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Unit 12

Chronic Disease

Introduction

  • Chronic disease
    • Any disease that develops over time
  • Examples of chronic disease
    • Cardiovascular disease (CVD)
    • Cancer
    • Diabetes
    • Osteoporosis

Cardiovascular disease

  • Leading cause of death in the U.S.
  • Types of CVD
    • Artherosclerosis:
      • Progressive narrowing and hardening of arteries due to formation of plaque
    • Coronary artery disease (CAD):
      • Responsible for most heart related deaths
    • Myocardial infarction: “Heart Attack”-
      • Death of a region of the myocardium do to insufficient blood supply
    • Angina pectoris
      • MI… but without the heart attack
    • Stroke
    • Thrombus
      • Blood clot attached to plaque on artery wall
      • Can be treated with clot-dissolving drugs

CVD risk factors

  • Cigarette smoking
    • 2x the risk
    • 2nd hand smoke increases risk by 30%
  • Hypertension
    • Blood pressure > 140/90
  • Elevated cholesterol
    • HDL < 45
      • “Good”: Picks up cholesterol in the body and delivers it through the blood to the liver, where it is processed and excreted
    • LDL > 130
      • “Bad”: Delivers cholesterol to cells, responsible for buildup
    • What is the desired total cholesterol level?
  • Physical inactivity
  • Obesity
  • Contributing factors
    • Age
    • Sex
    • Diabetes
    • Stress

CVD Prevention

  • Don’t Smoke
  • Stay Physically Active
  • Maintain Appropriate Body Weight/Comp.
  • Diet Low in Fat, Cholesterol, & Sodium
  • Monitor Blood Pressure and Blood Cholesterol Levels
  • Stress Management

Cancer

  • Number 2 Cause of Death in U.S.
  • Cancer Defined
    • Uncontrollable, abnormal cell growth
    • Over 100 different types
  • Tumors
    • benign = Non-cancerous
    • malignant = Cancerous
    • metastasis = New cancerous cell growth

Cancer Killers

  • Females
    • Lung
    • Breast
    • Colorectal
  • Males
    • Lung
    • Prostate
    • Colorectal
Cancer Symptoms Risk Factors Treatment
Lung chest pain
persistent cough
bloody sputum		 smoking
2nd hand smoke
occupational exposure		 surgery
radiation
chemotherapy
Prostate pain during urination
blood in urine
referred back pain		 Male
genetics
age
dietary fat		 surgery
radiation
chemotherapy
Breast unusual breast lump,
swelling
nipple discharge
breast pain,
tenderness		 female
age >40
genetics
early menarche		 surgery
radiation
chemotherapy
Colo-rectal rectal bleeding
bloody stool
irritable bowels		 age > 40
genetics
high fat/low fiber diet		 surgery
radiation
chemotherapy

Cancer Risk Factors

  • Environmental Exposure
  • Genetics
  • Lifestyle
    • diet
    • smoking
    • stress

Major Cancer-Causing Agents

Cancer Prevention

  • Change in bowel or bladder habits
  • A sore that doesn’t heal
  • Unusual bleeding or discharge
  • Thickening of tissue
  • Indigestions that persists
  • Obvious change in a wart or mole
  • Nagging cough or hoarseness

More Cancer Prevention

  • Avoid tobacco and alcohol
  • Anti-cancer diet (i.e., high fiber, low fat)
  • Control your weight
  • Exercise regularly
  • Protect yourself from excessive exposure to sunlight

Introduction to Diabetes

  • A leading cause of death in the U.S
    • 4th leading cause of death
  • Represents a major CVD health risk
  • >14 million Americans have diabetes
    • 6 million don’t even know it

Defining Diabetes

  • Diabetes mellitus
    • Abnormally high blood sugar levels
    • Also highly susceptible to atherosclerosis, CAD, increase BP, infection, blindness and chronic kidney disease
  • Insulin
    • Hormone produced in the pancreas that facilitates the transport of glucose from the blood to the muscle, adipose tissue and liver
  • Type 1
    • Formerly known as insulin-dependent
    • Occurs mostly slim children and adults
    • Individuals unable to produce insulin
  • Type 2
    • Formerly non-insulin-dependent
    • Resistance to the glucose transport effect of insulin
    • Most common in obese individuals over 40
    • 90% have type 2 diabetes

Diabetes Risk Factors

  • Genetics
    • Tendency to develop appears to be present at birth
  • Obesity and physical inactivity
    • > 20 lbs. Overweight = “at risk”
  • Age > 40 are more susceptible to type 2
  • Ethnicity
    • E.G., African Americans, Latinos and native Americans are all especially prone

Treatment For Diabetes

  • Type 1
    • insulin
    • Diet
    • exercise
  • Type 2
    • weight control
    • diet
    • exercise

Prevention Of Diabetes

  • Maintain normal weight
  • Engage in a regular program of aerobic fitness
  • Have blood sugar tested beginning at age 45
  • Recognize the warning signs

Warning Signs For Diabetes

  • Type 1
    • Frequent urination
    • Excessive thirst
    • Extreme hunger
    • Weight loss
  • Type 2
    • Same as type 1
    • Hard-to-heal skin
    • Tingling/ numbness in hands or feet

Osteoporosis

  • Defined
    • Low bone mineral content (BMC)
    • Increased susceptibility to bone fracture
  • Frequency
    • ~25 million Americans--80% are elderly women

Risk Factors For Osteoporosis

  • Genetics
  • Frame size
    • Thin or small frame at higher risk
  • Sex
    • Women 4 x more likely to develop
    • Frame size and estrogen decrease after menopause
  • Race
    • White & Asian women suffer 2-3 x more
  • Age
    • Peak bone mass at 15 years
    • 1% bone loss a year beginning at age 30
  • Low estrogen and testosterone levels
  • Physical inactivity
  • Inadequate calcium intake
  • Smoking
  • Alcohol consumption

Prevention Of Osteoporosis

  • Increase physical activity
  • Take dietary calcium
    • 1200 mg/dl = 4, 8 oz. glasses/day
  • Be wary of over exercising
  • Keep alcohol consumption moderate
  • Don’t smoke

 

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