1. 5. Health and Lifestyles

2. A Healthy Diet
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Variety of foods, balanced feeding, including
all nutrients needed
Cereals (bread, pasta, rice), potatoes,
legumes: base of feeding (carbohydrates: 5060 % of calories)
Less than 30 % fats, less saturated fats and
trans fatty acids
Proteins between 10 and 15 % of calories,
combining those of animal and vegetal origin
to be continued...

3. What do you know about it?
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Medical specialties: cardiology, pediatrics,
hematology, endocrinology, ophthalmology,
physiotherapy, neurology, traumatology,
pathology, radiology, oncology
What is anorexia? And bulimia?
Addictions: alcoholism, ludomania...
What is Alzheimer’s disease?
If you are doubtful about a possible
pregnancy, where and when shall you go?

4. The Concept of HEALTH
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It’s a state in which an organism, free from illnesses,
exerts all its functions normally
PUBLIC HEALTH: art and science of organizing and
commanding community efforts with the aim of
foreseeing, recovering and restoring people to reach
the very best health level
There is a self perception of health, depending on
each person
There is also a statistical perception of health,
according to some values considered standard for the
whole population

5. Data from the
Encuesta Nacional de Salud de España
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2002: Life expectancy 79,9 years (83 w; 76.5 m),
figure exceeded by Italy and Sweden. EU average 81.5
w, 75 m
Positive self-assessment in general, lower for women.
Intermediate position in EU (Table at your textbook,
p.68)
2003: 33 % usual smokers. In 2006, it reduced almost
9 %, because of the banning Tobacco’s Law, and in
2007 it reduced 5 %
The use of alcohol and other drugs is still an
increasing serious problem. At present a 56.1% of
older than 16 y.o. usually consume alcohol. It’s the
second country in use of cannabis

6. 
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Obesity: 13.3 % older than18 y.o. and 24.8 % child
population is overweight
BMI (Body Mass Index):
BMI = W (kg) / h2 (m2)
Morbidity : distribution of diseases in a population
and reasons for its death
Main reasons to be hospitalized: circulatory
apparatus, cancers, respiratory apparatus, digestive
apparatus and musculoskeletal diseases
Crude Death Rate: 900 deaths/100 000 inhabitants.
Cardiovascular (33.7 %), cancers (25.9 %)
Child Mortality: 4.1 children per 1000 live births

7. Data Updating (2010)
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Life expectancy at birth: 81.1 years, higher
than the EU-27 average (79.0)
Men: 77.8 y.o.; Women: 84.3 y.o.
Life expectancy at 65 y.o.: 20,0 y.o.; EU-27:
18.8 y.o.
Mortality due to cardiovascular diseases:
32.2 % ; tumors 26 % ; respiratory system...
Some 75.2 % men and 65.0 % women, make a
positive assessment of their health state

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AIDS: 77.4 % men diagnosed, average age 41
y.o.
TOBACCO use: 21.5 % women (>16 y.o.) and
31.5 % men, daily smokers
ALCOHOL intake: population from 16 y.o. and
older that consumed it the last 12 months: 68.6
% ; men 80.2 %, women 57.5 %. Some 31.4 %
declared they didn’t consume
Population of 18 y.o. or older: 15.4 % presents
OBESITY and 37.1 % OVERWEIGHT
Population from 2 to 17 y.o.: 9.4 % have
obesity and 19.2 % have overweight

9. Alzheimer’s disease
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Neurodegenerative disease with no cure that
involves a progressive loss of memory,
language and movement difficulties, inability
for everyday actions, change of personality
with confusion, anxiety, disorientation...
Alois Alzheimer (1906), identified it as a form
of dementia in older people
Progressive loss of neurons by accumulation
of amyloid beta (Aβ) protein deposits

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There is some genetic tendency
There are some external factors along the
illness’s development: unknown viruses,
agents that increase the risk of a vascular
accident (tobacco smoking), but some studies
are contradictory
Incidence increases with age. Since 65 years
on, the probability of having it is doubled
every 5 years
Other dementias produced by cerebral vascular
accidents are frequent but they are reversible

12. Diagnosis by brain imaging:
• Positron Emission Tomography (PET)
• Computed Tomography (CT scan)
• Magnetic Resonances (MRI) (left image)
They detect the loss of neurons and
the decrease of normal brain size
Neuropsychological Tests: questionnaires
to assess cognitive skills and detect
alterations in memory or attention
There is no treatment, there are only some
drugs that slow down the symptom
progression

13. Risky Sexual Behavior
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Besides the risk of pregnancy, when one has
sexual intercourse without any protection there
is the unnecessary risk of transmitting a
serious illness
The pregnancy test detects the feminine
hormone chorionic gonadotropin in urine
There is pregnancy when an ovum fertilized
by a spermatozoon (fertilized egg or zygote)
forms an embryo and attaches to the uterine
wall (implantation)

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It makes no sense to do the test immediately ,
because spermatozoa can survive some days
and pregnancy could happen later on
There is a drug to prevent pregnancy that
woman must take within 2 days after having
sexual intercourse
It’s about a hormonal dose called emergency
contraceptive pill (the morning-after pill) or
emergency postcoital contraception, that
modifies the menstrual cycle and prevents the
embryo implantation at the uterine wall
It is not abortive, because pregnancy never
happens

15. The morning-after pill prevents pregnancy
but it has side effects on woman’s health
to be avoided. It must be taken only
in case of emergency
Condom is the safest contraception
method and saves infection of
sexually transmitted diseases (STD),
like gonorrhea, syphilis,
hepatitis B or HIV (aids)

16. Nutrition and Teens
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During your teens some additional nutrients
are needed to help growing (11-16 y. girls)
(13-18 y. boys). Bone structures: 1300 mg
calcium daily: three pieces of dairy products
It depends on how much physical activity is
practiced: sedentary habits and fast
food(saturated fats and quick absorption
carbohydrates) generate overweight, a prelude
to obesity
Table of body mass index (BMI)

17. How are overweight (90) and obesity (95)
defined in men and women until 20 y.o.

18. Anorexia and bulimia
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Anorexia: a caloric ingest very much below
normality
Bulimia: ingest of a great amount of food
alternating with vomiting
Sònia’s case: BMI 13.8 kg/m2, at 5 % percentile
band and is 16 y.o. Amenorrhea. A year ago she
had a normal weight, but little by little she was
fearing to become too fat and started to lose weight
Anna’s case: she ate a lot and then vomited,
besides she was taking laxatives and diuretics

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These are disorders associated to
psychological risk factors
In anorexia: parental dependence, difficulties
to be independent, social and sexual isolation,
conceptual and abstract thought deficit
In bulimia: low self esteem, dissatisfaction
with body image, diets to control weight,
sexual activity, strict and emotionally cold
family

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Sònia’s case: she never had breakfast, she was
losing weight, her hair’s texture was changing and
it was even starting to fall...
Not well known genetic factors have an influence
there and a biochemical malfunction too
(decreasing in serotonin secretion) that makes the
food ingest decrease and causes a feeling of hunger
Psychological and personality factors have an
incidence: an excessive ambition, self requirement
and self requirement of excellence at school.
People for whom success is very important

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Prevalence in boys is lower. There are also
some girls and adult women to be affected.
Risky professions: dancers, gymnasts, models...
where the ideal image transmitted responds to
canons close to anorexia
In serious cases hospitalization is required
Therapies are bound to normalizing weight by
means of increasing between 200 and 400 g
daily. In some 10 or 12 days patients must be
able to ingest some 2500 kcal daily
A psychological therapy is also applied in order
to improve body image or family malfunctions

22. Obesity
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Social pressure and canons of ideal image can
convert a simple overweight into a torture

23. 
Anorexia and bulimia wreak havoc but obesity
is also an increasingly more serious problem.
Even one fourth of child population starts
suffering from it

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BMI > 40 kg/m2 : type 3 obesity
Morbid Obesity
Núria: 130 kg, 1.65 m high (BMI 47.8)
False “happiness” image. It is a serious illness
that gets other pathologies worse : hypertension,
hypercholesterolemia, diabetes 2, coronary
diseases, cancers (ovary, uterus, breast,
prostate), hypoventilation and sleep apnea,
osteoarthritis, legs venous failure,
gastroesophageal reflux, irregular menstruations
and infertility
Psychological disorders: depression, guilty
conscience or social marginalization

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A possible solution for Núria: bariatric surgery
It consists in surgically modifying the
gastrointestinal stretch of food, by reducing the
stomach’s size or making a bypass to
intermediate zones of the bowels, in order to
diminish nutrient absorption
It is used when other therapies, like food
regimens, have failed
The operation is performed by laparoscopy
(little incisions and making an air chamber in
abdomen)

28. Sports and Health
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Practicing sports in a healthy way has effects
on life quality, it can improve your state of
health and contribute to emotional and
psychological equilibrium
Sport as a healthy life habit doesn’t imply to
become an Olympic athlete or a sportsman
Sport as a show is a mass culture phenomenon
that “everybody” practices by screaming at a
stadium or sit at their home couch

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But a healthy sport implies a well-being feeling, a
personal balance... the well known Romans ’ motto:
MENS SANA IN CORPORE SANO
It is just the contrary of a sedentary life that
involves a risk factor for cardiovascular, respiratory
and musculoskeletal diseases, hypertension,
diabetes, obesity and neurodegenerative diseases
Between 9 % and16 % of deaths in developed
countries are due to a sedentary lifestyle
A regular practice of sports diminishes the risk of
falling ill in the future and increases life expectancy

30. The Dark Side of Sports
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In a professional level (doping), in a personal
level (muscle dysmorphia or bigorexia)
Dysmorphyic people (men between 18 and 35
y.o.) feel themselves as too skinny and need to
get more muscular mass by any means
They follow a regimen rich in proteins and
poor in carbohydrates and fats
They use anabolic steroids that make increase
muscular mass and make easier to recover after
an intense effort

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But they have many side effects : hepatic
tumors, cancer, arterial hypertension, increase
of “bad” cholesterol (LDL) and decrease of
HDL (the “good” one), acne, shivering,
hypogonadism (atrophy of the gonads) and
decrease of spermatozoa motility (infertility),
obsessive-compulsive personality disorder
with changes in mood and depression. During
adolescence it can stop growing

34. Mental Health and Addictions
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Health state o mental equilibrium is related not
only to mental illnesses, but also to a psychic
and emotional equilibrium given by your own
life experiences, relations with other people,
culture and education, work, etc.
We can feel psychic and emotional discomfort
in social activities and interpersonal relations,
in couple relations, in family relations or at
school, work or due to a certain individual
reality

35. 
Why do we feel such a discomfort? Because
we don’t understand other people or feel that
others don’t understand us, because we feel
pressed for excessive decisions o
expectancies... Because we think that we can
be attacked, insulted...

36. Addictions Can Be Very Different
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They are typified by a behavioral, physical
and/or psychic dependence to toxic substances,
objects or activities that become essential
Ludomania: videogames, games of chance,
gambling, lotteries (= pathological games)
Drug addition: drugs, tobacco and alcohol
New addictions: addiction to the Internet
(websites, chats, smartphones), addiction to
work (“workaholic”) or shopping
(“shopaholic”)

37. Key Features to Addictions
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Tolerance: a higher dose is needed each time
Abstinence: characteristic syndrome where more
consumption is required to overcome it
Dependence: persistent desire of consuming,
with unsuccessful efforts to overcome it
Abandonment of usual activities: a lot of time is
devoted to get the addictive substance and all
other activities are left behind
Conscience: there may be a conscience of the
negative effects but people go on with addictive
practice

38. Alcoholism

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Alcoholism affects psychological aspects but it has
also an organic facet that affects the liver, the
gastrointestinal tract, the musculoskeletal and
cardiovascular systems
It involves malnutrition and lack of vitamins and
indispensable nutrients
60 % of population >16 y.o. usually consume
alcohol in Spain
60 % of young people between 14 and 18 y.o. has
got drunk occasionally and more than12 % of
young population is in hard-drinking risk : they
consume at least 50 cm3 of pure alcohol (M) and
30 cm3 (W)

40. 
One out of three cases of medical
emergency due to addictions has alcohol
as the main cause
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Many road accidents can be attributed to
alcohol and drug abusing
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There is a social tolerance to alcohol
addiction higher than to other addictions
because of historical and cultural reasons

41. Drugs: What About Cannabis?
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Psychoactive drugs abusing increases in Spain
but risk perception linked to these substances
decreases
Higher prevalence in EU of abusing different
drugs in students from 15 to 16 y.o., specially of
cannabis: 43 % use in 2004
It is not justified the idea that this drug is
innocuous, neither some fake beliefs attributed
to its use

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There are more scientific evidences every day
about the relation between its intensive use and
becoming mentally disturbed or having several
mental diseases
Hemp (Cannabis sativa) by-products, mainly
hashish and marijuana, contain more than 60
cannabinoids, substances with psychoactive
effects, the foremost of which is δ-9-THC
(tetrahydrocannabinol)
In order to lower the price, preparations are
impoverished mixtures, presented in hashish
resin and a lot of contaminants: farming
fertilizers, tars, egg white or condensed milk

44. Effects of Using Cannabis
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Short-term: deterioration of motor coordination,
increase of hunger, mouth dryness, tachycardy,
euphoria, anxiety, feeling that time goes slowly,
altered perceptions, deterioration of reasoning
capacity and deliria (acute intoxication)
Long-term (usual use): altered perceptions,
psychotic disorders (delirious ideas and
hallucinations), anxiety disorder, permanent
organic harms in brain, cardiopulmonary
disorders

45. Tobacco and its
harmful components:

46. The NAOS Strategy
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Ingest of fruits and vegetables must be
increased until some 400 g/day (5 daily
rations of these foods)
Moderate the intake of products rich in simple
carbohydrates (sweets, confectionery, soda)
Decrease the use of salt to < 5 g/day, salt with
iodine
Drink between 1 and 2 L water per day
NAOS stands for
“Nutrition, Physical Activity and Obesity Prevention Strategy”

48. 9.
10.
Never do without a whole breakfast: dairy
products, cereals (or bread, cookies) and
fruits, devoting between 15 and 20 minutes.
So the need for consuming less nutritive food
before noon decreases and physical and
intellectual efficiency is improved
Involve all the family members in activities
related to feeding: go shopping, choosing a
weekly menu, preparing and cooking food,
etc.

49. To learn more
Enquesta nacional del Ministeri de Sanitat i Consum:
www.msc./estadEstudios/estatisticas/encuesta
Nacional/home.htm
 Instituts nacionals de salut dels Estats Units:
http://salud.nih.gov/centros .asp
 Pàgines WEB de la Generalitat de Catalunya amb
informació i orientació sexual per als adolescents:
www.gencat.net/salut/depsan/units/sanitat/pdf/primvegad
es.pdf.
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50. www.sexejoves.gencat.net/ics_webjove/AppPHP/index.
php
Associació contra l’anorèxia i la bulímia:
www.acab.org
Centers for Disease Control and Prevention (USA):
www.cdc.gov/nccdphp/dnpa/bmi
Informe anual 2006 de l’Observatori Europeu de les
Drogues i Toxicomanies:
www.pnsd.msc.es/Categoria3/coopera/pdf/Informe2006.
pdf
Portal europeu Elisad sobre alcohol, drogues i altres
addiccions:
www.addictionsinfo.eu/startpage.php?select_lang=spa