Course Syllabus

Required Reading:

Nutrition for Health,  Fitness and Sport.  Melvin Williams. 7th edition.  2005.

Weight-control Information Network (WIN), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH).
    http://win.niddk.nih.gov/

NIH - Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults - Executive Summary
    http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm

Nutrition and Athletic Performance.  Joint position statement by the American College of Sports Nutrition, the American Dietetic Association, and Dietitians of Canada.
    http://www.acsm.org/positionStands.htm
(Click on "ACSM Position Stands", then click on the December 1, 2000 position paper on Nutrition and Athletic Performance).

Grading Policy
 
 

Quiz 1 -     Nutrition & Exercise Physiology  Monday, April 16	50 points
Exam 1 -    Nutrition & Athletic Performance  Friday,  May 4	75 points
Exam 2 - Nutrition & Weight Control  Final exam period (Tuesday, June 5, 12-2 PM)	100 points
Nutritional Ergogenic Aid Research Paper (due at 2:00PM, Monday, April 30), 10%  deduction for each day late,	65 points
Ergogenic Aid Effort - Evaluation by team members (mid-project evaluation - Wednesday, April 18, no points), final project peer evaluation due May 2	10 points
TOTAL	300 points

  90% - 100% = A grades (typically > 93% = A, 90-92.9% = A-)
  80% - 89%  = B grades (typically 87-89.9% = B+, 83-86.9% = B, 80-82.9% = B-)
  65% - 79%  = C grades (typically 75-79.5% = C+, 70-74.9% = C, 65-69.5% = C-)
  60% - 65%  = D grades
  under 60%  = F grade

Late Papers:  All written assignments are due at the beginning of the class period.  Late papers receive a deduction of 10% for every day that the assignment is late by.  Papers turned in late over a weekend receive a 20% deduction for those days.

EXTRA CREDIT: NUTRITION STUDY GROUPS
To encourage students to study together in groups, students already working together on the Ergogenic Aid Project will also serve as study groups.  How the study groups functions is decided upon by its members.  Extra credit is based upon how the group as a whole performs on each exam.  If the average score of the group is between 70-79%, then each member of that group receives an additional 1 point to each of their scores for that exam.  If the average score is between 80-89% or 90-100%, then each member receives an additional 3or 4 points  respectively.   This is the only extra credit offered for this class.  Take advantage of it.
 
 

COURSE SCHEDULE
 
 

Week	Topic	Required Reading
1	Energy metabolism during exercise	Chapters 1 & 3
2	Audio for Energy Metabolism Slides Powerpoint slides Energy Metabolism Warning: the mp3 file is ~ 35mb is size and runs for about 38 minutes...action-packed minutes at that.  If possible, have the control bar for your player visible at the bottom of your screen so that you can pause it easily.  Good luck! Free Powerpoint Viewer download here
3	Macronutrient needs of athletes,  training diets, pre-event meals, Dietary Exchange Lists Audio file for Training Diets and Pre-Event Meal Slides PowerPoint slides on Training Diets and Pre-Event Meals	Chapters 4, 5,  6, 13 (note chapter 13 is a new chapter in the 8th edition)
4	PowerPoint slides on sports nutrition	Nutrition and Athletic Performance.  Position paper by ACSM, ADA, CDA Exchange Practice Problem
5	Fluids and electrolytes for athletes	Chapter 9
6	Obesity, statistics & pathogenesis PowerPoint Slides	NIH - Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults - Executive Summary The Executive Summary is now available only as part of the Full Report.  After clicking on Full Report, click on Download or View Free on the right.  You will probably only want to print the 20-page Executive Summary which are pages 13-32 on the web (pages xi - xxx on the document itself).  The whole document is 262 pages in length. Statistics Related to Overweight and Obesity Weight Cycling
7	Assessment of Obesity and Overweight Powerpoint Slides	Chapter 10
8	Dietary Methods for Weight Loss and Maintenance Powerpoint Slides	Chapter 11
9	Modification of eating behaviors  Exercise fjor Weight Loss and Maintenance Powerpoint Slides
10	Treatment of severe obesity: Very Low Calorie Diets Surgical Methods for Weight Loss      Powerpoint slides      Audio file for Surgical Methods for Weight Loss (24 minutes) Pharmacotherapy for Weight Loss      Powerpoint Slides      Audio file for Pharmacotherapy for Weight Loss (20 minutes)	Very Low-Calorie Diets Gastric Surgery for Obesity Prescription Medications for the Treatment of Obesity

 

Assignments

Nutritional Ergogenic Aid Assignment (Spring 2007)

Example of a good Ergogenic Aids Paper
 

Glutamine and Enhancement of Immune Function
by Kim Bouta, Rick Brajavich, Carrie Donaldson, and Maria Perez
Spring 2005
    
 

Dietary Recommendation for Athletes
Dr. David L. Gee
FCSN/PE 446

Metabolic Causes of Fatigue During Exercise.
Decreased Levels of Metabolic Substrates
decreased phosphocreatine levels
decreased muscle glycogen
decreased blood glucose
decreased blood branch-chain amino acids

Metabolic Causes of Fatigue During Exercise.
Disturbed Acid-Base Balance
lactic acidosis
Decreased Oxygen Transport
decreased blood volume due to dehydration

Metabolic Causes of Fatigue During Exercise.
Increased Core Body Temperature
dehydration
environmental conditions
Disturbed Electrolyte Balance
high sweat loss
no electrolyte replacement

Training Diet Recommendations: High Carbohydrate Diet
For "Power Athletes"
> 55% of calories
primary source of energy
effect of repeated high intensity workouts on glycogen

Training Diet Recommendations: High Carbohydrate Diet
For "Endurance Athletes"
> 60% of calories
endurance training can reduce glycogen
repeated training effects

Training Diet Recommendations: High Carbohydrate Diet
Recovery Meal
CHO ingested within 2hrs of workout is converted to glycogen 50% more rapidly.
Rec: up to 1.5 g CHO/kgBW of mixed CHO within 2 hours

Training Diet Recommendations: Moderate Protein Diet
RDA = 0.8 gP/kgBW
For "Power Athletes"
1.5 gP/kgBW
maintenance of large muscle mass
optimizes rate of protein synthesis (?)

Training Diet Recommendations: Moderate Protein Diet
For "Endurance Athletes"
1.0 gP/kg BW
replaces proteins used as fuel during endurance training (10-15% of energy)

Training Diet Recommendations: Moderate Protein Diet
Athletes do NOT need to consume supplementary amounts of protein
typical US diet: 15% of calories
4000 Cal diet = 150g Pro
90 kg "Power athlete" needing 1.5gP/kg = needs 135g Pro

Training Diet Recommendations:Low Fat Diet
>55-60% CHO, 10-15% PRO
< 25% FAT
Advantages of moderately low fat
High caloric density
Wider variety of foods available
May be more palatable

Dietary Exchange Lists
Dr.David L. Gee
Central Washington University

Exchange Lists Food Guide
1950
American Diabetes Association
American Dietetic Association
Tracking calories, CHO, PRO, FAT for diabetics
Revised in 1986

Exchange Lists Food Guide
Six food groups (exchange lists)
Portions of foods within a list have approximately the same Cal, CHO, PRO, FAT
Portions of foods within a list can be exchanged (substituted) for each other.

Exchange Lists Food Guide App E, p 470
Starch/Bread List
Fruit List
Milk List (NF, LF, HF)
Vegetable List
Meat List (very low, low, med, high fat)
Fat

Starch/Bread List p. 471-472
80 CAL, 15g CHO, 3g PRO
Breads
1 slice bread, 1/2 bagel
Cereals & grains
3/4 C breakfast cereal
1/2 C pasta 1/3 C rice
Starchy vegetables
potato, corn, green peas

Fruit List p. 472-473
60 CAL, 15 g CHO
0.5 cup of fruit or fruit juice
small piece of fruit
0.25 cup dried fruit

Milk List p. 473-474
Non-fat: 90Cal, 12gCHO, 8gPRO
1 cup skim milk, NF yogurt
1/3 cup NF dried milk
2% LF milk = 1 milk exch + 1 fat exch (5g fat)
whole milk = 1 milk exch + 1.5 fat exch(8g fat)

Vegetable List p475
25 CAL, 5g CHO, 2g PRO
0.5 C cooked vegetables
1 C fresh vegetable
corn, potatoes, peas in starch/bread list

Meat Lists p. 476-477
Very Lean = 35 Cal, 7g Pro, 1g fat
Lean Meat = 55 CAL, 7g PRO, 3g FAT
Med Fat Meat = Lean Meat + 0.5 Fat
75 CAL, 7g PRO, 5g FAT
Hi-Fat Meat = Lean Meat + 1 Fat
100 CAL, 7g PRO, 8g FAT

Very Lean Meat (1 oz)
Poultry (white meat)w/o skin
white fish
shellfish
non-fat cheeses (cottage cheese)
egg white, egg sub
dried beans, peas, lentils (.5C, + 1 bread)

Lean Meat List (1 oz)
Beef: USDA Select & Choice
Lean & trimmed cuts
Round
Sirloin
Loin
Flank

Lean Meat List
Pork: lean cuts, no visible fat, ham
Poultry (dark meat w/o skin)
Fish (salmon, drained canned tuna)
low fat cheeses

Medium Fat Meat List (1 oz)
Beef (ground beef, rib, chuck, marbled steaks, prime grade)
Pork (cuts with visible fat)
Poultry with skin
fried fish
Mozzarella, Ricotta cheeses
Egg

High Fat Meat List (1 oz)
Most cheeses
American, cheddar, jack, swiss
Many lunch meats and sausages
Peanut butter

Fat List p. 477-448
45 CAL, 5g FAT
1 Tsp oils, butter, margarine
1 Tbl mayo, salad dressing
1 Tbl nuts
2 Tbl cream, sour cream
1 Tbl cream cheese, heavy cream

Other Foods
Combination Foods (p 481)
Alcoholic Beverages (2 fat/serv)
Sugar (Fruit exchange)
Look at food label or food composition for estimation of exchanges

Exchange List Summary

Exchange List Summary
Milk Exchanges
NF/Skim milk exchange
LF milk = NF milk + 1 fat
Whole milk = NF milk + 1.5 fat
Meat Exchanges
very lean meat
lean meat = VLmeat + 0.5 fat
med fat meat = VLmeat + 1 fat
high fat meat = VLmeat + 1.5 fat

Uses of Food Exchange Lists
Estimation of food/meal composition
Dietary prescriptions

Dietary Prescriptions using Exchange Lists
Step 1:
Calculate calories, grams CHO, PRO, FAT
Step 2:
Establish # of exchanges for CHO-containing exchanges (MILK, FRUIT, VEG, BREAD)

Dietary Prescriptions using Exchange Lists
Step 3:
Establish # MEAT exchanges
Step 4:
Establish # FAT exchanges

Dietary Prescriptions using Exchange Lists
Step 1a
Establish caloric requirement and caloric distribution (% CHO, PRO, FAT)
Step 1b
Calculate grams of CHO, PRO, FAT

Dietary Prescriptions using Exchange Lists
Step 1c
Check if protein intake is adequate
Revise if necessary

Dietary Prescriptions using Exchange Lists
Step 2 - Establish CHO exchanges
Prescribe MILK, VEG, FRUIT exchanges
Subtotal grams CHO used
calculate grams CHO remaining
calculate # exchanges of BREAD

Dietary Prescriptions using Exchange Lists
Step 3 - Establish Meat Exchanges
subtotal grams PRO used
calculate grams PRO remaining
calculate # MEAT exchanges

Dietary Prescriptions using Exchange Lists
Step 4 - Establish FAT exchanges
subtotal grams FAT
calculate grams FAT remaining
calculate  # FAT exchanges

Practice Problem
Subject:
135 pound male high school basketball player
Nutrient needs:
2700Cal/day, 7gC/kg, 1.8gP/kg
Typical food intake
3 milk exchanges
15 fruit exchanges
6 vegetable exchanges

135 lbs / 2.2 = 61kg
CHO calcuations
7gCHO/kg x 61kg = 427gCHO
427gCHO x 4Cal/g = 1708Cal CHO
1709CalCHO/2700Cal = 63% CHO

PRO calculations
1.8gPRO/kg x 61kg = 110gPRO
110gPRO x 4Cal/g = 439CalPRO
439CalPRO/2700Cal = 16%PRO

FAT calculations
2700-1708-453 = 553Cal FAT
553CalFAT/9Cal/g = 61gFAT

            EXCH     gCHO     gPRO     gFAT     CAL
Milk         3         36             24                      270
Fruit         15         225                                   900
Veg         6         30             12                      150

Subtotal  CHO:  291 – 427=136g/15=9

Bread     9         135             27                      720

Subtotal  PRO:   63 – 110=47g/7=7

VLFMeat     7                      49         7             245

Subtotal  FAT:   61 -  7 = 54/5= 10.8

Fat             11                                   55             495
 

Pre-Event Meal

Goals
Load glycogen stores
Optimize hydration
Empty upper GI tract

Pre-Event Meal
Meal Composition
High in carbohydrates
mixed complex and simple
Reasonably low in fats and protein
Low in dietary fiber

Pre-Event Meal
Composition (cont.)
High in fluids
Individualize
Use familiar foods

Pre-Event Meal
Timing of meal
Complete > 2 hours before event
Individualize

Carbohydrates Just Prior to Event
Purpose: provide exogeneous CHO to avoid hypoglycemia and delay glycogen loading.
For endurance athletes only
Response highly individualized
May promote reactive hypoglycemia

Carbohydrates During Event
Sport drinks, energy bars, fruits, breads
Metabolically useful for endurance athletes
Flavored sport drinks increase consumption
Dilute concentration (<10%) promotes fluid absorption

Carbohydrate Loading
Theory:
Glycogen depletion is a cause of fatigue in endurance athletes.
Increasing glycogen stores above normal levels will enhance performance in endurance athletes.

Carbohydrate Loading Protocol: Classic Method
Depletion Phase (3-4 days)
Strenuous endurance training
Very low carbohydrate diet
Repletion Phase (3-4 days)
Tapered training --> rest
Very high carbohydrate diet

Carbohydrate Loading Protocol: Classic Method: Drawbacks
High level of fatigue during depletion phase
Very unusual diet during depletion phase
May not result in substantially higher glycogen levels than Modified Method

Carbohydrate Loading Protocol: Modified Method
Mild Depletion Phase
Normal training with tapering
Moderate carbohydrate diet
Repletion Phase
Light training --> rest
Very high CHO diet

Carbohydrate Loading
Diet a mixture of complex and simple carbohydrates to maximize liver and muscle glycogen
2-3 lbs of weight gain (water)
stiffness
hyper-hydration
nausea and diarrhea with diet changes

Fluid and Electrolyte Replacement in Athletes
Dr. David L. Gee
FCSN/PE 446

Water Balance: Normal

Water Output: Normal vs.Exercise

Water Intake: Normal vs Exercise

Heat and Sweat Production During Exercise
70kg subject, running 1 hr
900 Cal expended
mechanical efficiency = 20%
180 Cal movement, 720 Cal heat

Heat and Sweat Production During Exercise
body specific heat = 0.83Cal/kg/deg
780 Cal -> 12.4 deg C = 22 deg F
death

Heat and Sweat Production During Exercise
Evaporate 1 liter sweat = 580 Cal heat
720 Cal heat = evaporates 1.24 liters of sweat
Real conditions, approx. 2 liters or 4.4 pounds of water loss

Effects of Dehydration on Performance
Endurance Performance
2-3% dehydrated
Strength Performance
normal vs partial rehydrated

Effect of Dehydration on Physiological Function
2-4% wt loss - reduced muscular endurance time
4-6% wt loss - reduced muscular strength & endurance, heat cramps
> 6% wt loss - severe heat cramps, heat exhaustion, heat stroke, coma, death

Recognizing heatstroke
Warning signs vary but can include::
Extremely high body temperature (above 103 degrees, orally)
Red, hot and dry skin (no sweating)
Rapid, strong pulse
Throbbing headache
Dizziness
Nausea
Confusion
Unconsciousness

What to do:
Call for medical help immediately while you begin cooling the victim.
Do the following:
Get the victim to a shady area.
Cool the person rapidly however you can. For example, immerse him in a tub of cool water; place him in a cool shower; spray him with cool water from a garden hose; sponge him with cool water; or if the humidity is low, wrap him in a cool, wet sheet and fan him vigorously.

What to do:
Monitor body temperature, and continue cooling until body temperature drops to 101 to 102 degrees.
If emergency medical personnel are delayed, call the emergency room for further instructions.
Do not give the victim alcohol to drink.
Sometimes a victim's muscles will begin to twitch uncontrollably. If this happens, keep the victim from injuring himself, but do not place any object in his mouth and do not give fluids. If he is vomiting, make sure the airway remains open by turning the victim on his side.

Strategies for Avoiding Dehydration
Continual fluid replacement
Replace fluids as they are lost
Practice fluid replacement
0.5-1 cup per 10-15 min
Body weight changes
1 lb = 2 cups

Strategies for Avoiding Dehydration
Cold fluids
High risk conditions
High temperature
High humidity
Low air movement
Bright sun

Strategies for Avoiding Dehydration
Hyperhydration
1 pint, 15-30 minutes prior to exercise

Electrolyte Replacement
Sweat from extracellular fluids
Major electrolytes are Na and Cl
Sweat is hypo-osmolar compared to plasma
Dehydration leads to hypernatremia

Electrolyte Strategies for Athletes
Most athletes do NOT need additional electrolytes
Exception is for very high sweat losses (> 1hr or heat stress conditions)
Replacement with pure water can lead to hyponatremia (water intoxication

Prevalence of Hyponatremia in Elite Athletes
1999 New Zealand Ironman Ultradistance
330 Finishers
18% hyponatremic
45% female finishers hyponatremic
14% male finishers hyponatremic
Adequate water intake
but inadequate electrolyte replacement

Sport Drinks
Provide water
Provide dilute carbohydrates
should be < 10% (<8% optimal)
Gatorade: G+S @ 6%
Powerade: F+GP @ 8%
Fruit juice: F+S @ 11-15%
Soft drinks: F @ 11%

Carbohydrates in Sport Drinks
Glucose
rapidly absorbed and utilized by muscle
Fructose
more slowly absorbed and utilized by liver to replace liver glycogen
Sucrose (G-F)
Glucose Polymers
lower osmolarity than simple sugars and may allow for more rapid water absorption

Sport Drinks
Provide electrolytes
replace Na and Cl lost in sweat
enhances water uptake
[NaCl]  < 1000mg/L
Gatorade: Na,Cl,K,P (460mg/L)
Powerade: (Na,Cl) (300mg/L)
Orange Juice: (10 mg Na/L)
Soft drinks: (40 mg Na/L)

Sport Drinks
Preferred tastes
Particularly useful for:
endurance athletes
high heat stress environments
heavy sweaters

Tips on Drinking During Exercise
Determine typical “fluid shortfall”
change in BW
1 pound weight loss = 1 pint (16 oz)
body can adapt to increase fluid intake
gradually increase fluid intake during training
use alarm wristwatch, water bottle

Tips on Drinking During Exercise
Have trainer, team mates, organizers have fluids cold and easily available
Try different types of beverage containers
Drink small volumes more frequently
Try different flavors

Fluid Replacement after Exercise
Important
if dehydrated, electrolye imbalanced
if next event soon
Determine net BW loss
consume fluids  that double weight loss
1 pound = 1 quart
may need supplemental sodium
carbohydrates may improve palatability and increase rehydration rate
 
 
 
 
 

The Female Athlete Triad
David L. Gee, PhD
Professor of Food Science and Nutrition
Central Washington University

Components of the Triad
Disordered Eating
Amenorrhea
Osteoporosis

Symptoms of the Female Athlete Triad
fatigue & anemia
stress fractures
depression & decreased concentration
constipation or diarrhea
enlargement of parotid glands, erosion of tooth enamel
cold intolerance & lanugo

Symptoms of the Female Athlete Triad
edema of face and extremities
menstrual irregularities
preoccupation with weight
trips to bathroom during or immediately following meals
fasting
use of diuretics, diet pills, laxatives

Health Consequences
Increased risk of fracture
Irreversible bone loss
Permanent organ damage
kidneys
heart
skeleton

Prevalence
Disordered eating
15% - 62% of female athletes
self-reported surveys
Amenorrhea
similar variation (~40%)
definition
Osteoporosis
undetermined

Female athletes at high risk
Sports with emphasis on thinness
gymnastics
figure skating
dancing
diving
swimming
running

Disordered Eating
Continuum of behaviors
Mild
minimal/moderate self-restriction
occasional bingeing & purging
Severe
frequent bingeing & purging
anorexia nervosa

Amenorrhea
definition
no menses for > 3 months
no menses for > 6 months
< 3 menses per year
incidence in non-athletic population
2% to 4%

Contributors to Amenorrhea
Low body fatness
Low caloric intake
Physical and psychological stress
Decreased estrogen production

Osteoporosis
Loss of all bone components
may result in stress fractures or severe fractures compared to actual injury
may result in life-long risk of osteoporosis
screening with dual energy x-ray absorptiometry (DEXA)

Nutritional Treatment Guidelines
Increase calories gradually (+300 cal/d)
Increase weight slowly (+ 3% goal)
Increase calcium intake to 1500mg/d
Decrease training by 10-20%
Patient education
general nutrition & health
osteoporosis

Treatment Guidelines
Referral to appropriate professionals for psychological and medical treatment
Nutrition therapy integrated with overall treatment program
Education of coaches and athletic trainers
 

The High Protein/Low Carbohydrate Diets: Flaws in Rationale
Studies show that despite an increase in %CHO in diet, there is increasing obesity.
But, while %CHO increased & %FAT decreased, TOTAL Calories increased, caloric expenditure decreased and absolute fat intake stayed the same.

The High Protein/Low Carbohydrate Diets: Realities
Despite over 25 years of promoting his diet, Dr. Atkins has never conducted & published any long term studies on his patients.
Diets low in carbohydrate will deplete glycogen stores
result in significant early water loss
cause premature fatigue during exercise

The High Protein/Low Carbohydrate Diets: Realities
High protein diets will result in further weight loss if Ein < Eout
meat, cheese, egg diets become unappetizing over the long run
long-term compliance to this restricted diet is likely to be poor
Diets high in meat … are high in saturated fats and will increase risk of heart disease.

The High Protein/Low Carbohydrate Diets: Realities
Low Carbohydrate diets will result in ketosis
most cases degree of ketosis are mild
most cases there is some appetite suppression
in some cases, there will be ketoacidosis and electrolyte imbalance - need for physician supervision

The High Protein/Low Carbohydrate Diets: Conclusions
Here we go again….

Guidelines for Identifying Weight Loss Fraud
Claims easy, large, fast weight loss
eat all you want, no exercise
uses quackery terms
gets rid of “cellulite”
relies on undocumented cases

Guidelines for Identifying Weight Loss Fraud
Claims government approval
gives no or incomplete scientific references
cures everything
promotes use of unproven aids/gadgets
equipment
supplements

Guidelines for Identifying Weight Loss Fraud
Makes claims about “problems associated with combining certain foods in the same meal”
Describes diet as being opposed by the the established medical community
Distributed exclusively by mail order, internet, 800 phone, pyramid sales organization

Very Low Calorie Diets
VLCDs
Characteristics
400-800 Cal/d
Generally semi-synthetic beverages
‘high protein’ (50-100g/d)
Very low fat
Low to moderate CHO
Expensive

Very Low Calorie Diets VLCDs
Must be Medically Supervised
Generally safe
Minor side effects
Fatigue
Constipation or diarrhea
Nausea/dizziness
Cold intolerance
Possible significant side effects
Gall stones
Electrolyte imbalances

Very Low Calorie Diets VLCDs
Patient Criteria
BMI > 30
BMI= 27-30 with medical complications
Contraindications
Pregnancy
Children
history of
dysrhythmia of heart
gall stones
renal dysfunction

Very Low Calorie Diets VLCDs
Short term outcome
Rapid high quality weight loss
30-35 kg in 25 weeks
Reduction in health risks
Long term success
No more (or less) successful than other treatments
Maintenance program (diet, behavior, exercise) critical for success
 
 

Behavioral Therapy and Weight Control
Dr. David L. Gee
FCSN 446/PE 446
Nutrition, Weight Control and Exercise

Assumptions of Behavior Therapy
Weight problems caused/maintained by inappropriate learned behaviors.
These inappropriate behaviors can be replaced with new learned behaviors.
Behaviors are controlled by long and short term consequences.

Managing the ABC's
A: Antecedent conditions
B: Behaviors associated with eating
C: Consequences of eating

Characteristics of Effective Behavioral Therapy Programs
Long term
Focus on problem solving
Focus on relapse prevention
Focus on positive cognition
Involves professional group leader

Basic Components of Behavioral Therapy
1. Record Keeping
types & amounts of food
time of day
place of consumption
associated activities
degree of hunger

Basic Components of Behavioral Therapy
Record Keeping
rate of consumption
influence of other people
emotional state
reason for selecting food
reason for ending eating

Basic Components of Behavioral Therapy
2. Problem Analysis
establishing priorities
3. Goal Setting
setting reasonable goals
stepwise goal setting

Basic Components of Behavioral Therapy
4. Tactics
specific means to change behaviors
brain-storm ideas
short- and long-term rewards
Basic Components of Behavioral Therapy
5. Evaluation
evaluate tactics
evaluate goals
evaluate new problems

Basic Components of Behavioral Therapy
6. Continuation during weight maintenance
group meetings
individual
 
 

Exercise and Weight Control
Dr. David L. Gee
FCSN 446/PE 446
Nutrition, Weight Control, and Exercise

Benefits of Exercise for Overweight Individuals
Weight Loss Related Benefits
Increased energy expenditure during exercise
Preserves/increases leand tissue
Decreases diet-induced decline in RMR
Effect on appetite smaller than increase in energy expenditure

Benefits of Exercise for Overweight Individuals
Health Benefits Independent of Weight Loss
Improves plasma lipid profile
Improves insulin sensitivity
Decreases blood pressure

Benefits of Exercise for Overweight Individuals
Psychological Benefits
Increases self-reliance/self-confidence
Improves sense of well being
Decreases anxiety, depression
Enhances adherence to other weight control behaviors

Exercise for the Weight Loss: Intensity vs. Duration
Higher Intensity Exercises
burns calories at faster rate
greater cardiovascular benefits
burns lower percentage of fat

Exercise for the Weight Loss: Intensity vs. Duration
Longer Duration Exercises
burns higher percentage of fat
easier for sedentary subjects to maintain on exercise programs

Exercise for the Weight Loss: Intensity vs. Duration
Recommendations
Begin with lower intensity exercises
Work on increasing duration first
Focus on regular program (5-7 days/week)
Gradually increase intensity once available time is limiting
Just do it!

Weight Training for Weight Control
Benefits
Promotes greater increases in muscle mass
Increases RMR/kg BW
Add as a lower priority option 3X/wk

Considerations for the Overweight Exerciser
many currently inactive
many never active
many feel awkward exercising
many with poor self image

Considerations for the Overweight Exerciser
Very gradual introduction and progress
Appropriate types of exercise
group support
instructor support
low impact
heat intolerant
measure HR frequently

Considerations for the Overweight Exerciser
Make it a high priority (incentives)
Use as a substitute for problem behavior, not as a punishment
measure girth in addition to weight

Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle
NIH Consensus Development Conference Statement, Dec. 1995
Perceives a net benefit
Chooses an enjoyable activity
Feels competent doing activity
Feels safe doing activity

Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle
Easy access to activity
Activity fits into daily schedule
Financial and social costs acceptable
Minimum negative consequences
loss of time
negative peer pressure
problems with self esteem

Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle
Able to successfully address issues of competing time demands
Balance labor saving devices and sedentary activities with activities that involve higher levels of physical exertion
 
 

Useful Links for FCSN/PE 446

PubMed
The National Library of Medicine's (NLM) search service to access the 9 million citations in MEDLINE and Pre-MEDLINE (with links to participating on-line journals), and other related databases.

ProQuest Medical Library
Available through CWU's Library.  Combines Medline indexing with abstracts and texts of selected journals.

Web of Science
Available through CWU's Library of databases.  An on-line version of the Science Citation Index that allows you to search by topic, sort by publication date and number of times that article was cited (related to "importance" of that article), as well as provides other articles that cited that reference source.

Kittitas Valley Community Health Library
The Community Health Library is located in Ellensburg, Washington. It is their purpose to provide
health care consumers, in conjunction with their health care providers, the best and most
informative sources with which to make decisions regarding health care needs.  They have access to over 400
health related journals on line and can provide excellent assistance in researching a particular topic.

NIH Office of Dietary Supplements
The Office of Dietary Supplements supports research and dessiminates research results in the area of dietary
supplements.  The ODS also provides advice to other federal agencies regarding research results in the area of dietary supplements.  A useful publication is their Annual Bibliography of Significant Advances in Dietary Supplement Research.  The
25 papers published in this publication were considered to be "flagship" original research papers by editors of the
leading research journals in the field.

The American College of Sports Medicine
The ACSM  is the largest, most respected sports medicine and exercise science organization in the world.

The American Dietetic Association
The ADA is the national professional organization representing registered dietitians.

Sports, Cardiovascular, And Wellness Nutritionists
SCAN is a practice group of the American Dietetic Association..It is the mission of SCAN to provide
leadership in promoting the role of nutrition in physical performance, cardiovascular health, wellness
and disordered eating.

Gatorade Sports Science Institute
The Gatorade Sports Science Institute (GSSI) was created in 1988 by The Gatorade
Company to foster and share education, service and research in sports nutrition and other
aspects of exercise science and active lifestyles. The products & services of the Institute are
non-commercial and are designed as educational tools to be used by students and
practitioners in the exercise sciences.

National Council Against Health Fraud
The NCAHF is a non-profit, tax-exempt voluntary health agency that focuses its attention upon health fraud, misinformation
and quackery as public health problems. It is private, nonpolitical and nonsectarian. The organization is comprised of health
professionals, educators, researchers, attorneys and concerned citizens. Its officers and board members serve without
compensation.

Sports Science News
An interdisciplinary site for research on human physical performance.  Site is maintained by the
Royal Society of New Zealand.
 

Weight-control Information Network (WIN)
The Weight-control Information Network (WIN) is a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). WIN was established in 1994 to provide      health professionals and consumers with science-based information on obesity, weight control, and nutrition.
 

National Heart Lung and Blood Institute's Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
The National Heart, Lung, and Blood Institute, in cooperation with the National Institute of Diabetes and digestive and Kidney
Diseases, released the first Federal guidelines on the identification, evaluation, and treatment of overweight and obesity. About
97 million adults in the United States are overweight or obese. Obesity and overweight substantially increase the risk of
morbidity from hypertension; dyslipidemia; type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis;
sleep apnea and respiratory problems; and endometrial, breast, prostate, and colon cancers. Higher body weights are also
associated with increases in all-cause mortality.
 

National Association to Advance Fat Acceptance
NAAFA is a non-profit human rights organization dedicated to improving the quality of life for fat people. NAAFA has been working since 1969 to eliminate discrimination based on body size and provide fat people with the tools for          self-empowerment through public education, advocacy, and member support.
 

Shape Up America!
Shape Up America! is a high profile national initiative to promote healthy weight and increased physical activity in                  America involving a broad-based coalition of industry, medical/health, nutrition, physical fitness, and related                       organizations and experts.  The purpose of Shape Up America! is to educate the public on the importance of the achievement and maintenance of a healthy body weight through the adoption of increased physical activity and healthy eating.

World Anti-Doping Agency
The mission of WADA is to promote and coordinate at the international level the fight against doping in sports in all forms.  WADA cooperates with a wide variety of organizations including the International Olympic Committee (IOC),  International Sports Federations, National Olympic Committees, and others. This link will bring you to a list of prohibited substances and methods.

NCAA: Permissible Nutritional Supplements
This article summarizes NCAA Bylaw 16.5.2.2 which describes what nutritional supplements may be provided to NCAA athletes by their institutions and which supplements cannot.

Lance Armstrong's Workout and Diet
Article written in Men's Journal (August 2005) describing Armstrong's longtime coach, Chris Carmichael's workout and diet plan)

Sports Nutrition Related Journals On-Line

Journal of Applied Physiology
Contains primary, peer-reviewed articles.  Full abstracts and text available on line currently.

Journal of Physiology
Contains primary, peer-reviewed articles.  Only abstracts available.

American Journal of Clinical Nutrition
Contains primary, peer-reviewed articles.  Only abstracts available.  Hard copy available at CWU Library.

The Physician and Sportsmedicine
Contains secondary, review articles.  Full articles from past issues currently available on line.

Sport Science
A quarterly Australian publication containing both primary and secondary sport science articles.  Full articles and
abstracts currently available on line.