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Chapter 11

CHAPTER. OUTLINE. Chapter 11. An Educated Fitness/Wellness Consumer. The Seven Dimensions of Wellness. Causes of Death. Diseases of the Cardiovascular System. Coronary Heart Disease. Cancer. Substance Abuse. Sexually Transmitted Diseases. A Healthy Lifestyle.

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Chapter 11

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  1. CHAPTER OUTLINE Chapter 11 An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases A Healthy Lifestyle

  2. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases A Healthy Lifestyle • Improving the quality, and most likely the length of life is a matter of personal choice • Enhancing physical fitness alone is not sufficient to lower the risk for disease and ensure better health

  3. Wellness: The constant and deliberate effort to stay healthy and achieve the highest potential for well-being; it integrates seven dimensions An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Key Terms

  4. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Wellness Lifestyle • To enjoy a wellness lifestyle, a person has to practice behaviors that will lead to positive outcomes in the seven dimensions of wellness: physical, emotional, mental, social, environmental, occupational, and spiritual • These dimensions are interrelated; one dimension frequently affects the others

  5. Be physically active Do not use tobacco Eat a healthy diet Maintain recommended body weight Sleep 7 to 8 hours each night Decrease stress levels Drink alcohol moderately or not at all Surround yourself with healthy relationships Be informed about the environment and avoid environmental risk factors Take personal safety measures An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Lifestyle Habits to Live Healthier and Longer

  6. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Spiritual Well-Being • Spirituality provides a sense of meaning and direction in life, a relationship to a higher being, freedom, prayer, faith, love, closeness to others, peace, joy, fulfillment, and altruism • Prayer: sincere and humble communication with a higher power • Altruism: true concern for and action on behalf of others (doing good for others is good for oneself, especially the immune system)

  7. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Causes of Death in the U.S. • The leading causes of death in the U.S. are cardiovascular disease (38%), cancer (23%), chronic lower respiratory disease (5%), and accidents (4%) • More than 60% are caused by cardiovascular disease and cancer and about 80% of these deaths are preventable through a healthy lifestyle program

  8. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Actual Causes of Death in the U.S. • The top three causes of death in the U.S.— tobacco use, poor diet and inactivity, and alcohol abuse—are responsible for 920,000 deaths each year Tobacco 435,000 Poor diet/inactivity 400,000 Alcohol 85,000 Microbial infections 75,000 Toxic agents 55,000 Motor vehicles 43,000 Firearms 29,000 Sexual behaviors 20,000 Drugs 17,000

  9. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Cardiovascular Diseases • Any disease that affects the heart and the blood vessels • Cardiovascular disease is the number one health problem in the U.S. • About 20% of the U.S. population has some form of cardiovascular disease • More than 60% of the people who die of heart disease die suddenly and unexpectedly

  10. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Critical Thinking • What are your feelings about your own risk for diseases of the cardiovascular system? • Is this something that you need to concern yourself with at this point in your life? Why or why not?

  11. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Coronary Heart Disease (CHD) • The major form of cardiovascular disease • In CHD the arteries that supply the heart with oxygen and nutrients are narrowed by fatty deposits such as cholesterol and triglycerides • Narrowing of the coronary arteries diminishes blood supply to the heart muscle, which can precipitate a heart attack

  12. 11.5 The Heart and Its Blood Vessels

  13. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Coronary Heart Disease (CHD) • CHD accounts for 20% of all deaths and half of all cardiovascular deaths • More than half of the people who died suddenly from CHD had no previous symptoms • 80% of deaths from CHD in people under age 65 occur during the first heart attack • The risk of death is greater in the least educated segment of the population • Almost all risk factors are preventable and reversible • The individual can reduce risk by participating in a healthy lifestyle program

  14. Physical inactivity High blood pressure High body mass index Low HDL cholesterol High LDL cholesterol Elevated triglycerides Elevated homocysteine Inflammation An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Major CHD Risk Factors Diabetes Abnormal electrocardiogram (ECG) Tobacco use Stress Personal and family history Age Gender

  15. Improves aerobic endurance Decreases blood pressure Reduces body fat Lowers blood lipids Improves HDL cholesterol Helps control diabetes An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Physical InactivityIncreasing physical activity reduces the overall risk for heart disease Increases and maintains good heart function Motivates toward smoking cessation Alleviates tension and stress Counteracts a personal history of heart disease

  16. Blood pressure: A measure of the force exerted against the walls of the vessels by the blood flowing through them Systolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the forceful contraction (systole) of the heart; higher of the two numbers in blood pressure readings Diastolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the relaxation phase (diastole) of the heart; lower of the two numbers in blood pressure readings Hypertension: Chronically elevated blood pressure An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Key Terms

  17. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases High Blood Pressure • The “silent killer” • A blood pressure above 140/90 mm Hg • Approximately 20% of Americans are hypertensive • High blood pressure is a risk factor for • CHD, congestive heart failure, strokes, kidney failure, and osteoporosis

  18. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Treatment of High Blood Pressure • Increase physical activity • Weight control • A low-salt/low-fat and high potassium/high-calcium diet • Limit alcohol and caffeine intake • Smoking cessation • Stress management • Medication

  19. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Hypertension & Exercise • Hypertensive people who are physically active have a lower risk of mortality from all causes than inactive individuals with normal blood pressure • The death rates for unfit individuals with low systolic blood pressure are much higher than for highly fit people with high systolic blood pressure

  20. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Effects of Aerobic Exerciseon Blood Pressure • An individual can expect exercise-induced reductions of approximately 3 to 5 mm Hg in resting systolic and diastolic blood pressures (both through aerobic exercise and strength training)

  21. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Excessive Body Fat (Obesity) • Recognized as an independent risk factor for CHD • A BMI of 30 or higher recognized as a major risk factor for coronary heart disease • Risk factors such as high blood lipids, hypertension, and diabetes usually improve with weight loss and increased physical activity

  22. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Abnormal Cholesterol Profile • Blood lipids are carried in the bloodstream by molecules of protein known as • High density lipoproteins (HDLs) • Low density lipoproteins (LDLs) • Very low density lipoproteins (VLDLs) • Chylomicrons

  23. 11.2 Standards for Blood Lipids

  24. High-density lipoproteins (HDLs): Cholesterol-transporting molecules in the blood (“good” cholesterol) that help clear cholesterol from the blood Low-density lipoproteins (LDLs): Cholesterol transporting molecules in the blood (“bad” cholesterol) that tend to increase blood cholesterol An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Key Terms

  25. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases HDL Cholesterol • HDL cholesterol acts as a “scavenger,” removing cholesterol from the body and preventing plaque from forming in the arteries • For the most part, HDL cholesterol is determined genetically • Generally, women have higher levels than men up to menopause (estrogen tends to raise HDL)

  26. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Ways to Increase HDL Cholesterol • Habitual aerobic exercise(> 6 METs, 3 times/week for 20 min/session) • Weight loss (if necessary) • Niacin supplementation • Quitting smoking • Drug therapy

  27. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases LDL Cholesterol • Tends to release cholesterol, which then may penetrate the lining of the arteries and speed up the process of atherosclerosis

  28. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Ways to Lower LDL Cholesterol • Participate in a regular aerobic exercise program • Lose body fat (if necessary) • Choose a diet low in fat, saturated fat, and cholesterol • Replace saturated with unsaturated fats (saturated fat consumption should be under 7% of the total daily caloric intake) • Limit dietary cholesterol consumption to less than 200 mg per day • Consume 25 to 38 grams of fiber per day, including a minimum of 10 grams of soluble fiber

  29. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Ways to Lower LDL Cholesterol • Consume 25 grams of soy protein a day • Consume red meats fewer than three times per week, consume no organ meats (liver, kidneys) • Eat fish instead of red meat • Do not eat commercially baked foods • Avoid foods that contain transfatty acids, hydrogenated fat, or partially hydrogenated vegetable oil • Drink low-fat milk (1% or less) and choose low-fat dairy products

  30. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Ways to Lower LDL Cholesterol • Limit egg consumption to less than 3 eggs per week • Bake, broil, grill, poach, or steam food instead of frying • Refrigerate cooked meat before adding to other dishes; remove fat hardened in the refrigerator before mixing meat with other foods • Avoid fatty sauces made with butter, cream, or cheese • Consider drug therapy if the above fail to decrease LDL cholesterol

  31. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Elevated Triglycerides • Also known as free fatty acids • Contribute to atherosclerosis • Are carried in the bloodstream primarily by very low density lipoproteins (VLDLs) and chylomicrons • Found in poultry skin, lunch meats, and shellfish • Manufactured mainly in the liver, from refined sugars, starches, and alcohol

  32. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Ways to Lower Triglycerides • Cut down on high-triglyceride foods • Decrease overall fat consumption • Quit smoking • Reduce weight (if necessary) • Participate in aerobic exercise

  33. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Homocysteine • Clinical data indicates that many heart attack and stroke victims have normal cholesterol levels • Homocysteine is an intermediate amino acid in the interconversion of two other amino acids: methionine and cysteine • This interconversion requires the B vitamin folate (folic acid) and vitamins B6 and B12

  34. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Homocysteine • Homocysteine accumulation may: • Cause damage to the inner lining of the arteries • Stimulate the proliferation of cells that contribute to plaque formation • Encourage clotting, which may completely obstruct an artery

  35. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Homocysteine • A large number of people have high blood levels of homocysteine due to a • Genetic inability to metabolize homocysteine • Deficiency in the vitamins required for its conversion • Five servings of fruits and vegetables daily can provide sufficient levels of folate and vitamin B6 to remove and clear homocysteine from blood

  36. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Homocysteine • Vitamin B12 is found primarily in animal flesh and animal products • Vitamin B12 deficiency is rarely a problem(1 cup of milk or an egg provides the daily requirement) • The body recycles most of this vitamin, thus, a deficiency takes years to develop

  37. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Inflammation • Scientists are looking at inflammation as a major risk factor for heart attacks • Low-grade inflammation can occur in a variety of places throughout the body • For years it has been known that • Inflammation plays a role in CHD • Inflammation hidden deep in the body is a common trigger of heart attacks, even when cholesterol levels are normal or low and arterial plaque is minimal

  38. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases C-Reactive Protein (CRP) • A protein whose blood levels increasewith inflammation • Physicians have turned to CRP to evaluate ongoing inflammation in the body • People with elevated CRP are more prone to cardiovascular events • The risk of a heart attack is even higher in people with both elevated CRP and cholesterol, resulting in an almost 9-fold increase in risk

  39. 11.3 Homocysteine Guidelines 11.7 Relationships amongC-Reactive Protein and Cholesterol and Risk of Cardiovascular Disease • The hs-CRP (for high-sensitivity CRP) test is used to measure inflammation in the blood vessels

  40. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases C-Reactive Protein • Levels decrease with statin drugs • Also helpful are exercise, weight loss, proper nutrition, and aspirin • Omega-3 fatty acids inhibit proteins that cause inflammation • Excessive intake of alcohol and high protein diets increase CRP • Aspirin therapy may also help control inflammation

  41. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • A condition in which blood glucose is unable to enterthe cells because • The pancreas totally stops producing insulin • The pancreas does not produce enough to meet the body’s needs • The cells develop insulin resistance • The role of insulin is to “unlock” the cell to escort glucose into the cell • Diabetes affects more than 17 million people in the U.S.

  42. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • People with chronically elevated blood glucose levels may have problems metabolizing fats, which can make them more susceptible to • Atherosclerosis, coronary heart disease, heart attacks, high blood pressure, and strokes • Diabetics also have lower HDL cholesterol and higher triglyceride levels

  43. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • An 8-hour fasting blood glucose level above 126 mg/dl on two separate tests confirms a diagnosis of diabetes • A level of 126 or higher should be brought to the attention of a physician

  44. Type 1 Diabetes: Insulin-dependent diabetes (IDDM) Also called juvenile diabetes The pancreas produces little or no insulin Type 2 Diabetes: Non-insulin-dependent diabetes (NIDDM) The pancreas either does not produce sufficient insulin or it produces adequate amounts but cells become insulin-resistant Accounts for 90 to 95% of all diabetes cases An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Key Terms

  45. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • Although diabetes has a genetic predisposition, type 2 is related to • Overeating, obesity, and lack of physical activity • Once limited primarily to overweight adults • Now accounts for almost half of new cases in children • More than 80% of all type 2 diabetics are overweight or have a history of excessive weight • In most cases, type 2 can be corrected through • Diet, weight loss, and regular exercise

  46. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • Both moderate and vigorous physical activity are associated with increased insulin sensitivity and decreased risk for diabetes • The key to increase and maintain proper insulin sensitivity is regularity of the exercise program

  47. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Diabetes • A healthy diet is beneficial • High in complex carbohydrates and water-soluble fibers (found in fruits, vegetables, oats, and beans) • Low in saturated fat and sugar • Aggressive weight loss, especially if combined with exercise, often allows diabetic patients to normalize blood sugar level without the use of medication

  48. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Metabolic Syndrome • As cells resist insulin’s action, the pancreas releases even more insulin in an attempt to keep blood glucose from rising • A chronic rise in insulin appears to trigger a series of abnormalities referred to as metabolic syndrome or syndrome X • These abnormal conditions include • Low HDL cholesterol, high triglycerides, an increased blood clotting mechanism, and high blood pressure

  49. An Educated Fitness/Wellness Consumer The Seven Dimensions of Wellness Causes of Death Diseases of the Cardiovascular System Coronary Heart Disease Cancer Substance Abuse Sexually Transmitted Diseases Metabolic Syndrome • Syndrome X people should distribute daily caloric intake so that • 45% of the calories are derived from carbohydrates (primarily low-glycemic) • 40% from fat (30 to 35% mono- and polyunsaturated fats, and 5 to 10% saturated fat) • 15% from protein • Syndrome X patients also benefit from • Weight loss (if overweight) • Exercise • Smoking cessation

  50. Electrocardiogram (ECG): Provides a record of the electrical impulses that stimulate the heart to contract

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