Week 4: Health promotion (background, diet, exercise and weight loss)

Question 1

define HP

Answer 1

“Health promotion is the process of enabling people to increase control over, and to improve their health.”

Question 2

aim of HP

Answer 2

• aim to engage and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities

Question 3

making every contact count (MECC)

Answer 3

Making Every Contact Count (MECC) is an approach to behaviour change that utilises the millions of day to day interactions that organisations and individuals have with other people to support them in making positive changes to their physical and mental health and wellbeing.

• MECC enables the opportunistic delivery of consistent and concise healthy lifestyle information and enables individuals to engage in conversations about their health at scale across organisations and populations.

Question 4

behaviour change models

Answer 4

stages of change- proschaska and diclemente

behaviour change wheel

Question 5

Stages of change

Answer 5

Question 6

behaviour change wheel

Answer 6

• Helps us understand behaviour change at the individual, community and population level
• Can be used by clinicians to help identify and address barriers to behaviour change and also used to develop public health interventions

Question 7

universal approach to HP

Answer 7

aim to reduce risk across the whole population e.g. sugar tax

Question 8

target approach to HP

Answer 8

aim to identify those most at risk and then tailor messages and approaches to that group or groups e.g. breast feeding initiatives in young mums

Question 9

The Ottawa Charter- WHO 1986

Health promotion action means:

Answer 9

1. Building Healthy Public Policy - joint working across sectors, fiscal and wider policy, recognition of the role of public policy in health
2. Creating Supportive Environments - the role of work and leisure, protecting the natural and built environment
3. Strengthening community actions - empowering communities, strengthening public participation and access to opportunities
4. Developing personal skills - providing access to information and education for health, enhancing life skills and enabling people to make choices and be in control of their health
5. Re-orientating health services - health services as health promoting, wider and holistic focus on the individual
6. Moving into the future - addressing ecological issues, seeing health as an investment, promoting equity

Question 10

strategies for health promotion

Answer 10

macrolevel

community development

health communication

Question 11

Macrolevel

Answer 11

policy, legislation and system change

Question 12

Community development

Answer 12

• Formal participation in decision making
• Working with community leaders e.g. providing space for meetings and supporting activities

Question 13

Health communication

Answer 13

info, communication and health education

For health related info and communication to be understood it needs to be:

• Received
• Understood
• Change attitude or belief
• Stimulate behavioural changes

Question 14

Model for health promotion

Answer 14

Shows top down and bottom up approaches
→ Can be individual or collective, authoritative to negotiated

Question 15

Prevention is better than a cure

Answer 15

• Healthy population, healthy working population
• Better health reduces the pressures on the NNS, social care and other public services inc. crime, justice and welfare
• Reduced pressured on GPs, hospitals and social care services
• Important part of NHS 10-year long term plan

Question 16

In the UK we spend too much money on medication and tertiary prevention, we need to spend more money on

Answer 16

primordial prevention e.g. health promotion to help combat social determinants of health e.g. education not to start smoking

Question 17

levels of prevention

Answer 17

primordial, primary, secondary, tertiary

Question 18

primordial prevention e.g.

Answer 18

health promotion/improvement to eliminate risk factors

target pop: general population

Question 19

primary prevention e.g.

Answer 19

disease prevention - screening to reduce risk of disease

target pop: susceptible population i.e. those with a positive BRCA may choose to get mastectomy

Question 20

secondary prevention e.g.

Answer 20

screening/treatment to slow progression of disease

i.e. if found to have high cholesterol- change diet, exercise and statins etc

target pop: asymptomatic pop

Question 21

tertiary prevention

Answer 21

treatment/rehabilitation to minimise consequences of disease

e.g. coronary stents in pts with angina

target pop: symptomatic patients

Question 22

Healthy diet

Recommended calorie intake for adults

Answer 22

• Female- 2000
• Male -2500

Question 23

eatwell guide

Answer 23

Eat at least 5 portions of fruit and veg a day

• Vitamins and minerals
• High fibre meals
• Some dairy or dairy alternatives
• Eat some beans, pulses, fish, eggs, meat
• Unsaturated oils
• Drink 6-8 glasses of water a day

Question 24

Exercise

Answer 24

Adults should do some type of physical activity every day (30 mins). Exercise just once or twice a week can reduce the risk of heart disease or stroke.

Question 25

Adults should aim to (exercise):

Answer 25

• do strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week
• do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
• spread exercise evenly over 4 to 5 days a week, or every day
• reduce time spent sitting or lying down and break up long periods of not moving with some activity

You can also achieve your weekly activity target with:

• several short sessions of very vigorous intensity activity
• a mix of moderate, vigorous and very vigorous intensity activity

Question 26

Obesity definition

Answer 26

an abnormal or excessive fat accumulation that presents a health risk

Question 27

obesity causes

Answer 27

Causes

Obesity is generally caused by consuming more calories, particularly those in fatty and sugary foods, than you burn off through physical activity. The excess energy is stored by the body as fat.

Question 28

BMI equation

Answer 28

Calculating BMI: weight/ height²

• Not used to diagnose obesity, because people who are very muscular can have a high BMI without much fat
• A better measure of excess fat is waist size

Question 29

obese BMI

Answer 29

>30

>40 = very obese

Question 30

Obesity is not distributed equally:

Answer 30

• Ethnicity
• Sex
• Local inequalities
• Deprivation levels
  Inequality gap between those in deprived and affluent areas- obesity higher in deprived regions

Question 31

why does obesity matter

Answer 31

• Cancers
• Mortality
• CVD
• Liver
• Repro complications
• Osteoarthritis and back pain
• T2D
• Asthma
• Depression and anxiety
• Sleep apnoea

Question 32

weight loss recommendations

Answer 32

A combination of calorie restriction and increased activity are generally recommended: importantly, NICE specifically recommends the use of behaviour change approaches to support weight loss.

• Reduce calorie intake
  
  • Reduce calorie intake by 600kcal/day
• Exercise regularly
  
  • 150 hours of moderate exercise
• Psychological support i.e. behaviour changing techniques
• Medication

Question 33

weight loss medication

Answer 33

orlistat -→ energy wastage→ poo out fat

liraglutide →appetite suppression