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How disease spreads

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Introduction to microorganisms

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Microorganisms | Genetics | Biology | FuseSchool

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Lifestyle factors

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How is it that the United States spends the most money on healthcare, and yet still has the one of the lowest life expectancies of all developed nations? (To be specific: $9,400 per capita, 79 years, and 31st.)

Maybe those of us in healthcare have been looking at it all wrong, for too long.

Healthy lifestyle and longevity

Researchers from the Harvard T.H. Chan School of Public Health conducted a massive study of the impact of health habits on life expectancy, using data from the well-known Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). This means that they had data on a huge number of people over a very long period of time. The NHS included over 78,000 women and followed them from 1980 to 2014. The HPFS included over 40,000 men and followed them from 1986 to 2014. This is over 120,000 participants, 34 years of data for women, and 28 years of data for men.

The researchers looked at NHS and HPFS data on diet, physical activity, body weight, smoking, and alcohol consumption that had been collected from regularly administered, validated questionnaires.

What is a healthy lifestyle, exactly?

These five areas were chosen because prior studies have shown them to have a large impact on risk of premature death. Here is how these healthy habits were defined and measured:

1. Healthy diet, which was calculated and rated based on the reported intake of healthy foods like vegetables, fruits, nuts, whole grains, healthy fats, and omega-3 fatty acids, and unhealthy foods like red and processed meats, sugar-sweetened beverages, trans fat, and sodium.

2. Healthy physical activity level, which was measured as at least 30 minutes per day of moderate to vigorous activity daily.

3. Healthy body weight, defined as a normal body mass index (BMI), which is between 18.5 and 24.9.

4. Smoking, well, there is no healthy amount of smoking. "Healthy" here meant never having smoked.

5. Moderate alcohol intake, which was measured as between 5 and 15 grams per day for women, and 5 to 30 grams per day for men. Generally, one drink contains about 14 grams of pure alcohol. That's 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.

Researchers also looked at data on age, ethnicity, and medication use, as well as comparison data from the National Health and Nutrition Examination Surveys and the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research.

Does a healthy lifestyle make a difference?

As it turns out, healthy habits make a big difference. According to this analysis, people who met criteria for all five habits enjoyed significantly, impressively longer lives than those who had none: 14 years for women and 12 years for men (if they had these habits at age 50). People who had none of these habits were far more likely to die prematurely from cancer or cardiovascular disease.

Study investigators also calculated life expectancy by how many of these five healthy habits people had. Just one healthy habit (and it didn't matter which one) ... just one... extended life expectancy by two years in men and women. Not surprisingly, the more healthy habits people had, the longer their lifespan. This is one of those situations where I wish I could reprint their graphs for you, because they're so cool. (But if you're very curious, the article is available online, and the graphs are on page 7. Check out Graph B, "Estimated life expectancy at age 50 according to the number of low-risk factors.")

This is huge. And, it confirms prior similar research - a lot of prior similar research. A 2017 study using data from the Health and Retirement Study found that people 50 and older who were normal weight, had never smoked, and drank alcohol in moderation lived on average seven years longer. A 2012 mega-analysis of 15 international studies that included over 500,000 participants found that over half of premature deaths were due to unhealthy lifestyle factors such as poor diet, inactivity, obesity, excessive alcohol intake, and smoking. And the list of supporting research goes on.

So what's our (big) problem?

As the authors of this study point out, in the US we tend to spend outlandishly on developing fancy drugs and other treatments for diseases, rather than on trying to prevent them. This is a big problem.

Experts have suggested that the best way to help people make healthy diet and lifestyle change is at the large-scale, population level, through public health efforts and policy changes. (Kind of like motorcycle helmets and seat belt legislation...) We have made a little progress with tobacco and trans-fat legislation.

There's a lot of pushback from big industry on that, of course. If we have guidelines and laws helping us to live healthier, big companies aren't going to sell as much fast food, chips, and soda. And for companies hell-bent on making money at the cost of human life, well, that makes them very angry.

Follow me on Twitter @drmoniquetello

Sources

Impact of healthy lifestyle factors on life expectancies in the US population. Circulation, April 2018.

National Institute on Alcohol Abuse and Alcoholism, What is a standard drink?

The population health benefits of a healthy lifestyle: Life expectancy increased and onset of disability delayed. Health Affairs, August 2017.

The combined effects of healthy lifestyle behaviors on all-cause mortality: a systematic review and meta-analysis. Preventive Medicine, September 2012.

Changing minds about changing behavior. Lancet, January 2018.

The US Food and Drug Administration (FDA) Final Determination regarding Partially Hydrogenated Oils (trans fat)

The US Food and Drug Administration (FDA) Family Smoking Prevention and Tobacco Control Act- An Overview

Image: AlexSava/Getty Images

About the Author

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Healthy lifestyle: 5 keys to a longer life - Harvard Health

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Analysing karyopype for abnormalities

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Learning about chromosome numbers

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A karyotype provides meaningful information regarding the overall chromosome makeup of the cell. Translocations, deletions, inversions are some chromosome structural abnormalities that can be analysed along with chromosome numerical abnormalities. A try-it-yourself activity will teach you how chromosomes should be arranged in order to further study these abnormalities.

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Information about Down Syndrome

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Cystic Fibrosis

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ireland's most common genetically inherited disease

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highest proportion of cf people in the world

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Cystic Fibrosis is Ireland's most common genetically inherited disease. With 1100+ CF Patients, Ireland has the highest proportion of CF people in the world. CF Ireland was established by a small dedicated group of parents in 1963 with the first meeting in Crumlin Children's Hospital. 2013 marks the 50th anniversary of the Association.

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Food Labels

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Post-primary - Republic of Ireland (ROI) - What's on a label

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This resource is aimed at Junior Cycle and Transition Year Home Economics but it also supports the Social Personal Health Education curriculum. It allows you and your students to keep up to date on food labelling.

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Understanding Food Labels

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Food traffic lights

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Food Labelling

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Pages 5-8 Evaluating Nutritional needs data

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BMR calculator

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The Basal Metabolic Rate (BMR) Calculator estimates your basal metabolic rate-the amount of energy expended while at rest in a neutrally temperate environment, and in a post-absorptive state (meaning that the digestive system is inactive, which requires about 12 hours of fasting).

Result

Activity Level

Calorie

Sedentary: little or no exercise

2,060

Exercise 1-3 times/week

2,361

Exercise 4-5 times/week

2,515

Daily exercise or intense exercise 3-4 times/week

2,661

Intense exercise 6-7 times/week

2,962

Very intense exercise daily, or physical job

3,262

Exercise: 15-30 minutes of elevated heart rate activity.
Intense exercise: 45-120 minutes of elevated heart rate activity.
Very intense exercise: 2+ hours of elevated heart rate activity.

The basal metabolic rate (BMR) is the amount of energy needed while resting in a temperate environment when the digestive system is inactive. It is the equivalent of figuring out how much gas an idle car consumes while parked. In such a state, energy will be used only to maintain vital organs, which include the heart, lungs, kidneys, nervous system, intestines, liver, lungs, sex organs, muscles, and skin. For most people, upwards of ~70% of total energy (calories) burned each day is due to upkeep. Physical activity makes up ~20% of expenditure and ~10% is used for the digestion of food, also known as thermogenesis.

The BMR is measured under very restrictive circumstances while awake. An accurate BMR measurement requires that a person's sympathetic nervous system is inactive, which means the person must be completely rested. Basal metabolism is usually the largest component of a person's total caloric needs. The daily caloric need is the BMR value multiplied by a factor with a value between 1.2 and 1.9, depending on activity level.

In most situations, the BMR is estimated with equations summarized from statistical data. The Harris-Benedict Equation was one of the earliest equations introduced. It was revised in 1984 to be more accurate and was used up until 1990, when the Mifflin-St Jeor Equation was introduced. The Mifflin-St Jeor Equation has been shown to be more accurate than the revised Harris-Benedict Equation. The Katch-McArdle Formula is slightly different in that it calculates resting daily energy expenditure (RDEE), which takes lean body mass into account, something that neither the Mifflin-St Jeor nor the Harris-Benedict Equation does. Of these equations, the Mifflin-St Jeor Equation is considered the most accurate equation for calculating BMR with the exception that the Katch-McArdle Formula can be more accurate for people who are leaner and know their body fat percentage. You can pick the equation to be used in the calculation by expanding the settings.

The three equations used by the calculator are listed below:
Mifflin-St Jeor Equation:
BMR = 10W + 6.25H - 5A + 5

BMR = 10W + 6.25H - 5A - 161
Revised Harris-Benedict Equation:
BMR = 13.397W + 4.799H - 5.677A + 88.362

BMR = 9.247W + 3.098H - 4.330A + 447.593

W is body weight in kg
H is body height in cm
A is age
F is body fat in percentage

BMR Variables

Muscle Mass - Aerobic exercises, such as running or cycling, have no effect on BMR. However, anaerobic exercises, such as weight-lifting, indirectly lead to a higher BMR because they build muscle mass, increasing resting energy consumption. The more muscle mass in the physical composition of an individual, the higher the BMR required to sustain their body at a certain level.

Age - The more elderly and limber an individual, the lower their BMR, or the lower the minimum caloric intake required to sustain the functioning of their organs at a certain level.

Genetics - Hereditary traits passed down from ancestors influence BMR.

Weather - Cold environments raise BMR because of the energy required to create a homeostatic body temperature. Likewise, too much external heat can raise BMR as the body expends energy to cool off internal organs. BMR increases approximately 7% for every increase of 1.36 degrees Fahrenheit in the body's internal temperature.

Diet - Small, routinely dispersed meals increase BMR. On the other hand, starvation can reduce BMR by as much as 30%. Similar to a phone that goes into power-saving mode during the last 5% of its battery, a human body will make sacrifices such as energy levels, moods, upkeep of bodily physique, and brain functions in order to more efficiently utilize what little caloric energy is being used to sustain it.

Pregnancy - Ensuring the livelihood of a separate fetus internally increases BMR. This is why pregnant women tend to eat more than usual. Also, menopause can increase or decrease BMR depending on hormonal changes.

Supplements - Certain supplements or drugs raise BMR, mostly to fuel weight loss. Caffeine is a common one.

BMR Tests

Online BMR tests with rigid formulas are not the most accurate method of determining an individual's BMR. It is better to consult a certified specialist or measure BMR through a calorimetry device. These handheld devices are available in many health and fitness clubs, doctor offices, and weight-loss clinics.

Resting Metabolic Rate

While the two are used interchangeably, there is a key difference in their definitions. Resting metabolic rate, or RMR for short, is the rate at which the body burns energy in a relaxed, but not fully inactive state. It is also sometimes defined as resting energy expenditure, or REE. BMR measurements must meet total physiological equilibrium while RMR conditions of measurement can be altered and defined by contextual limitations.

Modern Wisdom

A 2005 meta-analysis study on BMR* showed that when controlling all factors of metabolic rate, there is still a 26% unknown variance between people. Essentially, an average person eating an average diet will likely have expected BMR values, but there are factors that are still not understood that determines BMR precisely.

Therefore, all BMR calculations, even using the most precise methods through specialists, will not be perfectly accurate in their measurements. Not all human bodily functions are well understood just yet, so calculating total daily energy expenditure (TDEE) derived from BMR estimates are just that, estimates. When working towards any sort of health or fitness goal, BMR can aid in laying down the foundations, but from there on, it has little else to offer. A calculated BMR and thus TDEE may result in unsatisfactory results because of their rough estimates, but maintaining a daily journal of exercise, food consumption, etc., can help track the factors that lead to any given results and help determine what works, as well as what needs to be improved upon. Tracking progress in said journal and making adjustments over time as needed is generally the best indication of progress towards reaching personal goals.

Reference

* Johnstone AM, Murison SD, Duncan JS, Rance KA, Speakman JR, Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine1. Am J Clin Nutr 2005; 82: 941-948.

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The Basal Metabolic Rate (BMR) Calculator estimates your basal metabolic rate-the amount of energy expended while at rest in a neutrally temperate environment, and in a post-absorptive state (meaning that the digestive system is inactive, which requires about 12 hours of fasting).

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Test from old course

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Energy in Food

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Food Types

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Cystic Fibrosis Genetics

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Food tests

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Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch?  Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter

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Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch?  Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter https://t.co/0eiqNw3csq

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Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch? Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter pic.twitter.com/0eiqNw3csq
— Mike Kavanagh (@Mikekav66) October 22, 2019

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Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch?  Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter https://t.co/0eiqNw3csq

# data[].attributes.attachment_link.metadata.attachment_props.original_text
Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch?  Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter https://t.co/0eiqNw3csq

# data[].attributes.attachment_link.metadata.attachment_props.text
Investigating the nutritional contents of fast food for #BW5. Testing the 100% beef claim! Do burgers contain starch?  Student photo padlet https://t.co/b5eEzmpYkm Identifying possible extension activities for #CBA1 #jcscience #edutwitter

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Looking at yoghurt bacteria

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Materials

Glass microscope slides

Plastic cover slips

Yogurt with live culture (eg: Actimel, Activia, Yakhult)

Toothpicks

Paper towels or tissues

Methylene blue solution (0.5 to 1%) Optional

See information on suppliers here.

Methods

1. Take a very small drop of yogurt with the toothpick and smear it for 2 to 3 seconds on the slide.

2. Place a small drop of methylene blue solution on a microscope slide (optional). Wear gloves and do NOT allow children to handle methylene blue solution.

3. Place a coverslip on top. Remove excess solution around the coverslip with a paper towel or tissue.

4. View in the compound microscope at 4 x or 10 x initially, before moving to higher magnification. Bacteria will appear small even at the highest magnification.

NOTE: Step 2 is optional. You will be able to see the bacteria even without using the stain.

Bacteria can be found isolated, in pairs (diplo), in clusters or in threads (strepto), and they can have different shapes like rods (bacilli), sphere (coccus) etc.

Yogurt is made from the fermentation of the lactose in milk by the rod-shaped bacteria Lactobacillus delbrueckii subsp. bulgaricus to produce lactic acid, which acts on milk protein to give yoghurt its texture and its characteristic acidic taste. Other bacteria found in yoghurt are Lactobacillus acidophilus or casei, Streptococcus salivarius subsp. thermophilus and Bifidobacterium bifidus.

There are 10 times more bacteria in our guts than there are cells in our body.

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Phil Banks. Visual Aids, MRC Laboratory of Molecular Biology

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Yoghurt Bacteria - Experiments on Microscopes 4 Schools

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Glass microscope slides Plastic cover slips Yogurt with live culture (eg: Actimel, Activia, Yakhult) Toothpicks Paper towels or tissues Methylene blue solution (0.5 to 1%) Optional See information on suppliers here . Take a very small drop of yogurt with the toothpick and smear it for 2 to 3 seconds on the slide.

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Glo Germ

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Microbes

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Balanced Diet