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Werner W. K. Hoeger Sharon a. Hoeger
amber L. Fawson Cherie i. Hoeger
fourteenth EDITION
Principles and Labs for

Fitness & Wellness
Copyright 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-203
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14 t h
edItIon
Principles
and Labs for
Fitness &
Wellness
Werner W. K. Hoeger
Sharon A. Hoeger
Amber L. Fawson
Cherie I. Hoeger
Australia ● Brazil ● Mexico ● Singapore ● United Kingdom ● United States
Principles and Labs for Fitness & Wellness, © 2018, 2016 Cengage Learning
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Werner W. K. Hoeger, Sharon A. Hoeger,
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Chapter Labs
Chapter 1 Lab 6B Caloric Expenditure and Exercise Heart Rate 252
Lab 6C Exercise Readiness Questionnaire 256
Physical Fitness and Wellness 1
Lab 6d Cardiorespiratory Exercise Prescription 258
Lab 1A Daily Physical Activity Log 35
Lab 1B Wellness Lifestyle Questionnaire 37
Lab 1C PAR-Q and Health History Questionnaire 40 Chapter 7
Lab 1d Resting Heart Rate and Blood Pressure 42 Muscular Fitness: Strength and Endurance 260
Lab 7A Muscular Strength and Endurance Assessment 289
Chapter 2 Lab 7B Strength-Training Program 291
Behavior Modification 44
Lab 2A Exercising Control over Your Physical Activity and Chapter 8
Nutrition Environment 72
Muscular Flexibility 310
Lab 2B Behavior Modication Plan 74
Lab 8A Muscular Flexibility Assessment 330
Lab 2C Setting SMART Goals 76
Lab 8B Posture Evaluation 332
Lab 8C Flexibility Development and Low Back
Chapter 3 Conditioning 334
Nutrition for Wellness 78
Lab 3A Nutrient Analysis 132 Chapter 9
Lab 3B MyPlate Record Form 135
Fitness Programming and Skill Fitness 341
Lab 9A Personal Refl ction on Exercise and Exercise
Chapter 4 Enjoyment 382
Body Composition 137 Lab 9B Assessment of Skill Fitness 386
Lab 4A Hydrostatic Weighing for Body Compostion Lab 9C Personal Fitness Plan 388
Assessment 160
Lab 4B Body Composition, Disease Risk Assessment, and
Recommended Body Weight Determination 162 Chapter 10
Stress Assessment and Management
Techniques 392
Chapter 5 Lab 10A Stress Events Scale 419
Weight Management 164
Lab 10B Type A Personality and Hostility
Lab 5A Computing Your Dally Caloric Requirement 208 Assessment 421
Lab 5B Weight-Loss Behavior Modifi ation Plan 209 Lab 10C Stress Vulnerability Questionnaire 423
Lab 5C Calorie-Restricted Diet Plans 210 Lab 10d Goals and Time Management Skills 425
Lab 5d Healthy Plan for Weight Maintenance or Gain 214 Lab 10e Stress Management 429
Lab 5e Weight Management: Measuring Progress 216
Chapter 11
Chapter 6 Preventing Cardiovascular Disease 431
Cardiorespiratory Endurance 218
Lab 11A Self-Assessment Coronary Heart Disease Risk
Lab 6A Cardiorespiratory Endurance Assessment 250 Factor Analysis 464
iv CHAPTER LABS
Chapter 12 Chapter 14
Cancer Prevention 466 Preventing Sexually Transmitted Infections 537
Lab 12A Cancer Prevention Guidelines 496 Lab 14A Self-Quiz on HIV and AIDS 557
Lab 12B Early Signs of Illness 497
Lab 12C Cancer Risk Profile 498 Chapter 15
Lifetime Fitness and Wellness 559
Chapter 13 Lab 15A Life Expectancy and Physiological Age Prediction
Addictive Behavior 500 Questionnaire 578
Lab 13A Addictive Behavior Questionnaires 531 Lab 15B Fitness and Wellness Community Resources 582
Lab 13B Smoking Cessation Questionnaires 533 Lab 15C Self-Evaluation and Future Behavioral Goals 584
Contents
Chapter 1 The Wellness Challenge for Our Day 30
Wellness Education: Using This Book 30
Physical Fitness and Wellness 1 A Personalized Approach 30
Life Expectancy 4 Exercise Safety 30
Leading Health Problems in the United States 6 Assessment of Resting Heart Rate and Blood Pressure 31
Diseases of the Cardiovascular System 6 Mean Blood Pressure 33
Cancer 7 Assess Your Behavior 33
Chronic Lower Respiratory Disease 7 Assess Your Knowledge 33
Accidents 7 Lab 1A Daily Physical Activity Log 35
Lifestyle as a Health Problem 9 Lab 1B Wellness Lifestyle Questionnaire 37
The Dose-Response Relationship between Physical Activity Lab 1C PAR-Q and Health History Questionnaire 40
and Health 9
Lab 1d Resting Heart Rate and Blood Pressure 42
Exercise Is Medicine 12
Additional Benefits of a Comprehensive Fitness
Program 12 Chapter 2
Health Benefits 12
Behavior Modification 44
Exercise and Brain Function 13
Living in a Toxic Health and Fitness Environment 46
Sitting Disease: A 21st-Century Chronic Disease 14
Environmental Influence on Physical Activity 47
Physical Activity and Exercise Defined 16
Environmental Influence on Diet and Nutrition 49
Types of Physical Fitness 18
Keys to Changing Behavior 52
Fitness Standards: Health versus Physical Fitness 18
Personal Values and Behavior 52
Health Fitness Standards 19
Your Brain and Your Habits 52
Physical Fitness Standards 20
Changing Habits through Mindfulness and Repetition 53
Which Program Is Best? 21
Changing Habits by Focusing on Long-Term Values 54
Federal Guidelines for Physical Activity 21
Planning and Willpower 54
Monitoring Daily Physical Activity 23
Implementation Intentions 55
Pedometers and Activity Trackers 23
Barriers to Change 55
Recommended Steps per Day 24
Self-Efficacy 56
Economic Benefits of Physical Activity 25
Sources of Self-Efficacy 57
Wellness 26
Motivation and Locus of Control 57
The Seven Dimensions of Wellness 26
Behavior Change Theories 58
The Transtheoretical Model of Change 60
Relapse 62
The Process of Change 63
Goal Setting and Evaluation 68
SMART Goals 68
Goal Evaluation 70
Assess Your Behavior 70
Assess Your Knowledge 70
Lab 2A Exercising Control over Your Physical Activity and
© Fitness & Wellness, Inc.
Nutrition Environment 72
Lab 2B Behavior Modication Plan 74
Lab 2C Setting SMART Goals 76
vi CONTENTS
Nutrient Supplementation 113

Antioxidants 114
Multivitamins 116
Vitamin D 116
Folate 118
Benefits of Foods 119
Functional Foods 120
Organic Foods 121
Genetically Modified Crops 122

Energy Substrates for Physical Activity 122
Energy (ATP) Production 122
Nutrition for Athletes 123
Carbohydrate Loading 123
Strenuous Exercise and Strength Training 124
Hyponatremia 124
Chapter 3 Creatine Supplementation 125
Nutrition for Wellness 78 Bone Health and Osteoporosis 125
Nutrients 84 Iron Deficiency 128
Carbohydrates 84 2015–2020 Dietary Guidelines for Americans 128
Simple Carbohydrates 84 Key Recommendations 129
Complex Carbohydrates 85 Physical Activity Recommendation 129
Fiber 86 Proper Nutrition: A Lifetime Prescription for Healthy
Types of Fiber 87 Living 130
Computing Daily Carbohydrate Requirement 87 Assess Your Behavior 131
Fats (Lipids) 88 Assess Your Knowledge 131
Simple Fats 88 Lab 3A Nutrient Analysis 132
Compound Fats 93 Lab 3B MyPlate Record Form 135
Derived Fats 93
Proteins 93
Vitamins 96 Chapter 4
Minerals 97 Body Composition 137
Water 97
What Is Body Composition? 138
A Healthy Diet 98
Essential and Storage Fat 140
Nutrition Standards 99
Why Does Body Composition Matter? 140
Dietary Reference Intakes 99
Body Composition and Weight Loss 141
Nutrient Analysis 101 Avoiding Creeping Changes in Body Composition 141
Achieving a Balanced Diet 105 Body Shape and Health Risk 141
Choosing Healthy Foods 107 Techniques to Assess Body Composition 142
Vegetarianism 107 Dual Energy X-ray Absorptiometry 143
Nutrient Concerns 108 Hydrostatic Weighing 143
Nuts 110 Air Displacement 145
Soy Products 110 Skinfold Thickness 145
Probiotics 110 Girth Measurements 146
Advanced Glycation End Products 111 Bioelectrical Impedance 146
Diets From Other Cultures 111 Metrics Used to Assess Body Size and Shape 149
Mediterranean Diet 111 Body Mass Index 149
Ethnic Diets 112 Waist Circumference 153
CONTENTS vii
Waist-to-Height Ratio: “Keep your waist circumference to less
than half your height.” 154
Obtaining an Accurate Waist Measurement 155
Determining Recommended Body Weight 156
Begin with Your Current Body Composition 156
Calculate Your Recommended Body Weight 157
Importance of Regularly Assessing Body
Composition 158
Lab 4A Hydrostatic Weighing for Body Compostion
Assessment 160
Lab 4B Body Composition, Disease Risk Assessment, and
Recommended Body Weight Determination 162
Chapter 5
Weight Management 164
Weight Management in the Modern Environment 166
The Wellness Way to Lifetime Weight Management 167
Overweight versus Obese 168
Body Weight Affects Wellness 168
Tolerable Weight 169
Body Image and Acceptance 169
The Weight Loss Dilemma 170 Reducing Your Eating Occasions 190
Health Consequences of Dieting 170 Foods that Aid in Weight Loss 191
Diet Crazes 171 Monitoring Your Diet with Daily Food Logs 192
Low-Carb Diets 171 Nondietary Factors that Affect Weight Management 193
Exercise-Related Weight Loss Myths 174 Sleep and Weight Management 193
Adopting Permanent Change 175 Light Exposure and BMI 193
Mental and Emotional Aspects of Weight Management 175 Monitoring Body Weight 193
Willpower versus Planning 175 Physical Activity and Weight Management 194
Mindful Eating versus Distracted Eating 176 Physical Activity and Energy Balance 194
Avoiding Perfectionism 177 Physical Activity Predicts Success at Weight Management 195
Feelings of Satisfaction versus Deprivation 177 Amount of Physical Activity Needed for Weight Loss 195
Eating and the Social Environment 177 Exercise and Body Composition Changes 196
Overcoming Emotional Eating 177 Overweight and Fit Debate 197
Physiology of Weight Loss 181 Types of Exercise Recommended 198
Energy-Balancing Equation 181 Strength-Training Increases Lean Body Mass 198
Setpoint Theory 182 The Roles of Exercise Intensity and Duration in Weight
Maintaining Metabolism and Lean Body Mass 184 Management 199
Rate of Weight Loss in Men versus Women 185 Healthy Weight Gain 202
Protein, Fats, Fiber, and Feeling Satisfied 186 Behavior Modification and Adherence to a Weight
Losing Weight the Sound and Sensible Way 186 Management Program 203
Estimating Your Daily Energy Requirement 186 The Simple Truth 203
Adjusting Your Fat Intake 187 Assess Your Behavior 206
Reducing Evening Eating 188 Assess Your Knowledge 206
The Importance of Breakfast 189 Lab 5A Computing Your Dally Caloric Requirement 208
Drink Water and Avoid Liquid Calories 190 Lab 5B Weight-Loss Behavior Modifi ation Plan 209
viii CONTENTS
Getting Started and Adhering to a Lifetime Exercise

Program 244
A Lifetime Commitment to Fitness 248
Lab 6A Cardiorespiratory Endurance Assessment 250
Lab 6B Caloric Expenditure and Exercise Heart Rate 252
Lab 6C Exercise Readiness Questionnaire 256
Lab 6d Cardiorespiratory Exercise Prescription 258
Chapter 7
Muscular Fitness: Strength and Endurance 260
Benefits of Strength-Training 263
Improves Functional Capacity 263
Improves Overall Health 263
Increases Muscle Mass and Resting Metabolism 263
Improves Body Composition 264
Chris Black
Helps Control Blood Sugar 264

Enhances Quality of Life as You Age 264
Gender Differences 265
Lab 5C Calorie-Restricted Diet Plans 210 Assessing Muscular Strength and Endurance 266
Lab 5d Healthy Plan for Weight Maintenance or Gain 214 Muscular Strength: Hand Grip Strength Test 267
Lab 5e Weight Management: Measuring Progress 216 Muscular Endurance Test 267
Muscular Strength and Endurance Test 267
Chapter 6 Basic Muscle Physiology 270
Types of Muscle Hypertrophy 271
Cardiorespiratory Endurance 218
Factors that Affect Muscular Fitness 272
Basic Cardiorespiratory Physiology: A Quick Survey 221
Neural Function 272
Aerobic and Anaerobic Exercise 222
Types of Muscle Fiber 272
Benefits of Aerobic Exercise 223
Overload 273
Assessing Physical Fitness 225
Specificity of Training 273
Responders versus Nonresponders 226
Training Volume 273
Assessing Cardiorespiratory Endurance 226
Periodization 273
Components of VO2 226
Guidelines for Strength-training 274
Tests to Estimate VO2max 227
Type (Mode) of Training 274
Interpreting the Results of Your VO2max 233 Intensity (Resistance) 277
Predicting VO2 and Caloric Expenditure from Walking and
Time (Sets) 278
Jogging 234
Frequency 279
Ready to Start an Exercise Program? 235
Results in Strength Gain 280
Guidelines for Developing Cardiorespiratory
Endurance 235 Dietary Guidelines for Muscular and Strength
Development 280
Intensity 236
Type (Mode) 239 Strength-Training Exercises 281
Time (Duration) 239 Exercise Variations 281
Frequency 241 Plyometric Exercise 281
“Physical Stillness:” A Deadly Proposition 241 Core Strength-training 283
Volume 242 Stability Exercise Balls 283
Progression Rate 242 Elastic-Band Resistive Exercise 284
Rating the Fitness Benefits of Aerobic Activities 243 Exercise Safety Guidelines 285
CONTENTS ix
When to Call a Physician 326
Treatment Options 327
Personal Flexibility and Low Back Conditioning Program 328
Lab 8A Muscular Flexibility Assessment 330
iStockphoto.com/Christopher Futcher
Lab 8B Posture Evaluation 332
Lab 8C Flexibility Development and Low Back
Conditioning 334
Flexibility Exercises 336
Exercises For the Prevention and Rehabilitation
of Low Back Pain 338
Setting Up Your Own Strength-Training Program 285

Assess Your Behavior 288 Chapter 9
Assess Your Knowledge 288 Fitness Programming and Skill Fitness 341
Lab 7A Muscular Strength and Endurance Assessment 289
Choosing an Exercise Program with Your Values in
Lab 7B Strength-Training Program 291 Mind 343
Strength-Training Exercises without Weights 293 Being Flexible with Your Exercise Routine 344
Strength-Training Exercises with Weights 297 Exercise Prescription for Health and Fitness 345
Stability Ball Exercies 307 Basic Exercise Training Principles 345
Interval Training 347
Chapter 8 High-Intensity Interval Training 347

Ultra-Short Workouts 348
Muscular Flexibility 310 Cross-Training 350
Benefits of Good Flexibility 312 Overtraining 350
Factors that Affect Flexibility 312 Periodization 351
Joint Structure 313 Skill-Related Fitness 352
Adipose Tissue 313 The Six Components of Skill-Related Fitness 352
Muscular Elasticity and Genetics 313 Team Sports 356
Body Temperature 313 Performance Tests for Skill-Related Fitness 356
Age 313 Exercise Programming for Sport or Event Participation 360
Gender 313 Sport-Specific Training 360
Level of Physical Activity 313 Preparing for Sports Participation 360
Assessing Flexibility 313 General Exercise Considerations 363
Interpreting Flexibility Test Results 316 Time of Day for Exercise 363
Guidelines for Developing Muscular Flexibility 318 Exercise in Heat and Humidity 363
Types of Stretching Exercises 318 Exercise in Cold Weather 364
Physiological Response to Stretching 319 Exercising with the Cold or Flu 366
Intensity 320 Nutrition and Hydration during Exercise 366
Time/Repetitions 320 Fluid Replacement during Exercise 366
Frequency 320 Meal Timing during Exercise 367
When to Stretch? 320 Exercise-Related Injuries 368
Flexibility Exercises 321 Muscle Soreness and Stiffness 368
Contraindicated Exercises 321 Exercise Intolerance 368
Preventing and Rehabilitating Low Back Pain 323 Side Stitch 368
Causes of Low Back Pain 323 Shin Splints 369
Evaluating Body Posture 323 Muscle Cramps 369
Effects of Stress 326 Acute Sports Injuries 369
x CONTENTS
Tailoring Exercise to Health Circumstances 370

Asthma and Exercise 370
Arthritis and Exercise 371
Diabetes and Exercise 371
Smoking and Exercise 372
Women’s Health and Exercise 373
Menstruation and Exercise 373
The Female Athlete Triad 373
Exercise and Dysmenorrhea 373
Exercise during Pregnancy 373
Exercise and Aging 375
Benefits of Lifelong Exercise 375
Exercise Training for Seniors 375
Body Composition in Seniors 378
Exercise and Mental Health in Seniors 378
Exercise Recommendations for Seniors 378
You Can Get It Done 378

Lab 9A Personal Refl ction on Exercise and Exercise
Enjoyment 382
Lab 9B Assessment of Skill Fitness 386
Lab 9C Personal Fitness Plan 388
Time Management 404

Chapter 10 Five Steps to Time Management 404
Stress Assessment and Management Techniques 392 Time-Management Skills 405
The Mind—Body Connection 394 Managing Technostress 406

The Brain 394 How the Body Responds to Stress 407
The Immune System 394 Coping with Stress 407
Stress 395 Physical Activity 408
Eustress and Distress 395 Relaxation Techniques 411
Chronic Distress Leads to Illness 396 Meditation 416
How the Body Adapts to Stress 396 Which Technique Is Best? 418
Alarm Reaction 396 Assess Your Behavior 418
Resistance 396 Assess Your Knowledge 418
Exhaustion and Recovery 396 Lab 10A Stress Events Scale 419
Sources of Stress 397 Lab 10B Type A Personality and Hostility Assessment 421
How Perception and Attitude Affect Health 398 Lab 10C Stress Vulnerability Questionnaire 423
Self-Esteem 398 Lab 10d Goals and Time Management Skills 425
Fighting Spirit 398
Lab 10e Stress Management 429
How Behavior Patterns Affect Health 399
Vulnerability to Stress 401
Sleep Management 402 Chapter 11
How Much Sleep Do I Need? 402
Preventing Cardiovascular Disease 431
What Happens If I Don’t Get Enough Sleep? 402
College Students Are Among the Most Sleep-Deprived 403 Cardiovascular Disease 434
Does It Help to “Catch up” on Sleep on Weekends? 403 Most Prevalent Forms of Cardiovascular Disease 434
CONTENTS xi
Stroke 434
Coronary Heart Disease 435
Coronary Heart Disease Risk Profile 435
Leading Risk Factors for Coronary Heart Disease 436
Physical Inactivity 437
Abnormal Electrocardiograms 439
Abnormal Cholesterol Profile 441
Elevated Triglycerides 447
Elevated Homocysteine 448
Inflammation 449
Diabetes 450
Hypertension (High Blood Pressure) 453
Excessive Body Fat 459
Tobacco Use 459
Tension and Stress 460
Personal and Family History 461
Age 461
Cardiovascular Risk Reduction 462
Lab 11A Self-Assessment Coronary
Heart Disease Risk Factor Analysis 464
Chapter 12
Cancer Prevention 466 Excessive Body Weight 482
How Cancer Starts 468 Abstaining from Tobacco 482
DNA Mutations 468 Avoiding Excessive Exposure to Sun 483
Tumor Formation 469 Monitoring Estrogen, Radiation Exposure, and Potential
Metastasis 470 Occupational Hazards 484
Genetic versus Environmental Risk 471 Physical Activity 485
Incidence of Cancer 472 Other Factors 485
Guidelines for Preventing Cancer 473 Early Detection 485
Ten Recommendations for a Cancer Warning Signals of Cancer 486
Prevention Lifestyle 473 Cancer: Assessing Your Risks 486
How Can I Know Which Substances Cause Cancer? 476 Risk Factors for Common Sites of Cancer 486
Dietary Changes 476 What Can You Do? 494
Vegetables 476 Assess Your Behavior 494
Vitamin D 477
Antioxidants 478
Lab 12A Cancer Prevention Guidelines 496
Phytonutrients 478
Fiber 478 Lab 12B Early Signs of Illness 497
Tea 479 Lab 12C Cancer Risk Profile 498
Spices 479
Sugar 479
Dietary Fat 479 Chapter 13
Processed Meat and Protein 479
Addictive Behavior 500
Soy 481
Alcohol Consumption 481 Addiction 502
Nutrient Supplements 481 How Addiction Develops 502
xii CONTENTS
Health Care Costs of Smoking 521

Morbidity and Mortality 521
Trends 521
Why People Smoke 522
Smoking Addiction and Dependency 522
Why Do You Smoke? Test 522
Smoking Cessation 523
Do You Want to Quit? Test 523
Breaking the Habit 524
Quitting Cold Turkey 525
Cutting Down Gradually 525
Nicotine-Substitution Products 526
Life after Cigarettes 527
Lab 13A Addictive Behavior Questionnaires 531
Lab 13B Smoking Cessation Questionnaires 533
Chapter 14
Preventing Sexually Transmitted Infections 537

Types and Causes of Sexually Transmitted
Infections 540
Four Most Common Bacterial STIs 540
Chlamydia 541
Drugs and Dependence 503
Gonorrhea 541
Caffeine 504
Syphilis 542
Nonmedical Use of Prescription Drugs 505
Trichomoniasis 542
Inhalant Abuse 506
Four Most Common Viral STIs 543
Marijuana 506
Human Papillomavirus (HPV) and Genital Warts 543
Cocaine 507
Genital Herpes 544
Methamphetamine 508
Hepatitis 545
MDMA (Ecstasy) 510
HIV and AIDS 546
Heroin 510
Preventing Sexually Transmitted Infections 552
New Psychoactive Substances 512
Wise Dating 552
Synthetic Cannabinoids (Fake Pot or Spice) 512
Monogamous Sexual Relationship 552
Alcohol 513
Effects on the Body 514
Addictive and Social Consequences
of Alcohol Abuse 514 Lab 14A Self-Quiz on HIV and AIDS 557
Alcohol on Campus 515
How to Cut Down on Drinking 516
Treatment of Addictions 517
Chapter 15
Tobacco 517 Lifetime Fitness and Wellness 559
Types of Tobacco Products 518 Life Expectancy and Physiological Age 562
Effects on the Cardiovascular System 519 Conventional Western Medicine 563
Smoking and Cancer 519 Finding a Physician 563
Effects of Secondhand Smoke 520 Searching for a Hospital 563
CONTENTS xiii
Integrative Medicine 568
Quackery and Fraud 568
Looking at Your Fitness Future 572
Health and Fitness Club Memberships 572
Personal Trainers 573
Purchasing Exercise Equipment 574
Self-Evaluation and Behavioral Goals for the Future 574
Self-Evaluation 574
Behavioral Goals for the Future 574
The Fitness and Wellness Experience and a Challenge for the
Future 575
Lab 15A Life Expectancy and Physiological Age Prediction
Questionnaire 578

Lab 15B Fitness and Wellness Community Resources 582
Lab 15C Self-Evaluation and Future Behavioral Goals 584
Appendix A: Nutritive Value
of Selected Foods 588
Complementary and Alternative Medicine 564

Notes and Suggested Readings 600
Types of CAM Practices 565 Answers to Assess Your Knowledge 612
Costs for CAM 566
Glossary 613
CAM Shortcomings 566
Finding a CAM Practitioner 567 Index 622
Preface
The current American way of life does not provide people book’s contents point out the need to go beyond the basic
with sufficient physical activity to maintain good health and components of fitness to achieve total well-being.
improve quality of life. Actually, our way of life is such a
In addition to a thorough discussion of physical fitness—
serious threat to our health that it increases the deteriora-
including all health- and skill-related components—exten-
tion rate of the human body and leads to premature illness
sive and up-to-date information is provided on behavior
and mortality.
modification, nutrition, weight management, stress manage-
Data released by the Centers for Disease Control and Pre- ment, cardiovascular and cancer-risk reduction, exercise
vention (CDC) indicate that only about 20 percent of U.S. and aging, prevention of sexually transmitted infections
adults 18 and over meet the Federal Physical Activity Guide- (STIs), and substance abuse control (including tobacco,
lines for both aerobic and muscular fitness activities, alcohol, and other psychoactive drugs). The information has
whereas slightly less than 50 percent meet the guidelines for been written to provide you with the necessary tools and
aerobic fitness and just 23 percent do so for muscular fit- guidelines for an active lifestyle and a wellness way of life.
ness. Another third of Americans are completely inactive
Scientific evidence has clearly shown that improving the
during their leisure time. Yet, most people in the United
quality—and most likely the longevity—of your life is a mat-
States say they believe that physical activity and positive life-
ter of personal choice. As you work through the various
style habits promote better health. However, many do not
chapters and laboratories in the book, you will be able to
reap benefits because they simply do not know how to
develop and regularly update your healthy lifestyle program
implement a sound fitness and wellness program that will
to improve physical fitness and personal wellness. The em-
yield the desired results.
phasis throughout the book is on teaching you how to take
The U.S. Surgeon General has determined that lack of physi- control of your health and lifestyle habits so that you can
cal activity is detrimental to good health. As a result, the make a constant and deliberate effort to stay healthy and
importance of sound fitness and wellness programs has as- achieve the highest potential for well-being.
sumed an entirely new dimension. The Office of the Sur-
geon General has identified physical fitness as a top health
priority by stating that the nation’s top health goals in this
century are exercise, increased consumption of fruits and New in the 14th Edition
vegetables, smoking cessation, and the practice of safe sex.
For this 14th edition of Principles and Labs for Fitness &
All four of these fundamental healthy lifestyle factors are
Wellness, the authors have reinvigorated the design to pro-
thoroughly addressed in this book.
vide a modern and visually stimulating layout throughout
Furthermore, the science of behavioral therapy has estab- the text and have developed and sourced many new figures,
lished that many behaviors we adopt are a product of our graphs, informational boxes, and photos in each chapter.
environment. Unfortunately, we live in a “toxic” health and Throughout the text, the authors have made substantial
fitness environment. Becoming aware of how the environ- changes with the focus of finding new ways to help students
ment affects our health is vital if we wish to achieve and understand and achieve a wellness way of life. New Hoeger
maintain wellness. Yet, we are so habituated to this modern- Key to Wellness boxes have been added as a continuous
day environment that we miss the subtle ways in which it chapter feature to highlight key concepts for students. Many
influences our behaviors, personal lifestyle, and health chapters have been rethought and reorganized with new
each day. headings and enhanced introductory text. Chapter 1, for
example, includes a new focus on the ways daily physical
Along with the most up-to-date health, fitness, and nutri-
activity and exercise work together to increase lifetime well-
tion guidelines, the information in this book provides exten-
ness. Chapter 4 has been reorganized to help students better
sive behavior modification strategies to help you abandon
understand how body weight and shape affect lifetime
negative habits and adopt and maintain healthy behaviors.
health outcomes. Chapter 5 has been reorganized with new
As you study and assess physical fitness and wellness param-
material to help students understand how thoughts and feel-
eters, you need to take a critical look at your behaviors and
ings affect weight maintenance. Chapter 9 has been restruc-
lifestyle—and most likely make selected permanent changes
tured to be the capstone chapter of exercise programming—
to promote your overall health and wellness.
to sum up all students have learned about cardiorespiratory,
Principles and Labs for Fitness & Wellness contains 15 chap- strength, and flexibility training—and to give them complete
ters and 43 laboratories (labs) that serve as guides to imple- confidence to write their own exercise programs throughout
ment a complete lifetime fitness and wellness program. The their lifetime. A new quick reference flow chart, the “Hoeger
PREFACE xv
Values-Based Quick-Reference Guide to Exercise Prescrip- Chapter 3, Nutrition for Wellness
tion,” has also been added to Chapter 9 to help students ● Editorial changes throughout the chapter to update nutri-
apply correct exercise prescription principles and see fitness tion concepts based on the most current research and re-
progress through their exercise efforts. ports in the field
All chapters have been revised and updated according to re- ● A more thorough description of the differences between
cent advances and recommendations in the field, including refined and whole grains
information reported in the literature and at professional
An enhanced description of types of fat based on the de-
health, fitness, and sports medicine conferences.
●
gree of hydrogen saturation

In addition to the new Hoeger Key to Wellness boxes, we ● New evidence on the detrimental effects of excessive
continue to provide the MyProfile feature at the beginning sugar in the diet and the effects of liquid calories on
of each chapter for students to evaluate their current knowl- health and weight control
edge of the chapter’s topic. Included also are the Confident
Consumer and Diversity Considerations boxes to help stu- ● A broadened discussion on the concept of chronic and
dents make healthier choices and be discerning fitness and acute inflammation and the role of nutrition in its
wellness consumers. These features, along with the Real Life prevention
Story and FAQ sections, are intended to perk the students’ ● New content about the current recommendations for sat-
interest in the chapter contents. urated fat replacement in the diet for cardiovascular dis-
ease prevention
Chapter Updates ● Additional information on the key role of adequate pro-
tein intake throughout the day for health and weight
Chapter 1, Physical Fitness and Wellness management
Reorganization of chapter material to better highlight
New updates on nutrient supplements, including Vitamin
●
●
the importance of daily physical activity and nonexer-

D supplementation
cise activity thermogenesis (NEAT), with new figures
and features ● Inclusion of the 2015–2020 Dietary Guidelines for Americans
A new feature box outlining the latest research on dis-
Chapter 4, Body Composition
●
tracted driving accidents and the cognitive processes

behind a variety of driving scenarios ● Reorganization of chapter material to better emphasize
the risks of android obesity and the benefits of regular
● New data regarding exercise and brain function, includ- body composition assessments
ing the role of exercise to combat cognitive decline and
Alzheimer’s disease ● New global recommendations for health metrics, includ-
ing a discussion of the way waist circumference, waist-to-
● Exploration of the causes behind the United States’ height-ratio (WHtR), and BMI are being used in con-
lagging life expectancy junction to prevent disease
● New information on the leading causes of death for ● A new feature titled “Can I Influence My Bodyshape?”
specific age groups
● A new feature explaining types of scientific studies Chapter 5, Weight Management
● A new section highlighting activity tracker options ● Updated data on the obesity epidemic in the United
States
Chapter 2, Behavior Modification ● Recommendations for preventing the dreaded “Freshman
● New figures and updated data on the health risks of mod- 15” weight gain syndrome
ern work and leisure habits, community design, and food ● A discussion on the rate of weight loss in men versus
quality and abundance women
● New feature explaining the mechanisms behind cravings ● The latest information about light exposure and BMI
● Updated and expanded information about the brain ● A discussion on the role of strength-training on visceral
and habit formation and the role of the prefrontal fat loss
cortex of the brain in carrying out value-centered
behavior ● An introduction to weight gain and fat cell size and
number increase in the lower body and abdominal areas
● Addition of the latest research about willpower, planning,
and the use of “implementation intentions” for changing ● An enhanced section on the importance of proper caloric
behavior distribution throughout the day for adequate weight
management
● A new feature offering tools for using positive self-talk
for goal achievement ● Additional suggestions for weight loss strategies
xvi PREFACE
Chapter 6, Cardiorespiratory Endurance ● New suggestions for attending a group exercise class for
● Updates on the physiological benefits of aerobic exercise, the first time or trying a new sport for the first time
an adequate cool-down phase following aerobic exercise, ● Additional information on high-intensity interval train-
and the health consequences of physical stillness (sitting ing (HIIT) and its wide range of applications for peak
disease) performers, new exercisers, and patients of chronic illness
● The latest recommendations for a suitable rate of training alike
progression for individuals suffering from chronic diseases ● Discussions of new fitness trends, including functional
● Updates on tips to increase daily physical activity and for fitness, Cross-Fit, Suspension Training, HIIT, high-
people who have been physically inactive intensity circuit training (HICT), outdoor training, and
senior fitness solutions, including tai chi
Chapter 7, Muscular Fitness ● New information about the “runner’s high”
● An update on the myriad of health benefits obtained ● New updated information about choosing footwear and
through proper strength-training activewear
● Enhancements to the content on training order (aerobic-
versus strength-training) Chapter 10, Stress Assessment and Management
● Additional information on aging and sarcopenia and ade- Techniques
quate protein intake for young and older adults ● New section on the damaging role of “technostress” in
today’s technology-dependent age, including tips on
Expanded information about timing, dose, and type of
managing tech-related stress at home, at school, and in
●
protein intake
the workplace
An updated discussion on strength-training and visceral
New information on the importance of proper breathing
●
fat
●
as a natural approach to reduce stress

An answer to the concern of heavy-resistance strength-
Expanded information on the benefits of mindfulness
●
training and arterial stiffness

●
meditation for stress management and the role adequate

sleep plays in managing stress
Chapter 8, Muscular Flexibility
● New introductory information on how joint structure, Chapter 11, Preventing Cardiovascular Disease
genetics, age, gender, and other factors affect individual
Up-to-date data on the prevalence of cardiovascular
flexibility
●
disease
New tips to prevent the instance of “text neck” symptoms
New information provided on the role of dietary choles-
●
that stem from the overuse of smartphones and other

●
terol, saturated fat, and refined carbohydrates on heart

mobile devices
disease risk; trans fat; and cardiovascular disease
Expanded section on preventing and rehabilitating low
New content on the use of medications versus exercise for
●
back pain to include the importance of core-strengthening

●
cardiovascular disease management

exercises
● An introduction to the PLAC blood test for heart disease
Chapter 9, Fitness Programming and Skill Fitness and genetic testing for heart disease
● Reorganization of chapter to give students added confi- ● Further updates on exercise, nutrition and type 2 diabe-
dence in their ability to understand and apply exercise tes; stress and CHD; and high blood pressure
prescription in their own lives ● Updates to the section on other less known possible risk
● Added review of basic exercise prescription principles factors for coronary heart disease
and new quick-reference flow chart titled “Hoeger
Values-Based Quick-Reference Guide to Exercise Chapter 12, Cancer Prevention
Prescription,” making Chapter 9 the capstone chapter of ● New information detailing the way cancer develops at the
exercise prescription, topping off material from the car- cellular level to help students better understand the cause
diorepiratory, muscular, and flexibility chapters and effect of cancer risk and prevention
● New information about exercise and behavior ● A review of innovative breakthroughs regarding telo-
modification meres and their role in cancer and aging
● New suggestions to guide students in choosing fitness ● A new section about genetic versus environmental influ-
solutions that fit personal values ences on cancer risk
● A new lab titled “Personal Reflection on Exercise and ● An introduction to the field of epigenetics, with a biologi-
Enjoyment” cal explanation of the epigenome and a discussion on the
PREFACE xvii
way lifestyle choices turn certain genes on or off, chang- ● New data graph illustrating the prevalence of various
ing their expression types of complementary and alternative medicine (CAM)
● New, practical, day-to-day suggestions for avoiding in the United States
cancer risk
● New feature on cancer research agencies that provide lists
of carcinogenic items
Ancillaries
● Updated information and explanation about processed ● Health MindTap for Principles and Labs for Fitness &
and red meat as risk factors for cancer Wellness. Instant Access Code, ISBN-13: 978-1-
305-25107-6. MindTap is well beyond an eBook, a
● Updated explanation on guidelines for mammography
homework solution or digital supplement, a resource
and breast cancer screenings, arming students with infor-
center website, a course delivery platform, or a Learning
mation on this controversial topic
Management System. More than 70 percent of students
● Updated data on the incidence and mortality rates of can- surveyed said that it was unlike anything they have ever
cer, along with the most common site-specific cancer risk seen before. MindTap is a new personal learning experi-
factors ence that combines all of your digital assets—readings,
multimedia, activities, and assessments—into a singular
Chapter 13, Addictive Behavior learning path to improve student outcomes.
● Updated data on the most recent trends in substance ● Diet & Wellness Plus. Diet & Wellness Plus helps you
abuse reported in the National Survey on Drug Use and gain a better understanding of how nutrition relates to
Health by the U.S. Department of Health and Human your personal health goals. It enables you to track your diet
Services and activity, generate reports, and analyze the nutritional
● New figures reflecting data specific to addictive behaviors value of the food you eat! It includes more than 55,000
most prevalent in college students, including marijuana, foods in the database, custom food and recipe features, and
heroin, and alcohol use the latest Dietary References, as well as your goal and
● Expanded section on the addictive and physiological actual percentages of essential nutrients, vitamins, and
effects of high caffeine intake minerals. It also helps you to identify a problem behavior
and make a positive change. After completing a Wellness
● Enhanced section on synthetic cannabinoids (known as Profile questionnaire, Diet & Wellness Plus will rate the
synthetic marijuana or Spice), the most prevalent new level of concern for eight different areas of wellness, help-
psychoactive substances in the United States ing you determine the areas where you are most at risk. It
● Discussions of recent trends in illicit drug use, energy then helps you put together a plan for positive change by
drink consumption, and e-cigarette use have been up- helping you select a goal to work toward, complete with a
dated and expanded reward for all your hard work. Diet & Wellness Plus is also
available as an App that can accessed from the App dock in
Chapter 14, Preventing Sexually Transmitted MindTap and can be used throughout the course for stu-
Infections dents to track their diet, activity, and behavior change.
● Expanded introductory information detailing the types ● Global Health Watch. Instant Access Code, ISBN:
and causes of the eight most common STIs and whether 978-1-111-37733-5. Printed Access Card, ISBN:
they are curable or treatable 978-1-111-37731-1. Updated with today’s current
headlines, Global Health Watch is your one-stop resource
New information on the success of pre-exposure prophy-
for classroom discussion and research projects. This
●
laxis (PrEP) in reducing the risk of HIV among those at

resource center provides access to thousands of trusted
highest risk for infection
health sources, including academic journals, magazines,
● Current STI screening recommendations and graphs on newspapers, videos, podcasts, and more. It is updated
the prevalence of STIs have been added and updated daily to offer the most current news about topics related
according to the newest data from the Centers for Dis- to your health course.
ease Control and Prevention (CDC) ● Cognero Test Bank. ISBN-13: 978-1-305-26544-8.
Cengage Learning Testing Powered by Cognero is a flexi-
Chapter 15, Lifetime Fitness and Wellness ble, online system that allows you to:
New information on the growing trend of integrative
Author, edit, and manage test bank content from mul-
●
●
medicine in hospitals, practices, and treatment centers

tiple Cengage Learning solutions.
Expanded guidelines for choosing a personal fitness trainer
Create multiple test versions in an instant.
●
●
Updated resources for students to access credible research

Deliver tests from your LMS, your classroom, or wher-
●
●
on health and wellness topics

ever you want.
xviii PREFACE
● Instructor’s Companion Site. Everything

you need for your course in one place! This
collection of book-specific lecture and class
tools is available online via www.cengage
.com/login. Access and download PowerPoint
presentations, images, instructor’s manual,
videos, and more.
● Careers in Health, Physical Education, and
Sport, second edition. ISBN-13: 978-0-
495-38839-5. This unique booklet takes
students through the complicated process of
picking the type of career they want to pur-
sue; explains how to prepare for the transition

into the working world; and provides insight
into different types of career paths, education
requirements, and reasonable salary expecta-
tions. A designated chapter discusses some of
the legal issues that surround the workplace,
including discrimination and harassment.
This supplement is complete with personal development Using his knowledge and personal experiences, Dr. Hoeger
activities designed to encourage students to focus on and writes engaging, informative books that thoroughly address
develop better insight into their futures. today’s fitness and wellness issues in a format accessible to
students. Since 1990, he has been the most widely read fit-
ness and wellness college textbook author in the United
Brief Author Biographies States. He has published a total of 63 editions of his nine
fitness and wellness-related titles. Among the textbooks
Werner W. K. Hoeger is a professor emeritus of the Depart-
ment of Kinesiology at Boise State University, where he
taught between 1986 and 2009. He had previously taught at
the University of the Andes in Venezuela (1978–1982);
served as Technical Director of the Fitness Monitoring Pre-
ventive Medicine Clinic in Rolling Meadows, Illinois (1982–
1983); The University of Texas of the Permian Basin in
Odessa, Texas (1983–1986); and briefly taught for one se-
mester in 2012, 2013, and 2016 as an adjunct faculty at
Brigham Young University Hawaii in Laie, Hawaii. He re-
mains active in research and continues to lecture in the areas
of exercise physiology, physical fitness, health, and wellness.
Dr. Hoeger completed his undergraduate and master’s de-
grees in physical education at the age of 20 and received his
doctorate degree with an emphasis in exercise physiology at
the age of 24. He is a Fellow of the American College of
Sports Medicine and also of the Research Consortium of
SHAPE America (Society of Health and Physical Educators).
In 2002, he was recognized as the Outstanding Alumnus
from the College of Health and Human Performance at
Brigham Young University. He is the recipient of the first
Presidential Award for Research and Scholarship in the Col-
lege of Education at Boise State University in 2004.
In 2008, he was asked to be the keynote speaker at the VII
Iberoamerican Congress of Sports Medicine and Applied Sci-
ences in Mérida, Venezuela, and was presented with the

Distinguished Guest of the City recognition. In 2010, he was
also honored as the keynote speaker at the Western Society
for Kinesiology and Wellness in Reno, Nevada.
PREFACE xix
As an innovator in the field, Dr. Hoeger has developed
many fitness and wellness assessment tools, including fitness
tests such as the Modified Sit-and-Reach, Total Body Rota-
tion, Shoulder Rotation, Muscular Endurance, and Muscular
Strength and Endurance and Soda Pop Coordination Tests.
Proving that he “practices what he preaches,” he was the old-
est male competitor in the 2002 Winter Olympics in Salt
Lake City, Utah, at the age of 48. He raced in the sport of
© Nancie Battaglia/Getty Images

luge along with his then 17-year-old son Christopher. It was
the first, and so far only time, in Winter Olympics history
that father and son competed in the same event. In 2006, at
the age of 52, he was the oldest competitor at the Winter
Olympics in Turin, Italy. In 2011, Dr. Hoeger raced in the
800-, 1,500-, and 5,000-meter events in track and field at the
World Masters Athletic Championships held in Sacramento,
California. At different times and in different distances in
written for Wadsworth/Cengage Learning are Lifetime Physi- 2012, 2014, 2015, and 2016, he reached All-American stan-
cal Fitness and Wellness: A Personalized Program, 14th edi- dards for his age group by USA Track and Field (USATF).
tion; Fitness & Wellness, 12th edition; Principles and Labs for In 2015, he finished third in the one-mile run at the USATF
Physical Fitness, 10th edition; Wellness: Guidelines for a Masters Indoor Track and Field National Championships,
Healthy Lifestyle, 4th edition; and Water Aerobics for Fitness and third and fourth, respectively, in the 800- and
& Wellness, 4th edition (with Terry-Ann Spitzer Gibson). 1,500-meter events at the Outdoor National Senior Games.
Dr. Hoeger was the first author to write a college fitness text- Sharon A. Hoeger is vice president of Fitness & Wellness,
book that incorporated the wellness concept. In 1986, with Inc., of Boise, Idaho. Sharon received her degree in com-
the release of the first edition of Lifetime Physical Fitness & puter science from Brigham Young University. In the 1980s,
Wellness, he introduced the principle that to truly improve fit- she served as a computer science instructor at the University
ness, health, and quality of life and to achieve wellness, a per- of Texas of the Permian Basin. She is extensively involved in
son needed to go beyond the basic health-related components the research process used in retrieving the most current sci-
of physical fitness. His work was so well received that every entific information that goes into the revision of each text-
fitness author in the field immediately followed his lead. book. She is also the author of the software that was written
specifically for the fitness and wellness textbooks. Her inno-
vations in this area since the publication of the first edition
of Lifetime Physical Fitness & Wellness in 1986 set the stan-
dard for fitness and wellness computer software used in this
market today.
Sharon is a coauthor of five of the seven fitness and wellness
titles. She also served as chef de mission (chief of delega-
tion) for the Venezuelan Olympic Team at the 2006 Winter
Olympics in Turin, Italy. A former gymnast, she now partic-
ipates in a variety of fitness activities to enjoy good health
and maintain a high quality of life.
Husband and wife have been jogging and strength training
together for more than 39 years. They are the proud parents
of five children, all of whom are involved in sports and life-
time fitness activities. Their motto: “Families that exercise
together, stay together.”
Amber L. Fawson and Cherie I. Hoeger received their de-
grees in English with an emphasis in editing for publication.
For the past 15 years Amber has enjoyed working in the
publication industry and has held positions as an Editorial

Coordinator for BYU Studies, Assistant Editor for Cengage
Learning, and freelance writer and editor for tertiary
education textbooks and workbooks. During the last decade,
Cherie has been working as a freelance writer and
xx PREFACE

editor; writing research and marketing copy for client
magazines, newsletters, and websites; and contracting as a
Acknowledgments
textbook copy editor for Cengage Learning (previously This book is dedicated to Norman and Laverne Kaluhiokalani.
under Thomson Learning and the Brooks/Cole brand). Their lifetime friendship and kind help and unconditional
Amber and Cherie have been working for Fitness & support throughout the years is most sincerely appreciated.
Wellness, Inc., for several years as writers and scientific The completion of the 14th edition of Principles and Labs
literature reviewers for new editions. They have now for Fitness & Wellness was made possible through the contri-
taken on a more significant role as co-authors of all butions of many professionals throughout the country. In
fitness & wellness textbooks. Their addition now consti- particular, we express our gratitude to the reviewers of the
tutes an enthusiastic four-person author team to sort 14th edition; their valuable comments and suggestions are
through and summarize the extensive literature available sincerely appreciated.
in the health, fitness, wellness, and sports medicine
fields. Their work has greatly enhanced the excellent We would also like to thank Gina Jepson and Jessica Eakins
quality of these textbooks. They are firm believers in for their kind help with new photography in this edition.
living a health and wellness lifestyle, regularly attend
professional meetings in the field, and are active mem-
bers of the American College of Sports Medicine.
1
Physical Fitness
and Wellness
The human body is extremely resilient during
youth—not so during middle and older age.
The power of prevention, nonetheless, is
yours: It enables you to make healthy lifestyle
choices today that will prevent disease in the
future and increase the quality and length of
your life.
Objectives
Understand the health and fitness consequences
of physical inactivity.
Identify the major health problems in the
United States.
Learn how to monitor daily physical activity.
Learn the Federal Physical Activity Guidelines
for Americans.
Define wellness and list its dimensions.
Define physical fitness and list health-related and
skill-related components.
State the differences among physical fitness,
health promotion, and wellness.
Distinguish between health fitness standards and
physical fitness standards.
Understand the benefits and significance of
participating in a comprehensive wellness
program.
Determine if you can safely initiate an
exercise program.
Learn to assess resting heart rate and
blood pressure.
Chris Black
2 Principles and Labs for Fitness and Wellness
FAQ
Why should I take a Is the attainment of good achieve the highest potential for well-
fitness and wellness physical fitness sufficient to being within all dimensions of wellness.
course? ensure good health? If a person is going to do only

Most people go to college to learn how Regular participation in a sound one thing to improve health,
to make a living, but a fitness and physical fitness program will provide what would it be?
wellness course will teach you how to substantial health benefits and signifi-
live—how to truly live life to its fullest cantly decrease the risk of many This is a common question. It is a
potential. Some people seem to think chronic diseases. And although good mistake to think, though, that you can
that success is measured by how much fitness often motivates toward adoption modify just one factor and enjoy wellness.
money they make. Making a good of additional positive lifestyle behaviors, Wellness requires a constant and deliber-
living will not help you unless you live to maximize the benefits for a healthier, ate effort to change unhealthy behaviors
a wellness lifestyle that will allow you more productive, happier, and longer and reinforce healthy behaviors. Although
to enjoy what you earn. You may want life we have to pay attention to all it is difficult to work on many lifestyle
to ask yourself: Of what value are a seven dimensions of wellness: physical, changes all at once, being involved in a
nice income, a beautiful home, and a social, mental, emotional, occupational, regular physical activity program, avoiding
solid retirement portfolio if, at age 45, environmental, and spiritual. These di- excessive sitting, observing proper nutri-
I suffer a massive heart attack that will mensions are interrelated, and one fre- tion, and avoiding addictive behavior are
seriously limit my physical capacity or quently affects the other. A wellness lifestyle factors to work on first. Others
end life itself? way of life requires a constant and de- should follow, depending on your current
liberate effort to stay healthy and lifestyle behaviors.
Real life StoRy | Jeremy’s Experience
I was a multisport athlete in high alcohol at these activities. I know exercise on an almost daily basis,
school. I played soccer, football, basket- we drank way too much, we and I learned so much about
ball, and ran track. I was not the best didn’t exercise, and my grades nutrition and healthy eating.
athlete on these teams, and I didn’t suffered as a result. I shouldn’t Parties and alcohol were no
have a chance to make a college team, have been so shocked when longer important to me. I had
but I sure loved sports and athletic I saw my final grades. To a life to live and prepare
competition. To earn extra money for add insult to injury, it for. It felt so good to once
college, I worked for a fast-food chain really hit home when I again become fit and eat a
that summer. I was so busy that I didn’t signed up for the fitness healthy/balanced diet. I
do any fitness activities or play sports and wellness class and rearranged my activities
that summer, and I ate too much junk found out I had gained so that schoolwork and fit-
food, which caused me to gain some more than 15 pounds since ness were right at the top of
weight. Later in college, it took some high school graduation. My my list. I stopped procrastinat-
time to get used to my new surround- fitness test results showed iStockphoto.com/bo1982 ing on my schoolwork, and
ings and the newfound freedom from I was not even in an average fitness I was doing cardio five times a week
my home life. My friends kept stress- category for most components. and lifting twice per week. My goal
ing that I needed to enjoy college life I am so glad the fitness course is to keep this up for the rest of my
as much as possible and not worry so was a required class because I was life. I now understand that if I want
much about academics. We went to able to correct my lifestyle before it to enjoy wellness, I have to make fit-
a lot of parties and watched sporting spiraled out of control and I wasted ness and healthy living a top priority
events. There was always plenty of more time in college. I started to in my life.
Chapter 1 Physical Fitness and Wellness 3
PeRSoNal PRofile: General Understanding of Fitness and Wellness

To the best of your ability, answer the following questions. If III. Cardiorespiratory endurance, strength, power, flexibility,
you do not know the answer(s), this chapter will guide you agility, and speed are the basic components of health-
through them. related fitness. True False
I. Wellness implies making a constant and deliberate effort IV. My current blood pressure is / mm Hg, which is
to stay healthy and achieve the highest potential for classified as (mark one) normal, prehyperten-
well-being. True False sion, or hypertension.
II. The minimum requirement in the U.S. Federal Physical V. Are you aware of potential risk factors in your life and
Activity Guidelines is that you accumulate minutes personal health family history that may increase your
of moderate-intensity aerobic activity or minutes of chances of developing disease? Yes No
vigorous-intensity aerobic activity weekly.
S
cientific findings have shown that physical inactivity kidney disease, polio, and other diseases of infancy. Progress
and a negative lifestyle seriously threaten health and in the medical field largely eliminated these diseases. Then, as
hasten the deterioration rate of the human body. more people started to enjoy the “good life” (sedentary liv-
Movement and physical activity are basic functions for which ing, alcohol, fatty foods, excessive sweets, tobacco, and drugs),
the human organism was created. we saw a parallel increase in the incidence of chronic diseases
Advances in technology however, have almost completely such as cardiovascular disease, cancer, diabetes, and chronic
eliminated the necessity for physical exertion in daily life. respiratory diseases (Figure 1.1).
Physical activity is no longer a natural part of our existence.
We live in an automated society where most of the activities GLOSSARY
that used to require strenuous exertion can be accomplished
by machines with the simple push of a button. Sedentary death syndrome Sedentary Description of a
Most nations, both developed and developing, are experi- (SeDS) Cause of deaths attributed person who is relatively inactive
encing an epidemic of physical inactivity. In the United to a lack of regular physical activity. and whose lifestyle is characterized
States, physical inactivity is the second greatest threat to pub- Hypokinetic diseases Hypo by a lot of sitting.
lic health (after tobacco use) and is often referenced in new denotes “lack of”; therefore, Chronic diseases Illnesses
concerns about sitting disease, sedentary death syndrome illnesses related to lack of that develop as a result of an
(SeDS), and hypokinetic diseases. physical activity. unhealthy lifestyle and last a
At the beginning of the 20th century, life expectancy for a Life expectancy Number of long time.
child born in the United States was only 47 years. The most years a person is expected to live
common health problems in the Western world were infec- based on the person’s birth year.
tious diseases, such as tuberculosis, diphtheria, influenza,
Modern-day conveniences lull people into a sedentary lifestyle.
Figure 1.1 Causes of death in the United States for Figure 1.2 Factors that affect health and longevity.
selected years.
ent
onm
100 vir
En
Be
90 Health &
havior
Longevity
80
Percent of all deaths
70 G en
e ti c s
60
50
40
30
There are three basic factors that determine our health
20
and longevity: genetics, the environment, and our behavior.
10 In most cases, we cannot change our genetic circumstances,
0
1900 1920 1940 1960 1980 2000 2010 though the budding field of epigenetics is showing us that
Year select genes can be switched on and off by lifestyle choices
Influenza and and environment. (For a more in-depth discussion on
pneumonia Cancer
Tuberculosis
Cardiovascular epigenetics see “Genetic versus Environmental Risk,”
disease
Chapter 12, pages 471–472.) We can certainly, however,
Accidents All other causes
exert control over the environment and our health behav-
Source: National center for Health Statistics, Division of Vital Statistics. iors so that we may reach our full physical potential based
on our genetic code (see Figure 1.2). How we accomplish
this goal will be thoroughly discussed through the chapters
of this book.
As the populations of the world have adopted a more sed-
entary lifestyle, the world has seen a steep incline in obesity
rates. Before 1980, obesity rates throughout the world re-
mained relatively steady. Then, beginning in the 1980s, obe-
1.1 Life Expectancy
sity rates started to grow rapidly, especially in the United Currently, the average life expectancy in the United States is
States, Australia, and England. Worldwide obesity now claims 78.8 years (76.5 years for men and 81.3 years for women).1 In
triple the number of victims as malnutrition. Overweight and the past decade alone, life expectancy has increased by
obese people are now the majority in the 34 countries that 1 year—the news, however, is not all good. The data show
make up the Organization for Economic Cooperation and that people now spend an extra 1.2 years with a serious illness
Development (OECD). Over the last two decades, the world and an extra 2 years of disability. Mortality has been post-
has transitioned from one where populations did not have poned because medical treatments allow people to live longer
enough to eat to one where, even in developing countries, an with various chronic ailments (cardiovascular disease, can-
abundance of unhealthy food and inactivity is causing obe- cer, and diabetes).
sity, chronic diseases, and premature death. Based on data from the World Health Organization
As the incidence of chronic diseases climbed, we recog- (WHO), the United States ranks 33rd in the world for life
nized that prevention is the best medicine. Consequently, a expectancy (see Figure 1.3). Japan ranks first in the world
fitness and wellness movement developed gradually, begin- with an overall life expectancy of 83.3 years.2 While the
ning in the 1980s. People began to realize that good health is United States was once a world leader in life expectancy, over
mostly self-controlled and that the leading causes of prema- recent years, the increase in life expectancy in the United
ture death and illness can be prevented by adhering to posi- States has not kept pace with that of other developed
tive lifestyle habits. countries.
Widespread interest in health and preventive medicine in Several factors may account for the current U.S. life expec-
recent years is motivating people to reexamine the foods they tancy ranking, including the extremely poor health of some
eat, incorporate more movement into activities of daily life, groups. This includes some Native American communities,
and participate in organized fitness and wellness programs. rural African Americans, and the inner-city poor. This also
Since 2014, overweight and obesity rates have begun to stabi- includes poorly educated middle-aged Caucasians, a demo-
lize in the United States, England, and Italy and are increasing graphic group whose death rates have been rising since the
at a slower pace than they once were in countries like Canada late 1990s, while that of other groups have been falling.3 The
and Spain. We all desire to live a long life, and wellness pro- United States also has fairly high levels of violence (notably,
grams seek to enhance the overall quality of life—for as long homicides), traffic fatalities, and suicide rates.4 The current
as we live. trend is a widening disparity between those in the United
Figure 1.3 Life expectancy at birth for selected countries: 34 OECD countries.7 In terms of average weight, the United
2005–2015 projections. States has the world’s third heaviest population, trailing only
Tonga and Micronesia. According to estimates from the Cen-
Japan 80 87
ters for Disease Control and Prevention, 35.1 percent of the
adult population in the United States is obese. As a nation, we
Spain 80 86
are seeing the consequences of these numbers unfold. Inci-
Switzerland 81 85 dence of diabetes climbed dramatically in parallel step with
France 79 85 the increased incidence of obesity.8 Today, nearly half of the
Canada 79 84
people in the United States have diabetes or prediabetes.9
Thankfully, the rise in U.S. diabetes rates have begun to
Germany 79 83
plateau, as obesity rates have done the same, providing one of
United Kingdom 79 83 the first glimmers of hope in our fight against chronic dis-
United States 77 81 ease. Diabetes is the third most expensive chronic disease to
Argentina 72 80
treat, preceded only by angina (heart disease) and hyperten-
sion, respectively. All three of these chronic conditions are
Mexico 74 79
linked with obesity.10 Additional information on the obesity
United Arab Emirates 76 78 epidemic and its detrimental health consequences is given in
Brazil 70 78 Chapter 5.
65 70 75 80 85 90
Life expectancy for men in the United States is almost
Years 5 years lower than for women. For years it had been as-
sumed that the difference is based on biology, but we are
Dark color is men; light color is women. learning that most likely the gender gap is related to life-
Source: World Bank, “Life expectancy at Birth (Male), 2013” and “Life
style behaviors most commonly observed in men. Around
expectancy at Birth (Female), 2013,” http://data.worldbank.org/indicator 1980, the gender gap in life expectancy was almost 8 years.
/SP.DYN.Le00.Fe.IN. The decrease in the gender gap is thought to be due to the
fact that women are increasingly taking on jobs, habits, and
stressors of men, including drinking and employment out-
side the home.
Men, nonetheless, still report higher stress on the job and
States with the highest and lowest life expectancy. For exam- are less likely to engage in stress management programs.
ple, males in Fairfax County, Virginia, can expect to live as Also, 95 percent of employees in the 10 most dangerous jobs
long as males in Japan, while those in Bolivar County, are men. Furthermore, men’s health is not given the same
Mississippi, have the same life expectancy as males in coun- degree of attention in terms of public health policies. Thus,
tries with much lower life expectancies, like Pakistan. People men need to take a more proactive role for their own health
with low socioeconomic status often lead more stressful lives, and public health policies.
have more dangerous jobs, have less access to healthy food, “Masculinity” itself is also partially to blame. Studies have
are more likely to be exposed to environmental toxins, and consistently shown that men are less likely to visit a physician
live in neighborhoods that are not as safe or as conducive to when something is wrong and are less likely to have preven-
physical activity. Physical activity trends by U.S. county, in tive care visits to be screened for potential risk factors such as
most cases, are aligned with life expectancy trends.5 hypertension, elevated cholesterol, diabetes, obesity, sub-
The United States also has not made the same headway stance abuse, and depression or anxiety. It is a troubling para-
with disease prevention as other countries. Some countries, dox, considering that men are at greater risk for each of the
like Australia, have made progress by arranging primary care top risk factors for chronic disease. As a result, chronic dis-
to better detect and intervene with hypertension, for exam- eases in men are often diagnosed at a later stage, when a cure
ple. The latest data indicate that one in four adults in the or adequate management is more difficult to achieve. Men
United States have at least two chronic conditions. In terms of also drive faster than women and are more likely to engage in
preventive health service, most of these patients do not re- risk-taking activities. Of all road traffic fatalities among
ceive 56 percent of the clinical recommendations from the countries studied in the most recent OECD report, a dispa-
U.S. Preventative Services Task Force. Eva H. DuGoff of rate 74 percent of victims were men.
Johns Hopkins Bloomberg School of Public Health has said,
“Our system is not set up to care for people with so many
different illnesses. Each one adds up and makes the burden of
disease greater than the sum of its parts.”6 GLOSSARY
A report by the OECD found that while the United States Health State of complete well-being—not just the absence of
far outspent every other country in health care cost per cap- disease or infirmity.
ita, it also easily had the highest rates of obesity of all
Figure 1.4 Leading causes of death in the United States by age.
Ages Ages Ages Ages Ages Ages Ages 65 Overall,

10–14 15–24 25–34 35–44 45–54 55–64 and over all ages
22% Cardiovascular disease

27% 26% 24%
32% (heart disease + stroke)
36% 34%
41%
16%
15% 20% 23% Cancer
14% 21%
22%
17% 15%
13% Chronic respiratory
6%
12% disease
9%
7% 5% Accidents
5% 9% 5%
5% 4% 3% Alzheimer’s
15% 8% 5%
Suicide
Homicide
5%
Source: centers for Disease control and Prevention, “Deaths, Final Data, 2014.”
1.2 Leading Health Problems adults in the United States are afflicted with diseases of the
cardiovascular system, including one in three adults living
in the United States with hypertension (high blood pressure) and 15.4 million
with CHD. (Many of these people have more than one type of
The leading causes of death in the United States today are largely cardiovascular disease.) These numbers are devastating but
related to lifestyle and personal choices (Figure 1.4). The U.S. can change. As we gained understanding of the effects of
Centers for Disease Control and Prevention have found that 7 of lifestyle on chronic disease during the second half of the 20th
10 Americans die of preventable chronic diseases. Specifically, century, more people participated in wellness programs, and
about 48 percent of all deaths in the United States are caused by cardiovascular mortality rates dropped. The decline began in
cardiovascular disease and cancer.11 Almost 80 percent of the about 1963, and between 1969 and 2013, the incidence of
latter deaths could be prevented through a healthy lifestyle pro- heart disease dropped by 68 percent and the incidence of
gram. The third and fourth leading causes of death across all age stroke by 77 percent. This decrease is credited to higher levels
groups, respectively, are chronic lower respiratory disease and of wellness and better treatment modalities in the United
accidents. From the age of 1 to 44, accidents are the leading States. A complete cardiovascular disease prevention pro-
cause of death, with automobile accidents being the leading gram is outlined in Chapter 10.
cause of death in the 5-to-24 age group.12
Healthy Habits That Cut the Risk

HoEGEr KEY to WELLnESS for Serious Disease
Scientists believe that a healthy lifestyle program According to the Centers for Disease Control and Prevention,
has the power to prevent 80 percent of deaths from four health habits can reduce your risk of chronic diseases such
cardiovascular disease and cancer.
as heart disease, cancer, and diabetes by almost 80 percent:
● Get at least 30 minutes of daily moderate-intensity
physical activity.
Diseases of the Cardiovascular System ● Don’t ever smoke.
The most prevalent degenerative diseases in the United States ● Eat a healthy diet (ample fruits and vegetables, whole grain
are those of the cardiovascular system. The umbrella of products, and low meat consumption).
cardiovascular diseases includes such conditions as coronary
heart disease (CHD), heart attacks, and strokes. About
● Maintain a body mass index (BMI) of less than 30.
28.5 percent of all deaths in this country are attributed to The latest research would add one more crucial life-saving
diseases of the heart and blood vessels. According to the habit: Reduce the amount of time you spend sitting each day.
American Heart Association (AHA), more than one in three
Cancer automobiles choose not to wear seatbelts, yet these people

account for half of all automobile deaths. As for the cause of
The second overall leading cause of death in the United States automobile accidents themselves, fatal accidents are often
is cancer. For Americans ages 45 to 64, however, it is the lead- related to failure to stay in the correct lane or yield the right
ing cause of death. Cancer is considered the number-one of way due to driver distraction or alcohol use.15
health fear of the American people. About 23 percent of all Most people do not perceive accidents as a health problem.
deaths in the United States are attributable to cancer. About Even so, accidents affect the total well-being of millions of
596,000 Americans died from this disease in 2016 (i.e., Americans each year. Accident prevention and personal
1674 each day), and more than 1.7 million new cases were safety are part of a health-enhancement program aimed at
reported the same year.13 The major contributor to the increase achieving a better quality of life. Proper nutrition, exercise,
in the incidence of cancer deaths during the past five decades stress management, and abstinence from cigarette smoking
is lung cancer, of which 90 percent for males and 80 percent for are of little help if the person is involved in a disabling or fatal
females is caused by tobacco use.14 Furthermore, smoking ac- accident as a result of distraction, making a single reckless
counts for almost 30 percent of all deaths from cancer. More decision, or not wearing seat belts properly.
than 30 percent of deaths are related to nutrition, physical in- Accidents do not just happen. We cause accidents, and we
activity, excessive body weight, and other faulty lifestyle habits. are victims of accidents. Although some factors in life, such
The American Cancer Society maintains that the most influen- as earthquakes, tornadoes, and airplane accidents, are com-
tial factor in fighting cancer today is prevention through health pletely beyond our control, more often than not, personal
education programs. Lifestyle choices at a young age affect safety and accident prevention are a matter of common sense.
cancer risk throughout a lifetime. A comprehensive cancer- Most accidents stem from poor judgment and confused men-
prevention program is presented in Chapter 12. tal states, which occur when people are upset, mentally spent,
not paying attention to the task at hand, trying to do too
Chronic Lower Respiratory Disease much at once, or abusing alcohol or other drugs.
Chronic lower respiratory disease (CLRD), the third leading With the advent of cell phones, distracted driving accidents
cause of death, is a general term that includes chronic ob- have climbed. For teens, specifically, 6 in 10 of all moderate to
structive pulmonary disease, emphysema, and chronic bron- severe automobile accidents result from driver distraction.16 On
chitis (all diseases of the respiratory system). Although CLRD an average day in the United States, nine people are killed as a
is related mostly to tobacco use (see Chapter 13 for discus- result of distracted driving, and more than 1,000 people are in-
sion on how to stop smoking), lifetime nonsmokers also can jured. As the Senior Director of Transportation Strategic Initia-
develop CLRD. tives for the National Safety Council, David Teater, put it, “You
Precautions to prevent CLRD include consuming a low-fat, never think it will happen to you—until it does.” Teater’s research
low-sodium, nutrient-dense diet; staying physically active; has been motivated by the loss of his 12-year-old son in a cell
not smoking and not breathing cigarette smoke; getting a phone–related accident. Research utilizing brain imaging has
pneumonia vaccine if older than age 50 and a current or uncovered the cognitive workload and collision risk during mul-
ex-smoker; and avoiding swimming pools for individuals tiple driving scenarios (see Distracted Driving Box on page 8).
sensitive to chlorine vapor. Alcohol abuse is the number-one overall cause of all acci-
dents. About half of accidental deaths and suicides in the
United States are alcohol related. Further, alcohol intoxica-
Accidents tion remains the leading cause of fatal automobile accidents
Accidents are the fourth overall leading cause of death and in the United States by taking the lives of 30 people every day.
the leading cause of death until age 44. Even though not all Other commonly abused drugs alter feelings and percep-
accidents are preventable, many are. Consider automobile tions, generate mental confusion, and impair judgment and
accidents, the leading cause of death for teens. Across the coordination, greatly enhancing the risk for accidental
United States, fewer than 15 percent of people taking trips in morbidity and mortality (Chapter 13).
GLOSSARY
Cardiovascular disease The array of condi- Coronary heart disease (CHD) A disease in of oxygen, usually due to blockage of a diseased
tions that affect the heart (cardio-) and the which plaque builds up in the arteries that sup- coronary artery.
blood vessels (-vascular); often used inter- ply blood to the heart (these are the coronary ar- Stroke A condition in which a blood vessel that
changeably with the term heart disease. Under teries, the term “coronary” evolved from the feeds the brain is clogged, leading to blood flow
the cardiovascular disease umbrella are dis- word for “crown or wreath,” referring to the disruption to the brain. Sometimes referred to as
eases including stroke and coronary heart dis- arteries that circle the heart). a brain attack.
ease (CHD). CHD, in turn, is an umbrella term Heart attack Damage to an area of the Morbidity A condition related to or caused by
for diseases that affect the heart and coronary myocardium (heart muscle) that is deprived illness or disease.
arteries, which includes heart attacks.
Distracted Driving
Automobile accidents are the number-one 5. Though crash risk is lower when time than texting and so causes
cause of death for teens in the United talking with a passenger, cognitive more deaths. Consider using your
States. Recent studies on distracted driv- workload can be the same as when phone’s do not disturb setting or an
ing have used new technology, including talking on a cell phone. Topic of app that blocks texting while
real-time brain imaging, to offer new conversation and emotional involve- driving. Because our minds are
insight about protecting ourselves behind ment affect safety in both types of social and curious, we find text
the wheel. Following are insights for conversation. alerts difficult to ignore.
drivers. 6. The brain does not multitask, but 12. Parents driving children are just as
1. Listening to the radio is nearly as rather switches attention between likely to talk on the phone and use
safe as driving with no distractions. tasks. Some dual tasks do not cause distractions, including navigation
2. Having a cell phone conversation in- a problem; others do. When driving systems, as other drivers.e
creases collision incidence fourfold. and holding a conversation, the 13. Using Apple’s Siri while driving to
The risk is identical for a hands-free brain often recognizes conversation get directions, send texts, post to
device and a hand held phone.a as the primary task. Switching is a social media, or check appointments
3. Having a cell phone conversation complex process that requires can be as dangerous as texting
causes the brain to screen out events to be committed to short- while driving, even when
50 percent of visual cues. The ability term memory before they can be hands-free.f
to look directly at but not “see” an “encoded,” the stage when the brain
We cannot control what information
object is termed “inattention blind- chooses what to “see.” It is not
our brain chooses to encode and screen
ness.” It is not uncommon for a dis- uncommon for switching time to be
out while driving. We can control our
tracted driver running a red light to tenths of a second, the difference of
decision to use a cell phone or to speak
collide with the second or third car in several car lengths when breaking.
up when a driver is putting passengers
an intersection, having not “seen” the This is termed “reaction time
in danger.
first cars. Talking on a phone while switching costs.”
driving decreases reaction time to 7. The brain remains somewhat dis- a
Training, Research, and Education for Driving Safety, “UC
pedestrians in a crosswalk by tracted for up to 27 seconds follow- San Diego Joins Nationwide Efforts to Curb Phone Use While
Driving,” released online December 4 2013, available at
40 percent.b ing a phone conversation, text, or http://health.ucsd.edu/news/releases/Pages/2013-12-04
voice technology interaction.c -TREDS-just-drive-program.aspx; J. G. Gaspar, W. M. Street,
4. Having a conversation with an adult M. B. Windsor, R. Carbonari, H. Kaczmarski, A. F. Kramer, and
passenger is safer than having a 8. Because the majority of trips do not K. E. Mathewson, “Providing Conversation Partners Views of
the Driving Scene Mitigates Cell Phone-Related Distraction,”
conversation on a cell phone. involve a situation that requires Proceedings of the Human Factors and Ergonomics Society
Annual Meeting 57, no. 1 (2013).
Passengers who are experienced split-second timing, drivers can b
Jill U. Adams, “Talking on a Cellphone While Driving Is Risky.
drivers help the driver by pausing gain a false sense of security about But simpler Distractions Can Also Cause Harm,” Washington
Post, February 10, 2014.
conversation and by pointing out being able to multitask. c
“Up to 27 Seconds of Inattention after Talking to Your
cues as needed. For a teen driver, 9. Making a left turn while talking on a Car or Smartphone,” The University of Utah UNews,
the incidence of collision resulting October 27, 2015, available at http://unews.utah.edu
cell phone or hands-free device is /up-to-27-seconds-of-inattention-after-talking-to-your
in death increases with the number among the most dangerous driving -car-or-smart-phone/.
of teen passengers. activities.d
d
Tom A. Schweizer, Karen Kan, Yuwen Hung, Fred Tarn, Gary
Naglie, and Simon J. Graham, “Brain Activity during Driv-
ing with Distraction: An Immersive fMRI Study,” Frontiers
10. Reaching for a moving object or in Human Neuroscience, February 28, 2013, doi:10.3389/
turning in your seat increases colli- fnhum.2013.00053.
e
Michelle L. Macy, Patrick M. Carter, C. Raymond Bingham,
sion incidence by eight to nine times.
AAA Foundation for Traffic Safety
Rebecca M. Cunningham, and Gary L. Freed, “Potential

Distractions and Unsafe Driving Behaviors Among Drivers of
11. Texting while driving increases 1- to 12-Year-Old Children,” Academic Pediatrics 14, no. 3
collision incidence by 16 times. (2014): 279.
Driving while talking on a cell
f
University of Utah News Center, “Talking to Your Car Is Often
Distracting,” October 7, 2014, available online at http://unews
phone is done more frequently by .utah.edu/news_releases/talking-to-your-car-is-often
-distracting/.
more drivers for longer lengths of
Figure 1.5 Death from all causes attributable to lifestyle-related risk factors for men and women in the United States.
Drug use 25,430
Alcohol use 88,587
Ambient air pollution 103,027
High total cholesterol 158,431
High blood sugar 213,669
Physical inactivity 234,022
High body mass index 363,991
High blood pressure 442,656
Smoking 465,651
0 100,000 200,000 300,000 400,000 500,000
Source: Institute for Health Metrics and evaluation News release, “Dietary risks Are Leading cause of Disease Burden in the uS and contributed to
More Health Loss in 2010 than Smoking, High Blood Pressure, and High Blood Sugar,” July 10, 2013, www.healthmetricsandevaluation.org/news-events
/news-releases.
1.3 Lifestyle as a Health Problem most people in the United States are threatened by the very
lives they lead today.
The underlying causes of death attributable to leading risk Because of the unhealthy lifestyles that many young adults
factors in the United States (Figure 1.5) indicate that most fac- lead, their bodies may be middle-aged or older! Many school
tors are related to lifestyle choices we make. Of the approxi- physical fitness programs do not emphasize the skills necessary
mately 2.5 million yearly deaths in the United States, the “big for young people to maintain a high level of fitness and health
five” factors—tobacco smoking, high blood pressure, over- throughout life. The intent of this book is to provide those
weight and obesity, physical inactivity, and high blood glucose— skills and help to prepare you for a lifetime of physical fitness
are responsible for almost 1.5 million deaths each year. and wellness. A healthy lifestyle is self-controlled, and you can
Based on estimates, more than half of disease is lifestyle learn how to take charge of your own health and fitness.
related, a fifth is attributed to the environment, and a tenth is Healthy choices made today influence health for decades.
influenced by the health care the individual receives. Only
16 percent is related to genetic factors (Figure 1.6). Thus, the
individual controls as much as 80 percent of his or her vul-
nerability to disease—and thus quality of life. In essence,
1.4 The Dose-Response
Relationship between Physical
Figure 1.6 Estimated impact of the factors that affect health
and well-being. Activity and Health
Among the benefits of regular physical activity and exercise
are a significant reduction in premature mortality and de-
creased risks for developing heart disease, stroke, metabolic
Lifestyle syndrome, type 2 diabetes, obesity, osteoporosis, colon and
53% breast cancers, high blood pressure, depression, and even
dementia and Alzheimer’s. But we did not always understand
the relationship between physical activity and mortality rates,
in particular, the dose-response relationship.
Health care
Environment 10% During the second half of the 20th century, scientists began
21% to realize the importance of good fitness and improved life-
Genetics
16%
style in the fight against chronic diseases, particularly those
GLOSSARY
Risk factors Lifestyle and genetic variables that may lead to disease.
of the cardiovascular system. Because of more participation rate decreases. Research has also corroborated that the biggest
in wellness programs, cardiovascular mortality rates dropped. drop in mortality rate happens when inactive people become
Furthermore, several studies showed an inverse relationship moderately active.19 One recent study found that if the world-
between physical activity and premature mortality rates. The wide inactivity rate were to go down by only 20 percent, more
first major study in this area was conducted in the 1980s among than 1 million lives could be saved on a yearly basis and global
16,936 Harvard alumni, and the results linked physical activity life expectancy would increase by almost a year.20
habits and mortality rates.17 As the amount of weekly physical One study looked to specifically compare the efficacy of
activity increased, the risk for cardiovascular deaths decreased. commonly prescribed drugs against the impact of regular
A landmark study subsequently conducted at the Aerobics exercise. The data are based on more than 14,000 patients
Research Institute in Dallas upheld the findings of the Harvard recovering from stroke, being treated for heart failure, or
alumni study.18 Based on data from 13,344 people followed looking to prevent type 2 diabetes or a second episode of
over an average of 8 years, the study revealed a graded and coronary heart disease. The study looked at the effectiveness
consistent inverse relationship between physical activity levels of exercise versus drugs on health outcomes. The results were
and mortality, regardless of age and other risk factors. As revealing: Exercise programs were more effective than medi-
illustrated in Figure 1.7, the higher the level of physical activity, cal treatment in stroke patients and equally effective as medi-
the longer the lifespan. The death rate during the 8-year study cal treatments in patients of diabetes and coronary heart
from all causes for the low-fit men was 3.4 times higher than disease. Only in the prevention of heart failure were diuretic
that of the high-fit men. For the low-fit women, the death rate drugs more effective in preventing mortality than exercise.
was 4.6 times higher than that of high-fit women. When physical activity is combined with other healthy life-
A most significant finding of this landmark study was the style factors, it becomes clear that individual lifestyle choice is
large drop in all-cause, cardiovascular, and cancer mortality the strongest predictor of longevity. Consider four health-
when individuals went from low fitness to moderate fitness—a related factors examined in a group of more than 23,000 people.21
clear indication that moderate-intensity physical activity, These factors included lifetime nonsmoker, not considered
achievable by most adults, does provide considerable health obese (body mass index less than 30), engaging in a minimum
benefits and extends life. The data also revealed that the partici- of 3.5 hours of weekly physical activity, and adherence to
pants attained more protection by combining higher fitness healthy nutrition principles (high consumption of whole-grain
levels with reduction in other risk factors such as hypertension, breads, fruits, and vegetables and low consumption of red
serum cholesterol, cigarette smoking, and excessive body fat. meat). Those who adhered to all four health habits were
Countless studies since have upheld these results and have 78 percent less likely to develop chronic diseases (diabetes, heart
established that as physical activity increases, overall mortality disease, stroke, and cancer) during the almost 8-year study.
Figure 1.7 Death rates by physical fitness groups.

Numbers on top of the bars are all-cause death rates per 10,000 person-years of follow-up for each cell; 1 person-year
indicates one person who was followed up 1 year later.
39.5
64.0
70 40
60 35
50 30
40 26.3 24.6 25
16.4 16.3
30 20.3 20
20.3
20 15
9.7 7.4
7.8 7.4
10 10 3.9
7.3 4.8 2.9
3.1 1.0
5.8 1.0
4.7
ry
ry
.8
C
s
o
es
o
au
au
se
g
g
Lo
Lo
aus
1.8
te
cau
5.4
te
se
se
w
w
ca
ar
ca
All c
o
All r
cul
o
nce
f
s
f
M
d
es
M
d
es
as er r
ea
od
Ca
ea
od
iov ula
n
nc
n
er
er
it
th
it
Ca asc
at
ard
at
F
F
nt
e
ent
Hi
Hi
C v
ide
gh
rdio
gh
c Men cid Women

Ac Ca Ac
Source: Based on Data from S. N. Blair, H. W. Kohl III, r. S. Paffenbarger, Jr., G. G. clark, K. H. cooper, and L. W. Gibbons, “Physical Fitness and All-cause
Mortality: A Prospective Study of Healthy Men and Women,” Journal of the American Medical Association 262 (1989): 2395–2401.
Furthermore, the risk for developing a chronic disease progres- through physical activity is to replace at least one-third of
sively increased as the number of health factors decreased. weekly moderate physical activity with vigorous physical ac-
While it is clear that moderate-intensity exercise does pro- tivity.22 Further, current research indicates that there is no
vide substantial health benefits, research data also show a increase in mortality risk when people participate in a large
dose-response relationship between physical activity and volume of moderate- or vigorous-intensity activity each
health. That is, greater health and fitness benefits occur at week. Benefits in decreased mortality risk continue to in-
higher duration and/or intensity of physical activity. Vigor- crease until a person reaches three to five times the recom-
ous activity and longer duration are preferable to the extent mended weekly minimum of 150 minutes, at which point,
of one’s capabilities because they are most clearly associated benefits in decreased mortality risk plateau.23
with better health and longer life. Current recommendations As compared with prolonged moderate-intensity activity,
suggest that a person accumulate 150 minutes of moderate- vigorous-intensity exercise has been shown to provide the best
intensity physical activity each week. For an inactive person, improvements in aerobic capacity, coronary heart disease risk
following this guideline is the most important step toward reduction, and overall cardiovascular health.24 A word of cau-
improving health. Once a person is regularly achieving this tion, however, is in order. Vigorous exercise should be reserved
weekly minimum, the next step toward improving health for healthy individuals who have been cleared for it (Lab 1C).
confidentconsumer which compare groups of people who have and do not have a
particular condition; cross-sectional surveys, which look at one
Types of Scientific Studies point in time to see how prevalent a given condition is; and case
reports, which are an in-depth history of a few select cases.
Most scientific health studies can be broken down into two basic
types: observational studies and experimental studies. Understand- Experimental studies seek to prove cause and effect and, therefore,
ing how these types of studies differ will help you better weigh the involve intervention by the researchers followed by an observation of
results of any study and how that study may directly apply to you. the outcome. Following are common examples of experimental studies.
Observational studies are what you would expect from the name:
● Laboratory studies can be done using animals or tissue from
data collected by observing a given population. Scientists do not animals or humans. These studies are also referred to as pre-
intervene with the subjects who make up these populations but clinical research because they are required before clinical re-
simply observe trends in the population. Observational studies, search in humans is allowed.
therefore, cannot prove cause and effect. ● Clinical trials use humans as subjects to test new treatments.
It is important when interpreting the results of a clinical trial to
● Among the types of observational studies are cohort studies,
know who funded the trial so you can be aware of any bias.
which follow a group of people over time; case-control studies,
Though sponsors of trials cannot affect the outcome, at times,
sponsors select researchers whose previous research best
Systematic review & aligns with the outcome they prefer to see from the study.
meta-analysis
● Randomized double-blind placebo control studies are the gold
Randomized double blind standard of experimental research. These studies employ two
placebo control study
Experimental
groups of subjects who are as similar as possible, with the

Clinical trials only difference being the variable that the scientists are in-
vestigating. Neither the researcher(s) nor the participants (or,
if applicable, sponsors) know who is being affected by the
Laboratory studies
variable being studied until the full completion of
the research.
Strength of conclusions
Cohort study
Systematic reviews gather all of the clinical or observational stud-
Observational
Case-control study ies that have already been completed on a particular topic and that
fit the criteria the researchers have set out to investigate. The in-
Cross-sectional survey vestigators then analyze and combine the data and summarize the
results. They often employ a meta-analysis, a statistical technique
Case reports to adjust data from smaller studies, so that they are easily compa-
rable with one another and can be combined together.
Exercise Is Medicine short-term memory and enhance one’s ability to perform

daily tasks throughout life. It also can have a major impact on
In order to help the public better see exercise for its true bene- health care costs and quality of life into old age.
fits, the American College of Sports Medicine (ACSM) and the An inspiring story illustrating what fitness can do for a per-
American Medical Association (AMA) have launched a nation- son’s health and well-being is that of George Snell from Sandy
wide “Exercise Is Medicine” program.25 The initiative is in Utah. At age 45, Snell weighed approximately 400 pounds, his
conjunction with the Physical Activity Guidelines for Americans, blood pressure was 220/180, he was blind because of undiag-
with the goal of improving the health and wellness of the nation nosed diabetes, and his blood glucose level was 487.
through exercise prescriptions from physicians and health care Snell had determined to do something about his physical
providers. It calls on all physicians to assess and review every and medical condition, so he started a walking/jogging pro-
patient’s physical activity program at every visit. “Exercise is gram. After about 8 months of conditioning, he had lost al-
medicine and it’s free.” All physicians should be prescribing most 200 pounds, his eyesight had returned, his glucose level
exercise to all patients and participating in exercise themselves. was down to 67, and he was taken off medication. Just
Currently, physicians and other professionals in the health field 2 months later—less than 10 months after beginning his per-
receive little training in exercise science and practical clinical sonal exercise program—he completed his first marathon, a
application. The prevalent approach of largely ignoring exercise running course of 26.2 miles!
in the health profession is an outdated way of practicing medi-
cine. Exercise is considered to be the much-needed vaccine in Health Benefits
our era of widespread chronic diseases. Further, as our under-
standing of human physiology deepens, we are continually Most people exercise because it improves their personal ap-
uncovering new reasons physical activity and exercise are pow- pearance and makes them feel good about themselves. Al-
erful tools that the human body uses for both the treatment and though many benefits accrue from participating in a regular
the prevention of chronic diseases and premature death. fitness and wellness program, and active people generally live
longer, the greatest benefit of all is that physically fit individuals
enjoy a better quality of life. These people live life to its fullest,
1.5 Additional Benefits of a with far fewer health problems than inactive individuals.
The benefits derived by regularly participating in exercise
Comprehensive Fitness Program are so extensive that it is difficult to compile an all-inclusive
list. Many of these benefits are summarized in Table 1.1. As
Regular physical activity is important for the health of far back as 1982, the American Medical Association indicated
muscles, bones, and joints and has been shown in clinical that “there is no drug in current or prospective use that holds
studies to improve mood, cognitive function, creativity, and as much promise for sustained health as a lifetime program
table 1.1 Long-term benefits of exercise

Regular participation in exercise:
● Improves and strengthens the cardiorespiratory system. ● Helps achieve peak bone mass in young adults and
● Maintains better muscle tone, muscular strength, and maintain bone mass later in life, thereby decreasing the
endurance. risk for osteoporosis.
● Improves muscular flexibility. ● Helps people sleep better.
● Enhances athletic performance. ● Helps prevent chronic back pain.
● Helps maintain recommended body weight. ● Relieves tension and helps in coping with life stresses.
● Helps preserve lean body tissue. ● Raises levels of energy and job productivity.
● Increases resting metabolic rate. ● Extends longevity and slows the aging process.
● Improves the body’s ability to use fat during physical ● Improves and helps maintain cognitive function,
activity. decreasing the risk for dementia and Alzheimer’s disease.
● Improves posture and physical appearance. ● Promotes psychological well-being, including higher
● Improves functioning of the immune system. morale, self-image, and self-esteem.
● Lowers the risk for chronic diseases and illnesses ● Reduces feelings of depression and anxiety.
(including heart disease, stroke, and certain cancers). ● Encourages positive lifestyle changes (improving nutri-
● Decreases the mortality rate from chronic diseases. tion, quitting smoking, controlling alcohol and drug use).
● Thins the blood so that it doesn’t clot as readily, ● Speeds recovery time following physical exertion.
thereby decreasing the risk for coronary heart disease ● Speeds recovery following injury or disease.
and stroke. ● Regulates and improves overall body functions.
● Helps the body manage blood lipid (cholesterol and ● Improves physical stamina and counteracts chronic fatigue.
triglyceride) levels more effectively. ● Retards creeping frailty, reduces disability, and helps to
● Prevents or delays the development of high blood pressure maintain independent living in older adults.
and lowers blood pressure in people with hypertension. ● Enhances quality of life: People feel better and live a
● Helps prevent and control type 2 diabetes. healthier and happier life.
table 1.2 Immediate (acute) benefits of exercise

You can expect a number of benefits as a result of a single exercise session. Some of these benefits last as long as 72 hours following your workout. Exercise:
● Increases heart rate, stroke volume, cardiac output, ● Increases fat storage in muscle, which can then be burned for energy.
pulmonary ventilation, and oxygen uptake. ● Improves endothelial function. (Endothelial cells line the entire
● Begins to strengthen the heart, lungs, and muscles. vascular system, which provides a barrier between the vessel
● Enhances metabolic rate or energy production (burning lumen and surrounding tissue—endothelial dysfunction contrib-
calories for fuel) during exercise and recovery. (For utes to several disease processes, including tissue inflammation
every 100 calories you burn during exercise, you can and subsequent atherosclerosis.)
expect to burn another 15 during recovery.) ● Enhances mood and self-worth.
● Uses blood glucose and muscle glycogen. ● Provides a sense of achievement and satisfaction.
● Improves insulin sensitivity (decreasing the risk of type ● Decreases blood pressure the first few hours following exercise.
2 diabetes). ● Decreases arthritic pain.
● Immediately enhances the body’s ability to burn fat. ● Leads to muscle relaxation.
● Lowers blood lipids. ● Decreases stress.
● Improves joint flexibility. ● Improves brain function.
● Reduces low-grade (hidden) inflammation ● Promotes better sleep (unless exercise is performed too close to
(see pages 80, 437, and 449). bedtime).
● Increases endorphins (hormones), which are naturally ● Improves digestion.
occurring opioids that are responsible for exercise- ● Boosts energy levels.
induced euphoria. ● Improves resistance to infections.
of physical exercise.” Furthermore, researchers and sports analysis looked at the short-term boost of exercise on aca-
medicine leaders have stated that if the benefits of exercise demics. After reviewing the results from 19 different studies
could be packaged in a pill, it would be the most widely pre- of children to young adults, researchers found that students
scribed medication throughout the world today. who had 20 minutes of exercise immediately preceding a test
While most of the chronic (long-term) benefits of exercise or giving a speech had higher academic performance and
are well-established, what many people fail to realize is that better focus than those who did not exercise.27 Exercise has
there are immediate benefits derived by participating in just proven to make us more clearheaded.
one single bout of exercise. Most of these benefits dissipate Emerging research shows that exercise allows the brain to
within 48 to 72 hours following exercise. The immediate ben- function at its best through a combination of biological reac-
efits, summarized in Table 1.2, are so striking that it prompted tions. First, exercise increases blood flow to the brain, providing
Dr. William L. Haskell of Stanford University to state: “Most oxygen, glucose, and other nutrients and improving the re-
of the health benefits of exercise are relatively short term, so moval of metabolic waste products. The increased blood and
people should think of exercise as a medication and take it on oxygen flow also prompt the release of the protein Brain-
a daily basis.” Of course, as you regularly exercise a minimum Derived Neurotrophic Factor (BDNF). This protein works by
of 30 minutes five times per week and maintain a certain strengthening connections between brain cells and repairing
amount of physical activity throughout the day, you will real- any damage within them. BDNF also stimulates the growth of
ize the impressive long-term benefits listed in Table 1.1. new neurons in the hippocampus, the portion of the brain in-
volved in memory, planning, learning, and decision making.
The hippocampus is one of only two parts of the adult brain
Exercise and Brain Function where new cells can be generated. The connections strength-
Exercise affects brain function and academic performance. ened by BDNF are critical for learning to take place and for
Physical activity is related to better cognitive health and effective memories to be stored. Exercise provides the necessary stimu-
functioning across the lifespan. While much of the research is lus for brain neurons to interconnect, creating the perfect envi-
still in its infancy, even in 400 years bc, the Greek philosopher ronment in which the brain is ready and able to learn.28
Plato stated: “In order for man to succeed in life, God provided Exercise also increases the neurotransmitters dopamine,
him with two means, education and physical activity. Not sepa- glutamate, norepinephrine, and serotonin, all of which are
rately, one for the soul and the other for the body, but for the two vital in the generation of thought and emotion. Low levels of
together. With these two means, man can attain perfection.” serotonin have been linked to depression, and exercise has
Data on more than 2.4 million students in the state of Texas repeatedly been shown to be effective in treating depression.
have shown consistent and significant associations between The hippocampus tends to shrink in late adulthood, lead-
physical fitness and various indicators of academic achieve- ing to memory impairment. In older adults, regular aerobic
ment; in particular, higher levels of fitness were associated exercise has been shown to increase the size of the hippocam-
with better academic grades. Cardiorespiratory fitness was pus and decrease the rate of brain shrinkage, dramatically
shown to have a dose-response association with academic minimizing declines in thinking and memory skills.
performance (better fitness and better grades), independent Physical activity appears to be the most important lifestyle
of other sociodemographic and fitness variables.26 Another change a person can make to prevent dementia and Alzheimer’s
later in life. Researchers have been surprised by the strength of

the association between exercise and these conditions. Even
1.6 Sitting Disease: A 21st-Century
light-intensity activities of daily living appear to provide protec- Chronic Disease
tion against cognitive impairment. The research further shows
that as the amount of activity increases, the rate of cognitive The human body requires time to recover (sit and sleep) from
decline decreases. And the amount of daily activity performed labor, tasks, and other typical daily activities. Most Ameri-
appears to be more important than the intensity itself in terms of cans, however, sit for way too many hours each day. On aver-
warding off dementia. Additionally, maintaining a high level of age, people spend about 8 hours per day or more of their
physical fitness in mid-life can reduce a person’s chances of devel- waking time sitting. Prolonged sitting is unnatural to the
oping Alzheimer’s by half, and dementia by 60 percent.29 body, and research now indicates that too much sitting is
Keeping the mind engaged with proactive cognitive chal- hazardous to human health and has a direct link to premature
lenges like reading, studying, playing games, and doing puz- mortality.30 Some organizations have suggested that exposure
zles is critical (but not passive TV watching). Consumers to sitting time be treated like any other deadly risk factor,
should be wary of modern brain training apps and games such as excessive sun exposure. Although not recognized by
because many tout benefits that are not supported by the cur- the medical community as a diagnosable illness, the scientific
rent scientific consensus. Further, physical activity and exer- community has coined the term “sitting disease” as a chronic
cise have been shown to provide better protection than intel- 21st-century disease.
lectual challenges themselves. Of course, the greatest The data indicate that the risks that come with sitting are
protection is obtained by combining both physical and cogni- independent from those related to physical activity levels.
tive challenges, along with an active social life. Like the gas or the brake pedal on a car, physical activity or
Which type of exercise is best for the brain? Most of the prolonged sitting each act upon human physiology in their
research on brain health has been done with aerobic exercise. own, independent way. Therefore, even individuals who exer-
Although nonaerobic exercise and brain health research is cise five times per week for at least 30 minutes but otherwise
still in its infancy, preliminary data on animal research do not spend most of the day sitting are accruing health risks.
support either high-intensity interval training or strength- This cause and effect has played out in numerous studies.
training with hippocampus development (as seen with sus- In one particular study, healthy young men who normally
tained moderate-intensity aerobic exercise). This is not to say accrued 10,000 steps per day were instructed to become sed-
that one should stop high-intensity interval training or entary and keep daily step count under 1,500 for two weeks.
strength-training—which, in and of themselves, provide a Within this short 2-week time span, these young men started
myriad of health benefits,—but it reinforces the need for a to develop metabolic problems, including reduced insulin
balanced fitness program that incorporates all training mo- sensitivity and increased abdominal fat (see Chapter 4,
dalities, including flexibility exercises as well. pages 141–142 for an overview of health risks associated with
increased abdominal fat).31
Our bodies are simply not designed for extended periods
of sitting. As we sink into inactivity, our biological processes
begin to change, down to a cellular and molecular level. Re-
searchers are only beginning to understand all of the factors
at work, but studies show, for example, that blood flow be-
comes sluggish and is more likely to form life-threatening
clots in the lungs and legs. Arteries lose flexibility and have a
lower capacity to expand and relax.32 Slower blood flow
means less oxygen and glucose delivered to the brain and
body, and as a result, cognitive function declines and the feel-
ing of fatigue increases. Additionally, during extended sitting,
cells in idle muscles don’t respond to insulin (when a person
is active, skeletal muscles are responsible for 80 percent of
glucose disposal); thus, insulin resistance increases along
with the accompanying risk for diabetes and cardiovascular
disease. When sitting, the level of triglycerides (blood fats)
jumps because inactive muscles also stop producing an en-
zyme (lipoprotein lipase) that usually captures these fats from

the blood in order to turn them into fuel. Even HDL choles-
terol levels (the good cholesterol) drop by 20 percent after as
little as 1 hour of uninterrupted sitting.
When we are sitting, some of the largest muscles in our
No current drug or medication provides as many health benefits as body, including leg and hip muscles, are relaxed and inactive.
a regular physical activity program. By simply standing up, we immediately activate these
Figure 1.8 the importance of nonexercise activity thermogenesis (nEAt) and exercise.
−250 calories
from exercise
−350 calories from

exercise and NEAT

exercise and NEAT

exercise and NEAT
Types of activity: Planned Exercise NEAT Sedentary
muscles. They work to keep us upright, requiring blood sugar Most people do not realize how much time they spend sit-
to fuel themselves. They further release an enzyme that cap- ting on a given day. Think about the seats you sit in every day
tures triglycerides (fatty acids) from the blood to help keep and how much time you spend in each: driving to and from
cholesterol levels in check and also help regulate other meta- school or work; sitting in classes or working at the office; eat-
bolic processes. The simple act of repeatedly standing and ing meals, doing homework, or enjoying your typical recre-
moving throughout the day can change disease risk. Further, ational hours watching shows and catching up with friends
remaining inactive following meals makes blood glucose lev- online (see Figure 1.8). We can easily accumulate 8 to 12
els spike. A slow stroll after a meal can cut this blood glucose sitting hours and spend the majority of our day in the seated
spike in half. Inactivity further appears to switch on or off position, with only the chair beneath us changing.
dozens of genes that trigger additional risk factors.
Death rates are high for people who spend most of their day
HoEGEr KEY to WELLnESS
sitting, even though they meet the minimum physical activity
recommendations on a weekly basis. The data show that: By being more active throughout the day and
avoiding excessive sitting, people can increase their
● Sitting for more than 3 hours per day cuts off two years daily energy (caloric) expenditure by the equivalent
of life, even if you regularly exercise and avoid unhealthy of a 7-mile run. they will also increase years of healthy
habits like smoking. life expectancy.
● People who spend most of their day sitting have as much
as a 50 percent greater risk of dying prematurely from all
causes and an 80 percent greater risk of dying from cardio- You can fight sitting disease by taking actions to break up
vascular disease. Excessive sitting is the “new smoking.” periods of inactivity and by becoming more physically active.
The risk of a heart attack in people who sit most of the day The key is to sit less and move more. To minimize inactivity
is almost the same as that of smokers. when you have limited time and space, look for opportunities
● Inactive adults over age 60 are at almost 50 percent to increase daily physical activity:
greater odds of disability for each additional hour they
1. Walk or bike instead of drive for short distances.
sit per day.33
● Prolonged daily sitting time is an underestimated risk 2. Park farther or get off public transit several blocks from
factor for cancer. Too much sitting has been estimated the campus or office. At the office, walk to the furthest
to cause 91,000 cancer deaths each year in the United bathroom rather than the nearest.
States alone (49,000 breast cancers and 42,000 colon 3. Take a short walk after each meal or snack. Stand up and
cancers). move for 1 minute every time you take a drink of water.
● Less sitting means greater comfort. Study participants 4. Walk faster than usual.
who reduced their sitting time by 66 minutes a day
reported feeling less fatigued and more energetic, GLOSSARY
focused, productive, and comfortable and reported Skeletal muscle The type of muscle that powers body movement.
less back and neck pain.34
5. Take the stairs often.

6. When watching a show, stand up and move during each
commercial break, or even better, stretch or work out
while watching. When working or watching a show,
drink plenty of water, which is not only healthy on its
own but will give you extra reasons to take a walk for
refills and bathroom breaks.
7. Do not shy away from housecleaning chores or yard
work, even for a minute or two at a time.
8. Stand more while working/studying. Place your computer
on an elevated stand or shelf.
9. Make a habit to stand or pace while talking on the phone.
10. Make a habit to walk or pace when you need to puzzle

through a problem.
11. Break up sitting by closing your office door, if possible,
and spending 1 minute doing a full-body exercise, such
as holding a plank position or doing slow squats into
and out of your chair.
12. When you accomplish a difficult task at work or while
during homework, stand up and give yourself a mini
victory parade or victory dance.
13. When reading a book, get up and move after every 6 to
10 pages of the book.
iStockphoto.com/mediaphotos
14. Use a stability ball for a chair. Such use enhances body
stability, balance, and abdominal, low back, and leg
strength.
15. Whenever feasible, walk while conversing or holding
meetings. If meetings are in a conference room, take
the initiative to stand. Make telephone conference calls
An active lifestyle increases health, quality of life, and longevity.
an opportunity for a stroll.
16. Walk to classmates’ homes or coworkers’ offices to
study or discuss matters with them instead of using the structured, and repetitive bodily movement to improve or
phone, e-mail, or computer. maintain one or more components of physical fitness. Exam-
ples of exercise are walking, running, cycling, doing aerobics,
Researchers are still working to come to a consensus
swimming, and strength training. Exercise is usually viewed as
about the ideal prescription of activity to break up sitting.
an activity that requires a vigorous-intensity effort.
As little as 2 minutes of gently walking around the room per
Physical activity is bodily movement produced by skeletal
hour has been shown to cut disease risk by one third.35 The
muscles. It requires energy expenditure and produces pro-
best current guideline seems to be to stand and stretch after
gressive health benefits. Physical activity can be of light in-
every 20 minutes of inactivity and to take intermittent 5- to
tensity or moderate to vigorous intensity. Examples of daily
10-minute breaks for every hour that you are at the com-
light physical activity include walking to and from work,
puter or studying or participating in any type of uninter-
taking the stairs instead of elevators and escalators, grocery
rupted sitting. Stretching, walking around, or talking to
shopping, and doing household chores. Physical inactivity, by
others while standing or walking is beneficial and increases
contrast, implies a level of activity that is lower than that re-
oxygen flow to the brain, making you more effective, cre-
quired to maintain good health.
ative, and productive.
Extremely light expenditures of energy throughout the day
used to walk casually, perform self-care, or do other light work
1.7 Physical Activity and like emptying a dishwasher are of far greater significance in
our overall health than we once realized. We now understand
Exercise Defined the impact of accumulating constant/small movements. Every
movement conducted throughout the day matters.
Abundant scientific research over the past three decades has To better understand the impact of all intensities of physical
established a distinction between physical activity and exer- activity, scientists created a new category of movement called
cise. Exercise is a type of activity that requires planned, nonexercise activity thermogenesis (NEAT).36 Any energy
expenditure that does not come from basic ongoing body

functions (such as digesting food) or planned exercise is cat- Light, Moderate, and Vigorous Physical Activity
egorized as NEAT. A person, on an average day, may expend
Adults should do 1 MET
1300 calories simply maintaining vital body functions (the
150 minutes a
basal metabolic rate) and 200 calories digesting food (thermic
effect of food). Any additional energy expended during the week of moderate-
day is expended either through exercise or NEAT. For an ac- intensity physical Sleeping
tive person, NEAT accounts for a major portion of energy activity, 75 minutes 2 METs
expended each day. Though it may not increase cardiorespira- a week of vigorous-
Extremely light
tory fitness as moderate or vigorous exercise will, NEAT can intensity physical physical activity
easily use more calories in a day than a planned exercise ses- activity, or an equiv-
Self care
sion. As a result, NEAT is extremely critical for keeping daily alent combination
energy balance in check. Especially when beginning or inten- 3 METs
of moderate- and
sifying an exercise program, some individuals tend to adjust vigorous-intensity Light physical
other activities of daily living, so they sit more and move less aerobic physical
activity
during the remainder of the day. This self-defeating behavior Washing dishes
activity. Adults
can lead to frustration that exercise is not providing the weight 4 METs
should also strive
management benefits it should. It is important to keep daily
NEAT levels up regardless of exercise levels. to incorporate light
A growing number of studies are showing that the body is physical activity
much better able to maintain its energy balance—and, there- into daily life as Moderate physical Yard work
often as possible. activity 5 METs
fore, keep body weight at a healthy level—when overall daily
activity level is high. An active person can vary calories from Intensity of physi-
day to day with fewer swings in body weight, while a seden- cal activity can
tary person who changes caloric intake will see those changes be measured in Brisk walking
amplified, observed by greater swings in body weight. METs. MET stands 6 METs
A person with a desk job who has the option to stand and for metabolic
move about throughout the day will expend 300 more calories equivalent. The
a day than a person who sits at the desk most of the day. People
baseline measure- Biking
who spend most of the day working on their feet, such as a
ment is a single
medical assistant or a stay-at-home parent, expend 700 daily 7 METs
calories more than a person with a sedentary desk job. People MET. One MET is the
with physically demanding jobs, such as construction workers, amount of oxygen
can easily burn 1,600 daily calories over a sedentary worker.37 utilized by a person
Vigorous physical Swimming
Beyond the workday are several hours of leisure time that can when resting. An activity 8 METs
also be spent quite differently on a vast variety of physical ac- activity that has
tivities, from activities that are light physical activity to sports the intensity of two
and exercise that is vigorous physical activity. Variations in METs utilizes double
NEAT add up over days, months, and years and provide sub- that amount of oxy- Racquetball
stantial benefits with weight management and health. gen. An activity that 10 METs
Regular moderate physical activity provides substantial has the intensity of
benefits in health and well-being for the vast majority of
three METs utilizes
people who are not physically active. For those who are al-
triple, and so on. Running
ready moderately active, even greater health benefits can be
achieved by increasing the level of physical activity.
GLOSSARY
Exercise A type of physical activity that requires cleaning the house, shoveling snow, washing Vigorous physical activity Any exercise that
planned, structured, and repetitive bodily move- the car, and all forms of structured exercise. requires a MET level equal to or greater than 6
ment with the intent of improving or maintaining Light physical activity Any activity that uses METs (21 mL/kg/min). One MET is the energy ex-
one or more components of physical fitness. less than 150 calories of energy per day, such as penditure at rest, 3.5 mL/kg/min, and METs are
Physical activity Bodily movement produced casual walking and light household chores. defined as multiples of this resting metabolic
by skeletal muscles, which requires expenditure rate. (Examples of activities that require a
Nonexercise activity thermogenesis
of energy and produces progressive health bene- 6-MET level include aerobics, walking uphill at
(NEAT) Energy expended doing everyday activi-
fits. Examples include walking, taking the stairs, 3.5 mph, cycling at 10 to 12 mph, playing dou-
ties not related to exercise.
dancing, gardening, working in the yard, bles in tennis, and vigorous strength training.)
Moderate physical activity has been defined as any activ- Figure 1.10 Motor skill–related components of physical fitness.
ity that requires an energy expenditure of 150 calories per
day, or 1,000 calories per week. Examples of moderate physi-
cal activity are brisk walking or cycling, playing basketball or Coordination
volleyball, recreational swimming, dancing fast, pushing a
stroller, raking leaves, shoveling snow, and gardening. Agility Speed
Light physical activity (along with moderate physical activi-
ties lasting less than 10 minutes in duration) is not included as Balance Power
part of the moderate physical activity recommendation, Reaction
though it is included as part of one’s NEAT for a given day. time
1.8 Types of Physical Fitness

As the fitness concept grew, it became clear that several spe-
cific components contribute to an individual’s overall level of !
fitness. Physical fitness is classified into health-related and Critical Thinking
skill-related fitness. What role do the four health-related components of physical
Health-related fitness relates to the ability to perform ac- fitness play in your life? Rank them in order of importance to
tivities of daily living without undue fatigue. The health-related you and explain the rationale you used.
fitness components are cardiorespiratory (aerobic) endurance,
muscular fitness (muscular strength and endurance), muscular
flexibility, and body composition (Figure 1.9). Skill-related fitness components consist of agility, balance,
coordination, reaction time, speed, and power (Figure 1.10).
Figure 1.9 Health-related components of physical fitness. These components are related primarily to successful sports and
motor skill performance. Participating in skill-related activities
contributes to physical fitness, but in terms of general health
Cardiorespiratory promotion and wellness, the main emphasis of physical fitness
endurance
programs should be on the health-related components.
1.9 Fitness Standards: Health

Muscular
versus Physical Fitness
flexibility
Our bodies adapt to the different types of physical activity we
participate in, and the result is different levels of personal fit-
ness. A meaningful debate regarding fitness standards has
resulted in two widely recognized categories of fitness: health
Body
composition
Photos © Fitness & Wellness, Inc.
Muscular fitness
(strength and
endurance) Good health-related fitness and skill-related fitness are required to
participate in highly skilled activities.
Figure 1.11 Health and fitness benefits based on type of lifestyle and physical activity program.
Low fitness Health/physiologic fitness High physical fitness

Sedentary Active lifestyle Active lifestyle and exercise
High
FITNESS HEALTH
BENEFITS Low
BENEFITS
High
Low
None Moderate High
INTENSITY
Source: Fitness & Wellness, Inc.
fitness standards (also referred to as criterion referenced) and weight loss or improvement in aerobic capacity. Metabolic
physical fitness standards. Following are definitions of both. fitness can be attained through an active lifestyle and moder-
The assessment of health-related fitness is presented in Chap- ate-intensity physical activity.
ters 4, 6, 7, 8, and 9, where appropriate physical fitness stan- One way to determine a person’s fitness level is by assessing
dards are included for comparison. his or her cardiorespiratory endurance, which can be ex-
pressed in terms of VO2max. Essentially, as a person moves or
Health Fitness Standards exercises more, the body adapts so that it is able to take in
more oxygen and better utilize the oxygen it takes in. Specific
The health fitness standards proposed here are based on
changes occur in the heart, lungs, and muscles to make this
data linking minimum fitness values to disease prevention
possible (see Chapter 6). The maximum (max) amount of
and health. Attaining the health fitness standard is conducive
oxygen (O2) that a person is able to use is measured in volume
to a low risk of premature hypokinetic diseases and requires
(V) per minute of exercise. A person’s VO2max is commonly
only moderate physical activity. For example, a 2-mile walk in
expressed in milliliters (mL) of oxygen (volume of oxygen)
less than 30 minutes, five or six times a week, seems to be
per kilogram (kg) of body weight per minute (mL/kg/min).
sufficient to achieve the health-fitness standard for cardiore-
Individual values of VO2max can range from about 10 mL/
spiratory endurance.
kg/min in cardiac patients to more than 80 mL/kg/min in
As illustrated in Figure 1.11 and as discussed earlier, signifi-
world-class runners, cyclists, and cross-country skiers.
cant health benefits can be reaped with such a program. These
benefits include reduction in blood lipids, lower blood pressure,
weight loss, stress release, less risk for diabetes, and lower risk
for disease and premature mortality. Fitness improvements, HoEGEr KEY to WELLnESS
expressed in terms of maximum oxygen uptake, or VO2max Individual Vo2max values can range from about
(explained next and in Chapter 6), are not as notable. Neverthe- 10 mL/kg/min in cardiac patients to more than
less, health improvements are quite striking. 80 mL/kg/min in world-class athletes. Aim for values of
More specifically, improvements in the metabolic profile 35 and 32.5 mL/kg/min to reach health fitness standards and
(measured by insulin sensitivity, glucose tolerance, and im- benefit from metabolic fitness.
proved cholesterol levels) can be notable despite little or no
GLOSSARY
Moderate physical activity Activity that Skill-related fitness Fitness components im- assess risk for diabetes and cardiovascular
uses 150 calories of energy per day, or 1,000 portant for success in skillful activities and ath- disease.
calories per week. letic events; encompasses agility, balance, coor- Cardiorespiratory endurance The ability
Physical fitness The ability to meet the ordi- dination, reaction time, speed, and power. of the lungs, heart, and blood vessels to deliver
nary, as well as unusual, demands of daily life Health fitness standards The lowest fitness adequate amounts of oxygen to the cells to
safely and effectively without being overly requirements for maintaining good health, decreas- meet the demands of prolonged physical
fatigued and still have energy left for leisure ing the risk for chronic diseases, and lowering the activity.
and recreational activities. incidence of muscular–skeletal injuries.
Health-related fitness Fitness programs pre- Metabolic profile A measurement of plasma
scribed to improve the individual’s overall health. insulin, glucose, lipid, and lipoprotein levels to
Research data from the study presented in Figure 1.7 most of life’s daily and recreational activities to their fullest
reported that achieving VO2max values of 35 and 32.5 mL/kg/ potentials. Current health fitness standards may not be
min for men and women, respectively, may be sufficient to enough to achieve these objectives.
lower the risk for all-cause mortality significantly. Although Sound physical fitness gives the individual a degree of in-
greater improvements in fitness yield an even lower risk for dependence throughout life that many people in the United
premature death, the largest drop is seen between least fit and States no longer enjoy. Most adults should be able to carry out
moderately fit individuals. Therefore, the 35 and 32.5 mL/kg/ activities similar to those they conducted in their youth,
min values are selected as the health fitness standards. though not with the same intensity. These standards do not
require being a championship athlete, but activities such as
changing a tire, chopping wood, climbing several flights of
Physical Fitness Standards stairs, playing basketball, mountain biking, playing soccer
Physical fitness standards are set higher than health fitness with children or grandchildren, walking several miles around
standards and require a more intense exercise program. a lake, and hiking through a national park do require more
Physically fit people of all ages have the freedom to enjoy than the current “average fitness” level of most Americans.
Behavior Modification Planning

financial fitness Prescription 5. Pay yourself first; save 10 percent of your income each month.
Although not one of the components of physical fitness, taking Before you take any money out of your paycheck, put 10 percent
control of your personal finances is critical for your success and of your income into a retirement or investment account. If pos-
well-being. The sooner you start working on a lifetime personal sible, ask for an automatic withdrawal at your bank from your
financial plan, the more successful you will be in becoming paycheck to avoid the temptation to spend this money. This
financially secure and being able to retire early, in comfort, if you strategy may allow you to have a solid retirement fund or even
choose to do so. Most likely, you have not been taught basic prin- provide for an early retirement. If you start putting away $100 a
ciples to improve personal finance and enjoy “financial fitness.” month at age 20, and earn a modest 6 percent interest rate, at
Thus, start today using the following strategies: age 65 you will have more than $275,000.
1. Develop a personal financial plan. Set short-term and long- 6. Set up an emergency savings fund. Whether you ultimately
term financial goals for yourself. If you do not have financial work for yourself or for someone else, there may be uncontrol-
goals, you cannot develop a plan or work toward that end. lable financial setbacks or even financial disasters in the
2. Subscribe to a personal finance magazine or newsletter. In the future. So, as you are able, start an emergency fund equal to
same way that you should regularly read reputable fitness/ 3 to 6 months of normal monthly earnings. Additionally, start
wellness journals or newsletters, you should regularly peruse a second savings account for expensive purchases such as a
a “financial fitness” magazine. If you don’t enjoy reading car, a down payment on a home, or a vacation.
financial materials, then find a periodical that is quick and 7. Use credit, gas, and retail cards responsibly and sparingly. As
to the point; there are many available. You don’t have to force soon as you receive new cards, sign them promptly and store
yourself to read The Wall Street Journal to become financially them securely. Due to the prevalence of identity theft (some-
knowledgeable. Many periodicals have resources to help you one stealing your creditworthiness), cardholders should even
develop a financial plan. Educate yourself and stay current on consider a secure post office box, rather than a regular mail-
personal finances and investment matters. box, for all high-risk mail. Shred your old credit cards, monthly
3. Set up a realistic budget and live on less than you make. Pay statements, and any and all documents that contain personal
your bills on time and keep track of all expenses. Then de- information to avoid identity theft. Pay off all credit card debt
velop your budget so that you spend less than you earn. Your monthly, and do not purchase on credit unless you have the
budget may require that you either cut back on expenses and cash to pay it off when the monthly statement arrives. Develop
services or figure out a way to increase your income. Balance a plan at this very moment to pay off your debt if you have
your checkbook regularly and do not overdraft your checking such. Credit card balances, high interest rates, and frequent
account. Remind yourself that satisfaction comes from being credit purchases lead to financial disaster. Credit card debt is
in control of the money you earn. the worst enemy to your personal finances!
4. Learn to differentiate between wants and needs. It is fine to 8. Understand the terms of your student loans. Do not borrow
reward yourself for goals that you have achieved (see Chapter more money than you absolutely need for actual educational
2), but limit your spending to items that you truly need. Avoid expenses. Student loans are not for wants but needs (see item
simple impulse spending because “it’s a bargain” or some- 4). Remember, loans must be repaid, with interest, once you
thing you just want to have. leave college. Be informed regarding the repayment process
Behavior Modification Planning (continued)

and do not ever default on your loan. If you do, the entire bal- 13. Protect your assets. As you start to accumulate assets, get prop-
ance (principal, interest, and collection fees) is due immedi- er insurance coverage (yes, even renter’s insurance) in case of
ately and serious financial and credit consequences will follow. an accident or disaster. You have disciplined yourself and worked
9. Complete your college education. The gap is widening be- hard to obtain those assets; now make sure they are protected.
tween workers who have and have not graduated from col- 14. Review your credit report. The best way to ensure that your
lege. On average, those whose education ends with their high credit “identity” is not stolen and ruined is to regularly review
school diploma bring home a paycheck that is 62 percent of your credit report, at least once a year, for accuracy.
the paycheck of their peers with a bachelor’s degree. Even 15. Contribute to charity and the needy. Altruism (doing good for
with rising tuition costs, this investment of time and money is others) is good for heart health and emotional well-being.
a financially sound choice. Of the two-thirds of students who Remember the less fortunate and donate regularly to some of
take on student loans to complete their degree, 86 percent
your favorite charitable organizations and volunteer time to
agree the degree pays off.
worthy causes.
10. Eat out infrequently. Besides saving money that you can then pay
to yourself, you will eat healthier and consume fewer calories. the Power of investing early
11. Make the best of tax “motivated” savings and investing op- Jon and Jim are both 20 years old. Jon begins investing $100 a
portunities available to you. For example, once employed, your month starting on his 20th birthday. He stops investing on his
company may match your voluntary 401(k) contributions (or 30th birthday (he has set aside a total of $12,000). Jim does
other retirement plan), so contribute at least up to the match not start investing until he’s 30. He chooses to invest $100 a
(you may use the 10 percent you “pay yourself first”—see item month as Jon had done, but he does so for the next 30 years
5—or part of it). Also, under current tax law, maximize your (Jim invests a total of $36,000). Although Jon stopped invest-
Roth IRA contribution personally. Always pay attention to cur- ing at age 30, assuming an 8 percent annual rate of return in
rent tax rules that provide tax incentives for investing in retire- a tax-deferred account, by the time both Jon and Jim are 60,
ment plans. If at all possible, never cash out a retirement Jon will have accumulated $199,035, whereas Jim will have
account early. You may pay penalties in addition to tax, in most $150,029. At a 6 percent rate of return, they would both accu-
situations. As you are able, employ a tax professional or finan- mulate about $100,000, but Jim invested three times as much
cial planner to avoid serious missteps in your tax planning. as Jon did.
Post these principles of financial fitness in a visible place at
12. Stay involved in your financial accumulations. You may seek
home where you can review them often. Start implementing these
professional advice, but you stay in control. Ultimately, no
strategies as soon as you can and watch your financial fitness
one will look after your interests as well as you. Avoid placing
level increase over the years.
all your trust (and assets) in one individual or institution.
Spreading out your assets is one way to diversify your risk. © David Johnson, CPA and Fitness & Wellness, Inc.
Which Program Is Best? complement the current Dietary Guidelines for Americans
(Chapter 3, pages 128–130) and parallel the international
Your own personal objectives will determine the fitness program recommendations issued by the World Health Organization
you decide to use. If the main objective of your fitness program (WHO)38 and recommendations issued by the American
is to lower the risk for disease, attaining the health fitness stan- College of Sports Medicine (ACSM) and the American Heart
dards will provide substantial health benefits. If, however, you Association (AHA).39
want to participate in vigorous fitness activities, achieving a high The federal guidelines provide science-based guidance on
physical fitness standard is recommended. This book gives both the importance of being physically active to promote health
health fitness and physical fitness standards for each fitness test and reduce the risk for chronic diseases. The federal guide-
so that you can personalize your approach. lines include the following recommendations.
1.10 Federal Guidelines

for Physical Activity GLOSSARY
Physical fitness standards A fitness level that allows a person to

Because of the importance of physical activity to our health, sustain moderate-to-vigorous physical activity without undue fatigue and
the U.S. Department of Health and Human Services issued the ability to closely maintain this level throughout life.
Physical Activity Guidelines for Americans. These guidelines
table 1.3 Physical activity guidelines
Benefits Duration Intensity Frequency per Week Weekly Time
Health 30 min MI* 5 times 150 min

Health and fitness 20 min VI* 3 times 75 min
Health, fitness, and weight gain prevention 60 min MI/VI† 5–7 times 300 min
Health, fitness, and weight regain prevention 60–90 min MI/VI† 5–7 times 450 min
*MI = moderate intensity, VI = vigorous intensity

†
MI/VI = You may use MI or VI or a combination of the two
Adults between 18 and 64 Years of Age Pregnant and Postpartum Women

Adults should do 150 minutes a week of moderate-
● ●Healthy women who are not already doing vigorous-
intensity aerobic (cardiorespiratory) physical activity, intensity physical activity should get at least
75 minutes a week of vigorous-intensity aerobic physical 150 minutes of moderate-intensity aerobic activity
activity, or an equivalent combination of moderate- and a week. Preferably, this activity should be spread
vigorous-intensity aerobic physical activity (also see throughout the week. Women who regularly engage
Chapter 6). Moderate physical activity should preferably in vigorous-intensity aerobic activity or high amounts
be divided into 30-minute segments over a minimum of of activity can continue their activity provided that
5 days each week (Table 1.3). Although 30 minutes of their condition remains unchanged and they talk to
continuous moderate physical activity is preferred, on their health care provider about their activity level
days when time is limited, three activity sessions of at throughout their pregnancy.
least 10 minutes each still provide substantial health ben- Because of the ever-growing epidemic of obesity in the
efits. When combining moderate- and vigorous-intensity United States and the world, adults are encouraged to in-
activities, a person could participate in moderate- crease physical activity beyond the minimum requirements
intensity activity twice a week for 30 minutes and high- and adjust caloric intake until they find their personal bal-
intensity activity for 20 minutes on another 2 days. ance to maintain a healthy weight.40 Individuals are also ad-
Additional health benefits are provided by increasing to vised that additional physical activity beyond minimum
●
5 hours (300 minutes) a week of moderate-intensity thresholds is necessary for some and can provide additional
aerobic physical activity, 2 hours and 30 minutes a week health benefits for all.
of vigorous-intensity physical activity, or an equivalent The latest Physical Activity Guidelines for Americans
combination of both. issued by the U.S. Department of Health and Human Ser-
Adults should also do muscle-strengthening activities vices have stated that some adults should be able to
●
that involve all major muscle groups on 2 or more days achieve calorie balance with 150 minutes of moderate
per week. physical activity in a week, while others will find they need
more than 300 minutes per week.41 This recommendation
Older Adults (ages 65 and older) was based on evidence indicating that people who main-
Older adults should follow the adult guidelines. If this is tain healthy weight typically accumulate 1 hour of daily
●
not possible due to limiting chronic conditions, older physical activity.42

adults should be as physically active as their abilities al- In sum, although health benefits are derived from 30 min-
low. They should avoid inactivity. Older adults should utes of physical activity performed on most days of the week,
do exercises that maintain or improve balance if they people with a tendency to gain weight need to be physically
are at risk of falling. active for longer, from 60 to as many as 90 minutes daily, to
prevent weight gain. This additional activity per day provides
Children 6 Years of Age and Older and Adolescents additional health benefits, including a lower risk for cardio-
Children and adolescents should do 1 hour (60 minutes) vascular disease and diabetes.
●
or more of physical activity every day. Most of the 1 hour

or more a day should be either moderate- or vigorous-
intensity aerobic physical activity. !
As part of their daily physical activity, children and
●
Critical Thinking
adolescents should do vigorous-intensity activity at Do you consciously incorporate physical activity throughout the
least 3 days per week. They also should do muscle- day into your lifestyle? Can you provide examples? Do you think
strengthening and bone-strengthening activities at you get sufficient daily physical activity to maintain good health?
least 3 days per week.
1.11 Monitoring Daily

Physical Activity
The majority of U.S. adults are not sufficiently physically ac-
tive to promote good health. The most recent data released in
2014 by the Centers for Disease Control and Prevention
(CDC) indicate that only 20.8 percent of U.S. adults 18 and
over meet the federal physical activity guidelines for both
iStockphoto.com/DeanDrobot
aerobic and muscular fitness (strength and endurance) activi-
ties, whereas 49.2 percent meet the guidelines for aerobic
fitness. Another 34 percent of Americans are completely in-
active during their leisure time (Figure 1.12).
Activity trackers are used to monitor daily physical activity; the

Pedometers and Activity Trackers recommendation is a minimum of 10,000 steps per day.
It is important to have an accurate idea of the level of activity
you get in a day because this will be the groundwork from
which you build your fitness goals. You may face an initial features like the ability to vibrate when the user has been
shock, as some of us have, when you see how little daily sedentary too long, to track sleep, or to check heart rate. Fur-
NEAT you accumulate, but remember that accurate data are ther, accompanying smartphone apps provide feedback on
the foundation for results. Studies have found that concrete progress, help set goals, and allow support through online
daily step goals inspire individuals to action. The first trick is social networks. In accuracy tests, accelerometers have shown
choosing the method you will use to track your activity, and an average 15 percent discrepancy from actual activity, a
today’s options abound. similar accuracy record to a good pedometer. Most are worn
Both an activity tracker built specifically for this job and on the wrist versus the hip or foot. While wrist placement is
the average smartphone contain a device called an acceler- not as accurate, most users find it most convenient.
ometer. The accelerometer itself is an inexpensive device that Activity trackers seem to be best at recording straightfor-
simply indicates changes in movement (acceleration and de- ward actions that are part of daily physical activity such as
celeration). Activity trackers add an array of features to that brisk walking or jogging. However, they tend to be inaccurate
functionality. Popular activity trackers not only count your when recording less rhythmic activities, vigorous exercise,
steps and monitor daily movement levels, but also offer overall calories burned, sleep, or other metrics. As you can
imagine, a wrist-worn activity tracker will not do well mea-
suring a grueling bike workout. Both accelerometers and pe-
dometers tend to lose accuracy at a very slow walking speed
Figure 1.12 Percentage of adults who met the 2008 federal
guidelines for physical activity and gender. (slower than 30 minutes per mile) because the movement of
the wrist or vertical movement of the hip is too small. Users
simply need to keep limitations in mind.
60
Men Women
In terms of step accuracy, a good pedometer will offer the
50
same information as an activity tracker for the price of about
53.0
$25 as opposed to $50 or more. For some individuals, the
46.8
40 added features of an activity tracker are worth the added
price. If you opt for an activity tracker, be sure to check reli-
Percent
30 able reviews and weigh the features that are most important
to you before purchasing. Some companies offer different
27.0
25.2 models depending on whether a user is interested in tracking
20
19.1 17.5 daily activity or vigorous exercise. Be sure to follow instruc-
10 tions to calibrate the device to your personal stride. In a
0
Aerobic Muscle Both
strengthening sets GLOSSARY
Guidelines met
Activity tracker An electronic device that contains an accelerome-
Source: cDc, “early release of Selected estimates Based on Data ter (a unit that measures gravity, changes in movement, and counts
From the National Health Interview Survey, 2014,” available at www.cdc footsteps). These devices can also determine distance, calories
.gov/nchs/data/nhis/earlyrelease/earlyrelease201506_07.pdf. burned, speeds, and time spent being physically active.
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of De
Nederlandsche stad- en dorpbeschrijver, Deel
3 (van 8)
This ebook is for the use of anyone anywhere in the United States
and most other parts of the world at no cost and with almost no
restrictions whatsoever. You may copy it, give it away or re-use it
under the terms of the Project Gutenberg License included with
this ebook or online at www.gutenberg.org. If you are not located
in the United States, you will have to check the laws of the country
where you are located before using this eBook.
Title: De Nederlandsche stad- en dorpbeschrijver, Deel 3 (van 8)

Amstelland, Weesper Kerspel, Gooiland, de Loosdrecht
enz.
Author: Lieve van Ollefen
Illustrator: Anna Catharina Brouwer
Release date: November 18, 2023 [eBook #72162]
Language: Dutch
Original publication: Amsteldam: H.A. Banse, 1797
Credits: Jeroen Hellingman and the Online Distributed

Proofreading Team at https://www.pgdp.net/ for Project
Gutenberg (This book was produced from scanned
images of public domain material from the Google Books
project.)
*** START OF THE PROJECT GUTENBERG EBOOK DE

NEDERLANDSCHE STAD- EN DORPBESCHRIJVER, DEEL 3 (VAN
8) ***
[Inhoud]
[1]
[Inhoud]
DE
NEDERLANDSCHE
STAD-
EN
DORP-BESCHRIJVER;
door
L. VAN OLLEFEN.
III. DEEL.
(Amstelland, Weesper Kerspel,

Gooiland, de Loosdrecht enz:)
Het spinwiel, weefgetouw, de drokke

Zeevaardij,
De baggerbeugel, ploeg, de nutte
melkerij,
En vischvangst, doen ons Gooi- en
Amstelland beschouwen,
Wier staat en lot dit boek ons duidlijk zal
ontvouwen.
te Amsteldam, bij H. A. BANSE, in de

Stilsteeg.
1795.
[I]
[Inhoud]
INLEIDING.
BEKNOPTE BESCHRIJVING
VAN
AMSTELLAND
IN ’T ALGEMEEN.
Ofschoon wij hier en daar in ons werk reeds iet van Amstelland in ’t
algemeen gezegd hebben, ter oorzaake wij ons werk stukswijze, ja
zelfs bij zeer kleine gedeelten in ’t licht doen komen, en des
genoodzaakt zijn op deeze of geene plaats zo veel van een Land of
district in ’t algemeen te zeggen, als tot het wèl verstaan der
beschrijvinge van een bijzonder pleksken deszelven vereischt wordt,
zullen wij echter, om aan onze gewoone orde in het zamenstellen van
de boekdeelen des geheelen werks, te blijven beantwoorden, ook hier
de in het hoofd deezer Inleiding gemelde algemeene beschrijving,
laaten voorafgaan.
Wat dan vooreerst betreft de
LIGGING,
Van Amstelland, deeze kan gezegd worden te zijn grenzende ten

noorden, of liever noord-oosten aan het IJ, ten oosten aan de
Muiderban, Weesperkerspel, en de Bijlmermeir; ten zuiden,
zuidoosten, en zuidwesten paalt het aan de Provincie van Utrecht; ten
westen heeft het een gedeelte van Kennemerland: in onze
beschrijving van Amstelveen, bladz. 2. tekenden wij [II]reeds aan hoe
Amstelland, door de rivier den Amstel, in twee deelen gescheiden, en
aan de westzijde Nieuwer-Amstel, aan de oostzijde Ouder-Amstel
genoemd wordt: gezegde rivier neemt zijnen aanvang omtrent drie
uuren ten zuidwesten der stad Amsteldam, naamlijk aan de
zamenvloejing der watertjens de Drecht, de kromme Mijdrecht, of
Miert, loopende voorbij Ouderkerk in en door Amsteldam voornoemd,
in het IJ.
De gezegde ligging is bepaaldlijk die van het Bailluwschap, dat niet

verward moet worden mee het Dijkgraafschap, waarvan nader.
De eigenschap van den grond deezer Landstreek, hebben wij in onze

gemelde beschrijving van Amstelveen reeds opgegeven, men voege
nog bij het geen wij aldaar wegens de voordbrengselen van
Amstelland gezegd hebben, dat er veel moes op gewonnen wordt, die
men meestal te Amsteldam vertiert.
NAAMSOORPRONG.
Deeze moet zekerlijk gezocht worden in de ligging, naamlijk, gelijk wij

gezegd hebben, ter wederzijde van de rivier de Amstel, betekenende
de naam Amstelland derhalven, Land aan den Amstel gelegen; doch
wat de oorsprong van den naam der rivier zelve, (Amstel,) aanbelangt,
desaangaande vinden wij niets aangetekend.
OUDHEID.
In onze meergemelde beschrijving van Amstelveen, (bladz. 2.) zagen

wij reeds hoe Amstelland van ouds niet behoorde onder de
eigendommen van de Hollandsche Graaven, maar eene bijzondere
Heerelijkheid van den huize Van Amstel was, en de Heeren, uit dit
huis, worden reeds op het jaar 1019 genoemd, weshalven men kan
bepaalen dat Amstelland reeds langer dan zeven en een halve eeuw
onder dien naam bestaan heeft. [III]
GROOTTE.
Wat deeze betreft, alvoorens dezelve zo na mogelijk te bepaalen,
moeten wij aantekenen, dat de grootte van Amstelland alleenlijk moet
verstaan worden van het Bailluwschap van dien naam, waarvan wij
ook eigenlijk thans spreeken: want het Hoogheemraadschap van
Amstelland, (waarvan, gelijk gezegd is, straks nader,) beslaat eene
veel grootere uitgebreidheid: onder het Bailluwschap dan behooren de
volgende Ambachten, als dat van
Morgen. Roeden. Huizen.

Ouderkerk beslaande 3504 527 249
Amstelveen 4076 — 1167
Diemen en Diemerdam 1426 367 113
Waverveen 1 114 450 93
Zamen 9122 M. 144 R. 1622 H.
behalven verscheidene Molens.
Men kan derhalven Amstelland, na genoeg, bepaalen te beslaan

eenen grond van meer dan 9100 morgen groot; waarop 1600 huizen
en veele molens gevonden worden.
De gemelde deelen, waaruit Amstelland bestaat, bevatten ieder weder

eenige onderdeden, en wel als volgt: [IV]
Het Ambacht van
Ouderkerk, wordt verdeeld in de Ronde hoep, Groot

Duivendrecht, Klein Duivendrecht, Holendrecht.
Amstelveen, in de Buitenveldersche polder, de Amstelveensche
of Middenpolder, de Bovenkerker polder, de Legmeer, voords in
de buurten, Over Ouderkerk, Waardhuizen, Zwaluwen buurt, de
Nes, de Overtoomsche of Heilige weg, tot aan het gebied van
Amsteldam, de Noorddammer brug, en de Hand van Leiden.
Diemen, in Diemen, Overdiemen, Diemerdam, en Diemerbrug: ten
aanzien van de gadering wordt dit Ambacht ook verdeeld in de
buurten: Bovenkerk, Buitenkerk, Overdiemen en Outersdorp, bij
Zeeburg, of Jaap hannes.
Waverveen, wordt verdeeld in drie polders, naamlijk de Gemeene
polder, of Beoosten Bijleveld, de Hollandsche polder, en
Benoorden de Zuwe.
De gezegde dorpen, hebben, ieder op zig zelf, hooge Jurisdictie, en zit

de Bailluw van Amstelland te recht met Schepenen van ieder dorp,
uitgenomen dat Waverveen, in ’t Crimineele, onder Ouderkerk
behoort.
Het
WAPEN
Van het Bailluwschap van Amstelland, is denkelijk geweest dat van het
geslacht van Amstel: voor het Hoogheemraadschap wordt gebruikt
een rond wapenschild, met een keizerlijke kroon er boven; van achter
hetzelve vertoonen zig de koppen, vleugels en pooten van een
dubbelden arend: in het schild zijn geplaatst de wapens van
Amsteldam, Weesp, Ouderkerk, Amstelveen, Diemen en Waverveen,
als leden van het Hoogheemraadschap.
GEBOUWEN.
Hier onder moeten wij brengen het Gemeenelandshuis, staande op

den dijk bij Jaap Hannis, niet ver van de IJperslooter sluis; wij hebben
hetzelve in onze aantekeningen wegens Diemen, reeds ten breedsten
beschreven: zie aldaar, bladz. 8. enz. [V]
In Amstelland liggen verscheidene
SLUIZEN.
Van welken de voornaamsten zijn
De IJperslooter
sluis
zie over dezelven gemelde onze beschrijving van
—
Diemen. bladz. 9.
Diemerdammer
sluis
REGEERING.
De Graaflijkheid stelt over het Bailluwschap van Amstelland een’

Bailluw aan, zijnde thans (sedert 1787,) de Wel-Ed. Gestr. Heer Mr.
Pieter Elias, Schepen en Raad in de Vroedschap der Stad
Amsteldam, Bewindhebber van de O. I. Compagnie, enz. deeze
vordert, als elders, recht van ’s Heeren wege, gelijk men zulks noemt,
doch omtrent deeze Heerelijkheid is zijne regeering daarin bijzonder,
dat bij geene algemeene vierschaar spant, over het geheele
Bailluwschap, maar in ieder Ambacht der algemeene Heerelijkheid
afzonderlijk, met de Schepenen des Ambachts, die aan hem wegens ’t
Crimineele den eed doen, en wegens het Civile aan den
Ambachtsheer: in de dorpen heeft de Bailluw niets omtrent de
middenbaare of laage jurisdictie te zeggen.
Oudtijds was er een Pluimgraaf over de zwaanen, en een afzonderlijke

Rentmeester; de Bailluw voerde alleen het recht van de jagt, zo als
thans over geheel Amstelland door hem wordt geëxerceerd.
Op wat wijze de Bailluw verkozen wordt, is in onze beschrijving van

Diemen, bladz. 9. reeds gezegd.
Zie wegens de Regeering van het Watergerecht, vervolgends onder

onze afdeeling, ten opschrifte voerende: Het Dijkgraaf- of,
Hoogheemraadschap van Amstelland.
Van de
GESCHIEDENIS
Van Amstelland in ’t algemeen, hebben wij in onze beschrijving van

Amstelveen, meergemeld, (bladz. 2.) reeds iet gezegd; thans zullen
wij er breeder van spreeken: op het jaartal, onder ’t voorgaande art.
Oudheid, genoemd, naamlijk 1019, vindt men wel, gelijk aldaar
gezegd is, van de Heeren Van Amstel gemeld, doch niet in
hoedanigheid van vrije bezitters der [VI]Heerelijkheid van hunnen
naam, maar als Leenmannen der Utrechtsche kerk: in 1155 bezat
Egbert van Amstel de Heerelijkheid van Amstel nog als zodanig,
naamlijk als Leenroerig van Utrecht; hij werd, om zekeren twist met
den Bisschop, gebannen, doch verzoende zig met hem op bevel van
den Keizer, welke zoen echter weder tot nadeel van hem was, want
daarin werd bepaald dat hij het geen hij in Amstel leenroerig bezeten
had, nu slechts als Stedehouder des Bisschops zoude behouden:
deezen zijn zoon, Gijsbrecht de Eerste, Heer van Amstel, vinden
wij echter weder als Leenman van den Bisschop van Utrecht vermeld;
onder de regeering van deezen moest Amstelland, om zijn gedrag in
het bekende geval van Graave Lodewijk van Loon, veel lijden; want
het werd om die reden in 1204, door de Kennemers, die den
Amsteldijk doorgestoken hadden, met rooven en branden geheel
verwoest; dit echter moesten zij naderhand door eene somme gelds
boeten: na dien tijd vinden wij bestendig de Heeren Van Amstel, als
Leenmannen van de Utrechtsche kerk, met betrekking tot hunne
Heerelijkheid Amstelland, genoemd, tot op Gijsbrecht, van wien wij
onder Amstelveen, ter bovengemelde plaatse, gesproken hebben, als
deelgenoot aan den moord van Graave Floris, om welke reden zijne
goederen een volstrekt eigendom van den Graaf werden; daarna is,
gelijk wij ter gemelde plaatse ook zeiden, Amstelland nu eens een
eigendom van de Utrechtsche kerk en dan weder van den Graave van
Holland geweest: Graaf Jan van Avennes gaf ze (gelijk wij in onze
meergemelde beschrijving van Amstelveen, bladz. 12. reeds zeiden,)
aan zijnen broeder Guido van Henegouwen, naderhand Bisschop
van Utrecht, doch na den dood van deezen, trok Willem, de zoon van
Graaf Jan voornoemd, de Heerelijkheid weder aan Holland: in 1346
verklaarde Keizerin Margariet Amstelland nimmer van de
Graaflijkheid te zullen scheuren, gelijk het sedert ook daaraan is
gebleven—De verdere lotgevallen der Heerelijkheid in ’t algemeen, is
vervat in die van de bijzondere deelen derzelve, aangetekend in onze
beschrijvingen dier deelen, art. Geschiedenissen. [VII]
HOOG-HEEMRAADSCHAP van AMSTELLAND.
Ten deezen opzichte beslaat Amstelland, gelijk reeds gezegd is, een
vrij ruimer grond, dan met betrekking tot het Bailluwschap zelf: de weg
langs welke de schouw over de wateren, die het recht hebben om over
Amstelland uittewateren, vinden wij bij Wagenaar, (en waarmede
onze ingewonnene berichten, desaangaande, overeenkomen,)
beschreven te gaan „van Amsteldam af, langs den Heiligen of
Overtoomschen weg, de Veendijk of Amstelveenschen weg, door
Amstelveen over de nieuwe sluis in de Bovenkerkerpolder, langs den
Bovenkerkerdijk, tot aan de Hand van Leiden; van hier de
Legmeerlaan op, tot aan de Noorddammerbrug; verder langs den
Noordveenderdijk naar en door Kudelstaart, tot aan en door
Kalslagen, van waar de ring heen loopt langs den Bilderdammercade,
en over het water de Drecht, langs den Wassenaarschen polderdijk,
naar en door Nieuwveen, alwaar de ring gebroken wordt door een
brug, en weder vervolgt langs de Nieuweveensche vaart, en voords
over den Zeevenhovenschen weg, naar Zevenhoven; van daar naar
Noorden; van Noorden naar Slikkendam, en langs de Hollandsche
Meent naar het Woerder Verlaat; van dit Verlaat strekt de weg langs
de Hollandsche Kade, die tot aan den Ouden dam, en voords met
verscheidene keeren tot door Teccop, en langs Gervershoop loopt, tot
aan de westzijde van de watering de Bijleveld, langs welke de ring
voordgaat tot aan den Broe- of Brenidijk; zig van dien dijk over een
voetpad keerende, door ’t oude land, naar Harmelen, en voords tot
aan en over het Haanwijker sluisjen, gelegd in den Haanwijker dam,
tot over den Rhijn, en over deezen stroom naar Haanwijkerdam, en de
Haanwijker kade; langs deeze benevens de Kattenbroeker kade, ter
zijde de landen van Haanwijk, Bijleveld, Reijers-koop, Kattenbroek en
Mastwijk, tot aan den IJsseldijk, niet verre van Montfoort, en langs
deezen, daar zij heenen loopt, ter zijde van het zuidelijkste gedeelte
van Mastwijk en Agthoven, tot aan den Meerendijk, en noordwaards
[VIII]langs denzelven, tot aan de Leidsche vaart, of Ouden Rhijn;
nevens welke de ring de zuidzijde heenen loopt tot aan den Heldam,
daar hij zig noordwaards keert, loopende ten westen van de Heikoper
watering, door Kockingen tot aan Joostendam, en verder langs de
Portengensche kade, tot aan de Rondeveensche polderkade, daar de
weg van den ring te rug keert, door ’t achterste en voorste bosch, en
zig uitstrekt tot over den dam Ter Aa, tot aan de kromme Angstel, die
met de nieuwe vaart bij Nieuwersluis, onder den schouw behoort tot
aan den Indijk, en zoo verre deeze dijk loopt tot aan de westzijde van
de Vecht, door Nichtevecht, Weesp en Muiden, daar de ring door den
Muider- of Diemer Zeedijk gesloten wordt, tot aan Amsteldam toe.”
De Bailluw van Amstelland, is tevens algemeen Dijkgraaf, en kiest,

ingevolge eenen last van Keizer Karel den Vijfden, uitgedrukt in
eene handvest van den jaare 1553, jaarlijks zes Hoog-Heemraaden,
naamlijk uit de Gerechten van Amsteldam, Weesp, Ouderkerk,
Amstelveen, Diemen en Waverveen, ieder één, ten einde met twee of
drie derzelven, den bovengemelden ring van de gemeene
waterschutting van Amstelland te schouwen, onverminderd de
schouwen, die de Schouten en Ambachtsheeren in hunne districten
hebben, en bij ons ieder op haare plaats aangetekend zijn, onder ons
art. Wereldlijke regeering: thans echter worden gezegde Hoog-
heemraaden van Amsteldam en Weesp, gesteld door Burgemeesteren
en Regeerders der gemelde Steden respective, en die van Ouderkerk,
Amstelveen, Diemen en Waverveen, ingevolge de verkoopconditien
der Ambachtsheerelykheden onder Amstelland, door derzelver
Ambachtsheeren.
Het gezegde Collegie vergadert gemeenlijk op de eerste maandagen

in Maart, Mei, Julij, September, en November; ook wel tusschentijds,
zo dikwijls de Dijkgraaf goedvindt hetzelve te beschrijven in ’t vertrek
van Heeren Burgemeesteren der stad Amsteldam, en over judicieele
zaaken in de kamer van Heeren Commissarissen van de kleine
zaaken derzelver stad.——Het heeft zijn eigen Secretaris en Bode. [IX]
Wegens het Dykcollegie, dat nog in Amstelland voorhanden is, zie

men onze beschrijving van Diemen, bladz. 11.
Dit Collegie vergadert gewoonlijk op den 12 en 13 Mei, den 24 en 25

Julij en 17 Augustus, dat de Schouwdagen zijn, als mede op den 1
September: des zomers wordt de vergadering gehouden in het
Gemeenelandshuis aan den dijk, bij Jaaphannes, alwaar, een
Castelein is, die mede ’t opzicht over den dijk heeft; als de wegen
derwaards, des winters, onbruikbaar zijn, vergadert het Collegie te
Amsteldam in een der Doeles of een ander voornaam Logement ter
dier stede.
De dijk waarover dit Hoog-Heemraadschap het bewind heeft, is van de

grootste aangelegenheid voor Amstelland, Muiden en
Weesperkerspel, enz.: als dezelve doorbreekt, of doorgestoken wordt,
overstroomt het platte land van Utrecht, tot boven Breukelen en
Portengen toe: kort voor den jaare 1509 schijnt dezelve op twee
plaatsen doorgebroken te zijn geweest: in 1598 en 1675 mede op
twee plaatsen; in 1702 ter lengte van ruim 31 roeden; in laatere jaaren
is hij dikwijls in groot gevaar van doorbraak geweest: om het nut dat hij
doet, zijn er door ’s Lands Graaven, en vervolgends door de Staaten
van tijd tot tijd breede handvesten en voorrechten vergund, wegens
ondersteuning van gelden uit ’s Lands Casse ter versterkinge van
denzelven: na de plaag van het paalgewormte, is hij ongemeen
versterkt; „een werk,” lezen wij, „’t welk aan arbeidsloon, aard,
plempen van zand, puin, het heiën van een regel paalen, enz. vijfmaal
honderd negen-en-dertig duizend, agt honderd, vier-en-negentig
guldens gekost heeft.”
Bij sommigen, onder anderen in den Tegenwoordigen staat van

Holland, vinden wij dit Collegie mede Hoogheemraadschap genoemd;
doch in onze beschrijving van Diemen hebben wij reeds doen zien, dat
de beheering aan dat Collegie niet is toegestaan over den geheelen
dijk, en dat zij des zouden kunnen doen en handelen als het
Hoogheemraadschap van Amstelland kan doen: „hetzelve”, voegt men
in aan ons gunstiglijk toegezondene berichten daarbij, „hetzelve is
bepaaldlijk ingesteld tot beschouwing van het ijzer- en houtwerk dat
toen aan [X]den dijk was, en de Graaf zegt met zo veele woorden in
zijn privilegie, dat zo lang men IJpesloot, (dat toen beplaat wierd, en
des niet de geheele dijk,) met ijzer en hout houden zou, dat zo lang
die schouw zou duuren; doch zo dat weggenomen wierd, zou de
schouw dood en te niet zijn—naderhand is wel dat Collegie
gemagtigd, om den geheelen houten dijk te beschouwen, doch dit
privilegie werd onder hetzelve verband gegeeven—nu het hout weg is,
is des dat geheele Collegie te niet, en heeft niets meer als eene
superintendentie over het schouwen, dat Diemen en Muiden doet; bij
resolutie van 1678 is dit Collegie genaamd een Hoogendijk-
Heemraadschap, en hetzelve mag niet vergaderen dan met den
Bailluw van Amstelland, die het hoofd is—men kan met geene
mogelijkheid sustineeren”, gaat onze begunstiger voord, dat het
Collegie van Zeeburg en Diemerdijk, een tweede
Hoogheemraadschap is, hoe zeer sommigen het daarvoor trachten te
debiteeren; dit Collegie is zelfs subject aan het Hoogheemraadschap
van Amstelland——misschien zal men zeggen: „in plaats van het hout
en ijzer zijn nu de steenen”, (zie onze beschrijving van Diemen, bladz.
12.) „en hierover voeren die Heeren echter hun gezach; ’t is waar dat
zij zulks doen; maar ’t is ook waar dat zij er eigenlijk geen recht toe
hebben: toen het paalwerk van den worm werd doorvreeten, verzocht
dat Heemraadschap van de Staaten de magt en de faculteit te mogen

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Nutrient Supplementation 113

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Getting Started and Adhering to a Lifetime Exercise

Helps Control Blood Sugar 264

Setting Up Your Own Strength-Training Program 285

Chapter 8 High-Intensity Interval Training 347

Tailoring Exercise to Health Circumstances 370

© Fitness & Wellness, Inc.

Time Management 404

The Mind—Body Connection 394 Managing Technostress 406

Health Care Costs of Smoking 521

Preventing Sexually Transmitted Infections 537

© Fitness & Wellness, Inc.

Complementary and Alternative Medicine 564

gree of hydrogen saturation

the importance of daily physical activity and nonexer-

tracted driving accidents and the cognitive processes

as a natural approach to reduce stress

training and arterial stiffness

meditation for stress management and the role adequate

that stem from the overuse of smartphones and other

terol, saturated fat, and refined carbohydrates on heart

back pain to include the importance of core-strengthening

cardiovascular disease management

laxis (PrEP) in reducing the risk of HIV among those at

medicine in hospitals, practices, and treatment centers

Updated resources for students to access credible research

on health and wellness topics

● Instructor’s Companion Site. Everything

© Fitness & Wellness, Inc.

© Fitness & Wellness, Inc.

ences in Mérida, Venezuela, and was presented with the

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publication industry and has held positions as an Editorial

© Fitness & Wellness, Inc.

© Fitness & Wellness, Inc.

course? ensure good health? If a person is going to do only

Real life StoRy | Jeremy’s Experience

PeRSoNal PRofile: General Understanding of Fitness and Wellness

© Fitness & Wellness, Inc.

Modern-day conveniences lull people into a sedentary lifestyle.

Figure 1.4 Leading causes of death in the United States by age.

Ages Ages Ages Ages Ages Ages Ages 65 Overall,

22% Cardiovascular disease

Healthy Habits That Cut the Risk

Cancer automobiles choose not to wear seatbelts, yet these people

Rebecca M. Cunningham, and Gary L. Freed, “Potential

Drug use 25,430

Alcohol use 88,587

Ambient air pollution 103,027

High total cholesterol 158,431

High blood sugar 213,669