SELECTING HEALTHY LIFESTYLE PROGRAMS

1. HLED 411 – CHAPTER FOUR SELECTING HEALTHY LIFESTYLE PROGRAMS

2. PHYSICAL FITNESS • Surgeon General’s PA recommendations: • 30 minutes • Moderate intensity • Most or all days • More is better • Fewer than 1 in 5 adult Americans meet this standard.

3. Risks of Physical Inactivity • Physically inactive people die younger • Technological advances have greatly reduced required daily physical activity • About 400,000 deaths in the U.S. are attributed each year to physical inactivity and poor dietary habits

4. 1996 Surgeon General’s Report • Poor health because of lack of physical activity is a serious public health problem • More than 60% of adults do not achieve the recommended amount of physical activity • 25% are not physically active at all • Almost half of all people between 12 and 21 years of age are not vigorously active on a regular basis

5. 1996 Surgeon General’s Report • Physical inactivity is more prevalent in • Women than men • African Americans and Hispanic Americans than whites • Older than younger adults • Less affluent than more affluent people • Less educated than more educated adults

6. Physical Activity vs. Mortality Studies show an inverse relationship between physical activity and premature mortality rates

7. Moderate Physical Activity • Provides benefits through regular participation • Can prevent premature death, unnecessary illness, and disability • For people who are not physically active: • Can provide substantial benefits in health and well-being • For people who are already moderately active: • Greater health and fitness benefits can be obtained when intensity of physical activity is increased

8. Health-Related Fitness Cardiorespiratory endurance Muscular flexibility Body composition Muscular strength and endurance

9. Growing evidence showing regular exercise can reduce the risk of heart disease, cancer, stroke, and many other conditions. • Increasing evidence of a direct relationship between physical activity and on-the-job productivity. • Growing frustration of paying billions of dollars to treat many illnesses and disorders that can be prevented by a physically active liftestyle. • Efforts to regain a competitive edge by improving employee health. • Growing appeal of fitness center or health club benefits by employees and job applicants. Why fitness in the workplace?

10. Selected Health Benefits • Improves cardiorespiratory endurance, muscular strength, and muscular endurance • Helps maintain recommended body weight and lean body mass • Increases resting metabolic rate • Improves the immune system • Decreases risk for chronic diseases (cardiovascular disease, cancer, diabetes, hypertension, osteoporosis)

11. Selected Health Benefits • Relieves tension and stress • Raises energy levels and job productivity • Encourages positive lifestyle habits • Promotes psychological wellness • Helps maintain independent living • Extends longevity and slows down the aging process • Improves quality of life

12. Shift from a predominant focus on a fitness center-based program to a holistic life center approach. • Most worksites do not have the need or resources for on-site fitness centers and instead set up small workout areas or subsidize employee memberships to local health clubs. • Walking programs during breaks are popular options for smaller organizations with space or financial limitations. Trends in worksite fitness programming

13. http://www.youtube.com/watch?v=nfMaiClrrTE Health, Mind, and Behavior

14. Staff members should be trained in CPR and have a communication plan in effect in case of emergency. AED’s may become required in worksite fitness centers. Organizations should comply with all current and future applicable local, state, and federal legal and regulatory requirements. Exercise precautions

15. Requires planning and coordination between the company and outside vendors, examination of budget, review of product literature, and consultations with other worksite personnel. • Average equipment costs: • Stationary bikes - $300 - $3000 • Multi-station wt. systems - $1000+ • Climbing machines - $1000-$4000 • Rowers - $300 - $1500 • Treadmills - $400 - $5000 Equipment and facilities considerations

16. Purchase equipment designed for institutional use. To cut shipping costs, buy from a local firm or manufacturer whenever possible. To save up to 50% off the retail price, buy carpet directly from the manufacturing mill. Ask distributors if they provide free equipment instruction. Closely compare maintenance requirements of mechanized equipment and computerized equipment. Check a firm’s stock inventory, credit plan, warranty, service contract, and whether or not the manufacturer has product liability insurance. Ask vendors for the names of other companies who have purchased their equipment, and solicit opinions before buying. Invite sales representatives to visit your worksite to discuss your particular needs. Tips for purchasing fitness equipment

17. Maintain temperature near 70˚F and humidity level lower than 50%. Maintain adequate ventilation. Monitor – misuse is biggest contributor to broken or malfunctioning equipment. Recommended flooring – wood spring-coil, polyurethane mix-foam, rubber with prices ranging from $5 - $17 per square foot. Maintaining fitness equipment

18. Obesity Treatment: Behavior Therapy - http://www.youtube.com/watch?v=x7-VxSSEzso Top Weight loss motivational quotes & inspirational quotes - http://www.youtube.com/watch?v=rXBl192gbzQ Nutrition and weight control

19. Definitions for CDC’s Obesity Trends among U.S. Adults between 1985 and 2003 • Obesity: Having a very high amount of body fat in relation to lean body mass, a Body Mass Index (BMI) of 30 or higher, or being 30 pounds or more overweight • Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters • Worldwide, over one half of all workers are overweight or obese & about 2/3 eat unhealthy diets.

20. Health Consequences of Obesity • Obesity is a risk factor for • Hypertension • Congestive heart failure • High blood lipids • Atherosclerosis • Stroke • Thromboembolitic disease • Varicose veins • Obesity is a risk factor for • Type 2 diabetes • Osteoarthritis • Gallbladder disease • Sleep apnea • Ruptured intervertebral disks • Arthritis • Cancer (breast, colon, and prostate)

21. Effects of Types of Diet and Exercise on Weight Loss

22. Exercise: The Key to Lifetime Weight Management • The most effective way to tilt energy balancing equation in your favor is through physical activity • Research shows that a combination of diet and exercise is the most effective way to lose weight • Maintenance of exercise program appears to be the best predictor of long-term weight loss maintenance • Weight maintenance: Calories in = calories out • Weight gain: Calories in > calories out • Weight loss: Calories in < calories out

23. Change in Eating Habits • Decrease fat intake: for good • Use primarily mono- and polyunsaturated fats • Eat adequate grains, fruits, and vegetables • Limit meat consumption to 3 oz. per day • Count calories when on a diet • Treat yourself once in a while • Juniorsize, NEVER supersize • Plan prior to socializing around food

24. Calories in Fast Food Wendy’s Frosty, med. Tuna Sweet Onion Teriyaki Veggie Del. Market Fresh Roast Beef Roast Chicken Club Regular Roast Beef Ice Cream Shake, med. Double Whopper Whopper w/ Cheese Whopper Large Fries Chicken McGrill Big Mac Subway Arby’s Burger King McDonald's

25. Fat Content in Fast Food

26. Make a commitment to change Set realistic goals Exercise regularly Exercise control over your appetite Consume less fat in the diet Eliminate unnecessary food items from the diet Include calcium-rich foods in the diet Use craving-reducing foods in the diet Avoid automatic eating Behavior Modification Techniques

27. Stay busy Plan meals ahead of time and shop sensibly Pay attention to the number of calories in food Cook wisely Do not serve more food than you should eat Use portion control in the diet and when dining out Do not eat out more than once per week; when you do, eat low-fat meals Eat slowly and at the table only Behavior Modification Techniques

28. Avoid social binges Avoid temptation by relocating or removing unhealthy foods Avoid evening food raids Practice stress management Have a strong support group Monitor changes and reward accomplishments Prepare for lapses/relapses Think positive Behavior Modification Techniques

29. 2005 Dietary Guidelinesfor Americans • Consume a variety of foods within and among the basic food groups while staying within energy needs • Control calorie intake to manage body weight • Be physically active every day • Increase daily intake of fruits and vegetables, whole grains, and nonfat or low-fat milk and milk products • Choose fats wisely for good health • Choose carbohydrates wisely for good health

30. Distribute and publicize nutritional educational materials in the cafeteria and near canteens, vending machines, or break areas. • Offer heart-healthy choices, salads, and other healthy options. • Affix “healthy choice” labels to foods that are low in fat, calories, sugar, salt, and cholesterol. • Offer a weekly menu of nutritious bag lunches that employees can prepare. • Offer discounted prices on healthy items in the cafeteria Nutrition & weight control programming

31. Ease out the junk food from vending machines and replace it with natural fruits, unsweetened fruit juices, low-fat dairy products, and other nutritious foods. • Place weight scales and body mass index (BMI) charts in company restrooms for employees to regularly monitor their weight. • Provide free body fat measurements at quarterly intervals. Nutrition & weight control programming

32. Back injury is one of the most common on-the-job injuries at the worksite and the primary cause of absenteeism in many companies. • Nearly 2% of the U.S. workforce files a low-back injury claim each year; most are classified as a minor low-back muscle strain, which costs employers about $500 per injury in medical care and lost productivity costs. • Serious back injuries can cost approx. $30,000 per case, comprise up to 50% of all workers comp claims, and can lead to long-term disability. Back health

33. Low-Back Pain • About 75 million Americans suffer from chronic low-back pain • Caused by • Physical inactivity • Poor posture habits and body mechanics • Excessive body weight

34. Common Causes • Sedentary lifestyle (weak abdominal, inflexible back muscles, & tight hamstring muscles creates poor posture by tilting the pelvis forward). • Occupations that require workers to stand for long periods, spend a significant amount of time sitting at a desk or in an automobile, or physical tasks. • Smoking may increase degenerative changes in the spine. • Excess body weight stresses the lower back by pulling the spinal column forward causing the lower back to arch.

35. Prevention and health promotion • Awareness and knowledge • Practice proper body mechanics • Implementation and follow-up • Intervention and treatment for injured employees • Rehabilitation and a return-to-work protocol Reducing low-back injuries

36. Tips to Prevent Low-Back Pain • Be physically active • Stretch often using spinal exercises through a functional range of motion • Regularly strengthen the core of the body using sets of 10 to 12 repetitions to near fatigue with isometric contractions when applicable • Lift heavy objects by bending at the knees and carrying them close to the body

37. Tips to Prevent Low-Back Pain • Avoid sitting (over 50 minutes) or standing in one position for lengthy periods of time • Maintain correct posture • Sleep on your back with a pillow under the knees or sideways with the knees drawn up and a small pillow between the knees • Warm up properly using mild stretches before engaging in physical activity • Practice adequate stress management techniques

38. A full-term delivery without complications costs about $3500 in the US, a pregnancy with complications can cost an employer over $100,000. • In the US, one of every 8 babies is born prematurely and 1 of every 14 American babies is born with a low birth weight; medical care costs for premature infants is over $5 billion a year. Prenatal health

39. Pre-pregnancy counseling: genetic counseling relating to age, family history, pregnancy history, lifestyle, health status, etc. • Identification – pregnancy test. • Referral – informed of health care benefits and referred to physician. • Education classes – two phases: • Information phase – prenatal care, nutrition, substance use/abuse, discomforts of pregnancy, fetal development, signs and symptoms of labor and birth, recommendations for postnatal home care. • Clinical Phase – one-on-one screenings and discussions to assess each woman’s blood pressure, weight, water retention level, and urine test results. Prenatal health education programs

40. Offer programs on company time • Waive the first year health insurance deductable and co-pay if the expectant mother attends all scheduled prenatal classes. • Offer monetary rewards (e.g., $100) for attending all scheduled prenatal classes and screening sessions. • Paying a higher percentage of the health care bill for participating mothers. Incentives

41. Nearly three-fourths of all medium and large worksites have smoking control policies and most offer smoking cessation programs. Reasons: • Federal agency support • Anti-drug campaigns that include smoking • Non-smoking workers requesting smoke-free environments • Employers are becoming aware of costs associated with smoking Smoking control

42. Nicotine Replacement Therapies • Gum • Inhaler • Nasal spray • patch • Non-Nicotine Prescription Drugs • bupropion • Counseling • Quit lines • Private telephone-based counseling • Group counseling in smoking cessation smoking cessation Programs

43. Consistent and repeated advice from a team of supporters to quit smoking • Setting a specific date • Providing a follow-up visits • With a counselor: • readiness • Support • Skills • Identify a quit date • Prevent relapse Smoking cessation programs