HLTB22

September 7, 2021
Lecture 1
Session I: Biological basis for the determinants of health; Scientific Method
Theoretical Framework
Biological determinants of health
Car metaphor
● The life of a car depends on 4 elements
○ Design
○ Accidents
○ Maintenance
○ Aging
Genes
● Less than 2% of human illness is attributable to a faulty single gene locus
● Genes matter in relation to other components of health
● Examples:
○ prader-Willi syndrome and Angelman syndrome (Syndromes that result from
mutations in an imprinted region of the genome)
○ Sickle cell anemia
External Agency
● The environment as a threat to the well-being
○ Pathogens
○ Injuries
○ Malignancy
Internal Agency
● Connotes an appropriate and constant interplay of the host and environment
● Environmental interfacing with a healthy body has 2 primary expressions
○ Fuel
○ Energy
● Examples: heart disease, arthritis, type II diabetes, and strokes
Aging
● Aging is the result of entropic decay inherent in the metabolic process, which is partially
but incompletely offset by countering mechanisms
● The decline in function in 12 organ systems has an underlying rate of 0.5% per year in all
systems, from ages 30 through 70
Scientific Method
● The scientific method is the systematic logical approach to gathering information and
reaching conclusions
○ Make careful observations and ask questions about those observations
 ● Formulate a testable hypothesis that provides an explanation about the observations and
answers to the questions
● Provide a prediction and then an experiment with two groups, control and experimental,
to determine whether the hypothesis is supported
○ Both groups should be treated identically except for one independent variable, the
factor whose effect the experiment is designed to reveal
● Reach a conclusion based on the results of the experiment, and review statistical
significance
● Develop new questions and additional experiments to further refine the conclusions
● Over time, after many experiments have repeatedly confirmed related hypotheses, a
theory may be developed that offers a broad-ranging explanation for some aspect of the
physical universe
● The scientific process consists of making observations, formulating questions, creating
testable hypotheses, conducting experiments, drawing conclusions, revising hypotheses,
and designing new experiments
Example
● Eating a bowl of oatmeal lowers blood cholesterol levels
● What observations led to this claim? Oatmeal contains to the soluble fiber B-glucan
○ Soluble fiber binds to bile in the intestines, preventing bile from being reabsorbed
into the body
○ Bile is high in cholesterol
○ Bile count to soluble fiber is removed from the body in feces
○ The liver then removes cholesterol from the blood to synthesize new bile
● Formulate a hypothesis. In this case, the hypothesis might be that B-glucan in oatmeal
lowers blood cholesterol levels
● They would then make a prediction that will hold true if the hypothesis is correct:
○ If oatmeal consumption lowers blood cholesterol levels, then a person will lower
his or her cholesterol level by eating a bowl of oatmeal a day for 6 weeks
● Experiment:
○ To test this hypothesis, we could gather adults whose LDL cholesterol levels are
similar- between 4.5 mmol/L and 5.5 mmol/L- and divide them randomly into
groups
○ Volunteers in the experimental group consume a 1 oz packet of oatmeal per day
for 6 weeks
○ Those in the control group eat a 1 oz packet of farina, a wheat cereal lacking
B-glucan. At the end of 6 weeks, the blood of LDL cholesterol of each volunteer
is measured again
Inductive reasoning
● Involves the accumulation of facts through observation until finally there are enough
facts to draw a conclusion or develop a testable hypothesis
Deductive Reasoning
● Involves making a general statement, often in the format of an “if-then” statement, then
drawing more specific conclusions from it
○ In deductive reasoning, a series of observations leads to a general statement that
often sets the stage for further experimentation
September 14, 2021
Lecture 2
Session 2: Cell theory and application to public health
The Cell Theory
● The cell theory is a fundamental organizing principle of biology that states the following:
○ The cell is the smallest unit of life
○ Cells make up all living things, including unicellular and multicellular organisms
○ New cells can arise only from preexisting cells
● Prokaryotic cells, such as bacteria, lack internal membrane-bound organelles
○ Has a plasma membrane, DNA region (no nucleus), cytoplasm, ribosome, and cell
wall
● Eukaryotic cells, such as the generalized animal cell, have internal membrane-bound
organelles

○
○ Plasma membrane
■ Regulates movement of materials into and out of the cell
○ Cytoplasm
■ The material surrounding the nucleus
○ Lysosome
 ■ Digests substances brought into cell and destroys old parts of cells
○ Mitochondrion
■ Provides cell with energy through the breakdown of glucose during
cellular respiration
○ Nucleus
■ Contains DNA and controls cellular activity
○ Nucleolus
■ Produces components of ribosomes (RNA and proteins)
○ Ribosome
■ Site where protein synthesis begins
○ Rough endoplasmic reticulum
■ Studded with ribosomes and produces membrane
○ Smooth endoplasmic reticulum
■ Detoxifies drugs and produces membrane
○ Golgi complex
■ Sorts, modifies and packages proteins
○ Microfilament
■ Plays a role in muscle contraction and cell division
○ Microtubule
■ Maintains cell shape and forms tracks on which vesicles move
○ Centrioles
■ May function in cell division
Basic and Specialized Cell Functions
● Basic functions
○ Necessary for the survival of cell itself
○ Eight types of basic functions
■ Obtaining nutrients and O2 from the environment
■ Converting nutrients and O2 into energy
■ Eliminating waste product from conversions
■ Synthesizing proteins for cell growth
■ Controlling the exchange of materials in and out of the cell
■ Moving material around within the cell
■ Monitoring the environment around the cell
■ Reproducing, except in case of nerve or muscle cell loss from disease or
trauma
○ Specialized functions
■ Involve modification of basic cell function
■ Contribute to survival of system or body
Cell Structure and Function
● These specialized cells have structures that reflect their particular functions
 ○ Sperm is specialized to be highly mobile. In contrast, an egg is specialized to be
large, immobile and packed with the material needed to initiate the development
○ A mature red blood cell, devoid of most organelles, is specialized for carrying
oxygen
Organelles
● Nucleus
● Endoplasmic reticulum
● Golgi apparatus
● Lysosomes
● Mitochondrion
Nucleus
● Contains almost all of the genetic information of the cell, DNA
● Surrounded by the nuclear envelope, a double membrane that allows communication
through nuclear pores
Endoplasmic Reticulum
● The endoplasmic reticulum (ER) is continuous with the nuclear membrane and consists
of two regions: rough ER and smooth ER
● An extensive network of channels connected to the plasma membrane, the nuclear
envelope, and certain organelles
● Two types of endoplasmic reticulum:
○ Rough endoplasmic reticulum
■ Has ribosomes attached to its surface and modifies proteins made by the
ribosomes
○ Smooth endoplasmic reticulum
■ Lacks ribosomes and detoxifies certain drugs and produces phospholipids
for incorporation into membranes
Golgi Complex
● The route by which protein-filled vesicles from the rough ER travel to the Golgi complex
for processing and eventual release
● A series of interconnected flattened membranous sacs. Proteins are packaged in vesicles
and transferred to the Golgi complex for processing and packaging
● Vesicles carrying proteins from the RER arrive at the “receiving” side of the Golgi
complex and empty their contents to the inside, where the proteins are modified
● Vesicles containing the modified proteins leave the “shipping” side of the Golgi complex
and travel to their specific destinations
Lysosomes
● Contains about 40 digestive enzymes that break down macromolecules, old organelles,
and invaders
● Lysosome formation and function in intracellular digestion
 ●
Mitochondria
● Sites of cellular respiration, providing cells with energy through the breakdown of
glucose to produce ATP
● Double membrane organelle
● Contain inner foldings, called cristae, that provide increased membrane surface for
cellular respiration
● Singular: mitochondrion
Cellular Respiration and Fermentation in the Generation of ATP
● Cell metabolism includes all of the chemical reactions that take place in a cell
○ Organized into metabolic pathways
○ Each pathway contains a series of steps
○ Specific enzymes speed up each step of the pathway
○ May be catabolic or anabolic
● Four phases of cellular respiration
○ Glycolysis
○ Transition reaction
○ Citric acid cycle
○ Electron transport chain
● Phases occur continuously in the cell
Phase 1
● Glycolysis is a sequence of reactions in the cytoplasm
○ Occurs in the cytoplasm
○ Splits glucose into two pyruvate molecules
○ Generates a net gain of two ATP and two NADH molecules
○ Does not require oxygen
Phase 2
● The transition reactions take place inside the mitochondrion and link glycolysis and the
citric acid cycle
 ○ Occurs within the mitochondria
○ Removes carbon as CO2 from each pyruvate
○ Generates an acetyl molecule and NADH molecule from each pyruvate broken
down
Phase 3
● The citric acid cycle occurs inside the mitochondrion and yields two molecules of ATP
and several molecules of NADH and FADH2 per molecule of glucose
○ Occurs within the mitochondria
○ Acetyl CoA enters the citric acid cycle
○ Produces two ATP, two FADH₂ and six NADH molecules and releases CO₂ as a
waste product
Phase 4
● Electron transport chain: the electron transport chain is the final phase of cellular
respiration
○ Occurs across the inner membrane of the mitochondria
○ Releases energy that results in 32 ATP molecules
○ Electrons from FADH2 and NADH are transferred from one protein to another
until they reach oxygen
○ Requires oxygen

Fermentation
● Breakdown of glucose without oxygen
○ Takes place entirely in the cytoplasm
○ Is very inefficient, compared with cellular respiration, resulting in only two ATP
○ Lactic acid fermentation takes place in the human body in muscles during
strenuous exercise when the oxygen supply runs low
■ Muscle pain is caused partly by the accumulation of the was product,
lactic acid
■ Soreness disappears as lactic acid is converted back to pyruvate in the
liver
Homeostasis
● The constant adjustment made by the organ systems to respond to changes in the internal
and external environments while limiting too large variations of the internal condition
required for life
○ Depends on the nervous and endocrine systems, which are mostly responsible for
internal communication
○ Maintained primarily through negative feedback mechanisms
● Receptor that detects a change in the internal or external environment
● Control centre (such as the brain) that integrates the information coming from all
receptors and selects an appropriate response
● Effector (such as a muscle or gland) that carries out the response
● Homeostatic regulation of body temperature by negative feedback mechanisms
Lecture 3
Genes, DNA, and Biotechnology
Basic properties of DNA
● Long strand of 5-carbon deoxyribose
○ Alternating with a phosphate group
● Nitrogenous bases
○ Four types
○ All information stored in bases
● Double strand
○ Bound by hydrogen bonds
● Genome
● DNA is a double-stranded molecule that twists to form a spiral structure called a double
helix
○ Following the rules of complementary base pairing, adenine pairs only with
thymine, and cytosine pairs only with guanine
● DNA is composed of four nucleotides
○ Base pair
○ Nucleotide
○ Sugar
○ Phosphate
The race to discover DNA structure
● Maurice Wilkins
● Rosalind Franklin
The birth of Molecular biology
● Watson and crick's model attracted great interest immediately upon its presentation
● “Central dogma of molecular biology” , which foretold the relationship between DNA,
RNA, and proteins, and articulated the “sequence hypothesis”
● Genetic code was based on non-overlapping triplets of bases, called codons
 ● Har Gobind Khorana and others deciphered the genetic code not long afterward (1966).
These findings represent the birth of molecular biology
Gene Expression
● Protein synthesis
○ Translation
■ Converts the nucleotide language of mRNA into the amino acid language
of a protein
○ Genetic code
■ Converts the DNA base sequence into an amino acid sequence
■ Codon
● “Words” in the genetic code
● A three-base sequence that translates into one amino acid
● Example: UUC on mRNA specified the amino acid phenylalanine
○ Stop codons
■ UAA, UAG, and UGA
■ Signal the end of a protein
■ Do not code for an amino acid
● How does DNA direct cellular activities
○ DNA codes for RNA, which codes for proteins
■ Proteins play structural or functional roles in cells
● Gene
○ Segment of DNA with instructions for producing a particular protein (or
polypeptide)
○ Expressed when the protein it codes for is produced
What DNA codes for?
● Protein-coding genes
○ Less than 2% of all nuclear DNA
● Ribonucleic acid molecules
● Regulatory sequences
● Repetitive sequences
● Sequences of unknown functions
When repetitive sequences get too long…
● Normal gene containing 10-26 CAG repeats
● Huntington’s Disease gene containing 35 or more CAG repeats
Inheritance: Gregor Mendel
● Detailed observation and notes
○ Developed ideas on how physical traits are passed from one generation to the next
● Conclusions
○ Law of segregation
■ Alleles
 ○ Law of independent assortment
■ Different genes that are not connected
● Dominant and recessive alleles
○ Homozygous
■ Same alleles
○ Heterozygous
■ 2 different alleles
● Multifactorial traits
○ Largely ignored by Mendel
○ Impacted by more than one gene
■ Often by environmental factors
Single Nucleotide Polymorphism (SNP)
● SNP location
○ Regions of DNA between genes
○ Within coding regulatory regions of genes
● Difference from Mendelian-type mutations
○ SNPs much more common in population
○ SNPs have lower correlation to phenotype
● A mutation is defined as any change in a DNA sequence away from normal. This implies
there is a normal allele that is prevalent in the population and that the mutation changes
this to a rare and abnormal variant. In contrast, a polymorphism is a DNA sequence
variation that is common in the population
How to detect genetic variation?
● Ability to affordably sequence individuals
○ Whole-genome analysis
● Genome-wide association studies
○ Identification of genetic similarities
■ Between unrelated people
Human Genome Project
● 1990: begun by
○ Department of energy
○ National institutes of health
● Goal
○ Understanding all genes that make up humans
● One of the largest and most collaborative scientific projects
● Risks
○ Technology for high-throughput sequencing inadequate
○ Bioinformatics completely underdeveloped
○ Data had potential to be misconstrued
● Results
 ○ Completed in 5 years
○ Spawned
■ Technologies, fields of study, and industries
Direct-to-Consumer (DTC) testing
● Offshoot of Human Genome Project goals
● Tests performed in laboratories
○ Receive samples from home collection
● Two dozen labs perform testing
○ Medical purposes
○ Nonmedical purposes
● Proponents
○ Privacy and personal empowerment
○ Low cost and ease of access
● Opponents
○ Easy misinterpretation of test results
○ Importance of discussions with physicians and genetic counsellors
● Future of DTC testing
Public Health Relevance
● Centers for Disease Control and Prevention (CDC)
○ Office of Public Health Genomes (OPHG)
● Genomics
○ Enabled deeper understanding of health risks
○ Provided methods to
■ Monitor public’s health
■ Investigate gene-environment interactions
The Public Health Wheel
Genetic Engineering
● Biotechnology
○ Field in which scientists make controlled use of living cells to perform specific
tasks
● Genetic engineering
○ A subset of biotechnology involving the manipulation of DNA for human
purposes
○ Some uses
■ Produce drugs and hormones
■ Improve treatments of human diseases
■ Increase food production from plants and animals
○ The basic idea behind genetic engineering is to join DNA from two or more
sources
● Recombinant DNA
○ DNA is made from two or more sources. Created when a gene of interest (one that
produces a useful protein or trait) is put into another piece of DNA
○ Steps in creating recombinant DNA
■ Restriction enzymes are used to cut genes of interest out of original DNA
and splice them into vector DNA. plasmids are common vectors (circular
pieces of DNA that exist separately from bacterial chromosomes)
■ Vector (recombinant plasmids) taken up by bacteria (new hosts cells)
■ Bacteria with genes of interest identified and isolated
■ Produce numerous copies of the gene (amplify the gene)
● Bacterial cloning
● Polymerase chain reaction (PCR)
● Applications
○ Environmental- example: oil-eating microbes that can withstand ocean conditions
○ Livestock- example: cows that produce more milk
○ Pharmaceuticals- example: gene pharming
■ Create transgenic animals that produce a protein with medicinal value in
their milk, eggs, or blood
■ Collect and purify protein
○ Raw materials- example: goats and bacteria genetically engineered to produce
spider silk proteins= pharming
○ Agriculture- example: crops genetically engineered to be resistant to pests
● The procedure for creating a transgenic animal that will produce a useful protein in its
milk
Lecture 4
Session 4: Epigenetics and Human Health
What is Epigenetics?
● C.H. Waddington’s original concept
○ He was describing the interaction between cell differentiation (epigenesis) and
genetic mutations during development
○ Waddington was describing what would become the field of molecular
development
● D.L. Nanney in the 1950s
○ Non-genetic “persistent homeostasis”
○ Equating epigenetics with cellular memory
○ Non-sequence-dependent mechanism of transmitting information fitted nicely
with a model of molecular mediation of cellular memory
● Do you want to use the word ‘epigenetic’ to describe a cellular memory, persistent
homeostasis in the absence of the original perturbation, or an effect on cell fate not
attributable to changes in a DNA sequence?
○ Go ahead. Waddington and Nanney will be pleased with you
● Do you want to describe a higher level of information that exists beyond the genome and
instructs genes how and when to switch on and off?
○ You are describing transcription regulation
○ Unless you are also describing the situation in the first point, you should not call
this epigenetic, even if you think it makes your research sound sexier.
 ● Epigenetics is the study of how your behaviors and environment can cause changes that
affect the way your genes work. Unlike genetic changes, epigenetic changes are
reversible, can be heritable, and do not change your DNA sequence, but they can change
how your body reads a DNA sequence
Epigenetic Modification
● Occurs through
○ Covalent modifications of DNA
○ Proteins that form the scaffolding for DNA packaging
● Impacts gene expression
○ Without changing the sequence of DNA
○ Changing phenotype, but not genotype
● Can be passed to future generations
Mechanisms of Epigenetic
● DNA methylation
○ Occurs at imprinting control regions
○ Can be reversed with demethylation
● Histone modification
○ DNA wrapping around a histone
○ Acetylation and deacetylation
■ Histone acetyltransferases
■ Histone deacetylases
The Dynamic Epigenome: Monozygotic Twins
● Genetics
○ Share identical genotypes
○ Have obvious phenotypic differences
● Fraga et al. (2005)
○ Can differ in the epigenome
■ DNA methylation
■ Histone modification
○ More differences in older twins
■ Who spend less time together
● These findings indicate how an appreciation of epigenetics is missing from our
understanding of how different phenotypes can be originated from the same genotype
Overnutrition During Fetal Development
● Greater birth weight
● More fat tissue
● Greater weight for height during childhood
● Long-term effects
○ May not emerge until puberty or later
● Insulin production
 ○ Maternal glucose
Severe Calorie Restriction
● The dutch hunger
○ Oct. 1944- May 1945
○ 400-800 calories per day
● Children conceived were of small gestational age
● As adults experience twice the risk of cardiovascular disease, higher rates of obesity, high
blood pressure, hospitalization rates
● Grandchildren were also of small gestational age
CRISPR case study
● CRISPR is a technology that can be used to edit genes
○ It's a way of finding a specific bit of DNA inside a cell
○ After that, the next step in CRISPR gene editing is usually to alter that piece of
DNA
Lecture 6
Body Defense Mechanism
The body’s three lines of defense against pathogens

First line of defense

● Physical barriers
○ Skin
■ Nearly impenetrable
■ Waterproof
■ Resistant to most toxins and enzymes of invading organisms
○ Mucous membranes
■ Line the respiratory and digestive tracts
■ Sticky mucus traps microbes
● Chemical barriers
○ Sweat and oil glands of the skin
○ The lining of the stomach
○ Urine
○ Saliva and tears
Second line of defense: defensive cells
● Phagocytes
○ (WBCs) that engulf pathogens
 ■ Neutrophils: arrive first
■ Macrophages: develop from monocytes that leave the circulatory system
● Eosinophils
○ Attack pathogens that are too large for phagocytosis, such as parasitic worms
● Natural killer (NK) cells
○ Also a type of WBC
○ Search out abnormal cells, including cancer cells, and kill them
○ Respond to any “suspicious character”
Second line of defense: defensive cells
● Interferons: slow viral reproduction
○ Small proteins secreted by a cell infected by a virus
■ Attract macrophages and natural killer cells that destroy infected cells
■ Stimulate neighboring cells to make proteins that prevent the viruses from
replicating
● Complement system: assists other defensive mechanisms
○ Group of proteins that enhances both nonspecific and specific defense
mechanisms
○ Destroy pathogens, enhance phagocytosis, stimulate inflammation

Second line of defense: inflammation

● Destroys invaders and helps repair and restore damaged tissue
● Four signs
○ Redness
○ Heat
○ Swelling
○ Pain
Second line of defense: Fever
● Fever: an abnormally high body temperature
○ Caused by pyrogens
■ Chemicals that reset the brain’s thermostat to a higher temperature
○ A mild or moderate fever helps fight the bacterial infection
○ A very high fever (over 105F or 40.6C) is dangerous

Third line of defense

● Adaptive immune response
○ Important characteristics
■ Specificity: directed at a specific pathogen
■ Memory: remembers the pathogen and attacks it so quickly that illness
does not result upon second exposure
Pop Quiz
● If a pathogen penetrates nonspecific physical and chemical surface barriers, it breaks
through the
○ First line of defense
● Which of the following is not a strategy of the body to defend against foreign organisms
and cancer cells?
○ Antibiotic pills
Antibody-Mediated Responses and Cell-Mediated Responses
● Antibody-mediated immune responses
○ Defend against antigens that are free in body fluids, including toxins or
extracellular pathogens
○ Effector B cells (plasma cells) use antibodies (Y-shaped proteins) to neutralize the
antigen
● Cell-mediated immune response
○ Protect against cancer cells and body cells that have become infected with viruses
or other pathogens
○ Cytotoxic T cells cause cancer cells and infected body cells to burst
Overview of the adaptive immune response

Antibody-mediated immune response

Cell-Mediated immune response

Overview of the adaptive immune response

The immune response to viral infections
● Innate immune response
○ General response to ANY infections
○ Innate immune response cells secrete interferons and other chemicals (cytokines)
○ Interferons interfere with virus replication
○ Phase 2 is triggered
● Adaptive immune response
○ Specific responses to the infection
○ Starts after 6-8 days
○ Involves two types of white blood cells
■ T cells (cellular response)
■ B cells (antibody response)

Lecture 7
Disease-causing organisms
● Include bacteria, viruses, protozoans, fungi, parasitic worms, and prions
● Virulence
 ○ The relative ability of a pathogen to cause disease
○ Determined by
■ Ease with which pathogen enters the body
■ Degree and type of damage to cells
● Pathogens
○ Virus
Viruses
● Viruses are responsible for many human illnesses
● Not considered living organisms
Structure
● Much smaller than bacteria
● Genetic material (DNA or RNA) surrounded by a protein coat, a capsid
● Some have an outer envelope studded with glycoproteins

Steps in Viral Replication

Viruses
● Some viruses cause cancer
○ Insert genes into host cell chromosomes near genes that regulate cell division
● Viruses are difficult to destroy
 ○ Hard to kill a virus inside a host cell without killing the host cell itself
○ Antiviral drugs often block a step in viral replication
● Review the possible effects of animal viruses on cells
● Best way to prevent viral infections is through:
Possible effects of the animal virus on cells

Bacteria
● Bacterial enzymes and toxins: cause direct tissue damage and may allow bacteria to
spread
○ Many toxins are released into the bloodstream
○ Disease symptoms depend on what areas are affected by a particular toxin
● Beneficial bacteria
○ Food production (yogurt, cheese)
○ Environment (decomposers, chemical cycles)
○ Genetic engineering
○ Normal inhabitants of the body that keep harmful organisms in check and produce
Vitamin K
1st Genetically engineered microbe
● Pseudomonas putida
● Ananda Mohan Chakrabarty
○ 1938-2020
Bacteria
● Reproduction
○ Very rapid, asexually, by binary fission
● Adaptive mechanisms
○ Flagella: allow for movement and spread of infection
○ Pili: used for attachment
○ Capsule: used for adherence and evading immune system
● Prokaryotes: lack of a nucleus and other membrane-bound organelles
 ○ Cell wall of peptidoglycan
● Three shapes
○ Sphere (coccus)
○ Rod (bacillus)
○ Spiral (spirilla)
Antibiotics
● Antibiotics are chemicals that inhibit the growth of bacteria
○ Disrupt processes in bacteria but not in human cells
○ Prevent synthesis of cell walls
○ Block protein synthesis
● Antibiotic resistance
○ When bacteria become resistant, antibiotics are no longer effective
○ Made worse by overuse and misuse of antibiotics
○ Example: MRSA, methicillin-resistant Staphylococcus aureus
Antibiotic Resistance
● Antibiotic resistance poses a grave and growing global problem: a World Health
Organization report released April 2014 stated, “this serious threat is no longer a
prediction for the future, it is happening right now in every region of the world and has
the potential to affect anyone, of any age, in any country. Antibiotic resistance… is now a
major threat to public health”

●
Slowing spread of antibiotic resistance
● Slowing spread of antibiotic resistance
○ Use antibiotics responsibly
○ Do not insist on antibiotics against the doctor’s advice
○ Take antibiotics exactly as prescribed
○ Reduce the risk of infection by washing hands frequently, rinsing fruits and
vegetables, and cooking meat thoroughly
Protozoans
 ● Single-celled eukaryotic organisms
● Cause disease by producing toxins and enzymes that prevent the normal functioning of
host cells
● Responsible for many diseases, including sleeping sickness, amebic dysentery, giardiasis,
and malaria
Fungi
● Eukaryotic organisms
● Obtain food by secreting enzymes that digest cells
● Very few fungi cause human disease
● Examples of fungal infections included athletes foot and ringworm
● Most can be cured with antifungal drugs
○ Target fungal cell membranes, which are slightly different from those of human
cells
Parasitic Worms
● Parasitic worms are multicellular animals whose life cycle involves a close physical
relationship with a host
○ Usually cause harm to, not the death of, host
○ Examples include flukes, tapeworms, and roundworms
● Cause disease by releasing toxins, feeding on blood, or competing with the host for food

Prions
● Prions are infectious particles of proteins
○ Misfolded versions of a protein normally found on the surface of nerve cells
● Prompt host protein to change its shape to the abnormal form
● Cause transmissible spongiform encephalopathies (TSEs), which result in brain
degeneration and death
● Animal TSEs: mad cow disease, scrapie (sheep), chronic wasting disease (deer and elk)
● Human TSE: Creutzfeldt-Jakob disease (CJD)
Pop Quiz
● A new antibiotic is introduced that will destroy only organisms lacking a nuclear
membrane. A dispute develops over its safety when used by people. What arguments
would you use in this discussion?
○ Human cells have nuclear membranes, so the antibiotic will not directly harm
people
○ However, there are many beneficial bacteria (lacking nuclear membranes) that
this new antibiotic might well wipeout
○ This may produce indirect harm to humans
● Bacteria that normally live on or in the body and prevent other bacteria from becoming
too numerous are referred to as
○ Beneficial bacteria
 ● Vibrio cholerae causes Asiatic cholera. It has a corkscrew shape, so we would say it has
this form
○ Spirillum
Spread of a Disease
● Direct contact
○ Example: STDs
● Indirect contact, including inhalation
○ Example: many respiratory infections
● Contaminated food or water
○ Examples: hepatitis A, Legionnaires disease
● Animal vectors
○ Lyme disease
■ Deer ticks are the vectors
■ Caused by a bacterium
■ Pain, swelling, and arthritis may develop
● Cardiovascular and nervous system problems may follow the
arthritis
● Intravenous (IV) drug use
○ Example: HIV and hepatitis C can be spread by sharing needles in IV drug use

Lecture 8
Global Trends in Emerging Infectious Diseases
Characteristics of Infectious Diseases that set them apart from other human diseases
● What is the perpetual challenge?
○ Potential for unpredictable and explosive global impact
○ Frequent acquisition by host of durable immunity against reinfection after
recovery
○ Reliance of disease on a single agent without requirement for multiple cofactors
○ Transmissibility
○ Potential for becoming preventable
○ Potential for eradication
○ Evolutionary advantage over human host because of replicative and mutational
capacities of pathogens that render them highly adaptable
○ Close dependence on the nature and complexity of human behavior
○ Frequency derivation from or coevolution in other animal species
○ Possibility of treatment for having multiplying effects on preventing infection in
contacts and the community and on microbial and animal ecosystems
Broad Categories of Infectious Diseases
Four patterns of disease
● Sporadic diseases
○ Occur occasionally at unpredictable intervals
○ Affect a few people within a restricted area
● Endemic diseases
○ Always present and pose little threat
○ Example: common cold
● Epidemic diseases
○ Occur suddenly and spread rapidly to many people
○ Example: smallpox
● Pandemic
○ Global outbreak of disease
○ Example: HIV/AIDS, Covid-19
Epidemiological Triangle
● Agent: a factor (e.g., a microorganism, chemical substance, or form of radiation) whose
presence, excessive presence, or (in deficiency diseases) relative absence is essential for
the occurrence of a disease
● Host: a person or other living animal, including birds and arthropods, that affords
subsistence or lodgment to an infectious agent under natural conditions
● Environment: the domain in which disease-causing agents may exist, survive, or originate
Four factors play important roles in the emergence or reemergence of diseases
● Development of new or drug-resistant organisms
 ● Environmental change that affects the distribution of organisms
● Population growth
● Failure to vaccinate
Methods of outbreak investigation
● Define the problem: (is there an outbreak?)
● Appraise the data: for example, from clinical observations, the epidemic curve, the
incubation period, attack rate, and case mapping
● Formulate the hypothesis: based on data review, what caused the outbreak?
● Confirm the hypothesis: identify additional cases; conduct laboratory assays to verify
causal agent
● Draw conclusions and formulate practical application
What is the basic reproduction number (R0)? And why is it important?
● The basic reproduction number is defined as the average number of secondary cases
caused by a single infectious individual in a totally susceptible population
● Infectious period
○ This is the duration that a person infected is able to transmit that infection to
another human- how long a person with the disease is contagious. Longer
infectious periods mean higher R0 values
● Mode of transmission
○ This is how the disease is spread. Airborne infectious diseases, like the flu, will
spread more quickly than those requiring physical contact to be transmitted, like
HIV or Ebola. Therefore, airborne infections tend to have higher R0 values
● Contact rate
○ This refers to how many people a person with the disease can be expected to
come into contact with. This variable is not specific to a disease like the first two.
Rather it is impacted by numerous factors, including location and public health
measures in place, such as quarantines or travel bans. This factor is considerably
modifiable
Microbial Disease Cycle
● Pathogen
● Reservoirs of infection
○ Zoonotic diseases
● Transmission
○ Direct contact
○ Indirect contact, including inhalation
○ Contaminated food or water
○ Animal vectors
○ Intravenous (IV) drug use
● Portals of entry
● Portals of exit
Formulate the Hypothesis
● The contagion: the chain of contagion involving bats and pigs is reminiscent of the trail
of the Nipah virus (which infects cells in the respiratory and nervous systems, the same
cells as the virus in the movie) that originated in Malaysia in 1997, which similarly
involved the disturbance of a bat colony by deforestation
● Most recent outbreak - Kerala, India
Factors that determine where new infectious diseases are likely to emerge
● Rate of human population growth
● Density of the human population
● Number of species of wild mammals
Steps in Viral Replication

What is the Case Fatality rate?

● Single overriding communication objective (SOCO)
● The main message to your target audience, by which you would like to achieve your
communication aim
● What is the ONE message you want the audience to take away from this
interview/report?
● “We are isolating the sick and quarantining those who we believe were exposed”
Pop Quiz
● A few children were infected with Chickenpox in a small town in central Canada. The
disease did not spread beyond the 3 children that were initially infected. Which pattern of
disease does this event reflect?
○ Sporadic
● There are several factors that play a role in the reemergence of old diseases. Which of the
following is an example of a re-emerging disease?
○ Tuberculosis
● SARS can be considered a(n):
○ Emerging disease and epidemic
Lecture 9
Cardiovascular Disease
The Prevalence of Cardiovascular diseases
● Cardiovascular disease is the single biggest killer of men and women globally
● Affects slightly more men than women, until menopause
● However, women who have heart attacks are twice as likely as men to die in the
subsequent weeks
Top causes of deaths in Canada

Blood Clots
● Thrombus: stationary blood clot that forms
○ Along the wall of a blood vessel or within the heart where it may obstruct blood
flow
○ In the deep veins of the legs or pelvis when blood flow is sluggish
● Embolism: blockage of a blood vessel (often a thrombus that breaks free), floats through
the circulatory system and lodges in a small vessel, where it can block blood flow and
cause tissue death beyond that point
Treatments for Blood Clots
● Blood thinning drugs
○ Warfarin
○ Heparin
● Clot dissolving drugs
○ Tissue plasminogen activator (t-PA)
Blood pressure
● Blood pressure is the pressure exerted by blood on the walls of the vessels
● Systolic value is the pressure when the heart is contracting
● Diastolic value is the pressure when the heart is relaxing
Hypertension= high blood pressure
● Silent killer
● Can cause fatal problems such as the following:
 ○ Heart is made to work harder, so it enlarges
○ Kidneys (in response to reduced blood flow, release renin, which further increases
blood pressure)
○ Blood vessels
High blood pressure treatment
● Most physicians consider a blood pressure of 160/90 mm Hg to be high and to require
treatment
○ Treatment may involve
■ Lifestyle changes
■ Medication
● Diuretics to reduce blood volume
● Drugs that cause blood vessels to dilate
Aneurysm
● An aneurysm is a permanent distention in an artery wall caused by the pressure of the
blood flowing past a weakened area of that wall
● When the wall of an artery becomes weakened, the pressure of the blood flowing through
it may cause swelling outward like a balloon, forming an aneurysm
○ Caused by disease, inflammation, injury, or a congenital defect
○ Common locations include
■ Arteries in the brain
■ The aorta, the major artery leaving the left ventricle that carries blood to
body cells
● An aneurysm does not always cause symptoms, but it can be threatening
○ The primary risk is that it will burst, causing blood loss and depriving tissues of
oxygen and nutrients, a situation that can be fatal
○ Even if it does not rupture, it can cause life-threatening blood clots to form
○ Can be detected with either an MRI or ultrasound
○ Treatment includes surgical removal or applying support with a coil or a stent
Atherosclerosis
● A buildup of fatty deposits in the walls of arteries
○ Fueled by an inflammatory response
○ LDL accumulation also further stimulates body’s defense system
○ May narrow the artery, which reduces blood flow
■ Can be fatal if this occurs in the heart (heart attack) or brain (stroke)
● Atherosclerosis, a low-level inflammatory response in the wall of an artery, is associated
with the formation of fat-filled plaques
Desirable Cholesterol Levels

Treatment for Atherosclerosis

● Healthy lifestyle
○ Control weight
○ Engage in regular aerobic exercise
○ Eat a heart healthy diet
● Medications
○ To lower blood pressure
○ To reduce blood cholesterol levels
○ To prevent formation of unwanted clots
■ Daily low-dose aspirin therapy
Coronary artery disease
● Fatty deposits of atherosclerosis occur in the coronary arteries that normally nourish heart
muscle
● Underlying cause of most heart attacks
● Angina pectoris (chest pain) serves as a warning that the heart muscle is not receiving
sufficient oxygen
Coronary angiography
● Diagnostic procedure in which high speed x-rays are taken as a contrast dye moves
through the coronary arteries
● Can show coronary artery blockage
Treatment: coronary artery blockage
● Medications (some dilate blood vessels)
 ● Surgical procedures
○ Angioplasty
■ A balloon is used to widen lumen of the artery; stents may be inserted to
keep the treated artery open
○ Coronary bypass surgery
■ A section of a leg vein is used to provide an alternate pathway, bypassing
a blockage between the aorta and a coronary artery
Balloon Angioplasty opens a partially blocked artery

In coronary bypass surgery, a section of a leg vein is removed

Heart attack
● Heart attack = myocardial infarction
● Part of the heart muscle dies because of an insufficient blood supply
● If the individual survives, the dead cardiac muscle is replaced by scar tissue, which
cannot contract, so part of the heart permanently loses its pumping ability
Heart failure
● Condition in which the heart becomes an inefficient pump
● Leads to shortness of breath, fatigue, and fluid accumulation
● Can result if a large enough section of heart muscle is damaged by a heart attack
● Symptoms can be treated with drugs
● Digitalis increases strength of heart contractions
● Diuretics reduce fluid accumulation
How could lipids lead to a myocardial infarction?
● The fat, arriving via low-density lipoproteins (LDLs), will be deposited on the arterial
lining, which stimulates inflammation
 ● The smooth muscle layer of the arteries will enlarge in response to the inflammatory (or
defense) cells, and that will result in thickening of the arterial walls
● Some defensive cells will take up more lipids, and fatty streaks will form on the arterial
wall. These processes produce plaques, which can narrow the passageway within the
artery, reducing blood flow. The plaque could rupture, and a blood clot may form
● At that point, the artery may be so narrow that the cells it serves will no longer get the
oxygen they need and then die
● When this happens in the heart, it can cause a heart attack
Cardiovascular disease and cigarette smoking
● Cigarette smoking
○ Each year cardiovascular disease kills many more people than lung cancer does
○ Smokers have a twofold to threefold increase in the risk of heart disease
○ Components of smoke product immediate effects on the cardiovascular system
○ Over the long term, smoking increases atherosclerosis
● Components of cigarette smoke
○ Nicotine
■ Increases heart rate
■ Constricts blood vessels, so raises blood pressure
■ Increases stickiness of platelets, so increases the risk of abnormal clots
○ Carbon monoxide
■ Prevents RBCs from transporting oxygen
● Smoking increases risk of atherosclerosis
○ It decreases protective high-density lipoproteins (HDLs)
○ It increases blood pressure
● Within 5 years of quitting smoking the risk of heart disease is reduced by 61% and the
risk of stroke by 42%
Lecture 11
Nutrition and Health I
● William Beaumont
○ (November 21, 1785- April 25, 1853)
○ Surgeon in the US Army known as the “Father of Gastric Physiology” following
his research on human digestion
● Alexis Martin was accidentally shot in the stomach from close range that injured his ribs
and his stomach
● Dr. Beaumont treated his wound, but expected Alexis Martin to die from his injuries
 ● The digestive system consists of a long tube, called the gastrointestinal tract, into
which accessory structures release their secretions
● Breaks complex organic molecules in food into smaller subunits that can be
absorbed into the bloodstream for delivery to cells
The Gastrointestinal Tract
● Regions of the GI tract are specialized to process food
○ Mechanical digestion
■ Physical breaking of food into smaller pieces
○ Chemical digestion
■ Breaking of chemical bonds so that complex molecules are broken into
smaller subunits
 ● The mucosa is a mucous membrane that lines the GI tract and secretes mucus that
lubricates and protects the GI tract
● The submucosa is a layer of connective tissue that contains blood vessels, lymph vessels,
and nerves
● The muscularis is made up of two layers of smooth muscle- one circular and one
longitudinal
● The serosa is a connective tissue covering that secretes a fluid to lubricate the outside of
the GI tract

Questions:
● Name any three organs of the digestive system that do not have mechanical or chemical
digestion taking place and state their functions
 ● Name any three organs of the digestive system where both mechanical and chemical
digestion are taking place

Teeth and Mechanical Digestion

● Functions of the mouth
○ Begins mechanical digestion
○ Begins chemical digestion
○ Monitors food quality
○ Prepares (moistens and manipulates) food for swallowing
● Teeth and mechanical digestion
○ Tooth decay
■ Bacteria digest trapped food and produce acid
■ Acid erodes enamel, causing a cavity
■ Plaque, an invisible layer of bacteria, mucus, and food, promotes tooth
decay
○ Gingivitis
■ Inflammation of the gums
■ Can develop into periodontitis
● Inflammation of the soft tissues around the tooth
● Tooth may become loose
Swallowing consists of (a) voluntary and (b) involuntary phases

● Peristalsis is a wave of muscle contraction that pushes food along the esophagus and the
entire remaining GI tract
● Esophagus: muscular tube that transports food from pharynx to stomach
● Food moved along esophagus and other regions of the GI tract by peristalsis
● Rhythmic waves of smooth muscle contraction
 ● No role in mechanical or chemical digestion
Stomach
● Structure
○ J-shaped expandable sac
○ Band of circular muscle (sphincter) guards opening at each end
○ If sphincter leading from esophagus into stomach is weak, then heartburn occurs
● Functions
○ Stores food and regulates its release to the small intestine
○ Liquefies food to form chyme
○ Begins chemical digestion of proteins
● Gastric glands
○ Some secrete hydrochloric acid (HCI)
■ Kills bacteria
■ Breaks down connective tissue of meat
■ Activates pepsinogen, which becomes pepsin
● Enzyme that digests protein
○ Intrinsic factor, a protein necessary for the absorption of vitamin B12 from the
small intestine
The stomach is an extremely hostile place. What protects it from digesting itself?
● Peptic Ulcer
● The duo proved to the medical community that the bacterium Helicobacter pylori (H.
pylori) is the cause of most peptic ulcer
○ Robin warren
○ Berry marshall
Small intestine
● Chemical digestion
○ Carbohydrates, proteins, fats, and nucleic acids are broken down into their
simplest forms
○ Performed by enzymes of the pancreas and small intestine, aided by bile produced
in the liver, stored in the gallbladder, and released into the small intestine
○ Aids in digestion and absorption of fats
● The features several structural modifications that increase its surface area, making it
especially effective in absorbing nutrients
● Surface area of small intestine is increased by
○ Pleated lining
○ Villi
○ Microvilli
● Each villus has a network of capillaries and a lacteal, a lymphatic vessel
○ Capillaries carry away absorbed products of protein and carbohydrate digestion,
as well as ions and water
 ○ Lacteal carries away absorbed products of fat digestion in the form of
chylomicrons
■ Chylomicrons: protein-coated products of fat digestion that are soluble in
water
● The small intestine is the primary site for chemical digestion and absorption
● The pancreas, liver, and gallbladder are accessory organs of the digestive system

Pancreas
● Pancreatic juice
○ Contains many digestive enzymes including
■ Amylase
■ Trypsin
■ Lipase
○ Contains bicarbonate ions important in neutralizing the acid in chyme
○ Drains from pancreas into pancreatic duct, which fuses with the common bile duct
before entering small intestine
Liver
● Largest internal organ
● Nutrient-laden blood from capillaries in villi of the small intestine travels through the
hepatic portal vein to the liver
● Portal system: vein linking two capillary beds
○ Hepatic portal system
■ Hepatic portal vein links capillary beds of the villi in the small intestine
with capillary beds in the liver
Digestive activities of the liver
● Produces bile
● Regulated blood glucose levels
● Packages lipids with proteins to form lipoproteins, which aid transport in the blood
● Removes poisonous substances
 ● Once liver adjusts composition of blood, the blood is returned to the general circulation

Disorders of the liver

● Cirrhosis
○ Fat and then scar tissue accumulate in the liver
○ Can be caused by excessive use of alcohol
● Hepatitis
○ Inflammation of the liver
○ Commonly caused by one of six viruses: A, B, C, D, E and G
○ Liver stops filtering bilirubin from the blood, resulting in jaundice (yellowish tint
to skin and whites of eyes)
Gallbladder
● Structure
○ Muscular, pear shaped sac
● Function
○ Stores, modifies, and concentrates bile produced by the liver
● Disorder: gallstones
○ Cholesterol and other substances build up around a particle
○ Can be surgically removed
Major digestive enzymes

Large Intestine
● Materials that have not been absorbed by the small intestine move to the large intestine
● Regions of the large intestine
○ Structure
■ Ascending (right); transverse (top); descending (left)
○ Functions
■ Absorbs water and ions
■ Contains beneficial bacteria that produce vitamins
○ Material left in the large intestine after passing through the colon is called feces

Disorders of the colon

● Diarrhea: material passes through colon too rapidly and not enough water is absorbed
● Constipation: material passes through colon too slowly and too much water is absorbed
Canada's Food Guide

Lipids
● Provide nine calories per gram
● Include fats, oils, and cholesterol
○ Saturated fat (fat that is solid at room temperature) and trans fat should be reduced
in our diet in favor of unsaturated fats or oils (fats that are liquid at room
temperature) and omega-3 and omega-6 fats
○ Elevated blood levels of cholesterol increase risk of heart disease
Carbohydrates
● Provide four calories per gram
● Complex carbohydrates are healthier than simple carbohydrates as they typically contain
additional nutrients such as vitamins and minerals
● Primary function is to provide energy
● Fiber is a type of carbohydrate that cant be broken down but does have some nutritional
benefits such as providing bulk and reducing LDL
Proteins are chains of amino acids
● Provide four calories per gram
● Essential aa are the 9 aa out of 20 that the body cannot synthesize and must be obtained
in the diet
○ Complete protein (mostly animal sources), contains all the essential aa
○ Incomplete protein (plant sources), lack one or more of the essential aa
○ Complementary proteins are combinations of incomplete proteins that supply all
of the essential aa
● Complementary proteins are combinations of two or more incomplete proteins that
together supply all the essential amino acids

Nutrients
● Vitamins
○ Needed in very small amounts serve as enzyme or coenzyme
○ Water soluble: vitamins C and B
○ Lipid soluble: vitamins A, D, E, and K
● Minerals
○ Inorganic substances needed for a variety of life processes
● Water
○ Transports materials, lubricates and cushions organs, helps in temperature
regulation, and provides a medium for many vital chemical reactions
Energy Balance
● Basal metabolic rate (BMR): the minimal energy needed to keep an awake, resting person
alive
○ Represents 60% to 75% of the body’s energy needs
● Depends on
○ Sex: male usually have higher BMR than female
○ Muscles use more energy than fat does
○ Age: muscle mass and metabolic rate decline
● The sum of your BMR and the number of calories you use in physical activity is the
number of calories you should consume to maintain a stable weight
● Exercise helps keep the body in good working order
 ● The Dietary Guide for Americans encourages adult (18 to 64 years) to do at least 2 ½
hours of moderate-intensity physical activity a week
● Aerobic exercise reduces the risk of disease of the heart and blood vessels and lowers
blood pressure
● Weight-bearing exercise reduces the risk of osteoporosis, a loss of bone density
● Regular physical exercise reduces stress and the risk of certain chronic diseases,
including diabetes
Pop Quiz
● Infection with Helicobacter pylori can cause
○ Peptic ulcers
● This enzyme will break down starch into smaller subunits
○ Amylase
● The stomach begins chemical digestion of which of these substances?
○ Proteins
● Chyme travels from the stomach to which specific structure?
○ Duodenum
● If a gallstone were to block the bile duct, which type of food would become more
difficult to digest?
○ Fat
● The following products diffuse into the lacteal
○ Triglycerides
● A PillCam traveling from the pharynx to the stomach will first pass through the
○ Esophagus
● Which of the following is a J-shaped muscular sac that serves in the temporary storage of
masticated food while digestive enzymes and HCL are released to digest proteins?
○ Stomach
Lecture 12
Nutrition and Health II
What is food security?
● Definition of food security
○ A person, household or community, nation or region is food secure when all
members at all times have physical and economic access to buy, produce, obtain
or consume sufficient, safe, and nutritious food to meet their dietary needs and
food preferences for a healthy and active life
Food insecurity
● Food insecurity versus hunger
○ Result of poverty, natural disasters, political unrest
● Food insecure individuals
○ “hunger/obesity paradox”
■ Least expensive foods tend to be highest in calories
 ■ Many food insecure people live in areas where there is limited access to
grocery stores but there are many fast-food outlets
■ There is evidence to support the theory that inconsistent access to food
may lead to overeating and the chronic significant variations in caloric
intake may lead to increased storage over time
The pillars of food security
● Food availability
● Food access
● Food utilization
● A severe drought can reduce a harvest or kill livestock
Link the following situations with availability/ access/utilisation of food
● High market prices of important food products
● Shortage of seeds or fertilisers
● Lack of nutritional knowledge causes people to have an inadequate diet or cause
extensive vitamin loss during preparation
● A broken bridge can hamper access to food or trade markets
● High medical fees can reduce household budget for food
● Some strong cultural beliefs prevent people from eating certain healthy food products
Nutrition Transition
Stages of the Nutrition Transition

The Nutrition Transition Problem

Obesity Epidemic
● Global health effects of overweight and obesity
● Highlights
○ Prevalence of obesity has more than doubled since 1980 and is now 5% in
children and 12% in adults- findings that mirror similar global trends in type 2
diabetes
○ Obese persons are healthier and live longer now than in previous decades because
of better care nad risk-factor management
○ The mix of increased prevalence and decreased mortality leads to more years
spent with obesity and more time for the damaging coexisting illnesses, such as
type 2 diabetes and chronic kidney disease, to develop
○ Once chronic conditions such as type II diabetes and cardiovascular disease
develop, the associated relative risk of death varies according to location- as was
recently seen in Mexico, where the relative risk of death associated with diabetes
far exceeds that in the United States and Europe
○ In some regions, the high prevalence of severe obesity may persist even when
levels of overweight and obesity appear to plateau
○ Global findings hint at some of the actual successes in prevention that may finally
be underway
Food systems in public health
● Industrialized food system
○ Able to produce more food when needed
■ Obesogenic environment
Five priority actions
● For combating non-communicable diseases
○ Salt reduction
○ Improved diets and physical activity
○ Essential drugs and technologies
○ Tobacco control
○ Reduction in hazardous alcohol intake
Sedentary living
● Deleterious association
○ Cardiometabolic risk
○ Cardiovascular risk
○ Cancer risk
● Overfeeding and over-storage of nutrients
● Omni-available food supply
○ Shift in composition of calories
Subsistence efficiency
● Paleolithic times
○ Energy intake and output linked
○ Subsistence efficiency ratio (SER) 3:1
○ 3000/1000 calories per day
● Modern humans
○ SER 7:1 (2100/300 calories per day)
■ Not ideal for metabolic functioning
■ Need 400 kcal more of daily energy expenditure
Weight Gain and obesity
● Body adaptation to overfeeding
○ Get bigger to burn more energy at rest
● Individuals rate of weight gain
○ Defined by body mass intake (BMI)
○ Has strong genetic influence
■ Amplified by environmental changes
Public Health Nutrition Interventions
Cardiometabolic Risk Reductions
● Weight loss
○ Metabolic obesity
■ Normal BMI
 ■ High ratio of body fat to lean mass
● Increase daily energy expenditure
○ Improve muscle quantity and quality
Promoting physical activity and good nutrition
● Recommendations
○ World health organization
○ 10,000 steps per day- 5 miles
● Physical inactivity
○ 31% of adults and 81% of adolescents fail to meet these physical activity
recommendations and are considered inactive
○ Population attributable fraction
■ Physical inactivity is 9%. Compared with 9% attributable to smoking and
5% obesity
● Environmental approaches
○ Traditional strategies
■ Passive in nature
● Physical activity as basic human right
○ Current efforts for healthy lifestyle
■ Yet to be realized
Gamifying Nutrition
● Nutrido
○ Board games
○ Story telling
○ Video games
○ Fruit and vegetable vouchers
○ Clubs
● Impact
○ Improved healthy eating
○ Increased physical activity
○ Improved overall well being
○ Increased nutritional knowledge
○ Influencing others
Pop quiz
● What is the key difference in defining “obese” and defining “overweight”?
○ An obese person always carries weight as excess fat
● This scenario, “unsafe drinking water can cause chronic diarrhoea and result in decreased
absorption of nutrients” is mostly referred to which of the pillars of food security?
○ Utilization
● To determine your body mass index (BMI), you look at the relationship between
○ Your height and weight
● Which of the following is not a health risk associated with obesity?
○ Type 1 diabetes
● This scenario, “a locust infestation can diminish food stocks or ruin harvests” is mostly
referring to which of the pillars of food security?
○ Availability