Outline for CLIFF Notes for



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Healthy Living Program

Participant Guide

16 Aug 07

The Healthy Living Program (HLP) is for individuals who fall in the poor fitness category according to the Air Force fitness standards. It is designed as a two to two and one half hour program to provide information related to nutrition and exercise that is needed to improve fitness and to identify motivational factors and behavior change strategies needed to implement and maintain a fit lifestyle. The workshop is co-run by a behavioral health provider, a physical fitness expert, and a diet therapist/dietitian. These individuals will provide the basic knowledge you will need to improve your level of fitness. Additionally, they will help develop individual goals and provide strategies for you to use to help you achieve and maintain your goals. Through daily healthy living, we can all get fit and stay fit. Completing this program and using the information you learn can get you started on the road to a healthy life.

The Air Force fitness standards create an opportunity to change the way you address your own physical fitness. Being physically and mentally fit is critical to an individual’s overall health and ability to serve in today’s Air Force. Individuals have a personal responsibility to be physically fit, for themselves, their family, their team, the Air Force and the country that they serve.

Objectives

The composite score is a scaled score that allows members to make direct comparison with other members to determine fitness level. The test places member on a continuum of fitness rather than being ‘pass/fail.’

The Composite Score:

1. Aerobic assessment—1.5 mile run, 3 mile walk or cycle ergometry (50%)

2. Body composition (30%) Abdominal Circumference

3. Muscular Strength—Pushups (10%)

Muscular Strength—Crunches (10%)

Categories based on composite score:

Excellent (90-100 points)

Exercise at least 3 times / week

Retest in one year

Good (75-89.9 points)

Exercise at least 3 times / week

Retest in one year

Poor (0-74.9 points)

Monitored exercise 4-5 times / week

Retest within 90 days

Attend HLP, maintain AF 1975 and turn in to FPM at monthly follow-up

Attend Body Composition Improvement Program, if needed, (abdominal circumference > 35 inches for women and > 40 inches for men) and maintain food record

FREQUENCY: 3-5 times/week

Begin exercising __________ times per week

After _____________ increase to ____________ days per week

INTENSITY: Exercise between 70 and 85% of an age predicted maximum heart rate

220 – Age ________ = _____________

or

Use the Borg Scale if heart rate is not an option

6 No exertion at all

7

8 Extremely light

9 Very Light

10

11. Light

12

13 Somewhat hard

14

15 Hard (heavy)

16

17 Very hard

18

19 Extremely hard

20. Maximal exertion

or

Use a Talk Test: easy to carry on a conversation, hard to carry on a conversation, cannot carry on a conversation

TIME: Duration should consist of warm up, continuous aerobic activity from 20-60 minutes, cool down, and muscular strength/endurance activities

Warm-up/stretching = _____________ minutes

Aerobic component = _____________ minutes

Crunches and push-ups = __________ minutes

Cool-down/stretching = ___________ minutes

TYPE: Circle your preferred methods of exercise

walking jogging running aerobic classes

walk/run steppers treadmill rowing machines

elliptical machine indoor cycling water exercise cardio interval classes

Other: _________________________________________________________

|Age |HR Max |70% |

|Cushioning | | |

|High Arch | | |

|Under pronation |[pic] |[pic] |

|Poor shock absorbers | | |

| | | |

|Stability | | |

|Normal Arch | | |

|Normal pronation |[pic] |[pic] |

| | | |

|Motion Control | | |

|Low arch | | |

|Overpronation (excessive inward rolling of foot) |[pic] |[pic] |

|Best shock absorbers | | |

| | | |

Focus on these large muscle group exercises to get the most out of your workout. Below are exercises that can be performed either in the fitness center using free weights or machines, or at home. For home exercises, using elastic bands, dumbbells, and stability balls will give greater variety to your workout.

Large muscle group exercises

LEGS: Leg press, squats (knee bends), lunges, step-ups (on stair or box)

Tips: Hold dumbbells in hands during knee bends, lunges or step-ups to increase intensity.

[pic] [pic] [pic] [pic]

BACK: Back Row, Lat pulldown, Single arm dumbbell row, pull-ups

Tips: Wrap an elastic band around a table leg or post to perform rows.

[pic] [pic] [pic] [pic]

CHEST: Bench press, dumbbell press, chest press, push-ups, modified push-ups, flys

Tips: Push-ups too hard right now? Do them on your knees or against a wall.

[pic] [pic] [pic][pic] [pic]

Also important to include in your workout, time permitting, are smaller muscle group exercises. Examples: Biceps curls, Triceps ext, shld press, calf extensions, ab. crunches, back extension.

How often? 2-3 times a week, 2-3 sets of each large muscle group.

How much weight? Look to do about 10-15 repetitions. Go to muscle fatigue and if you can

do more than 15 repetitions raise the weight, less than 10 repetitions lower the weight.

Results: Look to improve either # of sets, # of repetitions, or resistance each week.

Ask your fitness center staff for help on proper technique.

Category Website Features

General Health Information

nal.fnic/ links to nutrition websites

links to multiple topics

                        food guide pyramid

healthy lifestyle

Recipes and Meal Planning

recipes, abstracts

recipes, meal plans

recipes

Food Records/Calculators

calorie calculator

food and activity record

Exercise Information

running and nutrition tips

general exercise info

exercise books

training and nutrition tips

Supplements/Alt Medicine

consumer warnings

Ephedrine Alkaloids

• Approximately 10,000 adverse events have been reported to the FDA, with over 100 deaths, all associated with ephedrine alkaloid use.

• Products typically contain between 8-20 mg/serving, but the actual amounts are highly variable from product to product. Analysis has indicated over 60 mg of ephedrine per serving in some products).

• FDA was unable to determine a safe single or total daily dose, therefore ephedra and ephedrine alkaloids are not longer legal to use in dietary supplements.

• Do NOT take with the presence of heart condition, high blood pressure, thyroid disorder, seizure disorder, or pregnancy.

• Any production containing the following ingredients will likely contain ephedrine alkaloids:

|Cao Mahuang, Chinese Ephedra, Chinese Joint-Fir, Cao Ma-Huang, Desert Herb, Ephedrine, Ephedrine Alkaloid, Herbal Ecstasy, Indian |

|Jointfir, Joint Fir, Ma Huang, Mahuanggen (ma huang root), Mongolian Ephedra, Muzei Ma Huang, Pakistani Ephedra, Popotillo, Sea |

|Grape, Shuang Sui Ma Huang, Teamster's Tea, Yellow Astringent, Yellow Horse, Zhong Mahuang. |

| |

| |

o Ephedra

| Scientific Name: |

|[pic] |

| |

|Ephedra distachya, synonym Ephedra vulgaris; Ephedra equisetina, synonym Ephedra shennungiana; Ephedra gerardiana; Ephedra |

|intermedia; Ephedra sinica; and other Ephedra species. Family: Ephedraceae |

o

▪ Ma Huang

▪ Desert Herb

▪ Joint Fir

▪ Popotillo

▪ Sea Grape

▪ Teamster’s Tea

▪ Yellow Horse

o Epitonin

o Ephedrine

o PPA (phenylpropanolamine)

Caffeine

• Demonstrated positive effect on endurance.

• 200-800 mg divided daily for weight loss shown to have a mildly positive impact.

• Relative safety established.

Ephedrine, Caffeine, Aspirin Stack (ECA)

• Combination of 20 mg ephedrine, 200 mg caffeine, and 325 mg aspirin. Widely cited as an effective weight loss agent. Does have multiple studies showing effectiveness. Caffeine may be in the form of kola nut or mate. The aspirin in the product may be listed as willow bark. This combination may not be appropriate due to safety concerns associated with ephedra. Ephedra is banned in the US due to severe adverse effects.

• Bear in mind that the ephedra ban was not overturned and is still in effect. However, products may be available for sale over the internet that are labeled as containing ephedra or ephedrine alkaloids. These products are illegal for sale by the FDA.

• While safe, effective weight loss has been demonstrated, keep in mind that researchers are able to carefully control dosage and monitor for adverse effects in a lab. The weight loss demonstrated in most studies was 5.3 kg or 11.6 lb over 6 months; this correlates to 2 pounds per month weight loss.

• Over-the-counter products are very risky; manufacturers do not have to disclose all ingredients, nor do they have to prove safety and efficacy of their products. The burden of proof is on the FDA to prove a supplement is unsafe. Only once a product is believed to be unsafe can the FDA take any action against a manufacturer. Ephedra products, with over 10,000 claims of adverse effects, were investigated for 10 years before the ephedra ban became legal. You do not have any idea what you are getting.

Ephedrine-Free Fat Burners

• Will simply contain some other form of stimulant(s), natural or synthetic.

o Caffeine

o Kola Nut

o Guarana

o Ginseng

o Green Tea

o Mate

o Synephrine-compounds

▪ Bitter orange (Citrus aurantium)

▪ Country mallow (also known as heartleaf) (Sida cordifolia)

▪ Structurally similar to ephedrine and may pose the same risks as ephedra. The FDA has submitted a proposal to have these products added to the ephedra ban, and therefore illegal for use as a dietary supplement.

• There is no data that these products are any safer or more effective. Keep in mind that any stimulant can still produce side effects.

Conjugated Linoleic Acid (CLA)

• Taken in divided dose of 3 grams per day

• Handful of animal and human studies have demonstrated marginal positive impact on body fat loss and maintenance of weight loss.

• Appears to be safe.

• Evidence that the trans-10, cis-12 isomer of CLA can increase insulin resistance in people with abdominal obesity. Hyperproinsulinemia and insulin resistance is an independent risk factor for Type 2 diabetes and cardiovascular disease. Therefore, CLA may not be a wise choice for people with central or abdominal obesity. Most commercial products contain a mixture of CLA isomers; it is not known if these mixed isomer products have the same risks.

• Cost versus potential benefit is not very good.

Calcium Pyruvate

• Research has shown inconsistent but marginal impacts on fat loss in humans.

• Six grams per day, divided dose.

• No adverse effects reported.

• Cost versus potential benefit is terrible.

Hydroxy Citric Acid (Garcinia Cambogia)

• 1,500 mg daily, divided dose.

• Journal of the American Medical Association conducted a review of all published studies and concluded HCA to be ineffective.

• Save your money!

Chromium Picolinate

• 200 to 400 mcg daily.

• Continues to be universally present in countless supplements.

• An extensive body of research has accumulated which indicates chromium to be totally ineffective for fat loss.

• Just give your money to me!

Fad Diets

• Promote quick and easy weight loss

• Limit types of food selection

• Rely on testimonials

• Promoted as cure-all

• Often need supplements/special foods

• No attempts to change long-term eating habits and lifestyles

• Often have contempt for the scientific and medical community

• Don’t waste your time!

Examine all sides of Changing

You are faced with two basic choices: 1) Change fitness related habits or 2) Don’t change fitness related habits. The choices are basic but the issues that weigh on all sides of the equation can be complex. The following is designed to help you examine the advantages and disadvantages of changing.

Downside of Changing Benefits of Changing

____________________________________ ____________________________________

____________________________________ ____________________________________

____________________________________ ____________________________________

____________________________________ ____________________________________

____________________________________ ____________________________________

____________________________________ ____________________________________

_____________________________________________________

Decisional Balance

BASICS OF S.M.A.R.T. GOAL SETTING

1. Specific: Writing goals out in specifics so you can clearly see how you will attain your goal is important. State exactly what you want to do, when you want to achieve it, where you’re going to do it, how you’re going to do it, and who can help. The following questions might be useful in establishing goals:

What? What do I want to accomplish (short and long-term)?

Where? Identify a location where you will do the activities. Where will I do it?

When? Establish a time frame for short and long-term goals. When is my target date?

Who? Who can I get involved that might make reaching my goals more doable?

2. Measurable: Establish concrete criteria for measuring progress.

How much? (1 minute, 10% decrease)

How many? (10 pounds, 5 push-ups)

3. Attainable: Ask yourself is the goal is within reasonable reach. Is it doable? If your original short or long-term goal is not doable shoot for something that is attainable.

4. Realistic: Are you willing and able to work towards the goal? A goal could be attainable, but is meeting the goal unrealistic given the demands you currently have? If you truly believe your goal can be accomplished it is probably realistic.

Remember to start at a point that you already know you can achieve, and build onto the goal from there - - program the steps for a sense of early success to help give you the boost and momentum to keep you going.

5. Trackable: Keeping a documented record of your successful steps toward your goal encourages you to keep going and gives you solid information regarding how your efforts are helping or not helping you reach your goals. The AF Form 1975 is one important method to help you keep track of exercise. A food record is another helpful tool.

Instructions:

The best strategy for sticking to goals is to keep track of your progress by writing it down every day. The very act of writing down activity has been shown to improve results. It allows you to learn more about your habits, stay accountable to yourself, and keep track of any progress or slips.

A good exercise record includes the following:

a. Type of activity

b. How long you exercised

c. Intensity of exercise

d. Comments about any difficulties to help you in problem solving for the future

Your Plan

On page 3 of this guide you developed some specific exercise recommendations. Now it’s time to develop a plan you can put into practice: First write down your 2 long-term fitness goals (where do you want to be in 6-months). Next, indicate what your short-term goals are (where do you want to be in 4 weeks). Remember to keep the SMART principles in mind! As a part of this class, you can get started by developing a specific 4-week plan for your two short-term fitness goals.

Long-term Goal #1: ________________________________________________________________________

Short-term Goal #1: _______________________________________________________________________

Long-term Goal #2: ________________________________________________________________________

Short-term Goal #2: ________________________________________________________________________

Week 1

| |What specifically will you do this week to achieve your short-term goals | |

|Day |Type of Activities |How much? (intensity/duration/ |Where you will do |Time of Day? |

| | |repetitions) |it? | |

|M | | | | |

|T | | | | |

|W | | | | |

|Th | | | | |

|F | | | | |

|S | | | | |

|Su | | | | |

Week 2

| |What specifically will you do this week to achieve your short-term goals | |

|Day |Type of Activities |How much? (intensity/duration/ |Where you will do |Time of Day? |

| | |repetitions) |it? | |

|M | | | | |

|T | | | | |

|W | | | | |

|Th | | | | |

|F | | | | |

|S | | | | |

|Su | | | | |

Week 3

| |What specifically will you do this week to achieve your short-term goals | |

|Day |Type of Activities |How much? (intensity/duration/ |Where you will do |Time of Day? |

| | |repetitions) |it? | |

|M | | | | |

|T | | | | |

|W | | | | |

|Th | | | | |

|F | | | | |

|S | | | | |

|Su | | | | |

Week 4

| |What specifically will you do this week to achieve your short-term goals | |

|Day |Type of Activities |How much? (intensity/duration/ |Where you will do |Time of Day? |

| | |repetitions) |it? | |

|M | | | | |

|T | | | | |

|W | | | | |

|Th | | | | |

|F | | | | |

|S | | | | |

|Su | | | | |

TIPS FOR MAINTAINING PROGRESS

Maintaining progress is one of the greatest challenges you will face as you work to improve your fitness. Getting started can be a challenge, but often staying committed to new fitness or eating habits is the toughest part. The following tips will help:

1. Keep it meaningful! While you are likely making changes in large part because the Air Force wants you to be fit, continue to remind yourself of the personal benefits you will gain when achieving your goals. Setting and keeping goals that are meaningful will increase the likelihood of success. You are much more likely to strive toward a goal which you care about.

Using the exercise on page 12 (Benefits of Changing) how can you make the above changes meaningful?

__________________________________________________________________________

2. Reward yourself! You’ve earned it. Rewards increase the likelihood that you will do it again.

Rewards for weekly goals: _____________________________________________________

_____________________________________________________

Rewards for long-term goals: _____________________________________________________

_____________________________________________________

RECOGNIZING AND PLANNING FOR SLIPS

Here are some additional keys to maintaining and continuing your progress

1. Minimize/Prevent Slips:

Catching a slip early on is critical.

• If caught early a slip does not have to signal an inevitable downward spiral. Slips are inevitable with today’s demanding lifestyle. The important thing is to not let one slip turn into a string of slips and a collapse of your behavior change plans.

• Examples: You miss your workout for one or two days or you go TDY and you consume more calories than you planned during a special meal.

2. Have a Plan for Dealing With Slips:

The most important thing is to get back on track as quickly as possible!

• Learn from the past. You can identify many of these from past experience. Think back and identify situations in which you remember having a particularly difficult time coping.

• Plan in advance. When you know similar situations are coming, start planning for how to deal with them in advance. If you wait until you are in the midst of the situation, you are not likely to come up with effective solutions. Use the information from past struggles to guide your planning and identify past hurdles that will need to be overcome.

The measure of success is not whether there are dips in your line of progress, but whether overall you are progressing in spite of occasional dips. If you find you have relapsed, pull out all the resources that have helped in the past to get back on track.

What barriers may interfere with my plan? How can I address them?

(Examples: Rain, busy at work, feel tired, boredom, etc.) (Examples: Use gym, work out before caught up at

work, ask friend to workouts with me, music, etc.)

__________________________________________ _______________________________________

_________________________________________ ________________________________________

_________________________________________ ________________________________________

If I cannot do my primary plan, what is my backup plan?

Example: Change time of day, change exercise location, increase intensity so that I can decrease time

____________________________________________________________________________________

____________________________________________________________________________________

What are the ways that other people can help me with my exercise goals and help me get back on track if I slip?

Person/People: _______________________________________________________________________

Possible ways to help: _________________________________________________________________

______________________________________________________________________

Body Composition Improvement Program Introduction

We sincerely hope you have enjoyed the information presented in the HLP and have found it helpful to improve your lifestyle and overall health. We encourage you to expand on the concepts presented within this workshop by attending the Body Composition Improvement Program (BCIP). Designed to help participants shed unwanted weight and maximize fitness for the long-term with a “health-wise”, sensible approach, the BCIP program consists of a series of two core classes with monthly follow-up. Classes will last approximately 1 1/2 to 2 hours and will require approximately 30 minutes per day of self-monitoring and planning. This should be viewed as an investment in a happier, healthier, more energetic you!

The BCIP focus is on producing permanent behavior change by targeting nutrition habits to help maintain your positive lifestyle changes. It will build upon the basics you’ve learned in the HLP, and provide you an opportunity to actually apply the concepts to common barriers and daily situations.

In the initial BCIP class, Nutrition Strategies, you will complete a self-assessment, discover your genetic predisposition to health risk, and learn what you can do about it. You will identify why you eat and what may motivate you to change your behaviors. You will learn to identify proper serving sizes, the calories found in different food groups and how to choose healthy foods. We will review reading food labels and how to keep an accurate food record. The class wraps up with an evaluation of the goals you set in the HLP and you will set new goals.

After completing Nutrition Strategies, the next class you will learn to deal with any situation and still maintain a healthy diet. The focus of this class is to build on what you learned in the initial class and actually begin to apply that information. More specifically, you will critically analyze your food record, and practice dealing with everyday challenges so you can maintain a healthy diet. Finally, you will learn behavior modification techniques to maintain your healthy lifestyle.

Please bring this HLP Participant’s Guide to BCIP. We will build on what you worked on today.

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Introduction to Healthy Living Program

Exercise Recommendations

Training Heart Rate Table

AF Form 1975

Run 8 minutes, walk 2 minutes. Repeat 3x.

Run 8 minutes, walk 2 minutes. Repeat 3x.

Run 8 minutes, walk 2 minutes. Repeat 3x.

Run 8 minutes, walk 2 minutes. Repeat 3x.

Week 5

Run 7 minutes, walk 3 minutes. Repeat 3x.

Run 7 minutes, walk 3 minutes. Repeat 3x.

Run 7 minutes, walk 3 minutes. Repeat 3x.

Run 7 minutes, walk 3 minutes. Repeat 3x.

Week 4

Run 5 minutes, walk 2.5 minutes. Repeat 4x.

Run 5 minutes, walk 2.5 minutes. Repeat 4x.

Run 5 minutes, walk 2.5 minutes. Repeat 4x.

Run 5 minutes, walk 2.5 minutes. Repeat 4x.

Week 3

Run 3 minutes, walk 3 minutes. Repeat 5x.

Run 3 minutes, walk 3 minutes. Repeat 5x.

Run 3 minutes, walk 3 minutes. Repeat 5x.

Run 3 minutes, walk 3 minutes. Repeat 5x.

Week 2

Run 2 minutes, walk 4 minutes. Repeat 5x.

Run 2 minutes, walk 4 minutes. Repeat 5x.

Run 2 minutes, walk 4 minutes. Repeat 5x.

Run 2 minutes, walk 4 minutes. Repeat 5x.

Week 1

Sat

Fri

Wed

Mon

 

Run 30 minutes.

Run 30 minutes.

Run 30 minutes.

Run 30 minutes.

Week 10

Run 14 minutes, walk 1 minute. Repeat 2x.

Run 14 minutes, walk 1 min. Repeat 2x.

Run 14 minutes, walk 1 minute. Repeat 2x.

Run 14 minutes, walk 1 minute. Repeat 2x.

Week 9

Run 13 minutes, walk 2 minutes. Repeat 2x.

Run 13 minutes, walk 2 min. Repeat 2x.

Run 13 minutes, walk 2 minutes. Repeat 2x.

Run 13 minutes, walk 2 minutes. Repeat 2x.

Week 8

Run 9 minutes, walk 1 minute. Repeat 3x.

Run 9 minutes, walk 1 minute. Repeat 3x.

Run 9 minutes, walk 1 minute. Repeat 3x.

Run 9 minutes, walk 1 minute. Repeat 3x.

Week 7

Run 9 minutes, walk 2 minutes. Repeat 2x, then run 8 minutes.

Run 9 minutes, walk 2 minutes. Repeat 2x, then run 8 minutes.

Run 9 minutes, walk 2 minutes. Repeat 2x, then run 8 minutes.

Run 9 minutes, walk 2 minutes. Repeat 2x, then run 8 minutes.

Week 6

Sample Running Program

Proper Shoe Selection

Strength Training Program

Nutrition and Fitness Web Resources

Nutrition Supplements and Fad Diets

Be a Smart Consumer!!!

CHANGE

NO CHANGE

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