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Health 102 Exam Review.docx

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University of Waterloo
HLTH 102
Scott Leatherdale

Introduction 4/15/2013 7:26:00 AM World Health Organization (WHO) Definition  Health is a state of complete physical, mental and social well-being, not merely an absence of disease of infirmity o Problems:  Absoluteness of the word complete  Change in the nature of disease  No one is ever healthy Public Health Agency of Canada (PHAC) Definition  Health is a capacity or resource rather than a state, a definition which corresponds more to the notion of being able to pursue one’s goals, acquire skills and education, and grow Aboriginal Medicine Wheel Definition  Represents the circle of life. Considers spirituality: balance, harmony and interconnectedness Medical Definition  Based on germ theory, disease is caused by etiological agents o Normal Healthy Patient o Mild Systemic Disease o Severe Systemic Disease o Severe Systemic Disease, Constant Threat to Life o Moribound Patient, Relies on Operation o Brain-Dead Patient Well-Being  Presence of highest possible quality of life, in its full breadth of expression Illness-Wellness Continuum  From center to left – worsening health  From center to right – improving health  Center – no disease, no wellness, neutral Life Expectancy  Female higher than males, Canada higher than world and USA due to socialized medicine  Canada has an aging population that may lead to a health crisis, as many people are getting sick after age 55  As communicable disease levels lower, non-communicable will increase. People have to die of something  Chronic disease accounts for most deaths in Canada Cancer Problem  Lung cancer is very prevalent, 5 year survival rate is low  Genetics to not contribute to the cancer burden because it does not change the burden  Age structure, populations growth and risk behavior causes increases in the cancer burden Major Modifiable Causes of Cancer  Smoking  Physical Inactivity  Poor Nutrition  50% of deaths from cancer could be avoided Tobacco 4/15/2013 7:26:00 AM More than 4000 different chemicals in tobacco smoke  Different chemicals inhaled directly and indirectly  Second Hand smoke is worse for you Filter Holes  Holes in the mouth end that allow air to pass through, dilute toxins  Holes are covered by mouth and are useless  Self- Extinguishing paper, decreases house fires Health Effects  Causes some cancers  Premenopausal increases risk of breast cancer  Post menopausal decreases risk due to estrogen levels Important Conclusions 1. There is NO RISK FREE level of exposure 2. Inhaling chemical mixture causes adverse health effects 3. Risk and severity are directly related to duration and exposure 4. Powerfully addictive – nicotine and nicotine receptors in the brain 5. Low levels of exposure (second-hand) lead to rapid endothelial dysfunction and inflammation 6. Insufficient evidence that product modification lowers toxin emission Historical trend in Canada  Decreased since the 60s  Narrowing difference in male and female rates  Damaging effects may be worse for women Current Prevalence  4 million daily smokers, 2 million get a disease  Prevalence is decreasing  Women smoke less than men, slowly catching up  Cigar and Cigarillo use is higher in youth than adults  20-24 year olds are at greatest risk  Decline after 45 (diagnosed with disease) Youth and Smoking  Most start in youth  Rates in youth predict future rates  Increase in use as age increases International  Male prevalence is high in Asia o Tobacco is cheaper, no smoke free space legislation, government owns the industry  Females- mostly in USA  17 Countries have smoke-free policies  Kitchener-Waterloo, Canada’s first city to do this Alcohol 4/15/2013 7:26:00 AM Exposure  High level o 5 or more drinks at one occasion – binge  Low level o Potentially good  LCBO Important Conclusions 1. Impact is directed by total volume and pattern of drinking 2. Binge and daily heavy drinking are bad 3. Hazardous drinking can be heavy drinking, over 5 drinks (60g) 4. Can cause harm past physical and psychological of drinker. Can harm people around them 5. Long-term use damages every organ and system 6. Developing adolescent brain is particularly vulnerable Prevalence  In the past year, 80% of Canadians have had a drink  18-19 year olds had the highest rates, then 20-24  Women decrease at 20-24 due to child birth  More men binge drink than women  Men drink more, more frequently Low Risk Drinking Guidelines  No more than 2 drinks on any one day  Women: no more than 9 a week  Men: no more than 14 a week Youth Drinking  Larger issue than tobacco or marijuana  Kids are drinking more at younger ages  Effects healthy brain development  Few Prevention programs in elementary schools  Rates of use increase with age International Data  Canada is a light weight  Prevalence is highest in eastern Europe  Brazil and India have the highest rates of binge drinking  20% of cancers are related to heavy drinking Obesity 4/15/2013 7:26:00 AM Body Mass Index (BMI) 2  Weight (kg)/ Height (m )  Does not consider that muscle weighs more than fat  Adults (20+): 25-29.9 is overweight, 30+ is obese  Children (2-19): 85%-95% is overweight, 95%+ is obese  Easy and inexpensive Waist Circumference  Simple and common way to measure abdominal obesity  Not standardized, lack of comparison data Waist-to-hip Ratio  Abdominal Obesity  Subject to measurement error, complex to interpret Skinfold Thickness  Not accurate  Hard to measure on high BMIs Bioelectric Impedance  BIA  Small, imperceptible, safe electric current through the body, measure resistance  Hard to calibrate, Ratios change when sick etc. Underwater weighing (Desitometry)  Weighed in air and while submerged in a tank  Uses specialized equipment, and requires people to be submerged Dilution Method  Hydrometry  Drink isotope labeled water and give fluid samples Dual energy X-Ray Absorptiometry (DEXA)  X-Ray beams pass through different tissue in different ways Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI)  Most accurate Health effects  Related to chronic disease  Diabetes  Reproductive complications  Psychological and social factors Good Fat  Men 5.99%  Women 13.99% Caloric Balance Equation  Balance calories you eat with calories you burn  Healthy intake depends on the amount you burn Prevalence  Increasing since the 90s  Increase with age, then start to decrease in old age  Women are more obese than men International Prevalence  If kids become more active, so will adults  Female obesity is scattered around the globe  Male obesity is less prevalent Measured vs. Self Reported  More males self report obesity than females  Females have higher measured obesity rated  When measured, BMI increased over a kg from when reported Physical Activity 4/15/2013 7:26:00 AM Health Effects  Most important thing you can do to improve your health  Dose-Response relationship, more active you are, the better  Increase lifespan  Decrease risk for certain cancers Important Conclusions 1. People of all ages and genders benefit 2. Significant benefits can be obtained by moderate amounts of activity 3. With a modest increase, most Canadians can improve health and quality of life 4. Physiologic effects – Cardiovascular and musculoskeletal etc. 5. Beneficial effects diminish within 2 weeks of stopping or reducing, effects will disappear within 2-8 months Canadian Guidelines  CSEP developed new guidelines  Children 5-11, 12-17 o 60 mins/ day, vigorous 3 days, strength 3 days  Adults 18-64, 65+ o 150 mins/ week muscle and bone strength 2 days Moderate intensity  Cause light sweat and some trouble breathing Vigorous Intensity  Cause sweat and lose of breath Prevalence in adults  No one is getting enough  Maintained through age – good stays good, and bad stays bad  Flexibility needs a lot of improvement – yoga craze is helping  Getting worse, already bad Prevalence in Youth  Many need improvement  Not improving over time Nutrition 4/15/2013 7:26:00 AM Benefits of Healthy Eating  Promotes growth and development  Prevents high cholesterol and high blood pressure  Reduce risk of disease Consequences of poor diet  Obesity  Cancer  Under nutrition Essential Nutrients  Fats 30% of calories, 1g = 9 calories  Proteins 20% of calories, 1g = 4 calories  Carbohydrates – 50% of calories, 1g = 4 calories  Vitamins  Minerals  Water Fats  Provide essential fatty acids  Absorb A,D,E,K  Main types of Fatty Acids o Monounsaturated  One double bond, help reduce bad cholesterol o Polyunsaturated  More than one double bond, reduce cholesterol o Trans Fatty  Unsaturated, one or more double bonds in trans geometric configuration, elevated risk of CVD o Saturated Fatty  No double bonds, risk factor for CVD  Saturated fats – single bonds  Unsaturated fats – interior double bonds  Trans fats increase risk of heart disease o Raise LDL levels o Lower HDL levels  Saturated fats raise levels of LDL Protein  Amino Acids  Essential amino acids must be consumed through food  Complete: contains all amino acids  Incomplete: low in one or more amino acid  Lack of protein leads to many disorders (mental retardation and kwashiorkor) Carbohydrates  Make glucose to fuel the body  Glucose can be used immediately or stored  Two main types o Simple – sugars found naturally in fruits, veggies, milk, etc o Complex – starch and dietary fiber Vitamins and Minerals  Vitamins o Organic  Minerals o Inorganic o Must be absorbed from food  Salt  Regulate fluids and blood pressure, keeps muscles and nerves running smoothly  Increase risk of high blood pressure  1500- 2300 mg/ day is acceptable  everyone eats too much  needed to grow and develop normally Fruits and Vegetables  Reduce risk of cancer  Provide essential vitamins and minerals and fiber  Low in fat and calories and are filling  1 dark green and one orange vegetable per day  avoid over cooking and deep frying Canada’s Food Guide Social Determinants 4/15/2013 7:26:00 AM 12 Key Determinants 1. Income and Social Status* 2. Social Support Networks* 3. Education and Literacy* 4. Employment and Working Conditions* 5. Social Environments* 6. Physical Environments* 7. Personal Health Practices and Coping Skills 8. Healthy Child Development* 9. Biology and Genetic Endowment 10. Health services 11. Gender 12. Culture* Social Support Networks  Help people control their lives and their life circumstances  Buffer against health problems Education and Literacy  Health status improves as education level increases  Tied to socioeconomic status  Provides knowledge and control  Increases opportunity for jobs and job security Employment and Working Conditions  Worse is worse for health  More control means less stress and better health  Conditions at work effect health Social Environments  Values and norms of society  Three interrelated dimensions o Individuals o With their social environments o Relation between the two  Adds resources to a person’s life Physical Environments  Exposures  Environmental factor
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