LESSON 1:

HEALTH-ENHANCING
PHYSICAL ACTIVITY
OBJECTIVES:

 Evaluate baseline activities and recreational pursuits based on

physical activity recommendations.

 Explain changes in physical activity patterns across the lifespan.

 Identify barriers to physical activity.

 Adopt strategies to overcome barriers to physical activity.

Health
We all want to live healthy and better lives. How do we do it?

• First of all, health is more than just freedom from illness, disease,
and debilitating conditions.
• It is "a state of complete physical, mental and social well-being"
(WHO, 1948).
• This means that health is the dynamic interaction of the different
dimensions that constitute the whole person.
• This is important because the origin of the word health, from the Old
English 'hal' or 'hale' means whole, sound, or well.
 Secondly, the synergy of these different dimensions is a complex process
—one that demands your constant effort rather than simply a state that
you achieve. In order to preserve and optimize health, you must assume
responsibility for this process. This entails making a deliberate choice
about your lifestyle.
 One's lifestyle, or 'what a person does' is well within your control.
Evaluating your current lifestyle and its consequences through the
Healthy Lifestyle Assessment (Activity 1.1) will be the necessary first step
toward being responsible for your health.
 Conducting a health assessment is different from taking diagnostic tests.
A health assessment helps you find out whether you have a disease or a
health condition despite the absence of apparent symptoms. Meanwhile,
a diagnostic test is taken by one who already has symptoms or signs of a
disease.
 Looking at the results of your assessment, identify area(s) in which you
are currently experiencing problems.
Sleeping Habits
 Getting an average of seven to nine hours of sleep a night is important to our
health.
 Both the quantity and quality of your sleep contribute to how you feel and
function during the day.
 A restful sleep impacts on your energy level during the day and keeps you alert,
while habitual sleep deficits negatively impact on your mental functioning,
mood, and inevitably your health.
 Sleep deprivation decreases your reaction time, increases irritability, and
causes hormonal and metabolic changes that parallel the aging process.
 Inadequate sleep impairs your immunity and increases your risk for
obesity, hypertension, and depression.
 Sleep deficits also directly relate to fatigue which in turn can result in
injuries.
 Significant sleepiness during the day suggests that your body needs more
and/or better sleep.
 Regular participation in physical activity as well as moderately intense
aerobic activity three hours before your bedtime is associated with
improved sleep (ACSM, 2011).
Eating Habits
 Healthy eating means making choices about what you eat for the purpose of
providing our body with nutrients that improve or maintain good health.
 It essentially involves eating the right kinds of food in the right amounts in
accordance with experts' recommendations.
 Both the quality and quantity of foods are central not only to the prevention
of diseases, but proper nutrition also forms the foundation for physical
activity.
 Nutrition provides the fuel for physical activity, and the essential elements
that repair existing cells. It promotes the growth of new tissues and
provides the material for our bones and muscles. Adequate water intake
keeps you hydrated before, during, and after a physical activity. Avoiding
dehydration can prevent heat disorders and heat illnesses because water
and fluids are essential to maintaining body temperature.
 Expending energy through physical activity helps you manage your weight
for a healthy body composition. As your physical activity levels increase,
you will need a greater amount of energy. It now becomes important for
you to follow the serving recommendations for carbohydrates, proteins,
and water or fluids.
 In order to achieve and maintain a healthy body weight, focus on regular
physical activity and nutritious diet. These two major components will help
you avoid the effects Of creeping obesity or the negative consequences of
a cycle ofweight-gain-and-loss. For a fat-loss program, physical activity is
the best predictor for maintaining weight loss (Mcinnis, Franklin & Rippe,
2003).
 We may already know that nutrients provide energy for our daily
activities, growth, and for regulating our body processes.
Nevertheless, knowing may not necessarily mean that we eat
nutritious foods all the time.
 Our food choices are usually based on reasons other than nutrient
content such as preference and pleasure, emotional comfort, image,
social pressure, availability or convenience, cost, and habit.
 Eating well, therefore, is a habit that starts with a good
understanding of optimal nourishment, discerning misconceptions and
misinformation about nutrition, and knowing your own eating
patterns.
Health

 The dynamic interaction of the different

dimensions (e.g. physical, mental, social) that
constitute the whole person to achieve an
optimum state.

 It is significantly influenced by one's lifestyle—

sleeping, eating and physical activity habits,
and stress management.
Stress
 Our mental and physical reaction
to events that disrupt body
equilibrium.
Distress is perceived negatively and it
produces suffering and anxiety.

Eustress motivates us to strive for

healthy outcomes resulting in
fulfillment.
 If you already have healthy eating habits, keep doing what you are
doing. If not, would you like to look at ways to improve your eating
habits?

 If yes, write down what is it about your eating habits that you are not
satisfied with and would like to change.

 It is best to start with one thing. Write down a short-term goal that
involves a food choice (e.g. a piece of fruit instead of a fast food
snack), which can lead to the fulfillment of a long-term goal: that of
improving the quality of your food intake.
 Healthy eating is going to be a struggle though because the reality is
healthy choices are not always easy.

 The important thing is that you have made a choice to be actively

engaged in adopting healthy eating habits and a physically active
lifestyle.

 As you work on developing and maintaining this, understanding

motivation and cultivating self management skills will be critical. You
will learn more about this in a while.
Stress Management

 Hans Selye coined the word 'stress' which he defined as "the nonspecific
response of the body to any demand made upon it" (1976).
 This nonspecific response, which he termed the general adaptation syndrome
or GAS (see Figure 1.1) is based on the principle that our body constantly
strives to maintain homeostasis (homeo = equal, stasis = balance).
 Events that disrupt this homeostasis or equilibrium are called stressors.
 Our reaction to this stressor is referred to as the stress response, or stress.
 Stress includes both a mental reaction (stressor) and a physical reaction
(stress response).
 Common examples of stressors among college students are exams, grades,
deadlines, procrastination, traffic, and unfair or demanding teachers.

 Physical symptoms can manifest as headaches, neck and back pains, upset
stomach and indigestion; while psychological indicators include inability to
concentrate, anger and hostility, restlessness and worry, insomnia and
frustration.

 When we perceive the stress as negative, it is known as distress which

produces suffering and anxiety; but when it motivates us to produce
helpful outcomes, which in turn fulfills us, it is called eustress (eu is Greek
for good). What is central to good health is the presence of eustress and
the limitation of distress to a level in which the body can adapt.
 Acute stress is associated with reduced concentration, decreased
memory, poor self control, and low self-esteem (ACSM, 2011). Chronic
stress, or prolonged exposure to a stressor can wear down both the mind
and the body resulting in weakened immunity and increased susceptibility
to cardiovascular disease, obesity, and disorders of the digestive system
(Kotecki, 2011; ACSM, 2011).

 Regular participation in exercise can be therapeutic when it comes to

managing stress. First, it reduces the body's stress hormones such as
adrenaline and cortisol which remain elevated when the body experiences
a stressor. By expending these through exercise, these biochemicals are
flushed out of the body.
 Second, exercise stimulates the production of endorphins, which are
the body's natural painkillers and mood elevators. They are
responsible for the 'runner's high' or feelings of euphoria, and for the
feelings of relaxation as they diminish the perception of pain.
Endorphins are neurotransmitters that transmit electrical signals
within the nervous system.

 Third, exercise engages the different body systems—cardiovascular,

renal, muscular, central, and sympathetic nervous systems much
more closely than usual. These are the same body systems which are
involved in dealing with stress, thus, exercise parallels the body's
response to a stressor. In this way, exercise not only strengthens the
body but enhances its ability to respond to stress.

 Finally, it is easier to deal with stressors when we are healthy from

regular physical activity.
 Physical Activity Habits
 According to the U.S. Centers for Disease Control and Prevention,
"regular physical activity (at least sixty minutes daily) builds
healthy bones and muscles, improves muscle strength and
endurance, reduces the risk for developing chronic disease risk
factors, improves self-esteem, and reduces stress and anxiety
among children and adolescents.
 Beyond these known health effects, physical activity through
physical education, school-based or extra-curricular sports,
physical activity after school and during recess have found
positive associations with academic achievement (standardized
test scores, grades), cognitive skills and attitudes
(attention/concentration, memory, verbal ability), and classroom
behavior (conduct, time on task, homework completion)"
 Just like healthy eating, we may already know the health benefits that
result from physical activity participation, yet we struggle with it. As a
student, you have a busy schedule and spend most of the day sitting in
class.
 Exercise may not be your priority. You might think that physical activities
that constitute your daily routine such as climbing a flight of stairs, lifting
your books and backpack, standing while waiting in line, walking to and
from your classes, public commute, and performing house chores are
sufficient.
 These low levels of physical activity, however, are actually insufficient
for you to gain more substantial health benefits. It is only through
moderately intense activities, such as exercise and playing sports, that
impact significantly on your health.
 Another survey done by the Food and Nutrition Research Institute (FNRI), Manila, the
Institute for Medical Research, in Kuala Lumpur, Malaysia, and the Bogor Agricultural
University, in Indonesia, with the support of International Life Sciences Institute
Southeast Asia, examined physical activity patterns by children in Asia.

Their findings highlight low levels of physical activity among Asian children. Four of their
findings specifically describe the physical activity levels of Asian kids:

1) Less than one in four children participate in sports, outdoor games, or physical exercise
everyday.

2) The most common leisure activities are playing computer games, reading, and watching
television.

3) Children have physical education lessons in school only once or twice a week.

4) Girls are less active than boys at all ages.

 It is, therefore, important that you incorporate in your daily schedule
moderate intensity activities which you can either sustain for at least
thirty minutes or in short bouts of 10 minutes that accumulate to a
total of thirty minutes.

 These activities include active daily tasks and travel (e.g. walking,
stair climbing, biking), exercise, sports or rhythmic activities (dance),
and muscle- and bone-strengthening activities (e.g. weightor load-
bearing exercises involving major muscle groups).
 Our choices and the consequences of our actions make our lives what
they are now.
 While there may be numerous factors that influence your health and
risk for disease (see Figure 1.2), behavior is the single most important
modifiable factor (McGinnis, 2003).
 This is why health promotion efforts are geared toward enabling you
to adopt certain behaviors.
 Getting adequate sleep, eating healthily, managing stress, and being
physically active are behaviors that we choose—choices that can
primarily prevent the onset or development of disease while you are
at the peak of your health.
 By taking responsibility for how you live, you
may be able to gain control over your health,
your longevity, and most of all, the quality of
your life. An enhanced quality of life enables
you to study effectively, maximize your
potential, and live meaningfully.
Wellness
The notion of wellness evolved from the contemporary concept of
health—that it is a dynamic process based on self-responsibility.
The term was first used by Halbert L. Dunn who published a small
booklet entitled High Level Wellness in 1961. Dunn described it as
a disciplined commitment, for wellness was a process of change or
growth in one's level of functioning that was largely determined by
the decisions we make about how to live our lives.

It was only at the end of the 20th century when the concept of
wellness gained popularity. This idea became dominant once
people realized that physical fitness, although it can improve
quality of life, was not sufficient to lower the risk for disease and
ensure health. Exercise habits can be offset by factors such as
smoking, excessive drinking, and unhealthy eating habits. These
factors put you at risk for diseases.
 Although diseases do not manifest at the present, they have their origins
in one's present lifestyle. This is why wellness represents:
(1) a change in behavior to positive habits;
(2) a constant and deliberate effort to stay healthy and maximize one's
potential; and
(3) a way of life determined by personal choice.

 Wellness, however, does not assume you live free of disease or disability.
 You can achieve a sense of fulfillment, satisfaction, and happiness by
coping with your daily challenges and being consciously aware of what
you can become within the framework of your own unique capabilities.
 Quality of life can be achieved because it is a matter of choice to
recognize one's life as full of potential despite one's limitations. This
disposition represents a positive lifestyle.
 Health and wellness can be represented along a continuum (see Figure
1.3): on the right is a positive end of optimum health; at the center is a
neutral point where there is no discernible disease but risk factors may be
present, and on the left of the continuum is a negative end of premature
death.

 Moving to the left of the neutral point or the negative end indicates a
deterioration in one's health.

 It includes the presence of risk factors but with no manifestation of the

disease (asymptomatic), symptomatic disease, disability or limitation and
finally, the absence of functioning or premature death.

 Moving to the right of the neutral point or the positive end indicates
increasing levels of functioning and optimum health.
 Another feature of this continuum is the medical approach in terms of
cure and prevention of diseases.

 The curative or treatment approach aims to alleviate the signs and

symptoms of disease and disability.

 It is not designed, however, to bring an individual past the neutral

point. now becomes the thrust of the preventive approach: to
preserve the neutral point by reducing the risk factor, and getting an
individual to higher levels of growth and development towards
optimum health.
 A preventive approach consisting of primary, secondary, and tertiary
levels may also be applied to the left side of the continuum.

 Primary prevention refers to the prevention of disease by reducing the

risk factor; secondary prevention refers to early detection and prompt
treatment of disease to keep it from progressing or from further
complications; to halt or slow the progress of the disease (if possible) in
its earliest stage; and tertiary prevention involves managing complicated,
long-term health problems through the alleviation of pain, providing
comfort, and limiting disability resulting from the disease.

 Thus, the preventive approach can encompass the entire continuum of

health and wellness.
Physical Activity and Sedentary Behaviors
 Our health status affects our ability to carry out physical activities. Physical
activity (PA) is any bodily movement produced by our skeletal muscles that
requires energy expenditure above that of rest. It can be viewed as a
behavior that ranges from minimal (e.g. fidgeting, computer use, walking to
school) to maximal (e.g. playing sports, 100-meter sprint) movement.
Essentially, the term sedentary is used to describe a range of inactive
behaviors.
 The word sedentary, from the Latin verb sedere, means to sit and is a helpful
reminder that sedentary behaviors usually involve sitting.
 Physical activity should not be mistaken for exercise.
 Exercise is a form of physical activity that is structured, repetitive, and
planned for the purpose of improving or maintaining one or more fitness
components.
 Given the health implications of physical activity and exercise, it is
important to assess your physical activity habits. This entails identifying
what your daily physical activities are, the time spent in it, and how
intense they are. Assess your physical activity habits at work and/or
school, while in transit to and from places, and your leisure pursuits using
the General Physical Activity Questionnaire or GPAQ (Activity 1.2).

 The GPAQ determines the time that you spend doing different types of
physical activity in a typical week.

This include:
(1) activity at work or school,
(2) transit to and from places,
(3) moderate-to-vigorous activities (sports, fitness, and recreation), and
(4) sedentary behaviors (sitting or reclining).
 You may use the assessment results to identify areas that you can
improve on and set goals for yourself.

 Self-assessment is an important tool because it makes you aware of

your current physical activity habits.

 When used periodically, it can help you keep track of your habits,
your progress toward your goals, and most of all, make the necessary
changes along the way.
 The increase in sedentary behavior observed in our modern lifestyle may
also be attributed to the changes in the environments wherein we move.

 According to an article by the Stanford Wockets Activity Project

(http://wockets.stanford.edu/sedentary_behavior.html), "changes in
transportation, communication, workplace, domestic, and entertainment
technologies have been associated with significantly reduced demands for
physical activity," thus leading to sedentary behavior.

 Sedentary behavior include activities such as watching television, playing

video games, using the computer, driving or riding in a motor vehicle,
reading, and sitting around. Sedentary behavior has been associated with
poor metabolic health, as some studies have shown. Prolonged sitting, in
particular, has been the subject of research and recent reports that point
to its metabolic consequences.
 As a student, your physical activities typically consist of school-related
tasks, house chores, and transportation-related tasks that are part of your
daily routine.
 It is important to note that although baseline activities are helpful,
limiting yourself only to these would classify you as insufficiently active
based on the recommendations on physical activity for health.
 To enhance one's health, it would be necessary to engage in exercise,
sports, or active recreation. Together, physical activity and exercise
habits can result in an increase in physical fitness.
 Evaluate the, results of the GPAQ based on the Philippine National
Guidelines on Physical Activity (2010) issued by the Department of Health
(Figure 1.4). Are you currently meeting the physical activity
recommendations?
Changes in PA Patterns Across the Lifespan

 Guidelines on physical activity have been developed by different

organizations such as the Canadian Society for Exercise Physiology (CSEP),
Centers for Disease Control and Prevention (CDC), World Health
Organization (WHO), and our Department of Health (DOH).

 These guidelines give us information on suggested courses of action for

different age groups as regards the nature, intensity, duration, and
frequency of physical activity (see Table 1.1).

 The classification according to age groups is an important feature because

it recognizes our different abilities, capabilities, and needs as our activity
patterns change across the lifespan.
 CSEP and DOH issued guidelines for five age groups, yet there are
differences in terms of age ranges.

 The WHO global recommendations on physical activity for health are

classified into three age groups.

 CSEP also issued guidelines on sedentary behaviors, so that one is

informed not only about what ought to be done, but also what ought
to be avoided or minimized.
Overcoming Barriers to Physical
Activity and Exercise
 Why do we tend to be sedentary? Advancements in technology and labor-
saving devices have afforded us greater ease and convenience at work,
school, and at home.

 These have resulted in more free time, which we either fill up with more
work, or spend in recreation. However, passive forms of recreation, such
as watching television, computer use and video games, have dominated
our pursuits.

 All of these, along with personal variables like one's thoughts and
feelings, make people resistant to being physically active.
 As a student, most of your time is spent meeting the demands of your
studies.

 Staying in the classroom, attending meetings, and using the computer

to complete your assignments are characterized by prolonged sitting.

 With your busy schedule, exercise is often not a priority.

 Most of us recognize the benefits of a healthy lifestyle, but common

excuses for being sedentary include: lack of time, tiredness,
avoidance of or low tolerance for discomfort, and lack of skill and/or
confidence in playing or exercising.
 Most young people are also healthy so they tend to think that they will
not be affected by diseases at their age.
 This could be grounded on a false sense of invincibility that can be
corrected by knowing and understanding that our health in the future is
heavily influenced by our present lifestyle.
 It could also be a form of rationalization: "My diet is fine"; "I'm exercising
enough"; "I only smoke a few sticks"; "I only drink when there is an
occasion"; "I work best under pressure." It would be helpful then to face
the fact that you have a problem before you can commit to change.
 Most of the time though, we are simply unwilling to give up our present
convenience or comfort. We might also prefer immediate gratification so
we tend to take shortcuts or rush too quickly instead of changing slowly
but surely. Educating yourself by reading and understanding more
information about health and wellness could help you initiate changes in
your core values.
 How can you overcome some common barriers to physical activity?
 To optimize health, one must be active.
 Besides regular participation in physical activity, other healthy habits
that are equally important include eating healthily, managing our
stress, and sleeping adequately.
 These habits are acquired over time—but it starts with a choice.
 Choosing to live healthily requires constant effort: you must assess
your current behaviors, be well-informed of their consequences,
commit to and plan the necessary changes, and employ sound
techniques to modify these behaviors. Once established, these habits
become part of your lifestyle.
 This present lifestyle will ultimately impact on your future health.
Based on the results of your assessment, identify the areas where you feel
are problematic. Write them on a piece of paper.