Exercise Physiology: Nutrition, Energy, and Human Performance (reflowable text)

Námskeið SJÚ308G Árreynslulífeðlisfræði. - Höfundar: William McArdle, Frank I. Katch, Victor L. Katch

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SJÚ308G Árreynslulífeðlisfræði.

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etting the standard for more than 30 years, nearly half a million students have built a solid foundation of the scientific principles underlying modern exercise physiology with Exercise Physiology by William D. McArdle, Frank I. Katch, and Victor L. Katch. . This Eighth Edition is updated with the latest research in the field to provide current coverage of how nutrition, energy transfer, and exercise training affect human performance.

A vibrant new full color “magazine style” design, along with updated art in every chapter, works hand in hand with the descriptive content, making even complex topics easier to understand and key information easier to locate. Throughout the text, the authors apply exercise physiology principles to practical skills, illustrate how theory comes to life through research, and clarify complex issues and problems.

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Höfundur: William D. McArdle
Útgáfa:8
Útgáfudagur: 02/2014
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Format:ePub
ISBN 13: 9781496314932
Print ISBN: 9781451193831
ISBN 10: 149631493X

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Front Matter
- Preface
  - Moving Forward
  - ORGANIZATION
  - FEATURES
  - NEW TO THE EIGHTH EDITION
  - ANCILLARIES: THE TOTAL TEACHING PACKAGE
    - Students
- Acknowledgments
Introduction: A View of the Past
- EXERCISE PHYSIOLOGY: ROOTS AND HISTORICAL PERSPECTIVES
- IN THE BEGINNING: ORIGINS OF EXERCISE PHYSIOLOGY FROM ANCIENT GREECE TO AMERICA IN THE EARLY 1800S
  - FIGURE I.1
  - TABLE I.1: Table of Contents for Books 1 and 2a of Galen’s De Sanitate Tuenda (Hygiene)
  - FIGURE I.2
  - FIGURE I.3
  - FIGURE I.4
- RENAISSANCE PERIOD TO NINETEENTH CENTURY
  - FIGURE I.5
  - Notable Achievements by European Scientists
    - Leonardo da Vinci (1452–1519)
      - FIGURE I.6
    - Albrecht Dürer (1471–1528)
      - FIGURE I.7
    - Michelangelo Buonarroti (1475–1564)
    - Andreas Vesalius (1514–1564)
      - FIGURE I.8
    - Santorio Santorio (1561–1636)
    - William Harvey (1578–1657)
      - FIGURE I.9
    - Giovanni Alfonso Borelli (1608–1679)
    - Robert Boyle (1627–1691)
    - Stephen Hales (1677–1761)
      - FIGURE I.10
    - James Lind (1716–1794)
    - Joseph Black (1728–1799)
    - Joseph Priestley (1733–1804)
      - FIGURE I.11
    - Karl Wilhelm Scheele (1742–1786)
      - FIGURE I.12
    - Henry Cavendish (1731–1810)
    - Antoine Laurent Lavoisier (1743–1794)
      - FIGURE I.13
    - Lazzaro Spallanzani (1729–1799)
  - Nineteenth Century Metabolism and Physiology
    - Claude Louis Berthollet (1748–1822)
    - Joseph Louis Proust (1755–1826)
    - Louis-Joseph Gay-Lussac (1778–1850)
    - William Prout (1785–1850)
    - François Magendie (1783–1855)
    - William Beaumont (1785–1853)
    - Michel Eugene Chevreul (1786–1889)
    - Jean Baptiste Boussingault (1802–1884)
    - Gerardus Johannis Mulder (1802–1880)
    - Justus von Liebig (1803–1873)
      - FIGURE I.14
    - Henri Victor Regnault (1810–1878)
      - FIGURE I.15
    - Claude Bernard (1813–1878)
      - FIGURE I.16
    - Edward Smith (1819–1874)
      - FIGURE I.17
  - Health and Hygiene Influences in the United States
    - Austin Flint, Jr., MD: American Physician-Physiologist
      - FIGURE I.18
  - The Amherst College Connection
    - FIGURE I.19
    - Anthropometric Assessment of Body Build
      - FIGURE I.20
      - FIGURE I.21
      - TABLE I.2: Average and Best Anthropometric and Strength Records of Amherst College from 1861 to 1900 Inclusive
      - FIGURE I.22
      - FIGURE I.23
      - FIGURE I.24
      - FIGURE I.25
  - The First Exercise Physiology Laboratory and Degree Program in the United States
    - George Wells Fitz, MD: A Major Influence
      - FIGURE I.26
      - First Course in the Physiology of Exercise or in Exercise Physiology
  - Exercise Studies in Research Journals
  - The First Textbook in Exercise Physiology: The Debate Continues
  - Other Early Exercise Physiology Research Laboratories
    - FIGURE I.27
    - Contributions of the Harvard Fatigue Laboratory (1927–1946)
      - FIGURE I.28
      - TABLE I.3: Areas of Investigation at the Harvard Fatigue Laboratory that Helped to Establish Exercise Physiology as an Academic Discipline
  - Research Methodology Textbook Focusing on Physiologic Research
- THE NORDIC CONNECTION (DENMARK, SWEDEN, NORWAY, AND FINLAND)
  - Danish Influence
    - FIGURE I.29
  - Swedish Influence
    - FIGURE I.30
  - Norwegian and Finnish Influence
    - TABLE I.4: Nordic Researchersa Awarded the ACSM Honor Award and ACSM Citation Award
- OTHER CONTRIBUTORS TO THE KNOWLEDGE BASE IN EXERCISE PHYSIOLOGY
  - FIGURE I.31
- THE ROYAL SOCIETY OF LONDON
  - FIGURE I.32
- CONTRIBUTIONS OF WOMEN TO SCIENCE AT THE DAWN OF THE 20TH CENTURY
- Summary
- CONCLUDING COMMENT
  - INTERVIEW WITH: Dr. Charles M. Tipton
PART ONE: Exercise Physiology
- SECTION 1: Nutrition: The Base for Human Performance
  - OVERVIEW
  - INTERVIEW WITH: Dr. David L. Costill
  - CHAPTER 1: Carbohydrates, Lipids, and Proteins
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: CARBOHYDRATES
      - KINDS AND SOURCES OF CARBOHYDRATES
        Monosaccharides
        FIGURE 1.1
        Oligosaccharides
        What’s in a Name?
        Polysaccharides
        Plant Polysaccharides
        FIGURE 1.2
        Health Implications of Fiber Deficiency.
        TABLE 1.1: Recommended Daily Fiber Intake
        TABLE 1.2: Fiber Content of Common Foods (Listed in Order of Total Fiber Content)
        Added Sugar and the Blood Lipid Profile
        Not All Carbohydrates Are Physiologically Equal.
        Glycogen: The Animal Polysaccharide
        FIGURE 1.3
        How Much Glycogen Does the Body Store?
        FIGURE 1.4
        Important Carbohydrate Conversions
      - RECOMMENDED INTAKE OF CARBOHYDRATES
      - ROLE OF CARBOHYDRATES IN THE BODY
        1. Energy Source
        2. Protein-Sparer
        INTEGRATIVE QUESTION
        3. Metabolic Primer/Prevents Ketosis
        4. Fuel for the Central Nervous System
      - CARBOHYDRATE DYNAMICS DURING PHYSICAL ACTIVITY
        High-Intensity Exercise
        FIGURE 1.5
        Moderate and Prolonged Exercise
        FIGURE 1.6
        Effect of Diet on Muscle Glycogen Stores and Endurance
        FIGURE 1.7
    - Summary
    - PART 2: LIPIDS
      - THE NATURE OF LIPIDS
      - KINDS AND SOURCES OF LIPIDS
        Simple Lipids
        FIGURE 1.8
        Carbon Chains in Fatty Acids
        Unsaturated Fatty Acids
        FIGURE 1.9
        Triacylglycerol Formation
        FIGURE 1.10
        Triacylglycerol Breakdown
        FIGURE 1.11
        Trans-Fatty Acids: Unwanted at Any Levels
        Lipids: The Good, the Bad, and the Ugly
        Lipids in the Diet
        FIGURE 1.12
        Fish Oils.
        Compound Lipids
        High-Density, Low-Density, and Very Low-Density Lipoproteins
        FIGURE 1.13
        HDL Versus LDL: A Health Perspective.
        Derived Lipids
        Functions of Cholesterol
        Cholesterol and Coronary Heart Disease Risk
      - RECOMMENDED LIPID INTAKE
        Reduce Saturated Fat and Cholesterol in the Diet
      - ROLE OF LIPID IN THE BODY
        Energy Source and Reserve
        INTEGRATIVE QUESTION
        Fat and Energy Content of the Body.
        FIGURE 1.14
        Protection of Vital Organs and Thermal Insulation
        Vitamin Carrier and Hunger Depressor
      - FAT DYNAMICS DURING PHYSICAL ACTIVITY
        FIGURE 1.15
        FIGURE 1.16
        FIGURE 1.17
        Exercise Training and Fat Use
        FIGURE 1.18
        INTEGRATIVE QUESTION
    - Summary
    - PART 3: PROTEINS
      - THE NATURE OF PROTEINS
        FIGURE 1.19
      - KINDS OF PROTEIN
        Protein Sources
        TABLE 1.3: Common Sources of Dietary Protein Rated for Protein Quality
        TABLE 1.4: Good Food Sources of Protein
        The Vegan Approach
        FIGURE 1.20
      - RECOMMENDED PROTEIN INTAKE
        The RDA: A Liberal Standard
        TABLE 1.5: Protein Recommended Dietary Allowance (RDA) for Adolescent and Adult Men and Women
        Do Athletes Require a Larger Protein Intake?
      - PROTEIN’S ROLE IN THE BODY
      - DYNAMICS OF PROTEIN METABOLISM
        FIGURE 1.21
        IN A PRACTICAL SENSE: Reading and Understanding the Food Label (Nutrition Panel)
        NUTRITION PANEL TITLE
        NUTRIENTS LISTED ON LABEL
        DEFINITIONS
        Fate of Amino Acids After Nitrogen Removal
        FIGURE 1.22
      - NITROGEN BALANCE
        FIGURE 1.23
        INTEGRATIVE QUESTION
      - PROTEIN DYNAMICS DURING PHYSICAL ACTIVITY
        FIGURE 1.24
        Some Modification Required for Recommended Protein Intake
        INTEGRATIVE QUESTION
        The Alanine–Glucose Cycle
        FIGURE 1.25
    - Summary
  - CHAPTER 2: Vitamins, Minerals, and Water
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: VITAMINS
      - THE NATURE OF VITAMINS
      - KINDS OF VITAMINS
        Fat-Soluble Vitamins
        Water-Soluble Vitamins
      - ROLE OF VITAMINS
        FIGURE 2.1
        INTEGRATIVE QUESTION
        TABLE 2.1: Food Sources, Major Bodily Functions, and Symptoms of Deficiency or Excess of the Fat-Soluble and Water-Soluble Vitamins for Healthy Adults (19–50 Years)
      - DEFINING NUTRIENT NEEDS
        Dietary Reference Intakes
        FIGURE 2.2
        TABLE 2.2: Dietary Reference Intakes (DRIs): Recommended Vitamin Intakes
        TABLE 2.3: Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULsa)
        Antioxidant Role of Vitamins
        Protection from Disease
        How Antioxidant Vitamins Serve to Neutralize Free Radicals
        Obtain Vitamins From Food, Not Supplements
        Vitamin-Rich Food Sources
      - PHYSICAL ACTIVITY, FREE RADICALS, AND ANTIOXIDANTS
        Increased Metabolism in Exercise and Free-Radical Production
        FIGURE 2.3
        Important Questions
      - DOES VITAMIN SUPPLEMENTATION PROVIDE A COMPETITIVE EDGE?
        FIGURE 2.4
        INTEGRATIVE QUESTION
        Protection Against Upper Respiratory Tract Infection.
        A Healthful Way to Reduce Cold Risk
        Vitamins and Exercise Performance
        FIGURE 2.5
    - Summary
    - PART 2: MINERALS
      - THE NATURE OF MINERALS
        TABLE 2.4: Dietary Reference Intakes (DRIs): Recommended Mineral Intakes
        TABLE 2.5: Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULsa)
        TABLE 2.6: The Important Major and Trace Minerals for Healthy Adults (Age 19–50 Years) and Their Food Sources, Functions, and the Effects of Deficiencies and Excesses
      - ROLE OF MINERALS IN THE BODY
        FIGURE 2.6
      - CALCIUM
        Osteoporosis: Calcium, Estrogen, and Exercise
        FIGURE 2.7
        INTEGRATIVE QUESTION
        A Progressive Disease
        Bone Health Diagnostic Criteria Based on Variation (Standard Deviation [SD]) of Observed Bone Density Values Compared to Values for Sex-Matched Young Adult Population
        Fifteen Risk Factors for Osteoporosis
        Prevention of Bone Loss Through Diet
        FIGURE 2.8
        National Academy of Sciences Recommended Daily Calcium Intake
        Estrogen’s Role in Bone Health
        Physical Activity Benefits.
        FIGURE 2.9
        A More Important Role for Vitamin D
        Obtain Calcium From Food, Not Supplements
        Related to Muscular Strength.
        Site-Specific Effects.
        INTEGRATIVE QUESTION
        Six Principles to Promote Bone Health with Physical Activity
        Mechanism for Bone Matrix Increase.
        FIGURE 2.10
      - THE FEMALE ATHLETE TRIAD: AN UNEXPECTED PROBLEM FOR WOMEN WHO TRAIN INTENSELY
        FIGURE 2.11
        INTEGRATIVE QUESTION
        FIGURE 2.12
        INTEGRATIVE QUESTION
      - PHOSPHORUS
      - MAGNESIUM
      - IRON
        TABLE 2.7: Recommended Dietary Allowances for Iron
        Females: A Population at Risk
        Exercise-Induced Anemia: Fact or Fiction?
        Real Anemia or Pseudoanemia?
        FIGURE 2.13
        Should Athletes Take an Iron Supplement?
        Importance of Iron Source
        Factors Affecting Iron Absorption
        Functional Anemia
        FIGURE 2.14
      - SODIUM, POTASSIUM, AND CHLORINE
        TABLE 2.8: Electrolyte Concentrations in Blood Serum and Sweat, and Carbohydrate and Electrolyte Concentrations of Some Popular Beverages
        Optimal Sodium Intake
        Sodium-Induced Hypertension
      - MINERALS AND EXERCISE PERFORMANCE
        Mineral Loss in Sweat
        IN A PRACTICAL SENSE: Lowering High Blood Pressure with Dietary Intervention: The DASH Diet
        THE DASH APPROACH
        TABLE 1: Daily Nutrient Goals Used in the DASH Studies (for a 2100-Calorie Eating Plan)
        SAMPLE DASH DIET
        TABLE 2: Sample DASH Diet (2100 kcal)
        Defense Against Mineral Loss
        Trace Minerals and Physical Activity
    - Summary
    - PART 3: WATER
      - THE BODY’S WATER CONTENT
        FIGURE 2.15
        Functions of Body Water
      - WATER BALANCE: INTAKE VERSUS OUTPUT
        FIGURE 2.16
        Water Intake
        Water in Foods
        Water from Liquids
        Metabolic Water
        Water Output
        Water Loss in Urine
        Water Loss Through the Skin
        Water Loss as Vapor
        Water Loss in Feces
      - WATER REQUIREMENT IN PHYSICAL ACTIVITY
        Hyponatremia
        FIGURE 2.17
        Five Predisposing Factors to Hyponatremia
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 3: Optimal Nutrition for Physical Activity
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - NUTRIENT INTAKE AMONG THE PHYSICALLY ACTIVE
      - TABLE 3.1: Average Values for Nutrient Intake Based on 3-Day Diet Records by Levels of Cardiorespiratory Fitness in 7059 Men and 2453 Women
      - INTEGRATIVE QUESTION
      - Recommended Nutrient Intake
        FIGURE 3.1
        Protein
        INTEGRATIVE QUESTION
        Lipid
        High-Fat Versus Low-Fat Diets for Exercise Training and Performance
        High-Fat Diets.
        FIGURE 3.2
        Low-Fat Diets.
        Carbohydrate
        Glycogen: An Important Fuel for Physical Activity
        Carbohydrate Needs in Intense Training.
        FIGURE 3.3
        INTEGRATIVE QUESTION
        IN A PRACTICAL SENSE: Nutrition to Prevent Chronic Athletic Fatigue
        DEPLETED CARBOHYDRATE PLAYS A ROLE
        Four Practical Nutritional Guidelines to Prevent Chronic Fatigue
    - THE ESSENTIALS OF GOOD NUTRITION
    - MYPLATE: THE HEALTHY EATING GUIDE
      - FIGURE 3.4
      - Healthy Eating Plate: A Viable Alternative to MyPlate
      - Goals and Guidelines for Healthful Eating
      - INTEGRATIVE QUESTION
    - PHYSICAL ACTIVITY AND FOOD INTAKE
      - FIGURE 3.5
      - Physical Activity Makes a Difference
        FIGURE 3.6
      - Tour de France and Other Endurance Activities
        FIGURE 3.7
      - Ultra-Endurance Running Competition
        TABLE 3.2: Race Conditions, Distance Covered, Average Daily Speed, Rest and Sleep Patterns, and Nutrient Balance During an Elite Ultraendurance Performance Racea
        TABLE 3.3: Daily and Total Energy Balance, Nutrient Distributions in Food, and Water Intake During an Elite Ultraendurance Performance Racea
      - Extreme Ultra-Endurance Sports
        FIGURE 3.8
        High-Risk Sports for Marginal Nutrition
        FIGURE 3.9
      - Eat More and Weigh Less
    - PRECOMPETITION MEAL
      - Making a Choice—Protein or Carbohydrate?
      - INTEGRATIVE QUESTION
      - Liquid and Prepackaged Bars, Powders, and Meals
      - Liquid Meals
      - Nutrition Bars
        Nutrient Composition of Nutrition Bars Varies with Purpose
      - Nutrition Powders and Drinks
        Large Spike in Emergency Room Visits Linked to Energy Drinks
    - CARBOHYDRATE FEEDINGS PRIOR TO, DURING, AND IN RECOVERY FROM PHYSICAL ACTIVITY
      - Prior to Physical Activity
        Debate Concerning Fructose
      - During Physical Activity
        FIGURE 3.10
      - Replenishing Glycogen Reserves: Refueling for the Next Bout of Intense Training or Competition
        FIGURE 3.11
        FIGURE 3.12
        INTEGRATIVE QUESTION
        Practical Recommendations
        Glycogen Replenishment Takes Time
        Does the Coingestion of Caffeine and Protein with Carbohydrate Facilitate Postexercise Muscle Glycogen Synthesis? The Carbohydrate Amount May Be Crucial
        Cellular Uptake of Glucose
      - The Glycemic Index and Pre-exercise Feedings
        FIGURE 3.13
        INTEGRATIVE QUESTION
    - GLUCOSE FEEDINGS, ELECTROLYTES, AND WATER UPTAKE
      - Important Considerations
        FIGURE 3.14
        Particles in Solution
        Three Recommendations for Fluid and Carbohydrate Replenishment During Exercise
      - Recommended Oral Rehydration Beverage
        Conventional Fluid Replacement Beverage Versus Carbohydrate/Protein Powders and Drinks: Understanding the Difference
        Five Qualities of the Ideal Oral Rehydration Beverage
        FIGURE 3.15
    - Summary
- SECTION 2: Energy for Physical Activity
  - OVERVIEW
  - INTERVIEW WITH: Dr. John O. Holloszy
  - CHAPTER 4: Energy Value of Food
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - MEASUREMENT OF FOOD ENERGY
      - The Calorie as a Measurement Unit
        Calories, Calories, or Kilocalories?
      - Gross Energy Value of Foods
        FIGURE 4.1
        Clear Distinction Between Temperature and Heat
        Conversion Between Calories and Joules
        Heat of Combustion: Lipids
        Heat of Combustion: Carbohydrates
        Heat of Combustion: Proteins
        Comparing the Energy Value of Macronutrients
        INTEGRATIVE QUESTION
      - Net Energy Value of Foods
        Coefficient of Digestibility
        TABLE 4.1: Factors for Digestibility, Heats of Combustion, and Net Physiologic Energy Valuesa of Protein, Lipid, and Carbohydrate
        Atwater General Factors
        A Calorie is a Calorie is a Calorie: Maybe, Maybe Not!
        IN A PRACTICAL SENSE: Determining a Food’s Macronutrient Composition and Energy Contribution
        CALCULATIONS
        LEARN TO READ FOOD LABELS
        Macronutrient Energy Content and Percentage Composition of McDonald’s French Fries, Large (Total Weight, 122.3 g [4.3 oz])
        Use of Tabled Values
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 5: Introduction to Energy Transfer
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - ENERGY—THE CAPACITY FOR WORK
      - INTEGRATIVE QUESTION
      - Potential and Kinetic Energy
        FIGURE 5.1
      - Energy-Releasing and Energy-Conserving Processes
        FIGURE 5.2
    - INTERCONVERSIONS OF ENERGY
      - Forms of Energy
        FIGURE 5.3
        Examples of Energy Conversions
        Photosynthesis.
        FIGURE 5.4
        Respiration.
        FIGURE 5.5
        INTEGRATIVE QUESTION
    - BIOLOGIC WORK IN HUMANS
      - Mechanical Work
      - Chemical Work
        IN A PRACTICAL SENSE: Measurement of Work on a Treadmill, Cycle Ergometer, and Step Bench
        CALCULATION OF TREADMILL WORK
        Example
        CALCULATION OF CYCLE ERGOMETER WORK
        Example
        CALCULATION OF WORK DURING BENCH STEPPING
        Example
      - Transport Work
    - ENZYMES AND COENZYMES ALTER THE RATE OF ENERGY RELEASE
      - Enzymes as Biologic Catalysts
        Six Classifications of Enzymes
        Enzymes Alter Reaction Rates
        FIGURE 5.6
        Enzyme Mode of Action
        FIGURE 5.7
      - Coenzymes
        Vitamins Serve as Coenzymes But Do Not Provide Energy
        Enzyme Inhibition
    - HYDROLYSIS AND CONDENSATION: THE BASIS FOR DIGESTION AND SYNTHESIS
      - Hydrolysis Reactions
        FIGURE 5.8
      - Condensation Reactions
      - Oxidation and Reduction Reactions
        An Aid to Remember
        FIGURE 5.9
        INTEGRATIVE QUESTION
        FIGURE 5.10
      - Measuring Energy Transfer in Humans
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 6: Energy Transfer in the Body
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: PHOSPHATE BOND ENERGY
      - ADENOSINE TRIPHOSPHATE: THE ENERGY CURRENCY
        FIGURE 6.1
        FIGURE 6.2
        FIGURE 6.3
        ATP: A Limited Currency
      - PHOSPHOCREATINE: THE ENERGY RESERVOIR
        FIGURE 6.4
        Specificity of Training the Immediate Energy System
        The Fuel for Explosive, Short-Term Exercise
      - CELLULAR OXIDATION
        Electron Transport
        FIGURE 6.5
        FIGURE 6.6
        Oxidative Phosphorylation
        FIGURE 6.7
        Efficiency of Electron Transport–Oxidative Phosphorylation
      - OXYGEN’S ROLE IN ENERGY METABOLISM
    - Summary
    - PART 2: ENERGY RELEASE FROM MACRONUTRIENTS
      - FIGURE 6.8
      - FIGURE 6.9
      - ENERGY RELEASE FROM CARBOHYDRATE
        Anaerobic Versus Aerobic Glycolysis
        Anaerobic Energy Release From Glucose: Rapid Glycolysis
        FIGURE 6.10
        Metabolism of Glucose to Glycogen and Glycogen to Glucose
        Regulation of Glycogen Metabolism
        The Glycogenolysis Cascade
        Substrate-Level Phosphorylation in Glycolysis
        Regulation of Glycolysis
        Hydrogen Release in Glycolysis
        More About Lactate
        Lactic Acid Versus Lactate
        FIGURE 6.11
        Lactate: A Valuable “Waste Product.”
        FIGURE 6.12
        Lactate Shuttle: Blood Lactate as an Energy Source.
        Aerobic (Slow) Glycolysis: The Citric Acid Cycle
        FIGURE 6.13
        FIGURE 6.14
        Free Radicals Form During Aerobic Metabolism
        Total Energy Transfer From Glucose Catabolism
        FIGURE 6.15
        What Regulates Energy Metabolism?
        Independent Effects.
      - ENERGY RELEASE FROM FAT
        INTEGRATIVE QUESTION
        Adipocytes: The Site of Fat Storage and Mobilization
        FIGURE 6.16
        INTEGRATIVE QUESTION
        Hormonal Effects
        Catabolism of Glycerol and Fatty Acids
        FIGURE 6.17
        Glycerol
        INTEGRATIVE QUESTION
        Fatty Acids
        Total Energy Transfer From Fat Catabolism
        IN A PRACTICAL SENSE: Potential for Glucose Synthesis from Triacylglycerol Components
        NO GLUCOSE SYNTHESIS FROM FATTY ACIDS
        LIMITED GLUCOSE FROM TRIACYLGLYCEROL-DERIVED GLYCEROL
      - ENERGY RELEASE FROM PROTEIN
        INTEGRATIVE QUESTION
        Protein Breakdown Facilitates Water Loss
      - THE METABOLIC MILL: INTERRELATIONSHIPS AMONG CARBOHYDRATE, FAT, AND PROTEIN METABOLISM
        FIGURE 6.18
        Glucose Conversion to Fat
        Excess Dietary Protein Accumulates as Fat
        Protein Conversion to Fat
        Fats Burn in a Carbohydrate Flame
        A Slower Rate of Energy Release From Fat
    - Summary
  - CHAPTER 7: Energy Transfer During Physical Activity
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - IMMEDIATE ENERGY: THE ATP–PCr SYSTEM
    - SHORT-TERM GLYCOLYTIC (LACTATE-FORMING) ENERGY SYSTEM
      - Lactate Accumulation
        FIGURE 7.1
      - Lactate-Producing Capacity
    - LONG-TERM ENERGY: THE AEROBIC SYSTEM
      - Oxygen Consumption During Exercise
        FIGURE 7.2
        Lactic Acid, Lactate, and pH
      - Oxygen Deficit
        FIGURE 7.3
      - Oxygen Deficit in the Trained and Untrained
        INTEGRATIVE QUESTION
      - Maximal Oxygen Consumption
        FIGURE 7.4
        FIGURE 7.5
      - Fast- and Slow-Twitch Muscle Fibers Generate ATP Differently
        FIGURE 7.6
        IN A PRACTICAL SENSE: Interpreting V˙O2MAX—Establishing Cardiovascular Fitness Categories
        Cardiovascular Fitness Classifications
    - ENERGY SPECTRUM OF PHYSICAL ACTIVITY
      - FIGURE 7.7
      - TABLE 7.1: Estimate of the Percent Contribution of Different Fuels to ATP Generation in Various Running Events (Assumes 70-kg Male)
      - INTEGRATIVE QUESTION
    - OXYGEN CONSUMPTION DURING RECOVERY
      - FIGURE 7.8
      - Metabolic Dynamics of Recovery Oxygen Consumption
        Early Theories About Postexercise Oxygen Consumption (the So-Called “Oxygen Debt”)
      - Contemporary Concepts
        FIGURE 7.9
        FIGURE 7.10
      - Implications of EPOC for Exercise and Recovery
      - Optimal Recovery from Steady-Rate Physical Activity
      - Optimal Recovery from Non-Steady-Rate Physical Activity
        FIGURE 7.11
      - Intermittent (Interval) Physical Activity
        TABLE 7.2: Classic Study Results with Intermittent Physical Activity
    - Summary
  - CHAPTER 8: Measurement of Human Energy Expenditure
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - MEASURING THE BODY’S HEAT PRODUCTION
      - FIGURE 8.1
      - Direct Calorimetry
        FIGURE 8.2
      - Indirect Calorimetry
        INTEGRATIVE QUESTION
        Closed-Circuit Spirometry
        FIGURE 8.3
        Open-Circuit Spirometry
        Portable Spirometry
        FIGURE 8.4
        Bag Technique
        FIGURE 8.5
        Computerized Instrumentation
        FIGURE 8.6
        IN A PRACTICAL SENSE: Calculating Oxygen Consumption (V˙O2), Carbon Dioxide Production (V˙CO2), and the Respiratory Quotient (RQ) Using Open-Circuit Spirometry
        NITROGEN EXCHANGE: THE HALDANE TRANSFORMATION
        CALCULATING V˙O2 USING EXPIRED AIR VOLUME
        True O2
        CALCULATING V˙O2 USING INSPIRED AIR VOLUME
        CALCULATING CARBON DIOXIDE PRODUCTION (VC˙O2)
        CALCULATING THE RESPIRATORY QUOTIENT (RQ)
        Example
        INTEGRATIVE QUESTION
        Chemical Gas Analyzers for Calibration Purposes.
        FIGURE 8.7
        INTEGRATIVE QUESTION
      - Direct Versus Indirect Calorimetry
    - DOUBLY LABELED WATER TECHNIQUE
    - RESPIRATORY QUOTIENT
      - RQ for Carbohydrate
      - RQ for Fat
      - RQ for Protein
      - Nonprotein RQ
        TABLE 8.1: Thermal Equivalents of Oxygen for the Nonprotein RQ, Including Percentage Kilocalories and Grams Derived from Carbohydrate and Fat
        IN A PRACTICAL SENSE: The Weir Method to Calculate Energy Expenditure
        BASIC EQUATION
        EXAMPLE
        Weir Factors
      - How Much Food Metabolizes for Energy?
      - RQ for a Mixed Diet
        INTEGRATIVE QUESTION
    - RESPIRATORY EXCHANGE RATIO (RER)
    - Summary
  - CHAPTER 9: Human Energy Expenditure During Rest and Physical Activity
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - FIGURE 9.1
    - PART 1: ENERGY EXPENDITURE AT REST
      - BASAL AND RESTING METABOLIC RATE
      - METABOLIC SIZE CONCEPT
        FIGURE 9.2
      - METABOLIC RATES OF HUMANS: AGE AND GENDER COMPARISONS
        FIGURE 9.3
        Effects of Regular Physical Activity
        FIGURE 9.4
        “Normalcy” of BMR Values
        TABLE 9.1: Standard Basal Metabolic Rates
        Estimating Resting Daily Energy Expenditure
        TABLE 9.2: Estimation of Resting Daily Energy Expenditure (RDEE) Based on Fat-Free Body Mass (FFM)
        Contribution of Diverse Tissues to Human Metabolism
        TABLE 9.3: Oxygen Consumption of Various Body Tissues at Rest for a 65-kg Man
        INTEGRATIVE QUESTION
      - FIVE FACTORS THAT AFFECT TOTAL DAILY ENERGY EXPENDITURE
        Physical Activity
        IN A PRACTICAL SENSE: Estimating Resting Daily Energy Expenditure from Body Mass, Stature, and Age
        HARRIS-BENEDICT EQUATIONS FOR PREDICTING BMR
        Women
        Men
        Example—Female
        Example—Male
        Diet-Induced Thermogenesis
        IN A PRACTICAL SENSE: Predicting V˙O2max During Pregnancy from Submaximum Exercise Heart Rate and Oxygen Consumption
        PREDICTING V˙O2MAX FROM SUBMAXIMUM EXERCISE
        SUBMAXIMUM CYCLE ERGOMETER TEST
        PREDICTION EQUATIONS
        EXAMPLE
        Calorigenic Effect of Food on Exercise Metabolism
        Climate
        Pregnancy
    - Summary
    - PART 2: ENERGY EXPENDITURE DURING PHYSICAL ACTIVITY
      - CLASSIFICATION OF PHYSICAL ACTIVITIES BY ENERGY EXPENDITURE
      - THE MET
        TABLE 9.4: Five-Level Classification of Physical Activity Based on Energy Expenditure
        TABLE 9.5: Characterization of the Intensity of Leisure-Time Physical Activity Related to Age
      - DAILY RATES OF AVERAGE ENERGY EXPENDITURE
        TABLE 9.6: Reference Heights, Weights, and Energy Expenditures of Children and Adults Living in the United States
      - ENERGY COST OF HOUSEHOLD, INDUSTRIAL, AND RECREATIONAL ACTIVITIES
        Influence of Body Mass
        FIGURE 9.5
      - HEART RATE TO ESTIMATE ENERGY EXPENDITURE
        FIGURE 9.6
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 10: Energy Expenditure During Walking, Jogging, Running, and Swimming
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - GROSS VERSUS NET ENERGY EXPENDITURE
    - ECONOMY OF HUMAN MOVEMENT
      - Changes in Efficiency During a Competitive Season Related to Training Volume and Intensity
      - Economy of Movement
        FIGURE 10.1
        Running Economy Improves With Age
      - Mechanical Efficiency
        Delta Efficiency
    - ENERGY EXPENDITURE DURING WALKING
      - FIGURE 10.2
      - Influence of Body Mass
        TABLE 10.1: Prediction of Energy Expenditure (kcal · min−1) from Speed of Level Walking and Body Massa
      - Terrain and Walking Surface
        TABLE 10.2: Effect of Different Terrain on the Energy Expenditure of Walking Between 5.2 and 5.6 km · hr−1
        Downhill Walking
        FIGURE 10.3
      - Footwear and Other Distal Leg Loads
        Walking
        Running
        INTEGRATIVE QUESTION
        Competition Walking
        FIGURE 10.4
        FIGURE 10.5
        Speed, Pace Times, and Target Distance Conversions
    - ENERGY EXPENDITURE DURING RUNNING
      - Elite Runners Run More Economically
      - IN A PRACTICAL SENSE: Predicting Energy Expenditure During Treadmill Walking and Running
        BASIC EQUATION
        Walking
        Running
        PREDICTING ENERGY EXPENDITURE OF TREADMILL WALKING
        Problem
        Solution
        PREDICTING ENERGY EXPENDITURE OF TREADMILL RUNNING
        Problem
        Solution
      - Economy of Running Fast or Slow
        INTEGRATIVE QUESTION
      - Net Energy Expenditure Values
        TABLE 10.3: Net Energy Expenditure Per Hour of Horizontal Running Related to Velocity and Body Massa
        TABLE 10.4: Energy Requirements (METs) for Horizontal and Grade Walking and Running on a Solid Surface
      - Stride Length, Stride Frequency, and Speed
        Running
        FIGURE 10.6
        Competition Walking
        Optimum Stride Length
        FIGURE 10.7
        Edward Payson Weston: Walker Extraordinaire
      - Running Economy: Children and Adults, Trained and Untrained
        FIGURE 10.8
        FIGURE 10.9
        INTEGRATIVE QUESTION
      - Air Resistance
        FIGURE 10.10
        Drafting: Beneficial Outcomes
        Treadmill Versus Track Running
        TABLE 10.5: Comparison of Average Metabolic Responses During Treadmill and Track Running
      - Marathon Running
        Exercise Economy and Muscle Fiber Type
    - SWIMMING
      - Methods of Measurement
        FIGURE 10.11
      - Energy Expenditure and Drag
        Ways to Reduce Drag Force Effects
        FIGURE 10.12
        Kayaking.
      - Energy Expenditure, Swimming Velocity, and Skill
        FIGURE 10.13
      - Effects of Water Temperature
        FIGURE 10.14
      - Effects of Buoyancy: Men Versus Women
        TABLE 10.6: Comparisons of English Channel World Record Swimming Times Between Men and Women
      - Endurance Swimmers
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 11: Individual Differences and Measurement of Energy Capacities
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - SPECIFICITY VERSUS GENERALITY OF METABOLIC CAPACITY AND EXERCISE PERFORMANCE
      - FIGURE 11.1
      - INTEGRATIVE QUESTION
    - OVERVIEW OF ENERGY-TRANSFER CAPACITY DURING EXERCISE
      - FIGURE 11.2
    - ANAEROBIC ENERGY TRANSFER: THE IMMEDIATE AND SHORT-TERM ENERGY SYSTEMS
      - Performance Tests to Evaluate the Immediate Energy System
        Stair-Sprinting Power Tests
        FIGURE 11.3
        INTEGRATIVE QUESTION
        Jumping-Power Tests
        What is a Fast Runner?
        Other Power Performance Tests
        Interrelationships Among Power Performance Tests
        TABLE 11.1: Correlations Among Measures of Immediate Anaerobic Power Output
      - Tests to Evaluate the Immediate Energy System
        High-Intensity Interval Training (HIIT) Reduces Fat in Overweight Young Males
      - Performance Test Evaluation of the Short-Term Energy System
        A Considerable Energy Output
        TABLE 11.2: Wingate Percentile Norms for Average Power and Peak Power for Physically Active Young Adult Men and Women
        The Fastest Creatures in the Sky, On Land, and in Water
        FIGURE 11.4
        Lower in Children.
        Gender Differences.
        Marathon Records Difficult to Repeat
        Maximally Accumulated Oxygen Deficit
      - Assessing the Short-Term Energy System
        Blood Lactate Levels
        IN A PRACTICAL SENSE: Determining Anaerobic Power and Capacity: The Wingate Cycle Ergometer Test
        THE TEST
        RESISTANCE
        TEST SCORES
        EXAMPLE
        CALCULATIONS
        INTEGRATIVE QUESTION
        Glycogen Depletion
        FIGURE 11.5
      - Individual Differences in Short-Term Energy-Transfer Capacity
        Effects of Training
        Buffering of Acid Metabolites
        Motivation
    - AEROBIC ENERGY: THE LONG-TERM ENERGY SYSTEM
      - FIGURE 11.6
      - Physiologic Tests to Evaluate the Long-Term Aerobic Energy System Assessment of Maximal Oxygen Consumption
      - Criteria for Maximal Oxygen Consumption
        FIGURE 11.7
        Maximal Oxygen Consumption Tests
        INTEGRATIVE QUESTION
        Test Comparisons
        TABLE 11.3: Average V˙O2max for 15 Male College Students During Continuous and Discontinuous Tests on the Treadmill and Bicycle Ergometera
        Common Treadmill Protocols.
        FIGURE 11.8
        INTEGRATIVE QUESTION
      - Factors That Affect Maximal Oxygen Consumption
        Mode of Activity
        Heredity
        FIGURE 11.9
        State of Training
        Gender
        Body Size and Composition
        TABLE 11.4: Different Ways to Express Oxygen Consumption
        Age
        FIGURE 11.10
        Children.
        Adults.
        Prediction Test Evaluation of the Long-Term Aerobic Energy System
        A Word of Caution About Predictions
        Walking Tests
      - Endurance Runs
        Limitations for Use with Children
      - Predictions Based on Heart Rate
        FIGURE 11.11
      - The Step Test
        INTEGRATIVE QUESTION
        FIGURE 11.12
      - A Novel Approach to Predicting V˙O2max from Nonexercise Data
        TABLE 11.5: Input Information on Level of Physical Activity and Perceived Functional Capacity for Predicting V˙O2max from Nonexercise Data
        Equation
        Example
        Computation
    - Summary
- SECTION 3: Aerobic Systems of Energy Delivery and Utilization
  - OVERVIEW
  - INTERVIEW WITH: Dr. Loring B. Rowell
  - CHAPTER 12: Pulmonary Structure and Function
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - SURFACE AREA AND GAS EXCHANGE
      - FIGURE 12.1
    - ANATOMY OF VENTILATION
      - Pulmonary Respiration Versus Cellular Respiration: A Conflict in Terms?
      - The Lungs
        FIGURE 12.2
      - The Alveoli
    - MECHANICS OF VENTILATION
      - FIGURE 12.3
      - FIGURE 12.4
      - FIGURE 12.5
      - Inspiration
        Body Position Facilitates Breathing
      - Expiration
      - Surfactant
    - LUNG VOLUMES AND CAPACITIES
      - FIGURE 12.6
      - Static Lung Volumes
        Residual Lung Volume
        Effects of Previous Physical Activity.
      - Dynamic Lung Volumes
        FEV-to-FVC Ratio
        FIGURE 12.7
        Maximum Voluntary Ventilation
        INTEGRATIVE QUESTION
      - Physical Activity Implications of Gender Differences in Static and Dynamic Lung Function Measures
        Ventilatory Muscles Respond to Training
    - LUNG FUNCTION, AEROBIC FITNESS, AND PHYSICAL PERFORMANCE
      - TABLE 12.1: Anthropometric Data, Pulmonary Function, and Resting Minute Ventilation in 20 Marathon Runners and Healthy Controls
    - PULMONARY VENTILATION
      - Minute Ventilation
      - Alveolar Ventilation
        IN A PRACTICAL SENSE: Predicting Pulmonary Function Variables in Men and Women
        EQUATIONS
        Data
        EXAMPLES
        Woman
        Man
        Equations to Predict Pulmonary Function Variables by Age and Gender
        Typical Values for Pulmonary Ventilation During Rest and Moderate and Intense Physical Activity
        TABLE 12.2: Relationships Among Tidal Volume, Breathing Rate, and Both Total and Alveolar Minute Ventilation
        Dead Space Versus Tidal Volume
        Ventilation–Perfusion Ratio
        Bronchopulmonary Segments
        Physiologic Dead Space
        FIGURE 12.8
        Breathing Rate Versus Tidal Volume
        FIGURE 12.9
        INTEGRATIVE QUESTION
    - VARIATIONS FROM NORMAL BREATHING PATTERNS
      - Hyperventilation
      - Dyspnea
      - Valsalva Maneuver
        FIGURE 12.10
        Physiologic Consequences of Performing the Valsalva Maneuver
        A Common Misconception.
        INTEGRATIVE QUESTION
    - THE RESPIRATORY TRACT DURING COLD-WEATHER PHYSICAL ACTIVITY
      - Postexercise Coughing
    - Summary
  - CHAPTER 13: Gas Exchange and Transport
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: GASEOUS EXCHANGE IN THE LUNGS AND TISSUES
      - CONCENTRATIONS AND PARTIAL PRESSURES OF RESPIRED GASES
        Ambient Air
        TABLE 13.1: Partial Pressure and Volume of Gases in Dry Ambient Air at Sea Level
        Mercury Instead of Water
        Common Symbols for Gas Pressure in Respiratory Physiology
        Tracheal Air
        Alveolar Air
        TABLE 13.2: Partial Pressure and Volume of Dry Alveolar Gases at Sea Level (98.6°F [37°C])
      - GAS MOVEMENT IN AIR AND FLUIDS
        Pressure Differential
        FIGURE 13.1
        Solubility—The Dissolving Power of a Gas
      - GAS EXCHANGE IN THE LUNGS AND TISSUES
        FIGURE 13.2
        Approximate Solubility Coefficients of Gases in Physiologic Fluids
        Gas Exchange in the Lungs
        Impaired Alveolar Gas Transfer
        INTEGRATIVE QUESTION
        Gas Transfer in Tissues
    - Summary
    - PART 2: OXYGEN TRANSPORT
      - OXYGEN TRANSPORT IN BLOOD
        Oxygen in Physical Solution
        Oxygen Combined with Hemoglobin
        FIGURE 13.3
        Oxygen-Carrying Capacity of Hemoglobin
        IN A PRACTICAL SENSE: Factors that Contribute to the Smoking Habit
        WHY PEOPLE START SMOKING
        CIGARETTES CAUSE ADDICTION
        THE WHY-DO-YOU-SMOKE TEST
        Why-Do-You-Smoke Test
        Anemia Affects Oxygen Transport.
        TABLE 13.3: Hemoglobin (Hb) Levels and Exercise Heart Rates of Normal and Anemic Subjects Prior to and Following Supplemental Iron Treatment
        Po2 and Hemoglobin Saturation
        FIGURE 13.4
        Po2 in the Lungs
        The Bohr Effect
        FIGURE 13.5
        INTEGRATIVE QUESTION
        Po2 in the Tissues
        Arteriovenous Oxygen Difference
        FIGURE 13.6
        Red Blood Cell 2,3-DPG
        Myoglobin, the Muscle’s Oxygen Storage
        Oxygen Released at Low Pressures
    - Summary
    - PART 3: CARBON DIOXIDE TRANSPORT
      - CARBON DIOXIDE TRANSPORT IN THE BLOOD
        FIGURE 13.7
        Carbon Dioxide in Physical Solution
        Carbon Dioxide Transport As Bicarbonate
        Carbon Dioxide Transport as Carbamino Compounds
    - Summary
  - CHAPTER 14: Dynamics of Pulmonary Ventilation
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: REGULATION OF PULMONARY VENTILATION
      - VENTILATORY CONTROL
        FIGURE 14.1
        Neural Factors
        Humoral Factors
        Plasma Po2 and Peripheral Chemoreceptors
        FIGURE 14.2
        Plasma Pco2 and H+ Concentration
        Hyperventilation and Breath Holding
        A Potentially Dangerous Maneuver
      - REGULATION OF VENTILATION DURING PHYSICAL ACTIVITY
        Chemical Control
        FIGURE 14.3
        Nonchemical Control
        Neurogenic Factors
        Influence of Temperature
        Integrated Regulation
        During Physical Activity
        FIGURE 14.4
        During Recovery
    - Summary
    - PART 2: PULMONARY VENTILATION DURING PHYSICAL ACTIVITY
      - VENTILATION AND ENERGY DEMANDS DURING PHYSICAL ACTIVITY
        Ventilation in Steady-Rate Physical Acctivity
        FIGURE 14.5
        Ventilation in Non–Steady-Rate Physical Activity
        Ventilatory Threshold
        Onset of Blood Lactate Accumulation (OBLA)
        FIGURE 14.6
        A Word of Caution
        INTEGRATIVE QUESTION
        Specificity of OBLA.
        Some Independence Between OBLA and V˙2max.
        OBLA and Endurance Performance.
        FIGURE 14.7
        INTEGRATIVE QUESTION
        Racial Differences.
        INTEGRATIVE QUESTION
        IN A PRACTICAL SENSE: Determining the Lactate Threshold
        DIFFERENT INDICATORS OF LT
        Fixed Blood Lactate Concentration
        Ventilatory Threshold
        Blood Lactate–Exercise V˙O2 Response
      - ENERGY COST OF BREATHING
        FIGURE 14.8
        Respiratory Disease
        Cigarette Smoking
        TABLE 14.1: Oxygen Cost of Hyperventilation (HV) in “Smoking” and “Nonsmoking” Exercise at Approximately 80% of V˙O2max
        Cigarette Smoking Blunts Exercise Heart Rate Response
      - DOES VENTILATION LIMIT AEROBIC POWER AND ENDURANCE PERFORMANCE?
        INTEGRATIVE QUESTION
        An Important Exception
        FIGURE 14.9
        INTEGRATIVE QUESTION
    - Summary
    - PART 3: ACID-BASE REGULATION
      - BUFFERING
        FIGURE 14.10
        Chemical Buffers
        Bicarbonate Buffer
        Phosphate Buffer
        Protein Buffer
        Relative Power of Chemical Buffers
        TABLE 14.2: Relative Buffering Power of the Chemical Buffers
      - PHYSIOLOGIC BUFFERS
        Ventilatory Buffer
        Renal Buffer
      - EFFECTS OF INTENSE PHYSICAL ACTIVITY
        FIGURE 14.11
        Summary
  - CHAPTER 15: The Cardiovascular System
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - CARDIOVASCULAR SYSTEM COMPONENTS
      - FIGURE 15.1
      - The Heart
        FIGURE 15.2
        FIGURE 15.3
      - The Arterial System
        FIGURE 15.4
        INTEGRATIVE QUESTION
        Blood Pressure
        Systolic Blood Pressure.
        Diastolic Blood Pressure.
        Mean Arterial Pressure.
        Mean Arterial Pressure: Pulmonary Versus Systemic Circulations
        Cardiac Output and Total Peripheral Resistance.
      - Capillaries
        Blood Flow in Capillaries
        IN A PRACTICAL SENSE: Blood Pressure Measurement, Classifications, and Recommended Follow-Up
        BLOOD PREASURE MEASUREMENT PROCEDURES
        Classification and Recommended Follow-Up of Initial Blood Pressure Screening in Adultsa
        Classification of Blood Pressure (BP) for Adults
        FIGURE 15.5
      - The Venous System
        FIGURE 15.6
        FIGURE 15.7
        Venous Return
        FIGURE 15.8
        The Physiology of Crucifixion
        A Question of an Active Vasculature
        Varicose Veins
        Venous Pooling
        The Active Recovery “Cool-Down.”
        INTEGRATIVE QUESTION
    - HYPERTENSION
      - FIGURE 15.9
      - Lifestyle Choices That Lower Blood Pressure
      - A Prevalent Disorder
        Effective Treatment Strategies
        FIGURE 15.10
        IN A PRACTICAL SENSE: Understanding Hypertension: Effects on Bodily Systems
    - BLOOD PRESSURE RESPONSE TO PHYSICAL ACTIVITY
      - Resistance Exercise
        TABLE 15.1: Comparison of Peak Systolic and Diastolic Blood Pressure at Various Percentages of a Maximum Voluntary Contraction (MVC) During Isometric Exercise and Free-Weight and Hydraulic Bench Press Exercise
        FIGURE 15.11
      - Steady-Rate Physical Activity
        INTEGRATIVE QUESTION
      - Graded Exercise
        FIGURE 15.12
      - Blood Pressure in Upper-Body Physical Activity
        TABLE 15.2: Comparison of Systolic and Diastolic Blood Pressure During Dynamic Arm and Leg Exercise at Similar Percentages of V˙O2max
      - Recovery From Physical Activity
    - THE HEART’S BLOOD SUPPLY
      - FIGURE 15.13
      - Myocardial Oxygen Supply and Use
        For Use in an Emergency
        Effects of Impaired Blood Supply
        FIGURE 15.14
        Rate–Pressure Product: An Estimate of Myocardial Work
        RPP, Physical Activity, and the Heart Disease Patient.
        INTEGRATIVE QUESTION
    - MYOCARDIAL METABOLISM
      - FIGURE 15.15
    - Summary
  - CHAPTER 16: Cardiovascular Regulation and Integration
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - INTRINSIC REGULATION OF HEART RATE
      - FIGURE 16.1
      - The Heart’s Electrical Activity
        Electrocardiogram
        FIGURE 16.2
        The ECG Objectively Monitors Heart Rate During Physical Activity
    - EXTRINSIC REGULATION OF HEART RATE AND CIRCULATION
      - FIGURE 16.3
      - Sympathetic and Parasympathetic Neural Input
        FIGURE 16.4
        Sympathetic Influence
        FIGURE 16.5
        Parasympathetic Influence
        Heart Rate Variability
      - Central Command: Input from Higher Centers
        FIGURE 16.6
        INTEGRATIVE QUESTION
      - Peripheral Input
        Exercise Pressor Reflex
        Carotid Artery Palpation
        Local Factors
    - DISTRIBUTION OF BLOOD
      - Physical Factors Affect Blood Flow
        IN A PRACTICAL SENSE: Electrode Placement for Bipolar and 12-Lead ECG Recordings
        SKIN PREPARATION
        BIPOLAR (3-ELECTRODE) CONFIGURATION
        MODIFIED 12-LEAD (10-ELECTRODE TORSOMOUNTED) CONFIGURATION FOR EXERCISE STRESS TESTING
        ELECTRODE POSITIONING FOR THE MODIFIED 10-ELECTRODE, TORSO-MOUNTED SYSTEM
      - Exercise Effect
        Factors Within Active Muscle
        Nitric Oxide and Autoregulation of Tissue Blood Flow.
        FIGURE 16.7
        Hormonal Factors
    - INTEGRATIVE RESPONSE DURING PHYSICAL ACTIVITY
      - Venous Return Important
    - PHYSICAL ACTIVITY AFTER CARDIAC TRANSPLANTATION
      - FIGURE 16.8
      - Improved Function but Altered Circulatory Dynamics
        FIGURE 16.9
        Sluggish Circulatory Response
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 17: Functional Capacity of the Cardiovascular System
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - CARDIAC OUTPUT
      - Measuring Cardiac Output
        Direct Fick Method
        FIGURE 17.1
        Indicator Dilution Method
        CO2 Rebreathing Method
        INTEGRATIVE QUESTION
    - CARDIAC OUTPUT AT REST
      - Untrained Individuals
      - Endurance Athletes
    - CARDIAC OUTPUT DURING PHYSICAL ACTIVITY
      - TABLE 17.1: Maximal Values for Oxygen Consumption, Heart Rate, Stroke Volume, and Cardiac Output in Three Groups with Very Low, Normal, and High Aerobic Capacities
      - Enhancing Stroke Volume: Diastolic Filling Versus Systolic Emptying
        Ejection Fraction: A Measure of Ventricular Function
        Enhanced Diastolic Filling
        TABLE 17.2: The Effect of Body Position on Cardiac Output, Stroke Volume, and Heart Rate at Rest and During Exercise in Physically Active Subjectsa
        Greater Systolic Emptying
        Cardiovascular Drift: Reduced Stroke Volume and Increased Heart Rate During Prolonged Physical Activity
        FIGURE 17.2
        INTEGRATIVE QUESTION
    - CARDIAC OUTPUT DISTRIBUTION
      - Blood Flow at Rest
        FIGURE 17.3
      - Redistribution of Blood Flow During Physical Activity
        Blood Flow to the Heart and Brain
    - CARDIAC OUTPUT AND OXYGEN TRANSPORT
      - Rest
      - Physical Activity
      - Close Association Between Maximum Cardiac Output and V˙O2max
        FIGURE 17.4
        Cardiac Output Differences Among Men and Women and Children
      - Oxygen Extraction: The a-v¯O2 Difference
      - a-v¯O2 Difference During Rest
        INTEGRATIVE QUESTION
      - a-v¯O2 Difference During Physical Activity
        FIGURE 17.5
      - Factors That Affect the a-v¯O2 Difference During Physical Activity
        IN A PRACTICAL SENSE: Predicting V˙O2max Using Walking and Swimming Tests
        THE TESTS
        1-Mile Walk Test
        TABLE 1: Aerobic Fitness Categories for Men and Women
        12-Minute Swim Test
        TABLE 2: 12-Minute Swim Test Fitness Categories (Age 18–29 Years)
        INTEGRATIVE QUESTION
    - CARDIOVASCULAR ADJUSTMENTS TO UPPER-BODY EXERCISE
      - Maximal Oxygen Consumption
      - Submaximal Oxygen Consumption
        FIGURE 17.6
      - Physiologic Response
        Implications.
    - Summary
  - CHAPTER 18: Skeletal Muscle: Structure and Function
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - The Terms Muscle Contraction and Muscle Action
    - GROSS STRUCTURE OF SKELETAL MUSCLE
      - FIGURE 18.1
      - Interesting Facts About Muscles
      - Levels of Organization
        Subcellular Systems and Muscle Function
      - Muscles’ Chemical Composition
      - Blood Supply
        Capillarization
    - SKELETAL MUSCLE ULTRASTRUCTURE
      - FIGURE 18.2
      - The Sarcomere
        FIGURE 18.3
        TABLE 18.1: Twelve Proteins Associated with a Muscle Fiber’s Sarcomere and Their Proposed Functions
    - MUSCLE FIBER ALIGNMENT
      - FIGURE 18.4
    - Lengthened Sarcomeres in Cerebral Palsy Patients
    - Complex Fusiform Arrangement
      - INTEGRATIVE QUESTION
    - Fiber Length–Muscle Length Ratio
      - FIGURE 18.5
    - ACTIN–MYOSIN ORIENTATION
      - FIGURE 18.6
      - FIGURE 18.7
      - Intracellular Tubule Systems
        FIGURE 18.8
    - CHEMICAL AND MECHANICAL EVENTS DURING MUSCLE ACTION AND RELAXATION
      - Mechanics of Muscle Action: The Sliding-Filament Model
        FIGURE 18.9
        Multimedia Muscle Action Videos
      - Mechanical Action of Crossbridges
        FIGURE 18.10
        INTEGRATIVE QUESTION
        Sarcomere Length—Isometric Tension Curve in an Isolated Fiber
        FIGURE 18.11
        Sarcomere Length—Isometric Tension Curve in Human Muscle Fibers in Vivo
        FIGURE 18.12
        Link Between Actin, Myosin, and ATP
      - Excitation–Contraction Coupling
        FIGURE 18.13
      - Relaxation
      - Sequence of Events in Muscle Action
        FIGURE 18.14
    - MUSCLE FIBER TYPE
      - FIGURE 18.15
      - TABLE 18.2: Classification of Human Skeletal Muscle Fiber Types
      - Fast-Twitch Fibers (Type II)
        IN A PRACTICAL SENSE: A Vertical Jump Test to Predict Peak Anaerobic Power Output
        VERTICAL JUMP TEST
        PREDICTING IMMEDIATE ANAEROBIC POWER OUTPUT
        EXAMPLE
        COMPUTATIONS
        COMPARISONS
      - Slow-Twitch Fibers (Type I)
        INTEGRATIVE QUESTION
        Muscle Fiber Training Specificity
    - GENES THAT DEFINE SKELETAL MUSCLE PHENOTYPE
      - Decline in Skeletal Muscle Mass with Aging Mainly Attributed to Reduced Type II Muscle Fiber Size
    - FIBER TYPE DIFFERENCES AMONG ATHLETIC GROUPS
      - FIGURE 18.16
    - Summary
  - CHAPTER 19: Neural Control of Human Movement
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - NEUROMOTOR SYSTEM ORGANIZATION
      - FIGURE 19.1
      - Central Nervous System—The Brain
        FIGURE 19.2
        Brainstem
        Mnemonic to Remember the 12 Cranial Nerves—Try It!
        Cerebellum
        Diencephalon
        Telencephalon
        Limbic System
      - Central Nervous System—The Spinal Cord
        FIGURE 19.3
        TABLE 19.1: Common Names Describing Neurons and Axons of the Spinal Cord
        FIGURE 19.4
        Ascending Nerve Tracts
        Sensory Receptors.
        Descending Nerve Tracts
        Pyramidal (Lateral) Tract.
        Extrapyramidal (Ventromedial) Tract.
        Reticular Formation
      - Peripheral Nervous System
        FIGURE 19.5
        Sympathetic and Parasympathetic Nervous Systems
      - The Reflex Arc
        FIGURE 19.6
    - NERVE SUPPLY TO MUSCLE
      - Motor Unit Anatomy
        FIGURE 19.7
        The Anterior Motor Neuron
        FIGURE 19.8
        Neuromuscular Junction (Motor Endplate).
        FIGURE 19.9
        Excitation.
        Facilitation.
        FIGURE 19.10
        INTEGRATIVE QUESTION
        Inhibition.
        INTEGRATIVE QUESTION
    - MOTOR UNIT FUNCTIONAL CHARACTERISTICS
      - TABLE 19.2: Characteristics and Correspondence Between Motor Units and Muscle Fiber Types
      - Twitch Characteristics
        FIGURE 19.11
      - Tension Characteristics
        Gradation of Force
        Control of Motor Function and Motor Unit Activity.
        FIGURE 19.12
        INTEGRATIVE QUESTION
      - Fatigue Resistance
        INTEGRATIVE QUESTION
    - RECEPTORS IN MUSCLES, JOINTS, AND TENDONS: THE PROPRIOCEPTORS
      - IN A PRACTICAL SENSE: How to Determine Upper-Arm Muscle and Fat
        MEASUREMENTS
        EXAMPLE
        COMPUTATIONS
      - Muscle Spindles
        Structural Organization
        FIGURE 19.13
        The Stretch Reflex
        FIGURE 19.14
      - Golgi Tendon Organs
        FIGURE 19.15
      - Pacinian Corpuscles
    - Summary
  - CHAPTER 20: The Endocrine System: Organization and Acute and Chronic Responses to Physical Activity
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - ENDOCRINE SYSTEM OVERVIEW
      - FIGURE 20.1
    - ENDOCRINE SYSTEM ORGANIZATION
      - FIGURE 20.2
      - Types of Hormones
        TABLE 20.1: Storage, Synthesis, Release Mechanism, Transport Medium, Receptor Location and Receptor-Ligand Binding, and Target Organ Response of the Peptide, Steroid, and Amine Hormones
        The Term Hormone Enters the English Lexicon
        TABLE 20.2: Hormones Produced by Organs Other than the Major Endocrine Organs
      - Hormone–Target Cell Specificity
        Hormone–Receptor Binding
        Cyclic AMP: The Intracellular Messenger.
        FIGURE 20.3
        Hormone Effects on Enzymes
      - Factors That Determine Hormone Levels
        Important Discoveries in Endocrinology
        FIGURE 20.4
        Patterns of Hormone Release
        INTEGRATIVE QUESTION
    - RESTING AND EXERCISE-INDUCED ENDOCRINE SECRETIONS
      - TABLE 20.3: Endocrine Organs and Their Secretions, Targets, and Main Effects
      - Anterior Pituitary Hormones
        FIGURE 20.5
        Growth Hormone
        Growth Hormone, Physical Activity, and Tissue Synthesis.
        FIGURE 20.6
        Insulin-Like Growth Factors
        Thyrotropin
        Adrenocorticotropic Hormone
        Elevated Thyroid Hormones Predict Metabolic Syndrome in Females
        Prolactin
        Gonadotropic Hormones
      - Posterior Pituitary Hormones
      - Thyroid Hormones
        FIGURE 20.7
        Thyroid Hormones Affect Quality of Life
        Parathyroid Hormones
      - Adrenal Hormones
        FIGURE 20.8
        Fatigue in Coronary Artery Disease Patients Associates with Lower Thyroid Axis Hormones and Cortisol Independent of Exercise Capacity
        Adrenal Medulla Hormones
        FIGURE 20.9
        FIGURE 20.10
        Adrenocortical Hormones
        Mineralocorticoids.
        FIGURE 20.11
        Renin–Angiotensin Mechanism.
        Status of Cardiovascular Health of U.S. Adolescents
        Glucocorticoids.
        FIGURE 20.12
        Gonadocorticoids.
    - GONADAL HORMONES
      - FIGURE 20.13
      - Testosterone
        FIGURE 20.14
        High Doses of Anabolic Steroids Cause Adverse Cardiovascular Side Effects, Including Endothelial Dysfunction
        INTEGRATIVE QUESTION
      - Pancreatic Hormones
        FIGURE 20.15
        Insulin
        FIGURE 20.16
        Insulin Transport of Glucose into Cells: Glucose Transporters.
        Glucose–Insulin Interaction.
        FIGURE 20.17
        Diabetes Mellitus.
        TABLE 20.4: Data from the 2011 National Diabetes Fact Sheet
        IN A PRACTICAL SENSE: How to Reduce Diabetes Risk
        Calculating Your Diabetes Risk
        Tests for Diabetes Mellitus.
        Classification Categories for Fasting Blood Glucose
      - Metabolic Syndrome: A Dangerous Disease of Modern Civilization
        Metabolic Syndrome: Organs Affected, Common Characteristics, Associated Medical Conditions, and Treatment
        Treating Metabolic Syndrome
        TABLE 20.5: Thresholds of Percentage Body Fat (%BF) Corresponding to Established Body Mass Index Cutoffs Associated with Metabolic Syndrome Risk
      - Insulin Actions and Impaired Glucose Homeostasis
        FIGURE 20.18
      - Type 1 Diabetes
        Type 2 Diabetes
        IN A PRACTICAL SENSE: Diabetes, Hypoglycemia, and Physical Activity
        HYPOGLYCEMIA WARNING SIGNS
        HYPOGLYCEMIA ATTACK: WHAT TO DO
        LATE-ONSET HYPOGLYCEMIA
        ADJUSTING INSULIN LEVELS
        Type 2 Diabetes in Children: On the Rise and Not Easily Treated
        The Seven Leading Risk Factors for Type 2 Diabetes
        High Blood Sugar Linked to Dementia Independent of Diabetes
        Characteristics of Type 1 and Type 2 Diabetes
        Diabetes and Physical Activity
        INTEGRATIVE QUESTION
        Muscle as an Endocrine Organ
        Adipose Tissue as an Endocrine Organ
        Glucagon
        FIGURE 20.19
      - Other Glands and Hormones
    - EXERCISE TRAINING AND ENDOCRINE FUNCTION
      - TABLE 20.6: Hormones and Their Responses to Endurance Training
      - Anterior Pituitary Hormones
        Growth Hormone
        FIGURE 20.20
        ACTH (Adrenocorticotropic Hormone)
        PRL (Prolactin)
        FSH (Follicle-Stimulating Hormone), LH (Leuteinizing Hormone), and Testosterone
      - Posterior Pituitary Hormones
        ADH (Antidiuretic Hormone)
      - PTH (Parathyroid Hormone)
      - Thyroid Hormones
      - Adrenal Hormones
        Aldosterone
        Cortisol
        Epinephrine and Norepinephrine
        FIGURE 20.21
      - Pancreatic Hormones
        FIGURE 20.22
        Regular Physical Activity and Type 2 Diabetes Risk
        Resistance Training Reduces Risk of Type 2 Diabetes
        FIGURE 20.23
        Physical Activity Benefits for Type 2 Diabetes.
        Glycemic Control.
        Cardiovascular Disease.
        Weight Loss.
        Psychologic Profile.
        Occurrence of Type 2 Diabetes.
        Physical Activity Risks for Type 2 Diabetics.
        FIGURE 20.24
        Physical Activity Guidelines for Type 1 Diabetes.
    - RESISTANCE TRAINING AND ENDOCRINE FUNCTION
      - FIGURE 20.25
    - OPIOID PEPTIDES AND PHYSICAL ACTIVITY
      - INTEGRATIVE QUESTION
    - PHYSICAL ACTIVITY, INFECTIOUS ILLNESS, CANCER, AND IMMUNE RESPONSE
      - FIGURE 20.26
      - Upper Respiratory Tract Infections
        FIGURE 20.27
        Short-Term Physical Activity Effects
        TABLE 20.7: Immune System Components that Exhibit Negative Change after Prolonged, Intense Exercise
        Long-Term Exercise Effects
        Resistance Training.
        Perhaps a Role for Nutritional Supplements.
        Macronutrients.
        Micronutrients.
        Glutamine and the Immune Response.
        A General Recommendation to Optimize Immunity
        The Physical Activity–Cancer Connection
    - Summary
PART TWO: Applied Exercrise Physiology
- SECTION 4: Enhancement of Energy Transfer Capacity
  - OVERVIEW
  - INTERVIEW WITH: Bengt Saltin
  - CHAPTER 21: Training for Anaerobic and Aerobic Power
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - EXERCISE TRAINING PRINCIPLES
      - FIGURE 21.1
      - Overload Principle
      - Specificity Principle
        Specificity of V˙O2max
        An Example of Aerobic Training Specificity
        Specificity of Local Changes
      - Individual Differences Principle
      - Reversibility Principle
        TABLE 21.1: Changes in Measures of Physiologic and Metabolic Function with Various Durations of Detraininga
    - HOW EXERCISE TRAINING IMPACTS THE ANAEROBIC SYSTEM
      - TABLE 21.2: Typical Metabolic and Physiologic Values for Healthy, Endurance-Trained and Untrained Mena
    - ANAEROBIC SYSTEM CHANGES WITH TRAINING
      - FIGURE 21.2
      - TABLE 21.3: Changes in Resting Concentrations of PCr, Creatine, ATP, and Glycogen Following 5 Months of Heavy-Resistance Training in 9 Male Subjects
    - HOW TRAINING IMPACTS THE AEROBIC SYSTEM
      - FIGURE 21.3
      - Metabolic Adaptations
        Metabolic Machinery
        FIGURE 21.4
        Carbohydrate Metabolism.
        Muscle Fiber Type and Size
        Myoglobin
      - Cardiovascular Adaptations
        FIGURE 21.5
        Cardiac Hypertrophy: The “Athlete’s Heart”
        FIGURE 21.6
        Specific Nature of Cardiac Enlargement.
        TABLE 21.4: Comparative Average Cardiac Dimensions in College Athletes, World-Class Athletes, and Normal Subjects
        Training-Induced Plasma Volume Provides a Possible Explanation.
        Functional Versus Pathologic Cardiac Hypertrophy.
        INTEGRATIVE QUESTION
        Plasma Volume
        Heart Rate
        Exercise Heart Rate: Training Effects.
        FIGURE 21.7
        Stroke Volume
        Exercise Stroke Volume: Trained Versus Untrained.
        FIGURE 21.8
        Stroke Volume and V˙O2max.
        TABLE 21.5: Maximal Values for Oxygen Consumption, Heart Rate, Stroke Volume, and Cardiac Output in Three Groups with Low, Normal, and High Aerobic Capacities
        Cardiac Output
        FIGURE 21.9
        Endurance Training and Submaximal Cardiac Output.
        Oxygen Extraction (a-v¯O2 Difference)
        FIGURE 21.10
        Blood Flow and Distribution
        Submaximal Exercise.
        Maximal Exercise.
        Myocardial Blood Flow.
        Blood Pressure
      - Pulmonary Adaptations With Training
        Maximal Physical Activity
        Submaximal Physical Activity
        FIGURE 21.11
        Training May Benefit Ventilatory Endurance
      - Blood Lactate Concentration
        FIGURE 21.12
      - Four Additional Aerobic Training Adaptations
        FIGURE 21.13
        Six Potential Psychologic Benefits From Regular Physical Activity
      - Summary View
        FIGURE 21.14
    - FACTORS THAT AFFECT AEROBIC TRAINING RESPONSES
      - Initial Level of Aerobic Fitness
        INTEGRATIVE QUESTION
      - Training Intensity
        TABLE 21.6: Relationship Between Percentage Maximal Heart Rate and Percentage V˙O2max
        Train at a Percentage of HRmax
        FIGURE 21.15
        Is Strenuous Training More Effective?
        Determining the “Training-Sensitive Zone”
        FIGURE 21.16
        Perhaps a Modification Required.
        FIGURE 21.17
        Computing Lower- and Upper-Limit Target Heart Rates for Training
        METHOD 1: PERCENTAGE METHOD
        METHOD 2: KARVONEN METHOD (HEART RATE RESERVE)
        Predicting Maximum Heart Rate in Overfat Individuals
        EXAMPLE
        Running Versus Swimming and Other Forms of Upper-Body Physical Activity.
        Can Less Intense Training be Effective?
        Train at a Perception of Effort
        FIGURE 21.18
        Train at the Lactate Threshold
        FIGURE 21.19
      - Training Duration
      - Training Frequency
      - Exercise Mode
        A Well-Rounded Overall Training Program
        INTEGRATIVE QUESTION
    - HOW LONG BEFORE IMPROVEMENTS OCCUR?
      - FIGURE 21.20
      - TABLE 21.7: Maximum Physiologic Responses During Peak Cycle Ergometer Exercises Before and After 10 Consecutive Days of Aerobic Training
      - Trainability and Genes
        FIGURE 21.21
    - MAINTAINING GAINS IN AEROBIC FITNESS
      - Components Other Than V˙O2max
      - Tapering for Peak Performance
    - TRAINING METHODS
      - Anaerobic Training
        INTEGRATIVE QUESTION
        The Intramuscular High-Energy Phosphates
        Lactate-Generating Capacity
      - Aerobic Training
        FIGURE 21.22
        INTEGRATIVE QUESTION
        Interval Training
        One-Minute Bouts of Intense Physical Activity Improves Fitness and Health
        Rationale for Interval Training.
        TABLE 21.8: Guidelines for Determining Interval-Training Exercise Rates for Running and Swimming Different Distances
        INTEGRATIVE QUESTION
        Sprint-Type Interval Training Affects Anaerobic and Aerobic Physiologic Systems.
        FIGURE 21.23
        Continuous Training
        Fartlek Training
    - OVERTRAINING: TOO MUCH OF A GOOD THING
      - Definitions of Terms Related to Overtraining Syndrome
      - FIGURE 21.24
      - TABLE 21.9: Overtraining Syndrome: Symptoms of Staleness
    - PHYSICAL ACTIVITY DURING PREGNANCY
      - FIGURE 21.25
      - Physical Activity Effects on the Mother
        TABLE 21.10: Important Metabolic and Cardiorespiratory Adaptations During Pregnancy
      - Physical Activity Effects on the Fetus
        FIGURE 21.26
        INTEGRATIVE QUESTION
        IN A PRACTICAL SENSE: Exercise Prescription During Pregnancy
        PHYSICAL ACTIVITY GUIDELINES
        WHEN TO STOP EXERCISE AND SEEK MEDICAL ADVICE
      - Current Opinion Regarding Physical Activity and Pregnancy
    - Summary
  - CHAPTER 22: Muscular Strength: Training Muscles to Become Stronger
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: STRENGTH MEASUREMENT AND RESISTANCE TRAINING
      - FIGURE 22.1
      - Muscular Strength Development: Its Roots in Antiquity
        Early Strongmen Who Popularized Body Building and Strength Training
      - OBJECTIVES OF RESISTANCE TRAINING
      - MEASUREMENT OF MUSCLE STRENGTH
        Cable Tensiometry
        FIGURE 22.2
        Dynamometry
        One-Repetition Maximum
        Estimate the 1-RM
        Computer-Assisted, Electromechanical, and Isokinetic Methods
        Definition of Selected Terms Associated with Resistance Training
        FIGURE 22.3
        FIGURE 22.4
        TABLE 22.1: International System (SI) of Units for Expressing Muscular Strength and Power During Linear and Angular Motionsa
        INTEGRATIVE QUESTION
        Resistance-Training Equipment Categories
        Strength-Testing Considerations
        Exercise Equipment to Overload Skeletal Muscle
        Learning Factors Affect Strength Measurements
        FIGURE 22.5
      - GENDER DIFFERENCES IN MUSCLE STRENGTH
        Muscle Cross-Sectional Area
        FIGURE 22.6
        Absolute Muscle Strength as Total Force Exerted
        FIGURE 22.7
        INTEGRATIVE QUESTION
        Relative Muscle Strength Indexed to Estimates of Body Composition
        FIGURE 22.8
        INTEGRATIVE QUESTION
        Muscle Strength Indexed Using Allometric Scaling
        FIGURE 22.9
        INTEGRATIVE QUESTION
      - TRAINING MUSCLES TO BECOME STRONGER
        FIGURE 22.10
        Different Muscle Actions
        Resistance Training
        Progressive Resistance Exercise
        Variations of PRE.
        TABLE 22.2: Summary of Resistance Training Recommendations: an Overview of Different Program Variables Needed for Progression with Different Fitness Levels
        Periodization.
        FIGURE 22.11
        INTEGRATIVE QUESTION
        Resistance Training Guidelines for Sedentary Adults, the Elderly, and Cardiac Patients: Benefits for Health Enhancement and Disease Prevention
        TABLE 22.3: Strength-Training Guidelines for Sedentary Adults, Elderly Persons, and Cardiac Patients
        Impressive Resistance Training Results for Seniors
        Does Resistance Training Plus Aerobic Training Equal Less Strength Improvement?
        Resistance Exercise May Enhance Molecular Signaling of Mitochondrial Biogenesis in Skeletal Muscle Induced by Endurance Exercise
        Resistance Training for Children
        TABLE 22.4: Guidelines for Resistance-Exercise Training and Progression in Children and Adolescents
        Isometric Strength Training
        Isometric Training Limitations
        Isometric Training Benefits
        Which Method is Better: Static or Dynamic?
        Specificity of Isometric Training Response
        Practical Implications.
        Physical Testing in the Occupational Setting: The Role of Specificity
        INTEGRATIVE QUESTION
        Isokinetic Resistance Training
        Isokinetics Versus Standard Weightlifting
        FIGURE 22.12
        Isokinetic Training Experiments
        FIGURE 22.13
        Fast-Versus Slow-Speed Isokinetic Training
        Plyometric Training
        FIGURE 22.14
        FIGURE 22.15
        Practical Application of Plyometrics
        FIGURE 22.16
        Body Weight–Loaded Training
        Concept of the Core
        IN A PRACTICAL SENSE: Strengthening The Lower Back
        Window for Explosive Power Development
        FIGURE 22.17
    - Summary
    - PART 2: STRUCTURAL AND FUNCTIONAL ADAPTATIONS TO RESISTANCE TRAINING
      - FIGURE 22.18
      - FACTORS THAT MODIFY THE EXPRESSION OF HUMAN STRENGTH
        FIGURE 22.19
        Six Neural Adaptations to Resistance Training That Increase Muscular Strength
        Psychologic–Neural Factors
        FIGURE 22.20
        Superhuman Feats of Strength
        Muscular Factors
        TABLE 22.5: Physiologic Adaptations to Resistance Training
        Muscle Hypertrophy
        FIGURE 22.21
        Specificity of the Hypertrophic Response
        Significant Metabolic Adaptations Occur
        FIGURE 22.22
        TABLE 22.6: Effects of Specific Types or Training on Skeletal Muscle
        Muscle Cell Remodeling: Current Thinking
        FIGURE 22.23
        Benefits Regardless of Gender or Age
        FIGURE 22.24
        Muscle Hyperplasia: Are New Muscle Fibers Created?
        Changes in Muscle Fiber Type With Resistance Training
      - COMPARATIVE TRAINING RESPONSES IN MEN AND WOMEN
        INTEGRATIVE QUESTION
        Muscular Strength and Hypertrophy
        Does Muscle Strength Relate to Bone Density?
        FIGURE 22.25
      - DETRAINING EFFECTS ON MUSCLE
      - METABOLIC STRESS OF RESISTANCE TRAINING
      - CIRCUIT RESISTANCE TRAINING
        Specificity of Aerobic Improvement With CRT
        Energy Cost of Different Resistance-Exercise Methods
        TABLE 22.7: Energy Expenditure for Different Modes of Resistance Exercise Compared with Walkinga
      - MUSCLE SORENESS AND STIFFNESS
        Eccentric Actions Produce Muscle Soreness
        TABLE 22.8: Acute Effects of Concentric-Only and Concentric-Eccentric Exercise on DOMS 25 Hours After Exercisea
        Cell Damage
        FIGURE 22.26
        Altered Sarcoplasmic Reticulum
        Current DOMS Model
        FIGURE 22.27
        INTEGRATIVE QUESTION
    - Summary
  - CHAPTER 23: Special Aids to Exercise Training and Performances
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - AN INCREASING CHALLENGE TO FAIR COMPETITION
      - The Price of Lying and Cheating: The Rise, Fall, and Dishonor of Cyclist Lance Armstrong
      - Urine Testing for Steroids
      - Levels of Evidence
        TABLE 23.1: Levels of Evidence on Which to Judge Research Findings
        IN A PRACTICAL SENSE: A Need to Critically Evaluate the Scientific Evidence
        JUSTIFICATION
        SUBJECTS
        RESEARCH SAMPLE AND DESIGN
        CONCLUSIONS
        DISSEMINATION OF FINDINGS
    - ON THE HORIZON
      - Six Mechanisms for How Ergogenic Aids Might Work
    - PART 1: PHARMACOLOGIC AGENTS FOR ERGOGENIC EFFECTS
      - Diuretics to Mask Drug Use
      - Anabolic Steroids
        INTEGRATIVE QUESTION
      - Structure and Action
        A Drug with a Considerable Following
        Effectiveness Questioned
        Steroid Dosage Important
      - Risks Do Exist
        Steroid Use and Life-Threatening Disease.
        TABLE 23.2: Side Effects and Medical Risks of Anabolic Steroid Use
        Steroid Use and Plasma Lipoproteins.
        American College of Sports Medicine: Position Stand on Use of Anabolic Steroids5
        Specific Risks for Females.
      - Clenbuterol and Other β2-Adrenergic Agonists
        Potential Negative Effects on Muscle, Bone, and Cardiovascular Function (Animal Studies)
        Clenbuterol: Not Approved for Human Use in the United States
      - Other Adrenergic Agonists
        Training State Makes a Difference
        Animals.
        Humans.
        Muscle Receptor’s Sensitivity Changes with Training
      - Growth Hormone: Genetic Engineering Now Common in Sports
        A New Test Now Available
        No Unanimity Among Researchers
        TABLE 23.3: Maximal Force Production of Knee Extensor and Flexor Muscle Groups Before and After Training With or Without Growth Hormone Supplements
      - DHEA
        FIGURE 23.1
        FIGURE 23.2
        An Unregulated Compound with Uncertain Safety
      - Androstenedione: Benign Prohormone Nutritional Supplement or Potentially Harmful Drug?
        INTEGRATIVE QUESTION
        Summary of Research Findings Concerning Androstenediones
        Modified Versions of Androstenedione Available
        Competitive Athletes Beware
        INTEGRATIVE QUESTION
      - Amino Acid Supplementation
      - Specific Timing of Nutrient Intake Can Stimulate an Anabolic Effect
        Four Goals for Optimizing Postexercise Recovery with Nutritional Strategies
        Carbohydrate–Protein-Creatine Supplementation in Recovery Augments Hormonal Response to Resistance Exercise.
        FIGURE 23.3
        Postexercise Glucose Augments Protein Balance After Resistance-Training.
        FIGURE 23.4
        Dietary Lipid May Affect Hormonal Milieu.
        TABLE 23.4: Relationships Between Pre-exercise Testosterone Concentration and Selected Nutritional Variables
        IN A PRACTICAL SENSE: Nutrient Timing to Optimize Muscle Response to Resistance Training
        Potential Ergogenic Role of the Branched-Chain Amino Acids Leucine, Isoleucine, and Valine
      - Amphetamines
        Dangers of Amphetamines
        Amphetamine Use and Exercise Performance
        TABLE 23.5: Effects of Amphetamines on Athletic Performance
      - Caffeine
        TABLE 23.6: Caffeine Content (mg) of Some Common Foods, Beverages, and Over-the-Counter and Prescription Medications
        Ergogenic Effects
        Clandestine Caffeine—New Energy-Packing Foods
        FIGURE 23.5
        FIGURE 23.6
        No Dose–Response Relationship.
        FIGURE 23.7
        Proposed Mechanism for Ergogenic Effect
        Inconsistent Effects Relate to Diet and Habitual Caffeine Use.
      - Effects on Muscle
        Warning About Caffeine
      - Ginseng and Ephedrine
        Ginseng
        Ephedrine
        Not Without Risk
      - Buffering Solutions
        TABLE 23.7: Performance Time and Acid-Base Profiles for Subjects Under Control, Placebo, and Induced Pre-exercise Alkalosis Conditions Before and After an 800-M Race
        FIGURE 23.8
        Effect Related to Dosage and Degree of Anaerobiosis
        INTEGRATIVE QUESTION
        High-Intensity Endurance Performance
      - Anticortisol Compounds: Glutamine and Phosphatidylserine
        Glutamine
        Glutamine and the Immune Response.
        Phosphatidylserine
      - β-Hydroxy–β-Methylbutyrate
        Four Ways HMB Might Work as an Ergogenic Aid
        FIGURE 23.9
    - PART 2: NONPHARMACOLOGIC APPROACHES FOR ERGOGENIC EFFECTS
      - Red Blood Cell Reinfusion—Blood Doping
        How It Works
        Does Blood Doping Work?
        FIGURE 23.10
        TABLE 23.8: Physiologic, Performance, and Hematologic Characteristics Before and 24 Hours After Reinfusion of 750 mL of Packed Red Blood Cells
      - A New Twist: Hormonal Blood Boosting
        Iron Anomaly Among Elite Cyclists
        Other Means to Enhance Oxygen Transport
      - Warm-Up (Preliminary Exercise)
        Psychologic Considerations
        Physiologic and Performance Effects
        Clinical Considerations: Warm-Up Prior to Sudden Strenuous Physical Activity
      - Oxygen Inhalation (Hyperoxia)
        Pre-exercise Oxygen Breathing
        Oxygen Breathing During Exercise
        FIGURE 23.11
        FIGURE 23.12
        Oxygen Breathing During Recovery
        FIGURE 23.13
      - Modification of Carbohydrate Intake
        Nutrient-Related Fatigue in Prolonged Physical Activity
        Classic Loading Procedure
        TABLE 23.9: Two-Stage Dietary Plan to Increase Muscle Glycogen Storage
        Sample Diets to Achieve the Supercompensation Effect.
        TABLE 23.10: Sample Meal Plan for Carbohydrate Depletion and Carbohydrate Loading Preceding an Endurance Event
        Limited Applicability.
        Gender Differences in Glycogen Storage and Catabolism During Physical Activity
        FIGURE 23.14
        Glycogen Supercompensation Enhanced by Prior Creatine Supplementation
        Modified Loading Procedures
        FIGURE 23.15
        INTEGRATIVE QUESTION
        Rapid Loading Procedure: A One-Day Requirement.
        FIGURE 23.16
        Negative Aspects of Carbohydrate Loading
      - Chromium
        Numerous Alleged Benefits
        TABLE 23.11: Effects of Two Different Forms of Chromium Supplementation on Average Values for Anthropometric, Bone, and Soft-Tissue Composition Measurements Before and After Resistance Training
        Excess Chromium Poses Potential Risks
      - Creatine
        Important Component of High-Energy Phosphates
        Quercetin Fails the Test
        Documented Benefits in Humans
        TABLE 23.12: Selected Studies Showing Increases in Exercise Performance Following Creatine Monohydrate Supplementation
        FIGURE 23.17
        Potential Risks of Creatine Supplementation
        FIGURE 23.18
        Age Effects Uncertain
        Effects on Body Mass and Body Composition
        FIGURE 23.19
        Creatine Loading
        FIGURE 23.20
        Rapid Way to Creatine-Load
        Carbohydrate Ingestion Augments Creatine Loading.
        FIGURE 23.21
        Stop Caffeine When Using Creatine
        Some Research Shows No Benefit
      - Lipid Supplementation with Medium-Chain Triacylglycerols
        Inconclusive Exercise Benefits of MCTs
        INTEGRATIVE QUESTION
        FIGURE 23.22
      - Pyruvate
        Endurance Performance
        Body Fat Loss
    - Summary
- SECTION 5: Exercise Performance and Environmental Stress
  - OVERVIEW
  - INTERVIEW WITH: Barbara Drinkwater
  - CHAPTER 24: Physical Activity at Medium and High Altitude
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - THE STRESS OF ALTITUDE
      - FIGURE 24.1
      - FIGURE 24.2
      - Oxygen Loading at Altitude
        INTEGRATIVE QUESTION
    - ACCLIMATIZATION
      - TABLE 24.1: Immediate and Longer-Term Adjustments to Altitude Hypoxia
      - Immediate Responses to Altitude Exposure
        Hyperventilation
        INTEGRATIVE QUESTION
        Increased Cardiovascular Response
        FIGURE 24.3
        Catecholamine Response
        FIGURE 24.4
        TABLE 24.2: Cardiorespiratory and Metabolic Response During Submaximal and Maximal Exercise at Sea Level and Simulated Altitude of 4000 m (13,123 ft)
        FIGURE 24.5
        Fluid Loss
        Sensory Functions.
        FIGURE 24.6
        Myocardial Function.
      - Longer-Term Adjustments to Altitude
        Acid–Base Readjustment
        IN A PRACTICAL SENSE: Identification and Treatment of Altitude-Related Medical Problems
        ACUTE MOUNTAIN SICKNESS
        TABLE 1: Altitude-Related Medical Conditions and Symptoms
        HIGH-ALTITUDE PULMONARY EDEMA
        TABLE 2: Prevention and Treatment of High-Altitude Pulmonary Edema
        HIGH-ALTITUDE CEREBRAL EDEMA
        OTHER CONDITIONS
        Reduced Buffering Capacity and the “Lactate Paradox.”
        FIGURE 24.7
        Hematologic Changes
        Initial Plasma Volume Decrease.
        Red Blood Cell Mass Increases.
        INTEGRATIVE QUESTION
        FIGURE 24.8
        Cellular Adaptations
        Body Mass and Body Composition
      - Time Required for Acclimatization
    - METABOLIC, PHYSIOLOGIC, AND EXERCISE CAPACITIES AT ALTITUDE
      - Maximal Oxygen Consumption
        FIGURE 24.9
      - Exercise Performance
      - Circulatory Factors
        Submaximal Physical Activity
        Maximal Physical Activity
        INTEGRATIVE QUESTION
      - Aerobic Capacity on Return to Sea Level
      - Possible Negative Effects
    - ALTITUDE TRAINING AND SEA-LEVEL PERFORMANCE
      - FIGURE 24.10
      - Altitude Natives May Respond Differently
        INTEGRATIVE QUESTION
      - Decrement in Absolute Training Level at Altitude
        TABLE 24.3: Effect of Altitude on Training Exercise Intensity for Six Collegiate Athletes
    - COMBINE ALTITUDE STAY WITH LOW-ALTITUDE TRAINING
      - INTEGRATIVE QUESTION
      - At-Home Acclimatization
        FIGURE 24.11
    - Summary
  - CHAPTER 25: Exercise and Thermal Stress
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: MECHANISMS OF THERMO-REGULATION
      - THERMAL BALANCE
        FIGURE 25.1
        TABLE 25.1: Thermodynamics During Rest and Exercise
      - HYPOTHALAMIC TEMPERATURE REGULATION
        FIGURE 25.2
      - THERMOREGULATION IN COLD STRESS: HEAT CONSERVATION AND HEAT PRODUCTION
        Vascular Adjustments
        Muscular Activity
        Hormonal Output
      - THERMOREGULATION IN HEAT STRESS: HEAT LOSS
        FIGURE 25.3
        Heat Loss by Radiation
        Heat Loss by Conduction
        Heat Loss by Convection
        Heat Loss by Evaporation
        Evaporative Heat Loss at High Ambient Temperatures
        INTEGRATIVE QUESTION
        Different Liquids Evaporate at Different Rates
        Heat Loss During High Humidity
        INTEGRATIVE QUESTION
        Integration of Heat-Dissipating Mechanisms
        Circulation
        Evaporation
        Hormonal Adjustments
      - EFFECTS OF CLOTHING ON THERMOREGULATION
        Clothing Insulations (Clo Units)
        TABLE 25.2: clo Values Required to Maintain Core Temperature Related to Physical Activity Level and Ambient Temperature
        IN A PRACTICAL SENSE: Assessing Heat Quality of the Environment: How Hot Is Too Hot?
        FIGURE 1
        WB-GT RECOMMENDATIONS FOR CONTINUOUS ACTIVITIES SUCH AS ENDURANCE RUNNING AND CYCLING2
        FIGURE 2
        TABLE 25.3: clo Values for Some Common Garmentsa
        Cold-Weather Clothing
        Warm-Weather Clothing
        Football Uniforms
        FIGURE 25.4
        The Modern Cycling Helmet Does Not Thwart Heat Dissipation
    - Summary
    - PART 2: THERMO-REGULATION AND ENVIRONMENTAL HEAT STRESS DURING PHYSICAL ACTIVITY
      - PHYSICAL ACTIVITY IN THE HEAT
        Circulatory Adjustments
        Vascular Constriction and Dilation
        Maintenance of Blood Pressure
        Core Temperature During Physical Activity
        Temperature Regulated at a Higher Level During Physical Activity
        FIGURE 25.5
        INTEGRATIVE QUESTION
        Water Loss in the Heat: Dehydration
        Magnitude of Fluid Loss
        TABLE 25.4: Predicted Sweating Rates (L · hr−1) for Running at 8.5 to 15.0 km · hr−1 in Cool/Temperate (TDBa = 18°C) and Warm (TDB = 28°C) Weather
        Water Loss Relates to Activity Intensity and Ambient Temperature
        Significant Consequences of Dehydration
        FIGURE 25.6
        Physiologic and Performance Decrements
        Impact of Weather on Running Performance
        Diuretics
      - MAINTAINING FLUID BALANCE: REHYDRATION AND HYPERHYDRATION
        Optimal Goals for Fluid Intake During Physical Activity
        Does Exogenous Glycerol Provide a Benefit?
        Adequacy of Rehydration
        Optimize Hydration
        PRE-ACTIVITY
        DURING ACTIVITY
        Electrolyte Replacement: Added Sodium May Benefit Rehydration
        FIGURE 25.7
        Whole-Body Precooling
      - FACTORS THAT MODIFY HEAT TOLERANCE
        Acclimatization
        INTEGRATIVE QUESTION
        TABLE 25.5: Physiologic Adjustments During Heat Acclimatization
        Training Status
        Age
        FIGURE 25.8
        Age-Related Differences Do Exist
        Children
        Gender
        Sweating
        Evaporative Cooling versus Circulatory Cooling.
        Ratio of Body Surface Area to Body Mass.
        Menstruation.
        Body Fat Level
        INTEGRATIVE QUESTION
      - COMPLICATIONS FROM EXCESSIVE HEAT STRESS
        TABLE 25.6: Cardiovascular Responses During the Three Stages of Exercise Hyperthermia
        Heat Cramps
        Heat Exhaustion
        Heat Stroke
        Oral Temperature Unreliable
    - Summary
    - PART 3: THERMO-REGULATION AND ENVIRONMENTAL COLD STRESS DURING PHYSICAL ACTIVITY
      - PHYSICAL ACTIVITY IN THE COLD
        TABLE 25.7: Core Temperature and Associated Physiological Changes that Occur as Core Temperature Falls; Individuals Respond Differently at Each Level of Core Temperature
        Body Fat, Physical Activity, and Cold Stress
        Children and Cold Stress
      - COLD ACCLIMATIZATION
        The Ama
        FIGURE 25.9
        Other Examples of Cold Adaptation
        Acclimatization to Cold
      - HOW COLD IS TOO COLD?
        INTEGRATIVE QUESTION
        INTEGRATIVE QUESTION
        The Wind-Chill Temperature Index
        FIGURE 25.10
        Respiratory Tract During Cold-Weather Physical Activity
    - Summary
  - CHAPTER 26: Sport Diving
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - DIVING HISTORY—ANTIQUITY TO THE PRESENT
      - Chronology of Selected Events in Diving History
        TABLE 26.1: Breadth-Hold Diving World Records as of August 2013
        The Historical Roots of Deepwater Diving
        Santa Barbara, CA
        The Man and the Dive: Reflections of Bob Ratcliffe
        The Salvage of the Squalus: A Historic Undersea Rescue
    - PRESSURE–VOLUME RELATIONSHIPS AND DIVING DEPTH
      - Diving Depth and Pressure
        TABLE 26.2: Relationship of Depth in Water to External Pressure, Lung Volume, and Inspired Gas Pressures
      - Diving Depth and Gas Volume
        FIGURE 26.1
    - SNORKELING AND BREATH-HOLD DIVING
      - Limits to Snorkel Size
        Inspiratory Capacity and Diving Depth
        Snorkel Size and Pulmonary Dead Space
        IN A PRACTICAL SENSE: Training Regimen for Free Diving from a Free Dive Champion
        ANNELLE POMPE, SWEDISH CHAMPION FREE DIVER TRAINING REGIMEN
      - Breath-Hold Diving
        Hyperventilation and Breath-Hold Diving: Blackout
        Additional Considerations.
        Depths Limits With Breath-Hold Diving: Thoracic Squeeze
        IN A PRACTICAL SENSE: Estimating Residual Lung Volume from Age, Stature, and Body Mass
        RLV PREDICTION EQUATIONS
        EXAMPLES
        Mammalian Adaptation to Deep-Depth Dives
        Other Problems.
      - Diving Reflex in Humans
        FIGURE 26.2
    - SCUBA DIVING
      - Open-Circuit Scuba
        FIGURE 26.3
        FIGURE 26.4
      - Closed-Circuit Scuba
        FIGURE 26.5
        TABLE 26.3: U.S. Navy–Recommended Depth-Time Limits Breathing Pure Oxygen During Working Divesa
    - SPECIAL PROBLEMS WITH BREATHING GASES AT HIGH PRESSURES
      - FIGURE 26.6
      - Air Embolism
      - Pneumothorax: Lung Collapse
      - Facemask “Squeeze”
      - Blockage of Eustachian Tube: Middle-Ear Squeeze
        Never Use Earplugs.
        Aerosinusitis
      - Nitrogen Narcosis: “Rapture of the Deep”
      - Decompression Sickness
        FIGURE 26.7
        Nitrogen Elimination: Zero Decompression Limits
        FIGURE 26.8
        Consequences of Inadequate Decompression
        Treatment.
        FIGURE 26.9
        Higher Prevalence with a Patent Foramen Ovale.
      - Oxygen Poisoning
        TABLE 26.4: Representative Depth-Time Limits for Closed-Circuit Diving with 100% Oxygen
        Carbon Monoxide Poisoning
      - Women at No Greater Risk
    - DIVES TO EXCEPTIONAL DEPTHS: MIXED-GAS DIVING
      - FIGURE 26.10
      - Helium–Oxygen Mixtures
        TABLE 26.5: Representative Oxygen Partial Pressure Limits for Surface-Supplied Heliox Diving
        Three Recommendations to Avoid High Pressure Nervous System (HPNS)
      - Saturation Diving
        FIGURE 26.11
      - Technical Diving
        FIGURE 26.12
    - ENERGY COST OF UNDERWATER SWIMMING
      - FIGURE 26.13
    - Summary
  - CHAPTER 27: Microgravity: The Last Frontier
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - THE WEIGHTLESS ENVIRONMENT
      - Facts About the International Space Station (ISS)
      - Gravity
        FIGURE 27.1
        Gravity on the Moon and Mars
      - Microgravity and Weightlessness
        Passenger in a Falling Elevator
        Galileo’s Famous Leaning Tower of Pisa “Falling” Experiment—Did It Happen?
      - Examples of Near–Zero-G During Spaceflight
        FIGURE 27.2
        FIGURE 27.3
      - Strategies to Simulate Microgravity
        Human Testing
        Head-Down Bed Rest.
        FIGURE 27.4
        Wheelchair Confinement of Paraplegics.
        Water Immersion.
        Immobilization and Confinement.
        Parabolic Flights.
        FIGURE 27.5
        Mathematical Modeling and Computer Simulations
    - HISTORICAL OVERVIEW OF AEROSPACE PHYSIOLOGY AND MEDICINE
      - The Early Balloonists
      - Early Years
        Wernher von Braun—The Father of Space Rocketry
        Suborbital Flights
        High-Altitude Explorations
      - Sputnik: The Rocket Launch That Shocked the World
        FIGURE 27.6
    - MODERN ERA
      - TABLE 27.1: Potential Deleterious Effects of Weightlessness for Launch, Travel, and Reentry
      - United States Races into Space
        IN A PRACTICAL SENSE: Space Suits for Space Travel
        United States Human Space Program
    - MEDICAL EVALUATION FOR ASTRONAUT SELECTION
      - TABLE 27.2: Physiologic and Psychologic Testing of the First American Project Mercury Astronauts
      - First Astronauts
        FIGURE 27.7
        Occupational Health Program
        Radiation Effects.
    - BONE
      - FIGURE 27.8
      - Cardiovascular Adaptations
        TABLE 27.3: Changes in Cardiovascular Variables Associated with Microgravity
        FIGURE 27.9
        INTEGRATIVE QUESTION
        Pulmonary Adaptations
        TABLE 27.4: Pulmonary System Changes Associated with Microgravity During Spacelab Life Sciences-1 (Flight STS-40, June 5, 1991) and German Spacelab Mission D-2 Aboard STS-55 (April 26, 1993)
        FIGURE 27.10
        Denitrogenation and EVA
      - Body Fluid Adaptations
        TABLE 27.5: Body Fluid Changes Associated with Microgravity
        FIGURE 27.11
      - Sensory System Adaptations
        FIGURE 27.12
        TABLE 27.6: Sensory System Changes Associated with Microgravity
      - Musculoskeletal Adaptations
        TABLE 27.7: Musculoskeletal Changes Associated with Microgravity
        Increased Calcium Loss
        TABLE 27.8: Bone Loss on Mir Space Station Expressed as Percentage of Bone Mineral Density Lost Per Month
        FIGURE 27.13
      - Skeletal Muscle Adaptations
        Concentric and Eccentric Strength
        FIGURE 27.14
      - Muscle Ultrastructural Changes
        FIGURE 27.15
        Maximal Explosive Leg Power Before and After Space Missions
        FIGURE 27.16
        Microgravity’s Effects on Muscle Fibers
    - COUNTERMEASURE STRATEGIES
      - TABLE 27.9: Adverse Effects of Spaceflight and Proposed Countermeasures
      - In-Flight Exercise
        FIGURE 27.17
        Countermeasures on Long-Duration Missions
        FIGURE 27.18
        Microgravity Compromises Immune System Function
        FIGURE 27.19
        INTEGRATIVE QUESTION
      - Space Pharmacology
        TABLE 27.10: Incidence and Severity of Space Motion Sickness During 36 Space Shuttle Flights
      - Lower-Body Negative Pressure
        FIGURE 27.20
        Assessing Orthostatic Deconditioning Effects
        FIGURE 27.21
        LBNP Combined Countermeasures
      - Nutrition
        Effects on Body Weight
        INTEGRATIVE QUESTION
        Altered Protein Dynamics.
        INTEGRATIVE QUESTION
        Energy Expenditure and Energy Balance Dynamics on the Space Shuttle
        FIGURE 27.22
        International Space Station (ISS) Experiments on Nutrition and Body Composition
        Nutritionally Related Effects of Spaceflight on Physiologic Functions
        FIGURE 27.23
        Body Composition Changes.
        FIGURE 27.24
        INTEGRATIVE QUESTION
    - OVERVIEW OF PHYSIOLOGIC RESPONSES TO SPACEFLIGHT
      - FIGURE 27.25
      - Short- and Long-Term Responses
        FIGURE 27.26
      - Time Course of In-Flight Adaptations
        FIGURE 27.27
      - Time Course of Postflight Readaptations
        FIGURE 27.28
    - NASA’S NEW VISION FOR THE FUTURE OF SPACE EXPLORATION
      - Hubble Space Telescope
    - PRACTICAL BENEFITS FROM SPACE BIOLOGY RESEARCH
      - TABLE 27.11: Examples of Spin-off Technologies from the Apollo Space Program
      - TABLE 27.12: Examples of Spin-off Technologies from the Space Shuttle Program
      - Newly Won Knowledge Pays Huge and Unexpected Dividends
    - FINAL WORDS
      - FIGURE 27.29
      - FIGURE 27.30
      - FIGURE 27.31
      - Apollo Space Mission’s 41-Year Anniversary
    - Summary
- SECTION 6: Body Composition, Energy Balance, and Weight Control
  - OVERVIEW
  - INTERVIEW WITH: Dr. Claude Bouchard
  - CHAPTER 28: Body Composition Assessment
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - Four Limitations of Height–Weight Tables
      - TABLE 28.1: Terms Frequently Used in Describing and Measuring Body Composition
    - OVERWEIGHT, OVERFATNESS, AND OBESITY: NO UNANIMITY FOR TERMINOLOGY
    - THE BODY MASS INDEX: A POPULAR CLINICAL STANDARD
      - BMI Computation
        IN A PRACTICAL SENSE: Determining Body Frame Size from Stature and Two Bone Diameters
        MEASUREMENTS
        CALCULATIONS
        STEPS
        TABLE 1: Example of BFS Calculations for a Male and Female of Different Heights and Bone Measurements
        TABLE 2: BFS Categories
        EXAMPLE
      - New Standards for Overweight and Obesity
        FIGURE 28.1
        FIGURE 28.2
        One in Five American Children are Obese
        BMI Limitations
        FIGURE 28.3
        Miss America and BMI: Underweight Role Models?
        When a Model is Not Ideal
        FIGURE 28.4
    - COMPOSITION OF THE HUMAN BODY
      - Reference Man and Reference Woman
        FIGURE 28.5
        Essential and Storage Fat
        FIGURE 28.6
        Fat-Free Body Mass Versus Lean Body Mass.
      - Minimal Leanness Standards
        Men
        Women
      - Leanness, Regular Physical Activity, and Menstrual Irregularity
        INTEGRATIVE QUESTION
        Lean-to-Fat Ratio
      - Delayed Onset of Menstruation and Cancer Risk
    - COMMON TECHNIQUES TO ASSESS BODY COMPOSITION
      - Direct Assessment
      - Indirect Assessment
        Hydrostatic Weighing: Archimedes’ Principle
        FIGURE 28.7
        INTEGRATIVE QUESTION
      - Body Volume Measurement
        Water Displacement
        Hydrostatic Weighing
        FIGURE 28.8
        Variations with Menstruation.
        Calculating Body Composition from Body Mass, Body Volume, and Residual Lung Volume.
        TABLE 28.2: Measurements of Two Professional Football Players from Underwater Weighing
        Validity of Hydrostatic Weighing to Estimate Body Fat.
        Computing Body Density.
        Computing Percentage Body Fat.
        Limitations of Density Assumptions.
        TABLE 28.3: Body Fat Estimates Using Age- and Gender-Specific Conversions to Account for Age-Related Changes in the Density of the Fat-Free Body Mass
        Adjust for Large Musculoskeletal Development.
        Computing Fat Mass.
        Computing Fat-Free Body Mass.
      - BOD POD Measurement of Body Volume
        FIGURE 28.9
      - Some Discrepancies in the Literature
      - Skinfold and Girth Measurements
        Subcutaneous Fat Measurement with Skinfolds
        The Caliper.
        FIGURE 28.10
        Measurement Sites.
        FIGURE 28.11
        Usefulness of Skinfold Scores
        TABLE 28.4: Changes in Selected Skinfolds of a Young Woman During a 16-Week Exercise Program
        Skinfold Prediction for Athletes
        Skinfolds and Age
        User Beware
        INTEGRATIVE QUESTION
        Measurement of Girths
        FIGURE 28.12
        Usefulness of Girth Scores
        Body Fat Predictions from Girths
      - Bioelectrical Impedance Analysis
        FIGURE 28.13
        IN A PRACTICAL SENSE: How to Predict Percentage Body Fat from Girths for Overly Fat Men and Women
        PREDICTING PERCENTAGE BODY FAT
        EXAMPLES
        Influence of Hydration Level and Ambient Temperature
        Applicability of BIA in Sports and Exercise Training
      - Near-Infrared Interactance
        Questionable Validity of NIR
        FIGURE 28.14
      - Ultrasound Assessment of Fat
      - Computed Tomography, Magnetic Resonance Imaging, and Dual-Energy X-Ray Absorptiometry
        Computed Tomography
        FIGURE 28.15
        FIGURE 28.16
        Magnetic Resonance Imaging
        FIGURE 28.17
        FIGURE 28.18
        MRI Comparison of Lean and Obese.
        FIGURE 28.19
        Exercise Training.
        Dual-Energy X-Ray Absorptiometry
        FIGURE 28.20
        INTEGRATIVE QUESTION
    - AVERAGE PERCENTAGE BODY FAT
      - TABLE 28.5: Average Values of Body Fat for Younger and Older Women and Men from Selected Studies
    - DETERMINING GOAL BODY WEIGHT
    - Summary
  - CHAPTER 29: Physique, Performance, and Physical Activity
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PHYSIQUES OF CHAMPION ATHLETES
      - Michael Phelps—World Champion Swimmer Anomaly?
        TABLE 29.1: Comparison of Swimming Speed in Goldfish and Michael Phelps (100-m butterfly time of 51.25 s)
        Fat–Free-to-Fat Ratio
        FIGURE 29.1
        Racial Differences
      - Percentage Body Fat of Elite Athletes
        Body Dimensions Relate to Superior Performance
        By Category
        FIGURE 29.2
        Field Event Athletes
        FIGURE 29.3
        TABLE 29.2: Skinfold and Girth Anthropometry of the Top 10 American Athletes in the Discus, Shot-Put, Javelin, and Hammer Throw
        Comparison of Body Composition in Male Sprint, Distance, Marathon, and Decathlon Olympians from Tokyo (1964), Mexico City (1968), and London (2012)
        Female Endurance Athletes
        TABLE 29.3: Body Composition of Female Endurance Runners
        Male Endurance Athletes
        TABLE 29.4: Body Composition Characteristics of Elite Male Middle- and Long-Distance Runners and Elite Marathoners
        INTEGRATIVE QUESTION
        Swimmer Sets Swim Record from Cuba to Florida and Expends 29,000 Calories
        Triathletes.
        Swimmers versus Runners
        American Football Players
        TABLE 29.5: Body Composition of Collegiate and Professional Football Players Grouped by Position
        FIGURE 29.4
        TABLE 29.6: Average Body Mass and Stature for the 2007 NFL Super Bowl Offensive and Defensive Linemen
        IN A PRACTICAL SENSE: Predicting Body Fat from Skinfolds, Girths, and BIA Measurements for Different Athletic Groups
        CALCULATION EXAMPLES
        Boy Athlete (18 yr)
        Female Ballet Dancer (20 yr)
        Male Football Player (20 yr)
        A Worrisome Trend Even Among Less Skilled and Younger Players.
        FIGURE 29.5
        2004–2005 Division I Big Ten Collegiate Football Players
        TABLE 29.7: Average BMI of Division I Big Ten Collegiate American Football Offensive and Defensive Linemen
        INTEGRATIVE QUESTION
        Other Longitudinal Trends in Body Size for Professional Basketball and Baseball Players.
        FIGURE 29.6
        Increasing Trend for NFL Players to Exceed 300 Pounds
        INTEGRATIVE QUESTION
        Professional Golfers.
        TABLE 29.8: Comparison of Height, Body Weight, and BMI for 2005 Champions Tour and PGA Golf Tour Champions and 2011 Top 20 PGA Players
        Weightlifters and Bodybuilders
        Men.
        Women.
        Men versus Women.
        TABLE 29.9: Body Composition and Anthropometric Girths of Male and Female Bodybuilders
        INTEGRATIVE QUESTION
    - UPPER LIMIT FOR FAT-FREE BODY MASS
    - Summary
  - CHAPTER 30: Overweight, Overfatness (Obesity), and Weight Control
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - PART 1: OBESITY
      - HISTORICAL PERSPECTIVE
      - OBESITY REMAINS A WORLDWIDE EPIDEMIC
        Four Reasons for Classifying Overweight and Obesity
        FIGURE 30.1
        FIGURE 30.2
        Perspective About the Size of the Obesity Epidemic
        One Third of Americans Now Classified as Ill by AMA
        FIGURE 30.3
        Sugary Drinks: Difficult to Dethrone
      - INCREASED BODY FAT: A PROGRESSIVE LONG-TERM PROCESS
        Childhood Obesity Rates
        Generally an Overfed Nation
        FIGURE 30.4
      - GENETICS INFLUENCES BODY FAT ACCUMULATION
        FIGURE 30.5
        A Mutant Gene and Leptin
        FIGURE 30.6
        Influence of Racial Factors
        Obesity in African Americans and Mexican Americans
        RACIAL DISPARITIES
        CONSEQUENCES
        A Word of Caution
      - PHYSICAL INACTIVITY: A CRUCIAL COMPONENT IN EXCESSIVE FAT ACCUMULATION
        Physical Activity and Body Fat Accumulation Throughout Life
        Benefits of Increased Energy Output with Aging
        FIGURE 30.7
        INTEGRATIVE QUESTION
      - HEALTH RISKS OF EXCESSIVE BODY FAT
        Extra Pounds Weigh Heavily on Lifespan Quality and Life
        Extra Pounds Can Shorten Life
        Factors That Inhibit Life Extension
        Physical Fitness Makes Good Medicine
        Obesity and Cancer Risk
        Excessive Fatness in Childhood and Adolescence Predicts Adverse Health Effects in Adulthood
        FIGURE 30.8
        Defined Health Risks
        Five Potential Serious Medical Complications of Diabetes
        FIGURE 30.9
        Specific Health Risks of Excessive Body Fat
      - CRITERIA FOR EXCESSIVE BODY FAT: HOW FAT IS TOO FAT?
        Percentage of Body Fat
        Standard for Overfatness
        Distribution or Patterning of Fat at Different Anatomic Regions
        FIGURE 30.10
        Waist Girth and Health Risk With Normal Body Mass Index
        Related References
        Adipocyte Size and Number: Hypertrophy versus Hyperplasia
        Abdominal Obesity Associated with Death Risk
        FIGURE 30.11
        Fat Cell Development and Adipocytes
        FIGURE 30.12
        Cellularity Differences Between Nonobese and Obese Persons
        FIGURE 30.13
        Molecular Biology to the Rescue
        Effects of Weight Loss
        FIGURE 30.14
        Effects of Weight Gain
        Possibility of New Adipocyte Formation
    - Summary
    - PART 2: PRINCIPLES OF WEIGHT CONTROL: DIET AND PHYSICAL ACTIVITY
      - ENERGY BALANCE: INPUT VERSUS OUTPUT
        FIGURE 30.15
        Consuming Excess Calories Produces Fat Gain Regardless of Nutrient Source
        A Prudent Recommendation
      - DIETING FOR WEIGHT CONTROL
        New Controversy: Can You Really Reduce One Pound a Week with a 3500-kcal Deficit?
        Long-Term Success
        FIGURE 30.16
        FIGURE 30.17
        More Fat and Less Muscle With Regained Weight
        National Weight Control Registry: Clues to Long-Term Success
        Can Intestinal Bacteria Cause and/or Cure Obesity?
        TABLE 30.1: (Top) Dietary Strategies to Achieve Weight Loss of Participants of the NWCR. (Bottom) Effects of Weight Loss on Various Dimensions of Life Reported by Participants
        Structured Assistance May Prove Useful for Successful Weight Loss
        Weight Loss Improves Disease-Risk Biomarkers
        FIGURE 30.18
        Setpoint Theory: A Case Against Dieting
        Resting Metabolism Decreases
        A Challenge to the Weight-Loss Equation
        FIGURE 30.19
        Biologic Feedback Mechanism
        Challenge to the Setpoint Proponents.
        IN A PRACTICAL SENSE: Recognizing Warning Signs of Disordered Eating
        ANOREXIA ATHLETICA
        ANOREXIA NERVOSA
        TABLE 1: Warning Signs of Anorexia Nervosa
        BULIMIA NERVOSA
        TABLE 2: Warning Signs of Bulimia Nervosa
        BINGE-EATING DISORDER
        References
        Dieting Extremes
        Low Carbohydrate–Ketogenic Diets
        Confirming Evidence to Reduce Dietary Animal Fat
        High-Protein Diets
        Semistarvation Diets
      - FACTORS THAT AFFECT WEIGHT LOSS
        Early Weight Loss Largely Water
        Hydration Level
        FIGURE 30.20
        Longer-Term Deficit Promotes Fat Loss
        FIGURE 30.21
      - INCREASED PHYSICAL ACTIVITY FOR WEIGHT CONTROL
        Not Simply Gluttony
        Fat Loss Best with Aerobic Activity
        When Reality Meets the Road
        The Most Desirable Solution—Increase Energy Output
        Two Misconceptions About Physical Activity
        Misconception 1: Increased Physical Activity Increases Food Intake
        INTEGRATIVE QUESTION
        Misconception 2: Physical Activity Does Not Burn Many Calories
        Calories In versus Calories Out: The Amount of Physical Activity Required for a 150-lb Person to Burn Off the Calories in Some Popular Foods
        The Recovery “Afterglow.”
        Vigorous Physical Activity May Boost Recovery Metabolism
      - EFFECTIVENESS OF REGULAR PHYSICAL ACTIVITY
        FIGURE 30.22
        TABLE 30.2: Effectiveness of a 16-Week Walking Program on Body Composition and Blood Lipid Changes in Six Overfat, Young Men
        Resistance Training
        Use It or Lose It
        TABLE 30.3: Changes in Body Composition After 12 Weeks of Either Resistance Training or Endurance Training
        FIGURE 30.23
        Dose–Response Relationship for Energy Expended and Weight Lost
        INTEGRATIVE QUESTION
        Walking–Running for Different Durations
        TABLE 30.4: Effects of Three Training Durations of Walking and Running on Body Composition Changes
        Exercise Frequency
        INTEGRATIVE QUESTION
        Start Slowly and Progress Gradually
        Self-Selected Energy Expenditures: Mode of Physical Activity
        FIGURE 30.24
        Caloric Restraint Plus Physical Activity: The Ideal Combination
        TABLE 30.5: Benefits of Adding Exercise to Dietary Restriction for Weight Loss
        INTEGRATIVE QUESTION
        Reality Check.
        INTEGRATIVE QUESTION
        Spot Reduction Does Not Work to Selectively Reduce Local Fat Deposits
        Physical Activity Prevents Fat Infiltration into Muscle
        INTEGRATIVE QUESTION
        Possible Gender Difference in Responsiveness to Physical Activity
      - WEIGHT LOSS RECOMMENDATIONS FOR WRESTLERS AND OTHER POWER ATHLETES
        TABLE 30.6: Using Anthropometric Equations to Predict a Minimal Wrestling Weight and to Select a Competitive Weight Class
        Prudent Recommendations for Wrestlers
      - GAINING WEIGHT: THE COMPETITIVE ATHLETE’S DILEMMA
        Unsupported Hype
        Increase the Lean, Not the Fat
        How Much Gain to Expect
        FIGURE 30.25
        INTEGRATIVE QUESTION
    - Summary
- SECTION 7: Exercise, Successful Aging, and Disease Prevention
  - OVERVIEW
  - INTERVIEW WITH: Dr. Steven N. Blair
  - CHAPTER 31: Physical Activity, Health, and Aging
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - THE GRAYING OF AMERICA
      - Older Yet Still Competing
    - THE NEW GERONTOLOGY
      - Healthy Life Expectancy: A New Concept
        FIGURE 31.1
        New Advice for Osteoarthritis: Keep Moving and Lose Weight
    - PART 1: PHYSICAL ACTIVITY IN THE POPULATION
      - PHYSICAL ACTIVITY EPIDEMIOLOGY
        Terminology
        FIGURE 31.2
        Physical Activity Participation
        U.S. Adult Population
        U.S. Children and Teenagers
        Activities of Those Americans Who Report Regular Physical Activity
        Healthy People 2020
        IN A PRACTICAL SENSE: Assessing Hip-and-Trunk and Shoulder–Wrist Flexibility
        FIELD TESTS OF HIP-AND-TRUNK AND SHOULDER-WRIST STATIC FLEXIBILITY
        TEST 1: HIP-AND-TRUNK FLEXIBILITY (MODIFIED SIT-AND-REACH TEST)
        Starting Position
        Movement
        Score
        Modified Sit-and-Reach Ratings: Men (Score in Inches)
        Modified Sit-and-Reach Ratings: Women (Score in Inches)
        TEST 2: SHOULDER-WRIST FLEXIBILITY (SHOULDER-AND-WRIST ELEVATION TEST)
        Starting Position
        Movement
        Score
        SHOULDER-AND-WRIST ELEVATION RATINGS BASED ON COLEGE-AGE MEN AND WOMEN (SCORE IN INCHES)
        FIGURE 31.3
        Safety of Exercising
        FIGURE 31.4
        An Overblown Risk for Marathoners
        Prehabilitation Reduces Sports and Recreational Injuries
        Sedentary Environmental Death Syndrome
    - Summary
    - PART 2: AGING AND PHYSIOLOGIC FUNCTION
      - AGE TRENDS
        Differences in Exercise Physiology Between Children and Adults
        INTEGRATIVE QUESTION
        Muscular Strength
        Age Trends Among Elite Weightlifters and Powerlifters
        FIGURE 31.5
        Muscle Mass Decrease
        FIGURE 31.6
        Potassium-Rich Foods May Blunt Muscle Loss with Aging
        Resistance Training for Older Adults
        FIGURE 31.7
        FIGURE 31.8
        Neural Function
        FIGURE 31.9
        FIGURE 31.10
        Endocrine Changes
        FIGURE 31.11
        Hypothalamic–Pituitary–Gonadal Axis
        Adrenal Cortex
        Growth Hormone/Insulin-Like Growth Factor Axis
        Pulmonary Function
        Cardiovascular Function
        Aerobic Power
        FIGURE 31.12
        Central and Peripheral Cardiovascular Functions
        Heart Rate.
        Cardiac Output.
        Large Artery Compliance.
        Peripheral Factors.
        Physiologic Loss with Aging: Lifestyle or Chronologic Age?
        Endurance Performance
        Oldest Marathoner
        Sprint Performance
        FIGURE 31.13
        Body Composition
        FIGURE 31.14
        Bone Mass
      - TRAINABILITY AND AGE
        FIGURE 31.15
        Aerobic Trainability Among Older Adults: Perhaps a Gender Difference
        TABLE 31.1: Effects of 9 Months of Endurance Training on Maximal Oxygen Consumption and Cardiovascular Function in 15 Men Age 63 ± 3 yr, and 16 Women Age 64 ± 3 yr
    - Summary
    - PART 3: PHYSICAL ACTIVITY, HEALTH, AND LONGEVITY
      - The Federal Government Takes a Stand
      - PHYSICAL ACTIVITY, HEALTH, AND LONGEVITY
        Enhanced Quality to a Longer Life: The Harvard Alumni Study
        Vigorous Exercise and Longevity
        Epidemiologic Evidence
        INTEGRATIVE QUESTION
      - REGULAR MODERATE PHYSICAL ACTIVITY PROVIDES SIGNIFICANT BENEFITS
        Influence of Physiologic Factors
        TABLE 31.2: General Trend for Effects of Regular Physical Activity and/or Increased Physical Fitness and Risk for Chronic Disease Conditions
        Structured Physical Activity Not Necessary
        Can Increasing Physical Activity Levels Improve Health and Extend Life?
        INTEGRATIVE QUESTION
    - Summary
    - PART 4: CORONARY HEART DISEASE
      - CHANGES ON THE CELLULAR LEVEL
        C-Reactive Protein: An Indication of Arterial Inflammation
        Not Just For the Blood Lipid Profile: New Recommendations
        Vulnerable Plaque: Difficult to Detect Yet Lethal
        Vascular Degeneration Begins Early in Life
        Risks Develop at an Early Age
        FIGURE 31.16
        INTEGRATIVE QUESTION
        Cardiovascular Disease Epidemic
        Prevalence and Control of Cardiovascular Disease and Risk Factors: An Issue for Many Americans
      - CORONARY HEART DISEASE RISK FACTORS
        TABLE 31.3: Modifiable and Unmodifiable Risk Factors Most Frequently Implicated in Coronary Heart Disease
        Age, Gender, and Heredity
        Sleep Disorders: An Underdiagnosed and Undertreated CHD Risk Factor
        INTEGRATIVE QUESTION
        Blood Lipid Abnormalities
        AHA Recommendations for Cholesterol and Triacylglycerol
        FIGURE 31.17
        TABLE 31.4: Approximate Composition of Serum Lipoproteins
        LDL Particle Size Assessment Also Important
        Factors That Affect Blood Lipids
        Specific Effects of Physical Activity
        Short-Term Effects.
        Long-Term Effects.
        LDL-C.
        HDL-C.
        Protection from Gallstones.
        Other Influences
        Lipoprotein(a).
        Dietary Fiber, Insulin, and CHD Risk.
        Immunologic Factors.
        Beyond Cholesterol: Homocysteine and Coronary Heart Disease
        FIGURE 31.18
        INTEGRATIVE QUESTION
        CHD Risk Factor Interactions
        FIGURE 31.19
        TABLE 31.5: Novel Risk Factors for Atherosclerotic Vascular Disease
        Modifiable Risk Factors and Cardiovascular Health
        Risk Factors in Children
        FIGURE 31.20
        Calculate Your CHD Risk
        FIGURE 31.21
    - Summary
  - CHAPTER 32: Clinical Exercise Physiology for Cancer, Cardiovascular, and Pulmonary Rehabilitation
    - CHAPTER OBJECTIVES
    - ANCILLARIES at-a-Glance
    - THE EXERCISE PHYSIOLOGIST IN THE CLINICAL SETTING
      - TABLE 32.1: Clinical Areas and Corresponding Diseases and Disorders Where Regular Physical Activity Applies
      - FIGURE 32.1
      - Vital Link Between Sports Medicine and Exercise Physiology
        TABLE 32.2: Health Benefits of Regular Physical Activitya
    - TRAINING AND CERTIFICATION PROGRAMS FOR PROFESSIONAL EXERCISE PHYSIOLOGISTS
    - CLINICAL APPLICATIONS OF EXERCISE PHYSIOLOGY TO DIVERSE DISEASES AND DISORDERS
    - ONCOLOGY
      - Recent Cancer Statistics
        FIGURE 32.2
        Clinical Features
        TABLE 32.3: Cancer Therapies and Their Complications
      - Cancer Rehabilitation and Physical Activity
        FIGURE 32.3
        Physical Activity: Protective Effects on Cancer Occurrence
        Physical Activity and Cancer Risk
        Physical Activity Prescription and Cancer
        Breast Cancer Rehabilitation and Physical Activity
        FIGURE 32.4
    - CARDIOVASCULAR DISEASE
      - Cardiovascular Disease and Exercise Capacity
        TABLE 32.4: Cardiac Diseases That Cause Functional Impairment
      - Blood Pressure: Classification and Risk Stratification
        FIGURE 32.5
        TABLE 32.5: Classification of Blood Pressure for Adults Age 18 Years and Older
        TABLE 32.6: Risk Stratification and Recommended Treatment for Hypertension
      - Regular Physical Activity and Hypertension
        TABLE 32.7: Blood Pressure During Rest and Submaximal Exercise Before and After 4 to 6 Weeks of Training in Seven Middle-Age CHD Patients
        FIGURE 32.6
        Chronic Resistance Training Effects on Blood Pressure
      - Diseases of the Myocardium
        Angina Pectoris
        TABLE 32.8: Comparison of Symptoms of Angina Pectoris and Heartburn
        FIGURE 32.7
        Myocardial Infarction
        FIGURE 32.8
        Congestive Heart Failure
        FIGURE 32.9
        CHF and Regular Physical Activity.
        Aneurysm
        Heart Valve Diseases
      - Cardiac Nervous System Diseases
    - ASSESSING CARDIAC DISEASE
      - Purpose of Health Screening and Risk Stratification
        IN A PRACTICAL SENSE: Par-Q to Assess Readiness for Physical Activity
        ORIGINAL PAR-Q
        IF YOU ANSWERED YES TO ONE OR MORE QUESTIONS:
        IF YOU ANSWERED NO TO ALL QUESTIONS:
        PAR-Q (REVISED 1994)
        IF YOU ANSWERED YES TO ONE OR MORE QUESTIONS:
        IF YOU ANSWERED NO TO ALL QUESTIONS:
        ACSM Risk Stratification for Beginning an Exercise Program
      - Patient History
        TABLE 32.9: Diagnosis of Chest Pain
      - Physical Examination
        Heart Auscultation
        Laboratory Tests
        TABLE 32.10: Normal and Abnormal ECG Changes During Exercise
        Invasive Physiologic Tests
        Radionuclide Studies.
        Pharmacologic Stress Testing.
        Cardiac Catheterization.
        Coronary Angiography.
        FIGURE 32.10
        Noninvasive Physiologic Tests
        Echocardiography.
        Ultrafast CT Scan.
        Graded Exercise Stress Testing.
        TABLE 32.11: Data from an Exercise Stress Test to Diagnose and Formulate an Exercise Prescription
      - Prudent Pre-exercise Evaluation
      - Reasons for Stress Testing
        INTEGRATIVE QUESTION
      - Who Requires Stress Testing?
        TABLE 32.12: ACSM Recommendations for Current Medical Examination and Exercise Stress Testing (GXT) and Physician Supervision of GXT Prior to Participation in Exercise Program
      - Informed Consent
      - Stress Testing Contraindications
        GXT Termination
        TABLE 32.13: Criteria for Terminating a Graded Exercise Test by Apparently Healthy Adults
      - Stress Test Outcomes
        Stress Testing the “Oldest-Old”
      - Exercise-Induced Indicators of CHD
        Angina Pectoris
        Electrocardiographic Abnormalities
        FIGURE 32.11
        Cardiac Rhythm Abnormalities
        Other Exercise-Induced CHD Indicators
    - STRESS TEST PROTOCOLS
      - Bruce and Balke Treadmill Tests
      - Bicycle Ergometer Tests
      - Arm-Crank Ergometer Tests
        INTEGRATIVE QUESTION
      - Stress Testing Safety
        TABLE 32.14: Summary Reports of Incidence of Morbidity and/or Mortality During or Following a Graded Exercise Test (1969–1995)
    - PRESCRIBING PHYSICAL ACTIVITY AND EXERCISE
      - Practical Illustration
        FIGURE 32.12
      - Improvements in CHD Patients
      - The Program
        Supervision Level
        TABLE 32.15: ACSM Categories for Exercise Programs Related to Patient Symptoms
        Resistance Exercise Provides Benefits
        Resistance Training Prescription.
      - Cardiac Medications and Exercise Response
        TABLE 32.16: Cardiac Medications: Their Use, Side Effects, and Effects on Exercise Response
        INTEGRATIVE QUESTION
    - CARDIAC REHABILITATION
      - TABLE 32.17: Functional and Therapeutic Classifications of Heart Disease from the New York Heart Association.
      - TABLE 32.18: Guidelines for Risk Stratification from the AHA When Considering an Exercise Program
      - Inpatient Programs
      - Outpatient Programs
    - PULMONARY DISEASES
      - Restrictive Lung Dysfunction
        TABLE 32.19: Restrictive Lung Diseasesa
      - Chronic Obstructive Pulmonary Disease
        Differences Among Major COPD Diseases
        Chronic Bronchitis
        FIGURE 32.13
        Emphysema
        FIGURE 32.14
        FIGURE 32.15
        Cystic Fibrosis
        TABLE 32.20: Clinical Signs and Symptoms of Cystic Fibrosis and Related Pulmonary Involvement
        FIGURE 32.16
      - Pulmonary Assessments
        X-Ray
        FIGURE 32.17
        Computed Tomography
        Other Measures
      - Pulmonary Rehabilitation and Physical Activity Prescription
        FIGURE 32.18
        INTEGRATIVE QUESTION
      - Pulmonary Medications
        TABLE 32.21: Major Pulmonary Bronchodilator Drugs: Their Uses and Side Effects
    - PHYSICAL ACTIVITY AND ASTHMA
      - Asthma Statistics
        FIGURE 32.19
      - Sensitivity to Thermal Gradients and Fluid Loss
      - Environmental Impact
      - Benefits of Warm-Up and Medication
    - NEUROMUSCULAR DISEASES, DISABILITIES, AND DISORDERS
      - Stroke
        Clinical Features
        TABLE 32.22: Physical and Psychologic Conditions and Comorbidities in Stroke Patients
        Exercise Prescription
      - Multiple Sclerosis
        Clinical Features
        Exercise Prescription
      - Parkinson’s Disease
        Clinical Features
        Exercise Prescription
    - RENAL DISEASE
      - Clinical Features
      - Exercise Prescription
    - COGNITIVE/EMOTIONAL DISEASES AND DISORDERS
      - Use It or Lose It
      - Clinical Features
        TABLE 32.23: Twelve Common Signs and Symptoms of Depression
      - Exercise Prescription
    - Summary
- SECTION 8: On the Horizon
  - OVERVIEW
  - INTERVIEW WITH: Dr. Frank W. Booth
  - CHAPTER 33: Molecular Biology: A New Vista for Exercise Physiology
    - ANCILLARIES at-a-Glance
    - FIGURE 33.1
    - HISTORICAL TOUR OF MOLECULAR BIOLOGY
      - FIGURE 33.2
      - Discovery of Darwin’s inherited Medical Malady
    - REVOLUTION IN THE BIOLOGIC SCIENCES
      - FIGURE 33.3
      - Rosalind Franklin: An Unsung Hero in the Discovery of the Double Helix
    - THE HUMAN GENOME
      - FIGURE 33.4
    - NUCLEIC ACIDS
      - FIGURE 33.5
      - DNA and RNA
        FIGURE 33.6
        FIGURE 33.7
        FIGURE 33.8
      - Linking Nucleotides: Phosphodiester Bonding
        FIGURE 33.9
      - Structure of DNA
        FIGURE 33.10
      - Base Pairing
        FIGURE 33.11
      - Forms of RNA
        Codons and Nature’s Genetic Code
        FIGURE 33.12
      - Sequencing of Codons
    - HOW DNA REPLICATES
      - FIGURE 33.13
      - Three Stages of DNA Replication
        FIGURE 33.14
      - Pivotal Role for DNA Polymerase
        What Controls DNA Synthesis?
        FIGURE 33.15
      - Cell Life Cycle Controllers
    - PROTEIN SYNTHESIS: TRANSCRIPTION AND TRANSLATION
      - Generalized Overview of Protein Synthesis
        FIGURE 33.16
      - Transcription of the Genetic Code: RNA Synthesis and Gene Expression
        FIGURE 33.17
      - Examples of Gene Expression
        FIGURE 33.18
      - Protein Enzymes
      - Transcription Control
        FIGURE 33.19
      - Enzyme Turnover Number
        FIGURE 33.20
      - Gene Expression and Human Exercise Performance
      - Exons and Introns
        FIGURE 33.21
        RNA Splicing
        mRNA Packaging: Polyadenylic Acid and Guanosine Triphosphate— Tails and Caps
        FIGURE 33.22
        Exiting the Nucleus
      - Translation of the Genetic Code: Ribosomal Assembly of Polypeptides
        Ribosomes and Polypeptide Synthesis: Initiation of Protein Construction
        FIGURE 33.23
        Role of tRNA
        FIGURE 33.24
        Polypeptide Elongation and Termination
        FIGURE 33.25
        Protein Delivery System: The Golgi Complex
        FIGURE 33.26
        Termination of Protein Synthesis
        TABLE 33.1: Eight Categories of Proteins and Their Biologic Functions
        FIGURE 33.27
        Hemoglobin and the Evolutionary Tree
        Proteolysis: The Ultimate Fate of Proteins
        FIGURE 33.28
        Summary of Main Sequence of Events in Protein Synthesis
        TABLE 33.2: Essential Concepts and Sequence of Events in Protein Synthesis
    - MUTATIONS
      - Inherited Blood Disorder Can Be Deadly
      - Varieties of Mutations
        TABLE 33.3: Types and Examples of Genetic Mutations
        The Fight Against Chromosome 21 Mutations
        Single Nucleotide Polymorphisms
        FIGURE 33.29
        Cancer
        FIGURE 33.30
      - Mitochondrial DNA Mutations and Diseases
        FIGURE 33.31
        Mitochondrial DNA and the Evolutionary Tree
    - NEW HORIZONS IN MOLECULAR BIOLOGY
      - Supercharged Carrots and Lettuce
      - Medically Related Research
        FIGURE 33.32
        FIGURE 33.33
        FIGURE 33.33
      - DNA Technologies
        FIGURE 33.34
        DNA Cloning Isolates Human Genes
        FIGURE 33.35
        Practical Application in Bioremediation
        FIGURE 33.36
        Locating Specific Genes with Plasmids
        FIGURE 33.37
      - Electrophoresis and Gel Transfer Methods
        FIGURE 33.38
        FIGURE 33.39
        DNA Amplification with the Polymerase Chain Reaction
        FIGURE 33.40
        Applications of PCR
        Thwarting Counterfeits at Major Sporting Events
        FIGURE 33.41
        Five Steps to Cloning an Extinct Mammal
        Injection Experiments
        FIGURE 33.42
        Cloning a Mammal
        SCNT Method.
        FIGURE 33.43
        Roslin Method.
        FIGURE 33.44
        Honolulu Technique.
        Gene Knockout Technique
        FIGURE 33.45
        Knockout Mice to Study Mechanisms of Obesity
        FIGURE 33.46
    - HUMAN PERFORMANCE RESEARCH
      - FIGURE 33.47
      - FIGURE 33.48
      - Discoverer of Parkinson’s Disease
    - SHAPING THE FUTURE
      - FIGURE 33.49
Back Matter
- Index
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Exercise Physiology: Nutrition, Energy, and Human Performance (reflowable text)

Exercise Physiology: Nutrition, Energy, and Human Performance (reflowable text)

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