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Feldman: Modules 4-3
4-4
The Bio-psycho-social Model
 Biological: body, brain, genetic factors
 Psychological:
Lack of self-control, emotional
turmoil, negative thinking/emotions, emotional
stress
 Social:
social, economic, technological, religious
aspects of cultures
 Nutrition/obesity
 Exercise
 Substance
Abuse
 Genetics
 Infectious
disease
 Childhood injuries
 Hormones
 Emotional well-being
 Nutrition
 Infants
need about 50 calories per pound per
day: about twice the nutritional needs of
adults
 Breast
feeding is better than formula and is
recommended by the American Academy of
Pediatrics for up to one year
Advantages of breast feeding
Correct balance of fat & protein
Protects against disease & tooth
decay
Easily digested
Better cognitive development & visual
acuity
Breast feeding lowers risk of:
later obesity
allergies
infections including diarrhea
and otitis media
cancer & breast cancer in
mother
SIDS
 Why





mothers don’t breast feed.
Inability
Ignorance
Inconvenience
Illness (e.g., AIDS)
Use of drugs
•
leads to smaller body size
•
leads to learning & behavior problems
Attention, fine motor coord., IQ scores (effects
may be long-term or permanent.)
More of a problem in developing countries
Marasmus and Kwashiorkor
marasmus
due to insufficient calorie intake
shrunken, wasted appearance
Kwashiorkor
protein deficiency
feet and abdomen swell with water
Some studies found iron, zinc, &
vitamin D deficiencies
WIC – Special Supplemental Nutrition
Program for Women , Infants, and
Children (7,500,000 low-income
participants)
 Overall
poor
 Iron deficiency most common
 Calcium deficiency due to bone growth
 Obese children do not outgrow weight
problems
 Adolescent girls - fad dieting
 Obesity also a problem
 Usually
begins early to middle teens
 Starts with serious dieting & life stress.
 Most
are female, high SES, white
 Competitive & high achieving
 Suffer
malnutrition
 6% die of physical complications or suicide
 Family therapy most successful treatment
 Weigh
height
less than 85% of normal for age and
 Intense
fear of gaining weight that does not
decrease with weight loss
 Distorted
image of body shape. Appear fat
to themselves even when very thin.
 Binge
and purge pattern
 Fear of overweight
 Depressed & anxious
 90% women
 Damage
throat, stomach, teeth
 Some perfectionists, lack self-control
 Guilty and desperate to get help
 About 70% recover
There has been a marked rise in obesity in the
U.S. and other Western nations. Percentage
doubled since 1980;
quadrupled since 1965
U.S. may have 2nd highest rate
15% of U.S. children 6-11 overweight
Less common in African American than white
children; trend reverses in adolescence

Problems with social acceptance

Stereotyped as lazy, sloppy, ugly, stupid,
self-doubting, deceitful

Depressed, unhappy, bullied

Risk for high blood pressure, cholesterol,
adult-onset diabetes, gallbladder disease,
some cancers, early death, sleep apnea,
hip problems
 Individual/clinical
programs work best (not
school based)
 Exercise is key
 Moderate calorie restriction produces best
long-term results
 Behavioral therapy (e.g., keeping food
diaries) also effective
 People
who lost weight and maintain the loss
become less depressed and reduce health risks.
 Studies
comparing weight-loss programs shows
about equal effectiveness.
 The
most effective programs include exercise.
 Yo-Yo
dieting may increase health risks.
 Those
who take supplements show improved health
& physical functioning
 Protein
supplements may increase muscle mass
 Taking
prescription drugs changes nutritional needs,
rates of absorption
 Effective
doses, side-effects not known
 Antioxidants
(A,C, beta carotene) may slow aging &
improve older adult health
 Vitamin C deficiency associated with earlier death
 Vitamin E associated with reduced heart risk
 Calcium, vitamin D delay osteoporosis.
 Zinc, B6, C, and E improve immune function
 B vitamins improve cognitive function
 Otitis
media
 Asthma
 ADHD
 Autism
 Alzheimer’s
 Macular Degeneration
 Adult-onset Diabetes
 Cardiovascular disease
 - etc.
 Pollution
of air
 Water pollution (fluoridation)
 Depletion of soil nutrients
 Electromagnetic exposure
 Genetic engineering
 Exposure to chemicals
 Trans
fat
 MSG (monosodium glutamate)
 High fructose corn syrup
 GMO corn/soybean, etc.
 GMO wheat (amylopectin A, gluten)
 Hormones ( in meat, dairy, etc. )
 Chemical preservatives
 Pesticides, etc. (used on produce)
 Only
22 % of U.S. children in grades 4-12 are
physically active for at least 30 minutes every
day.
 Television & computer games are part of the
problem.
 Also other lifestyle issues
 The problem tends to increase as children
become adolescents.
 The
average American school child gets only
20 minutes of physical education per week.
 Informal
games should be emphasized rather
than organized sports.
 Only
15-20% of Americans get 20 minutes of
exercise 5 times per week.
 Experts
recommend that adults engage in 45
minutes or more of moderate physical activity on
most or all days.
 Some
experts stress aerobic exercise – sustained
activity that stimulates heart & lung function
(jogging, cycling, swimming)
 In
one study, people who were less fit were
more likely to die during the 8-year course of
the study.
 In
another study of people in their 40s to the
80s, beginning an exercise program was
associated with a 23% lower risk of death.
 enhances
the immune system.
 reduces body fat and builds muscle.
 linked with reduced rates of cancer, especially
colon cancer.
 strengthens the heart muscle and produces HDL
cholesterol
 reduces anxiety and depression, improves mood,
and enhances alertness and energy.
 Strength
training as well as aerobic exercise is
recommended for older adults.
 Endurance
training produces gains in vital
capacity to age 80 (oldest tested).
 Weight-bearing
exercise promotes muscle size
and strength, blood flow to muscles to age 90
(oldest tested).
 Exercise
increases blood circulation to the brain
& reduces cognitive declines.
 Minimizes
aging, contributes to health
 Optimize body composition (muscle v. fat)
 Prevents common diseases
 Improves treatment of some diseases
 Helps prevent & treat disabilities
 Counteracts side-effects of standard medical
care
 Linked to increased longevity
 Smoking



is related to many deaths
30% of cancer deaths
21% of heart disease deaths
82% of chronic pulmonary disease deaths
 By
HS graduation, 22 % of teens smoke, 60% have
engaged in heavy drinking at least once, 50+% have
experimented with illegal drugs
 Experimenters
 Abusers
usually quit
are more likely to be troubled and tend to
become addicted

Decreases delivery of oxygen to tissues

Limited night vision, skin wrinkling, loss of bone mass,
lower sperm count, male impotence

Causes heart rate and blood pressure to rise

Increased risks of heart attack, stroke, and cancer
of the mouth, throat, larynx, esophagus, lungs,
pancreas, kidneys, and bladder

Considered the single most important preventable
cause of death in industrialized nations

Half of all smokers have quit. U.S. men
50% in 1965 to 25%.

Most of the drop is among college
graduates,

Decline among high-school students, but
smoking among college students has risen.

Link between smoking and mortality is dose
related
 Drug
use among high-school students in the
U.S. declined (1980s), increased (1990s), and
has recently leveled off.
 U.S.
still has the highest rate of adolescent
drug use of any industrialized nation.
 Increasing
abuse of prescription and OTC
medications (oxycontin, vicodin, adderal)
 Parental


Setting limits
Monitoring
 Early




involvement
risk factors (kindergarten)
Male
Substance-abusing parent
Low level of parental reasoning
Low level of problem-solving skills
 Almost
half of U.S. college students drink
heavily.
 They
report problems with missed classes,
grades, the police, physical injuries, &
unprotected sex
 About
44% binge drink, including 70% living
away from home
 13


million people in the U.S. are alcoholics
Yearly 25.000 people are killed and 1.5 million injured
by drunk drivers
Alcohol is implicated in 65% of aggressive acts by
males against females
 College
students drink more than their
age counterparts.
 Those
more.
who don’t attend college smoke
 Singles
use marijuana more than married.
 Drinking
is heaviest among singles and
divorced.
 Religious
drugs.
people are less likely to take