GLOBAL RECOMMEDATION ON PHYSICAL ACTIVITY FOR HEALTH AND

NUTRITION, WEIGHT MANAGEMENT AND STRESS

| MODULE 4

GLOBAL RECOMMENDATIONS
FOR PHYSICAL EDUCATION AND HEALTH

Overview
Adherence to physical activities and observing healthy diets are the primary goals
of this module. Hence, universal standards and guidelines and recommendations of the
aforementioned should be known to all to have a baseline if one is carrying off a global
standard or not in terms of their physical activities and overall health.
This module will deal with the different global recommendations of physical
activity set by the World Health Organization (WHO) which will dissuade an individual from
indulging into a sedentary lifestyle. Fitness Concept and Healthy Eating will likewise be
discussed which will generate idea on what roles fitness hold in achieving high satisfaction
to an individual and what simple and known guidelines on a diet can be of help to attain
good health.

Discussion
Physical inactivity is now identified as the fourth leading risk factor for global
mortality. Physical inactivity levels are rising in many countries with major implic ations for
the prevalence of noncommunicable diseases
(NCDs) and the general health of the population
worldwide.
The significance of physical activity on
public health, the global mandates for the work
carried out by the World Health Organization
(WHO) in relation to promotion of physical activity
and NCDs prevention, and the limited existence
of national guidelines on physical activity for
health in low- and middle-income countries
(LMIC) make evident the need for the
development of global recommendations that address the links between the frequency,
duration, intensity, type and total amount of physical activity needed for the prevention
of NCDs.
The focus of the Global Recommendations on Physical Activity for Health is primary
prevention of NCDs through physical activity at population level, and the primary target
audience for these Recommendations are policy-makers at national level.

WHAT IS PHYSICAL ACTIVITY?

WHO defines physical activity as any bodily movement produced by skeletal
muscles that requires energy expenditure. Physical activity refers to all movement
including during leisure time, for transport to get to and from places, or as part of a
person’s work. Both moderate- and vigorous-intensity physical activity improve health.
Popular ways to be active include walking, cycling, wheeling, sports, active
recreation and play, and can be done at any level of skill and for enjoyment by
everybody.
Regular physical activity is proven to help prevent and manage
noncommunicable diseases such as heart disease, stroke, diabetes and several cancers.
It also helps prevent hypertension, maintain healthy body weight and can improve
mental health, quality of life and well-being.
WHO guidelines and recommendations provide details for different age groups
and specific population groups on how much physical activity is needed for good health.
 NUTRITION, WEIGHT MANAGEMENT AND STRESS | MODULE 4

The recommendations set out in this document address three age groups: 5–17
years old; 18–64 years old; and 65 years old and above. A section focusing on each age
group includes the following:

• narrative summary of scientific evidence;

• the current physical activity recommendations;
• the interpretation and justification for the recommendations made

RECOMMENDED LEVELS OF PHYSICAL ACTIVITY FOR HEALTH

(5–17 years old)
For children and young people of this age group physical activity includes play,
games, sports, transportation, recreation, physical education or planned exercise, in the
context of family, school, and community activities. In order to improve cardiorespiratory
and muscular fitness, bone health, cardiovascular and metabolic health biomarkers and
reduced symptoms of anxiety and depression, the following are recommended:
Children and young people aged 5–17 years old should accumulate at least 60
minutes of moderate- to vigorous-intensity physical activity daily.
Physical activity of amounts greater than 60 minutes daily will provide additional
health benefits.
Most of daily physical activity should be aerobic. Vigorous-intensity activities
should be incorporated, including those that strengthen muscle and bone, at least 3
times per week.

(18–64 years old)

For adults of this age group, physical activity includes recreational or leisure-time
physical activity, transportation (e.g walking or cycling), occupational (i.e. work),
household chores, play, games, sports or planned exercise, in the context of daily, family,
and community activities.
In order to improve cardiorespiratory and muscular fitness, bone health and
reduce the risk of NCDs and depression the following are recommended:
• Adults aged 18–64 years should do at least 150 minutes of moderate-intensity
aerobic physical activity throughout the week, or do at least 75 minutes of vigorous-
intensity aerobic physical activity throughout the week, or an equivalent combination of
moderate- and vigorous-intensity activity.
• Aerobic activity should be performed in bouts of at least 10 minutes duration.
• For additional health benefits, adults should increase their moderate-intensity
aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-
intensity aerobic physical activity per week, or an equivalent combination of moderate-
and vigorous-intensity activity.
• Muscle-strengthening activities should be done involving major muscle groups on
2 or more days a week.

(65 years old and above)

For adults of this age group, physical activity includes recreational or leisure-time physical
activity, transportation (e.g walking or cycling), occupational (if the person is still
engaged in work), household chores, play, games, sports or planned exercise, in the
context of daily, family, and community activities. In order to improve cardiorespiratory
and muscular fitness, bone and functional health, and reduce the risk of NCDs,
depression and cognitive decline, the following are recommended:

• Adults aged 65 years and above should do at least 150 minutes of moderate-
intensity aerobic physical activity throughout the week, or do at least 75 minutes of

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vigorous-intensity aerobic physical activity throughout the week, or an equivalent

combination of moderate- and vigorous-intensity activity.
• Aerobic activity should be performed in bouts of at least 10 minutes duration.
• For additional health benefits, adults aged 65 years and above should increase
their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in
150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent
combination of moderate- and vigorous-intensity activity.
• Adults of this age group with poor mobility should perform physical activity to
enhance balance and prevent falls on 3 or more days per week.
• Muscle-strengthening activities should be done involving major muscle groups, on
2 or more days a week.
• When adults of this age group cannot do the recommended amounts of physical
activity due to health conditions, they should be as physically active as their abilities and
conditions allow.

Levels of physical activity globally

More than a quarter of the world’s adult population (1.4 billion adults) are
insufficiently active.
Worldwide, around 1 in 3 women and 1 in 4 men do not do enough physical
activity to stay healthy.
Levels of inactivity are twice as high in high-income countries compared to
low-income countries.
There has been no improvement in global levels of physical activity since 2001.
Insufficient activity increased by 5% (from 31.6% to 36.8%) in high-income
countries between 2001 and 2016.

Activity

1. What roles do these global recommendations by WHO play in eliciting active

lifestyle and minimizing the number of people with sedentary lifestyle?
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2. In your opinion, is it important to have a universal standard (e.g., global
recommendation for PE by WHO) which people can rely on to achieve fitness?
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 NUTRITION, WEIGHT MANAGEMENT AND STRESS | MODULE 4

NUTRITION

Nutrition can be defined as the science of the action of food, beverages, and their
components in biological systems. A nutrient is a compound that provides a needed
function in the body.

Nutrients can be further classified based on the amount needed in the body.
Macronutrients are the nutrients the body needs in larger amounts. Micronutrients are
also important nutrients, but ones the body needs in smaller amounts.

Macronutrients

• Carbohydrates
The word carbohydrate literally means "hydrated
carbon," or carbon with water. Thus, it is no surprise that Macronutrients Micronutrients
carbohydrates are made up of carbon, hydrogen, and Carbohydrate Vitamins
oxygen. Sucrose (table sugar) is an example of a
commonly consumed carbohydrate. Some dietary Protein Minerals
examples of carbohydrates are whole-wheat bread,
oatmeal, rice, sugary snacks/drinks, and pasta. Lipids

Water
• Proteins
Like carbohydrates, proteins are comprised of
carbon, hydrogen, and oxygen, but they also contain nitrogen. Several dietary
sources of proteins include nuts, beans/legumes, skim milk, egg whites, and meat.

• Lipids
Lipids consist of fatty acids, triglycerides, phospholipids, and sterols
(cholesterol). Lipids are also composed of carbon, hydrogen, and oxygen. Some
dietary sources of lipids include, oils, butter, and egg yolks.

• Water
Water is made up of hydrogen and oxygen and is the only macronutrient that
provides no energy.

Micronutrients

• Vitamins
These compounds are essential for normal physiologic processes in the body.

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• Minerals
Minerals are the elements (think periodic table) that are essential for normal
physiologic processes in the body.

Calories (Food Energy)

Food energy is measured in kilocalories (kcals), commonly referred to as calories.
Although technically incorrect, this terminology is so familiar that it will be used throughout
this course A kilocalorie is the amount of energy needed to raise 1 kilogram of water 1
degree Celsius. A food’s kilocalories are determined by putting the food into a bomb
calorimeter and determining the energy output: Energy = Measurement of Heat
Produced. Below is a picture of a bomb calorimeter and a link to a video showing how
one is used.
https://www.youtube.com/watch?v=YXo9B2A bH0s

The number of kilocalories per gram for each nutrient is shown below:

As the table above illustrates, only

carbohydrates, protein, and lipids provide
energy. However, there is another dietary
energy source that is not a nutrient— alcohol.
To emphasize, alcohol is not a nutrient, but it
does provide 7 kilocalories of energy per
gram.

Knowing the number of calories in each

nutrient allows a person to
calculate/estimate the number of calories
contained in any food consumed.

Carbohydrates have become, surprisingly, quite controversial. Some people

passionately extol the merits of carbohydrates, while others berate them as nutritional
assassins. However, it is important to understand that carbohydrates are a diverse group
of compounds that have a multitude of effects on bodily functions. Thus, trying to make
blanket statements about carbohydrates is not a good idea.

My Plate
On average, a person needs 1500 to 2000 calories per day to sustain (or carry
out) daily activities. The total number of calories needed by one person is dependent
on their body mass, age, height, gender, activity level, and the amount of exercise per
day. If exercise Irregular part of one’s day, more calories are required. As a rule, people
underestimate the number of calories ingested and overestimate the amount they burn
through exercise. This can lead to ingestion of too many calories per day. The
accumulation of an extra 3500 calorie adds one pound of weight. If an excess of 200
calories per day is ingested, one extra pound of body weight will be gained every 18
days. At that rate, an extra 20 pounds can be gained over the course of a year. Of
course, this increase in calories could be offset by increased exercise. Running or
jogging one mile burns almost 100 calories.

The type of food ingested also affects the body’s metabolic rate. Processing of
carbohydrates requires less energy than processing of proteins. In fact, the breakdown

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of carbohydrates requires the least amount of energy, whereas the processing of

proteins demands the most energy. In general, the number of calories ingested and
the number of calories burned determines the overall weight. To lose weight, the
number of calories burned per day must exceed the number ingested. Calories are in
almost everything you ingest, so when considering calorie intake, beverages must also
be considered.

To help provide guidelines regarding the types and quantities of food that should
be eaten every day, the USDA has updated their food guidelines from MyPyramid to
MyPlate. They have put the recommended elements of a healthy meal into the context
of a place setting of food. MyPlate categorizes food into the standard six food groups:
fruits, vegetables, grains, protein foods, dairy, and oils. The accompanying website gives
clear recommendations regarding quantity and type of each food that you should
consume each day, as well as identifying which foods belong in each category. The
accompanying graphic (Figure) gives a clear
MyPlate visual with general recommendations for a
healthy and balanced meal. The guidelines
recommend to “Make half your plate fruits
and vegetables.” The other half is grains and
protein, with a slightly higher quantity of grains
than protein. Dairy products are represented
by a drink, but the quantity can be applied to
other dairy products as well.
The U.S. Department of Agriculture developed
food guidelines called MyPlate to help
demonstrate how to maintain a healthy
lifestyle.

Derived from OpenStax- You can

download material Download for free at
http://cnx.org/contents/14fb4ad7-
High-Fructose Corn Syrup [email protected].

Food manufacturers are always searching for cheaper ways to produce their
products.
One extremely popular method for reducing costs is the use of high-fructose corn syrup
as an alternative to sucrose. High-fructose corn syrup is approximately 50% glucose and
50% fructose, which is the same as sucrose. Nevertheless, because increased
consumption of high-fructose corn syrup has coincided with increased obesity in the
United States, a lot of controversy surrounds its use.

Alternative sweeteners are simply alternatives to sucrose and other mono- and
disaccharides that provide sweetness.

Protein
Protein is another major macronutrient that, like carbohydrates, consists of small
repeating units. But instead of sugars, proteins are made up of amino acids.

Proteins can be classified as either complete or incomplete. Complete proteins

provide adequate amounts of all nine essential amino acids. Animal proteins, such as
meat, fish, milk, and eggs, are good examples of complete proteins. Incomplete proteins
do not contain adequate amounts of one or more of the essential amino acids. For
example, if a protein does not provide enough of the essential amino acid leucine it
would be considered incomplete. Leucine would be referred to as the limiting amino
acid because there is not enough of it for the protein to be complete. Most plant foods
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are incomplete proteins, with a few exceptions, such as soy. The table below shows the
limiting amino acids in some plant foods.

Fat
There is neither bad nor good cholesterol, despite the common use of these
descriptions in reference to LDL and HDL, respectively. Cholesterol is cholesterol. HDL and
LDL contain cholesterol but are actually lipoproteins that will be described later. It is not
necessary to include cholesterol in your diet because our bodies have the ability to
synthesize the required amounts. The figure below gives you an idea of the cholesterol
content of a variety of foods.
http://www.webmd.com/cholesterolmanagement/foods-to-avoid-for-highcholesterol
Fiber
The simplest definition of fiber is indigestible matter. Indigestible means that it survives
digestion in the small intestine and reaches the large intestine. There are the three major
fiber classifications:

• Dietary fiber This type of fiber contains both nondigestible carbohydrates and
lignin and is always intrinsic and intact in plants.

• Functional fiber This type of fiber contains nondigestible carbohydrate only and
can be isolated, extracted, or synthesized. Functional fiber can be from plants or
animals and produces beneficial physiological effects in humans.

• Total Fiber. Fiber that contains both dietary fiber and functional fiber.

Vitamins are organic compounds found in foods and are a necessary part of the
biochemical reactions in the body. They are involved in a number of processes, including
mineral and bone metabolism, and cell and tissue growth, and they act as cofactors for
energy metabolism. The B vitamins play the largest role of any vitamins in metabolism
(Table and Table).

You get most of your vitamins through your diet, although some can be formed
from the precursors absorbed during digestion. For example, the body synthesizes vitamin
A from the βcarotene in orange vegetables like carrots and sweet potatoes. Vitamins are
either fat-soluble or water-soluble. Fat-soluble vitamins A, D, E, and K, are absorbed
through the intestinal tract with lipids in chylomicrons. Vitamin D is also synthesized in the
skin through exposure to sunlight. Because they are carried in lipids, fat-soluble vitamins
can accumulate in the lipids stored in the body. If excess vitamins are retained in the lipid
stores in the body, hypervitaminosis can result.

Water-soluble vitamins, including the eight B vitamins and vitamin C, are absorbed
with water in the gastrointestinal tract. These vitamins move easily through bodily fluids,
which are water based, so they are not stored in the body. Excess water-soluble vitamins
are excreted in the urine. Therefore, hypervitaminosis of water-soluble vitamins rarely
occurs, except with an excess of vitamin supplements.

Minerals in food are inorganic compounds that work with other nutrients to ensure the
body functions properly. Minerals cannot be made in the body; they come from the diet.
The amount of minerals in the body is small—only 4 percent of the total body mass—and
most of that consists of the minerals that the body requires in moderate quantities:
potassium, sodium, calcium, phosphorus, magnesium, and chloride.

The most common minerals in the body are calcium and phosphorous, both of
which are stored in the skeleton and necessary for the hardening of bones. Most minerals
are ionized, and their ionic forms are used in physiological processes throughout the
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body. Sodium and chloride ions are electrolytes in the blood and extracellular tissues, and
iron ions are critical to the formation of hemoglobin. There are additional trace minerals
that are still important to the body’s functions, but their required quantities are much
lower.

Like vitamins, minerals can be consumed in toxic quantities (although it is rare). A

healthy diet includes most of the minerals your body requires, so supplements and
processed foods can add potentially toxic levels of minerals. Table and Table provide a
summary of minerals and their function in the body.

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ACTIVITY 8: Calculate how many calories you need

Whether you are looking to lose a few pounds or simply maintain your current
weight, determining how many calories you need every day is important.

Step 1: Get your weight in pounds and height in inches.

Step 2: Calculate basal metabolic rate (BMR) for women
Multiply your weight b y 4.35 then multiply your height by 4.7. Add the
two products. Subtract the product of your weight and height by your
age in years multiplied by 4.7 and add 655.

Example. A 150 -pound woman who is 65 inches tall and 30 years old
would have a BMR of 1,472.

Calculate basal metabolic rate (BMR) for men

Multiply your weight by 6.23 then multiply your height by 12.7. Add the
two products. Subtract the product of your weight and height by your
age in years multiplied by 6.8 and add 66

Step 3: Determine your activity level.

Sedentary people get little to no activity. Light levels include activity a
few days a week, moderate includes activity three to five days a week,
and a very active individuals play sports daily.

Step 4: Multiply BMR by your appropriate activity factor

Sedentary – 1.2 light – 1.375 moderate – 1.55 very active – 1.725

Step 5: Calculation equals the total calories to maintain weight

Factor the BMR by the activity factor to give you the number of calories
per day that you need and you can eat to maintain your current
weight.

Example: if a 150-pound woman is active four days a week, her activity

level would be moderate. Multiplying her BMR of 1,472 by 1.55 gives
her a calculation of 2,281.6.

Show your solution below:

Tips: Subtract 500 calories per day to lose 1 pound each week. Keep tabs on your
caloric intake and you'll stay fit and strong. By walking additional 10,000 steps each
day, the average adult can burn an extra 500 calories, giving you a 1-pound loss in a
week without cutting calories.

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WEIGHT MANAGEMENT

The majority of Americans are unhappy with their current weight. Almost everyone
would like to lose at least 5 pounds. A growing percentage of Americans are carrying
enough excess weight to put them at risk for many diseases and even death. Few people,
however, know enough about their own bodies to successfully manage their weight.
Anyone planning to start a weight loss program should begin by carefully considering the
following factors:

• How many calories are being consumed daily?

• How many calories are being expended?
• How much fluids are being consumed?
• How well are electrolytes being managed?

Weight Management Through Diet

Achieving one’s ideal weight can be a real challenge. But like most endeavors in
life, knowledge is power. The more people know about their diet, the better equipped
they will be to manage their weight. Most people focus on the number of calories
consumed. However, it is also important for them to know how many macronutrients are
in the foods they eat. The most effective way to do this is performing a 10-day nutritional
intake analysis. These analyses are best done on consecutive days to account for the
habitual ebb and flow of one’s daily food intake.

Remaining healthy during any weight loss program is paramount. Fad diets that
promise quick results do not consider the effects of rapid weight loss on the body.
Restricting weight loss to 1 to 2 pounds a week is a far healthier approach. Slow weight
also prevents the body from burning lean muscle since the body can only burn a certain
amount of fat in a week. Dieters who experience steady declines in weight are more likely
to keep the weight off. The term “diet” is often synonymous with strict routines that require
drastic changes in one’s eating habits. In reality, the term “diet” simply describes the
intake of food.

To lose weight, dieters need a clear understanding of how weight loss occurs. One
pound of fat loss is going to require a reduction in caloric intake of 3,500 calories. When
viewed in terms of daily food intake, to lose a pound a week, a dieter needs to reduce
their daily food intake by 500 calories a day: 3,500 calories/7 days= 500 calories per day.
To successfully lose 2 pounds per week, that reduction would have to be doubled to 1,000
calories per day. Attempting to lose 2 pounds or more per week would require a calorie
reduction too drastic to be maintained and too restrictive to be healthy. Thus, the
recommendation of combining diet and exercise is the most effective method for
experiencing weight loss. Subtracting 500 calories of food intake and exerting 500 calories
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in exercise will provide that same 1000 calorie reduction, but in a manner that is far easier
to maintain, and certainly more enjoyable.

No matter what your weight loss goal is, even a modest weight loss, such as 5 to
10 percent of your total body weight, is likely to produce health benefits, such as
improvements in blood pressure, blood cholesterol, and blood sugars.

Getting Started with Weight Loss

The Centers for Disease Control and Prevention (CDC) recommends following the
step-by-step guide:

Step 1: Make a commitment. Making the decision to lose weight, change your lifestyle,
and become healthier is a big step to take. Start simply by making a commitment to
yourself. Many people find it helpful to sign a written contract committing to the process.
This contract may include things like the amount of weight you want to lose, the date you
would like to lose the weight by, the dietary changes you will make to establish healthy
eating habits, and a plan for getting regular physical activity.
Writing down the reasons why you want to lose weight can also help. It might be because
you have a family history of heart disease, or because you want to see your kids get
married, or simply because you want to feel better in your clothes. Post these reasons
where they serve as a daily reminder of why you want to make this change.

Step 2: Take stock of where you are. Consider talking to your health care provider. He or
she can evaluate your height, weight, and explore other weight related risk factors you
may have. Ask for a follow-up appointment to monitor changes in your weight or any
related health conditions.

Keep a "food diary" for a few days, in which you write down everything you eat. By doing
this, you become more aware of what you are eating and when you are eating. This
awareness can help you avoid mindless eating.

Next, examine your current lifestyle. Identify things that might pose challenges to your
weight loss efforts. For example, does your work or travel schedule make it difficult to get
enough physical activity? Do you find yourself eating sugary foods because that is what
you buy for your kids? Do your coworkers frequently bring high calorie items, such as
doughnuts, to the workplace to share with everyone? Think through things you can do to
help overcome these challenges.

Finally, think about aspects of your lifestyle that can help you lose weight. For example, is
there an area near your workplace where you and some coworkers can take a walk at
lunchtime? Is there a place in your community, such as a YMCA, with exercise facilities
for you and child care for your kids?

Step 3: Set realistic goals. Set some short-term goals and reward your efforts along the
way. If your long-term goal is to lose 40 pounds and to control your high blood pressure,
some short-term eating and physical activity goals might be to start eating breakfast,
taking a 15-minute walk in the evenings, or having a salad or vegetable with supper.

Focus on two or three goals at a time.

Great, effective goals are
• Specific
• Realistic
• Forgiving (less than perfect)

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For example, "Exercise more" is not a specific goal. But if you say, "I will walk 15 minutes, 3
days a week for the first week," you are setting a specific and realistic goal for the first
week.

Remember, small changes every day can lead to big results in the long run. Also,
remember that realistic goals are achievable goals. By achieving your short-term goals
day by day, you will feel good about your progress and be motivated to continue. Setting
unrealistic goals, such as losing 20 pounds in 2 weeks, can leave you feeling defeated
and frustrated. Being realistic also means expecting occasional setbacks. Setbacks
happen when you get away from your plan for whatever reason—maybe the holidays,
longer work hours, or another life change. When setbacks happen, get back on track as
quickly as possible. Also, take some time to think about what you would do differently if
a similar situation happens, to prevent setbacks.

Keep in mind everyone is different—what works for someone else might not be right for
you. Just because your neighbor lost weight by taking up running, doesn't mean running
is the best option for you. Try a variety of activities: walking, swimming, tennis, or group
exercise classes, to see what you enjoy most and can fit into your life. These activities will
be easier to stick with over the long term.

Step 4: Identify resources for information and support. Find family members or friends who
will support your weight loss efforts. Making lifestyle changes can feel easier when you
have others you can talk to and rely on for support. You might have coworkers or
neighbors with similar goals, and together you can share healthful recipes and plan group
exercise. Joining a weight loss group or visiting a health care professional, such as a
registered dietitian, can help.

Step 5: Continually "check in" with yourself to monitor your progress. Revisit the goals you
set for yourself in Step 3, and evaluate your progress regularly. If you set a goal to walk
each morning but are having trouble fitting it in before work, see if you can shift your work
hours or if you can get your walk in at lunchtime or after work. Evaluate which parts of
your plan are working well and which ones need tweaking. Then rewrite your goals and
plan accordingly.

If you are consistently achieving a particular goal, add a new goal to help you continue
on your pathway to success.

Reward yourself for your successes! Recognize when you are meeting your goals and be
proud of your progress. Use nonfood rewards, such as a bouquet of freshly picked flowers,
a sports outing with friends, or a relaxing bath. Rewards help keep you motivated on the
path to better health.

The Importance of Physical Activity in Maintaining a Healthy Weight

Why is physical activity important?

Regular physical activity is important for good health, and it is especially important
if you are trying to lose weight or to maintain a healthy weight.

• When losing weight, more physical activity increases the number of calories your
body uses for energy or "burns off." The burning of calories through physical activity,
combined with reducing the number of calories you eat, creates a
"calorie deficit" that results in weight loss.
• Most weight loss occurs because of decreased caloric intake. However, evidence
shows the only way to maintain weight loss is to be engaged in regular physical
activity.
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• Most importantly, physical activity reduces risks of cardiovascular disease and

diabetes beyond that produced by weight reduction alone.

Physical activity also helps to– •

Maintain weight.
• Reduce high blood pressure.
• Reduce risk for type 2 diabetes, heart attack, stroke, and several forms of cancer.
• Reduce arthritis pain and associated disability.
• Reduce risk for osteoporosis and falls.
• Reduce symptoms of depression and anxiety.

How much physical activity do I need?

When it comes to weight management, people vary greatly in how much physical
activity they need.
Here are some guidelines to follow:

To maintain your weight. Work your way up to 150 minutes of moderate-intensity aerobic
activity, 75 minutes of vigorous intensity aerobic activity, or an equivalent mix of the two
each week. Strong scientific evidence shows that physical activity can help you maintain
your weight over time. However, the exact amount of physical activity needed to do this
is not clear since it varies greatly from person to person. It is possible that you may need
to do more than the equivalent of 150 minutes of moderate-intensity activity a week to
maintain your weight.

To lose weight and keep it off. You will need a high amount of physical activity unless you
also adjust your diet and reduce the number of calories you are eating and drinking.
Getting to and staying at a healthy weight requires both regular physical activity and a
healthy eating plan. What do moderate- and vigorous-intensity mean?

• Moderate: While performing the physical activity, if your breathing and heart rate
is noticeably faster but you can still carry on a conversation, it is probably
moderately intense.

Examples include:
• Walking briskly (a 15-minute mile).
• Light yard work (raking/bagging leaves or using a lawn mower).
• Light snow shoveling.
• Actively playing with children.
• Biking at a casual pace.

• Vigorous: If your heart rate is increased substantially, and you are breathing too
hard and fast to have a conversation, it is probably vigorously intense.

Examples include:
• Jogging/running.
• Swimming laps.
• Rollerblading/inline skating at a brisk pace.
• Cross-country skiing.
• Most competitive sports (football, basketball, or soccer).
• Jumping rope.

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The table provides a list of common physical activities and the average calories
expended during those activities.

Calories Used per Hour in Common Physical Activities

Moderate Physical Activity Approximate Calories/30 Approximate

Min. for a 154 lb. Person1 Calories/Hr.
for a 154 lb. Person1
Hiking 185 370
Light gardening/yard work 165 330
Dancing 165 330
Golf (walking and carrying clubs) 165 330

Bicycling (<10 mph) 145 290

Walking (3.5 mph) 140 280
Weight lifting (general 110 220
light workout)
Stretching 90 180
Vigorous Physical Activity Approximate Approximate
Calories/30 Min. for a 154 Calories/Hr.
lb. Person1 for a 154 lb. Person1
Running/jogging (5 mph) 295 590
Bicycling (>10 mph) 295 590
Swimming (slow freestyle laps) 255 510
Aerobics 240 480
Walking (4.5 mph) 230 460
Heavy yard work 220 440
(chopping wood)
Weightlifting (vigorous effort) 220 440
Basketball (vigorous) 220 440

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1. Calories burned per hour will be higher for persons who weigh more than 154 lbs. (70
kg) and lower for persons who weigh less.
Source: Adapted from Dietary Guidelines for Americans 2005, page 16, Table 4.

Keeping the Weight Off

Permanent weight loss is a result of making changes to eating habits that become
a long-term part of a healthier lifestyle. Below is the process for improving your eating
habits.

• Create a list of your eating habits. Keeping a food diary for a few days, in which
you write down everything you eat and the time of day you ate it, will help you
uncover your habits.
For example, you might discover that you always seek a sweet snack to get
you through the midafternoon energy slump. Use a diary to help. It's good to note
how you were feeling when you decided to eat, especially if you were eating
when not hungry. Were you tired? Stressed out?

• Highlight the habits on your list that may be leading you to overeat. Common
eating habits that can lead to weight gain are:
o Eating too fast o Always cleaning your plate o Eating when not hungry
o Eating while standing up (may lead to eating mindlessly or too quickly)
o Always eating dessert
o Skipping meals (or maybe just breakfast)

Look at the unhealthy eating habits you have highlighted. Be sure you have
identified all the triggers that cause you to engage in those habits. Identify a few
you would like to work on improving first. Don't forget to pat yourself on the back
for the things you are doing right. Maybe you almost always eat fruit for dessert,
or you drink low-fat or fat free milk. These are good habits! Recognizing your
successes will help encourage you to make more changes.

• Create a list of "cues" by reviewing your food diary to become more aware of
when and where you are "triggered" to eat for reasons other than hunger. Note
how you are typically feeling at those times. Often an environmental "cue," or a
particular emotional state, is what encourages eating for non-hunger reasons.

• Common triggers for eating when not hungry are:

o Opening up the cabinet and seeing your favorite snack food. o
Sitting at home watching television. o Before or after a stressful
meeting or situation at work. o Coming home after work and
having no idea what's for dinner.
o Having someone offer you a dish they made "just for you!" o
Walking past a candy dish on the counter. o Sitting in the break
room beside the vending machine.
o Seeing a plate of doughnuts at the morning staff meeting. o
Swinging through your favorite drive-through every morning. o
Feeling bored or tired and thinking food might offer a pick-me-up.

Circle the "cues" on your list that you face on a daily or weekly basis. Going home
for the Thanksgiving holiday may be a trigger for you to overeat, and eventually, you
want to have a plan for as many eating cues as you can. But for now, focus on the ones
you face more often.

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Ask yourself these questions for each "cue" you have circled:
Is there anything I can do to avoid the cue or situation? This option works best for
cues that don’t involve others. For example, could you choose a different route to work
to avoid stopping at a fast food restaurant on the way? Is there another place in the
break room where you can sit so you are not next to the vending machine?

For things I cannot avoid, can I do something differently that would be healthier?
Obviously, you cannot avoid all situations that trigger your unhealthy eating habits, like
staff meetings at work. In these situations, evaluate your options. Could you suggest or
bring healthier snacks or beverages? Could you offer to take notes to distract your
attention? Could you sit farther away from the food so it won't be as easy to grab
something? Could you plan ahead and eat a healthy snack before the meeting?

Replace unhealthy habits with new, healthy ones. For example, in reflecting upon
your eating habits, you may realize that you eat too fast when you eat alone. So, make
a commitment to share a lunch each week with a colleague, or have a neighbor over
for dinner one night a week. Other strategies might include putting your fork down
between bites or minimizing other distractions (i.e., watching the news during dinner) that
might keep you from paying attention to how quickly— and how much— you are eating.

Here are more ideas to help you replace unhealthy habits:

• Eat more slowly. If you eat too quickly, you may "clean your plate" instead of
paying attention to whether your hunger is satisfied.

• Eat only when you are truly hungry instead of when you are tired, anxious, or
feeling an emotion besides hunger. If you find yourself eating when you are
experiencing an emotion besides hunger, such as boredom or anxiety, try to find
a non-eating activity to do instead. You may find a quick walk or phone call with
a friend helps you feel better.

• Plan meals ahead of time to ensure that you eat a healthy well-balanced meal.
Reinforce your new, healthy habits and be patient with yourself. Habits take time
to develop. It doesn't happen overnight. When you do find yourself engaging in
an unhealthy habit, stop as quickly as possible and ask yourself: Why do I do this?
When did I start doing this? What changes do I need to make?

ACTIVITY
Check the column that corresponds to your answer.

ALWAYS SOMETIMES NEVER

1. I eat breakfast every day.

2. I drink 8 (eight) glasses of water every

day.

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3. I usually avoid eating fried foods.

4. I make sure I eat at least one serving of

fruit a day.

5. I avoid eating lots of junk foods.

6. I try to keep my overall fat intake

down.
7. I usually eat one serving of vegetable
or salad with my evening meal.

8. I sleep 7 to 8 hours a day.

9. When I am buying a soft drink, I usually

choose a diet drink.
10. I generally try to have a healthy diet.

11. I take vitamins daily.

12. When I have a snack between meals,

I often choose fruits.

13. I often eat chocolates and biscuits.

14. I always choose coffee over milk.

15. I make sure to have enough intake of

poultry products and seafood.
WEIGHT MANAGEMENT

16. Exercise 30 minutes a day.

17. Have a ''meatless day'' once a week.

18. Replace sugary drinks like soda with

tea and water.

19. Take 5-minute walk daily.

20. Keep a food journal.

21. Eat healthy snacks.

22. Avoid eating processed foods.

23. Track how many calories I am eating.

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24. Practice portion control of food.

25. Strength train 3-4 times a week.

26. Moderate intensity cardio 3-4

times a week.

27. Choose to walk instead of riding.

28. Limit sweet intake.

29. Drink enough water for clear

urinations.

30. Eat more vegetable and fruits.

STRESS

In today’s fast-paced society, most people complain about being stressed.

However, when they use the term stress, they rarely know its true meaning. The word
carries many negative connotations
and is associated with an unpleasant or
traumatic event. As such, people
mistakenly believe that stress is simply
the nervousness and tension
experienced prior to, during, or after a
negative event. In fact, the effects of
stress are physiological, emotional, and
psychological.

Additionally, not all levels of stress

are detrimental. The stress athletes
experience right before a big game or
college students feel right before an
exam can enhance focus and increase
their ability to concentrate. Stress is
Anxiety. By Edvard Munch. 1894 either good or bad depending on how
long it persists and how it is perceived by
the individual.

This chapter will provide a deeper

understanding of what stress is and provide effective strategies for managing stress.

What Is Stress and How Does It Affect Wellness?

Stress is defined as the body’s physical, mental, and emotional response to a

particular stimulus, called a stressor. This adaption/coping-response helps the body
prepare for challenging situations. It is the level of a person’s response to a stressor that

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determines whether the experience is positive or negative. As a hardworking college

student, you may feel as if you know the meaning of stress all too well. You may dream
of a future where the demands on your time are diminished, so you can escape the high
levels of stress you are feeling now. Unfortunately, regardless of their situation, everyone
experiences stress on a regular basis. The good news is, not all stress is bad!

Small levels of stress can enhance cognitive brain function. Stress may provide the
motivation and concentration you need to write an essay, practice a speech, or prepare
for a job interview. For most people, these types of stressors are manageable and not
harmful. Stressors that have the potential for harm include the sudden loss of a loved one,
the unexpected ending of a romantic relationship, or the unfair demands of an
unreasonable boss.

Defining Stress
Stress, then, is more than simply the tension and apprehension generated by
problems, obstacles, or traumatic events. Stress is the body’s automatic response
(physical, mental, and emotional) to any stressor. It is a natural and unavoidable part of
life, and it can be empowering and motivating, or harmful and potentially dangerous.

Effects of Stress on Wellness

As stated previously, not all stress is bad. In fact, the stress associated with riding a
roller coaster, watching a scary movie, or scaling a cliff can enhance these experiences.
Regardless of whether the stress experienced is negative or positive, the effects on the
body are identical. When a person senses that a situation demands action, the body
responds by releasing chemicals into the blood. The hypothalamus signals the adrenal
glands to release a surge of hormones that include adrenaline and cortisol. The
physiological effects of those chemicals—enhanced focus, quicker reaction time, and
increased heart rate, energy, and strength—are quite beneficial when faced with a
potentially dangerous situation that is temporary.

Unfortunately, most of the stressors people face—work, school, finances,

relationships—are a part of everyday life, and thus, inescapable. Experiencing ongoing,
unavoidable stress can result in some very unpleasant and harmful effects, both mental
and physical. Chronic stress can cause upset stomach, headaches, sleep problems, and
heart disease. It can also cause depression, anxiety, and even memory loss.

What Are the Strategies for Managing Stress?

Although stress in everyday life is unavoidable, there are ways to cope with it that
will minimize or eliminate its harmful effects.

The Anxiety and Depression Association of America (ADAA) provides a list of

effective strategies for coping with stress.
When you are feeling anxious or stressed, these strategies will help you cope:

• Take a time-out. Practice yoga, listen to music, meditate, get a massage, or learn
relaxation techniques. Stepping back from the problem helps clear your head.
• Eat well-balanced meals. Do not skip any meals. Do keep healthful,
energyboosting snacks on hand.
• Limit alcohol and caffeine, which can aggravate anxiety and trigger panic
attacks.
• Get enough sleep. When stressed, your body needs additional sleep and rest.
• Exercise daily to help you feel good and maintain your health.
• Take deep breaths. Inhale and exhale slowly.

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• Count to 10 slowly. Repeat, and count to 20 if necessary.

• Do your best. Instead of aiming for perfection, which isn't possible, be proud of
however close you get.
• Accept that you cannot control everything. Put your stress in perspective: Is it really
as bad as you think?
• Welcome humor. A good laugh goes a long way.
• Maintain a positive attitude. Try to replace negative thoughts with positive ones.
• Get involved. Volunteer or find another way to be active in your community, which
creates a support network and gives you a break from everyday stress.
• Learn what triggers your anxiety. Is it work, family, school, or something else you
can identify? Write in a journal when you’re feeling stressed or anxious and look
for a pattern.
• Talk to someone. Tell friends and family you’re feeling overwhelmed, and let them
know how they can help you. Talk to a physician or therapist for professional help.
• Get help online. Lantern offers online programs guided by professional coaches
to help you turn healthy anxiety management into a habit. (Sponsored)

Fitness Tips: Stay Healthy, Manage Stress

To receive the greatest benefits from exercising, try to include at least 2½ hours of
moderate intensity physical activity (e.g., brisk walking) each week, 1¼ hours of a
vigorous-intensity activity (such as jogging or swimming laps), or a combination of the
two.
• 5 X 30: Jog, walk, bike, or dance three to five times a week for 30 minutes.
• Set small daily goals and aim for daily consistency rather than perfect workouts. It
is better to walk every day for 15–20 minutes than to wait until the weekend for a
three-hour fitness marathon. Lots of scientific data suggests that frequency is most
important.
• Find forms of exercise that are fun or enjoyable. Extroverted people often like
classes and group activities. People who are more introverted often prefer solo
pursuits.
• Distract yourself with an iPod or other portable media player to download
audiobooks, podcasts, or music. Many people find it is more fun to exercise while
listening to material they enjoy.
• Recruit an “exercise buddy.” It is often easier to stick to your exercise routine when
you have to stay committed to a friend, partner, or colleague.
• Be patient when you start a new exercise program. Most sedentary people require
about four to eight weeks to feel coordinated and sufficiently in shape so that
exercise feels easier.

ACTIVITY 10: Assess Your Stress Level

Are you more or less stressed than your peers? How Stressed Are You?

The following questions will help you determine if you’re stressed and if so, how much
stress you’re facing.

Here’s how to grade your quiz:

Almost never applies to me = 0 point
Applies to me some of the time or to a small extent = 1 point
Applies to me a substantial amount of time, but not the majority of the time = 2
points
Applies to me most of the time, almost all of the time = 3 points

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Choose your answer by putting a check inside the box.

SCORE
QUESTION
0 1 2 3
1.I find it difficult to take the first step to get things done.
2.I have tremors, twitches or shakiness in parts of my body.
3.I worry about situations where I could make a fool of myself.
4.I feel depressed or melancholy.
5.I no longer enjoy the things I used to enjoy.
6.I tend to overreact to situations, whether personal or
professional.
7.I am easily agitated or annoyed.
8.I have trouble sleeping or falling to sleep.
9.I engage in activities or work that make me nervous or anxious.
10.I get upset by unimportant or small things.
TOTAL

RESULT:
Put a check inside the box that determines your stress level based on your score.
3 points or less: You are suffering from levels of stress that are normal for the
average person from time to time. This stress will likely disappear within a short
period of time.
4-5 points: your stress levels might be getting more serious. This is the time to
look into resources that might help you deal with the stress and find new ways
to cope.
6-7 points: You are suffering from severe levels of stress. Without treatment,
this can progress to physical problems. Take steps now to find help, including
counseling sessions if appropriate.
8 or more points: Your stress level has reached a critical stage. Now is the time
to take serious steps to reduce the stressors in your life. Speak with your doctor
or counselor as soon as possible, and explain your life situation to them. Ask
for help!

Terminology Checklist:

 Stress- the body’s physical, mental, and emotional response to a particular stimulus
 Stressor- Something that causes stress
 Eustress- Good Stress
 Distress- Bad stress
 Adrenalin- a hormone secreted by the adrenal glands, especially in conditions of
stress, increasing rates of blood circulation and breathing

References & Links

• Lind shield, B. L. Kansas State University Human Nutrition (FNDH 400) Flex book.
goo.gl/vane
http://en.wikipedia.org/wiki/File:Heat-

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loss_calorimeter.giftp://en.wikipedia.org/wiki/File:Heat loss_calorimeter.gif
• NHANES Food Frequency Questionnaire -
http://riskfactor.cancer.gov/diet/FFQ.English.June0304.pdf
• Framingham Heart Study History –
http://www.framinghamheartstudy.org/about/history.html.
• Framingham Heart Study Research Milestones -
http://www.framinghamheartstudy.org/about/milestones.html
• The Nurses’ Health Study - http://www.channing.harvard.edu/nhs/?page_id=70
• Health Professionals Follow-Up Study – http://www.hsph.harvard.edu/hpfs/
• Links and references found at the end of the section on Protein:
http://en.wikipedia.org/wiki/File:L-phenylalanine-skeletal.png
http://en.wikipedia.org/wiki/File:L-tyrosine-skeletal.png
• Wardlaw GM, Hampel J. (2006) Perspectives in nutrition. New York, NY:
McGrawHill. http://upload.wikimedia.org/wikipedia/commons/a/a6/PBJ.jpg
(This link doesn’t work)
http://en.wikipedia.org/wiki/File:Red_beans_and_rice.jpg (This links to a great
picture of red beans and rice)
• Chiasma G. (2000) The protein digestibility-corrected amino acid score. J Nutra
130(7): 1865S.
• Derived from OpenStax- You can download material Download for free at
http://cnx.org/contents/[email protected].
• Need CDC source for benefits of losing 5 to 10 percent of body weight. CDC’s
step by step guide.
https://www.cdc.gov/healthyweight/losing_weight/getting_started.html.

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