1. Who is the fittest? Why do you say that? Akebono, a world famous sumo grand champion? Peter Crouch, the England forward? Venus Williams, Wimbledon champion?

2. What is our diet? Our diet is everything that we eat and drink. It provides all of the energy and nutrients that we take in. Our cells can convert some substances into others meaning they are not essential in the diet. Others it cannot and so these are needed in the diet. These are known as essential nutrients and include essential fatty acids, essential amino acids and most vitamins.

3. What do we need for a balanced diet? A balanced diet contains the correct amount of energy and nutrients we need for growth, repair, movement, organ function, homeostasis and other basic metabolic processes. To be ‘healthy’ we need the correct amount of macronutrients, micronutrients, water and fibre in our diet.

4. Malnutrition occurs if we do not consume the correct amounts of energy and nutrients for our body. Therefore we have an unbalanced diet. This can include consuming too much energy which could lead to obesity or some diseases, or not consuming enough which can result in starvation and deficiency diseases. What do we need for a balanced diet?

5. Macronutrients Macronutrients are things that we need lots of on our diet. They consist of carbohydrates, lipids and proteins. Carbohydrates are needed for energy. Lipids (fats) are needed for energy, plasma membranes and for some hormones. Proteins are needed for energy and also make up some structural proteins, hormones, enzymes and antibodies.

6. What is BMI? BMI = calculation to determine whether a person is under/over weight. BMI = body mass (kg) height (m)² The BMI reading is only used for adults – what are the reasons for this?

7. What do you might be the advantages and disadvantages about this BMI system? BMICategory Less than 18.5Underweight Over 18.5 – 25Desirable or healthy range Over 25-30Overweight Over 30-35Obese (Class I) Over 35-40Obese (Class II) Over 40Morbidity or severely obese (class III)

8. Obesity UK (>50% women; 66.6% men) Obesity in UK tripled since 1980 USA (65% adult population) Worldwide trend: –Increased data in children (developed Countries) –Economic growth = increased BMI –Africa & Asia obesity is uncommon

9. More reasons for an increase in BMI? Physical exercise decrease Sedentary occupations Heated homes and work places Better transportation Better wealth (living standards have improved) More fast food & convenience foods Higher stress & work-life imbalance Alcohol intake Urbanisation

10. Associated Health Risks CHD – increased B.P & cholesterol levels Type II diabetes Cancer –Breast (women) –oesophagus, colon, rectum, kidney (men) Osteoarthritis Rheumatoid Arthritis Hypertension Gallstones

11. Coronary Heart Disease Coronary heart disease develops if the blood supply to the heart muscle is reduced resulting in damage to the heart. The coronary arteries are the two arteries that branch off of the aorta and supply the heart muscles with oxygen. These arteries become narrow when atherosclerosis occurs in their lining. This restricts the blood flow to the heart muscles meaning the heart has to work harder to force blood through the arteries, causing blood pressure to rise. It is also therefore harder to supply the heart muscle with extra oxygen and nutrients during exercise.

12. Coronary Heart Disease. There are three types of coronary heart disease. –Angina pectoris –Myocardial infarction (heart attack) –Heart failure

13. Angina pectoris Its main symptom is severe chest pain brought on by strenuous activity. It occurs when exercising but retreats when resting. It is caused by a severe shortage of blood to the heart muscle No death of heart tissue occurs.

14. Myocardial infarction This occurs when a branch of the coronary artery is blocked by a blood clot. This means that the part of the muscle it serves is starved of oxygen and dies causing severe chest pain. Many people survive them if treated straight away but it can be fatal.

15. Heart failure Occurs due to the main coronary artery being blocked. This causes gradual damage to the heart which gradually weakens and cannot pump the blood efficiently.

16. Dietary links to CHD Diet is a significant factor in the incidence of heart disease, but not the sole factor. This means that other factors also make a contribution such as age, smoking, exercise levels, gender, inheritance, social class, alcohol, diabetes and body mass. People who consume a lot of saturated fat and cholesterol usually have high blood cholesterol levels which can lead to atherosclerotic plaques forming. This includes people with high levels of red meat and dairy products in their diet which have high levels of saturated fat in them. Meat and eggs have high levels of cholesterol. Studies have shown that high levels of vitamin E (an antioxidant) in the diet help protect the artery walls from atherosclerosis and so helps prevent the onset of CHD.

17. Dietary links to CHD There are still many studies being carried out looking at the role of diet in the development of coronary heart disease. This is due to the fact that many studies have found results that show inconsistencies. Such as that France has one of the lowest rates of CHD in the world but the consumption of animal fat is the same as the USA who’s rate is about 3x higher.

18. What does obesity cost us? £480m – obesity or associated conditions £9.5m – direct treatment of obesity (through GP) TOP 3 : Type II Diabetes, CHD, HT (£380m) Stroke & osteoarthritis (£52m) Obesity accounted for 18million days of sickness absence (40,000 lost years of working life in 1998) 1998 30,000 deaths were attributed to obesity (9,000 premature)

19. These were two essay questions on previous exam papers. They were each worth 8 marks. What was the Mark Scheme? 1.Describe the consequences of malnutrition with reference to energy and protein deficiency, anorexia nervosa, deficiencies of vitamins A and D, and obesity. 2.Discuss the possible links between diet and coronary heart disease.