Midterm -2 Notes

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Wilfrid Laurier University *

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Health Science

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Oct 30, 2023

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Ch. 3 Stress  Stress: hard to live with and impossible to live without. Stress in itself is neither positive nor negative, rather it is our reactions to it that can be described as positive or negative.  Your family, friends, environmental conditions, general health status, drug use, personality and support systems all influence how you respond to a given event. Most stress is actually internal and is usually the result of one’s emotional state that occurs in response to the demands of living.  Simply put, stress is the mental and physical responses to the demands put on us. Stressor is any physical, social or mental event or condition that forces our mind and body to adjust.  Eustress: also known as positive stress that can occur from getting married, building new relationships, starting school and more.  Distress: also known as negative stress can occur from financial problems, injury/illness, death of a loved one and more.  You can learn to manage your reactions by learning prestress coping skills and developing post stress management techniques .  The mind-body connection: Physical responses- psychoneuroimmunology (PNI)—interaction between mind, body, and the immune system. Stress causes negative long-term effects. Stress is also linked to depress immune functioning which results in a decrease in the ability to fight off diseases.  During periods of prolonged stress, there is suppression of Killer T cells in the body which decreases our ability to fight off illnesses.  Every living organism attempts to achieve the state of balance known as homeostasis and during periods of stress, our mind and body adjusts with an adaptive response—form of adjustment in which mind and body work to restore homeostasis .  The three stage response to stress, also known as General Adaptation Syndrome: o Alarm Phase: in this phase, the body detects a stressor that disturbs the homeostasis. The brain subconsciously perceives the stressor and prepares the body for flight and fight response (usually done by the ANS). The ANS has two parts—SNS (energizes the body) and PNS (calms body down)

o Resistance Phase: This phase begins immediately after the alarm phase where the body tries to regain physical and mental homeostasis. o Exhaustion Phase: physiological and psychological energy depleted to adjust to stressor. Chronic stress response = burnout or serious illness can occur.  Psychosocial sources of stress: o Change: there is a potential to experience stress whenever there is change, be it a good change or a bad change. The more changes you encounter, the more your body has to adjust and hence the more stress you have. Hassles, are the minor annoyances and irritations that also has the potential to cause harm to your body and your mental state. o Pressure: meeting higher standard of performance. This is often the result of your personal goals and of what the society thinks of you and expects from you. This causes your behavior to slow down, speed up, intensify in order to meet the expectations. o Inconsistent Goals and behaviors: your behaviors are not consistent with your goals and this can cause stress. Determining whether your behaviors are consistent with your goals are important in maintaining the rhythm of your life. o Conflict: these are probably the most common stressors where in you have simultaneous incompatible demands, needs and goals. This often happens when you are trying to decide and you have 2 opposing motives. o Overload: excessive time pressure, responsibility, and expectations. Burnout- exhaustion resulting from continuous overload.  Other forms of psychosocial stress include: problems with adaptation, frustration, overcrowding, discrimination, socioeconomic events and more. Indigenous people and people who are a part of LGBTQ community may face heavy impact of these stressors. o Environmental stress: these are the events the occur in your physical environments. For example: one-time events natural and industrial disasters. People are also often faced with background distresses like noise, pollution, extreme weather and more.  Self-imposed Stress:

o Self-concept and stress: the psychological system that governs our stress responses is called the cognitive stress system. It recognizes, evaluates and decides coping mechanisms on the basis of self- concept, past memories and emotions. o People with different personalities respond in different ways to stressors. Type A, B, and C, are the common personality types that you see in people. o Psychological hardiness is when you express or show type C personality, where you tend to show commitment, take responsibility for your actions, you make better life choices and more o Self-efficacy and control: belief’s in ones skills and abilities. You are more likely to face stressors successfully if you did in the past and vice versa. Learned helplessness—lack of confidence in coping. Internal VS external locus of control (when you believe that you are in control of your life)  Stress and post-secondary student: There are many factors/stressors that a post-secondary student faces: o Difficulty with schoolwork o Relationship problems o Frequent mood change o Lethargy and sleeping difficulties o Lack of interest in social activities o Usage of drugs and alcohol to avoid stress o Tendency to overeat o Lack of awareness  Stress Management: o When you have control over the stressor, you have to engage in a problem-focused stress management whereas when you don’t have control over the stressor, you have to engage in an emotion- focused stress management. o Assessing your stressor: can you alter the circumstances in any way to reduce the amount of distress you are experiencing? o Recognizing and Changing your responses: It is important to recognize your typical mental and physical responses to stress in order for you to manage these responses more effectively.

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o Learning to Cope: There are different way to cope with stress. Some are negative and some are positive. (some people end up using drugs and alcohol and some people go to therapy, relaxation, physical activity) o Downshifting: goals, planning finances, and career choices  Technostress: personal stress generated by reliance on technological devices. Suggestions for fighting technostress—enjoying the natural environment, being aware of what we are doing, managing the telephone, trying not to multitask (focusing on one task at a time), backing up your materials often, expecting technological changes.  Managing your emotional responses to stress: o Changing the way you think: o Work constructively o Look at life as fluid and rhythmical o Have moderate expectations o Weed our trivia o Do not rush into action o Keep things in perspective o See stumbling blocks as challenges o Break large tasks into smaller pieces o Reframe o Taking physical activity:  Releases hormones to enhance mood and reduces the stress response  Helps refocus energies  Meditation or deep breathing  Progressive muscle relaxation o Eating well:  Provides stamina  Poor eating creates distress in the body o Learning time management:  Never handle papers more than one  Prioritize your tasks  Avoid interruptions  Do not be afraid to say no  Reward yourself for being efficient  Use time to your advantage

 Become aware of your own time patterns Ch. 5 Nutrition  We often eat because of appetite, a learned psychological desire to eat, whether we are hungry or not. Hunger, on the other hand, is our physiological need to eat. Finding the right balance between eating to survive and eating to satisfy is a problem for many which often results in overweight and obesity in out population.  Social pressures, including family traditions social events that involve food, and busy work schedules also influence the quality and quantity of your dietary intake. Another factor that influences your food intake is your culture. Your culture influences almost all aspects of your dietary intake. Simply put, food choices are influenced by many factors o Family traditions, social factors, cultural influences, practical considerations (time, money, accessibility), and knowledge  Nutrition is the study between physiological function and the elements of food we take in.  Nutrients: the constituents of food that sustain us physiologically. They are chemical substances obtained from food by the body to: o Provide energy and structural materials o Support growth, maintenance, and repair of tissues o Prevent diseases of malnutrition  Traditionally, dietary diseases were associated with malnutrition but currently, they are associated with over-consumption. This over- consumption leads to poor eating habits, overweight and obesity.  There are 6 classes of nutrients: o Proteins, carbs, fats, vitamins, minerals, and water.  These ^ energy containing nutrients provide calories. However, vitamins, minerals, and water does not provide calories  Water: o Dehydration: lack of bodily fluids o Between 50-60% of our body weight is water. Water aids in cleansing cells, aids in fluids and electrolyte balance, maintains pH, and transports cells throughout the body. Water is also a major component of blood which carries oxygen and nutrients

o The recommendation for male is 3.0L of water per day and for female it is 2.7L of water per day. o The color of urine is one of the best indicators to see if your body is hydrated of not. Hydration however, depends on person to person, it is very common for athletes to lose 1-2L of fluids in intense hot and humid temperatures and the best way to measure this is to weigh before and after workout. For every Kg lost, an athlete must drink 1L of fluid/water. o Sports drink are not necessary for activities less than 60 mins or activities that are not associated with sweating. The purpose of energy drinks is to replenish the electrolytes and glycogen. o Milk also has the potential to replenish the body and restore nutrients. Milk is a rich source of protein and carbs o Our brain is 75% water and fluid deprivation leads to increased sleepiness and fatigue.  Proteins: o Next to water, proteins are the most abundant substances in the human body. They are the major components of almost every cell in the body. o Proteins are arranged in chains of amino acids. There are 22 amino acids and from those 9 are essential. o The role of a protein is very diverse: it helps in growth and repair, helps with regulation of several body functions (antibodies, enzymes, hormones, transport, fluid balance and pH balance. o Proteins can be obtained from different dietary sources like: meat, poultry, seafood, dairy products, and eggs (animal based) o However, not all protein you take is synthesized. The quality of a protein is based on its amino acid content and digestibility. o Complementary proteins are proteins you get from combining plant proteins to get all essential amino acids. o Health effects: if your body lacks protein, there are many bodily functions that start lacking and one example is the immune response. And if your body has severe prolonged protein deficiency, then it can lead to protein energy malnutrition. o When your body has excess proteins, the health effects are adverse. For example, when your body has excess protein it is stored as fat, which in-turn increases your body’s fat content.

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o How much protein do we need? 0.8g per Kg  Carbohydrates: o Carbohydrates supply us with energy we need to sustain our daily activities. They are a quick source of energy for the body. There are 2 types of carbs; simple carbs and complex carbs. Simple carbs consists of monosaccharides and disaccharides, whereas complex carbs consists of polysaccharides. o Monosaccharides: single sugars, easily broken down. Examples are glucose and fructose o Disaccharides: pairs of monosaccharides (2). Examples are sucrose and lactose (sugars found from milk products. o Polysaccharides: chains of monosaccharides. Examples are fibre and starch. o The primary role of carbs is to supply body with energy. These carbs are easily converted to glucose which is the fuel of our brain. Carbs are also a preferred energy source for RBCs and CNS o However, they contain sugar and when these sugars are in excess, it leads to the displacement of important nutrients. Along with contributing to obesity o Fibres: they are non-digestible polysaccharides  Soluble fibres: gums, pectins  Insoluble fibres: cellulose and lignans o Fibre plays an important role in gastrointestinal health, eases out stool, prevents constipation. It also aids in weight management, i.e., less intake more bulk, increases feeling of satiety. Decreases CVD and diabetes risk, and colon cancer risk o 130gm/day is the minimum carb intake recommendation  Fats: o Fat plays a vital role in maintaining healthy skin and hair, insulation of body organs against shock, maintenance of body temperature and functioning of cells. o Triglycerides: most common type of fat- 95% dietary lipids o Triglycerides are chains of carbon and hydrogen o There are 2 categories of fats:  Saturated: carry maximum number of hydrogen atoms  Unsaturated: lack some hydrogens

o Dietary sources of fats: meat, poultry, fish, eggs, dairy, nuts/seeds, vegetable oils and more. o Health effects:  Saturated fats are associated with an increase in the risk of heart disease  Mono and polyunsaturated fats provide a cardioprotective effect – maintaining the HDL-LDL ration  Essential fatty acids- Omega-3 and Omega-6. They serve as precursors for important bodily compounds, regulation of BP, blood clotting, immune function. Omega-3 provides additional heart health benefits. o Trans Fat: produced through hydrogenation of unsaturated fattu acids. o Makes unsaturated fat more saturated.  How much fat do we need daily? – 20-35% of total energy.  Vitamins: organic essential nutrients required by the body to perform specific vital functions and to support optimal health  There are 13 vitamins in our body: from those 13 vitamins some are fat- soluble and come are water-soluble o Water-soluble: B-complex and Vitamin C are water soluble which are easily absorbed and are transported in water compartments of the body. Unlike fat-soluble vitamins, they are not stored in the body and hence there should be frequent supply of these vitamins o Fat-soluble: Vitamin A, D, K, E are fat-soluble vitamins which requires fat for absorption in the GI tract. These vitamins are stored in the body and hence there can be less frequent supply. If fat soluble vitamins are in excess, it can cause toxicity problems.  Vitamins have a very diverse role, it aids in: o Growth and development o Healthy nerve and skin cells o New cell synthesis e.g blood cells o Build bones and teeth o Immune function o Support the production of energy  Hypervitaminosis: excess vitamins in the body leads to toxicity  Vitamin C does not reduce the frequency of a cold but it may reduce the duration and severity of the cold

 MINERALS: they are indestructible, inorganic elements that aid in physiological processes in the body. Without minerals, the body cannot absorb vitamins. Minerals are readily excreted and are usually not toxic.  Major minerals: are present and needed in large amounts. Eg. Calcium. Sodium, potassium and more  Trace minerals: present and needed in smaller amounts. Eg. Iron, zinc and more  Minerals play a diverse role in our body: o Regulation of several important body functions, nerve and muscle function, healthy bones and teeth, oxygen transport  Minerals of concern: o Sodium: 1500mg/day if there is excess sodium in the body, it can lead to hypertension and loss of calcium o Calcium: 1000mg/day. It is required for strong bones and teeth. Calcium intake in people tends to be very low, which can lead to Osteoporosis and it may also affect BP regulation and weight management o Iron: 8mg/day (M) 18mg (F). This mineral is required for oxygen transport. Iron intake in people tends to be very low which can lead to low hemoglobin, fatigue, pallor, cold intolerance.  Dietary supplements: they include vitamins, minerals, amino acids, and herbs.  Who would benefit from dietary supplements? –elderly, woman of childbearing age, pregnancy, lactation, weight loss, recovery periods  Vegetarian Diets: benefits of a vegetarian diet o Better cholesterol levels o Regular bowel movements o Lower risk of heart disease  Disadvantages of a vegetarian diet: o Possible vitamin deficiencies  IGF-1- cancerous cell o Cancerous cells are present in all of us. IGF-1 increases cellular proliferation, angiogenesis potential and reduces cell apoptosis o If you eat animal meat very often, there is a 4x increase in chance of you dying from cancer.  Heme Iron: it is a form or iron found in blood and muscle. It has a catalytic role in the formation of carcinogenic compounds

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 Non-heme iron are found in plants and they don’t have similar effects  Breast Cancer: hormones naturally found in dairy are seem to be associated with acne, cancers and male reproductive disorders. Women can reduce lifetime breast cancer risk by limiting alcohol and eating mostly plant-based food.  Cardiovascular diseases: high LDL levels are linked with CVD. Eggs are a #1 source of dietary cholesterol.  Intermittent Fasting: o Demonstrated positive effects of reducing food availability over a lifespan o Fasting results in metabolic switching from liver-derived glucose to adipose cell-derived ketones o Fasting period: cells activate pathways that enhance intrinsic defenses against oxidative and metabolic stress o Feeding Period: cells engage in tissue-specific processes of growth and plasticity o Metabolic Switching: glucose and fatty acids are the main sources of energy for cells. During fasting, triglycerides are broken down into fatty acids and glycerol for energy.  IF regimes: o Alternate day o 5:2 intermittent fasting o Daily time-restricted feeding  IF benefits: o Better stress response o Reduced food intake increases lifespan (mainly in animal models). In humans IF interventions ameliorate obesity, insulin resistance, hypertension, and inflammation o In animal models, it is evident that IF does increase endurance. It is believed that fasting for 16 hours daily results in fat loss and maintenance of muscle mass o IF is also believed to enhance cognitive functioning. 12 months of caloric restriction results in better verbal memory, executive function and global cognition. o IF can reverse insulin resistance in pre-diabetic and type II diabetic patients o IF improves CV health (BP, Heart rate, HDL-LDL levels)

o There is no evidence yet, but it is believed that IF has the potential to inhibit growth of cancerous cells. It is also suggested that caloric restriction decreases risk of stroke, Alzheimer’s disease, and Parkinson’s disease Ch 6 Healthy Body Weight  Body fat and its distribution: o Does not account for differences in body composition  Obesity: excessive body fat—associated with health risk  Body composition assessment: o Skinfold—measure thickness of subcutaneous adipose tissue. It can estimate the % of body fat using predictive equations. o Bioelectrical impedance analysis (BIA)—weak electrical current is passed through the body. Measures resistance based on water content. o Densitometry—based on body’s density and water/air displacement o Dual energy x-ray absorptiometry—small x-ray beam passed over body. Measures absorption in bone mineral and soft tissues o CT/MRI Scan—Computed Tomography/Magnetic Resonance Imaging. It provides precise images of body composition at tissue and organ level.  Consequences of Obesity: it is an important risk factor for any chronic diseases. CVD, stroke, type-2 diabetes, cancers (uterus, prostrate, breast, colon etc.) osteoarthritis. o There are also social and psychological consequences: discrimination, judgement, anxiety, depression o Plus it may act as a burden on the Canadian Health Care system.  Determinants of Obesity: at the simplest level, it is the long-term energy balance influenced by the interaction of Energy Intake and Energy Expenditure. In obesity, EI>EE, which leads to energy storage o Behavioral patterns: food intake and physical activity also determines if a person is obese or going to be o Environmental: when you live in an environment where there is not much physical activities and there’s a toxic food environment, you are more likely to get obese

o Psychosocial: Socioeconomic Status (SES), and social factors. The trend shows that the more you can afford, the less overweight or obese you would be. o Genetics/Endocrine: there are over 300+ genes and biological markers associated with obesity. GAD2 gene, a variation in this gene leads to an increase in the production of appetite boosting chemicals. Ob gene, prompts person to eat past point of being full. This was evident in the Prime Native Americans.  Hungry Hormones: o Ghrelin: stimulates hunger and appetite o Leptin: signals satiety o Insulin: regulates blood sugar  Leptin and Ghrelin are influenced by lack of sleep. Lack of sleep causes leptin levels to go down and ghrelin levels to up, increasing appetite and food intake.  Fat cell development: once there is an increase in the number of fat cells, they are always there, its just that their size will shrink during fat loss. o Hyperplasia: increase in the number of fat cells o Hypertrophy: increase in the size of cells  Positive energy balance: is when there is fat gain o Fat cell increase in number and size  Negative energy balance: is when there is fat loss o Fat cell decrease in size, no change in number  Ways of energy expenditure: o Basal metabolism (50-65%): this is a life sustaining process, the basal metabolism rate (BMR) fluctuates with age, body composition, illness, food intake o Physical activity (30-50%): during a physical activity you burn calories and hence there is energy loss o Food consumption (10%): thermic effect of food (TEF). This is the amount of energy it takes for your body to digest the food.  Underweight: too little body fat for optimal health. BMI for underweight people is usually below 18.5.  Low body weight is often associated with: o Low energy reserves o Menstrual irregularities and infertility o Osteoporosis and bone fractures

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o Increased risk of nutrition deficiency o Increased risk of premature death  Strategies for weight gain: o Healthy weight gain must combine: increased food intake and increase physical activity. o Focus should be on nutrition rich food, energy dense food o Should be regular on meals o Exercise to build muscle  Eating disorders: o Psychiatric diseases involving: severe disturbance in eating behaviours, abnormal attitudes towards body weight and shape, and unhealthy efforts to control body weight.  Anorexia Nervosa: Excessive preoccupation with food, self-starvation. o This disease is often associated with intense fear of gaining weight/becoming fat. This leads to severe restriction of food intake and results in significant weight loss (15-25%). This may also involve extreme exercise behaviours. o Health consequences of Anorexia Nervosa:  Neurological dysfunction, impaired immunity, osteoporosis, hair loss or development of lanugo, cardiac abnormalities.  Bulimia Nervosa: cycles of binge eating followed by purging. Self-induced vomiting. Weight is often within normal range. o Health consequences of Bulimia Nervosa:  Fluid and mineral imbalances  Kidney damage  Damage to GI tract  Dental caries  Disgust, guilt, and depression  Binge-eating disorder: episodes of binge eating without purging o Compulsive overeating o Dieting and binging behaviour less, severe o Similar psychological consequences  Unspecified Eating disorders: o Purge after normal eating o Binge/purge less frequently o Chew food without swallowing

 The female athletes triad: there are different conditions for female athletes apart from maintaining their diet: o Pressure to improve performance o Enhance aesthetic appeal o Meet weight guidelines  All this ^ often results in sever Kcal restriction, excessive exercise, weight loss and low body fat percentage  Factors that contribute to eating disorders: o Excessive pressure to be thin o Need for social approval, control o Associates with depression, anxiety, substance abuse  Treatments for these disorders: o Early diagnosis and recognition of need for intervention. o Should set goals –normal patterns of eating and exercising o Psychosocial wellness should be maintained o Multidisciplinary approach: health care team, family, and friends Ch 4- Physical Activity  Cardiorespiratory endurance—increase in stroke volume to deliver more blood with less effort  Aerobic power is usually determined by VO2 max test  Oxygen uptake represents the ability to: o Take up oxygen o Transport oxygen o Utilize oxygen  VO2 Max determinants: (delivery is most likely important) o O2 delivery to muscles- cardiorespiratory system o O2 utilization by muscles- mitochondrion content  How is VO2 Max determined: o Plateau o Reach age predicted max HR o High Blood lactate o RER > 1.15 o Voluntary exhaustion  Factors that affect VO2 Max:

o Mode of exercise o Genetics o Training status o Gender o Body size and composition o Age  VO2 max is the single best indicator of aerobic performance  Indicator of overall health  Also determines training intensity  If there is an increase in VO2 max by 1 MET, it can reduce the risk of many diseases  Improving cardiorespiratory endurance: o Increase the function of heart, lungs, and circulatory system o Frequency: 3-7 days/week o Intensity: 60-90% of maximal heart rate o 150min/week o Type of activities: continuous activities, working on large muscle groups  Estimating max HR= 220-age  In order to monitor the intensity of the workout, you can check the heart rate at the carotid artery or the radial artery  Talk test can also be used to see the intensity. If he/she can hold a conversation  Muscular Strength: ability of a muscle to exert maximal force against resistance  Muscular Endurance: ability of a muscle to excute repeated or sustained contractions over a period of time  After 40 years of age, the bone mass decreases at a rate of 0.5% every year  In young adults, peak bone mass is attained at the age of 30 years  It is very important for children to stay physically active during their puberty years as this influences the mineral accrual rate  Flexibility: range of motion about a joint or a series of joint  Static Stretching: position the muscle at the end of its ROM  Active and Passive stretching: o Active: muscle is actively stretched contracting the opposing muscle

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o Passive: muscle is stretched using outside assistance  Dynamic Stretching: muscle is stretched by moving repeatedly through a challenging but comfortable ROM