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By studying this chapter, you should be able to do the following:

  1. Contrast infectious with degenerative diseases as causes of death.

  2. Identify the three major categories of risk factors and examples of specific risk factors in each.

  3. Describe the difference between primary and secondary risk factors for coronary heart disease (CHD).

  4. Characterize physical inactivity as a coronary heart disease risk factor comparable to smoking, hypertension, and high serum cholesterol.

  5. Describe the process of atherosclerosis related to coronary heart disease.

  6. Describe the role of low-grade chronic inflammation in the development of chronic diseases.

  7. Describe the metabolic syndrome and possible causes.

  8. Describe the role of diet and physical activity from an anti-inflammatory standpoint.


  • Risk Factors for Chronic Diseases 331

    • Inherited/Biological 331

    • Environmental 331

    • Behavioral 331

  • Risk Factors for Coronary Heart Disease 333

    • Physical Inactivity as a Risk Factor 333

    • Physical Activity and Health 334

  • Inflammation and Coronary Heart Disease 336

    • Obesity, Inflammation, and Chronic Disease 336

    • Healthy Eating and Physical Activity to Combat Inflammation 338

  • The Metabolic Syndrome 339



degenerative diseases

infectious diseases

low-grade chronic inflammation

primary risk factor

secondary risk factor

web of causation


In this section of the textbook, the Physiology of Health and Fitness, we focus on the importance of two major variables, physical activity (Chaps. 15, 16, and 17) and healthy eating (Chap. 18), as crucial ingredients to a healthy lifestyle. There is absolutely no question that physical inactivity is a major risk factor for numerous chronic diseases including heart disease, type 2 diabetes, and cancer (65). In like manner, choosing healthy foods to obtain essential nutrients, while matching caloric intake with caloric expenditure, goes a long way in dealing with our obesity epidemic and its dire consequences. In this chapter, we begin with a discussion of risk factors for chronic diseases that examines the environmental, genetic, and behavioral links to health and disease. These risk factors direct public health interventions to reduce the overall risk to the population (e.g., stop-smoking campaigns). Although risk factors describe the causes of disease from a macro level, they don’t address the underlying physiological causes of these chronic diseases. We will try to do that by exploring the proposition that it is a low-level systemic inflammation (see Chap. 6) that is causing many of these chronic diseases. Finally, we will bring the discussion back to physical activity and healthy eating as ways of dealing with chronic disease.


Over the past 100 years, attention has shifted from infectious diseases (e.g., tuberculosis and pneumonia) as the major causes of death to chronic degenerative ...

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