final Flashcards
nutrition
- the act or process of nourishing or being nourished
- digestion break food down into nutrients that are small enough to be absorbed into the blood
- the food or drinks you regularly consume, determines the nutrient composition of your diet
- once absorbed, nutrients are metabolized
- any calories consumed in excess of the body’s needs is converted to fat and stored
- your diet should be chosen carefully
six classes of essential nutrients
- protein: (4 calories/ gram)
- carbohydrates: (4 calories/ gram)
- fats (9 calories/ gram)
- vitamins
- minerals
- water
macronutrients: protein
- basic framework of muscles, bones, blood, hair and fingernails
- critical for growth and repair
- made of 20 amino acids (9 are essential)
- animal proteins (meat, poultry, fish) and soy are complete. complete proteins contain all 9 essential amino acids.
- grains, dry beans, nuts are incomplete. these foods lack some or all essential amino acids.
- recommended intake: 0.8 g/gk of bodyweight per day
- provided 4 kcal/g (not a primary source of energy)
macronutrients: fats (lipids)
- provides 9 kcal/g (dense energy source)
- main fuel source during rest and light activity
- carry fat-soluble vitamins ( A,D,E,K)
- protect organs from injury
- help regulate body temperature
- involved in growth and development
- used to make some hormones
- any excess calories are stored as triglycerides
types of fats (lipids)
- unsaturated fats (e.g vegetable): liquid at room temperature; healthier. may help lower risk of heart disease (CVD)
- saturated fats (e.g animal fats): solid at room temperature; less healthy. associated with high heart disease risk.
- trans fats (e.g hydrogenated fats): synthetic unsaturated fat; unhealthy. the type most strongly linked to CVD. minimize or eliminate from diet.
macronutrients: carbohydrates
- primary source of energy for the body’s cells
- the brain can only use carbohydrates for fuel; many other tissues can switch to fats if needed
- metabolized to simple sugars (e.g glucose), which circulates in the body and is taken up by cells
- supplies 4 kcal/g of energy
- simple carbs: 1 or 2 sugar units, table sugar, fruit, milk, more likely to produce hyperglycemia.
- complex carbs: longer chains of sugar units, grains, cereals, vegetables, beans. take longer to digest, richer in fibre. help regulate blood glucose, promote fullness. animals, including humans, store some carbs as glycogen (in the liver and in muscle)
- fibre: complex plant carb we cannot digest, fibre promotes regularity and heart health, fibre rich foods includss whole wheats, ryes, oats, barley
`micronutrients: vitamins and minerals
-vitamins:
organic compounds (contain carbon), help regulate body growth, maintain tissue, release energy from foods, involved in manufacture of blood cells, hormones, and other compounds.
minerals:
help build bones and teeth, aid in muscle function, help nervous system transmission of messages and enzymatic function, e.g sodium, potassium, calcium, chloride, iron, zinc, magnesium, iodine
other substances in foods
-antioxidants:
prevent harmful effects caused by oxidation in the body or exposure to certain environment factors, vitamins C, E and carotenoids, blackberries, walnuts, strawberries cloves and red wine are rich in antioxidants, may help prevent some cancer, effect of aging
-phytochemicals:
compound (e.g capsaicin) found in plants, may be aassociated with lower risk of heart disease, certain cancers, type ll diabetes, stroke; emerging reesearch
water
- 85% of blood, 70% of muscle, and 75% of brain are composed of water
- we lose up to 2-2.5 litres of water a day that must be replenished
- functions: carries nutrients, maintains temperature, lubricates joints, aids digestions, removes waste via urine, sweat to cool the body
nutritional terminology
- dietary reference intake (DRI): scientifically-based reference values for the amounts of energy, nutrients and other food components that are necessary to reduce chronic disease risk, promote general health and minimize symptoms of deficiency
- recommended dietary allowance (RDA): average daily level of inatke sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals
- adequate intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy
- tolerable upper intake level(UL): maximum daily intake unlikely to cause adverse health effects, not all dietary substnaces have a UL, sodium, sodium (e.g) does.
nutrient density
- refers to foods being high in nutrient and low calories
- nutrient dense foods contain complex carbs, lean protein, healthy fats as well as vitamins and minerals
- other types of foods are “empty calories” low in sugar
- a healthy diet emphasizes nutrient dense foods and minimizes empty calories
food vs supplements
- healthful foods are generally a better way to meet nutritional needs than taking supplements
- but supplements can be helpful
- calcium to decrease risk of osteoporosis (especially in females)
- iron for anemia or low iron levels (especially in females with a high menstrual flow)
- folate before/ during pregnancy (any female capable of getting prgnant should ensure they recieve sufficient folate)
canada’s food guide
- variety: the plate has a wide range of foods in each section
- accessibility: the plate features foods that are relatively inexpensive for most people
- cultural relevance: given the diversity of the canadian population, there are foods that are key stables to many ethnic diets, such as rice and beans
- availability: the guide features options that are available at times of year in different forms, either fresh, frozen, canned or dried
key messages: canadas food guide
-plenty of fruits and vegetables
-whole grain food
protein rich foods
-mindful of eating habits
-cook more often
-enjoy ur food
-eat meals with others
-use food labels
-limit foods high in sodium, sugar and fat
-beware of food marketing
dietary recommendations
- eat slow, set aside a regular time to eat
- eat colourful, varied diet, more varied and rich in fruits and vegetables
- eat breakfast to have more energy in the morning
- choose healthy snacks
- drink water
- pay attention to portion sizes
- combine physical activity with healthy eating
current canadian diet
- for 20-30% of the population, complex carb intake is below recommend levels, fat intake is above recommended average
- most dont consume enough fibre
- prevalence of defiency is highest for vitamin A, vitamin D, magnesium, and calcium.
vegetarian diet options
- vegan: no animal products
- lacto-vegatarian: milk only
- lacto-ovo vegatarain; milk and eggs
- semi-vegetarian; fish only, sometimes poultry
protect from food-borne illnesses
- clean: wash hands and surfaces
- seperate: don’t cross contaminate
- cook to a safe temperature
- chill: refrigerate promptly
Physical Activity
Definitions
Physical Activity:
all leisure and non leisure
body movement produced by skeletal muscles
that results in an increase in energy (caloric)
expenditure.
Exercise
: planned, structured, repetitive
physical activity that is specifically aimed at
improving physical fitness.
Physical Fitness:
the extent to which the body
can respond to increased physical demand ; to
perform moderate to vigorous activity without
becoming tired
Active Living:
a way of life in which physical
activity is valued and integrated into daily living by
various means.
Physical
Fitness
The ability to respond to routine physical demands with enough reserve energy to cope with a sudden
challenge
Components: cardiorespiratory muscular strength muscular endurance Flexibility (the most body composition
Muscular Strength
Force a muscle can produce with maximal effort
Depends on muscle cell size
Depends on motor neuron activity
Strong muscles important for daily activities,
keeping the skeleton in proper alignment/posture
Obvious importance for recreational activities,
e.g. soccer, cycling, softball, tennis, and so on
Muscle tissue is an important element of overall
body composition; more muscle = higher
metabolism and faster energy use = easier to
maintain a healthy weight
Benefits
of Exercise
Improves digestion Increases metabolism Improves respiratory capacity Enhances immunity (reduce s cortisol levels Brightens mood release of endorphins) Improves mobility and independence in later life Longer life expectancy –(2.5 hr/wk 4.5yr; 2.5hr and good BMI 7.2yr)
Functional Fitness
Fit to Live Your Life (and deal with emergencies?) ..and keep you out of nursing homes
exercise Protection against
Disease
Cardiovascular disease and stroke
Stronger heart muscle, effective blood pumping, lower BP
Blood cholesterol levels
increased HDL, decreased HR
Type II Diabetes
Improved insulin sensitivity, reduced weight
Obesity
Lowers body fat, reduces weight
Certain cancers
Kidney, colon, head and neck, bladder, rectal, liver
Osteoporosis
Exercise and a well balanced diet increase bone mass (until age ~30)
Benefits of Exercise:
Exercise is Medicine
Risks of Exercise
Traumatic injuries e.g. ankle sprain, arm fracture Overuse injuries e.g. shin splints, tennis elbow General overstress Temperature injury Sudden cardiac death Involves known or unknown pre existing conditions Compulsive tendencies As with most things, moderation is key; it is possible to over exercise
exercise Recommendations
Age 5-12 : 60 min of moderate vigorous intensity
activity/day
Age 13-18: 60 min of moderate vigorous intensity
activity/day
Age 18-65: min of moderate vigorous activity
per week in bouts of 10 min or more
•<20 % of Canadian adults get this amount of activity
Do you?
On average, 69% of waking hours are sedentary
1/3 of Canadians walk 10,000 steps/day
10K steps is not a magic number, but a good goal
Two
ways the body produces energy
Aerobically ( with oxygen):
C 6 H 12 O 6 + 6O 2 → 6H 2 O 6CO 2 + 38 ATP
Glucose oxygen → water + carbon dioxide ENERGY
•
Or Anaerobically ( no oxygen)
C 6 H 12 O 6 → 2C 3 H 6 O 3 + 2 ATP
Glucose → Lactic Acid ENERGY
Aerobic and Anaerobic
Activity
aerobic: Cardiovascular conditioning
anaerobic: quick immediate excerise, HITT, weights
FITT
Principle:
type
Frequency
Intensity
time
Developing
Cardiorespiratory
Fitness
Appropriate aerobic activities that fit into your
schedule and you enjoy doing
4-7 times per week no more than 2 days in between sessions
150 minutes at a moderate vigorous level
Shorter bouts when increasing activity levels, can increase over time
Bouts of at least 10 minutes
30 minutes per day is a good rule
Balance with other components of physical fitness
Developing Muscular Fitness
Strength training requires resistance exercise
Strive for balance between right/left side, upper/lower body, and opposing muscle groups (e.g. triceps/biceps)
Do at least one exercise per muscle group
Isometric exercises involve force generation without movement (e.g. contracting your abdominal muscles)
Isotonic exercises involve force and movement, bench
press, sit ups, biceps curls, push ups
Schedule at least one day of rest between working the
same muscle group
Developing Flexibility
Flexibility = range of motion around a joint Most neglected component of a fitness program Static stretching is the safest You should feel tension, but not pain Go to the limit of your range of motion, relax into the stretch, hold for ~30 seconds, perhaps stretching a little further into it Also important to cool down
Basic Principles of
Training
Specificity: specific adaptation to imposed demand
Overload: in order to see improvements in fitness, must
challenge the body beyond its current abilities
Progressive overload: overload is increased over time
according to the FITT principle
Reversibility: aka ‘use it or lose it’
You can lose up to 50% of fitness improvements within 2
months if you stop exercising!
Individual differences
People have different responses to exercise
e.g., males tend to have higher endurance capacity than
females
Prevention of Activity
Related
Injuries
Obtain a medical evaluation if you are >35 and have been sedentary Increase activity level gradually Warm up : stimulates joints to produce lubricating (synovial) fluid; readies metabolism Progress to gentle movements, mobilization exercises Maintain correct techniques when exercising
Signs of Overtraining
Persistent pain, especially in or around a joint Increased difficulty performing a standard or familiar amount of exercise Increased susceptibility to infections (viral or bacterial; acne) General feeling of tiredness, lack of energy, or enthusiasm Ensure you are giving your body the recovery time it needs!
Physical activity recommendations
-general health: moderate to vigorous intensity aerobic physcial activity for 150 mins per week
increased health: moderate intensity for 300 mins per week or vigorous intenisty for 150 mins
-weight lose: moderate intenisity 60-90 min a day
-muscle strength and endurance: resistance exercises 8-12 repetitions 2-3 days a week
-flexibility: range of motion atleast 2 days a week
Leading Cause of Death in Canada
Cardiovascular Disease
Cardiovascular System
Transports O2 and nutrient-rich blood to the
body 2)
At the cells, O2 and fuel (e.g. glucose, fatty acids) are
used to generate ATP (energy):
C6 H12O6 + 6O2 6H2O + 6CO2 + 38ATP
Glucose + oxygen = water + carbon dioxide + ENERGY
Without the ability to make ATP, cells die
Death of cells can lead to death of organs (e.g. heart), which
can lead to shutdown of the human organism
The coronary arteries provide blood to the heart muscle
A blockage in the coronary arteries can cause a heart attack
Atherosclerosis
A major type of CVD Begins with a small lesion in a vessel Can be caused by nicotine, high blood pressure, cholesterol, free radicals Fats (e.g. trans fats) deposit in lesion Macrophages (immune cells) try to help, fill with cholesterol and explode = worse Smooth muscle covers it up Leads to a NARROWED ARTERY Atherosclerosis in a major heart artery = coronary artery disease (CAD) Soft tissue gradually becomes replaced with calcium, mineral deposits Walls become stiffer, causing arteriosclerosis Ateriosclerosis is irreversible Atherosclerosis 6
Heart Attack: Coronary Artery
Disease and a Thrombus (Clot)
A heart attack occurs when an artery is clogged, blocking nutrient and oxygen delivery to cells, leading to cell death Medically, this is called a myocardial infarction Results in damage to or death of heart muscle Blockages like this typically occur when a blood clot gets lodged in an atherosclerotic coronary artery
Heart Attack Symptoms
- chest discomfort
- discomfort in other areas of upper body
- shortness of breath
- sweating
- nausea
- light-headedness
Cardiovascular System: The
Heart as a Pump
- waste-carrying oxygen-poor blood enters the right atrium from the superior and inferior venae cavae
- blood flows from the right atrium into the right ventricle; from there, it is pumped through the pulmonary arteries into the lunges
- into the lunges, blood picks up oxygen and discards carbon dioxide; it then flows through the pulmonary veins into the left atrium
- oxygen-rick blood flows from the left atrium into the left ventricle; from there it is pumped through the aorta into the rest of the body’s blood vessels.
Cardiovascular System: Path of
Blood Flow
Veins: TO the heart Arteries: AWAY from the heart
Stroke
Brain cells require a constant blood supply A stroke occurs when there is a blockage in blood flow to a region of brain tissue Two types: Ischemic: blockage disrupts blood flow to brain (more common; ~80%) Can be thrombotic or embolic Hemorrhagic: blood vessel bursts (less common; ~20%) Both lead to reduced blood flow, lack of oxygen delivery, tissue death Called thrombovascular accidents
signs of stroke
Face: is it dropping?
Arms: can u raise both?
Speech: is it slurred or jumbled?
Time: to call 911 right away
Prevalence of Heart Disease & Stroke
Heart disease in Canada Overall, 5% (males > females) Aged 50 - 64 8% Aged >65 18% Stroke in Canada 1% (male = female) For those >75 7% live with effects of stroke (they are older and more likely to have had a stroke)
Preventing CVD
- don’t smoke; moderate alcohol intake (at most)
- Keep blood pressure and cholesterol in check
- Physical activity (150 min per week for adults)
- Eat heart healthy
Healthy fats (no trans, unsaturated > saturated fat; adequate omega
(6<3) fatty acids)
Lower sodium intake
Vegetables and fruits
Lots of fibre and whole grains; soy can lower cholesterol
Adequate B Vitamins - Keep a healthy weight
- Develop effective ways to manage stress
High Cholesterol: Dietary vs Blood
elevated blood cholesterol (rather than dietary cholesterol) is the main risk factor Some people are more sensitive to intake and are at greater risk for increased blood cholesterol Cholesterol is carried in blood by lipoproteins Low density lipoprotein (LDL; BAD cholesterol move from blood to vessel walls and increase CVD risk High density lipoprotein (HDL; GOOD cholesterol can promote reabsorption of cholesterol and lower CVD risk)
Major Risks of Tobacco
Leading behaviour-related preventable cause of death!
Smokers die ~7 years earlier on average than non-smokers
Smoking doubles risk of heart disease, stroke
2+ packs a day = 15-25x more likely to die of lung cancer
Associated with emphysema and chronic bronchitis
If mother smokes while pregnant: increased risk of
miscarriage, complications, asthma in offspring
Second hand smoke is the most hazardous form of indoor
pollution and also a risk factor for lung cancer
Hypertension: High Blood Pressure
Both a type of CVD and a risk factor for CVD Hypertension causes more strain on heart and blood vessels Extra strain can cause lesions in vessels, promoting atherosclerosis can cause eye damage, heart attack, kidney failure, stroke and damage to artery walls
Diabetes
Two types: Type I (insulin-dependent); hereditary; body cannot make enough insulin Type II (non-insulin dependent); caused by lifestyle choices; body doesnt respond to insulin Adults with untreated diabetes are 2-4 times more likely to suffer from heart disease or stroke More likely to suffer CVD or stroke at a younger age
Diabetes Mellitus
Dangers of Diabetes
CVD, stroke, kidney failure, compromised
circulation to extremities (may require
amputation), impotence, blindness, skin sores
Treatment
No cure, blood sugar levels must be kept stable
Type 1: insulin injections
Type 2: lifestyle modifications, medication/insulin
Diabetes Prevention Program
Individuals lost weight, improved their diet, and participated in
regular physical activity
Led to a 50%+ reduction in risk!
Obesity
>20% above ideal weight Strongly associated with: hypertension, lower HDL and Type II diabetes The Framingham study: sudden cardiac death 40X greater in obese persons Purposeful weight reduction is advised (through changes in diet and exercise)
Risk factors: Framingham Study
Factors you can't control: Non-modifiable Age (risk with age) Sex (M elevated risk ) Especially earlier in life Estrogen is protective (greater risk in post-menopausal F) Heredity Ethnicity Canadians of African, South Asian decent; Indigenous peoples at high risk.
Factors you can control: Modifiable Smoking, alcohol Diet and exercise Cholesterol Hypertension Sodium intake Diabetes Obesity Stress
Cardiovascular Disease: Treatments
Angioplasty: enlarging an artery by using a balloon-type instrument to push open the vessel and inserting a stent to hold it open Coronary artery bypass: If angioplasty fails, surgically replacing blocked or narrowed coronary arteries with healthy segments of vessels from elsewhere in the body (often part of a vein from the patients leg)
Infectious Disease
Caused by infection
occurs when a microorganism (bacteria, virus, fungi, protozoan) invades the body of a host;
typically accompanied by damage to cells
Followed by a latent period, the time
between infection and the development of
symptoms/signs can vary from a few hours to many years, typically is several days long
Pathogens: Agents of Infection
Bacteria: Are virtually everywhere (most don't cause disease) Cause harm by releasing enzymes or toxins Infections can be local or systemic Antibiotics kill bacteria Many are now resistant to multiple antibiotics Viruses: Acellular pathogens that invade living cells (can't survive without a host) Either kill the host cell or alter its function Antiviral drugs typically reduce the severity or duration of viral infections Fungi: Yeasts, mold, mushrooms Absorb nutrients from host, causing damage; release enzymes Protozoa: Single-celled organisms Release enzymes or toxins that destroy cells Parasitic Worms (Helminths): Attack tissues or organs and compete with host for nutrients Some enter by burrowing through skin, others via undercooked pork or fish Adult worms can be metres long!
How do you catch an Infection?
People
Direct contact or indirect contact
Your boy/girlfriend, your roommate, the person sitting next
to you in class or on the bus
Minimize contact when an individual is infectious
Food
e.g. E. coli, Salmonella from raw or undercooked food
Water
Contaminated water can carry pathogens
e.g. Vibrio cholera; parasites (e.g. Giardia)
Animals and Insects = vector transmission
Mosquitos (zika virus, malaria); rats/fleas (plague)
Most bacteria are not harmful
Most microbes do not cause disease!
For example, trillions of bacteria live in your
digestive tract
Aid in digestion and vitamin absorption
Compete with and exclude harmful microbes
‘broad spectrum’ antibiotics can kill good
bacteria as they eliminate the harmful ones
Probiotics (found in yogurt) can promote a
healthy microbial environment in the body
First and second Line of Defense
1.
Skin
Cilia
Mucus
Elevated body temperature
Cough, tears, saliva
2. Immune cells recognize pathogens as foreign
because pathogens have antigens (e.g.
proteins/sugars) on their surface that are
different from your own
Specialized cells including macrophages, T
cells and B cells launch an immune response
to eliminate the pathogen
Immune System: T cells
and Macrophages
Macrophages (‘big eaters”)
surround and digest foreign matter
aid immunity by engulfing antibody-bound pathogens
T-cells
Fight parasites, fungi, cancer cells, infected cells
Thousands of T-cells work together to kill pathogens
Immune System: B cells and
Antibodies
Antibodies (Abs): Made by B-cells Abs are proteins that stick to specific antigens on pathogens This is referred to as the humoral response Abs coat pathogens and make them clump together so that pathogens: cannot infect new cells can be more effectively eaten by macrophages
chain of infection
pathogen reservoir portal of exit means of transmission portal of entry new host
Vaccination: The Key to Prevention
Vaccination: Small quantity of inactive pathogen injected to create memory cells (T- and B-cells) When you encounter the actual pathogen, your immune system can fight it off (with antibodies) Eliminates pathogen before signs/symptoms experienced Vaccination led to the eradication of smallpox (~35% mortality) A number of other infectious diseases are under control
Infectious Disease: Globally
Smallpox (virus) has been eliminated
Polio (virus) should have been eliminated by now
(<100 cases in 2015 compared with 350,000 cases in
1998) but hotspots remain
Measles (virus) kills 150,000 people per year (down
from 750,000 in 2000)
Malaria (protozoan) kills 500,000 people per year
(down from ~1 million in 2000)
HIV/AIDS (virus) kills ~1 million per year
Tuberculosis (bacteria) kills ~1.5 million per year
Zika (virus) emerging pathogen
COVID19 (virus) emerging pathogen
Measles: A Case Study against the
Anti-Vaccination Movement
Recently BC, as well as other areas, have seen ongoing
measles outbreaks
Completely preventable in a vaccinated population!
Could be eradicated worldwide!
Most people recover after a bad skin rash, but in some
cases measles can lead to blindness, swelling of the
brain, pneumonia, and in severe cases, death
Anti-vaccine movement linked to this outbreak may be
attributed to misinformation from celebrities and social
media based on a discredited and retracted study
published in 1998 that falsely claimed a link between
vaccines and autism.
Colds and Flu
Common cold (rhinovirus, coronavirus) ~200 types (so you keep getting it) Spread by coughs, sneezes, direct, indirect contact Best prevention is hand-washing Best cure: Your immune system Rest, time, fluids, mild exercise, proper nutrition Medications mask symptoms Flu (influenza virus) More severe symptoms (aches, chills, dry cough, weakness) that last longer; Annual vaccine (flu shot) drugs available to high-risk patients
Outbreak: 1918 Spanish Flu
Flu (Influenza virus) Killed 50-100 million people 50% the population was infected Most of those who died were healthy, 18 to 40 year olds Several other deadly influenza outbreaks have occurred since Influenza has a high rate of mutation and can recombine with other strains to create new and potential deadly flu strains Get your flu vaccination yearly!
Hepatitis and Meningitis
Hepatitis (virus)
Viruses (A - G) cause inflammation of the liver
Symptoms: high fever, headaches, fatigue, aching joints, nausea,
vomiting, diarrhea, jaundice
Hep A/E transmitted by contaminated water
Hep B/C/D transmitted through sexual contact
Hep A/B vaccine is available in Canada
Some infections clear up, others are chronic life-long carriers and can
spread the virus
Meningitis (bacterial, viral or fungal (rare))
Infection of the membranes surrounding the brain and spinal cord
Symptoms: fever, drowsiness, confusion, severe headache, stiff
neck, nausea, vomiting
Viral meningitis usually clears up on its own, bacterial and fungal
are more serious and require antibiotic/antifungals immediately.
Reproductive and Urinary tract
Infections
Vaginal Infections
Trichomoniasis (protozoan): Itching, burning, discharge
Candidiasis (yeast infection; fungi): Itching, burning, discharge
Bacterial vaginosis (bacteria): White/grey discharge, strong odor
Penile Infections
Candidiasis (fungal); epididymitis, orchitis (bacterial or viral)
Redness, irritation, pain during urination or intercourse, discharge
Urinary Tract Infections (UTIs)
Typically caused by bacteria
Symptoms include burning sensation while urinating, chills, fever,
fatigue, blood in urine
Infections of the urethra are easier to treat, more serious infections
involve the bladder or kidneys
More common in females (females have a shorter urethra)
Antibiotic Resistance
Antibiotics kill bacteria (NOT viruses or fungi)
Penicillin dramatically decreased the number of
deaths from infectious disease
Natural selection has led to bacteria becoming
resistant to several antibiotics
We overuse antibiotics pharmacologically, in various sanitation
products, and in agriculture
If this trend continues, future generations may face
incurable bacterial infections
If you are prescribed antibiotics, be sure to
finish the entire regimen, even if you are
feeling better (this ensures all targeted
bacteria are killed off)
antibiotics
Avoid antibiotic soaps and cleansers
Bacterial STIs
Chlamydia
Most common bacterial STI reported in Canada; ~2X likely in women
Can lead to pelvic inflammatory disease (PID), disrupted menstruation,
pelvic pain, nausea/vomiting, vaginal discharge, burning during urination
Gonorrhea
(Males): cloudy penile discharge, burning while urinating
(Females): green/yellowish discharge; PID
Syphilis
First stage (days) : sore, usually painless at site of infection
Second stage (months): rash over the body
Third stage (years to decades): bacteria invade the nervous system;
neurological effects, mental disturbance, heart failure, blindness, death
Chlamydia
Caused by Chlamydia trachomatis Common; easily treatable with antibiotics (usually one dose) However, often there are no early symptoms (can increase inadvertent spreading of the disease) If left untreated, can lead to ectopic pregnancy; sterility in females (and males) Symptoms include discharge and burning when urinating (but often asymptomatic) Can be passed from mother to infant during childbirth Prevention: condom use Highest rate of infection: ages 15-29
Gonorrhea
Caused by Neisseria gonorrhoeae Often asymptomatic (and thus underreported) In females, can cause PID In males, can cause inflammation of the urethra, prostate, epididymis Can be treated with antibiotics, but resistance is a growing concern Prevention = condom use Spread by oral, vaginal or anal sex Highest incidence: F age 15-24; M age 30-39 Rates continue to rise
Syphilis
Caused by Treponema pallidum
Once caused death and disfigurement of
millions; now, easily treated with antibiotics
Transmitted through a break in the skin, via
kissing, oral, vaginal or anal sex
Infection has several stages
Primary: ulcer (chancre) at site of
infection (days to weeks after contact);
not usually painful; contains high
numbers of bacteria (highly contagious)
Secondary: flu-like symptoms; rash over
the body, hands and feet; ~2 months later
Tertiary: Neurological and cardiovascular
effects; blindness; years to decades later
Treatment: antibiotics if early enough
Viral STIs
Human Papilloma Virus
Most common viral STI in North America; ~75% of
sexually active adults will encounter an HPV strain
Can cause cervical (and other) cancers
Herpes Simplex Virus
Common: HSV1 affects mouth; HSV2 genitals.
Small, painful, leaking red blisters.
Prevalence in North America is ~50-60% for HSV1
and ~7- 20% for HSV2.
Human Immunodeficiency Virus
Less common in Canada; still a concern
The clinical endpoint of an HIV infection is AIDS;
specific criterial must be met for a person to be
diagnosed with AIDS
HIV attacks immune cells (T-cells)
Human Papilloma Virus
>100 types of HPV Cause common warts, genital warts, genital cancers Virtually all cervical cancers are caused by HPV Also causes vaginal, anal, vulvar, penile and oropharyngeal cancers Spread by sexual contact, including oral sex The immune system often clears the infection; in some cases infection persists to cause genital warts or cancer Prevention: Guardasil vaccination is available to males and females
HPV: Progression
Most HPV infections clear up with no serious consequences
In 5-10 % of infected women the infection persists > 2 years
Infections appear to clear up faster in men
Persistent infection has high risk of developing pre-cancerous cervical
changes, which can lead to cervical cancer in 10 -15 years
This long latency provides ample opportunity to remove pre-cancerous
lesions provided screening (i.e. Pap tests) are done regularly 15
HPV and Oropharyngeal Cancer
The incidence of HPV-associated oropharyngeal cancer has
increased during the past 20 years, especially among men.
Other factors may increase the risk of developing cancer following
HPV infection. These include:
Smoking
Having a weakened immune system
Having many children (for increased risk of cervical cancer)
Long-term oral contraceptive use (for increased risk of cervical cancer)
Poor oral hygiene (for increased risk of oropharyngeal cancer)
Chronic inflammation
HSV: Progression
Travels along nerves and lays dormant in nerve cells;
infection is life-long
Commonly transmitted through oral sex
Most contagious when carrier is shedding the virus
(usually when sores are visible)
Prevention difficult (especially for HSV-1) because
human reservoir is so large: ~2/3 North American
adults carry the virus
Outbreaks can be triggered by stress, illness, fatigue,
sun exposure, intercourse and menstruation
Prevention: Condom use
Treatment: Antivirals like acyclovir can lesson symptoms;
there is no cure 18
Human Immunodeficiency Virus
Transmission
Not spread by casual contact; requires blood-blood
or fluid-blood contact
Most common: unprotected sex
frequent sexual activity with multiple or anonymous
partners
higher-risk sexual activities such as anal intercourse
Injection-drug users who share contaminated
needles
Infected mother can transmit HIV to fetus (rare in
Canada) 19
HIV and AIDS
HIV infects immune cells (T-cells)
The immune system does launch a response BUT
(and slowly kills them)
HIV hides inside immune cells (and slowley kills them)
HIV replicates too fast for the immune system to fight it
HIV mutates (therefore changing its antigens) and avoids
elimination
HIV Testing measures antibodies
An untreated HIV infection typically leads to AIDS within 10 years
Severely compromises immune system
Death due to opportunistic infections
Main treatment
Highly Active Antiretroviral Therapy (HAART)
Combination of (usually) 3 different drugs that target various
stages of the HIV viral life cycle
An
HIV in Canada
~65,000 Canadians living with HIV at the end of 2016 ~50% are individuals who are gay or bisexual men (men who have sex withmen; MSM) ~33% are heterosexual individuals ~17% are intravenous drug users ~23% are female < 1% contracted the virus through mother-child transmission, blood transfusions or needlestick injuries Possible reasons: Feelings of invulnerability Multiple partners Infidelity Being unaware of partners history Failure to use protection Use of alcohol or drugs (increases likelihood of riskier behaviour) Lack of testing
Communication
Key to developing healthy relationships Verbal Communication desire to know decision to tell includes talking and listening Nonverbal Communication makes up 67% of communication touch, eye contact, facial expression , proximity comes from your own sense of self esteem Self disclosure, listening and feedback
Types of
Relationships
Self perception: can influence interactions with others;
lack of self esteem can impact relationships
Friendship: enhanced feelings of warmth, trust, respect;
honesty, acceptance, empathy and loyalty
Dating: Spending time together, practicing communication
skills, seeing if romantic feelings develop; testing
compatibility
Romantic attraction: What is attractive? (warmth and
kindness? physical attributes? financial stability?)
Intimacy: open trust, sharing of close confidential
thoughts and feelings; not always (but often) sexual
Mature
Love
Relationships often start with passionate love
and evolve into mature love
A relationship shows promise if:
You feel at ease with partner
You feel good about your partner whether they’re
around or not
Your partner is open with you
You can say no to each other without feeling guilty
You feel cared for, appreciated and accepted
Your partner listens to what you say
Crucial
Ingredients for Commitment
Love, sex, and intimacy Mutual trust , caring; respect, affection , loyalty Willingness to tolerate flaws Effective communication Willingness to change in response to each other Sharing of duties and responsibilities (egalitarian roles Balance of individual and joint interests/activities Shared morals and values
Committed
Relationships
Partnerships, cohabitation or marriage Fewer people are getting married More couples choosing to live together Married people are healthier and live longer compared to non married people Selection theory: healthy people are more attractive, more likely to get married Protection theory: married people look after each other, support each other Many different forms There is no one “normal” Married/cohabitating people are healthier than single, divorced or widowed ones Genetic selection? Support of a spouse/partner? Positive effect of raising children? Better lifestyle values? Other factors? Likely a combination.
Unhealthy Relationships
Everyone should be able to recognize warning signs
Physical, emotional or sexual abuse
Codependency
Criticism, contempt, defensiveness, withdrawal
Attempting to control various aspects of your life
Frequently humiliating you
Wanting to know where you are at all times
Becoming jealous or angry
Threatening harm
Trying to coerce you
Same
Sex Relationships
Same sex marriage was legalized in 2004 •~16.5% of couples are married •~54% of married couples are male Half of all same sex couples live in Canada’s three largest cities 16% of married couples have children 7% of common law couples have children
Sex and Gender
Sex
Sex
: Biological categorization based on physical features
(e.g., chromosomes, hormones , genitalia ); most individuals
are either XX (female) or XY (
Gender
: Includes roles and identity . Social categorization
based on psychological characteristics and roles that
society assigns to the biological sexes; more “fluid” than
sex; may or may not agree with biological categorization
Sexual Orientation
: An individual’s emotional and erotic
orientation toward people of the same sex or another sex.
Both are aspects of personality and identity
To what extent do you define yourself by
your sex and/or gender?
LGBTQ Identities in Canada
Agender A ndrogynous Asexual Bigender Bisexual Boy Ci sgender Female Feminine Gay Gende r queer Girl Lesbian Male Masculine Pangender Pansexual Polysexual P o l yamorous Queer Questioning Straight Third gender Trans Transgender Two Spirit
Female Reproductive anatomy
Egg (ovum): unites with sperm (fertilization)
Ovaries
production of eggs; released during ovulation
production estrogen and progesterone
Uterine tube: site of fertilization
Uterus: region where fetus develops
Vagina: canal for childbirth; penis
External
Female Genitalia
Vulva: Outer female genitalia Erogenous zone Consists of: Mons pubis pubic region covered by hair Labia (minor/major) inner and outer folds of skin that cover the vagina Clitoris pleasure center
Male Reproductive
Anatomy
Testes: produce sperm and testosterone Scrotum: encloses and protects testes Epididymis: stores sperm Vas deferens: connects the epididymis with the urethra Urethra: transports both semen and urine through the penis and out of the body
External
Male Genitalia
Penis: Two types of erectile tissue Erection occurs when spaces in erectile tissue fill with blood The end of the penis is glans Posterior indentation called the frenulum is the most sensitive part of the penis
Scrotum Contains sperm producing testes Sperm production is optimal at 34 C Circumcision is the surgical removal of the prepuce (foreskin) and is a widely debated procedure.
Does Size Matter?
The size of the penis can ‘shrink’ due to cold
temperature or nervousness
Average penis length is between 5 6 inches erect
Average aroused vagina length is 4.25 4.75
inches
The first 5 th of the female vagina has the most
nerve endings
80% or more of woman are satisfied with partner’s
size, whereas only 55% of men are satisfied with
their size (survey of 5000+ heterosexual couples)
The
Real “Masters of Sex”
William Masters & Virginia Johnson were renowned sex researchers Human Sexual Response (1966) Human Sexual Inadequacy (1970) Human Sexuality (1988) Laboratory studies Human volunteers (382 M, 312 F) had intercourse or masturbated while being observed, measured, & videotaped 10,000 female sexual cycles; 2,500 male sexual cycles
Described ‘4 stages of human sexual response’ 1. Excitement phase 2. Plateau phase 3. Orgasmic phase -Refractory phase (males) 4. Resolution phase
Female
vs. Male Sexual Response
Males experience a refractory period following orgasm, during which another orgasm cannot be achieved. Females can experience a prolonged orgasm compared with males. The female resolution stage may be longer. Females are able achieve multiple orgasms in short succession. Men are generally aroused more easily. Females may or may not have an orgasm with vaginal stimulation alone. Many require stimulation of the clitoris to achieve orgasm.
intercourse variations
Straight, curious, bisexual, gay Celibacy, asexuality Touching and foreplay Erotic fantasy Masturbation Oral sex Cunnilingus (female) Fellatio (male) Vaginal intercourse Anal intercourse Highest transmission of HIV, gonorrhea, syphilis Anal tissue tears easily
UNHEALTHY AND ILLEGAL ANY non consensual sex (e.g. assault, forcing, rape) ANY sex involving minors or children Commercial sex (e.g. prostitution) varies in acceptability
Male Performance Concerns
1.
Erectile Dysfunction
Physiological
Risk factors include : high BP, high cholesterol, diabetes,
alcohol, smoking, obesity, nerve damage
Constriction ring may help; Viagra/Cialis
Psychological
Performance anxiety, stress, mental disorders
Generally treated with therapy rather than medication
2.
Premature Ejaculation
Treatments: Practicing control/endurance; non sexual
thoughts; swapping foreplay and sex throughout;
Desensitizing creams
Female Performance
Concerns
Female Sexual Dysfunction
Persistent and recurring issues with arousal, desire, sexual
response, pain, and/or achieving orgasm.
Can occur at any stage of life
Can be physiological, psychological, hormonal,
psychosocial
Treatment or therapy based on individual situations.
Conception
Sperm: testes →_______ vas deferens
urethra vagina cervix →________
uterine tubes
Ovum: ovaries uterine tubes
one ovum is released each menstrual cycle (~day 14)
Fertilization occurs in uterine tube
Zygote divides to form a mass of cells, which will
implant into the endometrium
After several divisions, the mass becomes an embryo
After ~8 weeks, the embryo is known as a fetus
Natural Birth Control
Methods
Abstinence
Outercourse
Hugging, kissing, touching, manual stimulation
Coitus interruptus (withdrawal)
Not recommended as a means of birth control
Fertility awareness: Abstinence ~9 13 days/cycle
Cervical mucus/ovulation method
Calendar/rhythm method
Basal body temperature method
: Male Condoms
Pros \: provides the best protection against STIs ; no side effects Cons : can interrupt activity; some people are allergic to latex ; may diminish sensation; breakage Effectiveness \: varies; with perfect use, failure is about 2%, averages
: Female Condom
Pros \: can be inserted up to 8 hours before intercourse protect s against STIs Cons : can be noisy, move or be uncomfortable ; slippage often occurs Effectiveness \: varies; with perfect use, failure is about 5%; averages 27%; higher in new relationships
other non prescription birth control methods
Spermicide Pros \: inexpensive ; readily available Cons \: used with or without a diaphragm; must be inserted 10 20 minutes before intercourse; doesn’t protect against STIs
Contraceptive sponge Pros \: can insert right before or up to several hours before intercourse Cons \: doesn’t protect against STIs in fact, may increase HIV risk)
Emergency
Contraception
•‘Morning after Pill’, ‘Plan
No longer requires a prescription; available at most
drugstores ; progestin only pills
Can be used up to 5 days following unprotected sex
(or ‘failed protection’ sex; within 72 h is ideal)
The sooner it is used, the more effective it is
Reduces risk of pregnancy by 75% (not 100%)!
Side effects: nausea/vomiting, irregular bleeding,
fatigue, headache, dizziness, tender breasts
Should not be used as a primary means of
contraception
Prescription
Contraceptives
Hormonal: –“The Pill’; contraceptive ring patch implant s ; intrauterine device ( IUD) mimic pregnancy hormones, tricking the body into thinking it is pregnant ; prevents ovulation prevents development of endometrium, thickens cervical mucus Barrier (non hormonal) Diaphragm/ cervical cap Need to be fitted Hormonal Ring (NuvaRing): Pros: 3 weeks protection at a time; shorter, lighter periods Cons: doesn’t protect against STIs; may be side effects Diaphragm (barrier, non hormonal): pro: can insert up to 6 hours prior to intercourse; protects for 6 hours con: needs to be fitted; more expensive; can be moved out of place; must be left in place for 6 hours after sex
Prescription Birth Control
Injectable Contraceptive Pros: 3 months of protection; effective; discrete Cons: doesn’t protect against STIs; menstrual irregularities Contraceptive Patch Pros: effective; discrete Cons: doesn’t protect against STIs; side effects
Implanted
Contraceptives: IUDs
Typically hormonal Prevents fertilization (or implantation) Pros: Lasts approx. 3 5 years May stop menstruation Effective immediately Reduces risk of some cancers Cons: No protection against STIs Expensive $100/ Needs to be inserted Cramps, expulsion
Permanent
Contraception:
female sterilization (tubal ligation) male sterilization (vasectomy)
Abortion:
Termination of Pregnancy
Medical abortion, dilation and curettage or vacuum aspiration to empty contents Not normally preformed after 24 weeks Legal ; MSP covers cost in BC Remains a social controversy, with both ‘pro choice’ and ‘pro life’ advocates having very strong views of their respective sides A majority of Canadians identify as pro choice
Pregnancy Trimesters
First trimester
Morning sickness
Higher risk of
spontaneous abortion
Second trimester Abdomen starts to noticeably swell Movement of baby first evidenced
Third trimester
Rapid fetal growth
Keys to a Healthy Pregnancy
Eat sensibly: in second and third trimesters females should eat a bit more Don’t gain too much weight High pregnancy weight gain increases risk of future health problems (obesity, diabetes II etc.) in offspring Pregnant women at increased risk of infection Ensure proper food safety, minimize exposure to infectious agents Avoid sodium nitrite and nitrates Byproducts are potentially carcinogenic Ensure adequate intake of folic acid Prevents neural tube defects Required for DNA replication Keys to a Healthy Pregnancy Avoid alcohol, tobacco, limit caffeine Alcohol promotes fetal alcohol syndrome Moderate levels of physical activity PA promotes mental health and wellness Sexual intercourse is safe Avoid drugs, toxins, heavy metals Some prescription drugs are okay Always consult a physician Breathe clean air Drink clean water
Breastfeeding
Decreases newborn’s risk of cardiovascular disease, obesity, diabetes, autoimmune diseases, and allergies Increases immune system Increases bonding Acts a natural birth control; helps the mother heal Health Canada recommends exclusively breast feeding for the first six months
Fertility
Options
May be when an individual/couple cannot conceive on their own ( for various reasons): Assisted Reproductive Technology Sperm donor or surrogate Intrauterine insemination Hormone therapy In Vitro Fertilization Adoption
