CHAPTER 14: P R E V E N TI N G

O N I C DI S E A S E : P H Y S I C A L
CH R
V I T Y A N D H E A LT H Y E A T I N G
A C TI
ARVIN POOVALINGAM
M20231000044
 OBJECTIVE OF THIS CHAPTER
1. UNDERSTAND WHAT IS INFECTIOUS DISEASE & DEGENERATIVE DISEASE
2. IDENTIFY THREE MAJOR CATEGORIES OF RISK FACTOR
3. DESCRIBE THE DIFFERENCE PRIMARY & SECONDARY RISK FACTOR
4. CHARACTERIZE PHYSICAL INACTIVITY AS A CORONARY HEART DISEASE RISK FACTOR COMPARABLE TO
SMOKING, HYPERTENSION, AND HIGH SERUM CHOLESTEROL
5. DESCRIBE THE PROCESS OF ATHEROSCLEROSIS RELATED TO CORONARY HEART DISEASE
6. DESCRIBE THE ROLE OF LOW-GRADE CHRONIC INFLAMMATION IN THE DEVELOPMENT OF CHRONIC
DISEASES
7. DESCRIBE THE METABOLIC SYNDROME AND POSSIBLE CAUSES
INFECTIOUS DISEASES
• ARE DISORDERS CAUSED BY ORGANISMS — SUCH AS BACTERIA, VIRUSES, FUNGI
OR PARASITES. MANY ORGANISMS LIVE IN AND ON OUR BODIES. THEY'RE
NORMALLY HARMLESS OR EVEN HELPFUL. BUT UNDER CERTAIN CONDITIONS,
SOME ORGANISMS MAY CAUSE DISEASE.
DEGENERATIVE DISEASES
• REFER TO A CATEGORY OF MEDICAL CONDITIONS CHARACTERIZED BY THE
PROGRESSIVE DETERIORATION OR IMPAIRMENT OF THE STRUCTURE AND
FUNCTION OF ORGANS OR TISSUES OVER TIME.
MAJOR RISK FACTOR CATEGORIES

• INHERITED/BIOLOGICAL
• ENVIRONMENTAL
• BEHAVIORAL
INHERITED / BIOLOGICAL
• AGE - OLDER INDIVIDUALS HAVE MORE CHRONIC DISEASES THAN YOUNGER INDIVIDUALS.
• GENDER - MEN DEVELOP CARDIOVASCULAR DISEASE AT AN EARLIER AGE THAN WOMEN, BUT WOMEN
EXPERIENCE MORE STROKES THAN MEN (4).

• RACE - AFRICAN AMERICANS DEVELOP ABOUT 30% MORE HEART DISEASE THAN NON-HISPANIC WHITES
(67).

• SUSCEPTIBILITY TO DISEASE - SEVERAL DISEASES HAVE A GENETIC COMPONENT THAT INCREASES THE
POTENTIAL FOR HAVING A DISEASE
ENVIRONMMENTAL

• ENVIRONMENTAL FACTORS THAT AFFECT HEALTH AND DISEASE INCLUDE THE FOLLOWING:
• PHYSICAL FACTORS (E.G., CLIMATE, WATER, ALTITUDE, POLLUTION)
• SOCIOECONOMIC FACTORS (E.G., INCOME, HOUSING, EDUCATION, WORKPLACE CHARACTERISTICS)
• FAMILY (E.G., PARENTAL VALUES, DIVORCE, AND EXTENDED FAMILY AND FRIENDS
BEHAVIORAL

• SMOKING
• POOR NUTRITION AND INACTIVITY DRINKING ALCOHOL
• OVERUSE OF MEDICATION
• FAST DRIVING/NO SEAT BELT
PRIMARY (MAJOR) &
SECONDARY (CONTRIBUTING) RISK

• PRIMARY MEANT THAT A FACTOR IN AND OF ITSELF INCREASED THE RISK OF CHD.
• SECONDARY MEANT THAT A CERTAIN FACTOR INCREASED THE RISK OF CHD ONLY IF ONE OF THE PRIMARY
FACTORS WAS ALREADY PRESENT, OR THAT ITS SIGNIFICANCE HAD NOT BEEN PRECISELY DETERMINED
 SECONDARY RISK FACTOR
1. OBESITY:
1. EXCESS BODY WEIGHT, ESPECIALLY ABDOMINAL OBESITY, IS A RISK FACTOR.

2. POOR DIET:
1. DIETS HIGH IN SATURATED AND TRANS FATS, CHOLESTEROL, SODIUM, AND LOW IN FRUITS, VEGETABLES, AND FIBER INCREASE THE RISK.

3. STRESS:
1. CHRONIC STRESS CAN CONTRIBUTE TO UNHEALTHY BEHAVIORS AND MAY AFFECT THE CARDIOVASCULAR SYSTEM.

4. EXCESSIVE ALCOHOL CONSUMPTION:

1. HEAVY ALCOHOL INTAKE CAN CONTRIBUTE TO HIGH BLOOD PRESSURE AND INCREASE THE RISK OF HEART DISEASE.

5. SLEEP APNEA:
1. UNTREATED SLEEP APNEA MAY CONTRIBUTE TO HIGH BLOOD PRESSURE AND OTHER CARDIOVASCULAR ISSUES.

6. INFLAMMATORY CONDITIONS:
1. CONDITIONS SUCH AS RHEUMATOID ARTHRITIS OR LUPUS MAY INCREASE THE RISK OF CHD.

7. CERTAIN MEDICATIONS:
1. SOME MEDICATIONS, WHEN NOT PROPERLY MANAGED, MAY CONTRIBUTE TO CARDIOVASCULAR ISSUES.

8. ILLEGAL DRUG USE:

1. THE USE OF CERTAIN DRUGS CAN CONTRIBUTE TO HEART PROBLEMS.
After looking at the web of causation for cardiovascular
disease in Figure 14.2, one can understand how difficult it is to
determine whether an observed association between a risk
factor and a disease is a causal one or is due simply to chance
 CHARACTERIZE PHYSICAL INACTIVITY AS A CORONARY HEART
DISEASE RISK FACTOR COMPARABLE TO SMOKING, HYPERTENSION,
AND HIGH SERUM CHOLESTEROL

• PHYSICAL INACTIVITY IS A WELL-ESTABLISHED AND SIGNIFICANT RISK FACTOR FOR CORONARY HEART DISEASE (CHD),
COMPARABLE TO SMOKING, HYPERTENSION, AND HIGH SERUM CHOLESTEROL. HERE'S A CHARACTERIZATION OF
PHYSICAL INACTIVITY IN RELATION TO CHD:

• INDEPENDENT RISK FACTOR:

• PHYSICAL INACTIVITY IS RECOGNIZED AS AN INDEPENDENT RISK FACTOR FOR CHD. SEDENTARY LIFESTYLES HAVE BEEN
LINKED TO AN INCREASED RISK OF DEVELOPING HEART DISEASE.

• CONTRIBUTION TO ATHEROSCLEROSIS:
• LACK OF PHYSICAL ACTIVITY CONTRIBUTES TO THE DEVELOPMENT OF ATHEROSCLEROSIS, THE BUILDUP OF PLAQUE IN
THE ARTERIES. ATHEROSCLEROSIS IS A KEY FACTOR IN THE DEVELOPMENT OF CHD.
• IMPACT ON CHOLESTEROL LEVELS:
• PHYSICAL ACTIVITY HELPS TO RAISE HDL ("GOOD") CHOLESTEROL LEVELS AND LOWER LDL ("BAD")
CHOLESTEROL LEVELS, WHICH IS BENEFICIAL FOR HEART HEALTH. INACTIVITY, ON THE OTHER HAND, CAN
CONTRIBUTE TO UNFAVORABLE CHOLESTEROL PROFILES.

• INFLUENCE ON BLOOD PRESSURE:

• REGULAR EXERCISE IS ASSOCIATED WITH LOWER BLOOD PRESSURE. PHYSICAL INACTIVITY,
CONVERSELY, CAN CONTRIBUTE TO HYPERTENSION, A MAJOR RISK FACTOR FOR CHD.

• EFFECT ON WEIGHT AND OBESITY:

• LACK OF PHYSICAL ACTIVITY IS A SIGNIFICANT CONTRIBUTOR TO WEIGHT GAIN AND OBESITY, BOTH OF
WHICH ARE ASSOCIATED WITH AN INCREASED RISK OF CHD.
PHYSICAL ACTIVITY AND HEALTH
• LOWER RATES OF ALL-CAUSE MORTALITY, TOTAL CARDIOVASCULAR DISEASE (CVD), AND CORONARY
HEART DISEASE INCIDENCE AND MORTALITY

• INCREASED WEIGHT LOSS AND REDUCED AMOUNT OF WEIGHT REGAIN AFTER WEIGHT LOSS
• A LOWER INCIDENCE OF OBESITY, TYPE 2 DIABETES, AND METABOLIC SYNDROME
• A LOWER RISK OF COLON AND BREAST CANCER
• AN IMPROVEMENT IN THE ABILITY OF OLDER ADULTS TO DO ACTIVITIES OF DAILY LIVING
• REDUCED RISK OF FALLS IN OLDER ADULTS AT RISK OF FALLING
• A REDUCTION IN DEPRESSION AND COGNITIVE DECLINE IN ADULTS AND OLDER ADULTS
THE PROCESS OF ATHEROSCLEROSIS
RELATED TO CORONARY HEART DISEASE

• ATHEROSCLEROSIS IS A CONDITION CHARACTERIZED BY THE GRADUAL BUILDUP OF FATTY DEPOSITS, CHOLESTEROL,

CELLULAR WASTE, CALCIUM, AND OTHER SUBSTANCES WITHIN THE WALLS OF ARTERIES. THIS PROCESS CAN OCCUR
THROUGHOUT THE BODY, BUT WHEN IT SPECIFICALLY AFFECTS THE CORONARY ARTERIES SUPPLYING BLOOD TO THE
HEART MUSCLE, IT CAN LEAD TO CORONARY HEART DISEASE (CHD).
• IN ATHEROSCLEROSIS, THE NARROWING OF THE CORONARY ARTERY CAN RESULT IN A REDUCTION IN
BLOOD FLOW THAT MAY ULTIMATELY LEAD TO A HEART ATTACK. THE DECREASE IN THE DIAMETER OF THE
LUMEN IS DUE TO A BUILDUP OF LIPID AND FIBROUS MATERIALS (PLAQUE) IN THE INNER LINING OF THE
ARTERY, CALLED THE INTIMA (SEE FIG. 14.5)
LOW GRADE CHRONIC

• LOW-GRADE CHRONIC INFLAMMATION IS INCREASINGLY RECOGNIZED AS A CONTRIBUTING FACTOR IN THE

DEVELOPMENT AND PROGRESSION OF VARIOUS CHRONIC DISEASES. UNLIKE ACUTE INFLAMMATION, WHICH IS A
NORMAL AND ESSENTIAL PART OF THE BODY'S RESPONSE TO INJURY OR INFECTION, CHRONIC INFLAMMATION
PERSISTS OVER A MORE EXTENDED PERIOD AND IS OFTEN SUBTLE. THIS PROLONGED INFLAMMATORY STATE CAN
PLAY A ROLE IN THE INITIATION, PROMOTION, AND PROGRESSION OF SEVERAL CHRONIC DISEASES
• CARDIOVASCULAR DISEASES
• METABOLIC SYNDROME AND TYPE 2 DIABETES
• OBESITY
• NEURODEGENERATIVE DISEASES
• AUTOIMMUNE DISEASES
• CANCER
• CHRONIC RESPIRATORY DISEASES
 HEALTHY EATING AND PHYSICAL ACTIVITY TO COMBAT
INFLAMMATION
• COMBATING INFLAMMATION THROUGH A COMBINATION OF HEALTHY EATING AND REGULAR PHYSICAL ACTIVITY IS A
PROACTIVE APPROACH THAT CAN HAVE POSITIVE EFFECTS ON OVERALL HEALTH. CHRONIC INFLAMMATION IS
ASSOCIATED WITH VARIOUS DISEASES, INCLUDING CARDIOVASCULAR DISEASE, DIABETES, AND CERTAIN TYPES OF
CANCER. ADOPTING AN ANTI-INFLAMMATORY LIFESTYLE CAN HELP REDUCE INFLAMMATION AND PROMOTE WELL-
BEING.

• IN TERMS OF HEALTHY EATING, ESPOSITO ET AL. HAVE SHOWN THAT EATING A MEDITERRANEAN-STYLE DIET (HIGH IN
FRUITS, VEGETABLES, LEGUMES, WHOLE GRAINS, AND OLIVE OIL) FOR TWO YEARS RESULTED IN A DRAMATIC
REDUCTION IN CRP AND IL-6, WITH NO CHANGES OBSERVED IN THE CONTROL GROUP (23). FURTHER, SUCH RESULTS
WERE OBSERVED EVEN WITHOUT WEIGHT LOSS (58). THIS DIETARY-INDUCED REDUCTION IN INFLAMMATORY
MARKERS IS BELIEVED TO BE LINKED TO SUPPRESSION OF PATHWAYS THAT STIMULATES THE TRANSCRIPTION O
METABOLIC SYNDROME

• METABOLIC SYNDROME AS A WAY OF PULLING TOGETHER ALL OF WHAT WE HAVE SEEN AND EMPHASIZING,
AGAIN, THE IMPORTANCE OF HEALTHY EATING AND PHYSICAL ACTIVITY IN THE PREVENTION AND
TREATMENT OF CHRONIC DISEASES. EPIDEMIOLOGISTS ARE NOT THE ONLY SCIENTISTS INTERESTED IN
EXAMINING POTENTIAL RELATIONSHIPS BETWEEN VARIABLES IN ORDER TO HAVE A GREATER
UNDERSTANDING OF WHAT CAUSES CHRONIC DISEASES
• THE METABOLIC SYNDROME MODEL DESCRIBES CONNECTIONS BETWEEN AND AMONG OBESITY,
PERIPHERAL INSULIN RESISTANCE, HYPERTENSION, AND DYSLIPIDEMIA.

• POTENTIAL UNDERLYING CAUSES OF METABOLIC SYNDROME INCLUDE A LOW-GRADE CHRONIC

INFLAMMATION AND AN INCREASE IN OXIDATIVE STRESS.

• EXERCISING, EATING A HEALTHY DIET, AND MAINTAINING A HEALTHY WEIGHT ARE STRATEGIES TO BOTH
PREVENT AND TREAT THESE CHRONIC DISEASES.