YOUR HEALTH: A LIFETIME PLAN

Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. ~Author Unknown

Written and Presented by: Zack Zade CSCS, DPT ’14

Certified Strength & Conditioning Specialist - National Strength & Conditioning Association)Student - Des Moines University Doctor of Physical Therapy Program, Class of 2014

Health Promotion PracticumJanuary 2012

OBJECTIVESUpon conclusion, observer will be able to:• Identify ingredients for creating and following a healthy lifestyle

plan.• List several benefits for attaining better health.• Recognize common components of an exercise and nutrition

program.• Create a simple workout program based upon scientific

research and age-specific recommendations.• Be able to write goals using SMART framework.• Develop a personalized plan to track progress.• Assess their current level of health using objective data.

MOTIVATION & DETERMINATION

Organize your thoughts – set direction – Identify pitfalls:

Some Questions to answer: Why do you want to make a change? What has stopped you before? What are your weaknesses?

List at least 5 great accomplishments to remind yourself of how capable you are when you set your mind to something.

MOTIVATION & DETERMINATION (cont.)

Need More Reasons to be healthy?Live longer Less muscle painGreater flexibility Improved blood profileFaster injury recovery Stronger immune systemEnergetic sex life Reduced healthcare costsReduced Insurance Rates Less risk of diseaseMore self-confidence Sleep betterMore EnergyLess hospital time & expensesBetter focus & retention of informationMore muscle = faster metabolism

ASSESSMENT - Know your body from Head-to-Toe!

o Schedule physical examination with doctor Ask for blood panel, including fasting blood glucose Ask about physical activity recommendations

o Record accurate/ current health data in one place See “My Health Data” for suggestions

ASSESSMENT - Know your body from Head-to-Toe!

A Comprehensive Health Fitness Evaluation (ACSM p. 101) Prescreening Risk Stratification (discuss with doctor) Resting HR, BP, Height, Weight, BMI, ECG (if appropriate-Doctor) Body Composition

Circumference sites (most important is waist - others include: Abdomen, Arm, Hips, Calf, Forearm, Thigh) Skinfold Assessment (Bodyfat %)

Cardiorespiratory Fitnesso Submax YMCA cycle ergometer or treadmill testo Graded exercise test (performed by qualified professional)

Muscular Strengtho 1, 4, 6, or 8 repetition maximum testingo Upper body (bench press) & lower body (leg press)

Muscular Enduranceo Curl-up testo Push-up test

Flexibilityo Sit & Reach test or angular measure of isolated joints (physician, physical therapist, or skilled trainer)

EXERCISE - Phases

oWarm-up: 5-10 min low to moderate aerobic activity

o Stretching At least 10 min of stretching performed after the warm-up or cool

down phase Key: warm muscles stretch better

oConditioning: *10-60 minutes of aerobic, resistance, sport, or combination

activities *Exc. bouts of 10 minutes are acceptable if you accumulate at least 20-60 min total per day

oCool-down 5-10 min low to moderate aerobic activity

EXERCISE - Cardiorespiratory COMPONENTS OF EXERCISE DESIGN:

• FITT Principle = FREQUENCY, INTENSITY, TIME, TYPE, PROGRESSION o Frequency

5 days/week of moderate intensity exercise –or- 3 days/week of vigorous intensity exercise –or- 3-5 days/week of combination moderate and vigorous intensity

o Intensity Train, don’t strain. “No pain, no gain” is not the guideline for most to follow! Ways to measure:

o Rating of Perceived Exertion (RPE) – Subjective Measurement- Scale ranging from 6-20- 6 = no work at all; just sitting in place , 20 = extremely difficult; absolute

maximum- “Talk Test” – at 13-14 RPE you can talk normally, 15 and above – cannot

carry on conversationo % Age predicted heart rate max (% HRMAX) – Objective Measurement

- = HRMAX x %desired , HRMAX = 220 – Age- Example: 30 y/o at 70% HRMAX → (220-30) x 0.7 = 133 bpm

MODERATE Intensity = 64-76% HRMAX; 12-13 RPE VIGOROUS Intensity = 77-95% HRMAX; 14-17 RPE

EXERCISE – Cardiorespiratory (cont.) COMPONENTS OF EXERCISE DESIGN:

• FITT Principle = FREQUENCY, INTENSITY, TIME, TYPE, PROGRESSION o Time (aka Duration)

20-60 minutes Can be 10+ min bouts that accumulate through the day Low intensity? - Longer duration, e.g., 30+ minutes Higher intensity? - Shorter duration, e.g., ≤ 20 minutes

o Type (aka Mode) Type of exercise/activity matched to fitness component Cycle, swim, kickboxing, calisthenics, yoga, etc.

o Progression Advancing any component of the FITT framework—change one at a

time! Changes should be made gradually, avoiding large increases

EXERCISE – Resistance Training

COMPONENTS OF EXERCISE DESIGN: • FITT Principle = FREQUENCY, INTENSITY, TIME, TYPE, PROGRESSION o Frequency

2-3 days/week, training each major muscle group Rest muscle group at least 48 hours between sessions Major Muscle Groups:

Chest Back ShouldersArms Stomach Glutes (Buttocks)Thighs Calves

o Intensity Train, don’t strain. “No pain, no gain” is not the guideline for most to follow! 8-12 reps at 60-80% of the maximum amount of weight you can lift Older individuals or poorly conditioned should begin at 10-15 reps at a lower

percent of maximum

EXERCISE – Resistance Training

COMPONENTS OF EXERCISE DESIGN: o FITT Principle = FREQUENCY, INTENSITY, TIME, TYPE, PROGRESSION o Time (aka Duration)

Moderate rate of 3 seconds up (concentric), 3 seconds down (eccentric) 2-4 sets per muscle group ~2-3 minutes between sets (multi-joint), ~1-2 min (single joint), ≤ 1 hour to complete program

o Type (aka Mode) Free weights, machines, bands, calisthenics, etc. 8-10 exercises that address major muscle groups of the whole body Work larger muscle groups before smaller groups, multi-joint before single-joint Have a menu of a few exercises for different groups; pick a different menu item

every few sessionso Progression

Advance any component of the FITT framework—change one at a time! Changes should be made gradually, avoiding large increases

EXERCISE – Guidelines Physical Activity Guidelines

o CHILDREN & ADOLESCENTS (6-17 y/o): 1 hour or more of physical activity daily Several Bouts of 15 min. Extended periods (periods of two hours or more) of inactivity are discouraged

for children, especially during the daytime hours

o ADULTS (<65 y/o): A minimum of 2.5 hrs. (150min) of moderate-intensity aerobic activity a week Muscle-strengthening activity on 2 or more days a week – targeting all major

muscle groups

o OLDER ADULTS (65+ y/o) & PERSONS WITH DISABILITIES Same recommendations as adults, granted their abilities and conditions allow Balance exercises may be warranted if risk of falling present

Reversibility Principle – use it or lose it! Decreased function apparent in 1-2 weekso Good news: can decrease training frequency (~1x/wk) and maintain

NUTRITION

• Some Tips:•Whole foods•Eat Slowly•Sit down to eat•Eat with others if possible (granted they don’t overeat)•Chew thoroughly•Take time to think… Why am I eating this?•Eat according to activity level•Choose nutrient dense foods (i.e. Almonds vs Potato Chip analogy)•If you are having trouble controlling your weight… track your diet (you may

be surprised)•Avoid added sugar and sweeteners – increases appetite & cravings

NUTRITION Carbohydrates

o 45 – 65% of total daily Calories o Fiber 14 grams/1000 Calorieso Limit refined grains

Fat o 20 – 35% of total daily Calories o <10% of total Calories from saturated fatso <300 mg cholesterol

Proteino 10 – 35% of total Calories

Fluid and Electrolyteso Fluid follow thirst…i.e. drink when you are thirstyo Sodium - <2300 mg, reduce intake to 1500 mg for persons older than 51, and those of any

age who are African American, have hypertension, diabetes, or chronic kidney disease. o Potassium >4,700 mg

Calorie Contents:o Carbohydrate (1g) = 4 Cal.o Protein (1g) = 4 Cal.o Fat (1g) = 9 Cal.

TROUBLESHOOTING – Exercise & Nutrition

o Troubleshooting EXC & NUTRITION: I’m not getting the results I want. Remember:

o Consistency is crucial – the process works. Have faith!o Don’t be too hard on yourself. Be proud of your efforts!

Positive perspective → Positive results Double check/Areas to tweak:

o Are you being challenged? If not: increase resistance, repetitions, duration, etc.

o Are you being consistent? Review your journal/ planner to see if you are adhering to your plan.

Are you really not getting results or is it just you being overly critical?o Perform an assessment to find out – objective information can be a good motivator

ACCOUNTABILITY/TEAMWORKo Find a workout partner:

Difficult to skip a workout if someone is counting on you showing up. Reciprocating energy and motivation Friendly challenges Camaraderie

o Tell people about what you are doing: People will ask how you’re doing... reinforcing your desire to follow through

with your plan. People are more likely to encourage & compliment if they know you are

working on something. Talking about your health and goals reinforces your passion and desire.

ACCOUNTABILITY/TEAMWORK

o Hire a personal trainer It is harder to cancel a workout when your hard earned money is at stake. They are motivated, skilled professionals whose passion is promoting your

health and wellness. Familiar with your excuses. Skilled in adapting programs to improve adherence.

o Sign a covenant with yourself, get witnesses, place in prominent place: List your goals and display them so that you are continually reminded.

Out of sight – out of mind is the enemy here Utilize consistent reminders

TRACKINGo Record accurate/ current health data in one place

See “My Health Data” o Keep daily record/journal:

Use paper journal, electronic document, notebook, calendar, phone, etc. Must be appropriate for you, and easily/frequently accessible– no right or

wrong method. Record whatever you deem important – the key is in simply recording

something (this is a motivational tool!!) Possible journal items:

o Workout Intensity Time (duration) of activity

o Time of day Heart Rateo Hours of Sleep Water intakeo Foods eaten today Workout partnero Exercises performed # of Mileso Weather Moodo Hrs. at work Weighto Time to bed – Time awake Etc. etc.

GOALS & REWARDSI don't care how much power, brilliance or energy you have, if you don't harness

it and focus it on a specific target, and hold it there you're never going to accomplish as much as your ability warrants.  ~Zig Ziglar

o Why Make Time For Goals? Provides focus and purpose to life Achievement gives beneficial feeling of accomplishment Achievement leads to … REWARDS!!! Giving time and thought towards making goals brings one closer to

desired objective.

GOALS - Steps1. Brainstorm:

Begin with big picture, think long term. Think about multiple goal areas.

o Reaching these goals may be related to your health goals.o Can increase focus and motivation.

Do not worry about format, jot down your dreams & aspirations Areas to consider (in addition to health goals):

• Family Friendships Romance & Marriage• Spirituality Home Profession• Education Community Service• Financial Travel Hobbies

GOALS - Steps2. Write S.M.A.R.T. goals:

o Specific: Your goal should have its expected outcome stated as simply, concisely and explicitly as possible. This answers questions such as; how much, for whom, for what?

o Measurable: a measurable goal has an outcome that can be assessed and/or measured in some way.

o Attainable: an attainable goal has an outcome that is realistic given the current situation, resources and time available. Goal achievement may be more of a “stretch” if the outcome is tough or there is a weak starting position.

o Results Orientated & Relevant: a results orientated and relevant goal helps maintain focus on the mission or the “bigger picture.”

o Time-bound: a time-bound goal includes realistic timeframes. Sometimes timeframes are imposed. When that is the case, carefully consider what is attainable within the imposed timeframe.

Example Goal: By March 1, 2012 an improvement of my cardiovascular endurance will be demonstrated by a decrease in timed 1-mile run from 10:00 min to 9:00min.

3. Implement Plan & Achieve Goals

REWARDS Take time to celebrate your accomplishment Important to reinforce positive results Also gives you something to look forward to (another motivator) Ideas:– Vacation– Free time– New toy or gadget– Celebratory meal– Learn a new skill (guitar, language tutor, sculpting, stained glass, etc.)– Etc. Etc. – Whatever gets you motivated

And last but not least… GEARDon’t be stingy and neglect importance; quality equipment and preparation facilitates convenience:

o Cool gym bag always packed and ready to go Toiletries bag

Deodorant Hair gel CologneMouthwash Toothbrush/toothpasteRazor Tweezers/Clippers/Scissors Etc. Etc.

Powder (suggested for moisture management) Towel (pack in plastic bag after shower) Appropriate footwear

Strength Training – thin soles, cross trainers Running - Preferred running shoes

Workout clothes: Proper Fitting/Stylish/Fun/Comfortable/Functional Fresh clothes (don’t forget socks & undies)

o Heart rate Monitor (Recommended)

Resources: ACSM. ACSM's Guidelines for Exercise Testing & Prescription (8th ed.). Lippincott Williams & Wilkins,2009. National Association for Sport and Physical Education. (n.d.). Physical activity for children: A statement of guidelines for children ages 5 - 12, 2nd edition. Retrieved from http://www.aahperd.org/naspe/standards/nationalGuidelines Kansas State Department of Education. (n.d.). Writing smart goals . Retrieved from http://www.ksde.org/Default.aspx?tabid=2039 U.S. Department of Health and Human Services and the Department of Agriculture. Dietary guidelines for Americans. 2005. Washington, DC: U.S. Government Printing Office, 2005. p. 19-22 United States Department of Health & Human Services Physical Activity Guidelines for Americans, available at http://www.health.gov/PAGuidelines/pdf/paguide.pdf (October 7, 2008). World Health Organization. (1948). Retrieved from World Health Organization website: http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf

Thank you for your time and attention.

ANY QUESTIONS ?