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WACHEMO UNIVERSITYCOLLEGE OF NATURAL AND COMPUTATIONAL SCIENCEDEPARTMENT OF SPORT SCIENCECOURSE TITLE: HEALTH AND FITNESSCOURSE CODE: SPSc2082INSTRUCTOR:YEAR IISEMESTER ICOURSE DESCRIPTION This course provides the student with the concepts of health and fitness with other relationships, common infectious disease, communicable and hypo kinetic disease, sanitation and hygiene, components of physical fitness programs, means methods and measurements of physical qualities and preparing for physical activity.OBJECTIVES: At the end of this course students will be able to: -Acquire the basic knowledge of fitness, health and their relationships; Apply health related activities in the society; Value the contribution of fitness activities for sport gamesPromote and evaluate safe and effective fitness program; Understand effect of exercise on the body; Describe physical fitness components Describe training principles COURSE CONTENTCHAPTER ONE: - Concepts of health and wellnessWhat is health?Holistic health definitionDimension of healthWhat is wellness?Health promotionCHAPTER TWO: - Components of fitness Health related fitness componentsCardiovascular endurance, muscular endurance, muscular strength, flexibility, and body composition.Skill related fitness components Agility, balance, coordination, power, reaction time and speed.CHAPTER THREE:- Principles of exercise and the effect of exercise on the body.Principles of exercise The effect of exercise on the bodyTips for building aerobic endurance.Tips for flexibility CHAPTER FOUR: - Body composition and weight managementWeight management Civilization diseaseBody shapeGeneral guide for weight controlCHAPTER FIVE: - Human disease Communicable / infectious diseasesNon infectious diseasesHypo kinetic diseasesCause of cardiovascular diseasesRisk factor for cardiovascular diseasesLife style diseasesCHAPTER SIX: - Hygieneoverview on how to care health Personal hygieneFood hygiene Menstrual hygieneCHAPTER SEVEN: - Stress and Stress ManagementBasic nutrition and health.CHAPTER EIGHT: - Planning and management of the fitness programPlanning fitness programManaging fitness programPlanning and logging participation in active aerobics, sports and recreationCHAPTER NINE: - Means Methods and Measurements of Physical Qualities.Muscular strength Muscular endurance Cardiovascular endurance Flexibility Body compositionCHAPTER TEN: - Preparing for physical activity Facts to be consider before beginning physical activity Facts to consider during daily physical activityThe facts about physical activity in the heat and other environment The facts about soreness and injuryCHAPTER ELEVEN: - Fitness for health and performanceDeference and similarities between health and performance What is aerobic capacity?What is body build?EVALUATIONAssignment 20%Tests 30% Final Exam 50%REFERENCES IOC Medical Commission Position Stand on the Female Athlete Triad (2005) Female Athlete Triad Handbook for Coaches; NCAA Sports Medicine Handbook; NCAA 8/06Thomas D. Paul M. and Walton T., 2001. Fit and well: core concepts and labs in physical fitness and wellness. 9th edi.Sharon Elayne Fair, 2011 Wellness and physical therapy. Jones and Bartlet publisher.Edward T. howley, B. Don Franks, 2003. Health fitness Instructors Hand book, 4th Ed, human kinetics. P 203.CHAPTER ONECONCEPTS OF HEALTH AND WELLNESSWhat is health?World health organization WHO defines health as “not merely the absence of disease it is a state of complete physical, mental and social wellbeing”. Being healthy does not necessarily mean the absence of disease or illness.?Holistic health definitionWhat is the definition of holistic health? It's a wellness approach that addresses the body, mind and spirit or the physical, emotional/mental and spiritual aspects of an individual. Traditional medical doctors treat the body and ignore the mind; conventional mental health professionals treat the mind and ignore the body.? Neither one of them address the spiritual.?Both of them treat symptoms with drugs or surgery rather than looking for what causes the symptom. A holistic health approach doesn't view the body, mind and spirit as separate entities and promotes drugs and surgery only when absolutely essential and after other solutions have been sought.? It looks for the underlying causes of symptoms, rather than just covering up the symptoms with a drug.A definition of holistic health would not be complete without highlighting the fact that wellness approaches in the holistic field are considered to be wholesome, healthy and not harmful or toxic to the individual or the environment.? They promote balance and harmony for the individual, society and the planet. A holistic approach encourages the individual to engage in self care and educate themselves about their health.?It urges them be an active participant in their treatment and health care, rather than giving all the power to a health care provider. Here at Holistic Help my focus is on improving mental, physical and spiritual health issues through diet, nutrition, exercise, changes in lifestyle and awareness of environmental toxins.Dimension of healthPhysical health is important, but it is not the only component of overall well-being. Different Health organizations recognize and seek to improve five dimensions of health and well-being: physical, emotional, spiritual, social and intellectual/financial and these dimensions are inter-related.When one or more of the dimensions is impaired, your overall health and vitality suffers and your ability to thrive is diminished. Poor health may interfere with your ability to answer the call to serve your community.Typically, individuals are healthier in some areas than others. Research suggests that improving health in any one dimension can have a positive influence on health in the other dimensions. It’s best to focus on one or two dimensions of health for improvement, adding goals for other dimensions over time.The following diagram tell you more about the five dimensions of health What is wellness?Wellness has many definitions let us see different definitions:-Wellness is an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable within the environment in which he/she is functioning (Halbert Dunn, 1986).Wellness is “a dynamic or ever changing fluctuating state of being”. Wellness is giving care to the physical self, using the mind constructively, channeling stress energies positively, expressing emotions effectively, becoming creatively involved with others and staying in touch with the environment” (ardell, 1985).American physical therapy association (APTA) in its guide to physical therapist practice, defined “wellness as the concepts that embrace positive health behaviors that promote a state of physical and mental balance and fitness”(2001b, P.691).Dimensions of wellnessWellness is much more than merely physical health, exercise or nutrition. It is the full integration of states of physical, mental, and spiritual well-being. The model used by our campus includes social, emotional, spiritual, environmental, occupational, intellectual and physical wellness. Each of these seven dimensions act and interact in a way that contributes to our own quality of life.Diagrammatic illustration of the seven dimensions of wellnesslefttopHealth promotionHealth promotion is the science and art of helping people change their life style to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Life style change can be facilitated through a combination of efforts to enhance awareness, change behavior, and create environment that support good health practice. Adopting healthy behavior such as eating nutritious foods being physically active and avoiding drug abuse can control or prevent the devastating effect of many diseases. Health promotion can be described simply as purpose full activities designed to enhance the health of one self and or others. CHAPTER TWOCOMPONENTS OF FITNESSFitness is defined as a condition in which an individual has enough energy to avoid fatigue and enjoy life. Physical fitness is divided into four health and six skill related components. Skill related fitness components are fitness types which enhances one’s performance in athletic or sports settings. Health-related fitness is the ability to become and stay physically healthy. This component focus on factors that promote optimum health and prevent the onset of disease and problems associated with inactivity (NASPE, 2009).Health related fitness componentsCardiovascular enduranceCardiovascular endurance is the ability of the heart, lung and blood vessels?to deliver oxygen to working muscles and tissues, as well as the ability of those muscles and tissues to utilize that oxygen. Cardiovascular endurance is also called cardio respiratory endurance. Cardiovascular endurance can be measured using a number of formal testing methods including: VO2Max (Chris, 2011).Benefits of Cardiovascular endurance ? Stronger and more efficient heart (increase stroke volume)? Lower heart rate at rest, during exercise, and recovery? Lower blood pressure at rest, during exercise, and recovery? Lower cholesterol (lower total, raise HDL)? Improved body composition, burn fat? Improved ability to perform work, faster recovery? Maintenance of a healthy heart and cardiovascular systemMuscular endurance:- Muscular endurance refers to the ability of the muscle to work over an extended period of time without fatigue. Performing push-ups and sit-ups or crunches for one minute is commonly used in fitness testing of muscular endurance. In training setting muscular strength and muscular endurance can go in line. According to the research conducted on the effects of strength training on endurance capacity of top-level endurance athletes, strength training can lead to enhanced long-term (>30 min) and short-term (>15 min) endurance capacity both in well-trained individuals and highly trained top-level endurance athletes, especially when high-volume, heavy-resistance strength training protocols are applied (Aagaard and Andersen, 2010).Muscular strength:- Muscular strength refers to the maximum amount of force a musclecan exert against an opposing force. Fitness testing usually consists of a one-time maximum lift using weights, bench press, leg press, etc. Muscular strength and performance have direct relationship. According to the research result conducted on the skeletal muscle mass and muscle strength in relation to lower extremity performance of older men and women suggest that low muscle strength, but not low muscle mass, is associated with poor physical function (Paul et al., 2000).Benefits of Muscular Fitness: ? Ability to do more strenuous work? Ability to do more work over a longer period of time? Less susceptible to muscular fatigue ? Less injury prone ? Improved appearance? Improved athletic performanceFlexibilityFlexibility is the ability to move a body part through a full range of motion at a joint (ROM)The amount of flexibility that a person possesses can be seen by how easily they can bend, twist or stretch. A person’s flexibility can vary from joint to joint; they may have excellent range of motion in the shoulder joint while having limited range of motion in the hip joint. People who are active tend to have better flexibility than someone who is sedentary. Being sedentary can cause people to have weak and / or stiff joints.According to the information presented in Corbin’s Flexibility video-tape, people develop flexibility during the warm-up phase of an exercise program and will better maintain their flexibility by re-stretching during the cool down phase after an activity. Power walking, jogging, performing jumping jacks or other low-intensity activities can be used to ‘warm the muscle’ and increase the amount of oxygen and nutrients going to the muscles before stretching. This will make stretching easier and less dangerous.Factors that can affect flexibility: Agebody temperature (warmer muscles are more ‘elastic’)gender injuries excessive body fat lifestyle (active or sedentary)genetics Benefits of maintaining and / or improving flexibility:healthy joints decreased risk of joint injuryincreased range of motion helps control stability improved hamstring and lower back flexibility reduces risk of lower back pain maintenance stretching, after an activity, can reduce delayed on-set of muscle stiffness and / or soreness maintenance stretching, after an activity, reduces risk of muscle cramping? stretching can relieve muscle tension caused by stress? being flexible allows a person to be more functional (able to participate more fully in daily and sport-related activities)Body compositionBody composition refers to the amount of muscles, bones, and fat tissue that make up your body. One of the keys to having a healthy body is to have a good balance between the amount of muscle and fat tissue in the body. Having too much body fat puts an extra demand on the heart and the joints. It also raises a person’s risk of being afflicted with heart disease, diabetes, high blood pressure and osteoarthritis. On the other hand, having too little body fat is not healthy either. People need body fat to protect their organs, insulate the body and to have as a stored source of energy.Body weight alone is not an accurate indicator of how much body fat that a person has because muscle tissue weighs more than fat. In order for a person to know their particular percentage of fatness, they would need to complete some type of body composition assessment. Those assessments might include: using body circumference measurements, a Body Mass Index check, a skin fold evaluation, bioelectrical impedance device or some type of underwater weighing evaluation.Factors that can influence body composition: ? Calorie intake / diet ? Calorie expenditure / activity level? Genetics? Illness? Age? Metabolic rateHealth related fitness is more important than skill related fitness because it is for everyone! And health related fitness has a more direct impact on a person’s health, quality of life, and life expectancy. In addition to improving quality of life, health-related fitness:- ? increases muscle tone and strength; ? decreases susceptibility to injuries and illness; ? improves bone mineral density; ? reduces risk of osteoporosis; ? improves posture; ? increases efficiency of the respiratory and circulatory systems; ? decreases risk of cardiovascular disease and stroke; ? improves blood pressure; ? decreases risk of diabetes and some cancers; ? improves self-esteem and self-confidence; ? decreases body fat and improves metabolism; and ? increases energy level and academic achievement. Skill related fitness components AgilityAgility refers to a person’s ability to move their body quickly and easily.This also includes the ability to quickly and easily change direction with maintaining balance.Examples: ? Stepping aside quickly in the hallway to avoid running into someone else? Stopping, starting and changing directions quickly to avoid a defender? Stepping quickly on the court to return a serve or an opponent’s shot? Changing directions quickly to avoid stepping out of boundsEnhanced agility also help improve performance in basic activities of daily living, and even assist in the prevention of some types of injuries, especially fall. It is recommended that agility drills must be trained progressively and slowly with an emphasis on technique mastery, before learning the speed of movements and adding complex variations, such as open or non-programmed agility training (Dawes, 2008).BalanceBalance refers to a person’s ability to maintain their equilibrium when moving or when they are in a stationary position.Examples: ? Performing a v-sit on the beam or on the floor? Landing after a rebound in basketball? Re-gaining balance after ‘stepping in opposition’ when serving a ball CoordinationCoordination refers to a person’s ability to perform complex movements due to the working together of the nervous system and the muscles of the body. This is also referred to as a person’s ability to do two things at the same time. Example: ? Catching a ball in a lacrosse scoop while running? Dribbling a ball while moving? Hitting a pickle ball while moving forward on the courtPowerPower is a combination of strength and speed. Sportsmen and women use power to propel themselves or an object forward or upwards. In Football:-long throw, in weightlifting: clean and jerk and in athletics: long or high jump and throwing activities wants high power. It is created by releasing maximum muscular force at maximum speed. By exerting strength with speed, it can be achieved the advantages of both force generated by the muscles and momentum created through the speed. Power can be described in three ways: explosive power, dynamic power and static power (Sang and kim, 2008). Reaction timeReaction time refers to the time required to initiate a response to a given stimulus. It is important for starts of races, racquet sports, and self defense.SpeedSpeed refers to a person’s ability to move fast or to cover a distance in a short period of time. When speed combined with strength it will provide power. Running a fast-break in basketball, moving a racquet fast through the ‘hitting zone’ to hit a ball harder in racquet games, sprinting in short sprint running and fast reaction in karate needs speed. Speed can be improved by increasing a player’s power by using trainings like countermovement jumps and loaded squat jumps are effective for improving speed (Cronin and Hansen, 2005). But the effectiveness of this depends on the state of training and health as well as nutrition of the trainees.Major benefits of good Physical Fitness:? Improved appearance? Increased energy levels? Increased self esteem and confidence? Stronger and more efficient heart? Increased capacity to do physical work, including sport performance? Injuries are less frequent, less severe, and recovery time is shorter? Improved emotional control? Sleep better (and therefore more energized throughout the day) ? Body fat stays within normal healthy range ? Increased life expectancy / enjoy more healthy years? Improves overall health / all body systems are positively affectedCHAPTER THREEPRINCIPLES OF EXERCISE AND EFFECTS OF EXERCISE ON THE BODYPrinciples of exerciseThe Overload PrincipleThe Overload Principle is probably the most important principle of exercise and training. Simply stated, the Overload Principle means that the body will adapt to the workload placed upon it. The more you do, the more you will be capable of doing. This is how all the fitness improvements occur when exercising and training. The human body is an amazing machine. When you stress the body through lifting a weight that the body is unaccustomed to lifting, the body will react by causing physiological changes in order to be able to handle that stress the next time it occurs. This concept is similar in cardiovascular training. If you ask the heart, lungs and endurance muscles to do work not previously done, it will make changes to the body to be able to handle that task better the next time. This is how people get stronger, bigger, faster and increase their physical fitness level. When you are working out, you want to strive to somehow increase the workload you are doing above what you did on your previous workout so you have overloaded your body to create a training adaptation. This increase in workout stress can be a very small increase, as many small increases over time will eventually be a large increase or adaptation. To determine how to increase the workload of a given workout you need to understanding the F.I.T.T Principle. The f.i.t.t. principleAn easy way to get started on developing a personal fitness program is utilizing the F.I.T.T. principle. This acronym stands for Frequency, Intensity, Time and Type. These are the areas in which someone could increase or overload in order to improve physical fitness. Frequency: This refers to how often you will exercise. After any form of exercise is performed your body completes a process of rebuilding and repairing. So, determining the frequency of exercise is important in order to find a balance that provides just enough stress for the body to adapt and also allows enough rest time for healing. Intensity: Defined as the amount of effort or work that must be completed in a specific exercise. This too requires a good balance to ensure that the intensity is hard enough to overload the body but not so difficult that it results in over training, injury or burnout. Time: Time is simply how long each individual session should last. This will vary based on the intensity and type. Type: What type of exercise will you be doing? Will an exercise session be primarily cardiovascular, resistance training or a combination of both? And, what specific exercises will you perform. The Specificity PrincipleThis principle is just how it sounds how you exercise should be specific to your goals. If you're trying to improve your racing times, you should focus on speed workouts. If your main goal is simply health, fitness and weight management, you should focus on total body strength, cardio and a healthy diet. Make sure your training matches your goals. The Rest and Recovery PrincipleWhile we often focus on getting in as much exercise as possible, rest and recovery is also essential for reaching your weight loss and fitness goals. While you can often do cardio every day (though you may want to rest after very intense workouts) you should have at least a day of rest between strength training workouts. Make sure you don't work the same muscles two days in a row to give your body the time it needs to rest and recover. The Use or Lose Principle/ReversibilityThe Principle of Use or Lose implies that when it comes to fitness, you "use it or lose it." This simply means that your muscles build strength (hypertrophy) with use and lose strength (atrophy) with lack of use. This also explains why we or lose fitness when we stop exercising. Principle of IndividualityThis principle concentrates on individual differences or limits on adaptability. Everyone is different and responds differently to training. Some people are able to handle higher volumes of training while others may respond better to higher intensities. This is based on a combination of factors like genetic ability, predominance of muscle fiber types, other factors in your life, chronological or athletic age, & mental state.Effect of exercise on the bodyAdaptations to endurance training:- Cardiovascular (improved oxygen transport, increased heart size, increased stroke volume, decreased resting heart rate, increased cardiac output, improved blood flow distribution, increased blood volume, capillarisation, decreased blood pressure, respiratory (improved pulmonary ventilation, improved pulmonary diffusion, arterial-venous oxygen difference, decreased resting breathing rate, increased lung capacity).Effects of exercise on blood pressure: Short term effects of exercise (no change in diastolic pressure, progressive increase in systolic pressure), long term effects of exercise (reduction in overall resting blood pressure, improved regulation of overall blood pressure).Blood pooling: In the extremities, venous return (skeletal muscle pump, non-return valves), associated risks (dizziness, fainting), prevention of blood pooling through progressive cool down.Effects of exercise on bones and joints: Improved bone density, increased joint stability, improved mobilisation and range of motion at joints, significance of weight bearing exercise (bone structure, ageing and osteoporosis), types of weight bearing exercise (walking, running, resistance training), potential risk of injury.Effects of exercise on muscles: Short term (increased contractility, increased excitability, increased elasticity, increased energy metabolism, heat generation), long term effects of aerobic exercise (increased concentration of aerobic enzymes, increased size and number of mitochondria, increased ability to use fat as an energy source, increased storage of muscle glycogen, increased supply of intramuscular fat), hypertrophy (increase in muscle mass and cross-sectional area, possible increase in number of muscle fibres, increased motor unit recruitment).Tips for building aerobic endurance.Here are 5 great and simple ways to maximize your cardio.1) Interval RunningOne of the most common ways to improve your cardio is interval running. Preferably outdoors in the park or at a place where the air is clear. Set a goal you that you believe you can achieve and aim for it. For example:Jog at a steady pace for 2 minutesIncrease to running race for 30 secondsRepeat this exercise for 20 minutesOnce you’re able to sustain that level over a period of time, then you’re ready to raise the bar a bit higher. This will work on the endurance of your breathing and legs.2) Heavy Bag WorkoutIf you have a boxing area at your gym, then you should utilize the use of their equipment especially the heavy bag. For the duration of one professional round (3 minutes) You can:Hit the bag at a light pace (most basic combination is jab, jab, straight)Increase the pace and switch up the combination to just left and right hooks for the last 30 secondsRest for a minute and repeat this exerciseThis effectively improves your cardio as well as working on your upper body flexibility, strength and muscle groups. You must be careful not to over extend your arms when punching as this can damage your joints. Keep within a good range of the heavy bag at all times.3) Rope SkippingIf you’ve never skipped rope before then you should start now. It’s a great way to increase endurance to your breathing, legs and improves your balance and co-ordination. Here’s an example of an effective rope skipping exercise:Light skip for 2 minutesIncrease pace for 30 seconds and lift your knees right up when skippingRepeat for 15 minutesThere are many different skipping techniques but the most common and easiest one to start off with is the stationary running technique (you’re just basically running on the spot while timing the rope). Nearly all boxers implement this for better footwork. As you get better, you may want to practice different techniques, not only does it look good but it’s also fun.4) Cycling – Gear ShiftingThis will only work if you have a mountain bike with gears. This form of exercise will strengthen your legs as well as improve your cardio. You need to:Cycle at a gear that you’re comfortable with for 3 minutesIncrease the gears by one or top notches and cycle for 1 minutesResume back to normal gear and repeat for the rest of your journeyThe distance and duration all depends on what you feel comfortable with. Think of a destination to cycle to and then work out the distance on Google Maps. It also helps if the path is clear like in large parks which doesn’t involve many hills and slopes.5) Swimming LapsSwimming is an excellent way to work on your breathing technique, which is essential to maximizing your cardio potential. Perform the following activity using a stroke that you’re most comfortable with:Swim from one end of the pool to the other at a fast paceRepeat for several laps (depends on size of pool) without any breaks in betweenRest for 2 minutes and repeatIf the pool size is relatively small (5-10 meters) then around 4-5 laps would be recommended. Tips for flexibility How to Become Flexible?Edited by Danielle, Rob S, V Rod, 1guitarhero2 and 203 others2K+Article HYPERLINK "" \o "Edit" EditDiscussYou can't become flexible overnight. You need to get in the habit of doing stretching exercises every single day. But with patience and time, you'll become more flexible. And you will be amazed at how good you feel. Here are some basic steps in the process.Keep your joints and muscles lubricated. Start your workout with low impact stretches and work up to a full stretch workout. Later, wind down your routine with low-impact exercising.Do stretch every day and work at it progressively. This is important if you want to become flexible! Remember, you can't become flexible overnight. Work at the rate you are comfortable with, and then slowly increase the difficulty (length of time, length of reach or both).Make sure you have supervision. If you have no idea what you are doing you'll undoubtedly injure yourself. Most martial arts schools and gymnastics classes have extensive programs and teachers available. Check them out.Maintain a healthy diet. Eat more green leafy vegetables, and drink plenty of water. Increase your protein and calcium (drinking milk will increase your intake of both of these). The most important thing is to balance everything. Make sure that every morning you eat a good, healthy breakfast.Stretching TechniquesBelow is a list of basic stretching exercises for specific areas of your body. Remember to be careful and take each one slowly. The more comfortable you become with each technique, the more you can push yourself later on.Shoulders1Stretch each arm as far across your chest while holding it as you can without feeling pain for 5 or 10 minutes every day.Back (Be Extremely Careful)Lie down on the floor.Sit up straight, leaving your legs out in front of you. They don't have to be flat.Turn your upper body slowly, and make absolutely sure that you stop turning when it starts to hurt. It is relatively easy to damage your spinal cord if you stretch improperly, so pay attention.When you stop turning, hold that position for 5 to 10 seconds. Turn the other direction, and repeat.2Try and do a backbend/bridge. Be very careful not to go too far! Once you are in the bridge, push through your shoulders, and try to put your legs together and straighten them. Don't go onto your toes!3You can also stand up with your arms hanging out to the side and then very slowly twist from side to side.Another stretch is to lay flat on your tummy and then use your arms to put yourself in a snake or seal stretch.LegsSit down as you did before for the back exercises, only this time, make your legs as flat on the ground as possible, right beside each other.Stretch down toward your knees. Do not bend your head to face your knees, face forward.This will also stretch your neck muscles; if it hurts your neck to do this exercise, face your knees and stretch.You can also sit down with your legs straight out and take your right leg and swing it over your left leg a few times. Do the same with your left leg.Try doing the splits as well as possible, but carefully for about 4 minutes per day. If you are advanced and flat on the ground, take a sofa pillow and put one of your legs on it to give more of a stretch.Remember you must always be patient. The key to being flexible is waiting calmly.Upper Thighs (Butt)Squeeze both sides of your thighs together.Hold for 5 minutes. (If this is too long, start with 2 minutes, and build it up.)FingersHold one hand out in a fist.Slowly open up the fist.Stretch your fingers back as far as they can. Hold for a minute.Repeat with your other hand. This can help with carpal tunnel syndrome.AnklesFirst, sit with your legs straight out in front of you like you did in the legs stretch and twist your ankles in any shape or form (for example, the "abc"s).You can also sit with one leg in front of you and take the other ankle and rest it on your knee then grab your foot and twist your ankle.WristsSit on your knees and then put your hands out like you are reading a book.Flip your hands onto the floor with fingers facing you, like "save the page."You can also, after you do the stretch above, flip your hands in any way (fingers facing outward or inward to the side, whatever).Positive & Negative StretchingRemember to include both the positive and negative motions when you stretch. Keep it symmetrical. If you are stretching your left, stretch out your right too. If you are bending forward, bend backwards too.Extra TipThink positive and say, "Oh, I know I can do this!"Make sure when you are doing gymnastics at home or with friends, you are comfortable in dressing. (i.e tank top and shorts, leotard)If you don't feel strain in your muscles, you're not doing it properly!HintStretching exercises will help you become more flexible. Doing them every day will help (30 minutes minimum). The most important thing to do is have a regular exercise routine every day. And if you don't know what you're doing, having some sort of supervision is crucial. You don't want to injure yourself unintentionally.Once you can do the splits, you can do a lot more gymnastic tricks, so keep at it!Warm up your muscles before stretching. Never stretch a cold muscle! You could suffer serious injuries!Pick up a book on stretching so you know what to do, and how to do it.If you are advanced enough in your splits and only if you are advanced put your arms in the air it will make you go lower.Always remember to be patient and always do these stretches for at least 10 to 15 minutes a day.One way to warm up would to be to do a decent amount of jumping jacks.Be patient, if you think you're not getting any more flexible, don't quit. You will see progress eventually, and it will be worth it.Stay in your comfort zone. Do these stretches every day and you will be able to do these easily. Just keep in mind that practice makes perfect.Remember to begin gently with slow stretching. Warning: Starting with difficult and advanced stretches is dangerous and ill-advised for anyone.Begin from the easier ones and then move on to the tough ones.If you have a really hard time stretching, you can try putting a heating pad on the area and stretching after ten minutes: just remember to ice it afterwards!Practice makes perfect so never give up prove to everybody that you can do it.Build up how much you do, start at a little and work up to doing more to avoid injuring yourself.If you have trouble touching your toes go as far as you can go without bending your knees everyday and hold it for a couple more seconds. Eventually you will see improvement.Don't push yourself to the max just go little by little. You will get there.Make sure you're not constipated while stretching. It may hurt.Exercise and stay on a good and healthy diet so you can be in shape. Also try jogging, walking, or even running to boost up your blood and to get your blood running, then begin stretching. Practice makes perfect so practice everyday even if you practice for 10 minutes.Try to learn yoga postures. Indian classical dancing such as kuchipudi, silk weaving exercises are also good. Get your whole body massaged with ayurvedic herbal oil every week.Make up a routine of your stretches. Ex: first you do arms and then legs and so on and so forth. But don't be afraid to change it up.Go to ballet classes to get flexible, so a professional can train you.If you are feeling a pain in any part of your body then it means you're overdoing the stretch. You will need to slow down and use less force.Make sure you are wearing comfortable clothes and try to relax your mind this will help a lot.When you are doing the backbend make sure your shoulders ate over your hands or in line.Try running or jogging, it will strengthen your legs. This will cause the muscle to be more flexible!Don't continue stretching if you're in severe pain. This can cause you to pull a muscle.When stretching, remember to be in comfy clothes.Make sure you warm up first!Do not hurt yourself.Do small stretches first before you do bigger stretches!Warnings and ConditionsNever forget to warm up! You may hurt yourself.Be very careful, if you create your own stretches! This could be very dangerous for those who don't know how to do it!If you are rehabilitating an injury, consider consulting a physical therapist or trainer to make sure you are making things better, not worse.When stretching, don't bounce. This puts stress on the joints and muscles, as well as creating micro-tears in the muscle fibers. Stretch slowly and as gracefully as you can. Make sure the movements are in one fluid motion. Also be sure to keep your back and legs straight.Do not do these stretches, if you have a calcium deficiency. It is very easy to damage your bones that way.Speak with your doctor, if you are unable to do these exercises due to immediate fatigue, muscle weakness, or injury. Don't wait for it to clear up on its own.It is recommended not to smoke, if you are doing these exercises. Smoking can cause serious problems in your body that could be made worse by stretching your muscles.Depending on what you're doing, overdoing certain stretches can cause breaking of bones or sprains, which can cause problems.Don't over-do-it! Stretching should not be painful, but almost relaxing. You should feel a comfortable pull in each stretch...and not be too sore the next day!Don't worry: if you can't do splits a day into it, just commit to continuing, and there will be no problem.Heavy stretching must only be done 1 day in a week to allow time to heal muscle fibers and small-pulls, but you can use simple stretching every day.Never attempt stretches that you do not fully understand how to do properly or attempt ones that require spotters by yourself. You can easily hurt yourself.If you are a child, please get adult supervision before trying anything that could be a physical risk.CHAPTER FOURBODY COMPOSITION AND WEIGHT MANAGEMENTThere is no definite link between body weight or composition and performance. For example, a lower percent body fat or weight does not always correlate with improved performance and can, in fact, lead to a decrease in performance as well as an increased risk for injury and/or illness. Athletes will often do whatever it takes to reach a weight or body composition goal that may not be realistic. Without the proper knowledge of how to lose or gain weight appropriately, they may resort to unhealthy behaviours with significant health consequences. (e.g., eating disorders, anabolic steroid use, illicit drug use, etc.) Weight does not change rapidly unless the individual is either ill, is severely restricting/dehydrating, binge eating, and/or using anabolic steroids or other ergogenic agents. When weight becomes too important, it can precipitate body obsession and significant emotion, in turn making normal eating much more difficult. Weighing athletes, punishment for lack of weight control, and linking weight to performance can lead to pathogenic weight control behaviours, disordered eating, and ultimately eating disorders. Furthermore, body dissatisfaction and dieting are often precursors to disordered eating. Disordered eating patterns can negatively impact a student-athlete's mental and physical well being and ultimately their athletic performance. Frequent weigh-ins can encourage "competitive thinness," in which athletes try to be thinner than their teammates and communicates that their weight is more important than things like eating for training, sleeping regularly, hydrating, and recovery. Coaches can have a tremendous influence on athletes, and should be conscious of their attitudes, behaviours, and language that may directly or indirectly contribute to the onset of unhealthy eating behaviours and/or lifestyles. Civilization diseaseIt is increasingly recognized that certain fundamental changes in diet and lifestyle that occurred after Industrial Revolution and the Modern Age, are too recent, on an evolutionary time scale, for the human genome to have completely adapted. This mismatch between our ancient physiology and the modern diet and lifestyle underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis, which are rare or virtually absent in hunter–gatherers and other non civilized populations.Regarding dietary changes, it should be mentioned that dairy products, cereal grains (especially the refined form), refined sugars, refined vegetable oils, and alcohol make up to 70% of the total daily energy consumption.Another important lifestyle change is physical inactivity; they make a compelling case for its possible causal role in insulin resistance, dyslipidemia, obesity, hypertension, type 2 diabetes, coronary artery disease, angina, myocardial infarction, congestive heart failure, stroke, intermittent claudication, gallstones, various types of cancer, age-related cognitive dysfunction, sarcopenia, and osteopenia, among other diseases.Body shapeThere are different types of body types/shapes these are ectomorph, mesomorph and endomorph. An ectomorph is a typical skinny guy. Ecto’s have a light build with small joints and lean muscle. Usually ectomorphs have long thin limbs with stringy muscles. Shoulders tend to be thin with little width.Typical traits of an ectomorph:- Small “delicate” frame and bone structureClassic “hardgainer”Flat chestSmall shouldersThinLean muscle massFinds it hard to gain weightFast metabolismEctomorphs find it very hard to gain weight. They have a fast metabolism which burns up calories very quickly. Ecto’s need a huge amount of calories in order to gain weight. Workouts should be short and intense focusing on big muscle groups. Supplements are definitely recommended. Ectomorphs should eat before bed to prevent muscle catabolism during the night. Generally, ectomorphs can lose fat very easily which makes cutting back to lean muscle easier for them.MesomorphA mesomorph has a large bone structure, large muscles and a naturally athletic physique. Mesomorphs are the best body type for bodybuilding. They find it quite easy to gain and lose weight. They are naturally strong which is the perfect platform for building muscle.Typical traits on a Mesomorph:AthleticGenerally hard bodyWell defined musclesRectangular shaped bodyStrongGains muscle easilyGains fat more easily than ectomorphsThe mesomorph body type responds the best to weight training. Gains are usually seen very quickly, especially for beginners. The downside to mesomorphs is they gain fat more easily than ectomorphs. This means they must watch their calorie intake. Usually a combination of weight training and cardio works best for mesomorphs.EndomorphThe endomorph body type is solid and generally soft. Endomorphs gain fat very easily. Endo’s are usually of a shorter build with thick arms and legs. Muscles are strong, especially the upper legs. Endomorphs find they are naturally strong in leg exercises like the squat.Typical traits of an Endomorph:Soft and round bodyGains muscle and fat very easilyIs generally short"Stocky" buildRound physiqueFinds it hard to lose fatSlow metabolismMuscles not so well definedWhen it comes to training endomorphs find it very easy to gain weight. Unfortunately, a large portion of this weight is fat not muscle. To keep fat gain to a minimum, endomorphs must always train cardio as well as weights. Usually supplements may not be needed as long as the person has a high protein intake in their diet.A Combination of Body TypesThese body types aren’t set in stone. In fact, most guys have a combination of two body types. These combinations are either ectomorph/mesomorph or mesomorph/endomorph. It is not uncommon to find a pure mesomorph that gains weight like an endomorph for example.So which body type are you?According to the information above you should be able to identify your body type. You may also want to optimize your diet and training to suit your body type.General guide for weight controlBased on the important issues raised above, the following recommendations should be followed: Determining optimal body weight and composition is best performed by medical personnel, and must be individualized as there is significant variation to account for different body types, genetics, and other factors both modifiable and non-modifiable. A sports dietitian is available and should be utilized early in an athlete’s career at Princeton for any weight or body composition concerns as well as to optimize nutrition for performance. Checking weights more frequently than once per week is not useful unless dehydration is an issue or obligatory weight limits are imposed by the sport (wrestling, lightweight crew, sprint football) Coaches do not have sole responsibility for monitoring weight control of athletes Coaches not involved in weight restricted sports are strongly discouraged from weighing athletes If there is concern regarding a particular athlete’s weight gain or loss, this can be assessed by the sports dietitian, along with the athletic medicine staff (team physician, athletic trainer) with input from the coaching staff. If an athlete must be weighed, he/she should be weighed privately, by a healthcare professional, and told the purpose for the weighing. Preferably, it should be for "health" purposes or to monitor progress. If disordered eating or eating disorders are suspected, athletes should be referred to the team physician for further evaluation and treatment. For sports that mandate weight restrictions (e.g. sprint football, wrestling, men’s and women’s lightweight crew, etc.), weight management issues should be addressed by members of the athletic medicine team (team physician, athletic trainer) in conjunction with the sport dietitian and coaching staff. Determination of an individual athlete’s appropriate weight range should be assessed. The assessed weight range should be used as criteria in determining participation for that respective sport. If weight loss is desired and considered safe, it should start early, well before the competitive season. Weight loss should be agreed upon by the student-athlete and appropriate medical nutritional personnel, with consultation from the coach. Athletes are discouraged from buying dietary supplements on their own and should discuss all supplement use with the Athletic Medicine Staff (sports dietitian, athletic trainer, and team physician). Weight and body composition measurements are confidential medical indices and require permission from the student athlete in order to be shared. In certain situations (i.e., in the event of a life-threatening circumstance, or for weight restricted sports), the medical team may choose to disclose this information to coaches, parents, and other medical personnel as necessary. Coaches should promote healthy lifestyle practices which include appropriate rest, stress management, optimal eating choices and behaviours, and avoiding alcohol and other drugs.CHAPTER FIVEHUMAN DISEASECommunicable / infectious diseasesCommunicable diseases are those that are transmissible from one person, or animal, to another. The disease may be spread directly, via another species (vector) or via the environment. Illness will arise when the infectious agent invades the host, or sometimes as a result of toxins produced by bacteria in food.The spread of disease through a population is determined by environmental and social conditions which favour the infectious agent, and the relative immunity of the population. An outbreak of infection could endanger the operation. An understanding of the disease and the measures necessary for its containment and management is therefore important. The organisms that cause disease vary in size from viruses, which are too small to be seen by a light microscope to intestinal worms which may be over a meter long. The groups of infectious agents are listed with examples of diseases they cause.BacteriaPneumonia, tuberculosis, enteric fever, gonorrheaVirusesMeasles, varicella, influenza, colds, rabiesFungiRingworm, tinea pedis (athlete’s foot)ProtozoaMalaria, giardiaMetazoanTapeworm, filariasis, onchcerciasis (river blindness), Hookworm Prions Kuru, Creutzfeld-Jacob disease, Bovine spongiform encephalopathy (BSE)Modes of transmissionDirect transmission■ Direct contact with the infected person as in touching, kissing or sexual intercourse■ Droplet spread through coughing sneezing, talking or explosive diarrhoea■ Faecal-oral spread when infected faeces is transferred to the mouth of a non infected person, usually by hand.Indirect transmissionIndirect transmission of infectious organisms involves vehicles and vectors which carry disease agents from the source to the host.■ Water: - If polluted, specifically by contaminated sewage. Water is the vehicle for such enteric (intestinal) diseases as typhoid, cholera, and amoebic and bacillary dysentery.■ Milk is the vehicle for diseases of cattle transmissible to man, including bovine tuberculosis, brucellosis. Milk also serves as a growth medium for some agents of bacterial diseases such as campylobacter, a common cause of diarrhea.■ Food is the vehicle for salmonella infections (which include enteric fever), amoebic dysentery, and other diarrheal diseases, and poisoning. Any food can act as a vehicle for infection especially if it is raw or inadequately cooked, or improperly refrigerated after cooking, as well as having been in contact with an infected source. The source may be another infected food, hands, water or air.■ Air is the vehicle for the common cold, pneumonia, tuberculosisdischarges from the mouth, nose, throat, or lungs take the form of droplets which remain suspended in the air, from which they may be inhaled.■ Soil can be the vehicle for tetanus, anthrax, hookworm and some wound infections.■ Fomites: - This term includes all inanimate objects, other than water, milk, food, air, and soil, that might play a role in the transmission of disease. Fomites include bedding, clothing and the surfaces of objects. Vectors are animate or living vehicles which transmit infections in the following ways:■ Mechanical transfer: - The contaminated mouth-parts or feet of some insect vectors mechanically transfer the infectious organisms to a bite-wound or to food. For example, flies may transmit bacillary dysentery, typhoid, or other intestinal infections by walking over the infected faeces and later leaving the disease-producing germs on food.■ Intestinal harborage: - Certain insects harbor pathogenic (disease causing) organisms in their intestinal tracts. The organisms are passed in the faeces or are regurgitated by the vector and the bite-wounds or food are contaminated. (e.g. plague, typhus.)■ Biological transmission: - This term refers to multiplication of the infectious agent during its stay in the body of the vector. The vector takes in the organism along with a blood meal but is not able to transmit infection until after a definite period, during which the pathogen changes. The parasite that causes malaria is an example of an organism that completes the sexual stages of its life cycle within its vector, the mosquito. The virus of yellow fever also multiplies in the bodies of mosquitoes.Non infectious diseasesA?non-communicable disease, or?NCD, is a medical condition or?disease, which by definition is?non-infectious?and?non-transmissible?among people. NCDs may be chronic diseases of long duration and slow progression, or they may result in more rapid death such as some types of sudden stroke. They include?autoimmune diseases,?heart disease,?stroke, many?cancers,?asthma, diabetes,?chronic kidney disease,?osteoporosis,?Alzheimer's disease,?cataracts, and more. While sometimes (incorrectly) referred to as synonymous with "chronic diseases", NCDs are distinguished only by their non-infectious cause, not necessarily by their duration. The?World Health Organization?(WHO) reports NCDs to be by far the leading cause of death in the world, representing over 60% of all deaths. Out of the 36 million people who died from NCDs in 2005, half were under age 70 and half were women.[1]?Of the 57 million global deaths in 2008, 36 million were due to NCDs. That is approximately 63% of total deaths worldwide.?Risk factors such as a person's background, lifestyle and environment are known to increase the likelihood of certain NCDs. Every year, at least 5 million people die because of tobacco use and about 2.8 million die from being overweight. High cholesterol accounts for roughly 2.6 million deaths and 7.5 million die because of?high blood pressure (Wikipedia).Hypo kinetic diseasesA disease brought on, at least in part, by insufficient movement and exercise. Hypo kinetic has been identified as an independent risk factor for the origin and progression of several widespread chronic diseases, including coronary heart disease, diabetes, obesity, and lower back pain. Hypo kinetic diseases?are conditions that occur from a?sedentary lifestyle. Examples include?obesity?and complications arising from sedentary behaviour. Hypo kinetic conditions could include:Cardiovascular diseaseSome forms of cancerBack problemsObesityType 2 diabetesOsteoporosisMental healthHigh Blood pressureHeart diseaseCause of cardiovascular diseasesCoronary heart disease (CHD) is usually caused by a build-up of fatty deposits on the walls of the arteries around the heart (coronary arteries). The fatty deposits, called atheroma, are made up of cholesterol and other waste substances. The build-up of atheroma on the walls of the coronary arteries makes the arteries narrower and restricts the flow of blood to the heart. This process is called?atherosclerosis. Your risk of developing atherosclerosis is significantly increased if you:smokehigh blood pressure?(hypertension)high blood cholesterol levelphysical inactivitydiabetes mellitus Other risk factors for developing atherosclerosis include:being obese or overweighthaving a family history of CHD?CholesterolCholesterol is a fat made by the liver from the saturated fat that we eat. Cholesterol is essential for healthy cells, but if there is too much in the blood it can lead to CHD. Cholesterol is carried in the blood stream by molecules called lipoproteins. There are several different types of lipoproteins, but two of the main ones are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).?LDL, often referred to as bad cholesterol, takes cholesterol from the liver and delivers it to cells. LDL cholesterol tends to build up on the walls of the coronary arteries, increasing your risk of heart disease. HDL, often referred to as?"good cholesterol", carries cholesterol away from the cells and back to the liver, where it is broken down or passed from the body as a waste product. In the UK, the current government recommendation is that you should have a total blood cholesterol level of less than 5mmol/litre, and an LDL cholesterol level of under 3mmol/litre. This should be even lower if you have symptoms of CHD.Risk factor for cardiovascular diseasesThere are many risk factors associated with (cardiovascular) coronary heart disease and stroke. Some risk factors such as?family history, ethnicity and age, cannot be changed.? Other risk factors that can be treated or changed include tobacco exposure, high blood pressure (hypertension),?high cholesterol level,?obesity,?physical inactivity,?diabetes,?unhealthy diets, and harmful use of alcohol.Life style diseasesLife style disease is a disease that potentially can be prevented by changes in diet, environment, and lifestyle, such as heart disease, stroke, obesity, cancer and ten life style diseaseAlzheimer's disease: a form of brain disease.No one knows the exact cause, but a real breakdown ofthe cells of the brain does occur. There is no treatment, but good nutrition may slow the progress of this lifestyle disease, which lasts about seven years in most people who have it.Arteriosclerosis: A generic term for several diseases in which the arterial wall becomes thicken and loses elasticity. Atherosclerosis is the most common and serious vascular disease.Plaques (atheromas) deposited in the walls of arteries are major causes of heart disease, chest pain (angina pectoris), heart attacks, and other disorders of the circulation. In atherosclerosis yellowish plaques of cholesterol, fats, and other remains are deposited in the walls of large and medium-sized arteries. Atherosclerosis usually occurs with aging. It is linked to overweight, high blood pressure, and diabetes.Cancer: diseases characterized by uncontrolled, abnormal growth of cells.Cancer has been the number two cause of death since 1938, But, at the turn of the 20th century, Cancer is definitely considered the number one Disease of Civilization.There are more than 150 different kinds of cancer and many different causes.Chronic Liver Disease/Cirrhosis: any of a group of liver disorders.Characteristics of liver disease are jaundice, loss of appetite, liver enlargement, fluid accumulation, and impaired consciousness.Chronic Obstructive Pulmonary Disease (COPD): a disease characterized by slowly progressing, irreversible airway obstruction.The symptoms are problems in breathing while exercising, difficulty in breathing in or out deeply, and sometimes a long-term cough. The condition may result from chronic bronchitis, emphysema, asthma, or chronic bronchiolitis. Cigarette smoking and air pollution make it worse.Diabetes: a disease affecting sugars used by the body.There are four main types of diabetes mellitus. Type I diabetes is also called insulin-dependent diabetes, juvenile-onset diabetes, brittle diabetes, or ketosis-prone diabetes. Type II diabetes is also called non-insulin-dependent diabetes, adult-onset diabetes, ketosis-resistant diabetes, or stable diabetes. Type II often develops in over weight adults. Type III, or gestational diabetes, occurs in some women during pregnancy. Type IV includes other types of diabetes are linked to disease of the pancreas, hormonal changes, side effects of drugs, or genetic defects.Heart Disease: any of several abnormalities that affect the heart muscle or the blood vessels of the heart.Heart disease has been the number one cause of mortality and morbidity in most of the USA since1910. There are a couple dozen forms of this lifestyle disease. Heart disease and other forms of cardiovascular disease can lead to congestive heart failure, a condition in which the heart cannot pump sufficient blood to meet the demands of the body. The various forms of heart disease may also cause disturbances in normal heartbeat, called arrhythmia.Nephritis/CRF: any disease of the kidney marked by swelling and abnormal function.Characteristics of kidney disease are bloody urine, persistent protein in urine, pus in urine, edema, difficult urination, and pain in the back.Stroke: a condition due to the lack of oxygen to the brain that may lead to reversible or irreversible paralysis.Stroke is linked to advanced age, high blood pressure, previous attacks of poor circulation, cigarette smoking, heart disorders, embolism, family history of strokes, use of birth-control pills, diabetes mellitus, lack of exercise, overweight, high cholesterol, and hyperlipidemia.CHAPTER SIXHYGIENEPersonal hygieneGood personal hygiene is the first step to good health. It not only protects you from poor health, but also shields those around you from suffering?illnesses?that arise from poor personal habits. Habits such as washing your hands, bathing, brushing (flossing) may all look monotonous and boring, but they all come under important personal hygiene. They make you feel good about yourself and keep you free of bacteria, viruses, and related illnesses.Cleaning and disinfection of home and work spaces.?Viruses are breeding round the clock, especially when it comes to hard surfaces, like dining tables chairs in home, office desks, office floors and so on.?Make sure your home and office administration staff routinely cleans door handles, countertops, keyboards and doorknobs with anti-bacterial solution to remove the germs.?Go for soup and an alcohol-based sanitizer.?Clean your hands every now and then by using hand sanitizers like soup and alcohol. This is because they are a drying agent and kills all the viruses and bacterias immediately.?However, please note alcohol is liable to make your skin dry, thus always go for a branded alcohol-based fragrance-free hand sanitizer, which has a good amount of moisturizer in it.?Makeup hygiene.?Eyebrow pencil hygiene is a must. Always ensure that you clean your eyebrow pencil with a wet tissue before usage in order to get rid of bacterial residue.Wash your makeup brush and powder puffs on a weekly basis with a mild baby shampoo for best and safe usage. Dry the washed makeup product by using a clean towel.Never use your fingers to apply makeup, unless and until a professional artist does that for you. But, if you must use your fingers, then make sure they're clean.Brushing hygiene?Brush your teeth twice a day for at least 3-5 minutes. Make sure you do not put too much pressure as this can hurt your gums.?Place the bristles along the gum line at a 45-degree angle. Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back and forth motion. Clean outer, inner and biting surfaces of teeth with scrubbing motion.?Studies show an essential oil based mouthwash reduces plaque by 70% and gum problems by 36% over brushing alone. Use an anti-microbial mouthwash to get complete protection from germs.Floss your teeth easily by moving the floss gently between your teeth; pull the floss smoothly back and front. Additionally, Clean and brush the surface of your tongue daily because there is bacteria present particularly on the rougher top surface of the tongue. These can contribute to bad breath (halitosis) and negatively affect your dental health.Bath daily?A daily shower is a must whether you feel tired or not. A regular bath (every morning and after all athletic activities) helps in keeping you clean, fresh and odour free.Cleaning your body is also important to ensure your skin rejuvenates itself, as the scrubbing of your arms, legs, and torso will slough off dead, dry skin and help your skin stay healthy and refreshed, and will prevent acne, blemishes and other skin eruptions.?Also, do not share your towel and wash them on a regular basis.??Trim your nails?Keeping your finger and toenails trimmed and in good shape will prevent problems such as hang nails (when a loose strip of dead skin hangs from the edge of a fingernail) and infected nail beds.If possible, trim them weekly and brush them daily with soap so that no dirt or residue remains beneath the nail.Fingernails should be trimmed straight across and slightly rounded at the top whereas toenails should be trimmed straight across.The best time to cut your nails is after bathing when they are soft and easy to trim.Take care of your hair?Washing your hair at least every other day is important to keeping your hair and scalp healthy and in good shape.If you suffer from lice or dandruff, then take necessary action at the earliest. Also, it is critical that you get a haircut frequently for healthy hair.The longer you wait to get your hair cut, the more frail and brittle your hair can become, especially if it is longerWear Clean Clothes?Wear a fresh set of clothes as often as possible.?Dirty clothes are a source of contamination and can cause very serious skin disorders if worn over and over without washing them.?Also, try wearing a clean pair of socks every day (especially after athletic activities) as this keeps your feet dry and not smelly.Wash clothing and linens on a regular basis as the longer it takes you to clean them the smellier they become.?Hair Removal?Shave your underarms and legs if you desire, but do so with care. Use a new blade if you are going to shave with a manual razor to lessen your risk of cutting yourself. Also use shaving cream, or a shaving gel.?Take your time when shaving to avoid nicks and cuts.?Try using a moisturizer that contains no oil if you want to make facial hair less noticeable, or use a bleaching product.?Talk to your parents about removing facial hair permanently, if you are thinking about it.?Body Odour?Keep your underarms and groin area clean and dry to discourage bacteria.?Change out of sweaty clothes as soon as possible after exercising or perspiring.?Trim or shave your underarm and pubic hair so there is less surface area allowing for the accumulation of sweat and bacteria.?Use deodorants perfumes.Clean your ears?Clean your ears with your fingers by using clean cloths while having a bath.?The daily cleaning of all hearing devices is essential to remove germs that can be introduced into the ear?Earrings should be kept clean, and should be removed daily so the piercing can be attended to.?The use of hair products can build-up on the ear and should be washed off when possible to avoid irritation to the skin of the ear.?Foot Care?Wash your feet properly while having a bath, especially between the fingers?Wear the right socks?Make sure your shoes aren't too tight.?Switch shoes as per your economic capacity.?Wash shoes or insoles of your shoes?Aerate your foot in home by using slippers Genital care?Men?have to wash their genital area well in every shower daily and after sexual intercourse.Women?must clean genital area at list twice a day.?Change panties daily. ?This area should be kept shaved.Food hygiene Food is one of the essential needs for survival and well being of man.Why do we need food?Food is needed for: -Growth and development.To provide energy for movement, work and for maintaining vital functions ofthe body, e.g. the heart needs energy to circulate blood in our body.Food is needed to repair and replace our body cells.As food is essential for our life, it is also dangerous and cause diseases ifnot processed and maintained in sanitary and safe conditions. Diseasescommonly transmitted to man through contaminated unsafe food can bedivided into: -Those caused by pathogenic microorganisms (disease causing germs), suchas diarrhoea, Typhoid fever, cholera, intestinal parasites such as Amoebiasis,diseases transmittable to man from animals, e.g. Tape worm, Anthrax, BovineTuberculosis etc.Chemical food poisoning can also occur if foodstuff has been in contact withhazardous toxic chemicals during food production, processing, storage andhandling etc.Therefore, foodstuffs, which have been contaminated by microbial pathogens ortoxic chemicals, are dangerous to human beings, particularly to children,pregnant women, lactating mothers and aged people. Most of the time food is contaminated during food preparation and storage or preservation. Food preparationKeeping cleanliness of food preparation, food serving utensils and cutlery are some of the mechanisms to keep food hygiene during preparation. Here are some points to be kept in mind during food preparation.We should wash our hands properly with clean water and soap before preparing and eating food.Food preparation equipment such as clay pot, iron pot, slicing table, knife and the like should be properly washed with hot water before preparing food. After use, they should be washed, dried, and be kept covered in clean cupboard.Food serving equipment such as plates, food baskets, spoons, and drinking cups, and similar items should be washed properly before serving food, and after usage they should be washed, dried, covered and kept away from access to flies, dust andother contaminants.Other equipment used for long storage of food items, such as pepper, shiro (powdered lentil), butter and the like should be cleaned after the contents are used and before storing again in them.Baskets for keeping enjera, bread, should be kept away from access by fungi, moulds, and microorganisms which are likely cause disease should be washed and exposed to sunshine.Cleaning regularly and plastering the areas of food preparation, and preventing from access to dust and other contaminants.Always use clean and plenty of water for washing utility equipments hands and preparing food.The above described food preparation and food serving utensils and equipment be stored above ground level in properly constructed racks, the racks should be cleaned regularly.Always store raw meets, poultry, sea foods, fruits and vegetables in a refrigerator. The food should be stored away from dust and access to flies and other pests. (Federal Democratic Republic of Ethiopia. Ministry of HealthFood Hygiene and Safety Measures Extension PackageFebruary, 2004. Addis Ababa).Food preservationIn order to protect food poisoning by pathogenic micro organisms you have to preserve food with in limited temperature range and clean, dry, safe preservation area as well as clean instruments. The temperature range in which food-borne?bacteria?can grow is known as the?danger zone. Food safety agencies, such as the United States'?Food Safety and Inspection Service, define the danger zone as roughly 4–5 to 60 °C (39–41 to 140?°F).?Potentially hazardous food?should not be stored at temperatures in this range in order to prevent?food borne illness, and food that remains in this zone for more than two hours should not be consumed. Food borne microorganisms grow much faster in the middle of the zone, at temperatures between 21?and?47?°C (70?and 117?°F).[5]Food-borne bacteria, in large enough numbers, can cause so-called food poisoning, symptoms similar to?gastroenteritis?or "stomach flu" (a misnomer, as true?influenza?primarily affects the respiratory system). Some of the symptoms include stomach cramps,?nausea,?vomiting,?diarrhea, and?fever. Food-borne illness becomes more dangerous in certain populations, such as people with weakened immune systems, young children, the elderly and pregnant women.Menstrual hygieneMenstruation is associated with puberty. For girls – this is a time of biological flowering that immediately brings with it restrictions, rules, confinement and changed expectations in many cultures. The physical manifestations of puberty and the lack of safe, dignified practices to manage menstruation have somehow created a complex, heavy silence around this important and very positive lifecycle change. The resulting restrictions in self expression, schooling, mobility, freedom and space have far reaching and deleterious impacts on girls and women globally.Menstruation is not considered as a physiological phenomenon - it is surrounded by silence, shame and social taboos that are further manifested in social practices that in many cultures restrict mobility, freedom and access to normal activities and services. Menstruating women and girls – are considered impure, unclean, unfit for the public sphereof different cultures. This perception is further exacerbated by the lack of awareness, washing and bathing facilities, materials and spaces that can help women and girls manage their menstrual discharge with dignity and safety. Poor menstrual hygiene is linked to lower reproductory tract infections, urinary tract infections, bacterial vaginosis, vulvovaginal cardiosis and dysmenorrhoea, also indicating linkages with higher anaemia and infertility.Sanitation and hygiene concept is the very real need of women and girls to manage menstrual discharge, to keep clean and safe the reproductive organ from infection etc. Menstrual hygiene management is not the merely the use of sanitary pads or hygiene education on its own it is also psychological, and social concerns too. Hygiene programs starts from positive concept of menstruation, how to train girls managing their menstruation, proper disposal of the material used, in addition how to use water and materials for keeping hygiene.CHAPTER SEVENNUTRITION, STRESS AND STRESS MANAGEMENT Basic nutrition and healthThere are six classes of nutrients they are: - Carbohydrates (CHO), proteins, fats, vitamins, minerals and water. CHO, proteins, and fat, are called macronutrients, are the energy providing nutrients Vitamins and minerals, also called micronutrients, are needed in small amounts to help in the different energy metabolism. Water is the most abundant nutrient in the body and is essential for the normal functioning of all the organs in the body. All the six nutrients will be discussed in detail throughout the chapter.Carbohydrates CHO are found in grains, fruits, and vegetables and are the main source of energy in a healthy diet. Unfortunately, many people think CHO are unhealthy and lead to weight gain. That notion came about because most people add high-fat toppings and sauces to their starchy foods. The two types of CHO are:Simple CHO: - have one (mono-) or two (disaccharides) sugar molecules hooked together. Examples include: glucose, table sugar (sucrose), sugars in fruit (fructose), honey (fructose and glucose), sugar in milk (lactose), maple syrup, and molasses. Complex CHO: - have three or more simple sugar molecules hooked together and are digested into simple sugars by our bodies. Examples include: starch from whole grains and legumes (peas, beans). Both starch (digestible) and dietary fibers (indigestible) are forms of complex CHO. Although, dietary fiber does not provide any kcals, for health reasons it is recommended that adults eat 20-35 grams of fiber a day. This is achieved by eating more fruits, vegetables, and whole grains.CHO are used in the body to:Provide energy in the form of glucose (stored as glycogen).Provide fuel for the brain.Act as building blocks for chemicals needed by the body.Repair tissue damage in the body.Energy From CHO1 gram of CHO supplies 4k cal.CHO should supply 55-60% of your total daily kcals.ProteinsProteins are found in meat, fish, poultry and dairy foods. Beans and grains also provide proteins but in smaller amounts than animal foods. All proteins are made of various amino acids that are joined together. There are 20 different amino acids. Nine of these are called essential amino acids because the body cannot make them, so they must be obtained from the diet.Proteins are used in the body to:Form muscle, hair, nails, skin, and other tissues.Provide energy.Repair injuries.Serve as the building blocks of hormones and vitamins.Carry fats, vitamins and minerals to different parts of the body. Serve a structural role for every partEnergy From protein1gram of protein supplies 4 kcalYour protein needs are determined by your age, body weight, and activity level. Proteins should supply 10-15% of your total daily kcals. Most people eat 100 to 200 g of proteins each day, which is more protein than is actually needed by the body. Many people eat high-protein foods because they think that proteins make them grow “bigger and stronger”. Actually, these excess kcals from proteins can be converted to fat and stored. Although proteins provide energy, they should not be the main dietary source of energy. High-protein intakes also increase fluid needs and may be dehydrating if fluid needs are not met. In addition, high-protein intakes put the kidneys under great strain in order to get rid of all the breakdown products.FatsFats are an essential part of your diet, regardless of their bad reputation. However, not all fats are created equal. By knowing about the different types of dietary fats and using the guidelines for daily fat consumption, you can eat the right amount of fat. The three types of fats naturally present in foods are saturated fat, unsaturated (mono- and polyunsaturated) fats. And trance which is created during the processing of some foods.Saturated Fats are solid at room temperature and are found primarily in animal foods (red meats, lard, butter, poultry with skin, and whole milk dairy products); tropical oils such as palm, palm kernel and coconut are also high in saturated fat.Monounsaturated Fats are liquid at room temperature and are found in olive oil, canola oil and peanuts.Polyunsaturated Fats are liquid at room temperature and are found in fish, corn, wheat, nuts, seeds, and vegetable oils.Trance fats are created during manufacturing by a process known as hydrogenation. This process converts unsaturated fats Manufacturers hydrogenate foods to improve the shelf-life of their products. Currently, food labels do not list the trance fat content of a food but if “hydrogenated oils” are listed under ingredients it indicates the presence of trance fats. The more processed foods you eat the greater your trance fat intake. Trance fats may increase blood cholesterol. A high-fat diet is associated with many diseases, including heart disease, cancer, obesity, and diabetes. On average, people who eat high-fat diets have more body fat than people who eat high-CHO, low-fat diets. On the other hand, a fat-free diet is also very harmful since fat is an essential nutrient required by the body (see a list of its functions below). Fats are used in the body to:Provide a major form of stored energy.Insulate the body and protect the organs.Carry other nutrients throughout the body.Serve a structural role in cells.Satisfy hunger and add taste to foods.Energy From Fat1 gram of fat supplies 9 kcal, more than twice the energy supplied by CHO.Fats should supply no more than 30% of your total daily kcals.CholesterolCholesterol is a part of body cells, and serves as a building block for some hormones (e.g., testosterone and estrogens), and it is required to digest fats. The body makes cholesterol in the liver. Cholesterol is also consumed in the diet by eating animal products. A diet high in dietary cholesterol and saturated fats is associated with an increased risk for heart disease. The American Heart Association recommends that daily cholesterol intakes do not exceed 300 milligrams. Red meats and egg yolks are cholesterol rich foods that should be consumed in moderation.MicronutrientsVitaminsVitamins are classified as fat or water soluble.Fat Soluble Vitamins are absorbed with dietary fat, can be stored in the body, and are not excreted in the urine. These include vitamins A, D, E and K.Water Soluble Vitamins, including the B vitamins and Vitamin C, are not stored in the body in appreciable amounts and excess amounts are excreted in the urine each day.MineralsMinerals are classified according to their concentrations and functions in the body. Minerals - examples include: calcium and magnesium.Trace Minerals - are less abundant than minerals; examples include: zinc, copper and iron.Electrolytes - examples include sodium, potassium and chloride.Recommended Dietary AllowancesThe Recommended Dietary Allowances (RDA) The RDAs are designed to meet the daily requirements for most healthy people. The RDAs are undergoing revisions and new standards are gradually becoming available. These new standards are called the Dietary Reference Intakes (DRI). The military has also developed a set of allowances known as the Military DRIs (MDRIs) to be used for designing military rations.In most cases your micronutrient needs will be met by eating a variety of foods. Taking multivitamin and mineral supplements is another way to meet the RDAs for the micronutrients. However, if you elect to take micronutrient supplements, you are urged to take only the RDA amount for each micronutrient. Taking more than the RDA of a micronutrient could lead to toxicity and create deficiencies of other micronutrients.Micronutrients in the DietNo one food can provide all of the micronutrients, so you are encouraged to eat a variety of foods. Also, food preparation can affect the amount of nutrients that remain in the food, especially when cooking vegetables. To increase the retention of vitamins while preparing a meal: Cook food in just enough water to prevent burning, do not soak.Cook vegetables only until they are crisp and tender.Steam or stir-fry foods to retain the most vitamins.Use leftover cooking water for preparing soups and sauces to use the water soluble vitamins that were leached out.Cut and cook vegetables shortly before serving or store them in an airtight container.The amount of minerals that will be absorbed from foods depends upon a number of factors, such as:The presence of other dietary constituents, such as dietary fiber and other minerals.The body’s need for the mineral and the mineral’s chemical form.The integrity of the intestinal tract.Many things can affect your body’s ability to properly absorb vitamins and minerals. These include caffeine, tobacco, antibiotics, aspirin, alcohol and stress. For example, drinking coffee or tea with meals can decrease iron absorption and taking antibiotics can increase your Vitamin B needs.Requirements and Functions of VitaminsFat Soluble VitaminsSome Important FunctionsFood SourcesVitamin A:Retinol, Retinoids, Carotene 800-1,000 ?g. RE or 5,000 International Units (IU).Growth and repair of body tissues, immune function, night vision. Carotene is the water soluble form with antioxidant properties.Oatmeal, green and yellow fruits and vegetables, liver, milk.Vitamin D:5-10 ?g. or 200 - 400 IU.Regulates calcium metabolism and bone mineralization.Fortified milk, egg yolk, salmon, sunlight.Vitamin E: alpha-Tocopherol, 8-10 mg.Antioxidant, protects cell membranes, and enhances immune function. Fortified cereals, nuts, wheat germ, shrimp, green vegetables.Vitamin K:60 - 80 ?g.Assists in blood clotting and calcium metabolism.Green and leafy vegetables.Water Soluble VitaminsSome Important FunctionsFood SourcesVitamin B1: Thiamin, 1.0 -1.5 mg.Needed in energy production, CHO metabolism, and growth. Supports muscle, nerve, and cardiovascular function.Fortified cereals, legumes, pork, nuts, organ meats, molasses, yeast. Vitamin B2:Riboflavin, 1.2 -1.7 mg.Essential for energy metabolism; growth and tissue repair.Cereals, liver, milk, yogurt, green leafy vegetables, nuts, whole grain.Vitamin B3: Niacin, Niacinamide, Nicotinic acid 13 -19 mg.Essential for energy metabolism, blood circulation, nerve function, and appetite.Lean meat, seafood, milk, yeast, fortified cereals, whole grain.Vitamin B5: Pantothenic acid, 4 - 7 mg.Essential for energy metabolism and nerve function.Legumes, meat, fish, poultry, wheat germ, whole grain.Vitamin B6: Pyridoxine HCl, 2 mg.Essential for CHO and protein metabolism, immune function, red blood cell production, nerve function. Oatmeal and cereals, banana, plantain, poultry, liver.Folate: Folic acid, Folacin, 400 ?g.Vital for red blood cell synthesis. Essential for the proper division of cells. Maternal folate deficiency may result in an infant with birth defects. Fortified cereals, green leafy vegetables, liver, lentils, black-eyed peas, orange juice.Vitamin B12: Cobalamin, 2 ?g.Required for red blood cell production, energy metabolism, and nerve function. Ground beef, liver, seafood, milk, cheese.Biotin:30 - 100 ?g.Participates in energy metabolism, fatty acid formation, and utilization of the B vitamins.Legumes, whole grain, eggs, organ meats.Vitamin C: Ascorbic acid, Ascorbate 60 mg.Antioxidant, role in growth and repair of tissues, increases resistance to infection, and supports optimal immune function.Cantaloupe, citrus fruit, strawberries, asparagus, cabbage, tomatoes, broccoli.Requirements and Functions of MineralsMineralSome Important FunctionsFood SourcesBoronUnknownImportant in bone retention.Fruits, leafy vegetables, nuts, legumes, beans.Calcium1,000 - 1,300 mg.Essential for growth and structural integrity of bones and teeth; nerve conduction; muscle contraction and relaxation. Yogurt, milk, cheese, tofu, fortified juices, green leafy vegetables.Chromium150 - 200 ?g.Participates in CHO and fat metabolism; muscle function; increases effectiveness of insulin. Whole grains, cheese, yeast.Copper11.5 - 3 mg.Essential for red blood cell production, pigmentation, and bone health. Nuts, liver, lobster, cereals, legumes, dried fruit.Iron210 -15 mg.Essential for the production of hemoglobin in red blood cells and myoglobin in skeletal muscle, and enzymes that participate in metabolism. Liver, clams, oatmeal, farina, fortified cereals, soybeans, apricot, green leafy vegetables.Magnesium280 - 350 mg.Essential for nerve impulse conduction; muscle contraction and relaxation; enzyme activation.Whole grains, artichoke, beans, green leafy vegetables, fish, nuts, fruit.Manganese12 - 5 mg.Essential for formation and integrity of connective tissue and bone, sex hormone production, and cell function.Nuts, legumes, whole grains.Phosphorous800 - 1,200 mg.Essential for metabolism and bone development. Involved in most biochemical reactions in the body.Fish, milk, meats, poultry, legumes, nuts.Potassium32,000 mg.Essential for nerve impulse conduction, fluid balance, and for normal heart function.Squash, potatoes, beans, fresh fruits (bananas, oranges) and vegetables (tomatoes). Selenium55 - 70 ?g.Antioxidant, works with vitamin E to reduce oxidation damage to tissues.Meats, seafood, cereals.Sodium4500 - 2,400 mg.Essential for nerve impulse conduction, muscle contraction, fluid balance, and acidbase balance.Table salt, canned and processed foods.Zinc12 - 15 mg.Involved in metabolism, immune function, wound healing, and taste and smell sensitivity.Seafood, beef, lamb, liver, eggs, whole grains, legumes, peanuts.WaterApproximately 60% of total body weight is water. Thus, adequate amounts of water must be consumed daily to ensure the normal functioning of the body and to replenish lost fluids. Water is found both inside and outside the cells of the body, but most water is inside cells, especially muscle cells. The lowest concentration of water is in bone and fat. Since muscle mass contains more water than fat, the leaner you are, the more body water you have! Water in the body serves many important roles, including:Facilitating Digestion and absorbing nutrients.Excreting wastes.Maintaining blood circulation throughout the body.Maintaining body temperature.Note: Exercise, heat, cold, and altitude can increase fluid requirements. Maintaining Fluid BalanceFluid balance, like energy balance, is determined by the ratio of fluid losses to fluid intakes. With dehydration, water loss exceeds intake and fluid balance becomes negative. The average person loses 1,000 ml to 2,300 ml of water per day. This water is lost in the urine, in stools, in sweat, and through breathing. When activity levels are low, most fluids are lost through the urine. When activity levels are high or the temperature is high, most of the fluid is lost through sweat. In fact, up to 2,000 ml per hour can be lost through sweating, depending on the temperature. To maintain fluid balance you must consume enough fluids each day from:Water in beverages (water, fruit juices, milk, sport drinks).Water in food (fruits, vegetables, soups, meats, grains).DehydrationDehydration results when fluid losses exceed fluid intake. Conditions that can lead to dehydration include:Not drinking enough fluids daily.Working or exercising in a hot environment.Working or exercising in a cold environment. Drinking too much alcohol or exercising with a hangover.Drinking high amount of coffee. If 4% of your body weight is lost through fluid losses, decision-making, concentration, and physical work are impaired. A loss of 20% of body water can result in death.Symptoms of Dehydration0% Feeling great!1% Feeling thirsty. 2% Increased sense of thirst, feeling uncomfortable.3% Dry mouth, blood and urine volumes decreased and yellowish concentrated urine.4% Feeling sick, reduced performance.5% Feeling sleepy, headache, can’t concentrate.20% Death. Stress and Stress ManagementStress is what happens to our body, mind, and behavior in response to an event (E.g. heart pounding, anxiety, or nail biting). While stress does involve events and our response to then, these are not the most important factors. Our thoughts about the situations in which we find ourselves are the critical factor. When something happens to us, we automatically evaluate the situation mentally. We decide if it is threatening to us, how we need to deal with the situation, and what skills we can use. If we decide that the demands of the situation outweigh the skills we have, then we label the situation as “stressful” and react with the classic “stress response.” If we decide that our coping skills outweigh the demands of the situation, then we don’t see it as “stressful.”Stress can come from any situation or thought that makes you feel frustrated, angry, or anxious. Everyone sees situations differently and has different coping skills. For this reason, no two people will respond exactly the same way to a given situation. Additionally, not all situations that are labeled “stressful” are negative.Stress is a normal part of life. In small quantities, stress is good; it can motivate you and help you become more productive. However, too much stress, or a strong response to stress can be harmful. How we perceive a stress provoking event and how we react to it determines its impact on our health. We may be motivated and invigorated by the events in our lives, or we may see some as “stressful” and respond in a manner that may have a negative effect on our physical, mental, and social well-being. If we always respond in a negative way, our health and happiness may suffer. By understanding ourselves and our reaction to stress-provoking situations, we can learn to handle stress more effectively. In The most accurate meaning, stress management is not about learning how to avoid or escape the pressures and turbulence of modern living; it is about learning to appreciate how the body reacts to these pressures, and about learning how to develop skills which enhance the body’s adjustment. To learn stress management is to learn about the mind-body connection and to the degree to which we can control our health in a positive sense.Sources of StressWe can experience stress from four basic sources:The Environment – the environment can bombard you with intense and competing demands to adjust. Examples of environmental stressors include weather, noise, crowding, pollution, traffic, unsafe and substandard housing, and crime.Social Stressors – we can experience multiple stressors arising from the demands of the different social roles we occupy, such as parent, spouse, caregiver, and employee. Some examples of social stressors include deadlines, ?nancial problems, job interviews, presentations, disagreements, demands for your time and attention, loss of a loved one, divorce, and co-parenting.Physiological – Situations and circumstances affecting our body can be experienced as physiological stressors. Examples of physiological stressors include rapid growth of adolescence, menopause, illness, aging, giving birth, accidents, lack of exercise, poor nutrition, and sleep disturbances.Thoughts – Your brain interprets and perceives situations as stressful, difficult, painful, or pleasant. Some situations in life are stress provoking, but it is our thoughts that determine whether they are a problem for us or not.Types of StressorsSituations that are considered stress provoking are known as stressors. Stress is not always a bad thing. Stress is simply the body’s response to changes that create taxing demands. Many professionals suggest that there is a difference between what we perceive as positive stress, and distress, which refers to negative stress. In daily life, we often use the term “stress” to describe negative situations. This leads many people to believe that all stress is bad for you, which is not true. Positive stress has the following characteristics:? Motivates, focuses energy? Is short-term? Is perceived as within our coping abilities? Feels exciting? Improves performanceIn contrast, negative stress has the following characteristics:? Causes anxiety or concern? Can be short or long-term? Is perceived as outside of our coping abilities? Feels unpleasant? Decreases performance? Can lead to mental and physical problemsIt is somewhat hard to categorize stressors into objective lists of those that cause positive stress and those that cause negative stress, because different people will have different perceptions and reactions to particular situations. However, by generalizing, we can compile a list of stressors that are typically experienced as negative or positive to most people, most of the time.Examples of negative personal stressors can include:? The death of a partner? Filing for divorce? Losing contact with loved ones? The death of a family member? Hospitalization (oneself or a family member)? Injury or illness (oneself or a family member)? Being abused or neglected? Separation from a spouse or committed relationship partner? Con?ict in interpersonal relationships? Bankruptcy/money problems? Unemployment? Sleep problems? Children’s problems at school? Legal problems? Inadequate or substandard housing? Excessive job demands? Job insecurity? Con?icts with team mates and supervisors? Lack of training necessary to do a job? Making presentations in front of colleagues or clients? Unproductive and time-consuming meetings? Commuting and travel schedulesExamples of positive personal stressors might include:? Receiving a promotion at work? Starting a new job? Marriage or commitment ceremony? Buying a home? Having a child? Moving? Taking or planning a vacation? Holiday seasons? Retiring (shy)? Taking educational classes or learning a new hobbySymptoms of stressCognitive Symptoms:? Memory problems? Inability or dif?culty concentrating? Poor judgment? Seeing only the negative? Anxious, racing, or ruminating thoughts? Constant worryingEmotional Symptoms:? Moodiness? Irritability or short-tempered? Agitation, inability to relax? Feeling overwhelmed? Sense of loneliness or isolation? Depression or general unhappinessPhysical Symptoms:? Aches and pains, muscle tension? Diarrhea or constipation? Nausea, dizziness, or butter?ies in the stomach? Chest pain or rapid heartbeat? Loss of sex drive? Frequent colds? Shallow breathing and sweatingBehavioral Symptoms:? Eating more or less? Sleeping too much or too little? Isolating yourself from others? Procrastinating or neglecting responsibilities? Using alcohol, cigarettes, or drugs to relax? Nervous habits (nail biting, pacing)Keep in mind that the signs and symptoms of stress also can be caused by other psychological and medical problems.The Relaxation ResponseIn the late 1960’s, at Harvard Medical School, where Walter B. Cannon performed ?ght or ?ight experiments 50 years earlier, Herbert Benson, M.D. found that there was a counter balancing mechanism to the stress response. Just as stimulating an area of the hypothalamus can cause the stress response, activating other areas of the brain results in its reduction. He de?ned this opposite state the “relaxation response”. The relaxation response is a physical state of deep rest that changes the physical and emotional responses to stress. When eliciting the relaxation response:Your metabolism decreasesYour heart beats slower and your muscles relaxYour breathing becomes slowerYour blood pressure decreasesYou return to a calmer state of being.Other techniques for evoking the relaxation response are:Mindfulness MeditationProgressive Muscle RelaxationDeep BreathingImagerySelf-MassageExerciseCHAPTER EIGHTPLANNING AND MANAGEMENT OF THE FITNESS PROGRAMPlanning fitness programWhat does a well rounded fitness program include? 1. Cardiovascular activities including walking, swimming, water aerobics, jogging/running, cycling, stair climbing, using an elliptical trainer, and taking aerobic classes;2. Muscular Strength and endurance training exercises consisting of using free weights, weight machines, or doing callisthenic exercises such as push-ups or sit-ups. These exercises build strength and endurance in the muscles and joints; 3. Flexibility exercises such as yoga and stretching keep muscles and joints flexible and improve joint range of motion. What do you need to do before starting in fitness program?Setting goalsSetting goals to reach is a crucial step in planning fitness program based on measurable factors like raising vo2 max%, reducing time taken to run miles, increasing number of push-ups or sit-ups performed per minutes, improving BMI. The goals should be SMART (specific, measurable, attainable, realistic, and time framed).Applying the FITT principleA well-designed personal physical activity plan will outline how often (frequency), how long(time), and how hard (intensity) a person exercises, and what kinds of exercises (type) are selected. The exercise frequency, intensity, time, and type (FITT principle) are key components of any fitness plan or routine. An individual’s goals, present fitness level, age, health, skills, interest, and availability of time are among the factors to consider in developing a personal physical activity plan. Regardless of the specific goals, both programs would be based upon the elements of the FITT principle.Developing tools for monitoring your progressTo monitor the overall progress of your fitness program you may choose to reassess your cardio respiratory endurance, muscular strength and endurance, flexibility, body composition every three months or during the improvement phases of your program; for this you have to use measurement mechanisms and instruments of these fitness components to compare the result with the initial fitness level.Putting your plan into action and commitmentPutting plans into action and make a commitment is the central point of fitness program. Many people find it easier to plan fitness program than putting the plan into action and stick with it over time.Cardiovascular/respiratory enduranceCardio respiratory endurance (CRE): At least three days per week 20 to 30 minute bouts of aerobic (activity requiring oxygen) exercise each week are recommended. Popular aerobic conditioning activities include brisk walking, jogging, swimming, cycling, rope jumping, rowing, cross-country skiing, and some continuous action games such as basketball and soccer. The type of activity suitable for a person to develop cardio respiratory fitness is dependent upon the person’s initial fitness. A jog may be intense for one individual and serve as a warm-up for another. Start out with moderate-intensity exercise (comparable to brisk walking).? Participate in cardio exercise a minimum of 150 minutes each week.? Noticeably accelerate the heart rate. Use the "The Talk Test" to gauge your intensity level. You should be able to carry on a conversation while exercising at a moderate intensity level.? Can be accumulated in 10 minute bouts to equal 30 minute minimum.? Begin slowly and gradually increase frequency, duration, and intensity level. To create success full cardiovascular endurance exercise you must set realistic goals: set your starting frequency, Intensity and time (duration) at appropriate levels and type or appropriate exercise and remember to warm up and cool down.Through endurance training an individual may be able to improve: - Maximal oxygen consumption (VO2max ) increased by about 10-30%. But it depends on age, health status and initial fitness level.Resting heart rate may decreased by as much as 10- 15 bpm by about 4 to 6 week trainings.FrequencyTo build cardiovascular endurance you should exercise 3 to 5 days per week. Beginners have to start from 3 days and work up to 5 days per week. Works beyond 5 days can lead the athlete to injury and trainings less than 3 days per week can’t make it to improve your fitness level.IntensityThere two methods that help to monitor exercise intensity they are Target heart rate zone and rate of perceived exertion.Target heart rate zone It is one of the best methods of monitoring intensity of cardiovascular endurance training to improve maximum oxygen consumption (VO2max) training up to your maximum heart rate. According to ACSM target heart rate zone at which you should to exercise to get cardiovascular benefit is between 65% and 90% of your maximum heart rate.To calculate your target heart rate zoneEstimate your maximum heart rate by subtracting 220 by your age Multiplying your maximum heart rate by 65% and 90% but unfit people should train at their 55% MHR for their training threshold.Heart rate reserve (HRR) may be used some times for calculating target heart rate. HRR = MHR-RHR. And THR = HRR+40/50% for unfit person and HRR+85% for fit person.Ratings of Perceived ExertionIt is a system of monitoring exercise intensity based on assigning a number to the subjective perception of target intensity. For example if your target zone is about 135-155bpm, exercise intensity enough to raise your heart rate that level, and then associate a rating some “what hard or hard” with how hard you feel during working.Time (duration) of the trainingA total duration of 20- 60 minutes is recommended and sometimes it may be up to 70 minutes and 90 minutes according to the intensity (Thomas D. and Walton T., 2001). Muscular Strength Training Muscular strength: Perform a minimum of 8 to 10 exercises for each of the major muscle groups. Perform a minimum of 1 or more sets of 8 to 12 repetitions.Train strength training 2 to 3 days per week.Perform each exercise in a controlled manner through the full range of motion.Maintain a normal breathing pattern. Exercise with a partner for assistance and motivation (Edward T. and. Don Franks, 2003). Muscular endurance: Two to three 30-minute sessions each week that include exercises such as calisthenics, push-ups, curl-ups, pull-ups, and light weight training for all the major muscle groups are required. For a sedentary person, muscular strength and muscular endurance sessions can be combined and limited to two sessions per week. Then, as the behaviour is adopted (becomes a habit),Flexibility Training? Perform flexibility exercises that stretch the major muscle groups (chest, shoulders, back, arms, abdomen, hips, and legs). ? Do these a minimum of 2-3 days per week.? Perform stretches to a position of mild discomfort.? Hold each stretch 10-30 seconds. DO NOT bounce while in a stretch position.? Do 3-4 repetitions for each stretch.Special Exercise Guide Lines for People with Special Health ProblemsArthritisThere are three main types of exercise according to purposes 1) therapeutic/rehabilitative; 2) recreational/leisure; and 3) competitive/elite. Therapeutic exercises, prescribed by health professionals, address specific joints or body parts affected by the arthritis or arthritis-related surgery. A therapeutic exercise program is often a necessary first step for individuals who have been inactive, have restricted joint motion or muscle strength, are experiencing joint paint or are recovering from surgery such as a joint replacement.Recreational or leisure activities can range from walking and swimming to cross country skiing and running. Appropriate forms are those that can be done in a controlled and safe manner, have little risk of injury, and place little stress and loads on affected joints. In most cases, participating in recreational exercise does not do away with the need for therapeutic exercises.If you have arthritis, you may think that exercise will increase your joint pain or speed the joint breakdown; however, regular exercise is actually beneficial for the person with arthritis. Often the joint pain and stiffness that are the primary symptoms of arthritis cause us to reduce our activity.Unfortunately, this actually will lead to an increase in symptoms and loss of normal function, and may even speed the breakdown within the joint. Regular exercise will actually decrease symptoms and enable you to continue with normal activities. In fact, one study found that a group arthritic patients who exercised regularly had less joint replacement surgeries when compared to a group of similar-aged persons who did not exercise.Most experts agree that participating in a regular exercise program that follows ACSM guidelines is important and safe for those with arthritis. This means your program should include aerobic conditioning (30 to 60 minutes on five days per week), resistance training (one set, major muscle groups, two times per week) and flexibility activities. Some benefits relevant to arthritis include:Decreased joint pain and stiffness.Improved or maintained joint motion.Decreased risk of cardiovascular disease (higher in those with rheumatoid arthritis).Improved ability to do activities such as getting in and out of a car or going up and down stairs.Decreased disease activity.You may need to make a few modifications to your program based upon the type and severity of arthritis that you have. If you have a systemic type of arthritis, such as rheumatoid arthritis, the immune system is affected. Thus you may need more rest, especially when you are having a flare-up. Other modifications are usually activity specific.While some individuals can successfully jog for their aerobic training, and it does not speed up the breakdown within the joint, others find that the impact of jogging starts to become too stressful for their joints. Brisk walking, cycling or elliptical training are exercise activities that will reduce the joint impact. If you have not been very active, it is very important that you start out slowly and you will find that doing two to three short sessions a day will help you get used to the activity, without increasing your joint pain. Good shoes with proper arch support and cushioning are necessary. Another concern during aerobic activities is joint alignment and stability. Alignment may be improved with shoe inserts and joint stability is often addressed by use of a splint or brace.Resistance training is especially useful – it will help with functional activities, absorb stress around a joint, and help support unstable joints. Training moves for the legs that do not support the extremity, such as putting a weight around your ankle and straightening the knee when sitting, can put a lot of stress on a joint. A modified squat is a good alternative; either doing only a partial move or altering the position to keep your body weight behind the knee. A good alternative to training with machines are body weight activities, such as the modified squat.While flexibility is very important, you should make sure that the stretch is gentle. If you have joint instability you should not stretch beyond normal range for that joint. Probably more helpful than stretching are range of motion (ROM) activities. Moving your joints through the normal motion on a daily basis will help to prevent loss of motion and will also decrease the sensation of stiffness. You should do five to 10 moves for each joint that is affected, and can even do such activities a few times a day.If you enjoy group activities there are classes developed for people with arthritis. The “PACE” program (People with Arthritis Can Exercise) is a class that combines aerobic, flexibility and some muscular toning. Aquatic classes are great for reducing stress to the joints, although the aerobic benefits are not as great as some other activities. Tai chi, which is often promoted for balance and fall prevention, provides good conditioning and flexibility and there is a form which was specifically developed for individuals with arthritis. If you opt for a traditional class you may need to modify moves based on your specific limitations. Avoid extreme motions or positions – anything that may increase your pain.Regardless of the activity you choose, make sure you warm-up and cool-down properly. This means you start with smaller, slower movements and gradually increase the intensity of movement. Doing some range of motion prior to and following aerobic or resistance training is a good way to get the joints ready for the activity and to slow down afterwards. As noted in other issues and in many articles, the most important thing is for you to get started. If you are not sure about your medical limitations, check with your physician prior to starting. Find a partner or support group to help you and get moving.AsthmaBeing active is great for your health and wellbeing. Sometimes, however, the physical exertion of exercising or playing sport can trigger an episode of asthma. This is called ‘exercise-induced asthma’ (EIA). Exercise-induced asthma is usually easily managed and should be part of any asthma management plan.?As well as being good for you, regular physical activity can help you manage your asthma. Take time to learn how to manage your asthma so you can have a healthy and active lifestyle.?People with asthma should be able to participate in almost any sport or exercise. Scuba diving is the only sport not recommended. Most individuals with EIA can exercise to their full potential if their symptoms are managed properly. Many top athletes competing at national and international level have asthma.?Exercise-induced asthmaMost people with asthma have asthma symptoms if they exercise in dry or cold air. When at rest, you breathe through your nose and the air is warmed, moistened and filtered as it enters your body. When you exercise, you need more oxygen and so you breathe faster through your mouth. Your airways react to this cold, dry air and the muscles around them tighten.Asthma symptoms can occur during or, more commonly, after exercise. Some of the symptoms of EIA include:WheezingCoughingA feeling of tightness in the chestBreathlessness.It is the type of exercise, the amount of time spent exercising and the intensity of exercise that is important. Typically, vigorous activity for six minutes or more in cold, dry air is more likely to trigger asthma.Preparing for exerciseYou can reduce the risk or prevent exercise-induced asthma by preparing for physical activity in a few simple ways:Make sure your day-to-day asthma is well managed.Use your asthma reliever medication around five to ten minutes before you warm up. Speak to your doctor for advice.Always warm up with light exercise and stretching for 10 to 15 minutes before you play sport or exercise.Always cool down. If you get exercise-induced asthma during activityIf you feel the symptoms of asthma while exercising: Stop what you’re doing.Follow your asthma action plan. If you do not have a plan, take four separate puffs of your blue reliever medication (such as Airomir, Asmol, Bricanyl, or Ventolin). If appropriate, this medication is best taken one puff at a time via a spacer with four breaths taken from the spacer after each puff of medication. Wait four minutes.Only return to exercise or activity if you are free of symptoms. If the symptoms don’t go away, or if they return while you’re exercising, use your blue reliever as before. Do not return to any exercise or activity for the rest of the day and see your doctor. A ‘spacer’ is a special device shaped like a clear plastic football or tube through which aerosol inhaler (not dry powder inhaler) medications are inhaled. Medication must come in a metered dose inhaler (puffer) to be used with a spacer.When to avoid exerciseYou should avoid exercise if:Your asthma is not under controlYou have a cold or the fluYour peak flow meter reading is less than 80 per cent of your usual best.Exercise Tips for Persons with Allergic Conditions and Asthma ? Consult with an allergist and /or immunologist prior to starting an exercise program. The physician may test you to determine what you are allergic to and to possibly diagnose asthma. The doctor can then effectively treat the symptoms and recommend activities to do and to avoid. ? Take all allergy and asthma medications as prescribed. ? Breathe through the nose as much as possible when exercising. The nasal passages act as natural filters and humidifiers to maintain air at proper temperatures as well as filter out allergens, pollutants, and irritants. ? Exercise indoors during extreme temperatures and when allergen counts are high; pollen counts are usually highest in the morning and increase again in the afternoon. ? When exercising indoors, keep windows and doors closed to reduce allergen exposure; try to exercise on mats rather than carpeting. ? When exercising outdoors, avoid areas that contain high concentrations of allergens and irritants (e.g., fields, trees, busy roads, factories). ? Always have your asthma rescue medication on hand when exercising; you may be instructed to take your medication shortly before exercise; use as prescribed by your physician. ? Perform a prolonged aerobic warm-up and cool-down (15 minutes each) if you have asthma; this can reduce the chances or severity of exercise-induced asthma. ? Postpone exercise if asthma symptoms are not well-controlled of if you have a cold or respiratory infection. ? If allergic to insect stings, carry prescribed epinephrine when exercising outside. ? Know that some activities such as running, cycling, and basketball are more likely to cause exercise-induced asthma; resistance training, baseball, and swimming are less likely. ? Persons with exercise-induced anaphylaxis should exercise with a partner and always carry injectable epinephrine with them. ? Know the early signs of EIA, so you can stop exercising before the symptoms progress to the later, more serious ones. ? Know what to avoid to reduce the likelihood of EIA; these include avoiding certain foods or all foods before exercise, avoiding certain medications before exercise, and be cautious in extreme temperatures. Diabetes"High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently," the expert panel writes, "but it is now well established that participation in regular physical activity improves blood glucose control and can prevent or delay Type 2 diabetes mellitus, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life."Most of the benefits of exercise are realized through acute and long-term improvements in insulin action, accomplished with both aerobic and resistance training, the experts write.For people who already have Type 2 diabetes, the new guidelines recommend at least 150 minutes per week of moderate to vigorous aerobic exercise spread out at least 3 days during the week, with no more than 2 consecutive days between bouts of aerobic activity. These recommendations take into account the needs of those whose diabetes may limit vigorous exercise.Sheri R. Colberg, PhD, writing chair, professor of exercise science at Old Dominion University, adjunct professor of internal medicine at Eastern Virginia Medical School, Norfolk, Virginia, and regular?Diabetes In Control?contributor, stated that, "Most people with Type 2 diabetes do not have sufficient aerobic capacity to undertake sustained vigorous activity for that weekly duration, and they may have orthopedic or other health limitations."?"For this reason, the ADA [American Diabetes Association] and ACSM [American College of Sports Medicine] call for a regimen of moderate-to-vigorous activity and make no recommendation for a lesser amount of vigorous activity."The panel specifically recommends that such moderate exercise correspond to approximately 40% to 60% of maximal aerobic capacity and states that for most people with Type 2 diabetes, brisk walking is a moderate-intensity exercise.The expert panel also recommends that resistance training be part of the exercise regimen. This should be done at least twice a week -- ideally 3 times a week -- on nonconsecutive days. The panel also recommends that people just beginning to do weight training be supervised by a qualified exercise trainer "to ensure optimal benefits to blood glucose control, blood pressure, lipids, and cardiovascular risk and to minimize injury risk."Regular use of a pedometer is also encouraged. In a meta-analysis of 8 randomized controlled trials and 18 observational studies, people who used pedometers increased their physical activity by 27% over baseline. Having a goal, such as taking 10,000 steps per day, was an important predictor of increased physical activity, according to the expert panel.Finally, the new guidelines emphasize that exercise must be done regularly to have continued benefits and should include regular training of varying types.Physicians should prescribe exercise, Dr. Colberg said in a statement. "Many physicians appear unwilling or cautious about prescribing exercise to individuals with Type 2 diabetes for a variety of reasons, such as excessive body weight or the presence of health-related complications. However, the majority of people with Type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity."Med Sci Sports Exerc. 2010;2282-2303.Heart Disease and High Blood PressureExercise:lowers blood pressure, reducing strain on the heartincreases good HDL?cholesterol?that transports fat away from the arteries and back to the liver for processingmay reduce levels of bad LDL cholesterol that can form fatty deposits in the arteries and contribute to heart diseaseimproves circulation by preventing?blood clots?that can lead to heart attack and?strokeincreases fat losshelps weight-lossbuilds muscle mass.It also reduces stress by releasing feel-good hormones called endorphins. Stress and anxiety can slow recovery from a heart attack.You should aim to exercise for 30 minutes on five days out of seven, if not daily.You can split the recommended 30 minutes into manageable chunks – for example a ten minute walk to and from the bus stop to your place of work, plus a five minute walk to the shops and back. And the best exercise for your heart is aerobic activity. That means anything that works large groups of muscles such as your legs, arms and shoulders.Swimming, brisk walking, running, cycling, dancing and even digging your garden are all types of aerobic activity.The important thing is to combine exercise with a balanced diet of?protein,?carbohydrates,?unsaturated fat,?fibre,?vegetables and fruit.People with any of the following contraindications should not engage in physical activity without medical review prior to commencing physical activity.? unstable angina? symptoms such as chest discomfort and shortness of breath on low activity? uncontrolled cardiac failure? severe aortic stenosis? uncontrolled hypertension or grade 3 (severe) hypertension e.g. systole ≥180 and diastole ≥ 110 mmHg? acute infection or fever, or feeling unwell (not limited to but including acute myocarditis or pericarditis) ? resting tachycardia and/or arrhythmias? uncontrolled diabetes? change in clinical status (e.g. symptoms occurring at lower levels of exertion or at rest)? diabetes with poor blood glucose level control e.g. <6 mmol/L or >15 mmol/L.Indications for a person to stop physical activity Clinical advice should be given to stop physical activity if any of the following occur:23 ? squeezing, discomfort or typical pain in the centre of the chest or behind the breastbone; spreading to the shoulders, neck, jaw and/or arms? symptoms reminiscent of previous myocardial ischemia ? dizziness, light-headedness or feeling faint? difficulty breathing? Nausea? uncharacteristic excessive sweating? palpitations associated with feeling unwell? undue fatigue? leg ache that curtails function ? physical inability to continue? for people with diabetes: shakiness, tingling lips, hunger, weakness, palpitations.ObesityThe ACSM recommends the following guidelines for weight loss programs.A cardiovascular exercise program of a minimum of 3 days per week, 20 - 30 minutes per session.? Ideally, a 5 day per week 30 minute per session (or 150 minutes of cumulative exercise per week) should be performed.? Additionally, there may be additional benefits in progressively increasing exercise to 200 - 300 (3.3 – 5 hrs) per week.? The program should be at a minimum of 60% HRmax in otherwise healthy individuals.Additionally, strength training may provide benefit through the development of lean muscle mass.A diet that provides a minimum of 1200 calories per day for normal adults to meet nutritional requirementsThe diet should include food that is acceptable to the individual in terms of nutritional needs, socio-cultural background, taste, cost, and ease of acquisition and preparation.The difference between energy intake and expenditure should provide a negative caloric balance that does not exceed 500 - 1000 calories per day and results in gradual weight loss without metabolic abnormalities.? Weight loss should not exceed 2.2 lb per week.Behaviour modification should be instigated in order to identify and eliminate dieting habits that contribute to improper nutrition.New eating and physical habits should be reasonable, manageable, and appropriate.? This is important if such habits are expected to be continued for life.OsteoporosisHigh-impact exercises, such as skipping, aerobics, weight-training, running, jogging and tennis, are thought to be useful for the prevention of osteoporosis. People with osteoporosis must be careful of falling during exercise because of the risk of fracture. Always take advice from a healthcare practitioner first.Don’t use the lift at work! Running up and down a flight of stairs is one of the best ways to strengthen bones.Walking is a good exercise to maintain bone density if more high-impact activity isn’t possibleSpecial Exercise Guidelines for Different Life StagesChildrenChildren under age 5 should not be inactive for?long periods, except when they're a sleep. Watching TV, travelling by car, bus or train or being strapped into a buggy for long periods are not good for a child’s health and development. There's growing evidence that such behavior can increase their risk of poor health. All children under 5 who are overweight can improve?their health by?meeting the activity?guidelines,?even if their weight doesn't change. To achieve and maintain a healthy weight, they?may?need to do?additional?activity?and make changes?to their diet.For this age group, activity of any intensity should be encouraged,?including?light activity?and more?energetic physical activity.Light activity for children includes a range of activities?such as:standing upmoving aroundwalking at a slow paceless energetic playExamples of energetic activities suitable for most children who can walk?on their own?include:active play?(such as hide and seek and stuck in the mud)fast walkingriding a bikedancingswimmingclimbingskipping ropegymnasticsEnergetic activity for children will make kids “huff and puff” and can include organised activities, like dance and gymnastics. Any sort of active play will usually include bursts of?energetic activity.Children above 5 years1. Aerobic ActivityAerobic activity should make up most of your child's 60 or more minutes of physical activity each day. This can include either moderate-intensity aerobic activity, such as brisk walking, or vigorous-intensity activity, such as running. Be sure to include vigorous-intensity aerobic activity on at least 3 days per week.2. Muscle StrengtheningInclude muscle strengthening activities, such as gymnastics or push-ups, at least 3 days per week as part of your child's 60 or more minutes.Examples of muscle-strengthening activities suitable for children include:games such as tug of warswinging on playground equipment barsgymnasticsrope or tree climbingsit-upssports such as gymnastics, football, basketball?and tennis3. Bone Strengthening?Include bone strengthening activities, such as jumping rope or running, at least 3 days per week as part of your child's 60 or more minutes.Examples of bone-strengthening activities suitable for children include:activities that require children to lift their body weight or to work against a resistancejumping and climbing activities, combined with the use of?playground equipment?and toysgames such as hopscotchskipping with a ropewalkingrunningsports such as gymnastics, football, basketball?and tennismartial artsAdolescentsPregnant WomenExercise during Pregnancy and the Postpartum PeriodThe physiologic and morphologic changes of pregnancy may interfere with the ability to engage safely in some forms of physical activity. A woman's overall health, including obstetric and medical risks, should be evaluated before prescribing an exercise program. Generally, participation in a wide range of recreational activities appears to be safe during pregnancy; however, each sport should be reviewed individually for its potential risk, and activities with a high risk of falling or those with a high risk of abdominal trauma should be avoided during pregnancy. Scuba diving also should be avoided throughout pregnancy because the fetus is at an increased risk for decompression sickness during this activity. In the absence of either medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.The current Centers for Disease Control and Prevention and American College of Sports Medicine recommendation for exercise, aimed at improving the health and well-being of non pregnant individuals, suggests that an accumulation of 30 minutes or more of moderate exercise a day should occur on most, if not all, days of the week (1). In the absence of either medical or obstetric complications, pregnant women also can adopt this recommendation.Given the potential risks, albeit rare, thorough clinical evaluation of each pregnant woman should be conducted before recommending an exercise program. In the absence of contraindications (see boxes), pregnant women should be encouraged to engage in regular, moderate intensity physical activity to continue to derive the same associated health benefits during their pregnancies as they did prior to pregnancy.Epidemiologic data suggest that exercise may be beneficial in the primary prevention of gestational diabetes, particularly in morbidly obese women (BMI > 33) (2). The American Diabetes Association has endorsed exercise as "a helpful adjunctive therapy" for gestational diabetes mellitus when euglycemia is not achieved by diet alone (3, 4).Absolute Contraindications to Aerobic Exercise During PregnancyHemodynamically significant heart diseaseRestrictive lung diseaseIncompetent cervixMultiple gestation at risk for premature laborPersistent second- or third-trimester bleedingPlacenta previa after 26 weeks of gestationPremature labor during the current pregnancyRuptured membranesPreeclampsia/pregnancy-induced hypertensionThe cardiovascular changes associated with pregnancy are an important consideration for pregnant women both at rest and during exercise. After the first trimester, the supine position results in relative obstruction of venous return and, therefore, decreased cardiac output and orthostatic hypotension. For this reason, pregnant women should avoid supine positions during exercise as much as possible. Motionless standing also is associated with a significant decrease in cardiac output so this position should be avoided as much as possible (5).Epidemiologic studies have long suggested that a link exists between strenuous physical activities, deficient diets, and the development of intrauterine growth restriction. This is particularly true for pregnant women engaged in physical work. It has been reported that pregnant women whose occupations require standing or repetitive, strenuous, physical work (eg, lifting) have a tendency to deliver earlier and have small-for-gestational-age infants (6). However, other reports have failed to confirm these associations suggesting that several factors or conditions have to be present for strenuous activities to affect fetal growth or outcome (7, 8).In general, participation in a wide range of recreational activities appears to be safe. The safety of each sport is determined largely by the specific movements required by that sport. Participation in recreational sports with a high potential for contact, such as ice hockey, soccer, and basketball, could result in trauma to both the woman and fetus. Similarly, recreational activities with an increased risk of falling, such as gymnastics, horseback riding, downhill skiing, and vigorous racquet sports, have an inherently high risk for trauma in pregnant and nonpregnant women. Those activities with a high risk of falling or for abdominal trauma should be avoided during pregnancy (9). Scuba diving should be avoided throughout pregnancy because during this activity the fetus is at increased risk for decompression sickness secondary to the inability of the fetal pulmonary circulation to filter bubble formation (10).Warning Signs to Terminate Exercise While PregnantVaginal bleedingDyspnea prior to exertionDizzinessHeadacheChest painMuscle weaknessCalf pain or swelling (need to rule out thrombophlebitis)Preterm laborDecreased fetal movementAmniotic fluid leakageExertion at altitudes of up to 6,000 feet appears to be safe; however, engaging in physical activities at higher altitudes carries various risks (11). All women who are recreationally active should be made aware of signs of altitude sickness for which they should stop the exercise, descend from the altitude, and seek medical attention.Data regarding the effects of exercise on core temperature during pregnancy are limited (12, 13, 14). There have been no reports that hyperthermia associated with exercise is petitive athletes are likely to encounter the same physiologic limitations during pregnancy faced by recreational athletes during pregnancy. The competitors tend to maintain a more strenuous training schedule throughout pregnancy and resume high intensity postpartum training sooner. The concerns of the pregnant, competitive athlete fall into two general categories: 1) the effects of pregnancy on competitive ability, and 2) the effects of strenuous training and competition on pregnancy and the fetus. Such athletes may require close obstetric supervision.Many of the physiologic and morphologic changes of pregnancy persist 4–6 weeks postpartum. Thus, prepregnancy exercise routines may be resumed gradually as soon as it is physically and medically safe. This will vary from one individual to another with some women able to resume an exercise routine within days of delivery. There are no published studies to indicate that, in the absence of medical complications, rapid resumption of activities will result in adverse effects. Having undergone detraining, resumption of activities should be gradual. No known maternal complications are associated with resumption of training (15). Moderate weight reduction while nursing is safe and does not compromise neonatal weight gain (16). Finally, a return to physical activity after pregnancy has been associated with decreased incidence of postpartum depression, but only if the exercise is stress relieving and not stress provoking (17).Conclusions and RecommendationsRecreational and competitive athletes with uncomplicated pregnancies can remain active during pregnancy and should modify their usual exercise routines as medically indicated. The information on strenuous exercise is scarce; however, women who engage in such activities require close medical supervision.Previously inactive women and those with medical or obstetric complications should be evaluated before recommendations for physical activity during pregnancy are made. Exercise during pregnancy may provide additional health benefits to women with gestational diabetes.A physically active woman with a history of or risk for preterm labor or fetal growth restriction should be advised to reduce her activity in the second and third trimesters.Aged PeopleThese guidelines are relevant to all healthy adults aged 65 years and above, unless specific medical conditions indicate to the contrary, irrespective of gender, race, ethnicity or income level. They are also relevant to individuals in this age range with chronic NCD conditions or with disabilities. Individuals with specific health conditions, such as cardiovascular disease and diabetes, may need to take extra precautions and seek medical advice before trying to achieve the recommended levels of physical activity for older adults. Strong evidence demonstrates that compared to less active men and women, older adults who are physically active have: -? Lower rates of coronary heart disease, hypertension, stroke, diabetes, colon and breast cancer, a higher level of cardiorespiratory and muscular fitness, ? Healthier body mass and composition and enhanced bone health; and? Higher levels of functional health, a lower risk of falling, and better cognitive function.Inactive people should start with small amounts of physical activity and gradually increase duration, frequency and intensity over time. Inactive adults and those with disease limitations will have added health benefits when they become more activeWeekly Personal Fitness PlanDayFitness compActivity TypeIntensityTimeMondayCardio vascularStrengthFlexibilityTuesdayCardio vascularStrengthFlexibilityWednesdayCardio vascularStrengthFlexibilityThursdayCardio vascularStrengthFlexibilityFridayCardio vascularStrengthFlexibilitySaturdayCardio vascularStrengthFlexibilityCHAPTER NINEMEANS, METHODS AND MEASUREMENTS OF PHYSICAL QUALITIESMuscular strength TestsRepetition MaximumHow do you go about finding just how strong you are in a particular exercise?You could try using larger and larger loads until you reach the limit of your strength – but this is dangerous because, if you try too great a load, you could strain or tear muscles and tendons.This maximum strength you are trying to measure is given the name one repetition maximum (1RM). This is a measurement of the greatest load (in kilograms) that can be fully moved (lifted, pushed or pulled) once without failure or injury. This value is difficult to measure directly because the?weight?must be increased until you fail to carry out the activity to completion. Because of the high chance of injury, this activity should not be carried out and measured with untrained people.So, it is safer to estimate?1RM?by counting the maximum number of exercise repetitions you can make using a load that is less than the maximum amount you can move. This number is called the repetitions to?fatigue?(RTF) – you stop counting the repetitions when you can no longer perform the exercise properly or when you slow down too much and cannot keep a steady pace.One benefit of calculating your 1RM for various strength movements is that you then know a limit below which you can safely train.1RM can also be used as an indication of your strength development. Because 1RM will vary according to?muscle?strength, most people who are undergoing strength training will repeat this measurement at regular intervals to find out if they are gaining strength.How can you estimate 1RM?How 1RM is predicted?The values of the load you used and the number of repetitions you counted (the RTF) are entered into a prediction equation that calculates an estimate of your 1RM.One prediction equation for 1RM that was published by Epley in 1985 has the formula:?1RM = (0.033 x RTF x load) + load. Example, if a person can lift a 50 kg weight for nine repetitions before tiring significantly, their estimated 1RM is: 1RM = (0.033 x 9 x 50) + 50 = 14.85 + 50?= approximately 65 kgThis means the person should just be able to lift 65 kg and no more. It also means they would need a rest of several minutes before they could lift the same weight again.There are a number of equations that have been constructed by other sports science researchers over recent years to estimate 1RM and a number of calculators that use various 1RM prediction equations have been developed.The sport science community is debating the?accuracy?of estimating 1RM due to different reasons. For example:A person may become familiar with the technique and therefore have an advantage over a person with no experience.Does a self-made decision of no longer being able to carry out an activity lead to a valid 1RM measurement?Does carrying out an activity with fixed weights provide an advantage over someone doing the same activity with free weights?Maximum bench press testObjectiveThe objective of the bench press test is to evaluate an athlete's upper body strength.Materials Barbell and weightsWeighing ScalesBenchAssistantHow to conduct the testThis test requires the athlete to complete as many bench presses as possible with no rest.The assistant weighs and records the athlete's weightThe athlete?warms up?for 10 minutesThe assistant loads the bar bell with a weight close to the athlete’s one repetition maximum load.The athlete conducts bench presses until they are unable to continueThe assistant acts as a spotter for the athlete and counts the number of successful bench pressesIf the number of bench presses exceeds 8 then the athlete rests for 10 minutes, the assistant increases the barbell weight and the athlete repeats the testTop of FormAssessmentResearch by Dohoney P. et al. (2002)?identified the following equations to determine 1-RM for the Bench Press test:4-6RM : -24.62 + (1.12 x weight) + (5.09 x number of reps)7-10RM : -1.89 + (1.16 x weight) + (1.68 x number of reps)To determine your 1-RM enter the weight you lifted, the number of repetitions you completed before failure and then select the "Calculate" button. The number of repetitions before failure must lie in the range of 4 to 10 repetitions and the weight greater than 10 otherwise the calculated 1-RM will be zero.1-RM EvaluationTo evaluate the 1-RM bench press enter gender, age, body weight and 1-RM bench press weight and then select the 'Calculate' button. The 1-RM evaluation is based on McArdle et al. (2000)[2]?reference values for 1-RM bench press relative to body weight.Bottom of FormAnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's upper body strength.A good 1RM for the bench press is 1.25 × "Body Weight" for men and 0.8 × "Body Weight" for women.Target GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductDisadvantagesSpecialist equipment requiredAssistant required to administer the test and act as spotterThe maximum leg press testObjectiveThe objective of the leg press test is to evaluate an athlete's leg strength.Required ResourcesTo undertake this test you will require:Leg Press MachineWeighing ScalesAssistantHow to conduct the testThis test requires the athlete to complete as many leg presses as possible with no rest.The assistant weighs and records the athlete's weightThe athlete?warms up?for 10 minutesThe assistant loads the bar bell with a weight close to the athlete’s one repetition maximum load.The athlete conducts leg presses until they are unable to continueThe assistant counts the number of successful leg pressesIf the number of leg presses exceeds 8 then the athlete rests for 10 minutes, the assistant increases the barbell weight and the athlete repeats the testThe assistant uses the?maximum load calculator?to determine the athlete's of FormAssessmentTo evaluate the 1-RM leg press enter gender, age, body weight and 1-RM bench press weight and then select the 'Calculate' button. The 1-RM evaluation is based on McArdle et al. (2000)[1]?reference values for 1-RM leg press relative to body weight.Bottom of FormAnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's leg strength.A good 1RM for the leg press is 2.5 × "Body Weight" for men and womenTarget GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductThe test can be administered by the athleteDisadvantagesSpecialist equipment requiredAssistant required to administer the testHand grip strength testObjectiveTo monitor the development of the athlete's grip strength.Required ResourcesTo undertake this test you will require:DynamometerAssistantHow to conduct the testThe athlete using their dominant hand applies as much grip pressure as possible on the dynamometerThe assistant records the maximum reading (kg)The athlete repeats the test 3 timesThe assistant uses the highest recorded value to assess the athlete’s performanceTop of FormAssessmentFor an evaluation of the athlete's performance select the gender, enter the maximum reading and then select the 'Calculate' button.Calculations are based on the normative data table (Davis 2000)[1]Bottom of FormNormative data for the grip strength testThe following are national norms for 16 to 19 year olds. (Davis 2000)[1].GenderExcellentGoodAverageFairPoorMale>5651-5645-5039-44<39Female>3631-3625-3019-24<19Clerke (2005)[2]?conducted a study of the factors which influence grip strength in teenagers.AnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's grip strength.Target GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductCan be conducted almost anywhereDisadvantagesSpecialist equipment requiredAssistant required to administer the testMuscular endurance TestsCurl up testObjectiveThe objective of the Curl-Up Test is to assess the endurance of the athlete's abdominal muscles.Required ResourcesTo undertake this test you will require:Flat non-slip surfaceMatMetronomeAssistantHow to conduct the testThis test requires the athlete to complete as many curl ups as possible at a rate of 20/minute.The athlete?warms up?for 10 minutesThe assistant sets the metronome to 20 beats per minute (BPM)The athlete lies on the mat with their knees bent, feet flat on the floor and their hands resting on the thighsThe assistant, using their hands, ?supports the athlete’s head - see Figure 1The assistant gives the command “GO” and the athlete curls up sliding their hands up their thighs until the finger tips touch the top of knee caps (see Figure 2) and then returns to the starting position (see Figure 1) in time with the 20 BPM metronomeThe athlete is to perform as many curls as possible until they are unable to keep in time with the metronomeThe assistant is to count and record the total number of curls which is then used to assess the athlete’s performanceFigure 1Figure 2Top of FormAssessmentFor an evaluation of the athlete's performance select the age group and gender, enter the number of curls and then select the 'Calculate' button.Bottom of FormNormative data for the Curl-Up TestThe following table (McArdle et al. 2000)[1]?is for Male athletes.Classification<3535-45>45Excellent605040Good454025Fair302515Poor15105The following table (McArdle et al. 2000)[1]?is for Female athletes.Classification<3535-45>45Excellent504030Good402515Fair251510Poor1064AnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's core strength.Target GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductCan be conducted almost anywhereDisadvantagesSpecialist equipment required - MetronomeAssistant required to administer the testPush up testObjectiveThe objective of the Press Up test is to assess the strength endurance of the athlete's upper body muscles.Required ResourcesTo undertake this test you will require:Non-slip surfaceAssistantHow to conduct the testThe athlete?warms up?for 10 minutesThe athlete lies on the ground, places their hands by the shoulders and straightens the ?arms - see Figure 1 (start position)The athlete lowers the body until the elbows reach 90° (see Figure 2) and then extends the arms to return to the start positionThe athlete continuous this press-up action, with no rest, until they are unable to continueThe assistant counts and records the number of correctly completed press-ups?Figure 1Figure 2Athletes with less relative strength in the upper body can use the modified press up position to assess their upper body strength.The athlete?warms up?for 10 minutesThe athlete lies on the ground, places their hands by the shoulders, straightens the ?arms and keeps the knees on the ground- see Figure 3 (start position)The athlete lowers the body until the elbows reach 90° - see Figure 4 and then extends the arms to return to the start positionThe athlete continuous this press-up action, with no rest, until they are unable to continueThe assistant counts and records the number of correctly completed press-upsFigure 3Figure 4Top of FormAssessmentFor an evaluation of the athlete's performance select the age group and Test, enter the total number of press ups and then select the 'Calculate' button.Assessment is based on the normative data tables belowBottom of FormHow much weight are you pressing?When you perform the full press up (Fig 1), you are lifting approximately 75% of your body weight and in the modified press up position (Fig 3), you are lifting approximately 60% of your body weight.Normative data for the Press Up TestsThe following table, McArdle et al. (2000)[1],?provides normative data for the full body press up for MenAgeExcellentGoodAverageFairPoor20 - 29>5445 - 5435 - 4420 - 34<2030 - 39>4435 - 4425 - 3415 - 24<1540 -49>3930 - 3920 - 2912 - 19<1250 - 59>3425 - 3415 - 248 - 14<860+>2920 - 2910 - 195 - 9<5The following table, McArdle et al. (2000)[1], provides normative data for the modified Push Ups for WomenAgeExcellentGoodAverageFairPoor20 - 29>4834 - 3817 - 336 - 16<630 - 39>3925 - 3912 - 244 - 11<440 -49>3420 - 348 - 193 - 7<350 - 59>2915 - 296 - 142 - 5<260+>195 - 193 - 41- 2<1The following table, adapted from Golding et al. (1986)[2], provides normative data for the Push Ups for MenAgeExcellentGoodAboveAverageAverageBelowAveragePoor17 - 19>5647-5635-4619-3411-18<1120 - 29>4739-4730-3817-2910-16<1030 - 39>4134-4125-3313-248-12<840 -49>3428-3421-2711-206-10<650 - 59>3125-3118-249-175-8<560 - 65>3024-3017-236-163-5<3The following table, adapted from Golding et al. (1986)[2], provides normative data for the Push Ups for WomenAgeExcellentGoodAboveAverageAverageBelowAveragePoor17 - 19>3527-3521-2611-206-10<620 - 29>3630-3623-2912-227-11<730 - 39>3730-3722-2910-215-9<540 -49>3125-3118-248-174-7<450 - 59>2521-2515-207-143-6<360 - 65>2319-2313-185-122-4<2AnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's upper body strength endurance.Target GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesNo equipment requiredSimple to set up and conductThe test can be administered by the athleteCan be conducted almost anywhereDisadvantagesAssistant required to administer the testCardiorespiratory enduranceThere are different cardiorespiratory measurements, they areField tests like1mile walk testThe participant is required to walk one mile (1.6 kilometers) as quickly as possible. The test is easily administered and is well suited for sedentary and/or older individuals. EquipmentOne mile (1.6 km) track (not on a treadmill) and stopwatch(es)Procedure1. Briefly explain the purpose of the test and how it is conducted. 2. A level, one mile (1.6 km) course is required. The inside lane of a one mile (or 400 m) track is preferred, but any uninterrupted course of precisely one mile (1.6 km) is suitable. 3. Participants should wear appropriate clothing plus shoes and perform 5-10 min of light stretching before commencing the walk. 4. Instruct the participant to walk the one mile as quickly as possible (but not speed walking). 5. Record the participant’s heart rate (HR) immediately upon the completion of the mile. It is preferable to have the participant wear a heart rate monitor for this measurement but the assessment of HR via palpation (using a 15 sec. count from the radial or carotid artery) is a suitable alternative. 6. Estimate the participant’s VO2 max using the following formula, which incorporates his/her body weight (lb), age (yr), gender (males = 1, females = 0), time to complete one mile (min), and postexercise heart rate (bpm): Estimated VO 2 max (in mL ? kg/min) =132.853 – (0.0769 x weight) – (0.3877 x age) + (6.315 x gender) – (3.2649 x time) – (0.1565 x HR) To obtain the Health Benefit Zone Rating multiply the estimated VO2max by 10. EXAMPLE if a 33-year-old male (who weighed 160 lbs) completed the walk in 11:20* and had a post-exercise HR of 160 bpm, his estimated VO2max would be 52 mL ? kg/ min (as calculated below): It is important to note that completion time must be converted to minutes. This is accomplished by dividing the number of seconds by 60 and adding this value to the whole value for minutes. In the above example, the total time was 11 minutes and 20 seconds. When expressed as minutes, this equals 11 min + (20/60 sec) or 11.33 min.Estimated VO2max = 132.853 – (0.0769 x 160) – (0.3877 x 33) + (6.315 x 1) – (3.2649 x 11.33) – (0.1565 x 160) = 52 mL?kg-1?minAerobic Fitness Score= 10 x Estimated VO2max = 520Health Benefit Zone: Excellent Source: Rockport Walking Institute. Rockport fitness walking test. Malboro, MA:Rockport Walking Institute, 19861.5 mile run/ walk test or 12min run test cooper testStep 1:? Measure?the?height?and?weight?of?each?person?being?tested?and?record?The?results?on?their?individual?laboratory?data?sheets.?Measure?body?Mass?to?the?nearest?0.01?kg?and?height?to?the?nearest?0.1?cm.Step 2:? Have?each?subject?complete?a?structured?warm-up?of?about?10?min.Step 3:? Prior? to? starting? the? test,? clearly? explain? that? each? individual? should?Walk?or?run?the?1.5-mile?(2.4?km)?distance?as?fast?as?possible.Step 4:? Start?a?stopwatch?at?the?same?time?that?the?run/walk?is?initiated.Step 5:? When? a? subject? completes? the? distance,? his? or? her? time? should? be?Recorded?to?the?nearest?second?on?the?laboratory?8.1?individual?data?Sheets.Step 6:?After?completing?the?assessment,?each?tested?individual?should?perform?a?cooldown?consisting?of?slow?walking?followed?by?stretching.Step 7:? Use the?equations?presented?on?the?individualdata?sheet?to?estimateeach?individual’s?VO2max,?then?record?the?rmation sheetName or ID number: ___________________________Tester: _________________________Date: _____________________ Time: __________________ Sex: M / F (circle one) Age: ________________ yHeight: _________________ in. _________________ cm Weight: _________________ lb _________________ kgTemperature: ___________ °F _________________ °C Relative humidity: _______________________________ %Barometric pressure: ________________________ mmHgGraded exercise tests (GXT) many fitness programs use this multilevel tests by using stepping bench, cycle ergo meter, or treadmill.Cycle ergo meAstrand-Rhyming Cycle Ergometer TestThe Astrand Test is a submaximal cycle ergometer aerobic fitness test. There are many other?aerobic fitness tests.Equipment required:?cycle ergometer, clock or?stopwatch,?heart rate monitor,?ECG monitor(optional)Description:?Athletes pedal on a cycle ergometer at a constant workload for 7 minutes. Heart rate is measured every minute, and the steady state heart rate is determined.Scoring:?Generally the lower the heart beat the better your fitness. The steady state heart rate is looked up on published tables (nomogram) to determine an estimation of VO2max. Here is also the formula (Buono et al. 1989) that the nomogram is based on, where predicted VO2max is in L/min, HRss is the steady heart rate after 6 min of exercise, and the workload in kg.m/min. To convert a load in watts to kg.m/min, multiply the watts by 6.12.Females: VO2max = (0.00193 x workload + 0.326) / (0.769 x HRss - 56.1) x 100 Males: VO2max = (0.00212 x workload +0.299) / (0.769xHRss - 48.5) x 100validity:?the correlation to VO2max?approximately 0.85 - 0.90.advantages:?simple test to administer, reasonably accurate and appropriate for ECG monitoring during exercise.disadvantages:?the test score would be influenced by the variability in maximum heart rate in individuals. It would underestimate the fitness of those with a high maximum heart rate, and overestimate fitness with advancing age (as max HR reduces with age). As it is performed on a cycle ergometer, it would favor cyclists.references:Astrand, I. (1960). Aerobic work capacity in men and women with special reference to age. Acta Physiol. Scand. 49(suppl. 169).TreadmillObjectiveTo monitor the development of the athlete's general endurance (VO2?max). It was originally developed by Hanson (1984)[1]?to determine VO2?max in cardiac patients. The test has been used in a study of the physical fitness of Air Force personnel. (Balke & Ware 1959)[4]Required ResourcesTo undertake this test you will require:TreadmillStopwatchAssistantHow to conduct the testThis test requires the athlete to run for as long as possible on a treadmill whose slope increments at timed intervalsThe athlete?warms up?for 10 minutesThe slope of the treadmill is set to 0%, for active and sedentary men the speed is set to 3.3 mph (5.3 km/hr) and for active and sedentary women 3.0 mph (4.5 km/hr)The assistant gives the command “GO”, starts the stopwatch and the athlete commences the testThe assistant adjusts the treadmill slope at the appropriate times as follows:For active and sedentary men the slope is set to 2% (1.2°) after 1 minute and then every minute thereafter the slope is increased by 1% (0.6°)For active and sedentary women the slope is increased by 2.5% (1.4°) every 3 minutesThe assistant stops the stopwatch when the athlete is unable to continue and records the time - this ideally should be between 9 and 15 minutesBottom of FormAssessmentActive and sedentary men - (Pollock et al. 1976)[2]From the total time an estimate of the athlete's?VO2?max?can be calculated as follows:VO2?max = 1.444 × T +14.99"T" is the total time of the test expressed in minutes and fractions of a minute e.g. 13 minutes 15 seconds = 13.25 minutesActive and sedentary women - (Pollock et al. 1982)[3]From the total time an estimate of the athlete's?VO2?max?can be calculated as follows:VO2?max = 1.38 × T + 5.22"T" is the total time of the test expressed in minutes and fractions of a of FormAnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's VO2?max.Target GroupThis test is suitable for active and sedentary individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development. There are published VO2?max tables and the correlation to actual VO2?max is high. For an assessment of your VO2?max see the?VO2?max normative data tables.AdvantagesMinimal equipment requiredSimple to set up and conductDisadvantagesSpecialist equipment required - treadmillAssistant required to administer the testHarvard step testObjectiveThe objective of this test is to monitor the development of the athlete's?cardiovascular system.Required ResourcesTo undertake this test you will require:Gym bench (45cm high)StopwatchAssistantHow to conduct the testThis test requires the athlete to step up and down off a gym bench for 5 minutes at a rate 30 steps/minuteThe athlete?warms up?for 10 minutesThe assistant gives the command "GO" and starts the stopwatchThe athlete steps up and down onto a standard gym bench once every two seconds for five minutes (150 steps)The assistant stops the test after 5 minutesThe assistant measures the athlete's heart rate (bpm) one minute after finishing the test - Pulse1The assistant measures the athlete's heart rate (bpm) two minutes after finishing the test - Pulse2The assistant measures the athlete's heart rate (bpm) three minutes after finishing the test - Pulse3Top of FormAssessmentUsing the three pulse rates (bpm) an estimate of your level of fitness can be determined as follows:Result = 30000 ÷ (pulse1 + pulse2 + pulse3)Bottom of FormNormative data for the Harvard Step TestThe following table is for 16 year old athletes (Beashel and Taylor 1997)[1]?using a 45cm step.GenderExcellentAbove AverageAverageBelow AveragePoorMale>90.080.0-90.065.0-79.955.0-64.9<55Female>86.076.0-86.061.0-75.950.0-60.9<50AnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's level of fitness.Target GroupThis test is suitable for active and sedentary athletes but not for individuals where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductCan be conducted almost anywhereDisadvantagesAssistant required to administer the test3 minute step testEquipment: stopwatch, 16.5 inch stepping bench and metronome.The metronome will be set 96 times per minute or 24 steps per min for males and 88times per min or 22 steps per min.Left leg up, right leg up, left leg down, and then right leg down, It was the sequence of stepping on the bench one step with one beat of the metronome will be done for exactly three minutes.After exactly five seconds pulse will be taken for 15 seconds and multiply by 4. Maximal aerobic power VO2Max(ml/kg/min) will becalculated by using the following equation. VO2 Max = 111.33 – (0.42×RecvHR) for malesVO2 Max = 65.81- (0.1847 x RecvHR) for females (Marquaria et al., 1965).Flexibility TestsSit and reach testObjectiveThe objective of this test is to monitor the development of the athlete's lower back and hamstring flexibility.Required ResourcesTo undertake this test you will require:BoxMetre RulerTapeAssistantHow to conduct the testThe Sit and Reach Test is conducted as follows:The athlete?warms up?for 10 minutes and then removes their shoesThe assistant secures the ruler to the box top with the tape so that the front edge of the box lines up with the 15cm (6 inches) mark on the ruler and the zero end of the ruler points towards the athleteThe athlete sits on the floor with their legs fully extended with the bottom of their bare feet against the boxThe athlete places one hand on top of the other, slowly bends forward and reaches along the top of the ruler as far as possible holding the stretch for two secondsThe assistant records the distance reached by the athlete’s finger tips (cm)The athlete performs the test three timesThe assistant calculates and records the average of the three distances and uses this value to assess the athlete’s performanceTop of FormBottom of FormNormative data for the Sit & Reach testThe following table is for 16 to 19 year olds (Davis et al. 2000, p. 126)[1]:GenderExcellentAbove averageAverageBelow averagePoorMale>1414.0 - 11.010.9 - 7.06.9 - 4.0<4Female>1515.0 - 12.011.9 - 7.06.9 - 4.0<4AnalysisAnalysis of the test result is by comparing it with the athlete's previous results for this test. It is expected that, with appropriate training between each test, the analysis would indicate an improvement in the athlete's flexibility.Target GroupThis test is suitable for active individuals but not for those where the test would be contraindicated.ReliabilityTest reliability refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Reliability will depend upon how strict the test is conducted and the individual's level of motivation to perform the test. The following link provides a variety of?factors that may influence the results?and therefore the test reliability.ValidityTest validity refers to the degree to which the test actually measures what it claims to measure and the extent to which inferences, conclusions, and decisions made on the basis of test scores are appropriate and meaningful. This test provides a means to monitor the effect of training on the athlete's physical development.AdvantagesMinimal equipment requiredSimple to set up and conductCan be conducted almost anywhereDisadvantagesSpecialist equipment requiredAssistant required to administer the testRange of motion assessmentShoulder Abduction: (Note plane of movement - scapular vs. frontal plane of elevation)Measurement Tool: Universal GoniometryTesting Position: Supine with the hips and knees bent. Arm is in the anatomical position with the shoulder externally rotatedStabilization: Stabilize the thoraxGoniometer Axis: Anterior aspect of the shoulder just inferior and lateral to the coracoid processStationary Arm: Parallel to midaxillary line of the trunkMoving Arm: Anterior aspect of the upper arm parallel to longitudinal axis of the humerusMovement: Shoulder elevation in scapular or frontal plane Expected ROM: 90° of pure GH abduction; 150° with GH, AC, SC, and scapulothoracic contribution;180° if lumbar lateral flexion is allowed Substitutions: Lumbar lateral flexionExcessive scapular upward rotation contribution to movementShoulder Flexion: Measurement Tool: Universal GoniometerTesting Position: Supine with hips and knees bent and lumbar spine flat. Arm is at the side with the palm in and the thumb upStabilization: Body weight should stabilize scapula but manual stabilization may be required to prevent excessive scapular rising and tipping posteriorlyGoniometer Axis: Lateral aspect of the center of the humeral head approximately 1" below the acromion processStationary Arm: Parallel to midaxillary line of the trunkMoving Arm: Parallel to longitudinal axis of the humerus pointing toward the lateral epicondyleMovement: Shoulder flexion Expected ROM: 120° of pure GH flexion; 150° with GH, AC, SC, and scapulothoracic contribution; 180° if lumbar hyperextension permitted Substitutions: Lumbar hyperextension Scapular tipping Maintain slight elbow flexion so that long head of triceps does not restrict motionHip Extension:Measurement Tool: Universal Goniometer Testing Position: Prone with hips & knees in neutral and feet extending off end of the table Stabilization: Pelvis is stabilized through straps or manual fixationGoniometer Axis: Greater TrochanterProximal Arm: Parallel to midaxillary line of the trunkDistal Arm: Parallel to longitudinal axis of femur in line with lateral femoral condyleMovement: Hip extension with knee extended. ASIS must remain on table. Expected ROM: 30°Substitutions: Lumbar spine extensionHip Abduction:Measurement Tool: Universal GoniometerTesting Position: Supine with hips and knees in neutral and pelvis levelStabilization: Opposite innominateGoniometer Axis: ASIS on measured sideProximal Arm: Along a line between the two anterior superior iliac spinesDistal Arm: Parallel to the long axis of the femurMovement: Abduction until motion is detected at the opposite anterior superior iliac spine Expected ROM: 45°Substitutions: Hip external rotation, knee flexion/internal rotation, or lateral pelvic tiltHip Adduction:Measurement Tool: Universal GoniometerTesting Position: Supine with the opposite extremity abductedStabilization: prnGoniometer Axis ASIS on measured sideProximal Arm: Along a line between the two anterior superior iliac spinesDistal Arm: Parallel to the long axis of the femurMovement: Adduction Expected ROM: 30°Substitutions: Hip internal rotation or lateral pelvic tiltHip FlexionMeasurement Tool: Universal GoniometerTesting Position: Supine with hips and knees in neutral rotationStabilization: Trunk stabilized by body positionGoniometer Axis: Femoral Greater TrochanterProximal Arm: Parallel to midaxillary line of the trunkDistal Arm: Parallel to longitudinal axis of the femur in line with lateral femoral condyleMovement: Hip flexion with knee flexion allowed Expected ROM: 120°Substitutions: Lumbar Spine flexion different amounts of motion in each position may indicate soft tissue tightness of thehip flexors/extensors Knee Flexion: Measurement Tool: Universal GoniometerTesting Position: Supine or reclined with hip and knee in neutral rotationStabilization: Trunk and pelvis stabilized by body weight and positionGoniometer Axis: Lateral epicondyle of the femurProximal Arm: Parallel to the long axis of the femur & pointing at the greater trochanterDistal Arm: Parallel to the long axis of the fibula and pointing at the lateral malleolusMovement: The hip and knee are flexed as the heel moves toward the buttock Expected ROM: 135°Alternate Position: Prone lying with the femur stabilized. Knee flexion motion may be decreased as the Knee Extension: rectus femoris is now stretched over two joints. Prevent substitute motion of hipabduction and/or hip flexion. Measurement Tool: Universal GoniometerTesting Position: Supine with hips and knees in neutral rotation; distal leg on bolsterStabilization: Trunk and pelvis stabilized by body weight and positionGoniometer Axis: Lateral Epicondyle of the femurProximal Arm: Parallel to the long axis of the femur & pointing at the greater trochanterDistal Arm: Parallel to the long axis of the fibula and pointing at the lateral malleolusMovement: Knee extension Expected ROM: 0°. Hyperextension may be present up to 10-15°Alternate Position: Prone lying heel height techniqueTibial Internal/External Rotation: Measurement Tool: Universal GoniometerTesting Position: Prone lying with knee flexed 90 degreesStabilization: Therapist manually stabilizes the femurGoniometer Axis: Parallel to the long axis of the tibiaStationary Arm: Parallel to the long axis of the tibiaMoving Arm: Parallel to and in line with the bisection of the heel and the 2nd metatarsal shaftMovement: Internal and external tibial rotation Expected ROM: 30° internal and 40° external range of motion. It is difficult to establish neutral rotationand it may be more test-retest reliable to record the total ROMBody composition and bodymass indexBody mass indexBody Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.BMI = 70 kg / (1.75 m2) = 70 / 3.06 = 22.9Table 1: The International Classification of adult underweight, overweight and obesity according to BMIClassificationBMI(kg/m2)Principal cut-off pointsAdditional cut-off pointsUnderweight<18.50<18.50?????Severe thinness<16.00<16.00?????Moderate thinness16.00 - 16.9916.00 - 16.99?????Mild thinness17.00 - 18.4917.00 - 18.49Normal range18.50 - 24.9918.50 - 22.9923.00 - 24.99Overweight≥25.00≥25.00?????Pre-obese25.00 - 29.9925.00 - 27.4927.50 - 29.99?????Obese≥30.00≥30.00??????????Obese class I30.00 - 34.9930.00 - 32.4932.50 - 34.99??????????Obese class II35.00 - 39.9935.00 - 37.4937.50 - 39.99??????????Obese class III≥40.00≥40.00Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.BMI values are age-independent and the same for both sexes. However, BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI gradings in relation to risk may differ for different populations.In recent years, there was a growing debate on whether there are possible needs for developing different BMI cut-off points for different ethnic groups due to the increasing evidence that the associations between BMI, percentage of body fat, and body fat distribution differ across populations and therefore, the health risks increase below the cut-off point of 25 kg/m2?that defines overweight in the current WHO classification.There had been two previous attempts to interpret the BMI cut-offs in Asian and Pacific populations3,4, which contributed to the growing debates. Therefore, to shed the light on this debates, WHO convened the Expert Consultation on BMI in Asian populations (Singapore, 8-11 July, 2002)5.The WHO Expert Consultation5?concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMI's lower than the existing WHO cut-off point for overweight (= 25 kg/m2). However, the cut-off point for observed risk varies from 22 kg/m2?to 25 kg/m2?in different Asian populations and for high risk, it varies from 26 kg/m2?to 31 kg/m2?. The Consultation, therefore, recommended that the current WHO BMI cut-off points (Table 1) should be retained as the international classification.But the cut-off points of 23, 27.5, 32.5 and 37.5 kg/m2?are to be added as points for public health action. It was, therefore, recommended that countries should use all categories (i.e. 18.5, 23, 25, 27.5, 30, 32.5 kg/m2?, and in many populations, 35, 37.5, and 40 kg/m2) for reporting purposes, with a view to facilitating international comparisons.Skin fold measurementMeasurement of skin folds tries to take fat from several specific locations or site on the skin and then intered to the equation to estimate total body fatEquipment Body calipersTaking Measurements & Calculating Your PercentageMeasure all four locations shown in the table below and write down the readings on the calipers scale. It doesn’t matter what order you do the readings in. Add up the four readings. The % bodyfat can then be determined from the chart at the bottom of this page. You will notice one set of figures for males and one for females, make sure you use the right one!You may also note that the charts do not have a line for every millimeter or column for every age group on the chart, to do this would make the chart very large. To get accurate figures it is necessary to interpolate. For example, a female in the 16-29 age groups could have a sum of 29mm for the four measurements. This is halfway between the 28 and 30 on the chart. The % bodyfat for 28mm is 18.6% and that for 30 is 19.5%. Interpolating halfway between would give approximately 19.0%. Another example would be a 40 year old male with a sum of 42mm for the four measurements. Referring to the chart for males we find % bodyfat listings for 40 and 45mm. 42mm is 2/5ths of the way between 40 and 45. The bodyfat for 48mm is 20.3%, and for 45mm it is 21.8%. Two fifths of the way from 20.3 to 21.8 is approximately 20.9%.Where To Take The MeasurementsBack of the arm (triceps):The back of the upper arm, (Triceps). This is located halfway between the shoulder and elbow joints. The fold is taken in a vertical direction directly on the centre of the back of the arm.Front of the arm (Biceps):The front of the upper arm, (Biceps). This is taken exactly the same as the Triceps, except it is taken on the centre of the front of the upper arm.Chest the location for this site is half or a third the distance between the anterior axillary line and the nipple for men and women respectively and the measurement should be diagonal.Shoulder blade:Back, below the shoulder blade (sub scapular). This is located just below the shoulder blade. Note that the skinfold is taken at 45 degrees angle.Midaxillary vertical fold should be taken at the level of ziphoid process on the mid axillary lineAbdominal measure vertical fold 2cm to the right of and level with the umbilicus. Make sure the head of the caliper is not on the umbilicus Waist:Waist (Suprailiac). This is located just above the iliac crest, the protrusion of the hip bone, a little towards the front from the side of the waist. The fold is taken approximately horizontally.Thigh measure the vertical fold over quadriceps muscle in the midline of the thigh and the measurement site should be at the half way of the patella and the inguinal crease.Charts To Calculate Your Bodyfat PercentageChart #1 – Men% Fat For Sum Of Measurements At All 4 Locations triceps, biceps, supra iliac and sub scapularSum in mmAge 16-29Age 30-49Age 50+208.112.112.5229.213.213.92410.214.215.12611.215.216.32812.116.117.43012.916.918.53514.718.720.84016.320.322.84517.721.824.75019.023.026.35520.224.227.86021.225.329.16522.226.330.47023.227.231.57524.028.032.68024.828.833.78525.629.634.69026.330.335.59527.031.036.510027.631.737.311028.832.938.812029.934.040.213031.035.041.514031.936.042.815032.836.843.916033.637.745.017034.438.546.018035.239.247.019035.939.947.920036.540.648.8Chart #2 – Women% Fat For Sum Of Measurements At All 4 Locations: triceps, biceps, supra iliac and sub scapularSum in mmAge 16-29Age 30-49Age 50+149.414.117.01611.215.718.61812.717.120.12014.118.421.42215.419.522.62416.520.623.72617.621.524.82818.622.425.73019.523.326.63521.625.228.64023.426.830.34525.028.331.95026.529.633.25527.830.834.66029.131.935.76530.232.936.77031.233.937.77532.234.738.68033.135.639.58534.036.340.49034.837.141.19535.637.841.910036.338.542.611037.739.743.912039.040.845.113040.241.946.214041.342.947.315042.343.848.216043.244.749.117044.645.550.018045.046.250.819045.846.951.620046.647.652.3Normal or Ideal % Bodyfat?What is the correct or ideal % bodyfat? This is perhaps the most difficult question to answer. Not all people have the same ideal % bodyfat. It varies with age, sex, and genetics. One person might be better at a higher or lower bodyfat than another person of the same age and six. And the desirable bodyfat of athletes can vary depending on the sport. For example, swimmers seem to perform better at a higher % bodyfat than runners. But, some general guidelines can be given that are applicable to most people.For men:For men up to about the age of 30, 9-15% is good, from age 30 to 50, 11-17% is a good range, and from age 50 and up, 12 to 19%. A person should try to stay at or below the upper limits given, and a person near the lower limit would be described as lean.For women:For women, the range up to age 30 is 14-21%, from 30-50 it is 15-23%, and from 50 up it is 16-25%. Again it is desirable to be at or below the upper limit, and a woman near the lower limit would be lean.It should be noted that the ranges given above are not averages for the US and UK populations, but are the desirable ranges. The actual averages for the populations as a whole are much higher because of the large number of people with % bodyfat well above the upper limits of the desirable ranges.Waist circumference and waist to hip ratioHow to Measure Your Waist Circumference and Waist-to-Hip RatioBy?Erin Palinski-Wade?from?Belly Fat Diet For DummiesYour waist circumference is one way to determine whether you have an increased amount of fat around your belly and whether you’re at an increased health risk. The National Institutes of Health says that a high waist circumference is associated with an increased risk for health conditions like hypertension, elevated blood lipids, type 2 diabetes, and cardiovascular disease.Even if your BMI has indicates you’re at a healthy weight, it’s possible to have too large of a waist circumference. On the other hand, if you’re muscular and have a high BMI but suspect you have a lower body fat percentage, waist circumference is a great way to determine your risk.To help reduce your risk of medical complications, your waist circumference should be:Less than 35 inches(88cm) for womenLess than 40 inches(102cm) for menIf your waist circumference is high, but your waist-to-hip ratio is low, you may have less of a risk of heart disease than another individual with both an elevated waist circumference and elevated waist-to-hip ratio.The waist-to-hip ratio is especially important for individuals at a normal body weight. This measurement is an excellent way to see whether you’re storing too high a percentage of your body weight in your abdomen.Follow these steps to determine your waist-to-hip ratio:Using a tape measure, measure the circumference of your hips.First look in a mirror and identify the widest part of your buttocks. Then place the tape measure at this location and measure around the circumference of your hips and buttocks.Waist circumference: Wrap a flexible measuring tape around the natural waist (in between the lowest rib and the top of the hip bone), the umbilicus (belly button), or at the narrowest point of the midsection. Keep the tape parallel to the floor.Using your waist and hip circumference measurement, calculate your waist-to-hip ratio by dividing your waist circumference by your hip measurement.After you’ve determined your waist-to-hip ratio, use the following table to check your level of risk.Waist-to-Hip Ratio and RiskMale Waist-to-Hip RatioFemale Waist-to-Hip RatioHealth Risk0.95 or below0.80 or belowLow risk0.96–1.00.81–0.85Moderate risk1.0+0.85+High riskHydrostatic weighingUnderwater (hydrostatic) weighing, based on Archimedes' Principle, is generally regarded as the "gold standard" for body composition assessment, although this claim is being made less of late because of newer and more sophisticated procedures. Because body fat is less dense than water, it increases one's buoyancy while the fat-free mass, which has a density greater than water, makes one sink. After correcting for residual volume–which increases buoyancy and decreases the underwater weight percent fat can be calculated based on the underwater weight. The largest source of error in underwater weighing is thought to be the determination of residual volume (RV; the amount of air remaining in the lungs following maximal expiration). When RV is estimated rather than measured, the precision of underwater weighing is little better than anthropometric (skinfold) determination.The procedure for measuring underwater weight is used to determine the body density. Using body density, percent fat can be estimated using the Siri or Brozek formula.There is an excellent interactive web site on body composition and underwater weighing that was produced at the University of Vermont?(). Included is a simulated underwater weighing procedure.Equipment UsedSpecial weighing scale and submersion pool or tankHow It's DoneThe person is seated on a special scale, is submerged in a tank of water, and then exhales as much air as possible.S/he remains motionless while underwater while the underwater weight is recorded.This procedure is repeated two to five times to get a dependable underwater weight score.Body density and then percentage of body fat are calculated from the readingTesting ProceduresWeigh the subject to the nearest 0.1 kg.Measure or estimate the subject's RV. If possible, directly measure RV using the diluted helium or oxygen techniques. Otherwise, RV can be estimated by measuring vital capacity (VC) and multiplying it by 0.24 or 0.28 for males and females, respectively.VC is the amount of air that can be maximally exhaled. To measure VC, place a noseclip on the subject. Have the subject maximally inhale, place the mouthpiece from the spirometer in his/her mouth, and then maximally exhale. Perform 2-3 trials and use the highest volume. Also, correct the volume to BTPS by multiplying the volume by the correction factor (see an instructor for this value).Tare (zero) the scale in the underwater weighing tank. Doing so automatically subtracts the weight of the chair from the subject's underwater weight. While seated in the tank, instruct the subject to blow out all the air that he/she can exhale, bend slowly forward until the top of his/her head is underwater, and to remain motionless until the scale has settled and the computer indicates that it has a reading. After the subject has settled underwater, it takes the computer approximately 5-10 sec to determine the weight. Have the subject perform 6-10 trials and average the heaviest 2-3 readings.?Equations?Determination of Body Density?Body Density = dry weight / [((dry weight - wet weight) / water density)- RV - 0.1]??Note: Units for all weights are in kg and RV is in L. The 0.1 represents an estimated volume (L) of gas in the GI tract.Estimation of Percent FatThe two most commonly used equations for estimating percent fat from body density are the Siri (1961) and Brozek (1963) formulae. A limitation to these formulae is that they assume the density of fat-free mass to remain a constant across the population when in fact is varies. Thus, the actual percent fat tend to be slightly higher than the measured percent fat in the lean, muscular individual and the opposite effect in obese individuals.Siri percent fat = ((495/body density) – 450) x 100Brozekpercent fat = ((4.570/body density) – 4.142) x 100Bioelectrical impedance analysisBody fat percentage measurementBody fat scales use the Bioelectrical Impedance Analysis (BIA) technique. This method measures body composition by sending a low, safe electrical current through the body. The current passes freely through the fluids contained in muscle tissue, but encounters difficulty/resistance when it passes through fat tissue. This resistance of the fat tissue to the current is termed 'bioelectrical impedance', and is accurately measured by body fat scales. When set against a person's height, gender and weight, the scales can then compute their body fat percentage.Calculation of Body Fat %Lukaski & Bolonchuk's (1988)[1]?formula for total body water (TBW) is:TBW = 0.372(S?÷R) + 3.05(Sex) + 0.142(W) - 0.069(age)S = Height in centimetresR = ResistanceW = Weight in KgSex Male =1 Female = 0Age in yearsExampleAthlete is male, 25 years old, height 170cm, weight 65kg - measured resistance is 382TBW = 0.372(170? ÷ 382) + 3.05(1) + 0.142(65) - 0.069(25)TBW = 38.7kgThe hydration constant of the fat free mass (FFM) is 0.73 so we can determine the FFMFFM = TBW ÷ 0.73 = 38.7 ÷ 0.73 = 53.01 kgThe Fat Mass = Weight - FFM = 65 - 53.01 = 11.99kgBody Fat % = Fat Mass ÷ Weight x 100 = 11.99 ÷ 65 x 100 = 18.5%CHAPTER TEN: - Preparing for physical activity Facts to be consider before beginning physical activity Facts to consider during daily physical activity The facts about physical activity in the heat and other environment The facts about soreness and injuryCHAPTER ELEVEN: - Fitness for health and performanceDeference and similarities between health and performance What is aerobic capacity?What is body build?Deference and similarities between health and performance What is aerobic capacity?How body will be build?What is Vo2 max?What is oxygen dept?Design weekly fitness plan.Write some facts about muscle soreness and injuryFacts to be consider before beginning physical activity Facts to consider during daily physical activity physical activity in hot environment and their effectsphysical activity in cold environment and their effectsPhysical activity in high altitude and their effects.What are the facts considered to be healthy and fit Write about healthy dietsWhat is recovery time and what things are needed to recoverHow you can manage training intensity ................
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