Elements of Training and Fitness

A good exercises program encompasses five basic biomedical abilities: strength, endurance, speed, flexibility , and coordination. Other elements which must be considered in a holistic program include: specific skills acquisition, psychological training, and competition preparation.

A complete training program  of athletic trainers must encompass all of the above elements. However, not all elements can receive equal emphasis throughout the training cycle. Many factors determine the type of training program, and the stress placed upon each element. These include the age and sports maturity level of the athlete, his or her prior state of fitness, and the event(s) for which the athlete is preparing.

Rate Of Progression In An Exercise Conditioning Program

The recommended rate of progression in an exercise conditioning program depends on functional capacity, medical and health status, age, and individual activity preferences and goals. For apparently healthy adults, the endurance increase aspect of the sports therapy has 3 stages of progression: initial, improvement, and maintenance.

1. INITIAL CONDITIONING STAGE
The initial stage should include light muscular strength and endurance and low level aerobic exercises，which are compatible with minimal muscular soreness, discomfort, and injury . Exercise adherence may decrease if the program is too aggressively initiated. This stage usually lasts 4 to 6 weeks, but the length depends on the adaptation of the individual to the exercise program. The duration of the exercise session during the initial stage should begin with approximately 12 to 15 minutes and progress to 20 minutes. It is recommended that individuals who are starting a conditioning program exercise three times per week on non - consecutive days.

Individual goals should be established early in the exercise program. They should be developed by the participant with the guidance of an physical trainer. The goals must be realistic and a system of rewards - intrinsic or extrinsic - should be established at that time.

2. IMPROVEMENT STAGE
The improvement stage of the exercise conditioning program differs from the initial stage in that the participant is progressed at a more rapid rate. This stage typically lasts 4 to 5 months, during which intensity is progressively increased within the upper half of the target range of 50 to 85 %. Duration is increased consistently every 2 to 3 weeks until participants are able to exercise for 20 to 30 minutes continuously. The frequency and magnitude of the increments are dictated by the rate at which the participant adapts to the conditioning program. Deconditioned individuals should be permitted more time for adaptation at each stage of conditioning. Age should also be taken into consideration when progressions are recommended, as experience suggests that adaptation to conditioning may take longer in older individuals.

3. MAINTENANCE STAGE
The maintenance stage of the exercise program usually begins after the first six months of training. During this stage the participant may no longer be interested in further increasing the conditioning stimulus. Further improvement may be minimal, but continuing the same workout routine enables individuals to maintain their fitness levels.

At this point, the goals of the program should be reviewed and new goals set. To maintain fitness, a specific exercise program should be designed that will be similar in calorie burning to the conditioning program and satisfy the needs and interests of the participant over an extended period, It is important to include exercises that the individual finds enjoyable.

Dehydration and Weight Loss

  
Diuretics and impermeable clothing have been advocated from time to time for losing weight. These, however, cause weight loss rather than fat loss, and the resulting dehydration can be extremely dangerous. Although diuretics are often used in the treatment of hypertension in obese people, they have no place in the treatment of obesity itself.

Sauna belts and rubber suits are often used by the uninitiated in their quest to lose weight and inches. The resulting dehydration of the cells under the belts does cause a temporary loss of circumference. However, the change is short - lived, as normal fluid balance is quickly restored.

Body Composition and Obesity Index

   
Body Composition
Body composition can be divided into lean body mass and body fat. Lean body mass is fat - free weight. It includes the skeleton, water, muscle, connective tissue, organ tissues, and teeth. Body fat includes essential and nonessential fat stores. Essential fat includes lipid incorporated into organs and tissues such as nerves, brain, heart, lungs, liver, and mammary glands. Nonessential fat exists primarily within adipose tissue.

Measuring Body Composition
The morning weighing ritual cm the bathroom scale is really an attempt at estimating body composition. Using this method, it is impossible to determine accurately if a fluctuation in weight is due to a change in muscle, body water, or fat. The method also cannot distinguish between overweight and over fat. A 260 - pound muscular football player may be overweight according to population height - weight standards, yet actually have much less body fat than average. A 40 - year - old woman may weigh exactly the same as when she was in high school, yet have a considerably different body composition.

Anthropometric
Anthropometric assessment of body composition uses various superficial measurements such as height, weight， and anatomical circumferences. Of these, height - weight is by far the most popular. Height - weight tables, periodically produced by insurance companies, are inadequate, however, because they are subject to individual interpretation they require people to decide if they are of small, medium, or large frame. In addition, they do not take into consideration individual differences in lean body mass and relative fat.

Body Mass Index (BMI)
The body mass index is weight/height², and it is moderately correlated to percent fat. Because data are easy to collect, this index is widely used and reported in large epidemiological studies. A BMI of 25 - 30 for men and 27 - 30 for women is considered moderate obesity. A BMI of 30 -40 is considered massive obesity, and a BMI greater than 40 is classified as morbid obesity.

Ideal Body Composition

  
Perhaps the three most important considerations determining ideal body composition are health, aesthetics, and performance. The average person tends to be most concerned with health and aesthetics, while the athlete is concerned about all three.

Although the ideal healthy fat percentage has not been clearly established, it is generally agreed to be between 16% and 25% for women less than 20% for men，actually the average man and woman fall above the recommended fat percentage in almost all age categories. Tile ideal aesthetic body composition is even more difficult to establish. In our society, the lean, athletic look is prized, while the more corpulent look of the turn of the century is disdained. Unfortunately, the quest for the "lean look" often leads to unhealthy dietary habits. This is especially disturbing among athletes, who usually have very high caloric requirements because of heavy training. Young teenage, female athletes seem to be especially prone to overzealous caloric restriction, which can be dangerous.

Body composition is an extremely important consideration in many sports. In sports with weight categories, such as wrestling, boxing, and weight lifting, serious abuses have taken place in an attempt to lose weight. Weight - loss practices have sometimes even compromised the health of the athletes. Successful athletes in various sports usually possess a characteristic body composition. Variability in body fat depends on the metabolic requirement of the activity and the relative disadvantage of carrying an extra load. For example, successful male distance runners are almost always less than 9% fat. For these athletes, excess fat is a decided disadvantage. The tremendous caloric cost of running long distances makes it difficult for runners to gain much fat.

Football linemen, however, are almost always greater than 15% fat. This may be advantageous because of the added mass and padding provided by the subcutaneous fat and the increase in lean mass that accompanies excess weight (muscle mass accompanies gains in fat to support the extra weight). Unfortunately, many younger athletes gain too much fat in an attempt to attain the high body weights of the professional football player.

Exercise and long term weight - control program

Exercise is an important part of a successful long term weight - control program. It increases resting metabolic rate, maintains lean body mass, and increases energy expenditure. It also allows the consumption of enough calories to supply the body with adequate nutrients as well as energy. Caloric restriction alone can lead to malnourishment because the low - calorie diet may not contain sufficient vitamins and minerals, and chronic caloric restriction max eventually have serious health consequences.

A single session of exercise causes little fat loss. However, regular training can make a substantial difference in the weight - control program. The expenditure of 300 calories during exercise, three or four times a week, can result in a less of 13 to 23 pounds of fat a year, provided the caloric intake remains the same. That may not seem like much weight to a crash dieter. However, the weight loss consists largely of fat and is not a combination of water, lean tissue, and fat which is what is commonly lost on most fat diets. Although dieting is a drudgery, exercise is an enjoyable way to expend calories.

As fitness improves, exercise has a more potent effect on caloric utilization. A change in maximal oxygen consumption from 3 liters per minute to 3.5 liters per minute increases the ability to use calories by almost 20% . Exercise for weight control should center on long - term endurance activity for a minimum of 20 minutes.

Exercise and Weight Loss

Short - term studies have shown that endurance exercise without caloric restriction causes weight less- However,

exercise by itself is less effective than caloric restriction (i.e. , dieting) or caloric restriction plus exercise. Studies  have shown that exercise plus diet is more effective than dieting alone in maintaining weight loss (six months to three years after the beginning of the program).

Dieting by itself reduces lean body mass and decreases resting metabolic rate, sometimes by as much as 30% . During the initial stages of a starvation diet, 40% of the weight loss may be from lean mass. Most studies have shown that after one year, most weight lost through dieting alone is regained, and the dieter may become involved in a futile cycle of dieting and regained weight.

To be successful, long - term weight - control programs should include exercise. Exercise spares lean mass and increases resting metabolic rate during caloric restriction. Exercise also increases the thermic response to food (i.e. , digesting and processing food increases metabolic rate) . In addition, exercise exerts an independent effect on reducing the risk of coronary artery disease.

Exercise intensity may be important for increasing metabolic rate. Several studies have shown that intense exercise increases metabolic rate in obese subjects, while moderate exercise does not. Ute metabolic effects of exercise are temporary, however. In dieters, metabolic rate decreases when training is suspended for as little as three days.

The literature is unclear on the effects of exercise on food intake. Studies have found decreased, increased, and no change in food intake in people involved in moderate exercise. Likewise, it is not known if exercise influences dietary composition (i.e., the percentage of fats and carbohydrates in the diet).

Weight training has been suggested as an important component in a long - term weight - management program . Programs stressing caloric restriction cause decreases in lean body mass, negative nitrogen balance (i.e. , body loses protein) , and diminished muscle strength. Including weight training in the weight - reduction program helps spare lean body mass and maintain nitrogen balance. Also, improvements in strength between 17% and 22% have been reported in subjects who weight - trained during caloric restriction. Lean mass is the most important determinant of resting metabolic rate. Weight training increases or maintains lean mass in people on low -calorie diets.

Like endurance exercise, weight training has no effect on regional fat deposition (i.e., spot reducing is ineffective) . Although the improved muscle tone that results from training usually makes a particular area of the body look better, the subcutaneous adipose layer that lies over the muscles is unaffected .

Medical Procedures for Obesity

Medical intervention in the hospital is sometimes employed in extreme cases of obesity. Hospital procedures include: prolonged fasting, jejunoileal bypass, and lipectomy. These techniques, although often effective, are sometimes accompanied by undesirable side effects.

Starvation

Prolonged starvation has resulted in weight losses of over 100 pounds. However, this procedure causes loss of lean body mass and can have serious side effects, such as gout, anemia, hypotension, and various metabolic disturbances. Also, starvation does little to modify eating habits, which will help maintain lost weight.

Invasive Treatments

Invasive procedures for treating obesity include gastric bubble, jaw wiring, gastric bypass, gastroplasty, jejunoileal bypass, and liposuction. The long - term effectiveness of temporary measures, such as gastric bubble and jaw wiring, is low — as with starvation, the resting metabolic rate is depressed and healthy eating habits are seldom substituted, so weight is usually regained.

Bypass Operations

Bypass operations, such as gastric and jejunoileal bypasses, are much more effective than starvation and jaw wiring. These

procedures are very expensive, however, and much riskier than less invasive methods. Gastric operations reduce the gastric pouch size, which limits food intake. Clinical reports suggest that these procedures cause substantial weight loss. Although failure rates are as high as 50% , the procedures are satisfying to a large proportion of patients. Surgical risk is present but low. Other risks include vomiting, diarrhea, and peptic ulceration.

Jejunoileal bypass operations decrease the absorption of nutrients. These procedures cause weight losses similar to those from gastric operations. Side effects are much more severe, however, so the procedure is much less popular than it once was. Side effects include surgical complications, diarrhea, electrolyte disturbances, bacterial infection, and liver failure.

Suction Lipectomy

Liposuction has become the most popular type of elective surgery in the United States. The procedure involves removing limited amounts of fat from specific areas. Typically, no more than 2.5 kg of adipose is removed at a time. The procedure is usually successful if excess fat is limited and skin elasticity is good. The procedure is most effective, however, if integrated into a program of dietary restriction and exercise. Side effects include infection, dimpling, and wavy skin contours.

Drugs

Drugs used in weight control include those that suppress appetite and drugs affecting the gastrointestinal tract.

Appetite suppressants include amphetamine, diethylpropion, fenfluramine, and phenylpropanolamine. Although these drugs depress appetite and cause weight loss, some have serious side effects. Amphetamine, for example , is highly addictive and can cause cardiac arrhythmias and impair temperature regulation.

Drugs affecting the gastrointestinal tract include dietary fiber and sucrose polyester. Dietary fiber causes gastrointestinal distension and may restrict energy intake. Limited clinical trials suggest that including fiber supplements in the diet may aid weight loss. Sucrose polyester (Olestra) is a new diet ingredient of some promise. This substance cannot be digested and can be substituted for fats in the diet.

Diet and weight loss: Caloric Restriction

Caloric restriction is the most common treatment of obesity and is an essential part of any weight control program. Most quick - loss fad diets, however, stress weight loss rather than fat loss and fail to provide a regimen that can be followed for life. The goal of a dietary program should be to lose fat and then maintain the loss. Unfortunately, severe caloric restriction and the composition of these fad diets are so unpleasant and unnatural that rebound weight gains are typical.

Many of these quick - loss diets promote low carbohydrate intake, which results in dehydration as muscle and liver glycogen stores are depleted. Low carbohydrate diets lead to sodium diuresis and loss of intracellular and extracellular fluids. Although the weight loss appears impressive, most of it is in the form of water and lean mass rather than fat. Also, glycogen depletion greatly diminishes exercise capacity, which almost eliminates physical activity as a source of caloric expenditure.

The success or failure of any diet depends on its effect on energy balance. Studies of patients in metabolic wards, where diet and exercise are closely controlled and measured, have shown that people lose weight at a predictable rate when put on a low - calorie diet. Weight loss is independent of dietary composition. Fatter people tend to lose weight faster than people who are less fat. Men lose weight faster than women because of a higher lean body mass.

Although caloric content of the diet is most important for losing weight, dietary composition has an indirect influence on the quality of the weight loss. Protein (lean mass) loss is less in people consuming a high - carbohydrate diet.

Studies in metabolic wards have also shown that anyone consuming 1200 kcal per day will lose weight. They also show that water and protein loss are common during the early stages of the diet. These losses are most pronounced in more obese subjects. Exercise can slow the loss of lean

mass in obese people but cannot completely eliminate it.

Extremely low calorie diets ( <200 to 800 kcal per day) can be dangerous. Many people have died from cardiac arrest while on these diets.

Extremely low calorie diets have been associated with serious cardiac arrhythmias, loss of lean body mass, loss of hair, thinning of the skin, coldness in the extremities, gallbladder stones, gout, and elevated cholesterol. Such diets seldom result in the behavior changes necessary for permanent weight loss.

Some Key Index About Obesity

Obesity is a major health problem in Western countries, affecting nearly 30% of adults. Obesity increases the risk of a variety of diseases, including heart disease and stroke. Total weight and fat deposition patterns are related to increased mortality. People who store fat in the abdomen are at greater risk than those who store it in the lower body.

Energy balance determines whether body fat increases, decreases, or remains the same, The cause of the positive energy balance in obese people is not totally understood although the answer probably lies in the complex physiological and psychological factors that control food intake and energy expenditure. The control center for food intake is located in the hypothalamus. The hunger center max, be regulated by glucose, stored triglycerides, plasma amino acid levels, and hypothalamic temperature.

The components of energy expenditure include resting metabolic rate（RMR）, thermogenesis, and physical activity. RMR usually decreases during weight loss. Exercise increases metabolic rate and spares lean body weight during weight loss. Thermogenesis is stimulated by eating and processing meals. In some species, brown fat may be an important center of thermogenesis although its importance in adult humans is not known. Exercise contributes to weight loss and is important for maintaining weight loss.

Fat cells increase in size and number during growth. In adults, most increases in body fat occur due to fat cell hypertrophy. Recent evidence suggests that fat cells can be gained or lost in adults.

Common treatments for obesity include diet, exercise, drugs, surgery, liposuction, and hypnosis. Most weight - control programs are not successful. Successful weight - loss programs require caloric restriction and basic changes in lifestyle (behavior modification). Exercise enhances the chances of successful long - term weight loss.

The three most important considerations determining the ideal body composition are health, aesthetics, and performance. Exercise helps each of these by preserving lean body mass and decreasing fat mass.