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EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH

EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH. Key Lecture II NUTRITION Shupi Rinomhota UNIVERSITY OF LEEDS SCHOOL OF HEALTHCARE STUDIES 30 NOVEMBER, 1999. EXTERNAL ENVIRONMENT AND ITS IMPACT ON HEALTH.

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EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH

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  1. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH Key Lecture II NUTRITION Shupi Rinomhota UNIVERSITY OF LEEDS SCHOOL OF HEALTHCARE STUDIES 30 NOVEMBER, 1999

  2. EXTERNAL ENVIRONMENT AND ITS IMPACT ON HEALTH Aim:To show how cells and the internal environment are interdependent on nutrition and the effects of altered nutrition on health. Learning Outcomes: At the end of the session, you should be able to: • To reinforce the interdependency of the environments • To describe nutrition issues from a global perspective • To explain the role of nutrition in health • To identify and discuss nutrition related health problems

  3. A MODEL FOR THE STUDY OF BIOLOGICAL HEALTH THE ORGANISM EXTERNALINTERNAL CELL ENVIRONMENTENVIRONMENT INTERFACE MEMBRANES RESPIRATORY GASTROINTESTINAL RENAL INTEGUMENT • Interdependency of cells, systems & internal environment • Challenge to internal environment • Reduced system efficiency due to cell damage • Threatened cellular health • Adaptation in cellular & system function

  4. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH Environmental Biology: Study of organisms in relation to their environment. NB: You need to find out the definitions for the following terminology after this session? Biosphere Food Chain/Web Climate Population Growth HabitatCompetition Absence of Environmental Resistance: No predators No competition for food No competition for space Result:H - - - S - - - - - - -

  5. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH MALNUTRITION : ISSUES TO CONSIDER • Inadequate/ExcessCHO Intake • Inadequate/Excess Protein Intake • Inadequate/Fat Intake • MicronutrientDeficiencies • Inadequate NSP (Fibre) Intake • Excess Salt Intake

  6. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: The Global Perspective: The Economically The Economically Developed WorldDeveloping World • Energy Intake • Protein Intake • Fat Intake • Non-Starch Polysaccharide Intake • Salt Intake

  7. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: MALNUTRITION Insufficient CHO • leads to fat and protein metabolism • CHO has “protein sparing action” (Barker, 1996) Inadequate fat • reduces protein availability for tissue formation & repair • affects structure of brain, nervous tissue & body cells • affects synthesis of hormones Insufficient protein:

  8. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: ESSENTIAL NUTRIENTS Essential Fatty Acids (EFAs) linoleic acid, linolenic acid, arachidonic acid • maintain structure & function of cell membranes • regulate cholesterol metabolism • are precursors of prostaglandins & thromboxanes • reduce the severity of schizophrenia symptoms are low in the brains of schizophrenia (Mellor et al, 1996). • Incidence of schizophrenia high in Norwegian seaman (Christensen & Christensen, 1988)

  9. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION:{ UNDERNUTRITION} Undernutrition during childhood & adolescence: • stunts growth leading to smaller normal pelvis • pelvis in growing girl with rickets is flattened /kidney shaped instead of being round • undernutrition decreases fertility, if severe: conception rates low during siege of Leningrad (1942) and Arnhein (1944/45) Undernutrition During Pregnancy: • Infant birth weight low in poorly fed mothers • 20% of babies in Asia & 15% in Africa were below 2500g birth weight • cf... 7% and 8% in USA & Europe respectively (WHO 1979). • folate deficiency - leads to neural tube defects

  10. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: {UNDERNUTRITION} Undernutrition in Pregnancy: EARLY GESTATION EXPOSURE TO FAMINE: Dutch Hunger Winter: Arnheim, September 1944 to May, 1945 • Infants conceived at height of famine a two-fold increased risk of developing schizophrenia (Susser et al, 1996) • Females more affected than men (Susser & Lin, 1992) • Increased risk of developing affective disorder from famine exposure (Susser et al, 1996) OTHER ISSUES IN PREGNANCY: • certain drugs - teratogenic effects • alcohol: - foetal alcohol syndrome: low birth weight; congenital defects of face; low intelligence

  11. EXTERNAL ENVIRONMENT AND IMPACTON HEALTH • EFFECT OF MEAL COMPOSITION ON MOOD: • Temporal lifting in mood after CHO rich-meal • Reduction in depression after CHO rich-meal • [in obese individuals (Lieberman, et al, 1986)] • [in individuals who experience PMT symptoms( Wurtman et al 1989)] • Thus: there is CHO craving: • in depression (Hopkinson & Bland, 1982); • in Premenstrual syndrome [PMS] (Wurtman et al, 1989) • and in Obesity (Lieberman et al, 1986).

  12. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: Eating Behaviour & Mood constellation of moodluteal phase of behaviourmenstrual cycle physical symptoms CHO craving & increased caloric intake Paradox: CHO meals poor in protein increase brain tryptophan and serotonin synthesis. (Spring et al, 1986)

  13. EXTERNAL ENVIROMENT AND IMPACT ON HEALTH NUTRITION: ROLE OF M ICRONUTRIENTS Make a list of: Fat Soluble Water Soluble VitaminsVitamins 1. Which of the above vitamins have antioxidant properties? 2. Name three micro element that is an effective antioxidant? 3. What Role is played by antioxidants?

  14. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION : ROLE OF ANTIOXIDANTS • MOP UP OXYGEN (O2) DERIVED FREE RADICALS • PROTECT CELLULAR AND TISSUE STRUCTURE & FUNCTION • PREVENT OXIDATION OF PUFAs • ENHANCE IMMUNE FUNCTION • MAINTAIN A STABLE INTERNAL ENVIRONMENT • PROTECTIVE AGAINST CHD, CANCER ETC.

  15. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION : ROLE OF FOLIC ACID (FOLATE) • FOLATE DEFICIENCY CAUSES DEPRESSION • FOLATE IMPROVES CLINICAL AND SOCIAL RECOVERY IN SCHIZOPHRENIA (GODFREY ET AL, 1990) • FOLATE DEFICIENCY IN HEALTHY ADULTS LEADS TO: INSOM IA IRRITABILITY FATIGUE FORGETFULNESS (ALPERT & FAVA, 1997)

  16. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION : OVERCONSUMPTION • EXCESS • ENERGY LEADS TO OBESITY • EXCESS FAT INTAKE LEADS TO CHD & OBESITY • EXCESS FAT INTAKE ASSOCIATED WITH PROSTATE CANCER (ARMSTRONG & DOLL, 1973)

  17. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION : MEAT EATING VERSUS NON-MEAT EATING • ANTIOXIDANT NUTRIENT INTAKE HIGHER IN VEGETARIAN DIET • INTAKES OF Fe, Zn, Vit B12 LOWER AMONG VEGETARIANS • VEGETARIAN DIET INFLUENCES CHD RISK FACTORS FAVORABLY • VEGETARIAN DIET SHOWS REDUCED MORTALITY FROM CANCER (THOROGOOD ET AL, 1994)

  18. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH GENETICALLY MODIFIED FOODS: Myth or Reality? Discuss

  19. EXTERNAL ENVIRONMENT AND IMPACT ON HEALTH NUTRITION: REFERENCES: Alpert J E & Fava M (1997( Nutrition and depression: The role of folate. Nutrition Reviews 55 (5): 145-149 Armstrong B & Doll R (1973) Environmental factors & cancer incidence in different countries with special reference to dietary practices, Int. Journal of Cancer 15: 617-631 Godfrey P S A, Toone B K, Carney M W P, et al (1990) Enhancement of recovery from psychiatric illness by methylfolate. The Lancet, 336: 392-397 Barker H M (1996). Nutrition and Dietetics for Health care. Churchill Livingstone, Edinburgh. Christensen O and Christensen E (1988) Fat consumption and schizophrenia. Acta Psychiatr.Scand., 78:587-591 Hopkinson G and Bland RC (1982) Depressive symptoms in grossly obese women, Canadian J of Psychiatry, 27:213-215. Lieberman H R, Wurtman JJ, Chew B (1986b) Changes in mood after carbohydrate consumption among obese individuals. American J of Clinical Nutrition, 44: 772-778.

  20. EXTERNAL ENVIRONMENT AND IMPACTON HEALTH NUTRITION: REFERENCES: Pelletier D L (1994) The potentiating effects of malnutrition on child mortality: epidemiological evidence and policy implications. Nutrition Reviews, 52 (12): 409-415 Spring B J, Lieberman H R, Swope G & Garfield GS (1986) Effects of carbohydrates on mood and behaviour. Nutrition Reviews , 44 (Supplement): 51-60 Stephens N G, Parsons A, Schoffield P M, Kelly F, et al (1996). Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS), The Lancet, 347: 781-776 Susser E S and Lin S P (1992) Schizophrenia after prenatal exposure to the Dutch Hunger Winter of 1944-1945. Arch. Gen Psychiatry, 49: 983-988. Susser E, Neugebauer R, Hoek H W et al (1996) Schizophrenia after prenatal famine, Arch.Gen. Psychiatry, 53: 25-31. Thorogood M, Mann J, Appleby P and McPherson K (1994) Risk of death from cancer and ischaenic heart disease in meat and non-meat eaters. Brit. Medical Journal, 308: 1667-1670. Wurtman J J , Brzezinski A , Wurtman R J and Laferrere B (1989). Effect of nutrient intake on premenstrual depression, American J. of Obstetrics and Gynaecology, 161: 1223-1235

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