Nutrition and Public heath

Question 1

what can 29% of 13 most common cancers be prevented by

Answer 1

diet, exercise and weight management

Question 2

what are the two main cancers of the oesophagus

Answer 2

adenocarcinoma, squamous cell carcinoma

Question 3

what are the modifiable risk factors of oesophageal cancer

Answer 3

body fatness, alcoholic drinks

Question 4

what are the modifiable risk factors of stomach cancers

Answer 4

body fatness, alcoholic drinks, foods preserved by salt, processed meat

Question 5

what are the modiafiable risk factors for colon and rectum cancer

Answer 5

processed meat, alocohol, body fatness, red meat

Question 6

what decrease the risk of colon and rectum cancer

Answer 6

physical activity, wholegrains, dietary fibre, dairy, calcium supplements

Question 7

what is the most important avoidable cause of cancer in non smokers

Answer 7

obesity

Question 8

how many adults ins scotland in 2015 were overweight and obese

Answer 8

overweight 65%

obese 29%

Question 9

what can increase and decrease the mortality of cancer

Answer 9

increase= high BMI
decrease= exercise

Question 10

what is the western dietary pattern and what does is it associated with

Answer 10

high in meat, fat, refined grains, and desserts

Question 11

what is lynch syndrome

Answer 11

genetic disorder thought to cause one in 25 bowl cancers- should be given aspirin to reduce risk of cancer and weight management advice

Question 12

what are the immediate problems of obesity

Answer 12

Technical difficulties – surgical complications
DVT
Chest infection
Wound infection
Pressure ulcers

Question 13

what are the other linger term problems of obesity

Answer 13

Dealing with a stoma
Chemotherapy
Recurrent cancer
Second primary cancer
Cardiovascular disease risk

Question 14

what are the lifestyle influences on nutrition

Answer 14

general socioeconomic, cultural, environmental conditions

living and working conditions

social and community influences

individual lifestyle factors

age, sex, hereditary factors

Question 15

what are the sociological influences of nutrition

Answer 15

gender, age, ethnicity, socioeconomic status, income, education, marital status

Question 16

what are children in most deprived areas more and less likely to consume

Answer 16

more likely to consume meat products, non-diet soft drinks, consume chips and less likely to consume oily fish or cereals (high fibre/ low sugar) compared to those in the least deprived quintile.

Question 17

how does obesity change with deprivation

Answer 17

increase with deprivation

Question 18

what is’ prevention’

Answer 18

factors linked to disease causation

Question 19

what is ‘treatment’

Answer 19

disease management

Question 20

what us ‘reducing complications and progress’

Answer 20

prognosis

Question 21

what can influence life circumstances

Answer 21

employment, unemployment, housing conditions, education, family circumstances, area of residence

Question 22

what are the determinants of food choices in low income houshold

Answer 22

limited access to cost healthy food

poor housing- food storage and preparation

less education- awareness

unemployment- affordability

lower social class of parents- acceptability

Question 23

what can influence people to change their diet

Answer 23

awareness, access and availability, acceptability, affordability

Question 24

why is motivation a major influence on diet

Answer 24

many people not intending to eat healthier

Question 25

what needs to accompany educational dietary programmes

Answer 25

little effect on its own. needs right pricing, marketing and availability strategies

Question 26

what the reasons behind adherence to coeliac disease diet

Answer 26

``` individual: awareness diet planning and prep skills motivation stigma and isolation symptoms ``` ``` external- cost, availability, choice food labelling prescribes foods taste of GFF social support ```

Question 27

what cam high dietary sugar lead to

Answer 27

dental problems, diabetes

Question 28

how does dental problems affect nutritional status

Answer 28

restricted range of food they can eat

Question 29

what are the difficulties for the individual in dietary change

Answer 29

Positive reinforcers exist in the habits that require to be changed New behaviours may have initial adverse effects on well being Threat of disease less salient than immediate enjoyment Lack of positive feedback from improvements in symptoms

Question 30

what is the doctors role in addressing nutritional factors in disease

Answer 30

endorse health messages, signpost, brief intervention, provide written advice, refer to dietitian etc

Question 31

what triple the motivation to lose weight in patients

Answer 31

receiving advice from heath professionals to lose weight

Question 32

how many units a week should people consume a week

Answer 32

14

Question 33

what are the benefits of physical activity

Answer 33

Constipation - Mechanically stimulates bowel motility Diverticular disease - decreased straining and therefore formation of diverticula ``` Gall stones - Improves gallbladder motility, and reduces metabolic abnormalities Colon cancer (12%) - increased gut motility, decreased exposure to carcinogens (eg. prostaglandins) ``` Mortality from colon cancer if increased after diagnosis

Question 34

what are the current recommendations for physical activity

Answer 34

150 min of moderate or 75 mins intense a week including cardio and muscle strengthening

Question 35

what happens to physical activity as age increases and with gender

Answer 35

decreases with age, women always do less (except muscle strengthening when 65)

Question 36

describe the digestion of dietary fibre

Answer 36

Not hydrolysed by enzymes secreted by the small intestine But may be partially digested by microflora in the gut

Question 37

what is dietary fibre associated with reduced risk of

Answer 37

CHD, stroke, hypertension, diabetes, obesity, GI disease

Question 38

describe soluble fibre and give exmaples of its sources

Answer 38

Can be dissolved (by change in pH) forming gel; ferments Feeling of fullness Delays gastric emptying Slows rates of glucose and lipid absorption from the small intestine Good sources: beans, lentils, fruits, oats

Question 39

describe insoluble fibre and give examples of its sources

Answer 39

Absorb water and swells; slow and incomplete fermentation Feeling of fullness Greater effect on bowel habit Good sources: wholegrain products, vegetables, beans, lentils

Question 40

what GI disease is fibre thought to reduce the risk of

Answer 40

colorectal cancer, gastro-oesophageal reflux disease, peptic ulcer disease, gallbladder disease, divericular disease, constipation, haemorrhoids

Question 41

how is dietary fibre protective

Answer 41

Bulk reduces transit time and therefore also carcinogen absorption Fermentation produces short-chain fatty acids: An energy source for colonic cells and bacteria, improving barrier against infection Lowers the pH in colon, reducing growth of pathogenic organisms and formation of toxins

Question 42

how well to the pop achieve fibre goals

Answer 42

very few, majority get just over half of recommendation (30 g per day)

Question 43

what is the difference between whole and refined grains

Answer 43

refined grains have the bran an germ layers removed

Question 44

why are whole grains beneficial

Answer 44

same protecitve features of fibre provides antioxidants which protect against DNA damage

Question 45

what are the benefits of red meat

Answer 45

Rich source of protein, iron, zinc, B vitamins and vitamin A

Question 46

what are the risks of red meat

Answer 46

Source of saturated fat Form carcinogens When cooked at high temp During curing process (N-nitroso compounds) Haem iron content Results in free radical production, which damages lining of bowels

Question 47

what are the health risks associated with red and processed meats

Answer 47

red- mortality from any cause, diverticular symptoms and complications processed- mortality from any cause especially CVD and cancer

Question 48

what caners are associated with red and processed meat

Answer 48

colorectal, stomach, oesophageal

Question 49

what is the recommendations for red meat

Answer 49

70g per day max

Question 50

what health problems is high dietary salt associated with

Answer 50

hypertension, LVF, bone health, gastric cancer

Question 51

how does salt cause gastric cancer

Answer 51

Irritates and causes inflammation of stomach lining, exposing it to carcinogens Increases formation of carcinogenic compounds in stomach Increases growth and action of H pylori (major risk factor) Can cause inflammation and gastric ulcers and potentially progress to cancer

Question 52

what are the strategies for salt reduction

Answer 52

reformulation, raise awareness, informed choice

Question 53

what are the basic principles of behaviour change counselling

Answer 53

Ask Permission to discuss diet Assess Habits Motivation Advise Health benefits Personalised instruction Agree Setting goals ``` Assist Self monitoring tools, feedback Preventing relapse Referral (if applicable) Social support ```