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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