NCSF Personal Training Study Guide Chapter 6 – Physical Activity and Risk for Disease 1

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    Chapter Goals:

    • Know the information regarding the relationship between the three aspects of physical activity, the risk for cardiovascular disease, and premature mortality.
    • Find the effects physical activity has on coronary artery disease, atherosclerosis, and hypertension.
    • Know the lifestyle factors to consider when looking at risk for heart disease.
    • Know the effects physical activity has on other conditions such as obesity, diabetes, and cancer.
    • Explain the impact physical activity has on our skeletal and mental health.

    Physical Activity and Risk for Disease

    The amount of inactive people in the population of the united states proves to be a significant burden on societal health.

    The CDC estimates around 200,000 people die from causes stemming from inactivity each year in the US, and globally around 5 million.

    Physical activity is very important, as it is associated with a decrease in all-cause mortality, coronary artery disease, hypertension, cancers, diabetes, and cardiovascular diseases.

    Physical Activity Relationship to Mortality Risk

    The greatest impact on death rates comes from changes from low fitness levels to moderate fitness levels. This shows that some level of physical activity is always going to be better.

    44% lower death rates have been found in people that change from these low fitness levels to that of a moderate fitness level.

    Physical Activity and Cardiovascular Disease

    Heart disease and stroke are both found to be the most common cardiovascular diseases and make up the first and fifth leading causes for death.

    Essentially, these represent one death every 40 seconds that pass.

    Any form of physical activity is going to have a dramatic reduction in this risk people have for developing cardiovascular disease.

    So, it is safe to say that a strong inverse relationship exists between both physical activity and mortality rate.

    Coronary Heart Disease

    There is a small risk for acute coronary events in people that have advanced coronary pathology and are participating in exercise, but the inverse relationship between CVD and physical activity is so strong that it negates this and makes exercise still strongly recommended for these patients.

    A lot of people assume that high blood pressure and cholesterol levels are something that comes up in adulthood, but truly this starts in childhood and progresses to later in life.

    1 in 250 kids show high cholesterol levels and buildup of plaque already.

    Obesity and other physical inactivity conditions are very prevalent in kids these days, and this plays more into the need for physical activity.

    When discussing cholesterol, it is important that we know some different terms for things in the body and items to look for on blood tests.

    LDLs, or low-density lipoproteins, are a complex of lipids and proteins that work as transporters of cholesterol from the liver to the cells of the body. These are considered to be the “bad cholesterol” that people mention, but they are needed, and it is a poor choice of words.

    HDLs, or high-density lipoproteins, are another complex of lipids and proteins that function for the transport of cholesterol, but for these, they are transporting cholesterol to the liver and removing it from the body cells. These are considered to be the good cholesterol that people look at.

    VLDL, or very-low-density lipoproteins, are like the LDLs we discussed, but they also assist in moving triglycerides and other lipids throughout the body.

    Atherogenic is used to describe dynamics that promote the formation of fatty plaques in the arteries.

    Some factors that have been shown to lower the risks for heart disease are:

    Lowering your cholesterol and blood pressure when evidence shows them to be elevated.

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    Eating a diet lower in salt, refined sugars, total fat, saturated fat, and cholesterol.

    Consume a diet rich in fiber via fresh fruits and vegetables and heart-healthy fats

    Exercise regularly (at least 150 minutes a week)

    Avoid excessive intake of alcohol and do not smoke

    Ensure safe use of medications and any over-the-counter drugs

    Educate oneself on appropriate stress management

    Lose weight and body fat if overweight

    Exercise and Atherosclerosis

    Exercise and physical activity are proven to reduce the risks for atherosclerosis through several key ways.

    The integrity of the vessel walls is one important factor. This is improved with the benefits from added activity.

    The number of circulating LDLs in long-term exercise conditions is a key response with chronic cardio being done.

    Another part to consider is the reactions we must exercise and the positive stress we cause. This releases hormones that allow for better health and reduces atherosclerosis risk.

    Myocardial Ischemia

    When the heart needs an amount of oxygen it cannot get, ischemia begins. This could cause a severe blockage which could lead to a heart attack.

    Cardiac fibrosis is a thickening of the heart valves or the walls of the heart, and this is when the body is getting closer to heart failure.

    Some common medications mentioned to help with cardiovascular disease are:

    • Diuretics
    • Beta-blockers
    • Angiotensin-converting enzyme inhibitors
    • Angiotensin antagonists
    • Calcium channel blockers
    • Nervous system inhibitors
    • Vasodilators


    A thrombus is also known as a blood clot, and this cuts off the oxygen supply to a section of the heart.

    This is generally going to appear slowly over time until it essentially feels like an acute thing attacking your heart.

    The warning signs of a pulmonary embolism are:

    • Unexplained sudden onset of shortness of breath
    • Chest pain or discomfort that worsens when you take a deep breath or when you cough
    • Feeling lightheaded or dizzy, or fainting
    • Rapid pulse
    • Coughing up blood

    Some common risk factors for deep vein thrombosis:

    • Inheriting a blood-clotting disorder
    • Prolonged bed rest and lack of movement
    • Injury or surgery
    • Pregnancy
    • Birth control pills or hormone replacement therapy
    • Malignant varicose veins
    • Being overweight or obese
    • Smoking
    • Heart failure
    • Inflammatory bowel disease
    • A personal or family history
    • Age over 60

    Stroke and Physical Activity

    Strokes stand as the fifth most seen cause of death and contribute to the amount of disability seen.

    Strokes are like heart attacks, but this lack of oxygen occurs within the brain, instead of the heart.

    The two primary causes of stroke are vascular blockages or artery ruptures.

    Ischemic stroke is a result of an obstruction within a blood vessel that supplies oxygenated blood to the brain. This is the most seen case of strokes.

    Hemorrhagic stroke is a result of a weakened blood vessel rupture (aneurysm) in or on the surface of the brain. This is the most common cause when we consider prolonged high blood pressure throughout life.

    An important consideration to think about is that smokers are at an increased risk for just about any form of stroke or health condition.

    Hypertension and Physical Activity

    There are five stages of blood pressure that we look for:

    A normal blood pressure is when the systolic number is less than 120, and the diastolic is less than 80.

    An elevated blood pressure is a systolic number between 120 – 19 and a diastolic less than 80.

    High blood pressure stage 1 is considered to be at 130 – 139 systolic, and 80 – 89 diastolic. It can be either of these, or both.

    High blood pressure stage 2 is considered to be a systolic of 140 or more, and/or a 90 or higher in diastolic. It can be either of these, or both.

    Hypertensive crisis is considered to be higher than 180 systolic and higher than 120 diastolic. It can be either of these, or both. This requires immediate consultation.

    Hypertension and raised blood pressure are a major factor in a lot of cardiovascular pathologies.

    Some health problems and complications seen to come with hypertension are:

    • Organ damage
    • Congestive heart failure
    • Hemorrhagic stroke
    • Aortic aneurysms and dissection
    • Renal failure
    • Retinopathy

    Around one-third of all people from both genders suffer from high blood pressure.

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    Obesity and Physical Activity

    Obesity is one of the greatest health and economic issues that we see affecting the American population today.

    Genetics and medications may play a role, but behaviors seem to be the biggest problem and they are completely controllable.

    The reductions in total activity that people get each day, along with the increase in poor diets have led to the rise in these problems.

    Obesity is essentially an excessive amount of body fat that leads to many problems in the body.

    Diabetes and Physical Activity

    Diabetes mellitus is a chronic disease that looks at abnormalities in the body’s ability to manage its glucose.

    There essentially is a resistance to insulin, or the inability to make it in the body.

    Type one diabetes is one that is less common, and it is genetic. This is controlled by taking insulin to allow the body to use glucose properly.

    The real problem is the prevalence of type 2 diabetes, which is not genetic and is almost completely caused by poor diet and physical inactivity.

    There are some factors like family history that can play a role in people being more inclined to becoming obese, but it is not as large a role as diet and exercise.

    Osteoarthritis and Physical Activity

    This is the most common form of arthritis, but it is a term that covers a variety of disorders leading to problems in joints of the body.

    Osteoarthritis is arthritis that involves the degeneration of joint cartilage and the underlying bone, commonly associated with the previous injury, but starting during middle age; the condition causes pain and stiffness, especially in the hip, knee, and thumb joints, when bones begin to run directly against each other.

    The repair and damage cycle causes the osteophytes to form. These are bone spurs and cysts that form because of remodeling.

    Rheumatoid arthritis is chronic, a progressive autoimmune disease that causes notable joint inflammation and results in painful deformities and/or significant immobility over time.

    Osteoporosis and Physical Activity

    This is a progressive bone disease that happens as there is a loss of bone mass and deterioration of bone tissue over time.

    This is usually caused by three factors: deficient bone mass, bone mass reduced after 30 years of age, and further decreased peak bone mass after 50.

    With this disease, the bones start to become brittle and frail, and the bones will more easily fracture. This is often seen more in the elderly population.

    Females are at a much higher risk for this disease as they age.

    With both physical activity and a diet to counteract bone loss, osteoporosis can be overcome.

    Cancer and Physical Activity

    Cancer is viewed as the most feared disease of all and is the second leading cause of death within the US.

    What we do know is that there is a significant link between physical activity levels and decreased risks for cancer, as well as a link between body fat levels and increased risk for cancer.

    Mental Health and Physical Activity

    Millions of people are affected by depression, anxiety, and subjective feelings of self-worth, which all together affect our sense of well-being that we have.

    These problems can all be countered, to some degree, by physical activity and the boost in good stress that accompanies.

    It has been shown that the type of activity engaged in and the frequency of the activity all play a role in the mental shifts that occur.

    Alzheimer’s Disease

    This is a neurodegenerative disorder, or type of dementia, often occurring during older age, that causes progressive irreversible mental deterioration, memory loss, diminished cognition, and eventual loss of independence due to generalized degeneration of the brain.

    NCSF Personal Training Study Guide Chapter 6 – Physical Activity and Risk for Disease 2
    NCSF Personal Training Study Guide Chapter 6 – Physical Activity and Risk for Disease 3
    NCSF Personal Training Study Guide Chapter 6 – Physical Activity and Risk for Disease 4

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