Question

Overfeeding, Disuse, and Cardiometabolic Outcomes

1. Explain why a child who goes to school without eating breakfast would have difficulty concentrating on schoolwork.

2. Explain why caloric restriction alone would not be a feasible way to attain a 3:1 SER. List several other strategies for achieving a 3:1 SER.

3. Describe three cellular impairments resulting from substrate build-up in the cell. How do these cellular impairments relate to whole-body metabolic function?

4. Rank the risk factors of obesity, smoking, hypertension, and physical inactivity according to their level of public health burden. Be ready to justify your ranking.

5. In addition to the multisector strategies for improving population levels of physical activity described at the end of the chapter, list five of your own. How feasible would your strategies be to enact?

6. Does a ban on the sale of large sugary drinks (think Big Gulp or Double Gulp at 7-Eleven) make sense for public health practice? Why or why not?

Maternal Biology

1. Approximately 50% of pregnancies in the United States are unintended. In thinking about embryology, why is this a significant public health concern?

2. Fetal alcohol exposure is the leading cause of mental retardation in the United States. The data reveal a direct dose–response relationship between the amount of maternal alcohol consumption and the severity of adverse fetal outcomes; however, they do not identify a minimum threshold of effect.

• Discuss how these data inform the opinions of the CDC, ACOG, the American College of Nurse-Midwives, and other major health organizations that assert there is no safe level of alcohol consumption in pregnancy.

• How would you explain these data in simple terms to a friend who asks you if it is safe to have a few drinks in pregnancy?

3. In February 2016, the CDC provoked significant controversy with the release of the following recommendations in the Morbidity and Mortality Weekly Report, 2011-2013.

Three in four women who wanted to get pregnant as soon as possible reported drinking alcohol, putting them at risk for an alcohol-exposed pregnancy. Any sexually active woman of reproductive age who is drinking alcohol and not using birth control is at risk for an ­alcohol-exposed pregnancy.

To help prevent adverse consequences of alcohol consumption during pregnancy, health care providers should discuss and recommend, as appropriate, available contraception methods to women who are sexually active and drink alcohol.

• What was the likely intent of this public health message?

• Discuss some of the possible sources of controversy. What assumptions did the CDC make about its target audience? What might have been some effects of these assumptions?

• One of the major challenges in public health is to develop and disseminate messages that address risky health behaviors, while also not infringing on an individual’s sense of personal freedom or choice. Given your knowledge of pregnancy, embryology, and prenatal care, discuss alternative public health strategies for addressing fetal alcohol syndrome in the United States.

Aging

1. List several political, social, and economic consequences of having a shrinking workforce population (aged 18–64 years) relative to a growing population of older adults (≥ 65 years) in developed countries.

2. Let’s assume a marathon runner maintained exactly the same training regimen through middle age and after menopause. Describe the trajectory over 10 years in her marathon times and her body weight and why this might be so.

3. Discuss the pros and cons of compressing morbidity within a set life expectancy vs. extending the life expectancy without attempting to compress morbidity.

4. How can you help an older parent or relative to “age in place”? What would need to happen?

5. Create your own 2020 Health Objectives for older people.

Answer 1

1. Having a decent quality breakfast in the momentary will improve the feeling of sharpness and the craving to learn. The high metabolic proficiency of children and the quick development rates mean they need ideal nourishment. They have higher demands on their glycogen stores for the time being as they rest, and since they generally rest longer than adults, kids have a more extended "fasting" time (longer time for the time being without food). Consequently it is especially critical to have a solid breakfast to give fuel to glucose oxidation.

Hormones, for example, adrenaline and cortisol are discharged when blood glucose levels are low and can cause sentiments of dissatisfaction and crabbiness. It can weaken the attention of a kid, and can even reason vicious outbursts. Kids who don't have breakfast, will struggle to gain energy in the first part of the day to satisfy the school's needs.

Even research has shown a healthy nutritional breakfast can also contribute to improve sustained performance. When children skip breakfast that will be much harder to perform well in school.