) foods: •Supporters cite improved yields, increased disease resistance, better nutritional content, lower prices, and less pesticide use. •Most Americans want to know if their food contains genetically modified organisms (GMOs). •Foods certified as organic do not contain GM ingredients.

Arteriosclerosis

Form of arteriosclerosis, or thickening and hardening of the arteries. •Plaques accumulate in artery walls. Effects can be deadly. Coronary heart disease (CHD) or coronary artery disease (CAD). •Heart attack; stroke. Main risk factors: tobacco use, physical inactivity, high blood cholesterol levels, high blood pressure, and diabetes.

Cardiorespiratory Endurance Exercise

Frequency: Three to five times weekly. Intensity: Increased maximal oxygen consumption (V̇O2max). Target heart rate zone: the range to reach and maintain during exercise to obtain benefits. •Heart rate monitor. •METs: measures of the metabolic cost of an exercise. Time (duration): 20 to 60 minutes per workout. Type: Stress a large portion of the body's muscle mass for a prolonged period of time. •Walking, jogging, running, swimming, bicycling, aerobic dance. Volume of activity: 150 minutes per week of moderate-intensity activity; or equivalents in calories, MET-minutes, or steps. Progression: Rate depends on goals, fitness, health, age, and adaptation. Warm up and cool down.

Major Risk Factors that Cant Be Changed

Genetics: CVD has a genetic component associated with high cholesterol levels, blood clotting, and obesity. Age: about 70% of heart attack victims are 65 and older. Gender: men have higher risk earlier in life. •Estrogen production may protect against CVD in premenopausal women. Race and ethnicity: African Americans have a higher risk of hypertension, heart disease, and stroke.

Coronary artery disease and heart attack.

Heart attack, or myocardial infarction (MI), is usually the result of a chronic disease process. Damage to heart tissue from lack of oxygenated blood. Symptoms: •Chest pain or pressure. •Arm, neck, or jaw pain. •Difficulty breathing. •Excessive sweating. •Nausea and vomiting. •Loss of consciousness. About one-third of heart attack victims do not suffer chest pain. Angina: •Arteries are narrowed by disease. •Stressed heart cannot receive enough oxygen. •Angina pectoris—chest pain—is usually relieved by rest or nitroglycerin. Arrhythmias and sudden cardiac death: Electrical conduction system disrupted. Ventricular fibrillation. Cardiac defibrillation. •Automated external defibrillators (AEDs). Helping a heart attack victim: •Most deaths from a heart attack happen within two hours of initial symptoms. •Know the main warning signs. •Aspirin has an immediate anticlotting effect. •If no pulse found: cardiopulmonary resuscitation (CPR). Detecting and treating heart disease: Electrocardiogram (ECG or EKG). If symptoms or noninvasive tests indicate coronary artery disease: coronary angiogram. Treatments: •Balloon angioplasty. •Statin, or cholesterol-lowering medication. •Aspirin. •Other prescription drugs. •Coronary bypass surgery.

Contributing Risk Factors that Can Be Changed

High triglyceride levels are a reliable predictor of heart disease. Inflammation plays a key role in the development of CVD. Psychological and social factors: •Stress. •Chronic hostility and anger. •Depression. •Anxiety. •Social isolation. •Low socioeconomic status. Alcohol and drugs can cause serious cardiac problems

Possible Risk Factors Currently Being Studied

Homocysteine, an amino acid circulating in the blood at elevated levels. Infectious agents. Levels of lipoprotein(a), or Lp(a), which has a strong genetic component. LDL particle size. Uric acid.

Water- Vital but Underappreciated

Human body is 50 to 60% water. Humans can live up to 50 days without food but only a few days without water. Water is used in digestion and the absorption of food and is the medium in which chemical reactions take place. To maintain hydration, daily: •Men: 3.7 total liters of water, with 3.0 liters (13 cups) coming from beverages. •Women: 2.7 total liters of water, with 2.2 (9 cups) coming from beverages.

The Body Defense System

Immune system is the body's collective set of defenses against infection. •Protects us not just from pathogens (disease-causing organisms) but also from cancer. Physical and chemical barriers are the first line of defense. •Skin. •Mucous membranes. •Respiratory tract, lined with both mucous membranes and cilia.

Immunization

Immunization, such as by administering a vaccine, primes the body to remember an encounter with a specific antigen. Some people question whether vaccines do more harm than good; but decreases in vaccination rates can result in outbreaks of dangerous infectious diseases. •International travel contributes. Types of vaccines: •Attenuated organisms. •Killed viruses. Vaccine efficacy: Due in part to misinformation, some people question whether vaccinations do more harm than good. In the past century, vaccines have helped increase the average American life span by approximately 30 years. Vaccines are approved by advisory committees with expert knowledge in virology, microbiology, statistics, epidemiology, and pathogenesis. Strict testing is done before vaccines are licensed. Side effects are rare and usually mild. •Must be balanced against the risks of the disease that is prevented.

Stroke

In a stroke, or cerebrovascular accident (CVA), blood supply to the brain is cut off, and brain tissue subsequently dies. Ischemic stroke: impeded blood supply to the brain caused by a clot obstructing a blood vessel. •Thrombotic stroke, caused by a thrombus. •Embolic stroke, caused by an embolus. Hemorrhagic stroke: a blood vessel ruptures in the brain. •Intracerebral hemorrhage, within the brain. •Subarachnoid hemorrhage, on the brain's surface. •Aneurysm: a sac or outpouching formed by a distention or dilation of the artery wall. Effects of a stroke: Interruption of the blood supply to any area of the brain prevents the nerve cells from functioning, in some cases causing death. Those who survive have some lasting disability. •Paralysis. •Walking disability. •Speech impairment. •Memory loss. •Changes in behavior. Recognizing a stroke: •Ask the person to smile; unevenness is a sign of a possible stroke. •Ask the person to hold his/her limbs out; if only one can be moved or only one can be held still, there is a stroke possibility. •Trouble speaking may be a sign that a stroke has occurred. •Decreased sensation, numbness, or tingling in limbs can indicate stroke. Detecting strokes: •Transient ischemic attack (TIA) is a mini-stroke with temporary stroke-like symptoms. •Computed tomography (CT), MRIs, and ultrasound are used for diagnosis. Treatment: •Various drug therapies. •Rehabilitation: physical therapy; speech and language therapy; occupational therapy.

Defining Healthy Weight, Overweight, and Obesity

Is your body at a healthy weight? •Overweight: total body weight above the recommended range for good health. •Obesity: more serious degree of overweight that carries multiple health risks. Several methods are used to evaluate body weight and percent body fat. •Body composition. •Body mass index (BMI). •Body fat distribution.

Energy

Kilocalories (kcal) are the measure of energy in food. 1 kilocalorie is the heat needed to raise the temperature of 1 liter of water 1°C; commonly referred to as a calorie. 2000 kcal per day typically meets a person's energy needs. Energy is the capacity to do work; calories measure energy. Sources of energy: •Fat = 9 calories per gram. •Protein = 4 calories per gram. •Carbohydrates = 4 calories per gram. Nutrient density: the ratio of a food's essential nutrients to its calories.

Positive Body Image: Finding Balance

Knowing when you've reached the limits of healthy change is crucial. Weight management must take place in a positive and realistic atmosphere.

Training un Specific Skills

Learn the skills required for the sport or activity in which you choose to participate. Get help. •Instruction from a qualified instructor.

The Chain of Infection

Links in the chain: (1) Pathogen: disease-causing microorganism. (2) Reservoir: natural environment of the pathogen—person, animal, or environmental component. (3) Portal of exit: discharge. (4) Means of transmission: direct and indirect. •Vector: carrier of the pathogen from one host to another. (5) Portal of entry: skin penetration; inhalation; ingestion. •Pathogens that enter the bloodstream or lymphatic system cause a systemic infection. (6) New host.

Body Fat Distribution

Location of fat on your body is an important indicator of health. Waist circumference. Waist-to-hip ratio. Apple shape: android obesity. •Upper regions of the body, particularly abdomen. •Increased risk of high blood pressure, diabetes, early-onset heart disease, stroke, and cancer. Pear shape: gynoid obesity. •Fat storage in the hips, buttocks, and thighs.

Problem Associated with Very Low Levels of Body Fat

Low levels of body fat are a threat to wellness. •Reproductive, circulatory, and immune system disorders. Extremely lean people are more likely to suffer from dangerous eating disorders. Female athlete triad: •Abnormal eating patterns (and excessive exercising). •Amenorrhea: absence of menstruation. •Decreased bone density (premature osteoporosis).

Staying With Your Program

Maintain your program by exercising regularly at consistent intensity, 3 to 5 days a week. Adapt your program to changes in the environment or your schedule. Discover what motivates you. Cross-training can add variety to your workouts. •Try new activities.

risk factors of cardiovascular disease

Major risk factors that can be changed: •Tobacco use. •High blood pressure. •High cholesterol. •Physical inactivity. •Obesity. •Insulin resistance and metabolic syndrome. •Diabetes. Major risk factors that can't be changed: •Genetics. •Age. •Gender. •Race and ethnicity.

Minerals

Minerals help to regulate body functions and release energy, aid in growth, and maintain body tissues. About 17 essential minerals. Major minerals: 100 milligrams or more needed per day. •Calcium, phosphorus, magnesium, sodium, potassium, and chloride. Trace minerals: minute amounts. •Copper, fluoride, iodide, iron, selenium, zinc. Issues may arise if too many or too few. •Iron-deficiency anemia. •Osteoporosis.

The Incidence of Cancer

More than 1.7 million Americans are diagnosed yearly. •Five-year survival rate for all cancers (2007-2013) is 69%. Men are more likely to die from cancer. •Higher rates of tobacco use. •Higher rates of alcohol use and abuse. •Greater occupational exposure to carcinogens. •Less use of preventive measures, less contact with health care providers. Screening and self-examinations are crucial.

Prostate Cancer

Most common cancer in men. Risk factors: age, diet, lifestyle, genetic predisposition. Early detection is key. •Prostate-specific antigen (PSA) test. •Digital rectal exam (DRE), which may find cancer in men with normal PSA levels. Treatment: •Varies based on stage and age of patient. •Five-year survival rate is now nearly 100%.

Breast Cancer

Most common cancer in women. Risk factors: •Genetics. •Early onset of menstruation. •Late onset of menopause. •Having no children or having the first after age 30. •Current use of hormone replacement therapy. •Obesity. •Alcohol use. •Estrogen is the common factor in many of these. Detection: early detection is key. •Mammogram, followed up by ultrasonography if necessary. •Breast awareness and understanding warning signs. Treatment and prevention: •Surgery, chemotherapy, radiation. •Monoclonal antibodies. •Selective receptor modulators (SERMs). Five-year survival rates •99% if detected before it has spread; 90% for all stages.

Lung Cancer

Most common cause of cancer death in the United States. •About 136,000 deaths per year. Risk factors: smoking contributes to 80% of lung cancer deaths. Detection and treatment: Difficult to detect and hard to cure. Treatment depends on type and stage of cancer. •Surgery, chemotherapy, radiation. Five-year survival rate for all stages is only 19%.

Protecting Yourself against Foodborne Illness

Most foodborne illness is caused by pathogens. •Salmonella. •Norovirus. •Campylobacter jejuni. •Toxoplasma. •Escherichia coli (E. coli) O157:H7. •Listeria monocytogenes. •Clostridium perfringens. •Staphylococcus aureus—most often resulting from improper hand washing. Preventing and treating foodborne illnesses: Raw foods are the most common source of foodborne illnesses. Food safety principles: •Clean hands, food contact surfaces, and vegetables and fruit. •Separate raw, cooked, and ready-to-eat foods while shopping, storing, and preparing foods. •Cook foods to a safe temperature. •Chill (refrigerate) perishable foods promptly.

Additives in Food

Most widely used food additives are sugar, salt, and corn syrup. Health concerns have appeared over certain additives. •Nitrates and nitrites. •BHA and BHT. •Sulfites.

Muscular Strength, Endurance, and Flexibility

Muscular strength: the amount of force a muscle can produce with a single maximum effort. •Vital for healthy aging. Muscular endurance: the ability to resist fatigue and sustain a given level of muscle tension. •Important for good posture and injury prevention. Flexibility: the ability of joints to move through their full range of motion.

Treating Eating Disorders

Must address eating behaviors and misuse of food to manage stress and emotions. Psychotherapy and medical management. Anorexia nervosa: averting a medical crisis. •Adequate body weight; psychological aspects. Bulimia nervosa and binge-eating disorder: stabilizing the eating patterns. •Identifying and changing the patterns of thinking. •Improving coping skills.

USDA's MyPlate

MyPlate shows how to use the five food groups at each meal. Energy intake and portion sizes: •Food group goals should be based on an appropriate level of energy intake. •When your weight is stable, your current energy intake is sufficient. Dietary Guidelines recommend that adults who are obese or overweight shift their eating and physical-activity behaviors to prevent additional weight gain and/or promote weight loss Focus on whole fruits, which are rich in carbohydrates, dietary fiber, and many vitamins (especially vitamin C). Two cups of fruit daily. •Choose whole fruits over fruit juices. Serving size—1 cup equivalent. •1 cup fresh, canned, or frozen fruit. •1 cup 100% fruit juice. •1 small whole fruit. •1/2 cup dried fruit. Vary your vegetables. Naturally low in calories and fat. Contain carbohydrates, dietary fiber, carotenoids, vitamin C, folate, potassium, and other nutrients. 2 ½ cups of vegetables a day. •Half your plate should be fruits and vegetables. Serving size—1 cup equivalent. •1 cup cooked or raw vegetables. •2 cups raw leafy salad greens. •1 cup of vegetable juice. Make half your grains whole grains. Low in fat and rich in complex carbohydrates, dietary fiber, vitamins, and minerals. 6 ounce-equivalents each day—with half from whole grains. Serving size—1 ounce-equivalent. •1 slice of bread. •1 small muffin (2.5 diameter). •1 cup of ready-to-eat cereal flakes. •1/2-cup of cooked cereal, rice, grains, or pasta. 1 6-inch tortilla Vary your protein routine. Meat, poultry, fish, dried beans and peas, eggs, nuts, seeds, and processed soy foods. Provide protein, niacin, iron, vitamin B-6, zinc, and thiamin. •Animal foods contain B-12. 5 ½ ounce-equivalents daily. Serving size—1 ounce equivalent. •1 ounce cooked lean meat, poultry, fish. •1/4 cup cooked dry beans or tofu. •1 egg. •1 tablespoon peanut butter. 1/2 ounce nuts or seeds Move to low-fat and fat-free dairy. High in protein, carbohydrate, calcium, potassium, riboflavin, and vitamin D. Three cups of milk or the equivalent daily. Serving size—1 cup equivalent. •1 cup milk or yogurt. •1/2 cup ricotta cheese. •1 ½ oz. natural cheese. 2 oz. processed cheese. Oils: Oils and fats that are liquid at room temperature. •Mostly from plant and fish sources. Major sources of vitamin E and unsaturated fatty acids, including essential fatty acids. 6 teaspoons (27g) per day. Serving size—1 teaspoon equivalent. •1 teaspoon of vegetable oil or soft margarine. •1 tablespoon mayonnaise-type salad dressing. If your diet is consistently nutrient-rich, a small amount of additional calories in the form of solid fats and added sugars can be consumed. Physical activity is important. •2½ hours of moderate physical activity or 1¼ hours of vigorous physical activity per week.

Improved Psychological and Emotional Wellness

Reduced anxiety and depression. Improved sleep. Reduced stress. Enhanced self-esteem, self-confidence, and self-efficacy. Enhanced creativity and intellectual functioning. Increased work productivity. Increased opportunities for social interaction.

Benefits of Exercise

Reduced risk of premature death. Improved cardiorespiratory functioning. More efficient metabolism and improved cell health. Improved body composition. Disease prevention and management. Improved psychological and emotional wellness. Improved immune function. Prevention of injuries and low-back pain. Improved wellness for life.

Components of a Healthy Diet

Nutrition: science of food and dietary supplements, and how the body uses them in health and disease. Essential nutrients: about 45 nutrients we must get from food. Proteins, fats, carbohydrates, vitamins, minerals, and water. •Macronutrients: protein, fat, carbohydrate, and water; important nutrients required in relatively large amounts. •Micronutrients: vitamins and minerals; important nutrients required in minute amounts. These nutrients are available to the body through digestion—the process of breaking down foods into compounds the body can use.

Body Fat and Wellness

Obesity doubles mortality rates and can reduce life expectancy by 10 to 20 years. Obesity is associated with a number of chronic conditions. •Diabetes, cardiovascular disease, and many others. •Also associated with complications of pregnancy, psychological disorders, and increased surgical risk. Modest weight loss results in psychological improvements and improved quality of life for many.

First Steps

Obtain medical clearance. •Previously inactive men over 40 and women over 50 should get a medical exam before beginning an exercise program. •Diabetes, asthma, heart disease, and extreme obesity are conditions that may call for a modified program. •If you have an increased risk of heart disease, get a physical checkup including an electrocardiogram (ECG or EKG). Observe the basic principles of physical training: Specificity: perform exercises specifically designed for each fitness component. Progressive overload: placing increasing amounts of stress on the body causes adaptations that improve fitness. •FITT-VP: frequency, intensity, time, type, volume, and progression. Rest and recuperation. Reversibility: fitness improvements are lost when demands on the body are lowered. Individual differences. Select activities that work for you.

Organic Foods; and Fish Consumption

Organic foods: •These must meet certain criteria to be USDA certified. •Whether or not they are more healthy, they are better for the environment. Guidelines for fish consumption: •Mercury contamination is a concern, especially for women who are or may become pregnant, nursing mothers, and children.

Testicular Cancer

Relatively rare, but the most common cancer in U.S. men aged 20 to 35. Risk factors: European Americans; fathers who had testicular cancer; undescended testicles. Self-exam may help in early detection. Treatment: testicle is removed and, if the tumor has spread, chemotherapy is used. Five-year survival rate is 96% if regional.

Heart Disease and Other Chronic Conditions

Overweight and obesity are risk factors for: •Heart disease. •Metabolic syndrome. •Certain types of cancer.

Peripheral arterial disease.

Peripheral arterial disease (PAD) refers to atherosclerosis in the arteries of the limbs, which can limit or block blood flow. Risk factors: diabetes and use of tobacco products. Symptoms: •Claudication: aching or fatigue in limb. •Rest pain: occurs even when not physically active.

Components of an Active Lifestyle

Physical activity is any body movement carried out by the skeletal muscles that requires energy. •Activity is arranged on a continuum based on the amount of energy it requires. Exercise is a subset of physical activity. •Planned, structured, repetitive movement of the body intended to improve or maintain physical fitness. Moderate-intensity physical activity is essential to health.

What is Physical Fitness

Physical fitness: the body's ability to respond or adapt to the demands and stress of physical effort. Five components of health-related fitness: •Cardiorespiratory endurance. •Muscular strength. •Muscular endurance. •Flexibility. •Body composition.

Stages of Cancer

Physicians classify the disease according to the extent of the cancer in the patient's body, based on: •Size of the primary tumor. •Whether the cancer has invaded nearby lymph nodes. •Whether metastases are present. Remission: signs and symptoms of cancer disappear. •Disease is under control.

Flexibility Exercises

Proper stretching technique: •Static stretching. •Dynamic stretching. •Ballistic stretching (not recommended). Frequency: •2 to 3 days a week (5 to 7 is optimal). Intensity, time, volume, and progression: •Each muscle group for 60 seconds. •Increase intensity over time. Progressively build flexibility.

Proteins - The Basis of Body Structure

Proteins form parts of muscle, bone, blood, enzymes, hormones, and cell membranes. Amino acids: the building blocks of proteins. •There are 20 common amino acids. •Nine are essential. •11 are nonessential—meaning the body can produce them. Complete proteins provide all essential amino acids. Most animal proteins are complete proteins. Most plant proteins are incomplete proteins. •Legumes, nuts. •Certain combinations yield complete proteins. Recommended protein intake: 0.8 gram per kilogram of body weight. AMDR: 10 to 35% of total daily calorie intake. •Food and s Board's recommendations are called Acceptable Macronutrient Distribution Ranges, or AMDRs.

Colon and Rectal Cancer

Risk factors: Age and heredity—vast majority of cases diagnosed after 45 years of age. •Many cancers arise from preexisting polyps—small growths on the wall of the colon. Lifestyle—especially alcohol use Nonsteroidal anti-inflammatory drugs may decrease risk. Detection and treatment: Regular screening beginning at age 45. Surgery is the primary treatment. Five-year survival rate with early detection is 90%.

Causes of Cancer

Role of DNA: •Certain genes predispose some people to cancer. •Specific genetic mutations have been associated with cancer. •Some mutations are inherited, while others are caused by environmental agents. Tobacco use: Smoking is responsible for about a third of all cancer deaths Dietary factors: Certain food choices can increase your cancer risk by exposing you to dangerous compounds; while others are potentially protective. Limit dietary fat and meat. Avoid alcohol. Avoid foods cooked at high temperatures. Consume plenty of fiber. Consume plenty of fruits and vegetables. •Carotenoids. •Phytochemicals. Increased physical activity and a healthy body weight are related to a reduction in cancer risk. Being overweight or obese is linked to increased risk of death from several kinds of cancer.

Getting Started and Staying on Track

Selecting instructors, equipment, and facilities: •Finding help and advice. •Selecting equipment. •Choosing a fitness center. Eating and drinking for exercise: •Maintain a balanced diet. •Drink water before and during exercise.

Skill-Related Components of Fitness

Skill-related fitness involves the ability to perform a particular sport or activity. •Speed: to perform a movement quickly. •Power: to exert force rapidly, based on a combination of strength and speed. •Agility: to change position quickly and accurately. •Balance: to maintain equilibrium while either moving or stationary. •Coordination: to perform motor tasks accurately and smoothly using body movements and the senses. •Reaction time: to respond quickly to a stimulus.

Adopting a Healthy Lifestyle for Successful Weight Management

Slow weight gain is a major cause of overweight and obesity. Dietary patterns and eating habits: Dietary Guidelines for Americans; MyPlate; DASH. Pay attention to total calories. •To maintain weight, calories consume must equal calories expended. Pay attention to portion sizes. Replace energy-dense foods with nutrient-dense foods. Eat regular, balanced meals. Physical activity and exercise: Positive effects on metabolism. •Increased muscle mass. Improves cardiovascular and respiratory health. Enhances mood, sleep, self-esteem, and your sense of accomplishment. Thinking and emotions: Weight problems are associated with low self-esteem and negative emotions. •"Ideal self." •Self-talk can be self-deprecating or positively motivating. Coping strategies: Develop appropriate coping strategies to deal with the stresses of life. •Analyze your eating habits with fresh eyes.

Carcinogens in the Environment

Some environmental carcinogens are natural, like UV rays; others are not. Microbes, including viruses, bacteria, and parasites, account for 15 to 20% of the world's cancers. •Helicobacter pylori—stomach cancer. Hepatitis B and C—cause as many as 80% of all liver cancers Ingested chemicals: •Preservatives and additives. •Nitrosamines: nitrates and nitrites combined with dietary substances; highly potent carcinogens. Environmental and industrial pollution: •Occupational exposure may account for about 4% of cancer deaths. Radiation: •Medical scans. •Sunlight.

Dietary Reference Intakes (DRIs)

Standards for nutrient intakes in order to prevent deficiencies. Set of four values used for recommended intakes and maximum safe intakes. •Recommended Dietary Allowances (RDAs). •Adequate Intake (AI). •Estimated Average Requirement (EAR). •Tolerable Upper Intake Level (UL). Daily Values: the U.S. Food and Drug Administration uses these for food labels. Based on a 2000-calorie diet.

Managing Your Fitness Program

Start slowly, and get in shape gradually: •Beginning phase. •Progress phase. •Maintenance phase. Exercise consistently. Assess your fitness.

A Personal Plan: Making Informed Choices About Food

Use the information provided on food labels. Note calorie labeling required of certain restaurants and vending machines. Dietary supplements must not be taken in excess. Not authorized or tested by the FDA. Not a substitute for a healthy diet. People who benefit from supplements: •Women capable of getting pregnant—folic acid. •People over 50—vitamin B-12. •Smokers—vitamin C.

Nutritional Guidelines: Planning Your Diet

Variety of tools are designed to help: •Dietary Reference Intakes (DRIs): standards designed to prevent nutritional deficiencies and reduce the risk of chronic disease. •Dietary Guidelines for Americans: established to promote health and reduce the risk of major chronic diseases through diet and physical activity. •MyPlate: a helpful food guidance system.

Major Risk Factors that Can Be Changed

Tobacco use: •Nearly one in five deaths can be attributed to smoking. •When smokers have heart attacks, they are two to three times more likely than nonsmokers to die of them. •Cigarette smoking also doubles the risk of stroke. High blood pressure, or hypertension: Too much pressure against arterial walls. Systolic and diastolic blood pressure (mm Hg). •Normal blood pressure = below 120 systolic/80 diastolic. Primary (essential) hypertension: underlying cause unknown. Secondary hypertension: caused by an identifiable underlying illness. Under newly updated blood pressure guidelines, 46% of adults have hypertension; the rate is highest in African Americans. Lifestyle changes can control hypertension. High cholesterol: Excessive cholesterol clogs the arteries. Low-density lipoproteins (LDLs)—"bad." •Shuttle cholesterol from liver to organs and tissues. •Can accumulate on artery walls and be oxidized by free radicals. High-density lipoproteins (HDLs)—"good." •Shuttle unused cholesterol back to liver for recycling. •By removing cholesterol from blood vessels, help protect against atherosclerosis. Controlling high cholesterol: •Guidelines for treatment of blood cholesterol are based on an individual's risk of developing CVD in the next 10 years. •Lifestyle modifications. •Statin therapy is recommended at different intensity doses if lifestyle modifications are unsuccessful. Physical inactivity: An estimated 40 to 60 million Americans are so sedentary that they are at high risk for developing CVD. Exercise reduces risk by: •Controlling blood pressure and resting heart rate. •Lowering LDLs. •Increasing HDLs. •Maintaining weight. •Improving the condition of blood vessels. •Preventing or controlling diabetes. Obesity: •Risk of death from CVD is two to three times more likely at a body mass index (BMI) ≥ 30. Insulin resistance and metabolic syndrome: •With increased weight, muscles, fat, and liver become less sensitive to the effect of insulin. •Those who have insulin resistance tend to have several other related risk factors—together called metabolic syndrome. Diabetes: Higher rates of other risk factors: •Hypertension. •Obesity. •Unhealthy blood lipid levels. Elevated blood glucose and insulin can damage the endothelial cells lining the arteries. •More vulnerable to atherosclerosis. People with prediabetes are also at increased risk.

Exercise for Muscular Strength and Endurance

Types of strength-training exercises: •Resistance exercises. •Isometric (static) exercises. •Isotonic (dynamic) exercises. •Core training. Sex differences in muscular strength: •Testosterone. •Skeletal size and speed of nervous system control. Choose appropriate equipment. Work all major muscle groups. Frequency: at least two nonconsecutive days a week. Intensity, time, volume, and progression: •Do enough to fatigue your muscles. •Progress slows as you become more fit. Beware of supplements and performance-enhancing drugs, which can have dangerous side effects.

Choosing a Plant-Based Diet

Vegetarians restrict or exclude foods of animal origin. •Vegans. •Lacto-vegetarians. •Lacto-ovo-vegetarians. •Partial vegetarians. •Semivegetarians. •Pesco-vegetarians. Food plan for vegetarians needs to include vitamin B-12, vitamin D, calcium, iron, and zinc.

Vitamins--Organic Micronutrients

Vitamins are organic (carbon-containing) substances required in small amounts to regulate various processes in cells. Thirteen vitamins: •Four fat-soluble: A, D, E, and K. •Nine water-soluble: C, and the B-complex vitamins thiamin, riboflavin, niacin, vitamin B-6, folate, vitamin B-12, biotin, and pantothenic acid. Functions of vitamins: •Help chemical reactions take place; help unleash energy; produce red blood cells; maintain nervous, skeletal, and immune systems; and act as antioxidants. Sources of vitamins: •Human body does not manufacture most vitamins. •Abundant in fruits, vegetables, and grains. Certain vitamin deficiencies are associated with health risks. Vitamin excesses can be harmful, even toxic.

Congenital heart defects.

malformations of the heart or major blood vessel. •Hypertrophic cardiomyopathy.

Heart valve disorders.

•Abnormalities in valves between chambers of the heart. •Mitral valve prolapse (MVP).

Rheumatic heart disease.

•Streptococcal infection leading to rheumatic fever, which causes damage to the heart muscle and valves.