{"id":2610,"date":"2024-08-21T13:42:19","date_gmt":"2024-08-21T17:42:19","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/?post_type=chapter&p=2610"},"modified":"2025-03-12T17:02:27","modified_gmt":"2025-03-12T21:02:27","slug":"the-role-of-cardiorespiratory-fitness","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/chapter\/the-role-of-cardiorespiratory-fitness\/","title":{"raw":"The Role of Cardiorespiratory Fitness","rendered":"The Role of Cardiorespiratory Fitness"},"content":{"raw":"

Cardiorespiratory Fitness and Health<\/h1>\r\nNow that we have discussed the various methods for measuring body weight, body fat, and fat distribution, it is important to spend some time discussing a fitness-related indicator of health.\r\n\r\nCardiorespiratory fitness (CRF) refers to the integrated ability of the circulatory and respiratory systems to transport oxygen to the mitochondria of skeletal muscle for ATP production required to perform physical work.[footnote]Raghuveer, G., Hartz, J., Lubans, D. R., Takken, T., Wiltz, J. L., Mietus-Snyder, M., Perak, A. M., Baker-Smith, C., Pietris, N., & Edwards, N. M. (2020). Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation (Ovid), 142(7), e101\u2013e118. https:\/\/doi.org\/10.1161\/CIR.0000000000000866[\/footnote] Since CRF refers to the functional capacity of numerous body systems, it is often considered a predictor of total body health. Numerous studies have consistently reported that CRF is a strong and independent predictor of cardiovascular disease and all-cause mortality risk. In fact, CRF has been reported to be a more meaningful predictor of morbidity and mortality risk than other conventional risk factors such as hypertension, obesity, hyperlipidemia, type II diabetes, and smoking. A CRF level of <5 METs indicates an elevated risk of mortality, whereas CRF levels of >8 to 10 METs reflect increased survival.[footnote]Raghuveer, G., Hartz, J., Lubans, D. R., Takken, T., Wiltz, J. L., Mietus-Snyder, M., Perak, A. M., Baker-Smith, C., Pietris, N., & Edwards, N. M. (2020). Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation (Ovid), 142(7), e101\u2013e118. https:\/\/doi.org\/10.1161\/CIR.0000000000000866<\/a>[\/footnote] Similarly, when cardiorespiratory fitness is accounted for, BMI mortality risk is eliminated or reduced significantly and having a low cardiorespiratory fitness is associated with a 2-2.5 fold increase in mortality risk irrespective of BMI.[footnote]Gaesser , GA. And Angadi, AA. 2021. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016\/j.isci.2021.102995. eCollection 2021 Oct 22. https:\/\/pubmed.ncbi.nlm.nih.gov\/34755078\/[\/footnote] What's interesting is having a high cardiorespiratory fitness can outweigh the protective effect of a low BMI. In a study reviewed by Gaesser and Angadi, [footnote]Gaesser , GA. And Angadi, AA. 2021. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016\/j.isci.2021.102995. eCollection 2021 Oct 22. https:\/\/pubmed.ncbi.nlm.nih.gov\/34755078\/[\/footnote] having a moderate-to-high cardiorespiratory fitness level when categorized as being overweight or having obesity was associated with a lower death rate than those who had a low cardiorespiratory fitness level but were categorized as having a \"normal\" BMI.\r\n\r\nDespite these clinical observations and findings, the importance of CRF in determining one\u2019s CVD\/mortality risk can be undermined by healthcare professionals and CVD specialists. While it is useful to measure traditional risk factors such as smoking and obesity, the addition of CRF as a risk factor may allow healthcare professionals to more accurately assess a person's risk of experiencing adverse health outcomes.\r\n

Measuring Cardiorespiratory Fitness<\/h1>\r\nCRF can be measured directly, in the form of maximal oxygen consumption (VO2max<\/sub>), or predicted using the peak oxygen consumption achieved on a treadmill\/cycle ergometer exercise test.\u00a0 Some examples of a predictive<\/span> VO<\/span><\/span>2max<\/span><\/span><\/span><\/sub> test include the Balke and Ware<\/span> Treadmill Test<\/span> and<\/span> the 6-Minute Walk Test.<\/span> During the <\/span><\/span>Balke and Ware Treadmill Test<\/span><\/span><\/a>,<\/span> the speed is set to 3 mph for females and 3.3 mph for males at 0% grade. For men, after the first minute, the grade is raised to 2% and then increased by 1% for e<\/span>very<\/span> minute thereafter. For women, after 3 minutes, the grade is raised by 2.5% and then increased by 2.5% every 3 minutes <\/span>thereafter.<\/span> <\/span>The Balk<\/span><\/span><\/span>e and Ware<\/span><\/span><\/span> is a great test because it can be performed maximally to evaluate cardiac function in clinical settings and <\/span>submaximally<\/span> to assess CRF in fitness settings. <\/span>Additionally, since the speed is kept constant, this test is also <\/span>appropriate for<\/span> deconditioned and elderly populations that may experience gait disturban<\/span>ces at high speeds. <\/span>On the other hand, t<\/span>he<\/span><\/span> 6-Minute Walk Test<\/span> (6MWT)<\/span><\/span><\/a> is a great submaximal field test to use among clinical and older populations.<\/span> In this test, <\/span>the distance covered by an individual in 6 minutes is recorded.<\/span> The American Thoracic Society <\/span>recommends<\/span> using a 30 m <\/span>unimpeded<\/span> walking<\/span> course and using <\/span>a lap counter to keep track of how many laps the individual has completed.<\/span> The 6MWT is a great <\/span>option<\/span> because this <\/span>test <\/span>requires <\/span>minimal<\/span> equipment<\/span> and is <\/span>very easy<\/span> and quick <\/span>to administer<\/span>. <\/span><\/span>Although VO2max<\/sub> or VO2peak<\/sub> measurements are ideal for determining one\u2019s CRF level, not all patients are willing to perform exercise stress tests. For such patients, it may be beneficial to have them fill out self-report physical activity questionnaires. Although self-report questionnaires may not be the most accurate measure of CRF, they can still provide the healthcare professional with a broad understanding of the patient\u2019s CRF levels and disease risk. One such <\/span>publicly<\/span> available <\/span>questionnaire is the<\/span> <\/span>International Physical Activity Questionnaire (IPAQ)<\/span><\/a>, <\/span><\/span>a<\/span>n <\/span>open-ac<\/span>cess <\/span>27-item self-report measure of physical activity levels among <\/span>individuals<\/span> aged 15<\/span> years or older.<\/span><\/span>\r\n

\u00a0Physical Activity Guidelines and Health<\/span><\/h1>\r\nIt is also important for clinicians to educate clients on the numerous health benefits associated with exercise beyond weight loss. This is because research has consistently demonstrated that exercise alone is not an effective method for experiencing weight loss. The current Canadian 24- hour Movement Guidelines [footnote]https:\/\/csepguidelines.ca\/[\/footnote] recommend that individuals meet 150 minutes of moderate to vigorous-intensity exercise per week for adults aged 18-64. Following these guidelines is associated with a lower risk of mortality, cardiovascular disease, hypertension, type 2 diabetes, several cancers, anxiety, depression, dementia, weight gain, adverse blood lipid profile. as well as improved bone health, cognition, quality of life and physical function. However, the American College of Sports Medicine (ACSM) states that up to 60 minutes of moderate to vigorous-intensity exercise per day is needed when relying on exercise alone for weight reduction. [footnote]Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Progress in Cardiovascular Diseases, 56(4), 441\u2013447. https:\/\/doi.org\/10.1016\/j.pcad.2013.09.012[\/footnote]\u00a0 These ACSM are supported by another research study, in which male participants living with obesity (LWO) demonstrated a 7.5 kg body weight reduction in 3 months in the exercise group, which was comparable with the results seen in the calorie-restricted group. The participants in the exercise group were required to meet a daily 700-calorie energy expenditure goal, which translated to 60 minutes of exercise per day.[footnote]Ross, R., Dagnone, D., Jones, P., Smith, H., Paddags, A., Hudson, R., & Janssen, I. (2000). Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men - A randomized, controlled trial. ANNALS OF INTERNAL MEDICINE, 133(2), 92\u2013103.[\/footnote] Therefore, extremely high volumes of exercise are required to see meaningful reductions in body weight. Additionally, inter-individual differences contribute to the heterogeneity in individual capacity for weight loss in response to exercise interventions. While some individuals achieve clinically significant weight loss, others may experience either minimal to no changes in body weight or even experience some weight gain in response to exercise training without caloric restrictions. However, clinical studies have shown that those who are classified as being overweight or having obesity report no weight loss or modest weight loss (<5 kg) from exercise training but still experience numerous health benefits such as improved cardiorespiratory fitness (CRF), glucose control, endothelial function, lipoprotein particle size, high-density lipoprotein, and overall quality of life.[footnote]Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Progress in Cardiovascular Diseases, 56(4), 441\u2013447. https:\/\/doi.org\/10.1016\/j.pcad.2013.09.012[\/footnote] From this, it can be understood that exercise programs do not always guarantee weight loss. Instead, exercise programs guarantee vast improvements in cardiometabolic health profiles and cardiorespiratory fitness levels independent of weight loss.<\/span>\r\n

Ethnicity-Specific Guidelines<\/h2>\r\n
\r\n\r\nSouth Asian Canadians (SACs) currently make up 25.1% of the total minority population in Canada, establishing them as the largest visible minority group in Canada.[footnote]Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165[\/footnote] <\/span>These statistics highlight the importance of prioritizing the health and well-being of SACs due to their considerable implications on the healthcare system. This is particularly important considering the increased rates of cardiovascular disease (CVD) and CVD risk factors, and the highest physical inactivity rates seen among SACs when compared to other ethnic groups in Canada. Research studies have shown that SACs have unfavourable levels of total cholesterol, triglyceride, and glucose tolerance which consequently advances the atherosclerotic process, thus predisposing them to hyperlipidemia and CVD. When compared to other ethnic groups, SACs are also most susceptible to developing diabetes and diabetes-related risk factors due to their higher deposition of visceral adipose tissue and lower physical activity levels. Additionally, when compared to White Canadians with similar body mass indices, SACs have higher body fat percentages and are at greater risk of developing hypertension.<\/span>[footnote]Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165[\/footnote] <\/span>These differences in body fat percentages and prevalence of CVD can be partly attributed to their lower physical activity levels but are also influenced by factors such as their genetically unfavourable cardiometabolic health profiles, socio-cultural barriers, and inherently lower cardiorespiratory levels.[footnote]Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165[\/footnote]<\/span>\r\n\r\n<\/div>\r\n
\r\n\r\nThe current ACSM physical activity guidelines and the CSEP 24 hr movement guidelines recommend a minimum of 150 minutes of moderate to vigorous-intensity aerobic exercise per week. However, these physical activity guidelines largely derive from studies that use White European men as participants, thus limiting their applicability to SACs. In a study conducted by Iliodromiti et al. (2016), researchers found that South Asians have a \u2018low-fitness\u2019 phenotype due to their inherently lower cardiorespiratory levels and limited capacity to metabolize fats during exercise. As a result of these genetic variations, researchers have proposed new physical activity guidelines specific to South Asians, which suggest that South Asians would benefit from engaging in an additional 10-15 minutes of moderate-intensity aerobic exercise per day.[footnote]Iliodromiti, S., Ghouri, N., Celis-Morales, C., Sattar, N., Lumsden, M., & Gill, J. (2016). Should Physical Activity Recommendations for South Asian Adults Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and White European Men and Women. PLoS ONE, 11(8), e0160024. https:\/\/doi.org\/10.1371\/journal.pone.0160024[\/footnote] These guidelines suggest that South Asians must engage in a total of 230 minutes of moderate to vigorous-intensity aerobic exercise per week to achieve the same cardiometabolic health improvements as White Europeans engaging in 150 minutes of moderate to vigorous-intensity exercise per week. These ethnicity-specific guidelines further highlight the role of genetic influences in contributing to one\u2019s risk of developing CVD and obesity.\r\n\r\n<\/div>\r\n
\r\n\r\nAlthough the physical activity guidelines recommend meeting 230 minutes of moderate-intensity aerobic exercise per week, studies have shown that SACs will benefit from engaging in any aerobic exercise program. Typically, physical activity guidelines focus on more traditional forms of physical activity (e.g., jogging, biking etc.,) but it\u2019s possible that more culturally relevant activity can help with physical activity participation. For example, in a study conducted by Lesser et al. (2016), researchers found that a higher percentage of people attended a culturally relevant activity vs. a standard program. For individuals who find the idea of working out at a gym daunting, it may be helpful to opt for culturally relevant ways to remain physically active, especially to increase one\u2019s exercise self-efficacy and adherence. Culturally relevant exercise interventions such as Bhangra have high adherence rates because they promote increased energy levels, lower stress levels, and a friendly social atmosphere.[footnote]Lesser, I. A., Guenette, J. A., Hoogbruin, A., Mackey, D. C., Singer, J., Gasevic, D., & Lear, S. A. (2016). Association between exercise-induced change in body composition and change in cardiometabolic risk factors in postmenopausal South Asian women. Applied Physiology, Nutrition & Metabolism, 41(9), 931\u2013937. https:\/\/search.ebscohost.com\/login.aspx?direct=true&AuthType=sso&db=s3h&AN=117760908&site=eds-live.[\/footnote]\r\n\r\n<\/div>\r\n ","rendered":"

Cardiorespiratory Fitness and Health<\/h1>\n

Now that we have discussed the various methods for measuring body weight, body fat, and fat distribution, it is important to spend some time discussing a fitness-related indicator of health.<\/p>\n

Cardiorespiratory fitness (CRF) refers to the integrated ability of the circulatory and respiratory systems to transport oxygen to the mitochondria of skeletal muscle for ATP production required to perform physical work.[1]<\/sup><\/a> Since CRF refers to the functional capacity of numerous body systems, it is often considered a predictor of total body health. Numerous studies have consistently reported that CRF is a strong and independent predictor of cardiovascular disease and all-cause mortality risk. In fact, CRF has been reported to be a more meaningful predictor of morbidity and mortality risk than other conventional risk factors such as hypertension, obesity, hyperlipidemia, type II diabetes, and smoking. A CRF level of <5 METs indicates an elevated risk of mortality, whereas CRF levels of >8 to 10 METs reflect increased survival.[2]<\/sup><\/a> Similarly, when cardiorespiratory fitness is accounted for, BMI mortality risk is eliminated or reduced significantly and having a low cardiorespiratory fitness is associated with a 2-2.5 fold increase in mortality risk irrespective of BMI.[3]<\/sup><\/a> What’s interesting is having a high cardiorespiratory fitness can outweigh the protective effect of a low BMI. In a study reviewed by Gaesser and Angadi, [4]<\/sup><\/a> having a moderate-to-high cardiorespiratory fitness level when categorized as being overweight or having obesity was associated with a lower death rate than those who had a low cardiorespiratory fitness level but were categorized as having a “normal” BMI.<\/p>\n

Despite these clinical observations and findings, the importance of CRF in determining one\u2019s CVD\/mortality risk can be undermined by healthcare professionals and CVD specialists. While it is useful to measure traditional risk factors such as smoking and obesity, the addition of CRF as a risk factor may allow healthcare professionals to more accurately assess a person’s risk of experiencing adverse health outcomes.<\/p>\n

Measuring Cardiorespiratory Fitness<\/h1>\n

CRF can be measured directly, in the form of maximal oxygen consumption (VO2max<\/sub>), or predicted using the peak oxygen consumption achieved on a treadmill\/cycle ergometer exercise test.\u00a0 Some examples of a predictive<\/span> VO<\/span><\/span>2max<\/span><\/span><\/span><\/sub> test include the Balke and Ware<\/span> Treadmill Test<\/span> and<\/span> the 6-Minute Walk Test.<\/span> During the <\/span><\/span>Balke and Ware Treadmill Test<\/span><\/span><\/a>,<\/span> the speed is set to 3 mph for females and 3.3 mph for males at 0% grade. For men, after the first minute, the grade is raised to 2% and then increased by 1% for e<\/span>very<\/span> minute thereafter. For women, after 3 minutes, the grade is raised by 2.5% and then increased by 2.5% every 3 minutes <\/span>thereafter.<\/span> <\/span>The Balk<\/span><\/span><\/span>e and Ware<\/span><\/span><\/span> is a great test because it can be performed maximally to evaluate cardiac function in clinical settings and <\/span>submaximally<\/span> to assess CRF in fitness settings. <\/span>Additionally, since the speed is kept constant, this test is also <\/span>appropriate for<\/span> deconditioned and elderly populations that may experience gait disturban<\/span>ces at high speeds. <\/span>On the other hand, t<\/span>he<\/span><\/span> 6-Minute Walk Test<\/span> (6MWT)<\/span><\/span><\/a> is a great submaximal field test to use among clinical and older populations.<\/span> In this test, <\/span>the distance covered by an individual in 6 minutes is recorded.<\/span> The American Thoracic Society <\/span>recommends<\/span> using a 30 m <\/span>unimpeded<\/span> walking<\/span> course and using <\/span>a lap counter to keep track of how many laps the individual has completed.<\/span> The 6MWT is a great <\/span>option<\/span> because this <\/span>test <\/span>requires <\/span>minimal<\/span> equipment<\/span> and is <\/span>very easy<\/span> and quick <\/span>to administer<\/span>. <\/span><\/span>Although VO2max<\/sub> or VO2peak<\/sub> measurements are ideal for determining one\u2019s CRF level, not all patients are willing to perform exercise stress tests. For such patients, it may be beneficial to have them fill out self-report physical activity questionnaires. Although self-report questionnaires may not be the most accurate measure of CRF, they can still provide the healthcare professional with a broad understanding of the patient\u2019s CRF levels and disease risk. One such <\/span>publicly<\/span> available <\/span>questionnaire is the<\/span> <\/span>International Physical Activity Questionnaire (IPAQ)<\/span><\/a>, <\/span><\/span>a<\/span>n <\/span>open-ac<\/span>cess <\/span>27-item self-report measure of physical activity levels among <\/span>individuals<\/span> aged 15<\/span> years or older.<\/span><\/span><\/p>\n

\u00a0Physical Activity Guidelines and Health<\/span><\/h1>\n

It is also important for clinicians to educate clients on the numerous health benefits associated with exercise beyond weight loss. This is because research has consistently demonstrated that exercise alone is not an effective method for experiencing weight loss. The current Canadian 24- hour Movement Guidelines [5]<\/sup><\/a> recommend that individuals meet 150 minutes of moderate to vigorous-intensity exercise per week for adults aged 18-64. Following these guidelines is associated with a lower risk of mortality, cardiovascular disease, hypertension, type 2 diabetes, several cancers, anxiety, depression, dementia, weight gain, adverse blood lipid profile. as well as improved bone health, cognition, quality of life and physical function. However, the American College of Sports Medicine (ACSM) states that up to 60 minutes of moderate to vigorous-intensity exercise per day is needed when relying on exercise alone for weight reduction. [6]<\/sup><\/a>\u00a0 These ACSM are supported by another research study, in which male participants living with obesity (LWO) demonstrated a 7.5 kg body weight reduction in 3 months in the exercise group, which was comparable with the results seen in the calorie-restricted group. The participants in the exercise group were required to meet a daily 700-calorie energy expenditure goal, which translated to 60 minutes of exercise per day.[7]<\/sup><\/a> Therefore, extremely high volumes of exercise are required to see meaningful reductions in body weight. Additionally, inter-individual differences contribute to the heterogeneity in individual capacity for weight loss in response to exercise interventions. While some individuals achieve clinically significant weight loss, others may experience either minimal to no changes in body weight or even experience some weight gain in response to exercise training without caloric restrictions. However, clinical studies have shown that those who are classified as being overweight or having obesity report no weight loss or modest weight loss (<5 kg) from exercise training but still experience numerous health benefits such as improved cardiorespiratory fitness (CRF), glucose control, endothelial function, lipoprotein particle size, high-density lipoprotein, and overall quality of life.[8]<\/sup><\/a> From this, it can be understood that exercise programs do not always guarantee weight loss. Instead, exercise programs guarantee vast improvements in cardiometabolic health profiles and cardiorespiratory fitness levels independent of weight loss.<\/span><\/p>\n

Ethnicity-Specific Guidelines<\/h2>\n
\n

South Asian Canadians (SACs) currently make up 25.1% of the total minority population in Canada, establishing them as the largest visible minority group in Canada.[9]<\/sup><\/a> <\/span>These statistics highlight the importance of prioritizing the health and well-being of SACs due to their considerable implications on the healthcare system. This is particularly important considering the increased rates of cardiovascular disease (CVD) and CVD risk factors, and the highest physical inactivity rates seen among SACs when compared to other ethnic groups in Canada. Research studies have shown that SACs have unfavourable levels of total cholesterol, triglyceride, and glucose tolerance which consequently advances the atherosclerotic process, thus predisposing them to hyperlipidemia and CVD. When compared to other ethnic groups, SACs are also most susceptible to developing diabetes and diabetes-related risk factors due to their higher deposition of visceral adipose tissue and lower physical activity levels. Additionally, when compared to White Canadians with similar body mass indices, SACs have higher body fat percentages and are at greater risk of developing hypertension.<\/span>[10]<\/sup><\/a> <\/span>These differences in body fat percentages and prevalence of CVD can be partly attributed to their lower physical activity levels but are also influenced by factors such as their genetically unfavourable cardiometabolic health profiles, socio-cultural barriers, and inherently lower cardiorespiratory levels.[11]<\/sup><\/a><\/span><\/p>\n<\/div>\n

\n

The current ACSM physical activity guidelines and the CSEP 24 hr movement guidelines recommend a minimum of 150 minutes of moderate to vigorous-intensity aerobic exercise per week. However, these physical activity guidelines largely derive from studies that use White European men as participants, thus limiting their applicability to SACs. In a study conducted by Iliodromiti et al. (2016), researchers found that South Asians have a \u2018low-fitness\u2019 phenotype due to their inherently lower cardiorespiratory levels and limited capacity to metabolize fats during exercise. As a result of these genetic variations, researchers have proposed new physical activity guidelines specific to South Asians, which suggest that South Asians would benefit from engaging in an additional 10-15 minutes of moderate-intensity aerobic exercise per day.[12]<\/sup><\/a> These guidelines suggest that South Asians must engage in a total of 230 minutes of moderate to vigorous-intensity aerobic exercise per week to achieve the same cardiometabolic health improvements as White Europeans engaging in 150 minutes of moderate to vigorous-intensity exercise per week. These ethnicity-specific guidelines further highlight the role of genetic influences in contributing to one\u2019s risk of developing CVD and obesity.<\/p>\n<\/div>\n

\n

Although the physical activity guidelines recommend meeting 230 minutes of moderate-intensity aerobic exercise per week, studies have shown that SACs will benefit from engaging in any aerobic exercise program. Typically, physical activity guidelines focus on more traditional forms of physical activity (e.g., jogging, biking etc.,) but it\u2019s possible that more culturally relevant activity can help with physical activity participation. For example, in a study conducted by Lesser et al. (2016), researchers found that a higher percentage of people attended a culturally relevant activity vs. a standard program. For individuals who find the idea of working out at a gym daunting, it may be helpful to opt for culturally relevant ways to remain physically active, especially to increase one\u2019s exercise self-efficacy and adherence. Culturally relevant exercise interventions such as Bhangra have high adherence rates because they promote increased energy levels, lower stress levels, and a friendly social atmosphere.[13]<\/sup><\/a><\/p>\n<\/div>\n

 <\/p>\n

  1. Raghuveer, G., Hartz, J., Lubans, D. R., Takken, T., Wiltz, J. L., Mietus-Snyder, M., Perak, A. M., Baker-Smith, C., Pietris, N., & Edwards, N. M. (2020). Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation (Ovid), 142(7), e101\u2013e118. https:\/\/doi.org\/10.1161\/CIR.0000000000000866 ↵<\/a><\/li>
  2. Raghuveer, G., Hartz, J., Lubans, D. R., Takken, T., Wiltz, J. L., Mietus-Snyder, M., Perak, A. M., Baker-Smith, C., Pietris, N., & Edwards, N. M. (2020). Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation (Ovid), 142(7), e101\u2013e118. https:\/\/doi.org\/10.1161\/CIR.0000000000000866<\/a> ↵<\/a><\/li>
  3. Gaesser , GA. And Angadi, AA. 2021. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016\/j.isci.2021.102995. eCollection 2021 Oct 22. https:\/\/pubmed.ncbi.nlm.nih.gov\/34755078\/ ↵<\/a><\/li>
  4. Gaesser , GA. And Angadi, AA. 2021. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016\/j.isci.2021.102995. eCollection 2021 Oct 22. https:\/\/pubmed.ncbi.nlm.nih.gov\/34755078\/ ↵<\/a><\/li>
  5. https:\/\/csepguidelines.ca\/ ↵<\/a><\/li>
  6. Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Progress in Cardiovascular Diseases, 56(4), 441\u2013447. https:\/\/doi.org\/10.1016\/j.pcad.2013.09.012 ↵<\/a><\/li>
  7. Ross, R., Dagnone, D., Jones, P., Smith, H., Paddags, A., Hudson, R., & Janssen, I. (2000). Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men - A randomized, controlled trial. ANNALS OF INTERNAL MEDICINE, 133(2), 92\u2013103. ↵<\/a><\/li>
  8. Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Progress in Cardiovascular Diseases, 56(4), 441\u2013447. https:\/\/doi.org\/10.1016\/j.pcad.2013.09.012 ↵<\/a><\/li>
  9. Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165 ↵<\/a><\/li>
  10. Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165 ↵<\/a><\/li>
  11. Tharmaratnam, T., Iskandar, M., Doherty, S., D\u2019Urzo, K., Kopalakrishnan, S., Tabobondung, T., Gopee-Ramanan, P., Sivagurunathan, S., & Sivananthan, N. (2018). The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Frontiers in Cardiovascular Medicine, 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00165 ↵<\/a><\/li>
  12. Iliodromiti, S., Ghouri, N., Celis-Morales, C., Sattar, N., Lumsden, M., & Gill, J. (2016). Should Physical Activity Recommendations for South Asian Adults Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and White European Men and Women. PLoS ONE, 11(8), e0160024. https:\/\/doi.org\/10.1371\/journal.pone.0160024 ↵<\/a><\/li>
  13. Lesser, I. A., Guenette, J. A., Hoogbruin, A., Mackey, D. C., Singer, J., Gasevic, D., & Lear, S. A. (2016). Association between exercise-induced change in body composition and change in cardiometabolic risk factors in postmenopausal South Asian women. Applied Physiology, Nutrition & Metabolism, 41(9), 931\u2013937. https:\/\/search.ebscohost.com\/login.aspx?direct=true&AuthType=sso&db=s3h&AN=117760908&site=eds-live. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":1806,"menu_order":4,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-2610","chapter","type-chapter","status-publish","hentry"],"part":2124,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2610","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/users\/1806"}],"version-history":[{"count":12,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2610\/revisions"}],"predecessor-version":[{"id":2864,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2610\/revisions\/2864"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/parts\/2124"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapters\/2610\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/media?parent=2610"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/pressbooks\/v2\/chapter-type?post=2610"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/contributor?post=2610"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/humannutrition\/wp-json\/wp\/v2\/license?post=2610"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}