HEALTH ENHANCING BEHAVIOURS

EXERCISE
In recent years, health psychologists have examined the role of aerobic exercise in
maintaining mental and physical health.

What is aerobic exercise?

• Aerobic exercise is sustained exercise that stimulates and strengthens the heart and
lungs, improving the body’s utilization of oxygen.
• All aerobic exercise is marked by its high intensity, long duration, and requisite high
endurance.
• Among the forms of exercise that meet these criteria are jogging, bicycling, rope
jumping, running, and swimming.

What is anaerobic exercise?

Other forms of exercise, such as isokinetic exercise (weight lifting) or high intensity, short
duration, low-endurance exercises (such as sprinting), may be satisfying and build up
specific parts of the body but have less effect on overall fitness because they draw on short
term stores of glycogen rather than on the long term energy conversion systems associated
with aerobics.

How much exercise?

The typical exercise prescription for a normal adult is to accumulate 30 minutes or more of
moderate intensity activity on most, preferably all, days of the week and 20 minutes or more
of vigorous activity at least 3 days a week.

Physiological benefits of exercise

The health benefits of exercise are substantial.
1. A mere 30 minutes of exercise a day can decrease the risk of chronic disease
including heart disease and some cancers including breast cancer.
2. Exercise coupled with dietary change, can cut the risk of Type II diabetes in high-risk
adults significantly.
3. Aerobic exercise has been tied to increases in cardiovascular fitness and endurance,
and to reduced risk of heart attack.
4. Exercise is considered to be the most important health habit for the elderly, and
cardiovascular benefits of exercise have been found even for preschoolers.
5. Other health benefits of exercise include
• Increased efficiency of the cardiorespiratory system,
• Improved physical work capacity,
• The optimization of body weight,
 • The improvement and maintenance of muscle tone and strength,
• An increase in soft tissue and joint flexibility,
• The reduction or control of hypertension,
• Improved cholesterol tolerance,
• Improved tolerance of stress,
• Reduction in poor health habits, including cigarette smoking, alcohol consumption,
and poor diet,
• Increases strength and efficiency of heart
• Increases slow wave sleep,
• Decreases obesity,
• Increases HDL, unchanged total cholesterol,
• Decreases menstrual cycle length, decreases estrogen and progesterone,
• Increases immune system functions,
• Increases longevity.

Psychological benefits of exercise

1. Regular exercise improves mood and feeling of well-being immediately after a
workout.
2. There may also be some improvement in general mood and well-being as a result of
long-term participation in an exercise program.
3. Some of the positive effects of exercise on mood may stem from factors associated
with exercise, such as social activity and a feeling of involvement with others.
4. An improved sense of self-efficacy can also underlie some of the mood effects of
exercise.
5. Exercise has been used as a treatment for depression and for symptoms of menopause.
6. Exercise is an effective way of managing stress.
J.D. Brown and Siegel (1988) conducted a longitudinal study to see if adolescents
who exercised regularly were better able to cope with stress and avoid illness than
those who did not. Results indicated that the negative impact of stressful life events
on health declined as exercise levels increased.
7. An increase in endogenous opioids (natural pain inhibitors) stimulated by exercise
may also play a role in the modulation of immune activity during periods of
psychological stress.
8. Exercise may also have beneficial effect on cognitive processes by focusing attention
and concentration.
9. Exercise may offer economic benefits. Employee fitness programs can reduce
absenteeism, increase job satisfaction, and reduce health care costs, especially among
women employees.

Exercise versus stress

One puzzle is why exercise, which produces the release of adrenalin and other hormones, has
a beneficial effect on heart functioning, whereas stress, which also produces these changes,
has an adverse effect.
1. One theory maintains that infrequent activation and discharge of adrenalin (as in
exercise) may have beneficial effects, whereas chronically enhanced discharge of
adrenalin (as in stress) may not.
2. Another possibility is that adrenalin discharged under conditions for which it was
intended (such as running or fighting) is metabolized differently that adrenalin that
occurs in response to stress.
3. A third possibility is that, under conditions of stress, the hypothalamic-pituitary-
adrenocortical (HPA) axis is activated, which may be heavily responsible for the
adverse effects of stress on the body, whereas sympathetic nervous system arousal
alone or delayed HPA involvement, both of which are common in exercise, may have
fewer adverse effects.

In essence, then, exercise may engage different neurobiological and emotional systems and
patterns of activation than stress does.

Individualized exercise programs

• Understanding and individual’s motivation and attitudes with respect to exercise

provides the underpinnings for developing an individualized exercise program that
fits the person well.
• If people participate in activities that they like, that are convenient, for which they can
develop goals, and that they are motivated to pursue, exercise adherence will be
greater.
• Ensuring that people have realistic expectations for their exercise programs may also
improve long-term adherence.
• Because of the difficulties that arise in trying to get people to exercise faithfully, some
health psychologists have tried simply to increase overall activity level. The more
active people become, the more likely they are to maintain a proper body weight.
• Moreover, recent research suggests that moderate activity spread throughout the day
may be enough to achieve the cardiac gains previously thought to be achievable only
through vigorous exercise, especially for the elderly.

DIET

Developing and maintaining a healthy diet should be a goal for everyone.

Why is diet important? Negative effects of an unhealthy diet:
• Dietary factors have been implicated in a broad array of diseases and risks for disease.
 • Dietary change is often critical for people at risk for or already diagnosed with
chronic diseases such as coronary heart disease, hypertension, diabetes and cancer.
• Dietary recommendations of switching from trans fats (fried food) and saturated fats
(meat and dairy products) to polyunsaturated and monounsaturated fats is most
necessary to reduce elevated cholesterol levels (which is responsible for CHD and
hypertension).
• Diet may be implicated in sudden death, because danger from arterial clogging may
increase dramatically after a high-fat meal.
• Salt has been linked to hypertension and to cardiovascular disease as well.
• Dietary habits have also been implicated in the development of several cancers,
including colon, stomach, pancreas and breast.
• A poor diet may be especially problematic in conjunction with other risk factors.
Stress, for example, may increase lipid reactivity. Lipid levels may influence
intellectual functioning.

How can changing one’s diet improve one’s health?

• A diet high in fibre may protect against obesity and cardiovascular disease by
lowering insulin levels.
• A diet high in fruits and vegetables, whole grains, peas and beans, poultry, and fish
and low in refined grains, potatoes, red and processed meats has been shown to lower
the risk of CHD in women.
• Modifications in diet can lower blood cholesterol level.
• There is evidence from experiments on primates that caloric restriction or reduced
calorie diets have increased life span.

Resistance to Modifying Diet

It is difficult to get people to modify their diet, even when they are at risk for CHD or when
they are under the instruction of a physician.
1. Indeed, the typical reason that people switch to a diet low in cholesterol, fats, calories,
and additives and high in fibre, fruits and vegetables is to improve appearance not to
improve health.
2. Another difficulty with modifying diet is the problem of maintaining change.
Adherence to a new diet may be high at first, but falls off over time. Insufficient
attention to the needs for long-term monitoring and relapse prevention techniques are
responsible for this.
3. Another problem is the issue of self-management. Dietary recommendations may be
monitored only indirectly by medical authorities. Thus a strong sense of self-efficacy,
 family support, and the perception that dietary change has important health benefits
are critical to make successful dietary changes.
4. Some dietary recommendations are restrictive, monotonous, expensive, and hard to
find and prepare. Drastic changes in shopping, meal planning, cooking methods, and
eating habits may be required.
5. In addition, tastes are hard to alter.
6. So-called comfort foods, many of which are high in fat and sugars, may help to turn
off stress hormones, such as cortisol, thus contributing to eating things that are not
good for us.
7. A low sense of self-efficacy, a preference for meat, a low level of health
consciousness, a low interest in exploring new foods, and low awareness of the link
between eating habits and illness are all associated with poor dietary habits.
8. People who are high in conscientiousness and intelligence also seem to do a better job
of adhering to a cholesterol-lowering diet, and people high in anxiety or depression
are less likely to do so.
9. Conflict over dietary recommendations themselves may undermine adherence.
Different diets become fashionable at different times. With confusion regarding what
leads to weight loss and what leads to health, would be dieters do not always know
where to turn.

Link between stress and diet

1. Stress has a direct effect on eating, especially in adolescence. Greater stress is tied to
consuming more fatty foods, less fruits and vegetables, and to the lesser likelihood of
eating breakfast with more snacking in between meals. Thus stress may contribute to
long-term risk for disease by steering the adolescents’ and young adults’ diet in an
unhealthy direction.
2. A lower status job, high workload, and lack of control at work are also associated with
less healthy diets, as these jobs contribute to stress (which leads to the eating of
comfort foods).
3. Some dietary changes may alter mood and personality. Evidence is mounting that low
cholesterol diets may contribute to poor mood and behaviour problem. This could be
because people do not like low cholesterol meals, and thus get irritable after
consuming them.
4. Diet may also alter levels of neurotransmitters that affect mood as well.
5. Some studies suggest that low cholesterol diets may contribute to death from
behavioural causes, including suicides, accidents and murders. A possible cause of
these effects is that the diet produces lower levels of serotonin in the brain, causing
depressive symptoms.
Interventions to modify diet

1. Individual interventions
Many efforts to modify diet are done on an individual basis in response to a specific health
problem or health risk.
• Motivation to pursue dietary change and commitment to long-term health are essential
ingredients for success.
• Any effort to change diet needs to begin with education and self-monitoring training
because many people have a poor idea of the importance of particular nutrients and
how much of them their diet actually includes.
• Much dietary change has been implemented through cognitive-behavioural
interventions. These include:
a) Self-monitoring,
b) Stimulus control,
c) Contingency contracting,
d) Relapse prevention techniques

2. Family interventions
There are several good reasons for focusing diet interventions on the family.
• When all family members are committed to and participate in dietary change, it is
easier for the target family member to do so as well.
• In family interventions, family members typically meet with a dietary counsellor to
discuss the need to change the family diet and ways for doing so.
• Sometimes a family attempting to make these changes will get together with other
families who have done the same thing in order to share suggestions and problems
that have come up in their efforts to modify the family’s diet.
• Such programs may include social activities or potlucks, in which people share
recipes and bring food, and may use printed media, including newsletters, handouts
containing recipes, consumer shopping guides to find healthier foods, and new meal-
planning ideas.

3. Community interventions
Many interventions have been implemented on the community level.
• Nutrition education campaigns mounted in super-markets have revealed some
success. Computerized, interactive nutritional information systems placed in
supermarkets significantly decreased high fat purchases and somewhat increased high
fibre purchases.
• Factors such as banning of snack foods from schools, making school lunch programs
more nutritious, and making snack foods more expensive and healthy foods less so
will all make inroads into promoting healthy food choices.
Where can weight loss programs be implemented?

1. Work-site interventions
2. Commercial weight loss programs
3. Public health approach:
• Parents can be trained to adopt sensible meal planning.
• Better to teach children good eating habits.
• Increase activity level for children.
• Weight gain prevention throughout life span.
• WHO has recommended food labels with information regarding calories, size of
servings etc.
• Claim fees or tax reduction for weight loss programs.
• Responsible food marketing and scrutiny of products.
• Obesity tax.

RELAXATION:

An individual shifts his/ her body into a state of low arousal by progressively relaxing
different parts of the body. It involves controlled breathing – shift from relatively short
shallow breaths to deeper longer breaths.
Demonstration of Jacobson Progressive Muscle Relaxation.

MEDITATION:

Focus on a simple unchanging stimulus

TRANSCENDENTAL MEDITATION:

Repeating a simple syllable slowly over and over again.

MINDFULNESS:

Mindfulness is the psychological process of bringing one’s attention to experiences occurring

in the present moment, which can be developed through the practice of meditation. It
involves becoming aware of all incoming thoughts and feelings and accepting them, but not
attaching or reacting to them.