Section II: A Client-Centered Approach to Personal Training

MyPlate Daily Food Plan

A guide to healthy eating from the United States Department of Agriculture.that aims to make Americans eat a more balanced diet through a simple and easy to understand visual includes a personalized system to help people determine and individualized their eating plan and caloric needs

Transtheoretical Model of Change (Stages of Change Model)

A lifestyle modification model that suggests that people go through distinct, predictable stages when making lifestyle changes: precontemplation, contemplation, preparation, action, and maintenance. The process is not always linear. Four Components: stages of change, processes of change, self-efficacy, decisions balance

Adequate Intake (AI)

A recommended nutrient intake level that, based on research, appears to be sufficient for good health.

rapport

A relationship marked by mutual understanding and trust.

percent daily value (PDV)

A replacement for the percent Recommended Dietary Allowance (RDA) on the newer food labels. Gives information on whether a food item has a significant amount of a particular nutrient based on a 2,000-calorie diet.

Dietary Approaches to Stop Hypertension (DASH) eating plan

An eating plan designed to reduce blood pressure; also serves as an overall healthy way of eating that can be adopted by nearly anyone; may also lower risk of coronary heart disease. - low in saturated fat, cholesterol, and total fat

contemplation stage

Consist of people who are still in active but are thinking about becoming more active in the near future (within the next six months).

Key Guideline 2 (dietary guidelines)

Focus on variety, nutrient density, and amount To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts Choosing Nutrient dense foods helps to meet nutrient needs, manage weight, and may have health benefits because of the high levels of vitamins and minerals -Vegetables: Eat vegetables from all subgroups (dark green, red and orange, legumes (beans and peas), starchy, and other. -Fruits: eat whole fruits, including fresh, frozen, canned and dried forms to obtain key nutrients including dietary fiber, potassium, and vitamin C. Do not consume Moree than half of fruit from fruit juice. -Grains: majority of grain consumption comes from whole grains. - Dairy: adults should aim for 3 cups per day of milk, and children older than 3 should consume 2.5 cup in order to obtain necessary nutrients. (plant based milk replacements are not considered as high in nutritional value and are not explicitly recommended) - protein foods: include a diversity of foods from plant and animal sources (*seafood*, meats, poultry, eggs, nuts, seeds, and soy products) - Oils: consume aout 5 tsp of oil per day through oils present in olives, nuts, avocados, seafood, etc.

Key guideline 1 (dietary guidelines)

Follow a healthy eating pattern across the lifespan - all food and beverage choices matter - choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy and reduce the risk of chronic disease Healthy eating pattern includes: - a variety of vegetables from five subgroups - dark green, red and organ, legumes (beans and peas), starchy and others. - fruit. -grains, primarily whole grains. - fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy products. - a variety of foods rich in protein, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. - limited amount of saturated fats (less than 10% of calories), trans fat (as low as possible), added sugars (less that 10% of calories), and sodium (less than 2300 mg per day). If alcohol is consumed, it should be consumed in moderation, defined as up to one drink per day for women and two drinks per day for men. one drink is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. Three types of healthy eating patterns include: healthy U.S-style eating pattern, the Healthy Mediterranean-Style Eating Pattern, and the Healthy Vegetarian Eating Pattern.

Protein Supplementation

Goal is to boost protein intake and ensure consumption of a particular protein type or amino acid. Most popular hydrolysates are whey and casein. Whey offers numerous health benefits, including increase muscle hypertrophy and muscular strength (when combined with muscular training) and bone growth. Some suggest that a combined supplementation of whey and casein offers the greatest muscular strength improvements following a 10 week intensive muscular training program.

Preparation goals and strategies

Goals: co-create an action plan with frequent positive feedback and reinforcements on the progress Strategies: verify that the individual has the underlying skills for behavior change and encourage small steps towards building self-efficacy, identify and assist with problem-solving obstacles, assist client in identifying social support and establishing goals

Contemplation goals & strategies

Goals: collaboratively explore available options, support cues to action and provide basic structure guidance upon request Strategies: validate lack of readiness to change and clarify that this decision is theirs, encourage evaluation of the pros and cons of making change, identify and promote new and positive outcome expectations and his self-confidence

Action goals and strategies

Goals: establish the new behavior as a habit through motivation and adherence to the desired behavior Strategies: use behavior modification strategies, empower clients to restructure cues and social support toward building long term change, increase awareness of inevitable lapses and bolster self efficacy in coping with lapses, support client in establishing systems of accountability and self monitoring

Precontemplation goals & strategies

Goals: increase awareness of risks and benefits, focus on addressing something relevant to them, have them start thinking about change Strategies: validate lack of readiness to change and clarify that this decision is that's, encourage reevaluation of current behavior and self exploration while not taking action, explain and personalize the inherent risk, utilize general sources, explored the clients personal values

Maintenance goals and strategies

Goals: maintain support systems, maintain interest in avoid boredom or burn out Strategies: reevaluate strategies currently in effect, plan for contingencies with support systems (may not be needed, reinforce the need for transition from external to internal rewards, plan for potential lapses, encourage reevaluation of goals and action plans as needed

action stage

In this stage the client is ready to begin exercising Need self-monitoring approaches utilize effective teaching techniques provide feedback (provide reinforcement for what was done well, correct errors, motivate clients to continue practicing and improving)

Medications and Exercise

Medications can alter the biochemistry of the body and may affect a client's ability to perform or respond to exercise properties of these drugs must be understood by the personal trainer and discussed with the client many medications affect the heart's response to exercise responses are usually dose-dependent

decisional balance

One of the four components of the transtheoretical model; refers to the numbers of pros and cons an individual perceives regarding adopting and/or maintaining an activity program. *Important to emphasize a wide variety of benefits of being physically active and avoid refuting the cons they perceive about exercise

sarcoplasmic reticulum

Organelle of the muscle fiber that stores calcium.

Sources of self-efficacy

Past performance experience (ask about previous experience with exercise) Vicarious experience (having the observation or knowledge of someone else who is successfully participating in similar program) Verbal Persuasion (providing verbal encouragement and statements of belief - important motivational tool for pt) Physiological state appraisals (important to help clients evaluate appraisals of their physiological states to create positive interpretations and teach clients to identify muscle fatigue soreness, and tiredness) Emotional State and mood appraisals (give encouraging coaching cues and tailor programs that are challenging yet simply mastered which can elevate moods and positive emotional states) Imaginal experiences (preconceived notion of exercise - encourage positive imagined experiences by asking open-ended questions like how you imagine you';; feel when you reach your goal...)

Process of change

Second component of the TTM that entails the processes of change that people used to move through the stages

How a Pt can help clients decrease sodium intake

Set goals to: -read notion labels and pay attention to sodium content. - Consume more fresh foods and fewer processed foods. - eat more home prepared meals and add little table salt or sodium containing seasonings. - when eating out, ask that salt not be added. -reduce calorie intake (since most foods also contain sodium.

Associative stage of learning

The second stage of learning a motor skill, when performers have mastered the basics and can concentrate on skill refinement ready for specific feedback pt must balance the giving of appropriate feedback without providing too much info that might overwhelm the learning

precontemplation stage

The stage during which people are physically inactive and are not even intending to begin and activity program. Do not see physical activity as relevant and may even discount importance and practicality of being physically active

Autonomous stage of learning

The third stage of learning a motor skill, when the skill has become habitual or automatic for the performer. pt is doing less teaching and more observing may decide to teach some progressions or introduce new exercises or routines to being process over again

Learning Styles

The ways people think and learn. visual, auditory kinesthetic

carbohydrate loading

Up to a week-long regimen of manipulating intensity of training and carbohydrate intake to achieve maximum glycogen storage for an endurance event.

controlled motivation

doing a task with a sense of pressure, demand, or coercion. (extrinsic motivaiton)

fitness indicators for SMART goal setting

emotional health indicators-mood energy sleep stress resting heart rate - decrease in resting after first few months of program heart rate during a given sub maximal workload- muscular strength and endurance - decrease in exercise heart rate in first few months walking test - fitness improvements after a couple of weeks flexibility- progress is slow balance skill level - measured with motor skill test or activitygame performance medical indicators-bp, sugar levels, diet changes, body should be measured periodically and is affected by other factors besides exercise program body weight- poor indicator, clients should work towards low and consistent weight loss body size- body composition changes looseness in clothes body composition- body testing

autonomous motivation

engaging in activities out of free will and with the desire to do so (intrinsic motivation)

factors that complicate behavior change

environmental influences (physical, social) it is ongoing, not a single event, and factors that influence change change over time behavioral intention and action are not the same

B-alanine supplement

found in fish and meat, precursor to carnosine which has numerous important physiological functions including calcium, enzyme, and pH regulation. good for high intensity exercise .

investigation stage

gather information through lifestyle and health history questionnaires - use this stage to learn and understand a client's exercise likes and dislikes and their reason for exercising requires active listening (when the pt listens to a client carefully, empathetically, and with an open mind) Motivational interviewing (a method of speaking with people in a way that motivates them to make a decision or change their behavior - emphasizes establish rapport, reducing resistance, and eliciting a client's own rationale for change/change talk) - offer affriatmaitons, reflective listening, and summering Focus on engaging, focusing, evoking, and planning

nutritional supplements with little to no evidence not support efficacy and/or apparent safety

glutamine: said to increase lean body mass and/or muscular performance but little to no scientific evidence to support that. arginine: said to increase exercise performance but scientific literature has not reported a beneficial ergogenic result. Carnitine: said to increase the bioavailability of carnittine and enhance overall capacity fo lipid metabolism but research does reports no significant alters toto total muscle carnitine content etc. Chronic use of antioxidants: said to counter the increase in free radicals from exercise but research fins that supplementations hampers favorable exercise training adaptations and interferes with the recovery process.

tips for creating an environmental where psychological needs are met

(1) crating opportunities for mastery experiences through offering appropriately challenge exercises and consistent positive feedback (promoting competence) (2) including the client in aspects of goal setting and p program design (promoting autonomy) (3) encouraging a sense of camaraderie Among the client and others in. the fitness setting (promote relatedness)

post exercise hydration

- Goal is to fully replace fluid and electrolyte deficits. - consuming sodium will help recovery by stimulating thirsts and fluid retention. - if the client will have at least 12 hours to recover before the next strenuous workout, then rehydration the the usual meals and snacks and water should be adequate. - if rapid recovery is needed, drink 1.5L/kg (23ox per lb) of body weight lost

tips for clients when grocery shopping

- check produce for bruises and feel and smell for ripeness. - look for a sell by date for breads and naked goods, a use by date on some packaged foods and an expiration date on years and baking powder, and a packaged date on canned and some packaged foods. - make sure packaged goods are not torn and cans are not dented, cracked, or building. - separate fish and poultry form other purchases by wrapping them separately in plastic bags. - pick refrigerated and frozen foods last. make sure all perishable items are refrigerated within on hour of purchase.

steps to safe food handling

- clean hands, food contact surfaces, and fruits and vegetables. meat and poultry should not be washed or rinsed. - separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods. - cook foods to a safe termparature to kill microorganisms. pregnant women should eat only certain deli meats and frankfurters that have been reheated to steaming hot. - refrigerate perishable food promptly (within two hours) and defrost foods properly. eat refrigerated leftovers within three and four days. - avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs, or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juice, and raw sprouts. this is especially important for infants and young children, pregnant women, older adults and those who are immunocompromised.

Creating a caring task involving climate

- emphasizing process goals rather than outcome goals - do not compare clients to one another - celebrate the accomplishments each time using positive encouraging remarks and positive feedback - to promote feelings of belonging and relatedness consider introducing clients to one another

Social support strategies

- find an enjoyable and reliable exercise partner (introduce clients to one another or consider small group training) - ask friends and family for support and if they have similar interests/goals - ask for reminders from support system about goals and appointments - set up "contests" with friends that's include rewards on meeting process goals (meeting for a scheduled walk 10 times without a sense) - add a social element (arriving early for chat time) - find an enjoyable activity involving movement (dancing, bowling, or hiking)

when is medical clearance needed

- for those who do not exercise regularly: (perform plan dsttructured workouts for at least 30 min at moderate intensity at least 3 days a week): if the client has cardiovascular, metabolic, or renal disease, or signs o symptoms that suggest he or she does, then medical clearance is necessary. - for regular exercisers: if the clients has signs or symptoms suggestive of cardiovascular , metabolic, or renal disease, he or she should discontinue exercise and seek medical clearance. if the client has a known history of of cardiovascular , metabolic, or renal disease and has a desire to progress to vigorous-intensity aerobic exercises, medical clearance is recommended

tips to prepare the gut for exercise or competition

- get acclimatized to heat - stay hydrated. - practice drinking during training to improve competition day comfort. - avoid eating too much before exercise. - avoid high energy, hypertonic food and drinks before (within 30-60min) and after exercise. limit protein and fat intake before exercise. - limit nonseroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen, alcohol, caffeine, antibiotics, and nutritional supplements before and during exercise as they can cause GI discomfort. the client should experiment doing training to identify his or her triggers. - urinate nad defecate prior to exercise. -consult a physician if GI problems persist, especially abdominal pain, diarrhea, or bloody stool.

caffeine supplement

- natural stimulant found in coffee, tea, and also many nutritional supplements. - evidence suggesting that ttit serves as effective ergogenic aid for aerobic and anaerobic exercise perofmace, - ingested orally it is quickly absorbed in to the bloodstream and peaks within 30 to 60 min. - mechanistically effects the CNS, primarily by antagonism of adenosine receptors, which results in enhanced mood, reduced perception of pain, and increased attention. - promotes enhanced sodium/potassium pump activity, greater calcium release from the sarcoplasmic reticulum and increased fat oxidant/glycogen sparing. - been recommended that a dos of approx 3-6 mg/kg of body weight of caffeine ingested 30-60 min prior to exercise will increase work capacity, time to exhaustion, and reduced perceived effort during endurance exercise.

symptoms that should be medically examined

- pain; discomfort (or other angina equivalent) in the chest, neck, jaw, arms, or other areas that may result from myocardial ischemia - shortness of breath at rest or with mild exertion (dyspnea) - Orthopnea (dyspnea in a reclined position) or paroxysmal nocturnal dyspnea (onset is usually two to five hours after the beginning of sleep) - dizziness or syncope, most commonly caused by reduced perfusion to. Brian - ankle edema - palpitations or tachycardia - intermittent claudication (pain sensations or cramping in the lower extemities during exercise that is associated with inadequate blood supply) - known heart murmur - unusual fate or shortness of breath with usual activities

specific strategies to help clients shift eating pattern

- partner with individuals to increase awareness of the foods and beverages that make up their own or their family's eating patterns and identify areas where they can make small changes that align with the Dietary guidelines, such as modifying recipes or food selection. - enhance self-efficacy with skills like gardening, cooking, meal planning, and label reading. - explore ways that individuals can model healthy eating behaviors for friends and family. - co-create plans to help clients limit screen time and time spent being sedentary and increase physical activity.

lifestyle and health-history questionnaire should include

- past and present exercise and physical-activity information - medications and supplements - recent or current illnesses or injuries, including chronic or acute pain. - surgery and injury history. - family medical history - lifestyle information (related to nutrition, stress, work, sleep, etc.)

practical nutritional support/guidance

- provide grocery store tours; stick to the perimeters - collaborating with registered dietitians; know when it is outside of your scope of practice and a referral is needed.

pre exercise meal/snack should be:

- relatively high in carbohydrate to maximize blood glucose availability (1 to 4.5 g of carbohydrates per kg of body weight) - Relatively low in fat and fiber to minimize gastrointestinal distresss and facilitate gastric emptying. - moderate in protein. - approx 400 -800 calories - an amount that should fuel the exercise without causing noticeable sluggishness or fullness. - something that is well-tolerated by the individual.

important risk modulators for health screening

- the individuals current level of physical activity. -diagnosed cardiovascular, metabolic, or renal disease and/or the presence of signs or symptoms of cardiovascular, metabolic, or renal disease - the desired exercise intensity

goals of preparticipation health screening

- to identify who should receive medical clearance before initiating an exercise program or increasing the frequency, intensity, and/or volume of their current program - to identify who, with clinically significant diseases, may benefit from participating in a medically supervised exercise program - to identify who has medical conditions that may require exclusion from exercise programs until those conditions are resolved or better controlled

post-exercise carbohydrate ingestion

-most important factor determining the timeframe to recovery is muscle glycogen replenishment, - post-exercise carbohydrate ingestion is critical to synthesis of muscle glycogen. - two phases, a rapid rate that persists for 30-60 minted after exercise cessation and a considerably reduce rate (60-90%) in the time period after. - important.my, eating carbohydrates in smaller amounts overtime is more effective at restoring muscle glycogen then eating at one or two larger amounts less frequently.

Additional forms needed

-preparticipation health screening - agrees,ent to participate -an informed consent/assumptions of risk form -lifestyle and health-history questionnaire - Medical release.

lifestyle and health history questionnaire

A type of form utilized by personal trainers and healthcare processions that gathers an individuals personal medical information, family health history, and individual health behaviors

Postion on supplements

ACE recognizes that some fitness and health clubs encourage or require their employees to sell nutritional supplements try to... - obtain complete scientific understanding regarding safety and efficacy of supplements for qualified healthcare professionals and/or credible resources ( www.ods.od,nih.gov , www.nccam.nih.gov , www.fda.gov). - stay up to date on legal and/or regulatory issues. - obtain adequate insurance coverage should a problem arise.

other credible sources for nutrition info

Academy of nutrition and dietetics Canada's dietary guidelines for health professionals and policy makers Harvard university's healthy eating plate

Estimated Average Requirement (EAR)

An adequate intake in 50% of an age and sex specific group.

perceived seriousness

An individual's feeling. regarding the severity associated with developing an illness or disease. This is one of the four constructs of the health belief model

perceived susceptibility

An individual's perception of the risk of personal vulnerability to illness or disease. This is one of the four constructs of the health belief model

OARS: the core communication skills of motivational interviewing

Asking open-ended questions offering affirmations reflective listing summarizing

Spirit of Motivational Interviewing

Collaboration, acceptance, compassion, evocation

Key Guidelines 3 (dietary guidelines)

Limit calories from added sugars and saturated fats and reduce sodium intake Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns. -Added Sugars: no more than 10% of calories should come from added sugars Saturated Fats: recommend containing less than 10% of total calories from saturated fat as it is associated with increased LDL cholesterol which increases the risk for cardiovascular disease. trans fats: also increases LDL and cardiovascular risk and should consume as little artificial trans fat as possible Sodium: high levels associated with high BP and increased risk for cardiovascular disease, congestive heart failure, and kidney daises and so people should consume less than 2300mg or less than 1500mg for higher risk individuals

Key Guideline 4 (dietary guidelines)

Shift to healthier food and beverage choices Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain. Examples - shift from high calorie snacks (tortilla chips with cheese dip) to nutrient dense snacks (carrots with hummus dip) - shift from fruit products with added sugar (fruit filled cereal bar) to whole fruit (apple)

SMART goals

Specific, Measurable, Attainable, Realistic, Timely

Maintenance stage

Stage of change marked by regular physical activity participation for longer than six months. P

Preparation stage

Stage of change marked by some engagement in physical activity as individuals are mental and physically preparing to adopt an activity program. Activity during this stage may be a sporadic walk, or even a periodic visit to the gym but it is *inconsistent* Ready to adopt and live in active lifestyle

Action stage

Stage of change or people are engaging in regular physical activity but I've been doing so for less than six months

how to help clients eat healthy on a budget

Support client sin accessing additional support as needed through established programs, such as Supplemental Nutrition Access Program. Provide resources upon client requests, such as lists of local food pantries. Collaboritively brainstorm money-saving shopping tips, such as buying in bulk, using coupons, purchasing generic or store brands, and considering frozen over fresh produce when most economical.

Key Guideline 5 (dietary guidelines)

Support healthy eating patterns for all Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities Interventions should extend well beyond providing traditional education to individuals and families about healthy choices, and should help build skills, reshape the environment, and reestablish social norms to facilitate individuals healthy choices

New Nutrition Facts Label

The FDA released this (May 2016): -Refreshed Design -Greater understanding of nutrition science -Updated serving size requirements and new labeling requirements for certain package sizes - increase font size and bold type for "calories" and "serving size" - PDV. added for vitamin D, calcium, iron, potassium - types of fat listed

cultural competence

The ability to communicate and work effectively with people from different cultures. taking the time to learn about client's beliefs, attitudes, values, lifestyles.

Cognitive stage of learning

The first stage of learning a motor skill when performers make many gross errors and have extremely variable performances. movements are uncoordinated a jerky utilize the "tell, show, do" teaching technique be careful not to overwhelm clients by teaching them toto many new or complex motor skills

Tolerable Upper Intake Level (UL)

The levels of intake of essential nutrients that on the basis of scientific knowledge, are judged by the Food and Nutrition Board to be adequate to meet the known. person needs of practically all healthy persons

Recommended Dietary Allowance (RDA)

The maximum intake of a nutrient that is unlikely to pose risk of adverse health effects too almost all individuals in and age- and sex- specific group.

social support

The perceived comfort, caring, esteem, or help an individual receives from other people

Acceptable Macronutrient Distribution Range (AMDR)

The range of intake for a particular energy source that is associated with reduced risk of chronic disease while providing intakes of essential nutrients.

Dietary Supplement Health and Education Act (DSHEA)

a bill passed by congress in 1994 that sets forth regulation and guidelines for dietary supplements -structure/function claims are regulated (calcium build strong bones)

physical activity readiness questionnaire for Everyone (PAR-Q+)

a brief, self-administered medical questionnaire recognized as a safe pre-exercise screening measure for low-to-moderate (but not vigorous) exercise training -regularly updated and revised -different versions depending on the clientele

Dietary Reference Intakes (DRIs)

a generic term used to refer to three types of nutrient reference values: Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), and Tolerable Upper Intake Level (UL).

operant conditioning

a learning. approach that considers the manner in which behaviors are influenced by their consequences examines relationship between antecedent behaviors and consequences examines behavior chains that lead to engagement of certain behavior and avoidance of others

stimulus control

a means to break the connection between events or other stimuli and a behavior; in behavioral science, sometimes called "cue extinction" Adjusting the environment to increase the likelihood of healthy behaviors valuable tool in behavior modification e.g. setting a reminder on computer 15 min before I ts time to leave to the gym so theres no more rushing and being late for scehduled exercise sessions

Acute Myocardial Infarction (AMI)

a myocardial infarction resulting from a ute obstruction of a coronary artery

motivational interviewing

a person-centered conversation style that encourages clients to honestly examine beliefs and hebairos, and that motivates clients to make a decision to change a particular behavior *helpful to make them put into their. own words reasons for making behavior change if and when they want to *discussed benefits should be both short and long term

self-determination theory

a psychological theory suggesting that people need to feel autonomous, competent, and connected to others in many domains of life - infers that different type of motivation (intrinsic, extreinsic) influence the extent to thwihc a person will seek out new activities and persevere at a given task

readiness to change

a reference to how likely someone is to make a behavioral change based on their current stage of change (precontemplation, contemplation, preparation, action, or maintenance) according to the transtheroretical model of behavior change

Goal Setting Theory

a theory of motivation developed by psychologist Edwin Locke and Gary Latham that identified a connection between the establishment of goals and task performance four primary mechanisms: directed attention, mobilized efforts, persistence, strategy variables that effect goal setting: goal commitment, goal importance, self-efficacy, feedback, task complexity

NIH Body weight planner

a tool that accounts for the metabolic changes that occur during weight loss and more accurately predicts the timeline for weight loss. allows someone to enter their age, sex, weight high and current-physical activity level, goal weight, planned activity level, and goal time frame and it determines the caloric needs to maintain the current weight, reach a goal weight in a specified amount of time, and sustain the new body weight based on planned physical-activity levels.

hyponatremia

abnormally low levels of sodium ions circulating in the blood; severe levels can lead obtain swelling and death

sodium bicarbonate supplement

an alkalizing substance that has been found to improve recovery by increasing the muscle buffering capacity it mediates an ergogenic effect by promoting removal of protons from the skeletal muscle milieu. Main drawback is that some individuals experience gastrointestinal distress with ingestion. Recommended dosage and timeframe is 0.2 to 0.4 gams/kg with 1 liter of fluids at 60 to 120 minutes pre-exercsie.

lapses

an expected slip or mistake that is usually a discreet event and is a normal part of the behavior-change process

inherent. risks with exercise

an increased risk for harm in indivuduals who are unhealthy presenting with exertional signs and symptoms suggestive of a disease or who have been diagnosed with an e existing cardiovascular, metabolic, or renal disease and p lan on performing vigorous tot near-maximal-intensity exercise - individuals with underlying cardiovascular disease performing unaccustomed vigorous physical activity are at the greater trisk for activity associated acute myocardial infarction (AMI) and sudden cardiac death (SCD) - due to. this a health screening must be performed on all new participants, regardless of age, upon entering a facility that offers exercise equipment or services

Angiotensin II receptor antagonists drugs and its effect on exercise

antihypertensive agents (blockers) do not adversely affect blood lipid profile or cause rebound hypertension after discontinuation

innate psychological needs

autonomy (so that they feel like their behavior is self-determined), competence (positive feedback helps), relatedness (feeling like they belong and are connected to others and their environment promote intrinsic motivation)

pt's with nutrition cert or CEC's in nutrition scope of practice

be prepared to educate clients and discuss topics such as: - principles of healthy nutrition and food preparation - food to be included in the balanced daily diet essential nutrients needed by the body - actions of nutrients on the body - effects of deficiencies or excesses of nutrients - how nutrient requirements vary through the lifecycle - principles of pre- and post-workout nutrition and hydration - information about nutrients contained in foods or supplements

nonverbal communication

communication using body movements, gestures, and facial expressions rather than speech components include: voice quality, eye contact, facial expressions, hand gestures, body position.

fueling during exercise

goal is to provide the body with the essential nutrients needed by muslce cells and to maintain optimal blood glucose levels. -when exercise lasts longer than 1 hour, blood glucose levels begin to dwindle - after 1 -3 hours of continuous moderate-intensity exercise, muscle glycogen stores may become depleted.and performance falters. - to maintain a ready energy supply athletes should consume glucose containing beverages and snacks - athletes should consume 30-60 grams of carbohydrates per hour of training, - especially important for prolonged exercise in extreme heat, cold, or high alttititudes.

Hydration during exercise

goal of fluid intake during exercise is to prevent performance diminishing or health altering effects from dehydration or hyponatremia, guidelines include: - Aim for 1:1 fluid replacement/loss ratio (usually about .4-.8 L or 8-16oz/hr, but varies by individual) - Drink fluid with sodium during prolonged exercise >2 hrs especially in hot environment to prevent hyponetremia - Drink carbo-containing sports drinks to combat fatigue because muscle glycogen gets depleted and blood glucose becomes primary fuel (choose a drink or snack that contains 30-60 grams of carbohydrates)

domains of multifaceted interventions

home: develop skills in meal planning and cooking, build in time for family physical activity. School: commit to offering only healthy meals and snack, provide nutrition labels and info in cafeterias, communicate with parents, increase quality nutrition education, school gardens, support physcial-activit programs, high quality physical education, active play. Worksite: offer health and wellness programs that include nutritional counseling, m active breaks, flexible schedule that allow for physical activity and walking meetings, stand up desks. Community: support shelters, food banks, farmers markets, community gardens and walkable communities. Food Retail: reach out to consumers about making healthy changes; increase access to healthy and affordable food options.

Hydration before exercise

if fewer than 8 to 12 hours have elapsed since the last intense training session than an individual may benefit. from a rehydration program - drink 5-7ml/kg at least 4 hours before exercise (12-17 ounces for a 154 lb person) - if urine is not produced or is very dark, drinks nother 3-5 mL/kg (0.05-0.08 oz per pound) -sodiium contains beverages or salted snacks will help retain fluid

daily nutritional goals for age-sex groups based on DRI's and dietary guidelines (IMAGE)

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sudden cardiac death (SCD)

immediate death resulting from. a sudden change in the rhythm of the heart usually caused by heart rhythms that are too fast. this condition is also called cardiac arrest

relapse

in behavioral change, the return of an original problem after many lapses (i.e. slips or mistakes) have occurred

actions outside the scope of practice of personal trainers (for nutrition)

include but are not limited to: - personalized nutrition recommendations or meal planning other than that which is available through government guidelines and recommendation, or has been developed and endorsed by an RD or physician. - nutritional assessment to determine nutritional needs and nutritional status, and to recommend nutritional intake. - specific recommendations or programming for nutrient or nutritional intake, caloric intake, or specialty diets. - nutritional counseling, education, or advice aimed to prevent, treat, or cure a disease or condition, or other acts that may be perceived as medical nutrition therapy. - development, administration, evaluation, and consultation regarding nutritional care standards or the nutrition care process. - recommending, prescribing, selling, or supplying nutritional supplements to clients. promotion or identification of oneself as a "nutritionist" or "dietician."

rapport stage

initial stage of the personal trainer/client relationship Time spent establishing a good working relationship enhances adherence to behavior-change program develop empathy develop and use cultural competence positive first impressions emphasize positive verbal and nonverbal communication keep professional boundaries

Ergogenic

intended to enhance physical performance, stamina, or recovery

how to set health and fitness goals that motivate clients for long term adherence

listen carefully to understand what clients hope to accomplish with an exercise program help them define specific, measurable goals suggest additional goals that clients may not have thought of, such as feeling more. energetic and less. stressed break large goals (reachable in six months or more) into small goals (reachable in three to six months) and even weekly goals (such as completing a. certain number of exercise sessions) include many process goals, such as the completion of exercise sessions. in other words, simply completing workouts accomplishes a goal record goals and set up a record-keeping system to record workouts and track progress towards goals beside clients understand. what types of exercise will help them reach their health and fitness goals reevaluate and revise goals and exercise recommendations periodically to prevent discouragement if large goals are not being met

post exercise fueling

main foal is to replenish glycogen stores and facilitate muscle repair. - the average client training at moderate intensities every few days does not need aggressive post-exercise replenishment. - athletes following vigorous training regiments will benefit from strategic refueling, - best post-workout meals contain mostly carbohydrates with some protein. - refueling should being within 30 minutes after exercise and be followed by a high-carbohydrate meal within two hours. - a carbohydrate ini take of 1.5g/kg body weight in the first 30 min after exercise and then every two hours for 4 to 6 hours is recommende. - amount of refueling ultimately depends on the intensity and duration of training session.

Pre-exercise fueling

main goals: (1) optimize glucose availability and glycogen stores. (2) provide the fuel needed tot support exercise performance. - individuals preparing for long endurance events might consider carbohydrate loading. - athlete who plan to work for an extended duration in the early afternoon should consider eating a wholesome, carbohydrate-rich breakfast. - those who workout in the morning may benefit from a carbohydrate rich snack before bed. - eat a small carbohydrate and protein containing snack 30-60 minutes before exercise to help increase glucose availability.

bronchodilators and its effect on exercise

medications relax and open the air passages in the lunges allowing better air exchange stimulates sympathtic nervous system increases exercise capacity for people with bronchoconstriction but o otherwise have minimal effect on resting and exercise HRs and BPs

diuretics drugs and its effect on exercise

medications the increase the excretion of water and electrolytes through the kidneys prescribed for high BP or when a person is accumulating too much fluid as with congestive heart failure. no primary effect on HR can lead to cardiac arrhythmias may predispose client to dehydration so adequate fluid intake should be emphasized.

creatine supplement

most effective supplement available for fitness enthusiasts to increase high-intensity performance and muscle mass. increases skeletal muscle mass during exercise training. -long term safety is well established. - essential substrate for the phosphates energy system and involved in ATP regeneration during high intensity exercise. - supplementation can increase creatine storage in skeletal muscles with a loading phase (20 to 25 grams/day for five to seven days), followed by a maintenance dose of 3-5 grams/day

intrinsic motivation

motivation that comes from internal states such as enjoyment or personal satisfaction associated with social engagement, challenge, and skill development in the exercise context

Healthy U.S-style eating pattern

one of three USDA food patterns featured in the Dietary Guidelines for Americans; based on the types and proportions of foods Americans typically consume, bout in nutrient-dense forms and appropriate amounts

Healthy Vegetarian Eating Pattern

one of three USDA food patterns featured in the Dietary Guidelines for Americans; modified from the Healthy U.S-style eating pattern to more closely reflect eating patterns reported by self-identified vegetarians - contains m,orer soy products (tofu), legumes, nuts and seeds, and whole grains and eliminates meat, poultry, and seafood. - dairy and eggs are included as they were consumed by majority of vegetarians -higher in calcium and fiber and lower in vitamin D

Healthy Mediterranean-Style Eating Pattern

one of three USDA food patterns featured in the Dietary Guidelines for Americans; modified from the Healthy U.S-style eating pattern to more closely reflect eating patterns that have been associated with positive health outcomes in studies of mediterranean-style diets - contains more fruits and seafood and less dairy, meats, and poultry

how personal trainers can best "meet people where they are

pay attention to particular motivators such as: - Food access: access, to healthy, safe, and affordable food choices (influenced by proximity, finances, transportation, neighborhood resources) - household food insecurity: when access to nutritious and safe food is limited or uncertain. - Acculturation: moving towards a typical American eating plan from what is often a more nutritious eating pattern of the home country.

potential determinants for physical activity

personal attributes - demographic (education, income, age, and sex - lower levels of activity seen with increasing age and fewer education and lower income and higher rates are seen among men) - health status (individuals who suffer from chronic illness such as heart disease and diabetes generally exercise less) - Physical activity history (difficulty managing mood and negative thought is a barrier to lifestyle internveitons involving exercise - important to create enjoyable and sustainable exercise programs) -knowledge, attitude, and. beliefs (modifying the way a person thinks and feels about exercise has been shown to influence their intentions regarding being physically active) environmental factors - access to facilities - time (pt's can help alter perception and shift priorities through goal setting, time management and prioritizing) - social support (positive correlation between social support from fam and friends and exercise) physical activity factors - intensity (of the exercise program - higher intensity for beginners might discourage clients) -injury (the higher the dose of physical activity, the higher the risk for developing inactivity related injury)

Stages of Change

precontemplation, contemplation, preparation, action, maintenance

beta blocker and its effect on exercise

prescribed for a variety of cardiovascular and other disorders they limit the sympathetic nervous system/ block the effects of catecholamines (epinephrine and norepinephrine) Reduces resting, exercise, and maximal heart rates need to use ratings of perceived exertion or talk test verses target heart rate to measure exercise intensity

antihyperintensive drugs and its effect on exercise

prescribed for high blood pressure or hypertension primarily affect one of the four different sites: the heart, to reduce its face of contraction; the peripheral blood vessels, to open or dilate to allow more room for the blood; the brain, to reduce the sympathetic nerve outflow; or the kidneys, to reduce blood volume by excreting more fluid specific effects and side effects depend on the site the medication acts on

calcium channel blockers and its effect on exercise

prevents clacium-dpendent contraction of the smooth muscles in the arteries, casing them to dilate, which lowers blood pressure also used for angina and heart dysrhythmias effect on BP and HR spends on specific agent

Medical Release Form

provides the personal trainer with the client's medical information and explains physical-activity limitations and/or guidelines as outlined by their physician. Deviation from these guidelines must be approved by the client's personal physician.

In the ACE Position Statement on Nutrition scope of practice (for pt)

pt's not only can, but should share general nonmusical nutrition information with their clients scope of practice or each individual depends on state policies and regulations. education and experience, and competencies and skills. every pt is allowed to share evidence based dietary guidelines and resources such as the Dietary guidelines for Americans and the MyPlate recommendations those who are certified in nutrition or who have undertaken nutrition CECs should also discuss: principles of healthy nutrition and food preparation, food to be included in the balanced daily diet essential nutrients needed by the body, actions of nutrients on the body, effects of deficiencies or excesses of nutrients - how nutrient requirements vary through the lifecycle - principles of pre- and post-workout nutrition and hydration - information about nutrients contained in foods or supplements

planning stage

setting goals - avoid setting too many - avoid setting negative goals (don't set goals that focus on the behavior that should be avoided but rather the behavior to be achieved) - set short and long term goals - include the client in the process generating and discussing alternatives formulating a plan evaluating the exercise program generate ideas and discuss options formulate a plan

health belief model

states that people's ideas and underlying emotions about illnesses, prevention, and treatments may influence health behaviors and decisions about changing (or not changing) health behaviors -especially applicable to people in he beginning stages of change -at least four variables influence a person's decision to change; perceived susceptibility and perceived seriousness affect beliefs about a health threat, and benefits and barriers affect beliefs about the health behavior that could reduce said threat. all lead to the decision to change

cold medication drugs and its effect on exercise

sympathomimetic drugs are components that mimic the activity of the sympathetic onerous system (e.g. increase BP and HR) fond in mediations that treat allergic rhinitis, nasal congestion, and asthma the vasoconstriction caused by the medication may raise BP and increase HR both at rest and possibly during exercise antihistamines don't have a direct effect on HR or BP but may cause drowsiness many cold medications are a combinations of decongestants and antihistamines so they may have combined effects - taken in low doses have minimal effect on exercise capacity

tell-show-do method

tell them, show them, have them do it - motor learning - remind beginners that it takes time and practice to improve motor skills - introduce new skills slowly and clearly - allow clients the opportunity for focused practice

competence

the ability to do something successfully or efficiently

self-monitoring

the cognitive process of self-regulaitotn, which describes and individual's evaluation of his or her thoughts and feeling and how that info is then used to shape goals and behaviors encompasses self-control and can help clients articulate new action steps and adjust plans as needed to promote continued progress open-ended questions can be utilized to aid with this by pts

self-efficacy

the degree to which an individual believes he or she can successfully perform a given behavior relationship between this and activity and stage of behavior change (such that those in the precontemplation and contemplation stages have significantly lower levels of this than those in the. action and maintenance stages)

(exercise) adherence

the extent to which people follow their plans or treatment recommendations. the extent to which people follow an exercise program

Relatedness

the socially recognized ties that connect people in a variety of different ways

righting reflex

the tendency to give advice push recommendations, and offer solutions; makes sustainable behavior change less likely for a client who is ambivalent about change

social cognitive theory and PT training

theory supports the importance of. having positive outcome expectations, goal setting, self-monitoring behavior, prompting intention formation (helping clients make decision to change), and planning, which are all important practices for personal trainers to embrace.

Angiotensin-converting enzyme (ACE) inhibitors and its effect on exercise

they block a specific enzyme to prevent the formation of a potent hormone which in turn makes the vessels dilate and BP decrease does not effect HR

cognitive distortions and strategies to combat them for PT

unproductive thought process that can paralyze a client when making a positive and lasting behavioral change Questions to ask clients to combat this: what is the evidence for and against this thought? what would I tell a friend in this same situation (as opposed to myself)? what is the worst that could realistically happen? how bad would that be? is it really true that I must, should ought to, or have to..? are there any other possible responses besides blaming myself? is there any conceivable way to look at this positively? is thinking this way helping the situation, myself, or others, or only making it worse? how have I effectively managed or tolerated these situations in the past?

goal generating questions for clients

what are you short term (three to six months) and long-term goals (beyond six months)? What could hinder your fitness program (e.g. work schedules, commute times, and child care/activities)? what motivates you? what things are most important to you? how will a healthy lifestyle complement or support this? what kinds of exercise programs have you tried in the past? what did you like most and least about your previous exercise programs? what types of exercise or activities do you currently enjoy? what is you favors exercise or activity? how will you integrate exercise into your life? how much time do you have to commit to exercise? what kind of support (e.g. family and friends) do you have to help you change your lifestyle? what is something you are good at now? did you know you were good at it before. you did it for the first time? when was the last time you exercised regularly (at least three times per week) and how long did it last? why did you stop?