1.3: Health and Fitness

Learning Objectives

1. Define what health is.
2. Explain body composition.
3. Define aerobic vs anaerobic.

Many people think of “health” as someone’s physical fitness, and see someone as more healthy if they can run a fast mile or do a bunch of pushups in a row but that would be incorrect. Fitness or physical wellness is a measure of your body to work in an efficient manner to perform a physical activity. These activities can be part of daily living like standing up from a chair or carrying groceries up a flight of stairs, or they could be more sport related like running 100m or doing a barbell snatch. This idea of fitness is just a piece of a larger whole of health. Health is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” by the World Health Organization.

Health or wellness is a multifaceted and all-encompassing term that can be thought of using nine categories, called the “Nine Dimensions of Wellness” which include: Cultural Wellness, Occupational Wellness, Emotional Wellness, Environmental Wellness, Financial Wellness, Intellectual Wellness, Social Wellness, Spiritual Wellness, and of course Physical Wellness.

Cultural Wellness: Cultural wellness refers to the way you interact with others who are different from you. This includes understanding and celebrating our differences. Culturally well people are aware of their own cultural background, as well as the diversity and richness present in other cultural backgrounds. Cultural wellness implies understanding, awareness and intrinsic respect for aspects of diversity. A culturally well person acknowledges and accepts the impact of these aspects of diversity on sexual orientation, religion, gender, racial and ethnic backgrounds, age groups, and disabilities.

Occupational Wellness refers to personal fulfillment and enrichment from one’s work and/or responsibilities. An occupationally well person enjoys the pursuit of a career which is fulfilling on a variety of levels. This person finds satisfaction and enrichment in work, while always in pursuit of opportunities to reach the next level of professional success.

Emotional Wellness: Coping effectively with life and expressing emotions in an appropriate manner are keys to emotional wellness. An emotionally well person successfully expresses and manages an entire range of feelings, including anger, doubt, hope, joy, desire, fear, and many others. People who are emotionally well maintain a high level of self-esteem. They have a positive body-image and the ability to regulate their feelings. They know where to seek support and help regarding their mental health, including but not limited to, seeking professional counseling services.

Environmental Wellness: Environmental wellness includes a desire to positively impact our planet Earth and our local community by striving to occupy pleasant, healthy, and safe environments that support well-being and positively impact the quality of our surroundings (including protecting and preserving nature). An environmentally well person appreciates the external cues and stimuli that an environment can provide. People who have achieved environmental wellness recognize the limits of controlling an environment and seek to understand the role an individual plays in the environment.

Financial Wellness: Financial wellness refers to achieving satisfaction with current and future financial situations by handling finances wisely. Those who are financially well are fully aware of their current financial state. They set long- and short-term goals regarding finances that will allow them to reach their personal financial targets.

Intellectual Wellness: Intellectual wellness includes being open-minded, recognizing creative abilities, and/or finding ways to expand knowledge and skills. Those who enjoy intellectual wellness engage in lifelong learning. They seek knowledge and activities that further develop their critical thinking and heighten global awareness. They engage in activities associated with the arts, philosophy, and reasoning. You are working your intellectual wellness currently by reading this book and learning new concepts.

Social Wellness: People who are focused on their social wellness are striving for positive relationships, developing a sense of connection, belonging, and a sustained support system. A socially well person builds healthy relationships based on interdependence, trust, and respect. Those who are socially well have a keen awareness of the feelings of others. They develop a network of friends and co-workers who share a common purpose, and who provide support and validation.

Spiritual Wellness: Spiritual wellness refers to having a sense of purpose and meaning in life, this may come from establishing peace, harmony, and balance in our lives. People who can be described as spiritually well have identified a core set of beliefs that guide their decision-making, and other faith-based endeavors. While firm in their spiritual beliefs, they understand others may have a distinctly different set of guiding principles. They recognize the relationship between spirituality and identity in all individuals.

Physical Wellness: Usually when someone thinks of health, they are actually imagining physical wellness. This is how healthy or fit your body is. This dimension of wellness could be measured by lack of diseases or body composition or a fitness test (FitnessGram) like many students throughout grade school.

All these traits combined and looked at can be used to determine someone’s health or wellness. Each dimension is equally important, and individuals should spend time and effort improving and maintaining each of the nine dimensions of their wellness.

Critical Thinking

If your friend was an Olympic athlete but they had clinical depression, would you consider them healthy? What suggestions would you offer to help them improve their health? What about someone that earned tons of money at their job but dreaded work each day?

Check this video out about this topic.

As this is a kinesiology textbook the focus of the rest of this chapter will be in physical wellness, used interchangeably with the term fitness. As mentioned in Chapter 1 kinesiology and modern medicine overlap extensively including the basic physical nature of a person's health.

Physical fitness is important for the individual’s health, but it is also critical for the livelihood of a tribe/group/culture. Being able to do physical work like hunting, farming, building houses has been essential for all but the very rich throughout history except for in current times. As discussed in Chapter 1, it is important for a culture to have physically fit individuals to go to war or defend from invaders. It is just as important for groups of humans to be able to hike mountains to find wild game, climb trees to gather fruit, or dig holes to create foundations for structures. A united group of people can work together to provide for the few that cannot provide for themselves like the sick, injured, children or elderly, but if too large a section of the population is unable to be physically productive the society will collapse, and many people will die. Even in prisons, inmates are peer pressured into staying physically fit by their fellow gang members so they can be counted on if a fight breaks out.

A relatively new trend in the fitness world is cheap and accurate wearable fitness trackers. Devices like Fitbit, Apple Watch, and WHOOP allow people to track their daily steps, activity, and estimated calories used. These devices have helped many people become more active by giving them small daily goals to hit or building habits by hitting these goals day after day. While these devices have come down in price and improved in accuracy it is important to understand that they are still not perfect, but give close estimations. The habit building and social aspect of these wearable fitness trackers is much more important in motivating people to become more active, even if they are not perfectly accurate.

Clearly, this reliance on using one’s body to be fit and productive has changed drastically in the last few decades with the development of computers and robotics. One farmer operating a GPS-guided tractor can likely produce more food than 100 farmers working from horses. Many people now work their entire career and earn a lucrative income sitting in front of a computer.

The individual and cultural importance placed on personal physical fitness has dramatically decreased in the last few decades, but people and society are seeing the detriment from this decline in activity.

Worldwide obesity rates have tripled since 1975 and almost 50% of adults in the US are overweight or obese.

Currently, obesity-related health care costs the US healthcare system 173 billion dollars a year. Only 2 in 5 young adults are physically ready for military basic training.

All these health-concerning stats are why it is so important for people to study and work in the health and fitness area. Jobs as a group fitness instructor or personal trainer can make a literal life or death difference to those they work with.

Body Composition

This is simply the ratio of fat mass vs fat-free mass of a human body. Fat mass is all of the adipose tissue in the body and fat-free mass is everything else including bone, muscle, water, and organs. Some body composition sampling methods may be powerful enough to separate fat vs muscle vs bone. The key to understanding is knowing how much excess body fat mass a person may have, increasing their risk for certain diseases and all-cause mortality.

Remember some fat is vitally important to health. For women dropping below, about 13% body fat can cause menstrual cycle problems and other hormonal imbalances. Men can safely drop to 3-5% but there are no health benefits of being that lean.

Ideal body fat % for optimal health range from 15-25% for women and 6-17% for men.

Skeletal Muscle Mass is exactly what it sounds like, the total mass or weight of the amount of muscle tissue someone has on their body. It is a common saying that “muscle weighs more than fat” which is slightly incorrect, but 1lb of fat is the same weight as 1lb of muscle. Muscle is more dense so that 1lb has less volume. This is important to know because often when someone starts working out, they may not lose much weight (they might actually gain weight depending on what exercises they are doing) because their body composition is changing. They are losing fat and gaining muscle, so the weight on the scale remains the same but their body composition is becoming healthier. Oftentimes people will start to feel that their clothes fit them differently or they look different in the mirror even with no weight loss. Weight is not a health issue; excess body fat is. This is important information for people that want to “tone up”, as they often incorrectly think they will lose weight because they are physically smaller.

Cardiovascular Health: The cardiovascular system is made up of the heart, lungs, arteries, veins, and capillaries in your body. This system delivers nutrients and oxygen to your muscles and removes metabolic waste during exercise (and all parts of the body all the time) so the more efficient this system is the more capacity a person will have to physically move.

The following are some key terms needed to understand and evaluate cardiovascular health.

Resting Heart Rate is the beats per minute (BPM) someone’s heart takes while at rest. Ideally, this should be measured immediately after waking up for the morning but before standing up. This is not always practical so individuals should rest for 3-5 minutes while seated before finding their resting heart rate from counting their pulse over 60 seconds. Any prior caffeine, nicotine, or exercise that day could skew the results. In general, the lower someone’s resting heart rate is the better their cardiovascular health. It is common for someone’s resting heart rate to decrease as they become more fit.

Blood Pressure: The heart works as a pump to circulate blood around the body. Each beat of the heart consists of two parts, contraction (systole) and relaxation (diastole). A blood pressure measurement consists of two numbers, a pressure reading (denoted as in millimeters of mercury, mmHg) one for each. Systole is reported on top of diastole. Normal or healthy blood pressure is under 120 systole and under 80 diastoles. A reading of 120/80 would be spoken aloud as “One hundred and twenty over eighty”. Resting blood pressure consistently higher these numbers can cause health problems including arterial damage and decreased blood flow leading to more severe cardiovascular disease issues like heart attack or stroke.

Another easy fitness test using very little equipment is to evaluate how fast an individual’s heart rate can return to baseline after completing a brief but challenging activity such as a sprint or climbing a set of stairs. The quicker their heart rate drops back to baseline the more fit they are.

Heart rate variability (HRV) is the amount of time between heart beats. Some wearable fitness trackers can measure this but not all of them. The amount of variation is miniscule and tracked in milliseconds. The more variability in time between heartbeats, the better, in other words this can be understood as the person is in good health and recovered and ready to train. A variability of 100+ milliseconds is considered healthy/recovered. The less variability or difference in time between heartbeats (so the time between beats is all very close to the same) the less recovered a person is likely to be. HRV will decrease with age as well.

Many of the measures and evaluations can be quickly and easily taken when working with clients and these tests can be used to set goals and track progress.

You are not qualified to diagnose any disease, illness, or injury. Do not overstep your bounds, which could lead to legal repercussions. You can educate people and inform them of what their measurements and evaluations are indicative of but you cannot take someone's blood pressure, find a high reading and diagnose them with hypertension.

A goal of being healthy certainly is to live a long high-quality life. Life expectancy data is gathered and published each year in the United States by the Centers of Disease Control (CDC) here and on average Americans can expect to live into their mid to late 70’s. These trend lines are often subdivided by gender, race, income level, or education. There is a commonly believed misconception that hundreds of years ago our ancestors’ life expectancy was much less, that living to 40 was uncommon. This is a statistical misinterpretation because childhood mortality was more frequent that it lowered the entire population's life expectancy, but if you could survive childhood living to your 50s or 60s or even 70s was not uncommon.

Critical Thinking

Imagine what you would like your senior years and retirement to look like? Do any of your travels or dream activities involve movement like hiking, playing with grandchildren, or rebuilding a classic muscle car? How can the actions of your today affect the health and wellness of your life far into the future?

What has changed in the last 100 years is what kills us. For most of history humans have mostly died of infectious diseases like influenza, pneumonia, tuberculosis, or even dehydration from diarrhea. The discovery of antibiotics and the development of modern medicine has greatly reduced the deaths from infectious diseases in developed countries of the world. Now the leading causes of death in America are called Chronic Diseases and they mostly come from lifestyle factors. Heart disease and cancer are the top two causes of death in America, and both have major risk factors from lack of physical activity and poor nutrition.

Exercise reduces the risk of developing almost every chronic disease, develops strong muscles, dense bones, improves posture and joint range of motion and has been shown to improve mental health. All of this extends life expectancy and increases quality of life.

Physical activity is defined as any bodily movement using skeletal muscles. Which would include moving your eyes as you read this line but usually physical activity is discussed as non-structured activity such as playing frisbee in the park with a friend or walking a dog . Non-Exercise Activity Time (NEAT) is low intensity activity like walking from the parking lot to your classroom or doing yard work.

Exercise is planned, structured, and possibly repetitive physical activity usually with a goal. Exercise includes strength training, spin class, hiking, yoga, and much more.

When building an exercise program or plan the two most important aspects are that the person following the program enjoys the activities and the design aligns with their personal goals. This is covered in much more detail in Chapter 10.

Anaerobic vs aerobic

Anaerobic refers to the energy pathway used by the body for short term powerful bursts of movement. This includes sprints, heavy lifting, or high intensity interval training. These events can last for a maximum of about 120 seconds before rest is needed or the intensity decreases. Anaerobic training can improve strength and muscular power. At the basic level this can be thought of as “strength training”.

Reading in depth more on anaerobic training it is often discussed as energy production “without oxygen”. This means that the chemical reaction in the body converting glucose to usable energy in our muscles is done without oxygen molecules. This anaerobic reaction is quick but less efficient than aerobic energy production. This does not mean that if you are breathing during a workout it makes it not anaerobic.

Aerobic movements are powered by a slower, more efficient energy pathway that requires oxygen. This includes walking, biking, swimming, or any movement at a set intensity you can maintain for at least 10 minutes but with training, humans can perform aerobic exercise for many hours, like completing a marathon or Ironman triathlon. Aerobic training can improve cardiovascular fitness and build endurance. At a basic level this can be thought of as “cardio”.

The CDC recommends “Move More and Sit Less” but adults should be getting at least 150 minutes of moderate-intensity aerobic activity per week, or 75 minutes of vigorous activity, or a mix of both. Combined with two or more strength training sessions per week. There are greater health benefits for exceeding these recommendations.

Making physical activity part of each day can help individuals move more and sit less. Starting to be active does not mean a person needs a fully detailed workout plan using lots of different exercise equipment, a person can start by adding in a 10-minute brisk walk around their neighborhood each day. Gradually increasing the level of activity over time will increase the health benefits. Increasing activity can be done by increasing duration, number of days they are done, or intensity of the activity (from walk to run). These increases should be taken slowly and done over a period of weeks to months to reduce the chance of injury. Much more detail on exercise and programming is covered in Chapter 10.

As a kinesiologist you may work with people that are not interested or motivated to be physically active often, especially at a vigorous rate, but here are some tips on how to motivate people with ways to make the workout a little more palatable.

• Make the activities social, get a group together to walk everyone’s dogs around the neighborhood. This also adds in some social accountability.
• Find workouts that only use bodyweight or minimal equipment. A single kettlebell or jump rope can be used for endless workouts.
• Find free YouTube videos of workouts that can be done at home.
• Join a gym or hire a personal trainer.

Physical Recovery:

Sleep is very important for mental and physical health. Muscle recovery and “gains” are made while sleeping. During strenuous exercise muscle tissue is damaged with microscopic tears, during sleep the body rebuilds those tears and that leads to size and strength development in humans. Every adult should be aiming to get 7.5 to 8.5 hours of sleep per night.

Proper nutrition will be discussed at length in the next chapter, but eating the proper calories and macro nutrients for a healthy body composition and recovery of the day's activity is very important for physical recovery from exercise. Chapter 4 will also cover supplements, which many people incorrectly think are very important.

If this field of study is of interest to you, you may consider a degree in Public Health and looking at career opportunities in local or national organizations like The World Health Organization or the Center for Disease Control.