Chapter 16:

1. Human AdjustmentJohn W. Santrock Chapter 16: Health McGraw-Hill © 2006 by The McGraw-Hill Companies, Inc. All rights reserved.

2. Chapter Outline Explaining Health and Illness Nutrition and Eating Exercise Drugs and Addiction The Patient and the Health-Care Setting ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

3. Learning Goals 1. Describe some key factors in health and illness 2. Discuss nutrition, eating behavior, and eating problems 3. Summarize the role of exercise in health 4. Explain drug use and addiction 5. Characterize some important aspects of the patient and the health-care setting ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

4. EXPLAINING HEALTH AND ILLNESS The Bio-Psycho-Social Model Psychological Factors in Health and Illness Social Factors in Health and Illness ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

5. The Bio-Psycho-Social Model • Bio-psycho-social model - health is best understood in terms of a combination of biological, psychological, and social factors ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

6. Psychological Factors in Health and Illness • Psychological factors proposed as causes of health problems include: • lack of self-control • emotional turmoil • negative thinking ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

7. Psychological Factors in Health and Illness • Positive emotional states are associated with health patterns of physiological functioning in cardiovascular system and immune system • Positive emotions linked with release of secretory immunoglobin A, antibody defense for common cold • Mood also influences people’s beliefs about their ability to carry out health-promoting behaviors ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

8. Social Factors in Health and Illness • Frequency and intensity of health problems vary across cultures • Variations linked to cultural differences: • social • economic • technological • religious • poor health care ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

9. Social Factors in Health and Illness • Social factors that influence health: • frequency of daily stressors • unhealthy lifestyles • poor health care ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

10. Review - Learning Goal 1 • How is the bio-psycho-social model of health defined? • What are some psychological influences on health? • What are some social influences on health? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

11. NUTRITION AND EATING Nutrition and Eating Behavior Eating Problems ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

12. The Food Guide Pyramid • The Food Guide Pyramid consists of recommended daily servings of food, with an emphasis on consuming more bread, cereals, rice, pasta, and vegetables than milk, meats, fats, oils, and sweets • The Food Guide is being revised by U.S. Department of Agriculture ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

13. Adjustment Strategies for Eating Right 1. Study the Food Guide Pyramid and monitor proposed changes in it 2. Follow a diet low in fat, saturated fat, and cholesterol 3. Substitute plenty of vegetables, fruits, and grain products for unhealthy food 4. Use sugar only in moderation 5. Use sodium in moderation 6. Drink plenty of water 7. Eat breakfast every day ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

14. Nutrition and Eating Behavior • Cross-cultural study of women found strong correlation between fat consumption and death rates from breast cancer • Food restriction in laboratory animals can increase the animal’s lifespan • Whether low-calorie diets can increase human lifespan is not known • Recent research suggests the possibility that some vitamin supplements help slow the aging process and improve health of older adults ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

15. Obesity • Obesity is a serious and pervasive health problem for many individuals • Prevalence of obesity in U.S. adults is 25 percent • Obesity is linked to increased risk of hypertension, diabetes, and cardiovascular disease • Body mass index - measure of weight in relation to height, used to determine whether an individual is underweight, healthy weight, overweight, or obese ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16. Obesity • Factors likely involved in obesity include: • heredity • leptin • set point and metabolism • environmental factors • ethnicity • gender ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

17. Heredity and Obesity • Some individuals inherit a tendency to be overweight • Animals can be inbred to be obese • Human twins have similar weights, even when they are reared apart ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

18. Leptin • Leptin acts as an anti-obesity hormone Leptin = protein involved in satiety (condition of being full to satisfaction) and released by cells resulting in decreased food intake and increased energy expenditure ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

19. Leptin • In humans, leptin concentrations have been linked with: • weight • percentage of body fat • weight loss in a single diet episode • cumulative percentage of weight loss in all diet episodes ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

20. Set Point and Metabolism • Set point - weight maintained when no effort is made to gain or lose weight • Fat is stored in adipose cells • When people gain weight, the number of their fat cells increases • Some scientists suggest these fat cells do not decrease ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

21. Set Point and Metabolism • Basal metabolism rate (BMR) - minimal amount of energy an individual uses in a resting state • BMR decreases gradually during adulthood • Weight gain can be due to declining basal metabolism rate ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

22. Environmental Factors in Obesity • Our earliest ancestors probably developed preference for sweets because ripe fruit was accessible • The dramatic increase in rate of obesity in the United States is likely due to greater availability of food, energy-saving devices, and declining physical activity • Sociocultural factors are involved in obesity, which is six times more prevalent among women with low incomes ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

23. Dieting and Obesity • Many Americans are obsessed with dieting • Restrained eaters - individuals who chronically restrict food intake to control their weight • Restrained eaters are often on diets, very conscious of what they eat, and feel guilty after splurging on sweets • Many Americans regularly start diets, but few are successful in keeping weight off ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

24. Dieting and Obesity • Current hot trend is low-carbohydrate diet promoted by Robert Atkins • Short-term - individuals on low-carbohydrate diet do lose weight • Long-term - studies not yet done • Atkins diet may pose health risks - foods high in fats increase risk of heart disease and cancer-food restricted reduce heart disease, cancer and other diseases • Weight cycling (yo-yo dieting) is linked with some chronic diseases ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

25. Adjustment Strategies for Losing Weight 1. Exercise regularly 2. Keep a food diary 3. Shop from a list and don’t shop when hungry 4. Minimize exposure to food cues 5. Use smaller plate with smaller servings 6. Eat at the table with the TV off 7. At restaurants, eat only half your meal 8. Don’t starve yourself all day and then eat one big meal in the evening 9. Seek support from family and friends 10. Be realistic about weight loss goals ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

26. Anorexia Nervosa • Anorexia typically begins in teenage years • Ten times more likely to affect females Anorexia nervosa = eating disorder that involves relentless pursuit of thinness through starvation ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

27. Anorexia Nervosa • Characteristics of anorexia nervosa include: • weighing less than 85% of what is considered normal • having intense fear of gaining weight • having a distorted image of body ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

28. Bulimia Nervosa • A Bulimic goes on an eating binge and then purges by self-induced vomiting or use of a laxative • 90% of bulimics are women Bulimia nervosa = eating disorder in which individual consistently follows a binge-and-purge eating pattern ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

29. Bulimia Nervosa • Most bulimics are: • preoccupied with food • have strong fear of becoming overweight • are depressed or anxious ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

30. Review - Learning Goal 2 • What is the Food Guide Pyramid and how is it changing? What are some cultural variations in eating behavior? What are some links between nutrition and longevity? • What characterizes obesity and dieting? What are anorexia nervosa and bulimia nervosa? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

31. EXERCISE The Benefits of Exercise Exercise and Longevity ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

32. The Benefits of Exercise • Exercise helps to prevent heart disease Aerobic exercise = sustained exercise that stimulates heart and lung activity ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

33. The Benefits of Exercise • Regardless of other risk factors (smoking, high blood pressure, overweight, heredity), if you exercise enough to burn over 2,000 calories a week you can cut risk of heart attack by two-thirds • Health experts recommend at least 30 minutes of moderate-intensity physical activity a day ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

34. The Benefits of Exercise • Exercise also benefits mental health: • improves self-concept • reduces anxiety • reduces depression ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

35. Exercise and Longevity • Regular exercise can lead to healthier life as a middle-aged and older adult and increase longevity • Gerontologists recommend strength training in addition to aerobic activity and stretching for older adults • Weight-lifting can preserve and possibly increase muscle mass in older adults ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

36. Exercising and Aging • Conclusions on exercise and aging: • can influence physiological changes in brain tissue associated with aging • can optimize body composition • is related to prevention of chronic diseases • is associated with improvement in many diseases • is related to prevention of disability • can be used to counteract side-effects of standard medical care • is linked to increased longevity ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

37. Adjustment Strategies for Exercising Regularly 1. Consult with your doctor and get a physical exam 2. Make exercise a high priority in your life 3. Reduce TV time 4. Chart your progress 5. Get rid of excuses 6. Learn more about exercise ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

38. Review - Learning Goal 3 • What is aerobic exercise? What are the benefits of exercise? • What is the connection between exercise and longevity? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

39. DRUGS AND ADDICTION Psychoactive Drugs Addiction Alcohol Smoking ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

40. Psychoactive Drugs Psychoactive drugs = substances that act on the nervous system to alter states of consciousness, modify perceptions, and change moods ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

41. Psychoactive Drugs • Psychoactive drugs have been classified into three main categories: • Depressants - drugs that slow down the nervous system, body functions, and behaviors • Stimulants - drugs that increase activity of the nervous system • Hallucinogens - drugs that modify an individual’s perceptual experiences and produce hallucinations ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

42. Addiction Psychological dependence = person is preoccupied with a drug for emotional reasons (such as reduction of stress) Physical dependence = discontinuing use of a drug creates unpleasant, significant changes in physical functioning and behavior ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

43. Addiction • Withdrawal changes can include: • insomnia • tremors • nausea • vomiting • cramps • elevation of heart rate and blood pressure • convulsions • anxiety • depression ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

44. Models of Addiction • Disease model of addiction - addictions are biologically based, lifelong diseases that involve loss of control over behavior and require medical and/or spiritual treatment for recovery • Disease model supported by medical profession and Alcoholics Anonymous (AA) ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

45. Models of Addiction • Life-process model of addiction - addiction is a habitual response and a source of gratification or security that can be understood best in the context of social relationships and experiences ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

46. Alcohol • Alcohol acts on the body as a depressant • Approximately 1.4 million people in United States are alcoholics ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

47. Drinking in College Students and Young Adults • Almost half of college binge drinkers reported problems that include: • missing classes • physical injuries • trouble with police • Rate of binge drinking is about 44 percent • By the time individuals reach mid-20s, many have reduced their use of alcohol ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

48. Alcoholism Alcoholism = disorder that involves long-term, repeated, uncontrolled, compulsive, and excessive use of alcoholic beverages and that impairs the drinker’s health and social relationships ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

49. Alcoholism • Both genetic and environmental factors play a role in alcoholism • Heredity likely plays a role in half of the cases of alcoholism • About one-third of alcoholics recover ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

50. Adjustment Strategies for Curbing Alcohol Use 1. Admit you have a problem 2. Write down your reasons for cutting down your drinking 3. Set a drinking goal and keep a diary 4. Don’t ignore what others are saying to you 5. Don’t go out with others who make you feel uncomfortable if you are not drinking 6. Don’t keep beer, wine, or hard liquor at home 7. Seek help for your problem ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.