Week 11 - Physical activity and Health p2

Question 1

What are the 3 major risk factor categories for chronic diseases?

Answer 1

Genetic/Inherited
- Age
- Gender
- Race

Environmental
- Physical factors: air, water
- Socioeconomic factors: income, housing, employment, education
- Family: divorce, death of loved one, children leaving

Behavioural
- Smoking
- Poor dietary habits (nutrition, alcohol)
- Physical inactivity

Question 2

In the US, what two factors account for almost half of the recorded deaths?

Answer 2

heart disease (23%) and cancer (22%)

Question 3

Coronary heart disease is associated with Atherosclerosis. Describe it and identify what it is the leading pathological contributor to?

Answer 3

• chronic inflammation results in the thickening of the inner lining of arteries (due to plaque build up)
• Leading pathological contributor to heart attack and stroke death

Question 4

Identify the risk factors for coronary heart disease (CHD), referencing with factors can be changed.

Answer 4

Age, Family history - can’t be changed

Cigarette smoking, sedentary lifestyle, obesity, hypertension - can be changed

Question 5

How is hypertension characterized?

Answer 5

• Systolic bp >130mmHg or diastolic bp >80mmHg
• Major independent risk factor for CHD
• Progressive condition

Question 6

What is the most common lifestyle approach to counter hypertension?

Answer 6

Physical activity - it can lower resting SBP by an average of 3-10mmHg and DBP by 2-6mmHg

Question 7

Post-exercise hypotension:
a) What is post-exercise hypotension caused by?
b) How may physicians minimize symptoms associated with post-exercise hypotension
c) What does it stimulate?

Answer 7

a) an extenuation of exercise-induced vasodilation
b) combination of exercise and lower dose hypertensive medications
c) stimulates the expansion of plasma volume

Question 8

What is the clinical relevance of a potential 2mmHg reduction in SBP due to exercise?

Answer 8

its associated with reduction of 10% and 7% in the risks of stroke and coronary heart disease

Question 9

What does terms such as obesity and overweight refer to?
- What % of adults in England and the US are classified as overweight or obese?

Answer 9

excess of body fat and an increased weight-for-height
- England = 63% / US = 66%

Question 10

What diseases does obesity increase the risk of?

Answer 10

• CHD
• Stroke
• Hypertension
• Type 2 diabetes
• Cancer

Question 11

What two factors that be combined to promote weight loss?

Answer 11

exercise (activities such as fast walking, jogging, swimming for 150-300mins a week) + a balanced calorie-controlled diet

Question 12

How does obesity promote inflammation and accelerate the disease process (e.g. atherosclerosis)?

Answer 12

Visceral fat secretes more inflammatory cytokines such as IL-6 and TNF-a
- They interfere with action of insulin causing insulin resistance
- Leads to type 2 diabetes, CVD + metabolic syndrome

Question 13

Why is inflammation the “cornerstone” for many chronic diseases?

Answer 13

In atherosclerosis, chronic inflammation promotes pathological remodeling of the blood vessel walls, resulting in a plaque that occludes blood flow - this can eventually rupture, resulting in vascular events including heart attacks, strokes and peripheral vascular events

Question 14

How do statin drugs impact chronic inflammation?

Answer 14

• It lowers Low-density lipoprotein content and CRP
• It can reduce the risk of CV disease and death

Question 15

How does a mediterranean diet impact chronic inflammation?

Answer 15

fruits, veg, legumes, whole grains, olive oil… result in reductions in CRP and IL-6

Question 16

How does PA impact chronic inflammation?

Answer 16

• Lower levels of inflammation
• The IL-6 produced has an anti-inflammatory effect increasing cytokines such as adiponectin

Question 17

What does “Metabolic syndrome” refer to?

Answer 17

• Medical term for a combination of diabetes, high bp (hypertension) and obesity
• It’s a cluster of risk factors that promote the development of CHD, stroke and other conditions that affect blood vessels
• 1 in 3 older adults aged 50+ in UK

Question 18

What risk factors make up the metabolic syndrome?

Answer 18

• Abdominal obesity
• Hypertriglyceridemia (triglyceride levels in the blood of >1.7mmol/L)
• Low HDL cholesterol
• High blood pressure (140/90mmHg or higher)
• Inability to control blood sugar levels (insulin resistance, fasting blood glucose >5.6mmol/L)

Question 19

What are the two major causes of metabolic syndrome?

Answer 19

1) Low grace chronic inflammation: increases levels of TNF-a, IL-6, CRP causing insulin resistance + leads to obesity and type 2 diabetes

2) Increased oxidative stress: increased production of free radicals cause cellular damage and inflammation

Question 20

What are the 3 factors that are used to prevent/treat metabolic syndrome?

Answer 20

1) Regular PA: moderate intensity exercise daily for min of 30mins but preferably 60mins
2) Healthy diet
3) Weight reduction