Week 4: Health promotion (background, diet, exercise and weight loss) Flashcards
define HP
“Health promotion is the process of enabling people to increase control over, and to improve their health.”
aim of HP
- aim to engage and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities
making every contact count (MECC)
Making Every Contact Count (MECC) is an approach to behaviour change that utilises the millions of day to day interactions that organisations and individuals have with other people to support them in making positive changes to their physical and mental health and wellbeing.
- MECC enables the opportunistic delivery of consistent and concise healthy lifestyle information and enables individuals to engage in conversations about their health at scale across organisations and populations.
behaviour change models
stages of change- proschaska and diclemente
behaviour change wheel
Stages of change
behaviour change wheel
- Helps us understand behaviour change at the individual, community and population level
- Can be used by clinicians to help identify and address barriers to behaviour change and also used to develop public health interventions
universal approach to HP
aim to reduce risk across the whole population e.g. sugar tax
target approach to HP
aim to identify those most at risk and then tailor messages and approaches to that group or groups e.g. breast feeding initiatives in young mums
The Ottawa Charter- WHO 1986
Health promotion action means:
- Building Healthy Public Policy - joint working across sectors, fiscal and wider policy, recognition of the role of public policy in health
- Creating Supportive Environments - the role of work and leisure, protecting the natural and built environment
- Strengthening community actions - empowering communities, strengthening public participation and access to opportunities
- Developing personal skills - providing access to information and education for health, enhancing life skills and enabling people to make choices and be in control of their health
- Re-orientating health services - health services as health promoting, wider and holistic focus on the individual
- Moving into the future - addressing ecological issues, seeing health as an investment, promoting equity
strategies for health promotion
macrolevel
community development
health communication
Macrolevel
policy, legislation and system change
Community development
- Formal participation in decision making
- Working with community leaders e.g. providing space for meetings and supporting activities
Health communication
info, communication and health education
For health related info and communication to be understood it needs to be:
- Received
- Understood
- Change attitude or belief
- Stimulate behavioural changes
Model for health promotion
Shows top down and bottom up approaches
→ Can be individual or collective, authoritative to negotiated
Prevention is better than a cure
- Healthy population, healthy working population
- Better health reduces the pressures on the NNS, social care and other public services inc. crime, justice and welfare
- Reduced pressured on GPs, hospitals and social care services
- Important part of NHS 10-year long term plan
In the UK we spend too much money on medication and tertiary prevention, we need to spend more money on
primordial prevention e.g. health promotion to help combat social determinants of health e.g. education not to start smoking
levels of prevention
primordial, primary, secondary, tertiary
primordial prevention e.g.
health promotion/improvement to eliminate risk factors
target pop: general population
primary prevention e.g.
disease prevention - screening to reduce risk of disease
target pop: susceptible population i.e. those with a positive BRCA may choose to get mastectomy
secondary prevention e.g.
screening/treatment to slow progression of disease
i.e. if found to have high cholesterol- change diet, exercise and statins etc
target pop: asymptomatic pop
tertiary prevention
treatment/rehabilitation to minimise consequences of disease
e.g. coronary stents in pts with angina
target pop: symptomatic patients
Healthy diet
Recommended calorie intake for adults
- Female- 2000
- Male -2500
eatwell guide
Eat at least 5 portions of fruit and veg a day
- Vitamins and minerals
- High fibre meals
- Some dairy or dairy alternatives
- Eat some beans, pulses, fish, eggs, meat
- Unsaturated oils
- Drink 6-8 glasses of water a day
Exercise
Adults should do some type of physical activity every day (30 mins). Exercise just once or twice a week can reduce the risk of heart disease or stroke.
Adults should aim to (exercise):
- do strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week
- do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
- spread exercise evenly over 4 to 5 days a week, or every day
- reduce time spent sitting or lying down and break up long periods of not moving with some activity
You can also achieve your weekly activity target with:
- several short sessions of very vigorous intensity activity
- a mix of moderate, vigorous and very vigorous intensity activity
Obesity definition
an abnormal or excessive fat accumulation that presents a health risk
obesity causes
Causes
Obesity is generally caused by consuming more calories, particularly those in fatty and sugary foods, than you burn off through physical activity. The excess energy is stored by the body as fat.
BMI equation
Calculating BMI: weight/ height2
- Not used to diagnose obesity, because people who are very muscular can have a high BMI without much fat
- A better measure of excess fat is waist size
obese BMI
>30
>40 = very obese
Obesity is not distributed equally:
- Ethnicity
- Sex
- Local inequalities
- Deprivation levels
Inequality gap between those in deprived and affluent areas- obesity higher in deprived regions
why does obesity matter
- Cancers
- Mortality
- CVD
- Liver
- Repro complications
- Osteoarthritis and back pain
- T2D
- Asthma
- Depression and anxiety
- Sleep apnoea
weight loss recommendations
A combination of calorie restriction and increased activity are generally recommended: importantly, NICE specifically recommends the use of behaviour change approaches to support weight loss.
- Reduce calorie intake
- Reduce calorie intake by 600kcal/day
- Exercise regularly
- 150 hours of moderate exercise
- Psychological support i.e. behaviour changing techniques
- Medication
weight loss medication
orlistat -→ energy wastage→ poo out fat
liraglutide →appetite suppression
