Nutrition and Public heath Flashcards
what can 29% of 13 most common cancers be prevented by
diet, exercise and weight management
what are the two main cancers of the oesophagus
adenocarcinoma, squamous cell carcinoma
what are the modifiable risk factors of oesophageal cancer
body fatness, alcoholic drinks
what are the modifiable risk factors of stomach cancers
body fatness, alcoholic drinks, foods preserved by salt, processed meat
what are the modiafiable risk factors for colon and rectum cancer
processed meat, alocohol, body fatness, red meat
what decrease the risk of colon and rectum cancer
physical activity, wholegrains, dietary fibre, dairy, calcium supplements
what is the most important avoidable cause of cancer in non smokers
obesity
how many adults ins scotland in 2015 were overweight and obese
overweight 65%
obese 29%
what can increase and decrease the mortality of cancer
increase= high BMI decrease= exercise
what is the western dietary pattern and what does is it associated with
high in meat, fat, refined grains, and desserts
what is lynch syndrome
genetic disorder thought to cause one in 25 bowl cancers- should be given aspirin to reduce risk of cancer and weight management advice
what are the immediate problems of obesity
Technical difficulties – surgical complications DVT Chest infection Wound infection Pressure ulcers
what are the other linger term problems of obesity
Dealing with a stoma Chemotherapy Recurrent cancer Second primary cancer Cardiovascular disease risk
what are the lifestyle influences on nutrition
general socioeconomic, cultural, environmental conditions
living and working conditions
social and community influences
individual lifestyle factors
age, sex, hereditary factors
what are the sociological influences of nutrition
gender, age, ethnicity, socioeconomic status, income, education, marital status
what are children in most deprived areas more and less likely to consume
more likely to consume meat products, non-diet soft drinks, consume chips and less likely to consume oily fish or cereals (high fibre/ low sugar) compared to those in the least deprived quintile.
how does obesity change with deprivation
increase with deprivation
what is’ prevention’
factors linked to disease causation
what is ‘treatment’
disease management
what us ‘reducing complications and progress’
prognosis
what can influence life circumstances
employment, unemployment, housing conditions, education, family circumstances, area of residence
what are the determinants of food choices in low income houshold
limited access to cost healthy food
poor housing- food storage and preparation
less education- awareness
unemployment- affordability
lower social class of parents- acceptability
what can influence people to change their diet
awareness, access and availability, acceptability, affordability
why is motivation a major influence on diet
many people not intending to eat healthier
what needs to accompany educational dietary programmes
little effect on its own. needs right pricing, marketing and availability strategies
what the reasons behind adherence to coeliac disease diet
individual: awareness diet planning and prep skills motivation stigma and isolation symptoms
external- cost, availability, choice food labelling prescribes foods taste of GFF social support
what cam high dietary sugar lead to
dental problems, diabetes
how does dental problems affect nutritional status
restricted range of food they can eat
what are the difficulties for the individual in dietary change
Positive reinforcers exist in the habits that require to be changed
New behaviours may have initial adverse effects on well being
Threat of disease less salient than immediate enjoyment
Lack of positive feedback from improvements in symptoms
what is the doctors role in addressing nutritional factors in disease
endorse health messages, signpost, brief intervention, provide written advice, refer to dietitian etc
what triple the motivation to lose weight in patients
receiving advice from heath professionals to lose weight
how many units a week should people consume a week
14
what are the benefits of physical activity
Constipation - Mechanically stimulates bowel motility
Diverticular disease - decreased straining and therefore formation of diverticula
Gall stones - Improves gallbladder motility, and reduces metabolic abnormalities Colon cancer (12%) - increased gut motility, decreased exposure to carcinogens (eg. prostaglandins)
Mortality from colon cancer if increased after diagnosis
what are the current recommendations for physical activity
150 min of moderate or 75 mins intense a week including cardio and muscle strengthening
what happens to physical activity as age increases and with gender
decreases with age, women always do less (except muscle strengthening when 65)
describe the digestion of dietary fibre
Not hydrolysed by enzymes secreted by the small intestine
But may be partially digested by microflora in the gut
what is dietary fibre associated with reduced risk of
CHD, stroke, hypertension, diabetes, obesity, GI disease
describe soluble fibre and give exmaples of its sources
Can be dissolved (by change in pH) forming gel; ferments
Feeling of fullness
Delays gastric emptying
Slows rates of glucose and lipid absorption from the small intestine
Good sources: beans, lentils, fruits, oats
describe insoluble fibre and give examples of its sources
Absorb water and swells; slow and incomplete fermentation
Feeling of fullness
Greater effect on bowel habit
Good sources: wholegrain products, vegetables, beans, lentils
what GI disease is fibre thought to reduce the risk of
colorectal cancer, gastro-oesophageal reflux disease, peptic ulcer disease, gallbladder disease, divericular disease, constipation, haemorrhoids
how is dietary fibre protective
Bulk reduces transit time and therefore also carcinogen absorption
Fermentation produces short-chain fatty acids:
An energy source for colonic cells and bacteria, improving barrier against infection
Lowers the pH in colon, reducing growth of pathogenic organisms and formation of toxins
how well to the pop achieve fibre goals
very few, majority get just over half of recommendation (30 g per day)
what is the difference between whole and refined grains
refined grains have the bran an germ layers removed
why are whole grains beneficial
same protecitve features of fibre
provides antioxidants which protect against DNA damage
what are the benefits of red meat
Rich source of protein, iron, zinc, B vitamins and vitamin A
what are the risks of red meat
Source of saturated fat
Form carcinogens
When cooked at high temp
During curing process (N-nitroso compounds)
Haem iron content
Results in free radical production, which damages lining of bowels
what are the health risks associated with red and processed meats
red- mortality from any cause, diverticular symptoms and complications
processed- mortality from any cause especially CVD and cancer
what caners are associated with red and processed meat
colorectal, stomach, oesophageal
what is the recommendations for red meat
70g per day max
what health problems is high dietary salt associated with
hypertension, LVF, bone health, gastric cancer
how does salt cause gastric cancer
Irritates and causes inflammation of stomach lining, exposing it to carcinogens
Increases formation of carcinogenic compounds in stomach
Increases growth and action of H pylori (major risk factor)
Can cause inflammation and gastric ulcers and potentially progress to cancer
what are the strategies for salt reduction
reformulation, raise awareness, informed choice
what are the basic principles of behaviour change counselling
Ask
Permission to discuss diet
Assess
Habits
Motivation
Advise
Health benefits
Personalised instruction
Agree
Setting goals
Assist Self monitoring tools, feedback Preventing relapse Referral (if applicable) Social support
