physical, mental and social well being.

It is
more than just being free from disease.
Disease is a malfunction of the mind or body
leading to a condition of poor health. Health is
more than just simply the absence of disease,
some may not suffering from the symptoms of
a disease may have low physical fitness and
may be developing a serious condition such as
heart disease or lung cancer.
Categories of disease and illness
Social - iving conditions and behavior are
factors in development of disease
Smo!ing related disease, "#
$hysical - $ermanent or temporary damage to
the body
Stro!e
%ental
Changes to the mind, with or without !nown
physical cause
Schi&ophrenia, an'iety
(on infectious - )ny disease not caused by a
pathogen
ung cancer, night blindness
Infectious - *rganisms +pathogen, invade the
body
malaria
Deficiency - Caused by poor diet
-ic!ets, 'erophthalmia
Degenerative - .radual decline in a function or
functions of the body
Coronary heart disease
Inherited - )n inherited genetic fault
Cystic fibrosis
Self conflicted - Damage to the body
)ttempted suicide, drug abuse and lung
cancer.
-easons for collecting health statistics
%a!e comparisons between populations at the
same time
%a!e comparisons between populations at
different times
/ind out which diseases are important
/ind new, emerging diseases, such as S)-S
Inform policy-ma!ing about providing
resources in the health service
/ind out how well government health policies
are wor!ing
Investigate the spread of disease and
investigate the li!ely causes.
Difference between standards of Health in
%0DC and 0DC
0DC
$oor sanitation leading to the spread of water-
borne diseases li!e cholera, diarrhoea,
dysentery and typhoid
1nsafe water that often contains the pathogen
of many diseases
Densely populated cities and over crowded
accommodation increasing the li!elihood of
air-borne diseases, such as "# and influen&a
being transmitted from person to person.
2idespread poverty leading to poor diet and a
lac! of doctors and health facilities to treat
disease. 3%alnourished individuals are less
able to fight infections.
%any developing countries situated in warmer
areas of the world where pathogens and the
insects can spread and reproduce rapidly and
build up large populations.
%ore death at birth or in the early year of life.
%0DC
#oth the incidence of infectious disease and
the mortality associated with disease have
been reduced.
iving conditions are substantially better than
in developing countries, which improved
hygiene, sanitation and nutrition.
Successful vaccination programmes, and
antibodies are readily available to cure
bacterial infections.
"he relative affluence of developed countries
brings an increase in deaths from
cardiovascular diseases, cancer and road
accidents, albeit that cardiovascular disease is
more prevalent amongst the poorer sections of
developed countries.
Degenerative disease associated with old age
are often seen.
0'plain the terms
$andemic an outbrea! of disease that occurs
across the world or across continents.
0pidemic an outbrea! of disease in a
population.
0ndemic this describes diseases that are
always in a population.
"here is a clear difference between
epidemic, pandemic, and endemic. "he main
difference between an epidemic and a
pandemic lies in the numbers of diagnosis
and the si&e of the area involved. 0pidemic
is an outbrea! of a certain disease that
attac!s a human population at about the
same time. 2hen an epidemic spreads to
other areas and affects a substantial
number of people, it is referred as a
pandemic. )n endemic is a disease that
permanently e'ists or occurs fre4uently in
a a particular region.
)dvantages for health of the Human
.enome $roject are
.enetic tests have been developed for
inherited disease such as cystic fibrosis, more
of these will be developed as now the
se4uences of the genes are !nown.
"ests have also been developed to find out
whether people have inherited alleles of genes
that increase the li!elihood that they will
develop diseases such as breast cancer and
)l&heimer5s.
Doctors will be able to diagnose diseases more
accurately and choose more appropriate
treatments, avoiding drugs li!ely to have side
effects.
.ene therapy may be carried out to insert
properly functioning alleles. "his has already
happened to treat a rare immunodeficiency
disease.
$harmaceutical companies may be able to
develop drugs better able to target specific
problems.
%edical researchers will have more data when
loo!ing for causes of disease and finding cure.
%*-0 S"1//
Diet Components of a balanced diet
Sufficient energy for our
needs provided by the macronutrients
+carbohydrates, proteins and fat,
0ssential amino acids
+essential means can5t be made by
the body, must be in the diet
0ssential fatty acids
+linolenic acid and linoleic acid,
%icronutrients vitamins
and minerals
2ater for replacing the
water lost in urine, sweat, breath
and faeces
/ibre for preventing
constipation
0nergy and nutrient re4uirements of people
.ender
%ales re4uire more protein because their
growth is greater than females during
adolescence, and after that stage they have a
greater mass of tissue to repair and replace.
%ales re4uires more of the vitamin #
comple'es that are needed for respiration and
metabolism. %ales re4uire more calcium and
phosphorus in adolescence because they
develop larger bones than females during this
stage of growth.
)ge
0nergy re4uirements increase with age, up to
and including adolescence, as growth is rapid
during these years and physical activity is
generally at high level. "hese energy
re4uirements remain almost constant up to the
age of 67 years, after which they decrease as
physical activity diminishes and body mass
often decreases. $rotein re4uirements
increase with age, especially around puberty.
"his is because additional protein is needed for
the rapid growth around adolescence and
thereafter, to repair and replace cells. Calcium
and phosphorus re4uirements are greater in
the first year of life as they are laid down in
the bones of infants. "he rate again increases
in adolescence when the second growth spurt
involves relatively rapid elongation of the
bones. )fter adolescence, the re4uirements
remain constant. -e4uirements for other
minerals and vitamins increases up to the age
87 years, but thereafter remains relatively
constant.
)ctivity
"he more physically active a person is, the
greater their energy re4uirement. It follows
that, compared to an office wor!er, a manual
labourer re4uires a greater energy inta!e,
especially of carbohydrate food.
$regnancy
0nergy during the last three months of
pregnancy, when fetal growth is at its greatest
and the mother has this additional mass to
carry around. $rotein needed to supply the
growth needs of the rapidly dividing cells of
the fetus. 9itamin ), C and D, although too
much vitamin ) can be harmful to the fetus in
the early stages of pregnancy. /or this reason
pregnant women are recommended to avoid
liver, which is very rich in vitamin ).
actation
%ore calcium, phosphorus and magnesium, as
these are needed by the newly born to develop
their bones. %ore &inc because it is present in
a number of en&ymes, including those involved
in growth and metabolism.
Dietary reference value
"his is sets of figures
relating to the re4uirements for
energy and nutrient inta!e of all
healthy individuals in the 1:, this
is sat by the department of Health
in ;<<;.
"he three D-9 are=
0stimated )verage -e4uirement this is the
population average -eference (utrient Inta!e
this is at the top end of the range and is
enough for about <>? of the population
ower -eference (utrient Inta!e this is at
the bottom of the range and is enough for only
about 8? of the population. 1se of Dietary
-eference value=
Chefs and caterers to
design appropriate menus for groups
of people living in communities such
as schools, old people5s home and
prisons.
%anagers to plan food
supplies for large groups of people.
Dieticians and others to
assess the dietary needs of
individuals, e.g. "he elderly and
pregnant women.
Individuals to calculate
their own dietary re4uirements and
to maintain or improve health.
/ood manufacturers to
provide appropriate nutritional
information on food labels.
Describe the functions of...
0ssential amino acids -
1sed to synthesis protein for growth
and repair of cells
0ssential fatty acids -
1sed to ma!e phospholipids and fats
9itamin ) - 1sed to ma!e
rhodopsin for functioning of rod
cells in the eye. 1sed to ma!e
retinoic acid, which aids cell
development and growth, especially
in epithelia.
9itamin D - ) steroid
hormone that controls absorption of
calcium from the gut and its
deposition in bones.
Conse4uences of malnutrition
0nergy
Stunting results from chronic protein-energy
malnutrition, occurs in children from 8-@
years of age. 2asting results from acute
protein-energy malnutrition, occurs in
individuals over @ years of age. "his is
characteri&ed by rapid weight loss in those who
had near normal weight.
:washior!or
#loated appearance %oon face )pathetic
marasmus
9ery thin! with wrin!led s!in *ld man5s face
%entally alert
)nore'ia nervosa
%uscles waste +including
heart muscles,
$eriods stop
#lood pressure falls
Hair becomes thin and
sparse
Hands and feet are cold
"here is increased
susceptibility to infection
"here are personality
changes.
9itamin )
(ight blindness rod cells
do not ma!e enough rhodopsin so
people can not see in dim light
'erophthalmia the surface
of cornea is scarred which leads to
blindness
$oor defence against
disease such as measles.
Dry, rough s!in, as vitamin
) is needed to ma!e retinoic acid,
which is needed to maintain
epithelial tissues li!e the s!in.
9itamin D
-ic!ets occur in Children
the bone become soft and grow
irregularly, the joints become
swollen and limbs and the chest may
be distorted. "ypically the legs are
bow-shaped.
*steomalacia occur in
adults this causes a softening of
the bones, ma!ing them tender and
painful, fracture of bone occur more
easily. %uscle wea!ness as well as
loss of appetite and weight.
*besity
Coronary heart disease
caused by increased blood pressure
and blood cholesterol.
"ype II diabetes
Cancer
*steoarthritis
-heumatoid arthritis
Hypertension
Diet and coronary heart disease
High level of salt
increases hypertension.
High #lood cholesterol
contribute to the formation of
pla4ues in the coronary arteries
High fatty acid inta!e
saturated fatty acid increases the
ris! of CHD
0ating dietary fibre
protect against obesity and reduce
insulin levels in the blood, so
reducing CHD.
%oderate consumption of
alcohol shown by some studies to
reduce the ris! of CHD.
0ating oily fish such as
mac!erel and herring
/ormation of heart attac!.
"hose who are over-weight are twice
as li!ely to suffer from CHD than
those with acceptable #%I.
It is a Degenerative
condition which involves the build-
up of fatty tissue in the walls of
arteries that supply heart muscles.
If these arteries become
narrowed as a result, the flow of
blood decreases and the supply of
nutrients and o'ygen to heart muscle
decreases.
"he muscle doesn5t release
enough energy, the heart becomes
wea!.
"here may be a blood clot
in the coronary artery, so cutting
off the supply of blood to that area
completely and leading to a heart
attac!.
@.8 %odule 8A78= Human Health and Disease
$reamble In addition to meeting the aims of
the specification as a whole, this module is
intended to develop= an understanding of
what is meant by health and diseaseB an
appreciation of disease in a global conte't and
the factors that affect patterns of disease
globallyB an understanding of the principles
upon which preventive medicine is basedB an
understanding of the e'tent to which people
can influence their health by their behaviourB
an appreciation of the role and implications of
medical technology in the conte't of limited
resourcesB an understanding of how our
bodies attempt to maintain good healthB a
positive attitude and approach to health as
being more than simply the absence of disease.
)ssessment *bjectives See Section C.
Candidates are e'pected to appy !nowledge,
understanding and other s!ills gained in this
module to new situations andDor to solve
related problems. -ecommended $rior
:nowledge Candidates should have a !nowledge
of :ey Stage E $rogramme of Study Sc.8, 8 a
- g, m, n, p, 4 and rB #iology /oundation,
%odule 8A7;B "ransport, %odule 8A7C,
Component 7;, sections @.C.; and @.C.8.
@.8.; Introduction to Health and Disease
I"C.;, I"C.C -ecommended $rior :nowledge
Candidates should have a !nowledge of :ey
Stage E $rogramme of Study Sc8, 8d-g,m,n,4
and rB #iology /oundation, %odule 8A7;B
"ransport, %odule 8A7C, Component 7;,
sections @.C.; and @.C.8. *'ford Cambridge
and -S) 0'aminations *C- .C0 #iology
Specification Content E; Content Definitions
of the terms health and disease. .lobal
patterns of disease distribution. earning
*utcomes Candidates should be able to= +a,
discuss what is meant by the terms health and
disease. +b, discuss whether health is more
than simply the absence of disease. +c, e'plain,
with one e'ample of each, what is meant by
the following categories of disease or illness=
physical, mental, social, infectious, non-
infectious, degenerative, inherited, self-
inflicted and deficiency. +d, e'plain the reasons
for collecting health statistics. "C.;, I"C.C +e,
describe and e'plain the differences between
standards of health in developed and
developing countries. +f, e'plain the terms
pandemic, epidemic and endemic. +g,
appreciate the significance of the Human
.enome $roject to human health and disease.
@.8.8 Diet CC.;a -ecommended $rior
:nowledge Candidates should have !nowledge
of :ey Stage E $rogramme of Study Sc8, 8 a
and bB #iology /oundation, %odule 8A7;B
"ransport, %odule 8A7C, Component 7;,
sections @.C.; and @.C.8. Content "he
concept of the balanced diet. 0nergy and
nutrient re4uirements. 0ssential nutrients.
"he conse4uences of malnutrition. Diet and
coronary heart disease. *'ford Cambridge and
-S) 0'aminations E8 Specification Content *C-
.C0 #iology earning *utcomes Candidates
should be able to= +a, list the components of a
balanced diet. +b, discuss the energy and
nutrient re4uirements of people with reference
to gender, age, activity, pregnancy and
lactation. +c, e'plain what is meant by the
term dietary reference value +D-9, and
describe how these values should be used. +"he
Department of Health publication Dietary
-eference 9alues for /ood 0nergy and
(utrients for the 1:, ;<<; should be
consulted., +d, describe the functions of
essential amino acids, essential fatty acids and
vitamins ) and D in the body. +e, describe the
conse4uences of malnutrition with reference to
energy and protein deficiency, anore'ia
nervosa, deficiencies of vitamins ) and D, and
obesity. +f, discuss the possible lin!s between
diet and coronary heart disease. C.;a @.8.C
.aseous 0'change and 0'ercise $C.;, $C.8,
$C.CB $SC.;, $SC.8, $SC.C -ecommended
$rior :nowledge Candidates should have a
!nowledge of :ey Stage E $rogramme of
Study Sc8, 8 d-g, m-pB #iology /oundation,
%odule 8A7;B "ransport, %odule 8A7C,
Component 7;, sections @.C.; and @.C.8.
Content "he gaseous e'change system. "he
conse4uences of e'ercise. *'ford Cambridge
and -S) 0'aminations *C- .C0 #iology
Specification Content EC earning *utcomes
Candidates should be able to= +a, describe the
distribution of alveoli and blood vessels in lung
tissue. +b, describe the distribution of
cartilage, ciliated epithelium, goblet cells and
smooth muscle in the trachea, bronchi and
bronchioles. +c, describe the functions of
cartilage, cilia, goblet cells, smooth muscle and
elastic fibres in the gaseous e'change system.
+d, e'plain the meanings of the terms tidal
volume and vital capacityB +e, measure their
pulse rate and understand that pulse rate is a
measure of heart rate. +f, e'plain the
significance of resting pulse rate in relation to
physical fitness. +g, e'plain the terms systolic
blood pressure, diastolic blood pressure and
hypertension. +h, e'plain the meaning of the
term aerobic e'ercise. +i, describe the
immediate effects of e'ercise on the body,
including the concept of o'ygen debt and the
production of lactate by anaerobic respiration.
+j, design and carry out e'periments to
investigate the effects of e'ercise on the body.
+"eachers should satisfy themselves that any
e'ercise underta!en by candidates can be done
safely., SC +all,, $C +all, +!, appreciate how
much e'ercise needs to be ta!en for significant
sustained improvement in aerobic fitness. SC
+all,, $C +all, +l, discuss the long-term
conse4uences of e'ercise on the body and the
benefits of maintaining a physically fit body,
relating these benefits to the concept that
health is more than the absence of disease. SC
+all,, $C +all, @.8.E Smo!ing and disease CC.8
-ecommended $rior :nowledge Candidates
should have !nowledge of :ey Stage E
$rogramme of Study Sc8, 8 c-e ,4 and rB
#iology /oundation, %odule, 8A7;B
"ransport, %odule 8A7C, Component 7;,
sections @.C.; and @.C.8. *'ford Cambridge
and -S) 0'aminations EE Specification Content
*C- .C0 #iology Content 0ffects of smo!ing
and disease on the gaseous e'change and
cardiovascular systems. $revention and cure.
earning *utcomes Candidates should be able
to= +a, describe the effects of tar and
carcinogens in tobacco smo!e on the gaseous
e'change system. +b, describe the symptoms of
chronic bronchitis and emphysema +chronic
obstructive pulmonary disease, and lung
cancer. +c, evaluate the epidemiological and
e'perimental evidence lin!ing cigarette
smo!ing to disease and early death. CC.8 +d,
describe the effects of nicotine and carbon
mono'ide in tobacco smo!e on the
cardiovascular system with reference to
atherosclerosis, coronary heart disease and
stro!es. +e, discuss the reasons for the global
distribution of coronary heart disease. +f,
discuss the difficulty in achieving a balance
between prevention and cure, with reference
to coronary heart disease, coronary by-pass
surgery and heart transplant surgery. @.8.@
Infectious Diseases -ecommended $rior
:nowledge Candidates should have !nowledge
of :ey Stage E $rogramme of Study Sc8, 8 a-
f, m, p and 4B #iology /oundation, %odule
8A7;B "ransport, %odule 8A7C, Component
7;, section @.C.;. Content Cholera, malaria,
tuberculosis +"#, and )IDS. )ntibiotics.
*'ford Cambridge and -S) 0'aminations *C-
.C0 #iology Specification Content E@ earning
*utcomes Candidates should be able to= +a,
describe the causes and means of transmission
of cholera, malaria, )IDSDHI9 and "#.
+:nowledge of the symptoms of these diseases
is not re4uired., +b, assess the worldwide
importance of these diseases. +c, describe the
roles of social, economic and biological factors
in the prevention and control of these diseases.
+d, outline the role of antibiotics in the
treatment of infectious disease. @.8.6
Immunity 2*C.;, 2*C.8, 2*C.C
-ecommended $rior :nowledge Candidates
should have a !nowledge of :ey Stage E
$rogramme of Study Sc8, 8 c and 4B #iology
/oundation, %odule 8A7;B "ransport, %odule
8A7C, Component 7;, section @.C.;. Content
"he immune system. "he role of vaccination
in controlling disease. earning *utcomes
Candidates should be able to= +a, describe the
origin, maturation and mode of action of
phagocytes and lymphocytes. +b, e'plain the
meaning of the term immune response. +c,
distinguish between the actions of #
lymphocytes and " lymphocytes in fighting
infection. +d, appreciate the role of memory
cells in long-term immunity. +e, relate the
molecular structure of antibodies to their
functions. 2*C +all, *'ford Cambridge and -S)
0'aminations E6 Specification Content *C- .C0
#iology +f, vaccination can control disease. +g,
discuss the reasons why vaccination has
eradicated smallpo' but not measles, "#,
malaria or cholera. +h, outline the role of the
immune system in allergies, with reference to
asthma and hay fever.
Diet
Components of a balanced diet
Sufficient energy for our needs provided by
the macronutrients +carbohydrates, proteins
and fat,
0ssential amino acids +essential means can5t be
made by the body, must be in the diet
0ssential fatty acids +linolenic acid and linoleic
acid,
%icronutrients vitamins and minerals
2ater for replacing the water lost in urine,
sweat, breath and faeces
/ibre for preventing constipation
0nergy and nutrient re4uirements of people
.ender
%ales re4uire more protein because their
growth is greater than females during
adolescence, and after that stage they have a
greater mass of tissue to repair and replace.
%ales re4uires more of the vitamin #
comple'es that are needed for respiration and
metabolism.
%ales re4uire more calcium and phosphorus in
adolescence because they develop larger bones
than females during this stage of growth.
)ge
0nergy re4uirements increase with age, up to
and including adolescence, as growth is rapid
during these years and physical activity is
generally at high level. "hese energy
re4uirements remain almost constant up to the
age of 67 years, after which they decrease as
physical activity diminishes and body mass
often decreases.
$rotein re4uirements increase with age,
especially around puberty. "his is because
additional protein is needed for the rapid
growth around adolescence and thereafter, to
repair and replace cells.
Calcium and phosphorus re4uirements are
greater in the first year of life as they are laid
down in the bones of infants. "he rate again
increases in adolescence when the second
growth spurt involves relatively rapid
elongation of the bones. )fter adolescence, the
re4uirements remain constant.
-e4uirements for other minerals and vitamins
increases up to the age 87 years, but
thereafter remains relatively constant.
)ctivity
"he more physically active a person is, the
greater their energy re4uirement. It follows
that, compared to an office wor!er, a manual
labourer re4uires a greater energy inta!e,
especially of carbohydrate food.
$regnancy
0nergy during the last three months of
pregnancy, when fetal growth is at its greatest
and the mother has this additional mass to
carry around.
$rotein needed to supply the growth needs of
the rapidly dividing cells of the fetus.
9itamin ), C and D, although too much vitamin
) can be harmful to the fetus in the early
stages of pregnancy. /or this reason pregnant
women are recommended to avoid liver, which
is very rich in vitamin ).
actation
%ore calcium, phosphorus and magnesium, as
these are needed by the newly born to develop
their bones.
%ore &inc because it is present in a number of
en&ymes, including those involved in growth
and metabolism.
Dietary reference value
"his is sets of figures relating to the
re4uirements for energy and nutrient inta!e of
all healthy individuals in the 1:, this is sat by
the department of Health in ;<<;.
"he three D-9 are=
0stimated )verage -e4uirement this is the
population average
-eference (utrient Inta!e this is at the top
end of the range and is enough for about <>?
of the population
ower -eference (utrient Inta!e this is at
the bottom of the range and is enough for only
about 8? of the population.
1se of Dietary -eference value=
Chefs and caterers to design appropriate
menus for groups of people living in
communities such as schools, old people5s
home and prisons.
%anagers to plan food supplies for large
groups of people.
Dieticians and others to assess the dietary
needs of individuals, e.g. "he elderly and
pregnant women.
Individuals to calculate their own dietary
re4uirements and to maintain or improve
health.
/ood manufacturers to provide appropriate
nutritional information on food labels.
Describe the functions of...
0ssential amino acids - 1sed to synthesis
protein for growth and repair of cells
0ssential fatty acids - 1sed to ma!e
phospholipids and fats
9itamin ) - 1sed to ma!e rhodopsin for
functioning of rod cells in the eye. 1sed to
ma!e retinoic acid, which aids cell
development and growth, especially in
epithelia.
9itamin D - ) steroid hormone that controls
absorption of calcium from the gut and its
deposition in bones.
Conse4uences of malnutrition
0nergy
Stunting results from chronic protein-energy
malnutrition, occurs in children from 8-@
years of age.
2asting results from acute protein-energy
malnutrition, occurs in individuals over @ years
of age. "his is characteri&ed by rapid weight
loss in those who had near normal weight.
:washior!or
#loated appearance
%oon face
)pathetic
marasmus
9ery thin! with wrin!led s!in
*ld man5s face
%entally alert
)nore'ia nervosa
%uscles waste +including heart muscles,
$eriods stop
#lood pressure falls
Hair becomes thin and sparse
Hands and feet are cold
"here is increased susceptibility to infection
"here are personality changes.
9itamin )
(ight blindness rod cells do not ma!e
enough rhodopsin so people can not see in
dim light
'erophthalmia the surface of cornea is
scarred which leads to blindness
$oor defence against disease such as measles.
Dry, rough s!in, as vitamin ) is needed to
ma!e retinoic acid, which is needed to
maintain epithelial tissues li!e the s!in.
9itamin D
-ic!ets occur in Children the bone become
soft and grow irregularly, the joints become
swollen and limbs and the chest may be
distorted. "ypically the legs are bow-shaped.
*steomalacia occur in adults this causes a
softening of the bones, ma!ing them tender
and painful, fracture of bone occur more
easily. %uscle wea!ness as well as loss of
appetite and weight.
*besity
Coronary heart disease caused by increased
blood pressure and blood cholesterol.
"ype II diabetes
Cancer
*steoarthritis
-heumatoid arthritis
Hypertension
Diet and coronary heart disease
High level of salt increases hypertension.
High #lood cholesterol contribute to the
formation of pla4ues in the coronary arteries
High fatty acid inta!e saturated fatty acid
increases the ris! of CHD
0ating dietary fibre protect against obesity
and reduce insulin levels in the blood, so
reducing CHD.
%oderate consumption of alcohol shown by
some studies to reduce the ris! of CHD.
0ating oily fish such as mac!erel and herring
/ormation of heart attac!. "hose who are over-
weight are twice as li!ely to suffer from CHD
than those with acceptable #%I.
It is a Degenerative condition which involves
the build-up of fatty tissue in the walls of
arteries that supply heart muscles.
If these arteries become narrowed as a result,
the flow of blood decreases and the supply of
nutrients and o'ygen to heart muscle
decreases.
"he muscle doesn5t release enough energy, the
heart becomes wea!.
"here may be a blood clot in the coronary
artery, so cutting off the supply of blood to
that area completely and leading to a heart
attac!.