1. 6-response of the cardiovascular
system to exercise
Advanced Nutrition and Fitness
Dr. Siham Gritly

2. Cardio-vascular system
Dr. Siham Gritly

3. Definitions to be learn
• aerobic physical activity:
activity in which the body’s large muscles
move in a rhythmic manner for a sustained
period of time.
Aerobic activity, also called endurance
activity, improves cardiorespiratory fitness.
Brisk walking, running, swimming, and
bicycling are examples.
Dr. Siham Gritly

4. • moderate-intensity physical activity:
physical activity that requires some increase in
breathing and/or heart rate and expends 3.5 to
7 kcalories per minute. Walking at a speed of 3
to 4.5 miles per hour (about 15 to 20 minutes
to walk one mile) is an example.
Dr. Siham Gritly

5. • vigorous-intensity physical activity: physical
activity that requires a large increase in
breathing and/or heart rate and expends more
than 7 kcalories per minute.
• Walking at a very brisk pace (>4.5 miles per
hour) or running at a pace of at least 5 miles
per hour are examples.
Dr. Siham Gritly

6. The Cardiovascular System and Exercise
• The heart is a muscle that is required to
contract continuously throughout the life to
deliver oxygen to all organs in the body and
breathe out carbon dioxide
• Blood vessels connect the heart and lungs so
that carbon dioxide can be removed from the
blood and oxygen can be added to the blood.
• The heart then pumps this blood throughout
the body.
Dr. Siham Gritly

7. • Exercise places an increased demand on the
cardiovascular system to pump more oxygen to
supply the working muscle to produce energy
(aerobic oxidation).
• Oxygen demand by the muscles increases,
more nutrients are needed and more waste is
created.
Dr. Siham Gritly

8. The human heart
3D ANIMATION OF WORKING OF HEART
Human Anatomy - Heart circulatory system
How the Heart Works
Dr. Siham Gritly

9. Functions of The Cardiovascular System
during exercise
The cardiovascular system serves five important
functions during exercise:
• 1- Delivers oxygen to working muscles
2- Deoxygenates blood by returning it to the
lungs
3- Transports heat from the center to the skin
4- Delivers nutrients and fuel to active tissues
5- Transports hormones
Dr. Siham Gritly

10. Response and Adaptation of the
Cardiovascular System to Exercise
• 1-Heart rate
• 2-Stroke volume
• 3-Cardiac output
• 4-Blood flow
• 5-Blood pressure
• 6-Blood
Dr. Siham Gritly

11. 1-Heart Rate
• Heart Rate
Resting heart rate averages 60 to 80 beats/min
in healthy adults.
• In sedentary, middle aged individuals it may
be as high as 100 beats/min.
• In elite endurance athletes heart rates as low
as 28 to 40 beats/min
Dr. Siham Gritly

12. Anticipatory response
• Anticipatory response (increased heart rate before
exercise) Caused by the release of epinephrine
• Before exercise even begins heart rate increases
in anticipation (expectation). This is known as the
anticipatory response.
• It is mediated through the releases of
neurotransmitters epinephrine and
norepinephrine also known as adrenaline and
noradrenaline (adrenal gland)
Dr. Siham Gritly

13. 2-Stroke volume
• Stroke volume is the amount of blood ejected
per beat from left ventricle and measured in
ml/beat.
• Stroke volume increases proportionally with
exercise intensity.
• In untrained individuals stroke volume at rest
it averages 50-70ml/beat
Dr. Siham Gritly

14. • during intense, physical activity stroke volume
increasing up to 110-130ml/beat
• In elite athletes resting stroke volume
averages 90-110 ml/beat increasing to as much
as 150-220ml/beat .
Dr. Siham Gritly

15. 3-Cardiac output
• Cardiac Output
Cardiac output is the amount of blood pumped
by the heart in 1 minute measured in L/min.
• It is a product of; stroke volume and heart
rate (SV x HR).
• If either heart rate or stroke volume
increase, or both, cardiac output increases also.
Dr. Siham Gritly

16. • Cardiac Output remains relatively unchanged
or decreases only slightly following endurance
training.
• During maximal exercise on the other hand,
cardiac output increases significantly. This is a
result of an increase in maximal stoke volume
as maximal heart rate remains unchanged with
training.
Dr. Siham Gritly

17. 4-Blood flow
The vascular system can redistribute blood to those
tissues with the greatest immediate demand for
energy such as muscles (Skeletal muscle receives
a greater blood supply)
• At rest 15-20% of circulating blood supplies
skeletal muscle.
• During vigorous exercise this increases to 80-
85% of cardiac output.
Dr. Siham Gritly

18. 5-Blood Pressure
• Blood Pressure
At rest, a typical systolic blood pressure in a
healthy individual ranges from 110-140mmHg
and 60-90mmHg for diastolic blood pressure.
• During exercise systolic pressure, the pressure
during contraction of the heart (known as
systole) can increase to over 200mmHg and in
highly trained, healthy athletes.
Dr. Siham Gritly

19. Cardio-respiratory endurance
• “Cardio respiratory endurance is the ability of
the body’s circulatory and respiratory systems
to supply fuel during sustained physical
activity”
• Cardio-respiratory endurance; is the amount of
oxygen individuals are able to take in and
oxidized it for energy production to be used for
working muscles.
Dr. Siham Gritly

20. • the most important benefit to increases cardio
respiratory endurance is an increased VO2max
which is the body’s ability to deliver oxygen
and nutrients to the cells, lead to;.
• Lower risk of heart disease
• Reduced Risks of type 2 diabetes
• Lower Blood pressure
Dr. Siham Gritly

21. Aerobic capacity and Cardiorespiratory
system
• Aerobic capacity is defined as “the
maximum amount of oxygen the body can
use during a specified period, usually
during intense exercise”. This is the function
of Cardiorespiratory system include the heart,
lungs and blood vessels;-
• 1-cardiorespiratory performance
• 2-the maximum ability to remove and utilize
oxygen from circulating blood..
Dr. Siham Gritly

22. Cardiorespiratory;- &Type of Activity Aerobic activity
that uses large muscle groups and can be maintained
continuously. 5 to 7 days per week. Intensity Moderate
(equivalent to walking at a pace or speed of 3 to 4
miles per hour). Duration At least 30 minutes.
running, cycling, swimming, inline
skating, rowing, power
walking, skiing, kickboxing, jumping rope; sports
activities such as
basketball, soccer, racquetball, tennis, volleyball
Dr. Siham Gritly

23. Cardio-respiratory and aerobic physical
activity
• aerobic physical activity:
Aerobic activity, also called endurance activity,
improves cardio-respiratory fitness.
• Quick walking, running, swimming, and
bicycling are examples.
Dr. Siham Gritly

24. Cardio-respiratory and moderate-
intensity physical activity:
• moderate-intensity physical activity:
physical activity that requires some increase
in breathing and/or heart rate and expends 3.5
to 7 kcalories per minute.
• Walking at a speed of 3 to 4.5 miles per hour
(about 15 to 20 minutes to walk one mile) is an
example.
Dr. Siham Gritly

25. Cardio-respiratory and vigorous-
intensity physical activity
• vigorous-intensity physical activity: physical
activity that requires a large increase in
breathing and/or heart rate and expends more
than 7 kcalories per minute.
• Walking at a very fast pace (>4.5 miles per
hour) or running at a pace of at least 5 miles
per hour are as example
Dr. Siham Gritly

26. Measurement of Cardio-respiratory endurance
(maximal aerobic capacity)
• To measure maximal aerobic capacity,
an exercise physiologist or physician use a VO2 max
test,
• The individual is typically connected to a
respirometer to measure oxygen consumption
• The higher the measured cardiorespiratory endurance
level, the more oxygen has been transported to and
used by exercising muscles
• the higher the aerobic capacity, the higher the level of
aerobic fitness.
Dr. Siham Gritly

27. The higher the measured cardiorespiratory endurance
level, the more oxygen has been transported to and used
by exercising muscles, and the higher the level of
intensity at which the individual can exercise
Dr. Siham Gritly

28. The cardiorespiratory system responds to the muscles’ demand
for oxygen by building up its capacity to deliver oxygen.
Researchers can measure cardiorespiratory fitness by measuring
the maximum amount of oxygen a person consumes per minute
while working out, a measure called VO2max
Dr. Siham Gritly

29. Maximum oxygen consumption
• An important measure of sports fitness is
aerobic capacity or VO2 max, which is the
amount of oxygen your body can consume and
turn into energy.
• Maximum oxygen consumption;-VO2 is the
Ability to Deliver and Use Oxygen
• As work rate is increased, oxygen uptake
increases linearly, No further increase in VO2
with increasing work rate
Dr. Siham Gritly

30. • there is an upper limit to oxygen uptake and,
therefore, above a certain work rate oxygen
consumption reaches a maximum. This is
termed the maximal oxygen uptake.
• Physiological factors influencing VO2max
– Ability of cardio-respiratory system to
deliver oxygen to muscles
– Ability of muscles to use oxygen and
produce ATP aerobically
Dr. Siham Gritly

31. Oxygen carrying capacity of the blood
• Energy production through Kerbs cycle or
mitochondrial respiration depend on
continuous supply of oxygen.
• Enhanced oxygen delivery and utilization
during exercise will improve mitochondrial
respiration and subsequently the capacity for
endurance exercise
Dr. Siham Gritly

32. • A reduction in the oxygen carrying capacity in
conditions such as anaemia produces fatigue
and shortness of breath and affect
performance.
Dr. Siham Gritly

33. Respiratory Quotient (RQ)
• respiratory quotient-is the ratio of carbon
dioxide expired/moles of oxygen consumed
• The respiratory quotient (or RQ or respiratory
coefficient), measured by indirect calorimeter
using respirometer
• The respiratory quotient (RQ) is calculated
from the ratio:
• RQ = CO2 expired / O2 consumed
Dr. Siham Gritly

34. • The ratio between CO2 / O2 is known as the
respiratory exchange ratio (RER).
Dr. Siham Gritly

35. Indirect calorimeter
Dr. Siham Gritly

36. The benefits of cardio-respiratory to
exercise
The benefits of cardio-respiratory, (aerobic,
exercise) include:
1- A stronger heart and lower resting heart rate.
2- Fitness and performance benefits, such as
increased aerobic capacity and muscle
endurance.
Dr. Siham Gritly

37. 3- maintenance of a healthy body weight and
body fat percentage
4- management of stress, and decreased blood
cholesterol and fat (triglycerides) levels
5-Increased performance in physically- jobs such
as lift-and-carries.
Dr. Siham Gritly

38. 6- Increased muscle tone (quality) and enhanced
physical appearance
7- low-resistance exercises (e.g., biking) train the
heart and muscles to use oxygen more
efficiently.
Dr. Siham Gritly

39. Diseases of Cardio-vascular system and
exercise
• examples
• 1-Blood Pressure (hypertension)
2-Coronary Heart Diseases (CHD)
Dr. Siham Gritly

40. 1-Blood Pressure (hypertension)
• hypertension: higher-than-normal blood
pressure. Two types;
• Essential or primary hypertension;
Hypertension that develops without an
identifiable cause
• Secondary hypertension; hypertension that is
caused by a specific disorder such as kidney
disease
Dr. Siham Gritly

41. • The high blood pressure is above normal, the
risk of death from CVD.
• Low blood pressure, on the other hand, is
generally a sign of long life expectancy and
low heart disease risk.
• The high blood pressure contributes to more
than a million heart attacks and half a million
strokes each year.
Dr. Siham Gritly

42. Arterial Blood Pressure
Expressed as systolic/diastolic
• The Cardiac Cycle or Arterial Blood Pressure :
includes all of the events between two
consecutive cycles;-
1 -Systole: contraction phase;-systolic pressure-
the blood pressure in the arteries when the heart is
contracting and pumping blood (the pressure at
which a sound of heart beat heard)
2 -Diastole: relaxation phase;-diastolic pressure-
the blood pressure in the arteries when the heart is
at rest between beats (the pressure at which the
sound disappears)
Dr. Siham Gritly

43. if the resting blood pressure is above normal, the
reading should be repeated before confirming the
diagnosis of hypertension
Dr. Siham Gritly

44. Classification of blood pressure for adults
(WHO)
category Systolic(mmHg) Diastolic
(mmHg)
Normal < 120 < 80
Pre-hypertension 120-139 80-89
Hypertension
*Stage one 140-159 90-99
*Stage two > 160 > 100
Dr. Siham Gritly

45. How Exercise Lowers Diastolic Blood
Pressure
• Aerobic exercise, like
running, walking, swimming, and using cardio
machines, has a positive impact on diastolic blood
pressure.
• Oxidation of fat for energy decrease fat body
mainly cholesterol (LDL) which will lower blood
pressure.
• Releasing water and salt through sweating might
reduces blood pressure.
Dr. Siham Gritly

46. Dietary Strategies;- Hypertension &
CHD
• The following dietary plans based on;-
• USDA (United States Department of
Agriculture)
• the American Heart Association Dietary
Strategies to Stop Hypertension (DASH) ,
Dr. Siham Gritly

47. Dietary Strategies to Stop Hypertension
(DASH)
• The Dietary Strategies to Stop Hypertension
(DASH) recommended that;-
• diet rich in fruits, vegetables, nuts, and low-fat milk
products and low in total fat and saturated fat have
positive effect on blood pressure.
Dr. Siham Gritly

48. • the DASH diet lowers total cholesterol and
LDL cholesterol.
• Compared to the typical American diet, the
DASH eating plan provides more fiber,
potassium, magnesium, and calcium and less
red meat, sweets, and sugar-containing
beverages
Dr. Siham Gritly

49. The DASH Eating Plan
and the USDA Food Guide
adapted from; Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition, Twelfth Edition. 2011
Food Group DASH USDA
Grains 6–8 oz 6 oz
Vegetables 2–2 c 2c
Fruits 2–2 c 3c
Milk (fat-free/low- 2–3 c 2 c
fat
Lean meats, poultry, 6 oz or less 5. oz
fish
Nuts, seeds, 4–5 oz per week combines nuts,
legumes seeds, and legumes
with meat, poultry,
and fish.
Dr. Siham Gritly

50. • These diet plans are based on 2000 kcalories
per day. Both DASH and the USDA Food
Guide recommend that fats and sugars be used
sparingly (carefully) and with discretion
(caution)
Dr. Siham Gritly

51. • Salt/Sodium Intake control;
• The combination of the DASH diet with a limited
intake of sodium, however, improves blood pressure
better than either strategy
• the lower the sodium intake, the greater the drop in
blood pressure.
• Dietary Guidelines for Americans recommended
no more than 1500 mg of sodium per day and to meet
the potassium recommendation
• Dr. Siham Gritly

52. • Weight Control to reduce high blood
pressure
• Weight loss alone is one of the most effective
nondrug treatments for hypertension.
• Those who are using drugs to control their
blood pressure can often reduce or discontinue
the drugs when they lose weight. Even a
modest weight loss of 10 pounds can lower
blood pressure.
Dr. Siham Gritly

53. • Physical Activity
• Physical activity helps with weight control, but
moderate aerobic activity, such as 30 to 60
minutes of brisk walking most days, also helps
to lower blood pressure directly.
• Those who engage in regular aerobic activity
may not need medication for mild
hypertension.
Dr. Siham Gritly

54. Lifestyle Modifications to Reduce Blood
Pressure
adapted from; Ellie Whitney and Sharon Rady Rolfes; Under
standing Nutrition (2008),
Modifi cation Recommendation Expected Reduction
in Systolic Blood prssure
Weight reduction Maintain healthy body 5–20 mm Hg/10 kg lost
weight (BMI below 25).
DASH eating Adopt a diet rich in fruits, 8–14 mm Hg
vegetables, and 8–14 mm
Hglow-fat milk products
with reduced saturated
fat intake.
Sodium restriction Reduce dietary sodium 2–8 mm Hg
intake to less than 2–8 mm
Hg 2400 milligrams sodium
(less than 6 grams
salt) per day.
Dr. Siham Gritly

55. 2-Cardiovascular Disease (atherosclerosis)
• Cardiovascular Disease
• The major causes of death ,are diseases of the
heart and blood vessels, collectively known as
cardiovascular disease (CVD).
• Coronary heart disease (CHD) is the most
common form of cardiovascular disease and is
usually caused by atherosclerosis in the
coronary arteries that supply blood to the heart
muscle.
• Atherosclerosis is the accumulation of lipids and
other materials in the arteries
Dr. Siham Gritly

56. • Atherosclerosis : a type of artery disease
characterized by plaques (accumulations of
lipid-containing material) on the inner walls of
the arteries
Dr. Siham Gritly

57. • Major Risk Factors for CHD
• High blood LDL cholesterol
• Low blood HDL cholesterol
• High blood pressure (hypertension)
• Diabetes
• Obesity (especially abdominal obesity)
• Physical inactivity
• Cigarette smoking
• An “atherogenic” diet (high in saturated fats
• and low in vegetables, fruits, and whole grains
Dr. Siham Gritly

58. Dietary Strategies to Reduce Risk of CHD
Energy: Balance energy intake and physical activity
to prevent weight gain and to achieve or maintain
a healthy body weight.
Saturated fat, trans fat, and cholesterol: Choose
lean meats, vegetables, and low-fat milk products;
minimize intake of hydrogenated fats. Limit
saturated fats to less than 7 percent of total
kcalories, trans fat to less than 1 percent of total
kcalories, and cholesterol to less than 300
milligrams a day
Dr. Siham Gritly

59. Soluble fibers:
a diet rich in vegetables, fruits, whole grains,
and other foods high in soluble fibers.
Potassium and sodium:
a diet high in potassium-rich fruits and
vegetables, low-fat milk products, nuts, and
whole grains.
• with little or no salt (limit sodium intake to
2300 milligrams per day).
Dr. Siham Gritly

60. Added sugars: Minimize intake of beverages
and foods with added sugars.
Fish and omega-3 fatty acids: Consume fatty
fish rich in omega-3 fatty acids
(salmon, tuna, sardines) at least twice a week.
Dr. Siham Gritly

61. Soy: Consume soy foods to replace animal and
dairy products that contain saturated fat and
cholesterol.
Alcohol: If alcohol is consumed, limit it to one
drink daily for women and two drinks daily for
men.
Dr. Siham Gritly

62. Lifestyle Choices
• Physical activity: Participate in at least 30
minutes of moderate-intensity endurance
activity on most days of the week.
• Smoking cessation (end): Minimize exposure
to any form of tobacco or tobacco smoke.
Dr. Siham Gritly

63. cardio machines
Dr. Siham Gritly

64. cardio machines
Dr. Siham Gritly

65. Ellipticals and ergometer stepper
Dr. Siham Gritly

66. List of Cardiovascular Exercises
• Swimming -- Swimming is an
excellent cardiovascular/muscular defining exercise.
• Football American football is america's most popular sport and
involves high intensity exercise for usually around 30 seconds
• Golf Golf is the most popular sport for people over the age of 40
and is growing rapidly.
• Boxing This is definitely one of the most intense cardiovascular
exercises known to man.
• Aerobics Aerobics is the most popular aerobic exercises performed
mostly by women.
Dr. Siham Gritly

67. • Hockey Hockey is a great sport that can be played by
just about anyone at any age.
• Skiing Skiing is an incredible cardiovascular workout
that is usually around 5-10 minutes
• Squash Squash is a great anaerobic exercise that can be
played by all ages
• Stepper This exercise was made
popular by the popular myth of
spot reducing Rowing Ergometer
Dr. Siham Gritly

68. • Treadmill This is the most popular cardiovascular
exercise. Due to the impact on the knees and
other joints,
• Running or Jogging Jogging is probably one of the most popular
exercises in the world
• Biking or Cycling Biking or cycling is a tremendous cardiovascular
workout and requires very little equipment which most people have
• Walking While intense walking is a good aerobic exercise it is
probably more used as a weight loss tool than it should be.
Dr. Siham Gritly

69. • Recumbent Bike This exercise is very popular
for people who do not want to jog and run.
• Elliptical or Cross Trainer
This is the newest in cardiovascular
equipment,
Dr. Siham Gritly

70. • Housework or Cleaning While most people
wouldn't call this a cardiovascular exercise, it
certainly is one.
• Dancing Dancing is an excellent cardio
workout that can be done by anyone at any
level....
Dr. Siham Gritly

71. • Cross-Country Skiing Similar to the elliptical machine but this
exercise is a sport. It is mostly performed at a slower intensity
for a long.
• Baseball, this sport is known around the world as a moderate
intensity
• Sprinting Sprinting involves 100% intensity followed by a
period of rest. This could be deemed a high intensity interval
training ...
• Soccer Soccer is the worlds sport as it is officially the most
Dr. Siham Gritly
popular sport in the world. Usually this sport is called 'football

72. references
• Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition
and Human Metabolism, fifth ed. WADSWORTH
• Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th
ed, McGraw Hill
•
• Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999.
Modern Nutrition in Health and Disease; Shils E Maurice,
Olson A. James, Shike Moshe and Ross A. Catharine eds. 9th
edition
• Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th
edition, W.B. Company
Dr. Siham Gritly

73. • Scott K. Powers & Edward T. Howley; Theory and
Application to Fitness and Performance, 6th edition.
EXERCISE PHYSIOLOGY
• Sports Fitness Advisor: The Cardiovascular System and
Exercise
• Read more: http://www.livestrong.com/article/192489-
immediate-effects-of-exercise-on-the-cardiovascular-
system/#ixzz1miWxuYrs
• Diastolic Blood Pressure During Exercise | eHow.com
• Lactate Theshold Training. Len Kravitz, and Lance Dalleck,
Dr. Siham Gritly

74. • Ellie Whitney and Sharon Rady Rolfes; Under
standing Nutrition, Twelfth Edition. 2011,
2008 Wadsworth, Cengage Learning
Dr. Siham Gritly

75. Measurement of blood pressure
Dr. Siham Gritly

76. Glossary
• flexibility: the capacity of the joints to move
through a full range of motion; the ability to
bend and recover without injury.
• muscle strength: the ability of muscles to
work against resistance.
• muscle endurance: the ability of a muscle to
contract repeatedly without becoming
exhausted.
Dr. Siham Gritly

77. • cardiorespiratory endurance: the ability to
perform large-muscle, dynamic exercise of
moderate to high intensity for prolonged
periods.
• conditioning: the physical effect of training;
improved flexibility, strength, and endurance.
• training: practicing an activity
regularly, which leads to conditioning.
(Training is what you do; conditioning is what
you get.)
Dr. Siham Gritly

78. • progressive overload principle: the training
principle that a body system, in order to
improve, must be worked at
frequencies, durations, or intensities that
gradually increase physical demands.
• frequency: the number of occurrences per unit
of time (for example, the number of activity
sessions per week).
• intensity: the degree of exertion while
exercising (for example, the amount of weight
lifted or the speed of running).
Dr. Siham Gritly

79. • duration: length of time (for example, the
time spent in each activity session).
• Hypertrophy; growing larger; with regard to
muscles, an increase in size (and strength) in
response to use.
• Atrophy: becoming smaller; with regard to
muscles, a decrease in size (and strength)
because of disuse, under-nutrition, or wasting
diseases
Dr. Siham Gritly

80. • aerobic physical activity: activity in which the
body’s large muscles move in a rhythmic
manner for a sustained period of time.
Aerobic activity, also called endurance activity,
improves cardiorespiratory fitness. Brisk
walking, running, swimming, and bicycling are
examples.
Dr. Siham Gritly

81. • Anaerobic exercise is short-lasting, high-intensity
activity, where your body’s demand for oxygen exceeds the
oxygen supply available.
• Examples of anaerobic exercise include: heavy weight-
lifting, all types of sprints (running, biking, etc.), jumping
rope, hill climbing, interval training, isometrics, or any
rapid burst of hard exercise.
• Anaerobic exercise relies on energy sources that are stored
in the muscles and, unlike aerobic exercise, is not dependent
on oxygen from (breathing) the air.
Dr. Siham Gritly