PROMOTING HEALTH

Feldman: Modules 4-3 4-4

ASSESSING HEALTHThe Bio-psycho-social Model

Biological: body, brain, genetic factors

Psychological: Lack of self-control, emotional turmoil, negative thinking/emotions, emotional stress

Social: social, economic, technological, religious aspects of cultures

TAKING CARE OF YOURSELF IN ADULTHOOD Nutrition/obesity

Exercise

Substance Abuse

INFLUENCES ON PHYSICAL GROWTH & HEALTH

Genetics Infectious disease Childhood injuries Hormones Emotional well-being Nutrition

NUTRITION IN INFANCY Infants need about 50 calories per

pound per day: about twice the nutritional needs of adults

Breast feeding is better than formula and is recommended by the American Academy of Pediatrics for up to one year

Advantages of breast feedingCorrect balance of fat &

proteinProtects against disease & tooth decay

Easily digestedBetter cognitive development & visual acuity

NUTRITION IN INFANCY

Breast feeding lowers risk of:later obesity

allergiesinfections including diarrhea and otitis media

cancer & breast cancer in mother

SIDS

NUTRITION IN INFANCY

NUTRITION IN INFANCY Why mothers don’t breast feed.

Inability Ignorance Inconvenience Illness (e.g., AIDS)Use of drugs

• leads to smaller body size

• leads to learning & behavior problems Attention, fine motor coord., IQ scores (effects

may be long-term or permanent.)

More of a problem in developing countriesMarasmus and Kwashiorkor

MALNUTRITION

marasmusdue to insufficient calorie intakeshrunken, wasted appearance

Kwashiorkorprotein deficiencyfeet and abdomen swell with water

MALNUTRITION

Some studies found iron, zinc, & vitamin D deficiencies

WIC – Special Supplemental Nutrition Program for Women , Infants, and Children (7,500,000 low-income participants)

MALNUTRITION IN CHILDHOOD: UNITED STATES

TEENAGE NUTRITION Overall poor Iron deficiency most common Calcium deficiency due to bone growth Obese children do not outgrow weight

problems Adolescent girls - fad dieting Obesity also a problem

ANOREXIA NERVOSA

Usually begins early to middle teens Starts with serious dieting & life stress.

Most are female, high SES, white Competitive & high achieving

Suffer malnutrition 6% die of physical complications or

suicide Family therapy most successful treatment

ANOREXIA NERVOSA

Weigh less than 85% of normal for age and height

Intense fear of gaining weight that does not decrease with weight loss

Distorted image of body shape. Appear fat to themselves even when very thin.

BULIMIA NERVOSA Binge and purge pattern Fear of overweight Depressed & anxious 90% women

Damage throat, stomach, teeth Some perfectionists, lack self-control Guilty and desperate to get help About 70% recover

OBESITY: U. S. & WESTERN NATIONSThere has been a marked rise in obesity in

the U.S. and other Western nations. Percentage doubled since 1980; quadrupled since 1965

U.S. may have 2nd highest rate15% of U.S. children 6-11 overweight

Less common in African American than white children; trend reverses in adolescence

CONSEQUENCES OF OBESITY Problems with social acceptance

Stereotyped as lazy, sloppy, ugly, stupid, self-doubting, deceitful

Depressed, unhappy, bullied

Risk for high blood pressure, cholesterol, adult-onset diabetes, gallbladder disease, some cancers, early death, sleep apnea, hip problems

TREATING OBESITY Individual/clinical programs work best

(not school based) Exercise is key Moderate calorie restriction produces

best long-term results Behavioral therapy (e.g., keeping food

diaries) also effective

NUTRITION ADULT DIETING People who lost weight and maintain the loss

become less depressed and reduce health risks.

Studies comparing weight-loss programs shows about equal effectiveness.

The most effective programs include exercise.

Yo-Yo dieting may increase health risks.

NUTRITION: VITAMINS & AGING Those who take supplements show improved

health & physical functioning

Protein supplements may increase muscle mass

Taking prescription drugs changes nutritional needs, rates of absorption

Effective doses, side-effects not known

NUTRITION: VITAMINS & AGING Antioxidants (A,C, beta carotene) may slow

aging & improve older adult health Vitamin C deficiency associated with earlier

death Vitamin E associated with reduced heart risk Calcium, vitamin D delay osteoporosis. Zinc, B6, C, and E improve immune function B vitamins improve cognitive function

EPIDEMICS

Otitis media Asthma ADHD Autism Alzheimer’s Macular Degeneration Adult-onset Diabetes Cardiovascular disease - etc.

NEGATIVE ENVIRONMENTAL CHANGES Pollution of air Water pollution (fluoridation) Depletion of soil nutrients Electromagnetic exposure Genetic engineering Exposure to chemicals

FOODS REPORTED AS BAD FOR YOU

Trans fat MSG (monosodium glutamate) High fructose corn syrup GMO corn/soybean, etc. GMO wheat (amylopectin A, gluten) Hormones ( in meat, dairy, etc. ) Chemical preservatives Pesticides, etc. (used on produce)

EXERCISE

EXERCISE - CHILDREN

Only 22 % of U.S. children in grades 4-12 are physically active for at least 30 minutes every day.

Television & computer games are part of the problem.

Also other lifestyle issues The problem tends to increase as children

become adolescents.

PHYSICAL EDUCATION

The average American school child gets only 20 minutes of physical education per week.

Informal games should be emphasized rather than organized sports.

EXERCISE - ADULTHOOD Only 15-20% of Americans get 20 minutes of

exercise 5 times per week.

Experts recommend that adults engage in 45 minutes or more of moderate physical activity on most or all days.

Some experts stress aerobic exercise – sustained activity that stimulates heart & lung function (jogging, cycling, swimming)

EXERCISE & LONGEVITY In one study, people who were less fit

were more likely to die during the 8-year course of the study.

In another study of people in their 40s to the 80s, beginning an exercise program was associated with a 23% lower risk of death.

BENEFITS OF EXERCISE enhances the immune system. reduces body fat and builds muscle. linked with reduced rates of cancer, especially

colon cancer. strengthens the heart muscle and produces

HDL cholesterol reduces anxiety and depression, improves

mood, and enhances alertness and energy.

EXERCISE & AGING Strength training as well as aerobic

exercise is recommended for older adults.

Endurance training produces gains in vital capacity to age 80 (oldest tested).

Weight-bearing exercise promotes muscle size and strength, blood flow to muscles to age 90 (oldest tested).

Exercise increases blood circulation to the brain & reduces cognitive declines.

EXERCISE & AGING (SINGH, 2000) Minimizes aging, contributes to health Optimize body composition (muscle v. fat) Prevents common diseases Improves treatment of some diseases Helps prevent & treat disabilities Counteracts side-effects of standard

medical care Linked to increased longevity

SUBSTANCE ABUSE & ADDICTION

Smoking is related to many deaths30% of cancer deaths21% of heart disease deaths82% of chronic pulmonary disease deaths

SUBSTANCE USE & ABUSE By HS graduation, 22 % of teens smoke, 60%

have engaged in heavy drinking at least once, 50+% have experimented with illegal drugs

Experimenters usually quit

Abusers are more likely to be troubled and tend to become addicted

SMOKING Decreases delivery of oxygen to tissues

Limited night vision, skin wrinkling, loss of bone mass, lower sperm count, male impotence

Causes heart rate and blood pressure to rise

Increased risks of heart attack, stroke, and cancer of the mouth, throat, larynx, esophagus, lungs, pancreas, kidneys, and bladder

Considered the single most important preventable cause of death in industrialized nations

SUBSTANCE ABUSE

Half of all smokers have quit. U.S. men 50% in 1965 to 25%.

Most of the drop is among college graduates,

Decline among high-school students, but smoking among college students has risen.

Link between smoking and mortality is dose related

TRENDS IN DRUG USE: UNIVERSITY OF MICHIGAN INSTITUTE FOR SURVEY RESEARCH

Drug use among high-school students in the U.S. declined (1980s), increased (1990s), and has recently leveled off.

U.S. still has the highest rate of adolescent drug use of any industrialized nation.

Increasing abuse of prescription and OTC medications (oxycontin, vicodin, adderal)

HOW CAN DRUG USE BE PREVENTED?

Parental involvementSetting limitsMonitoring

Early risk factors (kindergarten)MaleSubstance-abusing parentLow level of parental reasoningLow level of problem-solving skills

DRINKING IN COLLEGE & EARLY ADULTHOOD

Almost half of U.S. college students drink heavily.

They report problems with missed classes, grades, the police, physical injuries, & unprotected sex

About 44% binge drink, including 70% living away from home

SUBSTANCE ABUSE & ADDICTION

13 million people in the U.S. are alcoholicsYearly 25.000 people are killed and 1.5 million

injured by drunk driversAlcohol is implicated in 65% of aggressive acts

by males against females

SUBSTANCE ABUSE SLOWS BY MID-20S

College students drink more than their age counterparts.

Those who don’t attend college smoke more.

Singles use marijuana more than married.

Drinking is heaviest among singles and divorced.

Religious people are less likely to take drugs.