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ACSM's Complete Guide to Fitness & Health

Fit, Active, and Healthy

 Although many aspects of life may feel out of one’s control, you have choices each day that can affect your fitness and health. Physical activity and nutrition are two areas that have a major impact on many aspects of your life in regard to both disease risk and daily function. Chapters 1 to 4 will help you to place scientifically-based recommendations into the context of your life so you can tackle the challenge of establishing healthy habits for the long term.

Making Healthy Lifestyle Choices: Physical Activity and Nutrition

What you do really does matter when it comes to your health. Your level of physical activity along with dietary choices affects day-to-day function as well as your risk of a number of diseases, including heart disease and some cancers. Healthy lifestyle choices are made within the context of individual and biological factors, as well as your home, work, and community environments (to help visualize this, see figure 1.1). You are an individual and, as such, need an individualized plan of action to achieve your health and fitness goals.

Figure 1.1 Diet and physical activity, health promotion, and disease prevention across the lifespan.

source: U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015.

Rather than viewing healthy choices as distinct, unrelated activities, consider how various influences in your life interact to promote, or challenge, your efforts to make healthy choices. As you opened this book and started to peruse the pages, you have already taken the first step toward improving your health and wellness. In the upcoming pages, you will find research-based recommendations for exercise and dietary choices, with chapters on many specific topics written by experts in their fields. The value of these

recommendations can be realized only when placed within the context of your life and your experiences. Armed with this perspective, you can develop your action plan to begin, or improve, your wellness journey. Time to jump on board!

 You: Living Well

How do you define wellness? Your definition will reflect your personal experiences and perspectives. One way to consider the concept of wellness centers on engaging in activities in order to avoid negative consequences—for example, exercising in order to be free of disease and debilitating conditions, or substituting water for sweetened beverages to keep from gaining weight. To take a more positive viewpoint, contemporary approaches to wellness focus on balancing the many aspects, or dimensions, of life to promote health (8). Examples include exercising in order to develop a level of fitness that allows for full participation in recreational activities you enjoy, or consuming a balanced diet in order to provide your body with needed nutrients for optimal function. Outcomes may be similar, but the mindset is one of pursuing health rather than avoiding illness.

Wellness reflects physical, emotional, social, intellectual, spiritual, and occupational aspects (11). Wellness exists across a continuum between the presence and the absence of each dimension or aspect of life. Table 1.1 provides a brief definition and a pair of terms reflecting the presence or absence of each wellness dimension. Take a moment to consider where you fall on the continuum between two sample indicators listed for each dimension. Wellness isn’t a static or all-or-none situation but rather is dynamic and changing. At any time, you may find some dimensions to be more present than others in your life. By adopting healthy behaviors, you can have greater balance in each dimension and therefore a greater sense of well-being and health.

Wellness touches all aspects of life, and fully discussing all areas is beyond the scope of this book. The focus of this book is physical wellness, and the following sections introduce the benefits of physical activity and a healthy diet. In addition, insights into two areas that can affect physical wellness—sleep and stress management—are discussed.

Promoting Health and Wellness

 Seeking better health involves many daily decisions and actions. This section explores the benefits of physical activity and exercise as well as dietary choices. In addition, taking steps to ensure adequate sleep and manage stress are integral to your pursuit of health and wellness.

Physical Activity and Exercise

Physical activity recommendations are not new, although the message has been clarified in recent years. In 1996, the U.S. Surgeon General’s Report on Physical Activity and Health was described as “a passport to good health for all Americans,” and the goal was to weave physical activity into the fabric of daily life as highlighted by these take-home points of the report (27):

  • Americans can substantially improve their health and quality of life by including moderate amounts of physical activity in their daily lives.
  • For those who are already achieving regular moderate physical activity, additional benefits may be gained by further increases in activity levels.
  • Health benefits from physical activity are achievable for most Americans.


What are current activity levels in the United States?

Although the Surgeon General’s report gave high-level attention to the importance of physical activity, it did not ultimately spark the increase in physical activity desired and needed. Figure 1.2 shows the percentage of adults who engage in aerobic and muscular activity and also the percentage who are not   active during leisure time (26). In a perfect scenario, 100 percent of people would exercise (aerobically and with resistance training), and no one would remain inactive during leisure time. The most active age group is the youngest; unfortunately, activity decreases and inactivity increases with age. Currently, the percentages are far from ideal. Now is the time for everyone to increase physical activity and find enjoyable ways to be more active.

Armed with increased awareness of the value of physical activity provided by the Surgeon General’s report, the U.S. Department of Health and Human Services provided clear recommendations on physical activity in its Physical Activity Guidelines for Americans (25). The Physical Activity Guidelines for Americans is based on hundreds of research studies conducted to examine the effects of physical activity on health. Following are some of the major findings:
  • Regular physical activity reduces the risk of many unwanted health outcomes and diseases. 
  • Some physical activity is better than none. The greatest health risk comes from being totally sedentary. Getting up and moving is important to start reducing disease risk and claiming benefits. Some health benefits have been identified with as little as 60 minutes of activity a week.
  • A target of 150 minutes per week of moderate-intensity activity provides significant health benefits (additional benefits accrue to those who do more). An example of moderate-intensity activity is brisk walking.
  • If you are already active, additional benefits are possible for most health outcomes if you increase the amount of physical activity by exercising at a higher intensity, more often, or for a longer period of time.
  • When one considers risks versus benefits, the benefits of physical activity outweigh possible adverse outcomes.
  • Regular exercise, week after week and year after year, is the goal. Maintaining such a program can produce both short-term and long-term benefits. Starting early in life and continuing throughout the lifespan is recommended.

Current recommendations from the American College of Sports Medicine (ACSM) continue to support the value of a comprehensive exercise program (1, 10). The upcoming chapters reflect these research-based guidelines, providing more detail on the components of a balanced exercise program and the role that activity and nutrition play in promoting health and fitness throughout the lifespan, as well as when people are faced with special health conditions.

Both physical activity and exercise are valuable. Although similar in some ways, there is a subtle difference between these two terms (1). “Physical activity” is the appropriate wording to use to refer to movement of the body that takes effort and requires energy above that required at rest. Day-to-day tasks such as light gardening, household chores, and taking the stairs at work are examples of baseline physical activity. Including activities like these in your daily routine is helpful, but adding exercise to your schedule provides additional health and fitness benefits. Exercise is a specific, planned type of physical activity that is done in a structured manner to promote physical fitness. Going for a brisk walk with the purpose of increasing your aerobic fitness or lifting weights to improve muscular fitness are both physical activity options that fall under the category of exercise. Thus physical activity is a broader, umbrella term, and exercise is one category of physical activity (i.e., all exercise is physical activity but not all physical activity is exercise). Over the past few years, the value of both physical activity (see Sit Less, Move More) and exercise has been supported. The focus of this book is exercise, but realize that exercise is a type of physical activity and that the terms are often used interchangeably.

 Sit Less, Move

More Reflect on the amount of time you spend sitting over the course of the waking hours of the day: sitting while commuting, when working at the computer, during television watching, and at other times throughout the day. One study reported the following averages for nonsleeping activity levels (19):
Moderate to vigorous physical activity = 0.3 hours
Light physical activity = 4.1
hours Sedentary = 10.2 hours

These averages display a high amount of time spent each day in inactivity, with little time spent being physically active at moderate or vigorous levels.

Research supports the recommendation to sit less as a means to promote health. All-cause death rate is higher for those who sit more, and that association was found regardless of how active a person was otherwise (20). Sitting time has been associated with higher risk for heart- and metabolic-related issues such as increased waist circumference, poorer insulin resistance (how the body handles glucose), and changes in cholesterol (sitting is detrimental to “good” cholesterol levels) (23). Thus, finding ways to infuse more activity into the day appears to be key. Here are some examples:

Stand or walk while talking on the phone.
Get up and move during commercials when watching TV.
Include some movement time every half hour when working on the computer or doing desk activities.
 Go for a short walk after meals.

Keep looking for additional ways to infuse activity into your day!

Being active is one of the most important habits people of all ages can develop to improve their health (1, 25). Why are physical activity and exercise so important to your well-being? Children who are active are more likely to be at a healthy body weight, perform better in school, and have higher self-esteem (22). They are also less likely to develop risk factors for heart disease, including obesity (25). Adults who exercise are better able to handle stress and avoid depression, perform daily tasks without physical limitation, and maintain a healthy body weight; they also lower their risk of developing a number of diseases (10, 25). Exercise continues to be important for older adults by ensuring quality of life and independence; regular exercise boosts immunity, combats bone loss, improves movement and balance, aids in psychological well-being, and lowers the risk of disease (9). Physical activity and nutrition information for children and adolescents is found in chapter 9, for adults in chapter 10, and for older adults in chapter 11.

Although disabilities may affect one’s ability to be physically active, research supports the health benefits for avoiding inactivity and becoming as regularly active as possible within one’s ability. An appropriate physical activity level can be determined in consultation with a health care provider (25). Similarly, people with chronic medical conditions should consult with their health care providers regarding the appropriate types and amounts of activity (25). Chronic medical conditions encompass a wide range of situations, including arthritis, type 2 diabetes, and cancer. Within the limitations of their ability, adults with chronic medical conditions can obtain health benefits from regular physical activity (25). Chapters 12 to 17 include nutrition and physical activity recommendations unique to a number of chronic conditions, including heart disease, high blood pressure, high cholesterol, diabetes, cancer, Alzheimer’s disease, osteoporosis, and arthritis. In addition, the value of regular physical activity and healthy dietary choices is reviewed for weight management (chapter 18), pregnancy and postpartum (chapter 19), and depression (chapter 20).

The benefits of a regular exercise program extend into many areas of life. Improvements in body function as a result of exercise are well documented and are highlighted in this chapter. In addition to physiological benefits, psychological and mental health benefits can also be realized. Exercise appears to provide relief from symptoms of depression and anxiety; in addition, exercise enhances well-being and quality of life and is associated with a lower risk of dementia (10). Exercise also has the potential to enhance emotional well-being and improve mood (21). Researchers continue to explore why exercise promotes mental well-being. Potential reasons include offering a distraction, increasing self-confidence, providing physical relaxation, and promoting a positive body image (13).

Stated simply, exercise is the best prescription! No other “product” can provide so many positive changes with so few side effects. To underscore this, take a moment to review the impressive summary list of health benefits related to physical activity, for all age groups, in table 1.2. The scientists working with the U.S. Department of Health and Human Services rated available evidence as strong, moderate, or weak based on the type, number, and quality of the research studies (25). Only the health benefits with at least moderate evidence are included in this table.