MPU3313 - MPU2313 Health & Wellness PDF
MPU3313 - MPU2313 Health & Wellness PDF
MPU3313 - MPU2313 Health & Wellness PDF
HEALTH AND
WELLNESS
Prof Dr Shaari Abd. Hamid
Assoc Prof Raijah Rahim
Rames Prasath Mahatam Rai
Rosnida Abu Bakar
INTRODUCTION
MPU3313/MPU2313 Health and Wellness is one of the courses offered by
Faculty of Nursing and Allied Health Sciences at Open University Malaysia
(OUM). This course is worth 3 credit hours course and should covered over 8 to
15 weeks.
COURSE AUDIENCE
This course is a compulsory course for all learners of OUM.
STUDY SCHEDULE
It is a standard OUM practice that learners accumulate 40 study hours for every
credit hour. As such, for a three-credit hour course, you are expected to spend
120 study hours. Table 1 gives an estimation of how the 120 study hours could be
accumulated.
Study
Study Activities
Hours
Briefly go through the course content and participate in initial discussions 3
Study the module 60
Attend 3 to 5 tutorial sessions 10
Online participation 12
Revision 15
Assignment(s), Test(s) and Examination(s) 20
TOTAL STUDY HOURS ACCUMULATED 120
COURSE OUTCOMES
By the end of this course, you should be able to:
COURSE SYNOPSIS
This course is divided into seven topics. The synopsis for each topic can be listed
as follows:
Topic 1 introduces the learners to the basic concept of health and wellness,
characteristics of a healthy lifestyle and personal responsibility to maintain
health and wellness. As a learner, you will have the opportunity to plan for
personal health and wellness improvement based on individual scores for the
healthy lifestyle.
Topic 2 focuses on the first four dimensions of health and wellness; physical,
emotional, spiritual and intellectual. In this topic, learners will be exposed to
examples of physical activities that contribute to physical wellness. Hopefully,
the lesson will help learners to plan the strategies for emotional wellness, achieve
spiritual support as well as recognise the importance of intellectual dimension in
health and wellness.
Topic 3 concentrates on the other four dimensions of health and wellness which
are social, occupational, environmental and financial. It also explains some
strategies to enhance social wellness. It is hoped that you can identify the factors
that contribute to occupational wellness as well as your personal responsibility to
promote environmental awareness. Last but not least, basic understanding on
personal management of financial matters is also available in this topic.
Topic 5 discusses the concept of weight management related to body mass index
(BMI). You will be able to relate obesity, anorexia nervosa and bulimia as a
consequence of eating disorders. It is hoped that by the end of this topic, you will
be able to suggest techniques for ideal weight management.
Topic 7 focuses on financial health and wellness. This topic begins with a
discussion on financial health and financial wellness, followed by the challenges
confronting young adults in their quest for financial wellness. Then, you will be
introduced to the elements of financial wellness. Lastly, you will learn about
financial fitness. Hopefully by the end of this topic, you will be able to construct
your own financial fitness plan based on the knowledge given in this topic as
well as other topics.
Learning Outcomes: This section refers to what you should achieve after you
have completely covered a topic. As you go through each topic, you should
frequently refer to these learning outcomes. By doing this, you can continuously
gauge your understanding of the topic.
Summary: You will find this component at the end of each topic. This component
helps you to recap the whole topic. By going through the summary, you should
be able to gauge your knowledge retention level. Should you find points in the
summary that you do not fully understand, it would be a good idea for you to
revisit the details in the module.
Key Terms: This component can be found at the end of each topic. You should go
through this component to remind yourself of important terms or jargon used
throughout the module. Should you find terms here that you are not able to
explain, you should look for the terms in the module.
PRIOR KNOWLEDGE
No prior knowledge required.
ASSESSMENT METHOD
Please refer to myVLE.
REFERENCES
Donatelle, R., Snow, C., & Wilcox, A. (1999). Wellness: Choices for health and
fitness (2nd ed.). Belmont, CA: Wadsworth.
Edlin, G., & Golanty, E. (2010). Health and wellness (10th ed.). Sudbury, MA:
Jones & Bartlett.
Hoeger, W. K., & Hoeger S. S. (2003). Lifetime physical fitness and wellness:
A personalized program (7th ed). Belmont, CA: Thomson Wadsworth.
Insel, P. M., & Roth, W. T. (2008). Core concepts in health (10th ed.). Boston, MA:
McGraw-Hill.
Ismawati, S., Zainalabidin, M., & Golnaz, R. (2014). Healthy eating: The
preventive factors among Malaysians. Journal of Economics, Business and
Management, 2(4), 257-261.
Payne, W. A., Hahn D. B., & Mauer, E. B. (2005). Understanding your health (8th
ed). Boston, MA: McGraw-Hill.
Whitney, E. N., & Rolfes, S. R. (2002). Understanding nutrition (9th ed.). Victoria,
Australia: Wadsworth Thomson Learning.
Williams, M. H., Anderson, D. E., & Rawson, E. S. (2013). Nutrition for health,
fitness and sport (10th ed.). New York, NY: McGraw-Hill.
The TSDAS Digital Library has a wide range of print and online resources for the
use of its learners. This comprehensive digital library, which is accessible
through the OUM portal, provides access to more than 30 online databases
comprising e-journals, e-theses, e-books and more. Examples of databases
available are EBSCOhost, ProQuest, SpringerLink, Books24x7, InfoSci Books,
Emerald Management Plus and Ebrary Electronic Books. As an OUM learner,
you are encouraged to make full use of the resources available through this
library.
INTRODUCTION
Let us begin our learning of this module by first considering a concept which
may be familiar to you.
An important inference one can draw from the foregoing discussion is that the
well-being of a person is dependent on a combination of factors. Hence,
happiness, healthiness and prosperity are collectively desirable elements for a
sense of well-being. It is difficult to be happy if one is not healthy. Likewise, one
may not be able to relish his/her prosperity if one is not happy or healthy
enough to enjoy it.
In the following subtopics, you will acquire further clarity on the concepts of
health and wellness as being vital components of well-being. In addition, the
contents of the subtopic will also cover characteristics of a healthy lifestyle,
personal responsibilities for attaining and maintaining health and wellness,
factors that characterise the health and wellness state of an individual and the
benefits of a comprehensive health and wellness lifestyle. We hope that you will
enjoy this first topic and gain a lot of knowledge on health and wellness. Let us
delve deeper into the lesson!
How would you define health? As you may be well aware, there are people who
may not have an actual idea about what health means, though each may
express it in his/her own unique way. Some however understand what health
means but are unable to express the concept clearly. Let us look at a formal
definition of health by the World Health Organization (WHO).
As you can infer from the definition by WHO, being healthy encompasses a wide
span of factors and is not just about being free from diseases.
ACTIVITY 1.1
2. Cite any major differences between the WHO definition and other
explanations of health.
Historically, the concept of wellness was first introduced in the early 1970s to
represent individual attempts at perking up the existing state of health. Dunn
(1977) first used the word wellness to signify an active process in which a
person becomes aware of and makes conscious personal choices to achieve a
healthier state of being in all important dimensions of his or her life.
Edlin and Golanty (2010) further summed up the concept of wellness as being a
proactive and preventive approach designed to achieve optimum levels of
physical health, as well as social and emotional functioning. It can be seen as a
commitment within personal limitations and potentials and a process of
continued striving towards optimal health, without merely focusing on the
absence of diseases.
From the previous explanations, it is hoped that you have noticed the subtle
differences between wellness and health. To summarise, health is a state of
well-being at a particular moment based on the ability of an individual to
perform basic activities of daily living. Wellness on the other hand, is an active
process through which a person becomes aware of personal limitations and
makes conscious choices to gain more independence from the constraints to his
or her contentment for a successful existence.
Are you ready for the next subtopic? We will explore the significant
characteristics that reflect a health and wellness lifestyle in the following
subtopic.
SELF-CHECK 1.1
ACTIVITY 1.2
Reflect on your own state of health and answer the following questions:
(a) What are some of your concerns regarding personal health issues?
(c) Compare your answers to the above questions with those of your
course mates.
Now that you have a basic understanding about the concepts of health and
wellness, let us deliberate on the characteristics of a healthy individual. Before
we proceed, do ponder about the kind of life you live now and what
improvements you wish for yourself in the future. Chances are that you will opt
for being well, having an abundance of energy for your daily activities and being
free to pursue your dreams for as long as Gods given lifespan permits.
What can a person do to adopt a healthy lifestyle? The immediate choice may be
driven by the degree of internal or external locus of control within the person for
the desire to change. A person with strong internal locus of control will be
inspired by a personal wish to adopt a healthy lifestyle, regardless of how strong
the obstacles are. A person with a strong sense of external locus of control, on the
other hand, would want to survey the worth of external rewards or approval
from external sources as a reason to commit to change.
Sometimes the external source of persuasion to act may seem trivial or intangible
such as idealistic thinking of wellness after seeing a model that we admire or a
chance reading of an article on health and wellness strategies. At other times, the
desire could be more resolute such as making a strong commitment to change
dietary practices after a disheartening observation of body weight on the
weighing scale. Whatever the motives, closing the gap between aspiration and
accomplishment requires a firm commitment that is executed gradually in a
consistent manner towards desired goals.
Copyright Open University Malaysia (OUM)
TOPIC 1 CONCEPT OF HEALTH AND WELLNESS 7
Humans are very much influenced by social factors. Many of our motives and
compulsions are driven by external influences. We all wish to look and feel good
especially within our social circles. It is a common human trait to be acutely
conscious about body image. But a person who has invested time and effort to
maintain a high degree of wellness will project self-confidence and will not easily
be distraught by the negative opinions of others.
Based on the above discussion, we can see that lifestyle choices can be influenced
by numerous circumstances, ranging from personal factors to external influences.
Whatever the nature of influence, ultimately, it is up to the individual to act.
The following are some guidelines that characterise healthy lifestyle choices:
ACTIVITY 1.3
(a) List down as many factors as possible that have influenced your
current health status.
In the next subtopic, we will examine some of the attributes which impact an
individuals personal responsibility for health and wellness. What are they? Let
us look at Figure 1.2 for the answers.
Refers to factors within the control of an Refers to factors that are not within the
individual, whereby he or she can take control of an individual, such as increased
action to reduce or prevent the risks of vulnerability to certain diseases due to
adverse events from occurring, such as gender or as a result of advancing age.
choosing to refrain from smoking.
Good individuals show a caring attitude through words and actions that
reflect their respect and concern for others around them. In addition, they
tend to be un-critical and do not impose their own values by being
judgmental towards others. They are more likely to be socially aware of
variants in health issues among other people around them and act in a
socially responsible manner to fit in with like-minded individuals with
similar goals.
ACTIVITY 1.4
Clearly, there are numerous factors that influence people to pursue fitness and
adopt a healthy lifestyle. Most people who are consistent in their efforts to
maintain their health do so with the firm belief of reaping a range of physical,
psychological and social benefits for themselves. Then, there are fitness buffs
who take up fitness activities after being inspired by good-looking role models.
There are still others who indulge in fitness activities solely to develop their
physique to draw attention to themselves.
In the following subtopic, we will consider specific factors that cause people to be
susceptible to diseases, regardless of their state of fitness.
There are over seven billion people on this planet today. Although we are all
unique in our own ways, we are also similar in others. All humans have similar
physiological needs yet there are some socio-cultural and individual uniqueness
among us.
There is a popular saying that we are a product of our past. Our unique traits are
in many ways influenced by genetic factors passed down from our ancestors.
Blood-linked family members are particularly vulnerable to certain diseases that
are genetically inherited. Often close family members with these chronic diseases
pass down their genetic predisposition to their offsprings. Genetic traits can carry
risks of serious chronic diseases such as diabetes, hypertension, mental disorders
and serious blood disorders like haemophilia and thalassemia.
The good news is that even though a person may have genetic predisposition
towards certain types of chronic diseases, following properly designed and
comprehensive health and wellness programmes can reduce the risks or delay
the onset of such conditions. Although you may not be able to avoid your genetic
predisposition for certain diseases, you can still make lifestyle changes to reduce
the chances of developing them. For example, if a person has a family history of
diabetes, it would be wise for him or her to start early in life to adopt suitable
lifestyle changes as a preventive strategy to reduce the risk of developing
diabetes later on.
Aside from genetic factors, the general nature of emotional responses of a person
in dealing with his or her daily life also has a significant influence on health and
wellness outcomes. Usually, a healthy person who is emotionally resilient would
be more able to rebound back easily from incidents of emotional trauma.
Apart from these dispositions, social and environmental conditions are also
significant predisposing factors that influence health and wellness. The nature
and quality of interpersonal relationships can influence a person to be positive-
minded, loving and well-adjusted. But on the flip side, it can result in a person
indulging in unhealthy and risky activities such as violence, heterosexual
practices, smoking and alcohol and drug abuse. Conforming to herd-mentality
and peer pressure are some examples of social influences that shape a persons
action. It is believed that children of alcoholic parents have a greater risk of
becoming alcoholic themselves, but if their social environment is altered to
become more healthy and positive, the risks can be easily neutralised.
Another predisposing factor that greatly influences health and wellness choices
are values, attitudes and beliefs that are instilled in a person from early
childhood. Children of health conscious parents are more likely to choose healthy
activities as their natural recreational pursuits. Alternatively, children brought
up in a family of obese siblings while practising poor dietary habits and
sedentary lifestyles, will be more likely to perpetuate such poor practices as
adults.
ACTIVITY 1.5
Reinforcing factors for health and wellness are elements that help to promote
and encourage behaviours towards health and wellness options in a persons
life.
Some reinforcing factors may be due to external or internal motives as they may
be linked to a variety of personal reasons for persisting with a wellness
programme. Examples of external drivers may range from wanting to look and
feel good in the eyes of peers or loved ones, to conforming to a particular social
group that espouses the importance of health and wellness.
ACTIVITY 1.6
There are many tangible as well as barriers that prevent the adoption of healthy
lifestyle behaviours. For example, economic factors can be a major obstacle for a
person even if he or she is very passionate about leading a health and wellness
lifestyle. A person with an average income would find it challenging to spend
money regularly on a costly fitness programme or having to purchase customary
exercise apparel.
For some people, health and wellness activities are regarded as secondary
choices compared to physiological and security needs. In addition, the nature of
occupation and work schedules also influence the continuity of a health and
wellness routine. Many people who work on rotating shifts find it hard to cope
with a regular exercise programme, particularly due to disruption of their
circadian rhythm.
Furthermore, urban settings have been identified as another major factor that
impacts participation in health and wellness routines. Overcrowding, pollution
and lack of safety measures are major features of many urban settings, which
then discourage fitness activities. Playgrounds and recreational parks are scarce
due to the ever increasing premium on land space. The emergence of commercial
gymnasiums and fitness clubs does provide a conducive ambience for fitness, but
often these exclusive establishments are commercial in nature and cater mostly
for the well-to-do.
ACTIVITY 1.7
Generally, the choices that people make have a significant impact on the quality
and length of their lives. For example, decisions to indulge in risky forms of
behaviours can lead to detrimental consequences even in the pursuit of health
and wellness activities. Inappropriate selection of physical activities and extreme
forms of recreational indulgence increase the chances of adverse reactions and
freak accidents.
There are some people with delusional thinking who believe that they are
immune to negative health effects as a result of their risky behaviours.
Unfortunately, most of the time these are the people who are likely to drop
dead one day.
ACTIVITY 1.8
For example, physical fitness due to regular exercise and proper dietary practices
will lead to improved cardiovascular fitness and enable a person to be involved
in team sports with friends. In fact, this will improve goodwill and cordiality
within their social circles and help reduce stress and increase self-esteem among
group members. If you make it a routine, this cycle will lead to higher levels of
personal physical conditioning along with improvements in cardiovascular
fitness as well as boost energy levels. Your actions will also help to perpetuate a
healthy culture among your friends and family. Such efforts will lead on towards
creating a healthy and happy community.
There is an extensive list of benefits that one can gain by maintaining a high
degree of wellness. Some of these benefits are listed in Figure 1.4.
Figure 1.5: A person with high self-esteem always feels good about himself or herself
Such feelings of goodness and self-confidence can positively impact other areas
of a persons life as well as people around him or her.
In addition, the person also has the potential to recover quickly from a stressful
event and is able to think clearly about options to withstand pressure. People
with self-confidence are generally better equipped to face challenges and
setbacks and see them as opportunities and growth experiences.
SELF-CHECK 1.2
1.6 CONCLUSION
Congratulations! You have successfully completed the first topic. It is hoped that
you have grasped the basic concepts for an individual to take personal
responsibility for his or her health and wellness. The next topic will further
expand on the concepts of wellness and provide you with a holistic view of the
eight dimensions of wellness namely; emotional, environmental, financial,
intellectual, occupational, physical, social and spiritual dimensions.
It is hoped that the understanding gained from reading this module will enrich
you intellectually and at the same time, empower you on a path of personal
wellness. All the best!
ACTIVITY 1.9
2. Based on your score levels, prepare an action plan for healthy lifestyle
activities for yourself. Present your plan in class and compare your
plan with others to identify similarities and differences in approaches
to activities and priorities for wellness.
Donatelle, R., Snow, C., & Wilcox, A. (1999). Wellness: Choices for health and
fitness (2nd ed.). Belmont, CA: Wadsworth.
Dunn, L. (1977). What high level wellness means. Health Values, 1(1), 9.
Edlin, G., & Golanty, E. (2010). Health & wellness (10th ed.). Sudbury, MA: Jones
& Bartlett.
INTRODUCTION
Let us start this topic by reading the following quote from Benjamin Disraeli
(refer to Figure 2.1):
Figure 2.1: Benjamin Disraeli, former prime minister of Great Britain (from 1804 to 1881)
Source: www.azquotes.com
What can you infer from this quote? Obviously, the quote in Figure 2.1 states the
importance of health. But do you know that there are other dimensions as well
that are essential to health and wellness? These are the physical, emotional,
spiritual and intellectual dimensions which are important attributes for health
and wellness.
Therefore, this topic will focus on these four dimensions physical, emotional,
spiritual and intellectual. Are you ready to discover more? Let us start the
journey!
Do you agree that health is more than a matter of individual choices, family and
other social relationships? For instance, if a spouse has a serious illness, the
chances that his/her marital partner will acquire a serious illness doubles
(Stroebe et. al, 2007). This is the reason why the philosophy of holistic health
emphasises the unity of the mind, spirit and body.
For example, think of the time when you had a headache. Although headaches
can be associated with brain injury or the symptoms of another illness, more
often than not it is caused by emotional stress. This produces a tightening of the
muscles on the neck or head. These contracting muscles increase the blood
pressure in the head, thereby causing the headache. Most people relieve
headaches by taking analgesic drugs or seeking other alternative remedies such
as massage to relieve the pain as it can alter physiological mechanisms that
produce the pain.
In contrast, someone may use the holistic approach as the first step to determine
the source of stress, tension, worry, anger or frustration and then plan to reduce
the emotional stress that may cause the illness.
Health can also be defined as a reflection of your ability to use the intrinsic and
extrinsic resources related to each dimension of health to participate fully in the
activities that contribute to your growth and development, with the goal of
feeling a sense of well-being as you evaluate your progress through life (Payne,
Hahn & Mauer, 2005).
Did you realise that the real problem of health lies within ourselves? Even
though most people are aware of their unhealthy lifestyles such as smoking,
inactivity, high-fat diets or excessive stress, they seem satisfied as long as they
think they are free from any symptoms of diseases or illness. Therefore, they will
not change their lifestyle until they suffer a major health problem such as
hypertension, diabetes or heart problems. That is why it is important for us to
recognise that our current lifestyle habits dictate our future health and well-
being.
The description of the four dimensions that we will look into in the next subtopic
is as follows:
Take note that when all the dimensions to health and wellness are integrated and
function together, one will achieve a high level of wellness or optimal health.
As stated before, these dimensions are interrelated; one frequently affects the
others. For example, a person who is emotionally down often has no desire to
exercise, study, socialise with friends, or attend mosque or church and may be
more susceptible to illness. Therefore, these eight dimensions of wellness will
show you how the concept clearly goes beyond the absence of disease.
SELF-CHECK 2.1
Let us learn more on the first dimension of wellness which is physical. What does
it mean to be a physically well individual?
In addition, people in good physical condition also avoid harmful drugs and
smoking as well as seek medical care as needed and participate in activities that
help prevent illness.
How does one achieve such a condition? We will look briefly at one big factor
that contributes to the physical wellness of a person, which is physical fitness.
Jim Fixx (refer to Figure 2.3) is the famous author of the best seller book
entitled The Complete Book of Running. He died at the age of 52 due to heart
attack, although he had been running between 60 and 80 miles a week.
He believed that his high level of fitness would prevent dying from heart
attack. At age of 36, Jim Fixx smoked two packs of cigarettes per day, and did
not participate in regular physical activity and had a family history of heart
disease.
His father had his first heart attack at the age of 35 and died when he was 43
years old. Jim Fixx began to raise his level of fitness. He started to jog and quit
smoking. On several occasions, he declined to have electrocardiogram (ECG)
test, which would likely have revealed his cardiovascular status.
Now, what can you say as a conclusion to the given scenario? It illustrates that an
exercise programme itself is unable to make high-risk people immune to heart
disease, though it may delay the onset of cardiac arrest. What kind of exercises
can you practise to achieve physical fitness? Well, let us look at Figure 2.4 for
some examples.
Physical fitness is defined as the ability to meet the ordinary as well as the
unusual demands of daily life safely and effectively without being overly
fatigued and still have energy left for leisure and recreational activities.
Did you realise that when you choose to commit to physical activities as a way of
life, you will regularly exercise in order to keep fit? Aside from that, when you
are pursuing your physical fitness activities, you will probably meet other
healthy and active people. Through this, you will be able to expand your circle of
friends.
As a conclusion, we can say that a person with physical wellness is able to:
ACTIVITY 2.1
Appoint an instructor and start the exercise for the first 15 minutes.
SELF-CHECK 2.1
The emotional dimension of health encompasses the ability to cope with stress
such as remaining flexible and compromising to resolve problems. Please note
that our ability to cope with stress will change as we age and as we learn new
skills of managing our emotion. For example, young adults who are in the
process of growth and development will experience emotional vulnerability,
which may lead to feelings of rejection and failure. This can affect productivity
and self-satisfaction (refer to Figure 2.6).
Now, what can we say about emotional stability? What does it stand for?
When success is evident, people who are emotionally well radiate with expected
joy. On the contrary, when failure seems imminent, they respond by making the
best of circumstances and move beyond failure.
Last but not least, emotional wellness also involves happiness; it is seen as a long
term state of our mind that permeates the various facets of life and influences our
outlook. In other words, it means that true happiness signals exemption from
tension and depression that many people endure.
2.3.2 Self-concept
Now we will discuss self-concept and self-esteem as part of emotional health.
Firstly, the definition of self-concept. Do you have any idea what it means?
Self-concept is also the informational side of things, where you know facts about
yourself. What about self-esteem?
Self-esteem is how you feel about your own character and abilities. For
example, whether you enjoy the fact that you are talkative (high self-esteem)
or you think that you are annoying (low self-esteem).
Therefore, how can we achieve balanced emotional wellness? Well, here are some
practices that will help to enhance your emotional wellness:
We can summarise that a person with emotional wellness will be able to:
SELF-CHECK 2.2
ACTIVITY 2.2
Select the activities that you think can be used to foster Azmans
emotional growth. Discuss your plan in a group.
In fact, religious activities or meditation can also have a positive effect on our
social lifestyle as they may help us in overcoming crisis and provide us with
better coping techniques to deal with future trauma.
Another key term under the subject of spiritual dimension is altruism. What does
it stand for?
Altruism means true concern for the welfare of others which enhance ones
health and longevity.
Did you know that altruism is a powerful attribute? It is so powerful that even
watching films of altruistic endeavours would enhance the formation of an
immune system which helps fight disease.
What can we practise to increase our spiritual wellness? Well, here are some
practices that can be adopted to increase your spiritual wellness:
ACTIVITY 2.3
In the other words, when you possess positive intellectual dimension, you are
not intimidated by facts and figures with which you are unfamiliar, but you
embrace the chance to learn something new. You are self-motivated to enhance
your life in terms of further studies or professional development while holding
your own ideas and philosophies.
Furthermore, you will gain self-confidence which guarantees that you can take
your place among others without having to give up part of yourself and without
requiring others to do the same. Let us look at Figure 2.8 which shows you an
example of self-motivation quotes.
What can we do to enhance our intellectual wellness? Well, here are some
practices that will enhance your intellectual wellness:
(a) Learning to trust your ability to make good decisions;
(b) Recognising and valuing learning as a life-long learning process;
(c) Developing creativity and resourcefulness;
(d) Being discerning when taking in information from TV, the Internet and
newspaper; and
(e) Critically analysing situations and solving problems.
ACTIVITY 2.4
Reflect on your life experiences when you have been seriously ill.
(a) Describe how you feel about the nature and duration of the
illness.
(b) Discuss all the factors that you think might have contributed to
your becoming sick.
(c) Summarise all the factors that contributed to your getting well.
(d) What do you think were the most important factors that led to
your sickness?
(e) What do you think were the most important factors in your
healing process?
Please note that you need to include factors such as stress, emotional
problems and poor nutrition. Also, you may include medical care,
prayer, alternative medicines and other factors too.
Edlin, G., & Golanty, E. (2010). Health and wellness (10th ed.). Sudbury, MA:
Jones & Bartlett.
Hoeger, W. K., & Hoeger, S. S. (2003). Lifetime physical fitness and wellness:
A personalized program (7th ed.). Belmont, CA: Thomson Wadsworth.
Payne, W. A., Hahn, D. B., & Mauer, E. B. (2005). Understanding your health (8th
ed). New York, NY: McGraw-Hill.
Stroebe, M., Schut H., & Stroebe, W. (2007). Health outcomes of bereavement. The
Lancet, 370(9603), 19601973.
INTRODUCTION
Can you still recall what the eight dimensions of wellness are? Can you list them?
Well, the answers are mental, spiritual, occupational, environmental, financial,
emotional, social and physical. In the previous topic, you have learnt the first
four dimensions of wellness which are physical, emotional, spiritual and
intellectual dimensions. Therefore, this topic will continue with the rest of the
dimensions social, occupational, environmental and financial.
Before we continue, let us reflect a little. Are you working and furthering your
studies at the same time? How do you cope between them? Do you realise that
occupational dimension of wellness is important for you? Occupational
dimension of wellness is important to working adults. This is because they have
to balance between studies and work, parenting and other responsibilities.
So how do you balance your life with your study, family and work
commitments? How about your social interaction skills? Are you able to
participate in a group discussion? As a distance learner, you are expected to
share your ideas, experience and knowledge with your course mates through
interaction in the classroom or online discussion.
Social dimension is described as the relationships that you have and how
you interact with others.
So how do you achieve that? Well, in order to achieve social wellness, you need
to actively seek ways to preserve the beauty and balance of nature. As you go
along the pathway, you may discover the power to make wise choices to enhance
personal relationships, the importance of friendships and finally build a better
living space and community.
How can we develop our personal social skills? Are they inherited from your
parents? Or developed through life experience? Appropriate social skills are
developed and nurtured throughout ones adult years. During the process of
becoming a young adult, we develop many interactions and form relationships
with friends, work-mates and even parents. This may enable a person to develop
social skills effectively beyond levels that they have achieved before.
Therefore, for the young adult to achieve social wellness skills, they need to
refine a variety of social skills including effective communication skills, listening
skills and conflict management skills. In other words, it is a circle of social
adaptations that we will naturally go through unconsciously as we age. The
circle begins with family interactions, school experiences and peer group
interaction that foster social skills development among young adults (see Figure
3.1).
At a later stage, we will develop new social skills with our colleagues when we
enter college. The interaction at the higher institution will enhance the social
dimension of health among the students, lecturers and others. Thus, the social
dimension entails valuing living in harmony with course mates and housemates,
seeking positive, interdependent relationships with others and developing good
communication skills.
This later develops into social wellness. What does social wellness refer to?
Basically, social wellness refers to the ability to communicate and relate with
others with a positive self-image. This positive self-image means that you are
confident, outgoing, friendly and affectionate toward others. In addition, your
own balance and sense of self allows you to extend respect and tolerance to
others.
On the other hand, social wellness is not only concerned about ones self, but also
an interest in humanity and the environment as a whole. Socially well adapted
people are consciously enhancing their personal relationships, nurturing the
importance of friendships to build a caring community. In other words, being
socially well adapted will enhance your physical and emotional well-being.
Today, we have another term named social media. What does social media
represent? Well, let us look at Figure 3.2 for the answer.
How can we enhance our social wellness? Below are some suggestions of
practices that can enhance our social wellness:
(a) Create good rapport with others by building a strong social support
network;
(e) Interact with people of other cultures, backgrounds and beliefs; and
ACTIVITY 3.1
Sometimes/
Almost always Very seldom
occasionally
= 2 points = 0 point
= 1 point
Statement Score
I contribute time and/or money to social community projects.
SELF-CHECK 3.1
Try to reflect on these questions about yourself: Are you happy with your current
job? Do you feel stress at work? What are the factors that contribute to your stress
at the workplace? Well, these questions are related to occupational dimension.
Let us discuss more on this matter, starting with its definition.
It also entails seeking for personal satisfaction and enrichment in ones life
through work. If you are able to achieve occupational wellness, you will find
personal self-fulfilment and make a contribution to the well-being of the
institution or community at large. In other words, occupational wellness is
employment that provides personal satisfaction and enrichment in ones life.
The World Health Organization (WHO) (1994) stated that up to 58% of the
worlds population spend one third of their adult life at work. We contribute
actively to the development and well-being of themselves, our families and of
society.
This statistics means occupational wellness forms a crucial part of our overall
sense of well-being. Trying to achieve a balance between work and no work
related activity is the key to occupational wellness. Managing workplace
stressors and building functional relationships with colleagues will contribute to
your sense of occupational wellness too.
Salary might be the most important element for some people, but to others, it is
more on value and creativity or work commitment. Conversely, to some people,
the most important thing is the rewards rather than the job as people with
occupational wellness will also face demands on the job. However, they also
have some say over demands that are placed on them.
Let us move on to the key issues in occupational wellness. What are they? Well,
there are six key issues related to this dimension as described in Table 3.1.
Issue Description
Stress Ability to handle the stress that you are dealt every day at workplace.
Balance Ability to get all our work done, besides having fun, and keeping the
rest of our lives and other dimensions of wellness balance.
So, what would be the factors that contribute to occupational wellness? How do
you encourage the culture of occupational wellness at your workplace? How
about recognition from your superior or employer? Are they really appreciative
of your contribution?
You need to find ways to engage in creative and stimulating activities that allow
you to maximise your skills or broaden existing skills and gain new ones. You
can also take the opportunity for advancement and recognition of achievement.
Not to forget to encourage collaboration and interaction among co-workers,
which foster a sense of good teamwork and support.
In addition, occupational wellness will allow you to find a path to explore your
creativity, problem solving skills, and ways to learn more about your personal
interests and the world around you. Furthermore, you can keep up with current
events, find new ideas and to satisfy your intellectual curiosity that will allow
you to continue to grow.
However, occupation wellness may have positive or adverse effects on the health
of the workers. In actual circumstances, work provides the income and material
outputs that are necessities for life and at the same time, also have a positive
impact on social, psychological and physical well-being. Moreover, a high level
of occupational wellness will contribute to the achievement of material and
economic objectives that will provide high quality and performance in the
workplace.
(a) You may have to find out what type of occupation interests you. Are you
doing what you want to do with your life? Choose a career which is
consistent with your personal values, interests and beliefs.
(b) Learn how to achieve the right work life balance. You need to understand
your work and learning styles so that you are able to work both
independently and with others.
(c) Be aware of your strength and weaknesses by exploring your talents and
interests. You should talk to your manager or co-workers when a problem
arises. Believe that you have the qualities of a valuable employee and is
valued by others.
(d) Commitment to contribute your unique skills for personal and professional
development (in a meaningful and rewarding way).
(c) Make a huge difference in how they deal with situations as they project
positive image and energy which can be a healing force to those around
them.
SELF-CHECK 3.2
ACTIVITY 3.2
In other words, you should be aware of the limits of the earths natural resources
and the impact of our actions on the environment. Environmentally well people
consciously choose to live in ways that protect the world around them.
However, in todays climate, many people may still be unconcerned about what
they can do to help with environmental wellness. As an individual, you do not
have to be a member of an organisation. You can help by simply leading an
environmentally conscious life.
Do not forget to have regular meetings with your community or society to ensure
they support and are actively involved in the programme. Make sure the
recycling bins available in your home and workplace are being utilised (see
Figure 3.3).
It is important to note that we also need to protect the environment so that our
children and our future generations can live in a safer and clean environment.
For example, if we take account of the recent haze problem that affected our
environment, most of us were unaware of its danger to our health. We need to
educate people to take this situation seriously in order to keep their family and
children safe from haze. This is to prevent any sickness as haze causes many
respiratory problems as well as skin diseases (refer to Figure 3.4). Therefore,
precautions and quick judgment against environmental pollution may lead to
environmental wellness.
Have you heard about the environmental theory? What does it mean?
Basically, the focus of this model in nursing is to alter the patients environment
in order to affect change in his or her health. Florence Nightingale believed that
the environmental factors will affect health (as described in the theory) such as
fresh air, pure water, sufficient food supplies, efficient drainage, cleanliness of
the patient and bright light (particularly direct sunlight). In case any of these
factors is lacking, the patient may experience diminished health.
In situations where the air conditioning system is not in place, windows and
doors are opened to allow free movement of air and ventilation but still, they
should be checked for efficiency to ensure the air is free from microorganisms. In
order to ensure environmental safety in the hospital, all the air condition
systems, especially in the operation theatre, must be checked regularly to detect
the presence of any microorganism.
So, how do we enhance environmental wellness? Well, here are some tips for you
to practise:
(c) You need to protect yourself and others from environmental hazards. It
could be from second hand smoke, noisy environment, air and water
pollution, and also ultraviolet radiation; and
ACTIVITY 3.3
(www.definitionofwellness.com)
The recession led to the bursting of the housing bubble and the nose-diving of
the stock market and the consequent drop in family wealth. A great deal of stress
ensued too.
People become stressed over money and this has taken both a mental and
physical toll on workers, impacting health-related costs and reducing
productivity by a significant number.
However, it is observed that among all predictors, financial stress has the highest
effect (a negative effect) on financial well-being. It can be assumed that reducing
the level of employees financial strain will improve their satisfaction towards
finance aspects.
We are sure you agree that employees financial problems become the employers
problems as well. Financial wellness and the workplace that fosters it can go a
long way towards providing solutions that increase productivity and peace of
mind. Employees who experience financial wellness are happier and potentially
more productive employees to the company.
SELF-CHECK 3.3
ACTIVITY 3.4
Some of the strategies to enhance social wellness are to build good rapport
with others by a strong social support network, practise effective
communication skills with others, interact with people of other cultures,
backgrounds and beliefs, and value the principles of time management.
Hoeger, W. K., & Hoeger, S. S. (2003). Lifetime physical fitness and wellness,
a personalized program (7th ed.). Belmont, CA: Thomson Wadsworth.
Payne, W. A., Hahn, D. B., & Mauer, E. B. (2005). Understanding your health (8th
ed). New York, NY: McGraw-Hill.
INTRODUCTION
Let us begin our lesson in this fourth topic by looking at these quotes (refer to
Figures 4.1 and 4.2).
Figure 4.1: Hippocrates (from 460BC to 370BC) Greek physician of the Age of Pericles
Source: www.azquotes.com
Have you ever heard of all these quotes? Do you understand their meanings?
How does medicine relate to food? Can our bodies really run on fresh green fuel?
Imagine how this really happens in life! Isnt that interesting? These quotes are
related to healthy diet and healthy food intake to improve our lives
tremendously.
This topic will enhance your understanding of nutrition and diet. In addition,
there are a few related activities that can assist you to gain a better understanding
of this topic. As a working adult, it is very important for you to understand the
basic information about nutrition and diet so that you benefit from the
knowledge gained.
Do you agree that food is a source of pleasure? This is what some people say.
There are many reasons why people eat the way they do and it is true that food is
much more than a tool of survival. Food can be a source of comfort, a symbol of
hospitality and also an indicator of social status. For whatever reason, remember
that food also can be the source of our sickness. So, how do we prevent ourselves
from getting sick because of our food?
Food is generally good but it can also get you into trouble. So, how do we stay
healthy? Well, first of all you need to ask yourself Am I eating right? Next is
awareness. By increasing your awareness of healthy eating, you can prevent
yourself from getting sick. Most people are aware of the role of nutrition in
health and they want to eat better for health purposes but fail to translate their
desire into proper action.
Poor eating habits span all age groups. Healthy eating is a growing factor of
concern in many countries due to the increase in cases of overweight and obesity,
not only in Malaysia but worldwide. Modern lifestyles such as eating late and
young generations relying on fast food have led to eating disorders.
In order to eat right or plan your diet, you need to know the components of a
healthy diet. Therefore, this topic will teach you how to do this and then, you
will be able to choose your right diet according to your body requirements.
Remember: to stay and maintain a healthy lifestyle, you need to exercise too!
Based on Figure 4.3, can you identify the contents in these foods? Generally, our
body requires proteins, fats, carbohydrates, vitamins, minerals and water which
can be found in the food we eat. These are called essential nutrients, which mean
you must get these substances from the food you eat because your body is not
able to manufacture them at all.
4.1.1 Proteins
Did you know that proteins are the basics of our body structure? Proteins form
an important part of the bodys main structural components (muscles and bones)
and also form important parts of blood, enzymes, some hormones and cell
membranes (Insel & Roth, 2008).
What are proteins composed of? Proteins are composed of chains of amino acids.
Amino acids are the brick from which the body constructs its own protein. In
our body, we use 20 amino acids in various combinations to build the protein
required for physiological processes so that we can continue to be healthy
(Williams, Anderson & Rawson, 2013).
In addition, proteins act as a shield too. They will defend the body against
various diseases. When the body detects any invading antigens, they will
manufacture antibodies and giant protein molecules designed specifically to
combat the antigens.
Where can we get the proteins? What kind of diet contains proteins? Proteins in
the human diet come from the following two main sources:
(a) Animal proteins (such as egg, milk, meat and fish); and
(b) Plant proteins (such as cereals, nuts, beans and soy products).
ACTIVITY 4.1
Form small groups during your tutorial and discuss the importance of
proteins in the diet, according to age groups.
4.1.2 Carbohydrates
You have learnt that protein makes up the basic structure of the body. How
about carbohydrates? What is the role of carbohydrates in our body? Well, let us
look at its definition first.
What will happen if the brain and nervous system do not have adequate energy?
Lack of glucose can result in weakness, dizziness and low blood glucose
(hypoglycaemia). Reduced blood glucose during exercise decreases performance
and could lead to mental as well as physical fatigue. All the cells and tissues in
our body need carbohydrates. Furthermore, they are also important for intestinal
health and waste elimination. In fact, carbohydrates are easily converted to fuel
once they entered our body.
There are two types of carbohydrates, which are simple and complex. Simple
carbohydrates (also called simple sugars) include sugars found in fruits,
vegetables and milk, as well as sugars added during food processing.
Now let us look at the functions of carbohydrates. What are they? Do you have
any idea? Let us look at Table 4.1 for the answers.
Function Description
Provide energy Carbohydrates are like a fuel source in our body. When you eat
foods that contain carbohydrates, your body will break them down
into glucose for better absorption.
Maintain Fibre is one carbohydrate that is necessary for digestive health. The
digestive health main function is to help prevent constipation and diarrhoea and
also helps you feel full longer, which helps you avoid overeating.
Stimulate growth Carbohydrates that ferment in your intestines will stimulate the
of bacteria in growth of bacteria. This bacteria helps to break down food so that it
intestines can be used by the body. Some bacteria protect the colon from
harmful cells such as cancer. The foods that stimulate this type of
bacteria are known as prebiotics. Prebiotics are very important for
intestines health and you may want to consume it in tablet or liquid
form. For example, yogurt drinks such as Yakult or Vitagen.
ACTIVITY 4.2
Think of one recipe for your lunch to ensure you get enough portions of
carbohydrates. Discuss with your course mates during tutorial and
share your findings.
4.1.3 Fats
Now let us turn our attention to fats. Did you know that fats are also known as
lipids? The fats stored in our body represent usable energy, they help insulate
our body, and they support and cushion our organs. Fats in the diet help our
body to absorb fat-soluble vitamins (A, D, E and K) as well as add important
flavour and texture to foods. In addition, fats are the major fuel for the body
during rest and light activities.
There are two types of fats linoleic acid and alpha-linolenic acid. They are
essential components of our diet. They are used to make compounds that are key
regulators of body functions such as the maintenance of blood pressure and the
progress of healthy pregnancy.
Function Description
Energy Carbohydrates are the main source of fuel in our body. Sometimes
our body system turns to fat as a backup energy source when
carbohydrates are not available.
Vitamins Some types of vitamins rely on fat for absorption and storage.
absorption Vitamins A, D, E and K (called fat-soluble vitamins) cannot
function without adequate daily fat intake. These vitamins are
essential parts of your daily diet. Absorption of these vitamins may
be compromised without proper diet.
Insulation Fat cells, stored in adipose tissue, insulate your body and help to
sustain normal body temperature. Adipose tissue is not always
visible, but if you are overweight, you may be able to see it under
your skin. Stored fats surround vital organs to keep them protected
from sudden movements or outside impacts.
Did you realise that most of the fats that we eat are hidden in food? This is
because they have been incorporated during the preparation or cooking method
such as frying.
Saturated fats have been found to impair the ability of HDLs to prevent
inflammation of blood vessels and reduce their ability to react normally to stress,
thus reducing the risk of heart disease. So it is important for us to choose
unsaturated fats instead of trans or saturated fats.
How do we reduce both saturated and trans fat in our diet? The best way is to
lower your intake of meat and full-fat dairy products (whole milk, cream, butter,
yogurt and ice-cream). How about trans fats? Do you like to eat French fries? If
you do, please reconsider because deep-fried food, crackers, cookies and baked
goods contain trans fat which is not so good for your health.
ACTIVITY 4.3
Discuss the relationship between good and bad fats and how these fats
can lead to heart disease. Then, suggest ways to prevent it.
4.1.4 Vitamins
What do you understand about vitamins? We have heard about all types of
vitamins but how far do we understand the importance of vitamins in our diet?
Should we take supplements to ensure we have adequate vitamins? These are the
questions people always ask when they plan to buy additional vitamins. Now, let
us look at the details of vitamins. Firstly, its definition.
Take note that vitamins do not serve as calories but serve as coenzymes. By
facilitating the actions of enzymes, vitamins help initiate a variety of body
responses including energy production, use of minerals and growth of healthy
tissues.
As human beings, we need 13 types of vitamins; four are fat-soluble (A, D, E and
K) and nine are water-soluble (C and the 8 B-complex vitamins such as thiamin,
riboflavin, niacin, vitamin B-6, folate, vitamin B-12, biotin and pantothenic acid).
Water-soluble vitamins are absorbed directly into the bloodstream (Insel & Roth,
2008).
Where can we easily get vitamins? Forget about the bottled ones in the
pharmacies! Let us look at the natural sources. Vitamins are abundant in fruits,
vegetables and grains. In fact, our skin makes vitamin D when exposed to
sunlight and our intestinal bacteria make vitamin K.
What will happen if you dont get enough vitamins? Vitamins deficiency will
lead to a lot of problems. For example, vitamin A deficiency can cause blindness
and vitamin B6 deficiency can cause seizures. But remember! If you consume
extra vitamins, it will cause you harm too! For example, high doses of vitamin A
are toxic and increase risk of birth defects while excessive intakes of vitamin B6
can lead to irreversible nerve damage.
Let us look at Table 4.3 which shows you the water-soluble vitamins and their
functions. You might want to remember these functions to ensure you get
adequate dose.
Vitamin Function
B12 Helps to make red blood cells, nerve cells and genetic material
(cyanocobalamin) (DNA).
Breaks down carbohydrate and fat.
Folate (folic acid) Helps to make red blood cells and enzymes and prevents neural
tube defects.
Breaks down DNA material and reduces levels of homocysteine
(high levels are a risk factor for cardiovascular disease).
C (ascorbic acid) Forms collagen (an essential component of the skin, blood
vessels, bone and teeth).
Acts as an antioxidant, providing resistance to infections and
promoting wound healing.
Improves non-harm iron absorption.
Vitamin Function
Vitamin A Maintains healthy skin and eyes, improving vision at night and
(retinol) in dim light.
Acts as an antioxidant, having a role in cancer prevention.
ACTIVITY 4.4
Do you think that by exposing yourself to direct sunlight, you can get
enough vitamin D? Discuss the pros and cons of this method with your
tutor.
4.1.5 Minerals
Why do we need minerals? Minerals are important elements to regulate body
functions, aid in the growth and maintenance of body tissues, and help release
energy. They are also critical in the regulation of a number of body processes,
including fluid balance, nerve impulses, muscle contraction, heart function,
blood clotting, protein synthesis and red blood cell synthesis.
For your information, there are about 17 essential minerals that your body needs
including calcium, phosphorus, magnesium, sodium, potassium and chloride.
Essential minerals are divided into major minerals (macro minerals) and trace
minerals (micro minerals). These two groups of minerals are equally important,
but trace minerals are needed in smaller amounts than major minerals. Examples
of macro minerals are calcium, phosphorus, sodium, potassium and magnesium
whereas micro minerals consist of zinc, iron, copper, selenium and iodine.
Can you name some examples of food that contain the minerals? Examples of
food that contain minerals are lean meats (rich in iron), dairy products (excellent
source of calcium). Green leafy vegetables, white and sweet potatoes, banana and
other fruits contain potassium.
SELF-CHECK 4.1
Name all the nutrients that we need to stay healthy and give three
examples for each.
4.1.6 Water
I am sure you are aware that water is the major component in our body and in
foods. Generally, people can die if they do not have water for certain periods due
to dehydration. Our body is made up of 50 to 60% water. Water forms the basis
of blood, digestive juices, urine and perspiration, and is contained in lean muscle,
fat and bones.
Why do we need water? Our body needs water to regulate body temperature;
water plays a key role in nearly all of the bodys biochemical reactions. However,
most people never seriously think about the importance of water for their body.
In fact, many of us obtain fluids from fruits or vegetables rather than drink it
straight.
Here are some interesting facts about water for you to know (Better Health
Channel, 2015):
(a) Body water content is higher in men than in women and falls in both with
age;
(b) Most mature adults lose about 2.5 to 3 litres of water per day. Water loss
may increase in hot weather and with prolonged exercise;
(d) An air traveller can lose approximately 1.5 litres of water during a three-
hour flight; and
What are the risks if we do not drink enough water? Inadequate water intake can
increase the risk of kidney stones and urinary tract infection, especially in
women! It can also lower our physical and mental performance and lead to
dehydration. How do you know when your body needs water? A small amount
of dark-coloured urine can be the indicator that you are not consuming enough
water! Do you know what the solution is? Drink a lot of water (recommended
eight glasses per day) as clear or pale coloured urine is the indicator for enough
fluids in your body.
Generally, people from different age groups will need different types of food. For
example, young people need to consume a variety of foods. Children and
teenagers, often need encouragement to eat vegetables and fruits. This group
usually loves to take fast food that contain more sodium and preservatives than
healthy fresh foods. The best thing a parent can do is to provide children with a
variety of foods.
College students always choose to consume unhealthy food because of their daily
activities. Some colleges provide dining hall or food court that does not offer
food that is high in nutrients or low in fat. They also love to grab fast food meals
because of their busy schedules.
Take note that nutrients are not changing so much as people age, but older adults
tend to become less active and they require fewer calories to maintain body
weight. Because of the age-related changes in digestive tract, their body also have
problems with the absorption of nutrients. Thus, they need to consume nutrient-
dense food in order to meet their body nutritional requirement.
Becoming an elite athlete requires good genes, good training and conditioning,
and not forgetting, a sensible diet. Optimal nutrition is essential for peak
performance. The most important aspects for athletes are to increase their energy
requirement and make sure they take enough fluids during their training to
remain hydrated.
(a) Athletes can achieve peak performance by frequent training and eating a
balanced diet that includes a variety of foods;
(b) Carbohydrates and fat can provide fuel for their body;
(c) The use of fat as a fuel source depends on the intensity and duration of the
exercise, and the athletes condition;
(d) Exercise will increase the athletes need for protein; and
(e) Water is a very critical nutrient for all athletes. Without enough intake of
water, dehydration may occur and cause muscle cramps and fatigue.
Furthermore, these conditions will increase the risk of heat stroke.
In order for you to understand the types of diet, further discussion in the next
subtopic will enable you to see the differences between healthy and therapeutic
diets. Let us continue our lesson!
ACTIVITY 4.5
1. Discuss with your tutor the appropriate diet for 6-year-old boys
and girls. Provide an appropriate diet that these children should
take.
2. Form two groups and debate these statements:
(a) Every time you eat or drink, you are either feeding disease
or fighting it.
(b) Do not eat less, eat right.
Eating more fruits and vegetables, cooking meals at home, and reducing your fat
and sugar intake, on the other hand, will help to improve mood and lower your
risk for mental health problems. If you have already been diagnosed with a
mental health problem, eating well may even help you to manage your
symptoms and regain control of your life. This shows the power of food.
How do we ensure we follow a healthy diet? You do not need to be perfect and
completely eliminate foods you enjoy to have a healthy diet that will make a
difference to the way you think and feel.
Here are some tips for planning a healthy diet (Robinson, Segal & Segal, 2015):
(i) Prepare your own meals: Cooking meals at home will help you take
charge of what you are eating. You can monitor exactly what goes into
your food.
(ii) Make the right changes: Choose healthy foods only for your diet.
(iii) Simplify: Count your calories; think of your diet in terms of colour,
variety and freshness. Avoid packaged and processed foods and opt
for more fresh ingredients.
(iv) Read the labels: Be aware of what is in your food such as hidden
amounts of sugar and salt in packaged food.
(v) Your feelings after eating: This will help to foster healthy new habits
and tastes. The more healthy food you eat, the better you will feel
after a meal. Do not eat junk food as it causes more harm than good.
(i) Water can help in flushing our systems of waste products and toxins.
(ii) You may get dehydrated if you do not drink enough water and the
symptoms are tiredness, low energy and headaches.
(ii) You should feel satisfied after eating, but not stuffed.
(iii) Get a balanced diet: Protein, fat, fibre, vitamins and minerals to
sustain a healthy body.
(i) Fruits and vegetables are low in calories and nutrient dense. Focus on
eating the recommended daily minimum of five servings of fruits and
vegetables.
(ii) Try to eat a variety of colourful fruits and vegetables every day as
deeply coloured fruits and vegetables contain higher concentrations of
vitamins, minerals and antioxidants. You may add berries to breakfast
cereals, fruit for dessert and snack on vegetables such as carrots, snow
peas or cherry tomatoes instead of processed snack foods.
(i) Sugar not only creates weight problems but it also causes energy
spikes. In addition, it has been linked to diabetes, depression and
increase in suicidal behaviours for some people.
(ii) That is why we need to reduce the amount of candy and desserts that
we eat. However, it is only part of the solution as sugar is also hidden
in foods such as bread, cereals, canned soups and vegetables, pasta
sauce, margarine, instant mashed potatoes, frozen dinners, low-fat
meals, fast food and ketchup.
(iv) Taking too much salt can cause high blood pressure and lead to an
increased risk of stroke, heart disease, kidney disease, memory loss
and erectile dysfunction.
A therapeutic diet is a meal plan that controls the intake of certain foods or
nutrients.
For this module, the discussion on therapeutic diet will focus on diabetes, high
blood pressure and renal diet only. You can get more information on other
diseases from textbooks or the Internet. Why do we just focus on these three
major diseases? This is because these diseases are very common nowadays and
they can affect the public at any age.
So, what is a diabetes diet? In the medical field, it is also known as medical
nutrition therapy (MNT) for diabetic patients. It is about eating a variety of
nutritious foods in moderate amounts and following regular mealtimes. It
is not a restrictive diet but MNT is a healthy-eating plan that is naturally
rich in nutrients and low in fat and calories. In fact, this diet emphasises
fruits, vegetables and whole grains; it is the best eating plan for everyone to
stay healthy.
(ii) Fibre-rich foods: They are important to reduce risk of heart disease
and help in controlling blood sugar control. For examples, vegetables,
fruits, beans, nuts, whole-wheat flour and wheat bran.
(iii) Fish: Patients can eat fish at least twice a week. Fish can be a good
alternative to high-fat meats. For example, cod, tuna and halibut have
less total fat, saturated fat and cholesterol than meat and poultry. Fish
such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty
acids, which can promote heart health by lowering blood fats called
triglycerides.
(iv) Good fats: Most fats are high in calories. However, foods that
contain monounsaturated and polyunsaturated fats like avocados,
almonds, pecans, walnuts, olives, canola oil, olive oil and peanut oil
can help lower your cholesterol levels.
Take note that diabetes can increase your risk of heart disease and stroke by
accelerating the development of clogged and hardened arteries. The
following are foods that you need to avoid if you have diabetes:
(i) Saturated fats: High-fat dairy products and animal proteins such as
beef, hot dogs, sausage and bacon contain a lot of saturated fats. You
should limit these foods to ensure you can stay healthy.
(ii) Trans fats: These fats are found in processed snacks, baked goods,
shortening and stick margarines, and should be avoided completely.
(iv) Sodium: Aim for less than 2,300mg of sodium a day. High sodium is
highly not recommended as it can increase your risk for high blood
pressure and other diseases.
What does DASH diet consist of? What to eat according to this diet? To stay
healthy, you need to follow the recommended diet to prevent diseases
(refer to Table 4.5).
Food Description
This diet is to keep the levels of electrolytes, minerals and fluid in your
body balanced especially when you have chronic kidney disease or are on
dialysis. People on dialysis need to follow this special diet to limit the
build-up of waste products in the body. Limiting fluids between dialysis
treatments is very important because most people on dialysis urinate very
little due to the malfunction of their kidneys. Without urination, fluid will
build up in the body and cause too much fluid in the heart, lungs and
ankles and could cause other complications.
SELF-CHECK 4.2
ACTIVITY 4.6
People of different age groups will need different types of food. Special
population groups include children and teenagers, college students, older
adults, athletes and pregnant women.
Healthy eating is about feeling great, having more energy, improving your
outlook and stabilising your mood.
A therapeutic diet is a meal plan that controls the intake of certain foods or
nutrients.
Blakely, T. (2013). A fat week: Debates about saturated fat that will not go away.
Retrieved from http://blogs.otago.ac.nz/pubhealthexpert/2013/10/29/a-
fat-week-debates-about-saturated-fat-that-will-not-go-away/
Carruthers, F. (2006). The facts about vitamins and minerals. Retrieved from
http://www.healthyfood.co.nz/articles/2006/december/the-facts-about-
vitamins-and-minerals
Insel, P. M., & Roth, W. T. (2008). Core concepts in health (10th ed.). Boston, MA:
McGraw-Hill.
Mayo Clinic. (2013). DASH diet: Healthy eating to lower your blood pressure.
Retrieved from http://www.mayoclinic.org/healthy-lifestyle/nutrition-
and-healthy-eating/in-depth/dash-diet/art-20048456
Mayo Clinic. (2015). Sample menus for the DASH diet. Retrieved from
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-
eating/in-depth/dash-diet/art-20047110?pg=1
Robinson, L., Segal, J., & Segal, R. (2015). Healthy eating. Retrieved from
http://www.helpguide.org/articles/healthy-eating/healthy-eating.htm
Whitney, E. N., & Rolfes, S. R. (2002). Understanding nutrition (9th ed.). Victoria,
Australia: Wadsworth Thomson Learning.
Williams, M. H., Anderson, D. E., & Rawson, E. S. (2013). Nutrition for health,
fitness and sport (10th ed.). New York, NY: McGraw-Hill.
INTRODUCTION
Are you happy with your weight? Do you weigh yourself every morning and feel
dissatisfied? How do you feel when you look at the scale? Hopefully, you do not
hurt the scale, unlike the cartoon in Figure 5.1!
Do you agree that most people think they should weigh more or less than they
do? Why do they think this way? Well, the primary reason for this is usually
their appearance! Our appearances have a very strong link to our weight. For
instance, the size of your clothing. Just think of your clothing size when you were
20. Is it the same as your current size? If the answer is no, then there are two
possibilities, either that you have sized down or sized up. If you have sized
down, yeay! Hurray for you! But if you have sized up, then you need to ponder
on your diet and physical activities.
Most of us have our own image or perception of how we would like to look,
particularly if it concerns our body weight. Sometimes we need to change the
way we look to ensure we achieve the image that we intend to have. Changes
may be needed to achieve an ideal body weight especially to attain a new
appearance. Ones physical appearance may improve ones self-esteem.
The two basic concepts of weight management are body mass index (BMI) and
body composition. How do we differentiate them? Let us find out the answers in
the following subtopics.
Nowadays, there are a lot of computer applications and websites that can perform
the calculation for you. You can try one at this website http://goo.gl/zURa85.
Take note that calculating BMI for children and teens is more complex than for
adults as it includes both gender and age (Insel & Roth, 2008). Did you know that
BMI is used as a screening tool to identify weight problems in children? The
Centers for Disease Control and Prevention (CDC) (2015) has developed BMI age
growth charts for girls and boys which can be consulted to provide a percentile
for a childs or teens gender and age (Williams, Anderson & Rawson, 2013). This
is shown in Figure 5.3.
BMI does not reveal anything about body composition. Therefore, we need
another method to evaluate actual body composition. This will be explained in
the next subtopic.
But, keep in mind that the most important fact you should know are the factors
that contribute to excess body fat. Most of us claim that we follow a proper diet
but still gain weight. Why is that so? This is because of our body weight and
body compositions are determined by multiple factors that may vary from
individual to individual. Those factors can be grouped into genetic,
physiological, lifestyle and psychosocial.
These four factors are further explained in the following Table 5.1.
Factor Description
Genetic Genes influence body size and shape, body fat distribution and
metabolic rate. The genes that you inherit from your parents may
influence your body weight but the lifestyle you adopt can change
that! That is the fact that you need to remember.
Lifestyle Eating and physical activities influence our body weight. Majority of
overweight adults and children will admit they are overeating,
consume high-fat, high-sugar and high-calorie foods.
You can visit the listed websites for more explanation on these factors:
SELF-CHECK 5.1
Form a group of three or four people in your tutorial class and discuss
the factors that contribute to excess body fat.
5.2 OBESITY
Now let us look at obesity. It is hoped that by the end of this subtopic, you will
be able to identify the causes of obesity.
Did you realise that healthy eating is currently a growing concern in many
countries? This is due to the rise in overweight and obesity rates worldwide (see
Figure 5.4).
Overweight and obesity has changed the way we view nutrition. Nutrition
transition is a term that refers to the change in diet structure, sedentary lifestyles
and rapid increase in obesity rate (Ismawati, Zainalabidin & Golnaz, 2014; Wan
Nazaimoon et al., 2011). Based on WHO report in 2010, Malaysia has been rated
as the sixth country with the highest obesity rate in Southeast Asia (Ministry of
Health Malaysia, 2010). Are we going to keep this record? Of course not! That
is why we need to have a healthy lifestyle.
Figure 5.5: Body mass index (BMI) for overweight and obesity
Keep in mind that being obese or overweight is not about aesthetics, but more on
being at greater risk of health problems. Some of the health problems related to
weight issues are explained in Table 5.2.
Heart diseases As your BMI increases, so does the risk for heart problems. This
problem happens when plaque builds up in your coronary
arteries or arteries that supply your heart muscles with blood and
reduces the blood flow to the heart muscle. Plaque that
accumulates on the inner walls of your arteries is made from
various substances that circulate in your blood. These include
calcium, fat, cholesterol, cellular waste, and fibrin, a material
involved in blood clotting. As plaque deposits grow, it results in a
condition called atherosclerosis. This condition causes the arteries
to narrow and harden.
High blood Blood pressure is the force of blood pushing against the walls of
pressure arteries. If the pressure rises for a long period of time, it can
damage our body in many ways. The chance is higher if you are
obese.
Stroke When you are overweight or obese, plaque can easily build in
arteries. If the area of plaque ruptures, blood clot might form and
this condition can cause blockage of blood and oxygen flow to the
brain. The risk of stroke is higher if your BMI is higher.
Diabetes (type 2) Diabetes in simple words means high level of glucose in our
blood. For type 2 diabetes, your bodys cells fail to use insulin
properly. Overweight people are more likely to develop type 2
diabetes if they fail to reduce their weight.
You can visit this website for more information about health problems related to
obesity at http://goo.gl/T16QGR.
ACTIVITY 5.1
As shown in Figure 5.6, there are two extreme conditions of eating habits that
lead to eating disorder. First, someone who consumes too much food and loves
eating is at risk of obesity. This disorder is known as bulimia nervosa. Second,
someone who refuses to eat is at risk of an extreme condition known as anorexia
nervosa.
Teenagers and young women are those groups of people who mostly experience
eating disorders. Why are these eating disorders dangerous for our health?
Figure 5.7 shows you how people with anorexia nervosa look like.
You can visit this YouTube link for better understanding on this problem at
https://goo.gl/W2AycE.
For those suffering from anorexia nervosa, life becomes a relentless pursuit of
thinness; they are willing to go to extremes to lose weight, even though they are
already skinny. Anorexia is not about food or weight but is much more
complicated than that. A person who suffers from this condition can die if he or
she does not seek proper treatment. Fortunately, recovery is possible if they want
to change.
Restricting Purging
Now let us talk about the characteristics of anorexia nervosa. What are they?
People with anorexia nervosa are typically introverted, emotionally reserved and
socially insecure. In addition, their sense of self-esteem may be tied up entirely in
their evaluation of their body shape and weight (Insel & Roth, 2008).
What are the health risks if you have anorexia nervosa? Well, health
consequences that can happen include the following:
(a) For women, they can stop menstruating because of extreme weight loss;
(b) Intolerance of cold temperature;
(c) Low blood pressure; and
(d) Low heart rate.
Did you know that when body fat is virtually gone and muscles are severely
wasted, our body will turn to its own organs in a desperate search for protein?
That is why this may be the primary cause of death for anorexia nervosa patients.
In addition, their desperation to look thin can be one of the reasons they commit
suicide.
Figure 5.8: Vomiting food after eating is one of the characteristics of bulimia nervosa
Source: http://amarhealth.com/2015/09/20/bulimia-nothing-unusual-good-for-health/
Sometimes, people purge after eating only a small snack or a normal-size meal.
Have you heard of any famous celebrity who has this problem?
Purging Non-Purging
Regularly self-induce vomiting or misuse Use other methods to get rid of calories
laxatives, diuretics or enemas after bingeing. and prevent weight gain, such as fasting,
strict dieting or excessive exercise.
What do you think about the characteristics of a person with bulimia nervosa?
A bulimic person on a binge will consume a lot of food and this is usually
followed by purging, vomiting or using laxatives. They always appear to eat
normally but in real situation, they do not feel happy when surrounded by food.
A factor that may contribute to this problem is changes in life such as having a
new baby, losing a job or stress.
Copyright Open University Malaysia (OUM)
TOPIC 5 MAINTAINING WEIGHT 99
What are the health risks of this eating disorder? One of the risks is tooth decay.
Tooth decay may develop because of the large consumption of sugar. In addition,
repeated vomiting or the use of laxatives in combination with deficient calorie
intake may damage liver and kidneys and can cause abnormal heart rhythm
(cardiac arrhythmia). There are a lot more health consequences of bulimia
nervosa which you can read more in any related websites. One example is from
this website at http://goo.gl/K8dBXX.
So how do we treat this disorder? A person suffering from bulimia nervosa needs
to stabilise the eating pattern and improve their coping skills. For medical
treatment, they need to get advice from qualified psychiatrists and nutritionists.
SELF-CHECK 5.2
ACTIVITY 5.2
Imagine you are suffering from a eating disorder. What are the steps
that you may take when you realise that your life is worth more than
the problem you are having?
What can we do to gain an ideal weight? Exercise? Limit what we eat? I know
most of us would choose the second option but why do you need to suffer when
you can enjoy your food by planning your diet. Just keep in mind that you must
know how to ensure you get your ideal weight and stay healthy. In order to
ensure these targets are achieved, you must learn weight management
techniques.
First of all, let us look at how we should adopt healthy lifestyles for successful
weight management.
Take note that you also need to pay attention to the total calorie in take and
portion size so as to adjust eating habit to suit your requirement.
We here discussed some tips to ensure you are able to adopt proper techniques
for weight management. Now let us look at how body image is important to help
you feel good. The objective is to ensure that you are happy with your ideal
weight and able to get rid of negative thoughts if your weight increases.
When you have an ideal body weight, immediately your image will change and
you will be happy with your appearance.
However, some of us have severe body image problems. This will cause
significant psychological distress. Adolescents and adults who have negative
body images are more likely to have restricted diet or other eating disorders.
Generally, women are more concerned or dissatisfied with their body (Insel &
Roth, 2008).
How can you avoid body image problems? The following are some tips for those
who plan to make changes:
(a) Focus on healthy diet and ensure you take proper exercise.
(b) Ensure you have good psychological health because your worth as a
human being is not based on your appearance.
(c) You can influence your body size and determine your own lifestyle. You
may want to accept your size.
(f) Do not judge yourself or others based on appearance. Body size is just one
characteristic; you need to keep in mind that being happy is more
important.
ACTIVITY 5.3
There are two important concepts in weight management, which are body
mass index and body composition.
Body composition refers to fat-free mass and body mass (fat). Our body is
divided into these two components. Fat-free mass includes non-fat tissues
like bone, muscle, water, connective tissue, organ tissues and teeth, while
body fat includes fats that incorporated in the nerves, brain, heart, lungs,
liver and mammary glands.
There are four factors that contribute to excess body fat genetic,
physiological, lifestyle and psychosocial factors.
There are two types of eating disorders, namely, anorexia nervosa and
bulimia nervosa.
Centers for Disease Control and Prevention (CDC). (2015). Division of nutrition,
physical activity and obesity. Retrieved from
http://www.cdc.gov/healthyweight/assessing/bmi/index.html
Insel, P. M., & Roth, W. T. (2008). Core concepts in health (10th ed.). Boston, MA:
McGraw-Hill.
Ismawati, S., Zainalabidin, M., & Golnaz, R. (2014). Healthy eating: The
preventive factors among Malaysians. Journal of Economics, Business and
Management, 2(4), 257-261.
Keyes, A. (2014). Infographic: Obesity skyrockets across the globe. Retrieved from
http://www.nbcnews.com/nightly-news/infographic-obesity-skyrockets-
across-globe-n116996
Wan Nazaimoon, W. M., Kamarul Imran, M., Amir Sharifuddin, M. K., Aziz
al-Safi, I., Ikram Shah, I., Khalid, A. K., Nor Azmi, K., ... Wan Mohamad,
W. B. (2011). Prevalence of overweight and obesity among adults
Malaysian: An update. Asia Pacific Journal of Clinical Nutrition, 20(1), 35-
41.
William, M. H., Anderson, D. E., & Rawson, E. S. (2013). Nutrition for health,
fitness and sport (10th ed.). New York, NY: McGraw-Hill.
INTRODUCTION
Let us start our lesson by looking at this famous quote:
We are sure you are familiar with it. What does this quote imply? The implied
message here is that promoting good habits to maintain health is a better option
than seeking cure for an ailment. The implication of the message proposes that
people who practise healthy habits as a way of life have a higher chance to enjoy
freedom from disease as dependence on medications and treatments to maintain
wellness is not a healthy way of living.
You will learn their definitions, risk factors, signs and symptoms as well as
preventions. It is hoped that by the end of this topic, you can design your
personal plan to improve your health and wellness as well as preventing these
diseases.
Did you know that since the beginning of the 20th century, life expectancy has
improved dramatically worldwide especially in developed countries? Now,
people are living longer with significantly improved quality of life and not
succumbing easily to debilitating diseases. In Malaysia, the average life
expectancy has risen dramatically in the last 50 years, from below 60 years
during the Independence era to an average of 75 years today (MOH, 2015).
In addition, most people now prefer to take an active role in decisions related to
their health matters as they dread the prospect of being hooked to a lifetime of
medications to cope with chronic illnesses.
The United Nations (UN) and the World Health Organization (WHO) work
closely with member countries to promote health and wellness of the
community. The promotion of healthy behaviours by health authorities has
effectively reduced the burden of preventable diseases and promoted better
quality of life and sense of well-being among the population.
For example, some of the deadly diseases like small pox and poliomyelitis is said
to be totally eradicated now. With the effective control of dreaded infections and
communicable diseases especially in countries with modern healthcare systems,
chronic and non-communicable diseases due to lifestyle choices is now emerging
as significant forms of disease patterns.
You will learn more on these five diseases in the next subtopics. Hopefully you
can understand that many of these diseases can be controlled and even
prevented through lifestyle modifications. Let us now focus on some of the
serious but common diseases prevalent in this country.
ACTIVITY 6.1
3. Briefly state the lifestyle habits that relate to the cause of each of
the diseases you have identified in Question 2.
The most serious cardiovascular diseases that are related to lifestyle choices are
coronary heart diseases, heart failure, hypertension and stroke. There are some
heart conditions caused by other factors such as rheumatic heart disease and
valvular heart diseases due to infection and septal defects caused by congenital
anomalies.
The heart is a muscular organ about the size of your fist and is located at the
centre of the chest, behind the sternal bone.
The following Figure 6.1 shows you the location and diagram of the heart.
Take note that there is a disease associated with coronary arteries. It is called
coronary heart disease (CHD) which accounts for the most number of fatalities
among cardiovascular diseases in adults. In other words, coronary artery disease
leads to coronary heart disease. Therefore, we will learn about this disease so that
you will be able to identify the common risk factors for coronary heart disease.
Did you know that the narrowing of the arteries due to the plaque is known as
atherosclerosis? Take note that as the size of the plaque gradually gets bigger, the
oxygenated blood supply reduces, causing damage to the cells of the heart
muscle. During this event, a person will eventually experience a heart attack that
manifests as chest pains. In medical terminology, a minor heart attack or
transient chest pains is known as angina pectoris, whereas a full-blown heart
attack is known as myocardial infarction.
(a) Smoking;
(b) Diabetes mellitus;
(c) Hypertension;
(d) High blood cholesterol;
(e) Obesity; and
(f) Excessive and prolonged stress.
ACTIVITY 6.2
In fact, coronary heart disease also happens to be among the top five reasons for
hospital admissions in Malaysia since the past decade. This trend is similar to
other developed and major developing countries.
For example, the Centres for Disease Control and Prevention (CDC) (2015)
reports that about 610,000 people die of heart disease in the US every year that
is one in every four deaths. As for the UK, about 1 in 6 men and 1 in 10 women
die of CHD annually. The astonishing facts are a grim reminder of the serious
threat that CHD poses on the health and wellness of people.
ACTIVITY 6.3
(a) Radiation of pain over left arm, neck, jaw, shoulder or stomach;
(b) Tightness over chest;
(c) Breathlessness;
(d) Heart palpitations;
(e) Excessive sweating;
(f) Feeling lightheaded or fainting; and
(g) Nausea.
Take note that not all victims of heart attacks experience the signs and symptoms
mentioned above as a person may even develop a silent heart attack during
sleep. Silent heart attacks are known to occur among people with diabetes.
Lifestyle choices are linked to CHD. Some of the specific ways to prevent CHD
are as follows:
SELF-CHECK 6.1
ACTIVITY 6.4
Did you know that since the past 50 years, cancer has instilled great fear among
people? This is due to likelihood of it being a fatal disease with almost no
prospect of cure. In spite of major advances in medical science and technology,
the disease continues to afflict people of all ages, gender, ethnic origins and
socioeconomic status.
Previously, cancer used to be a worry among older age groups, but now
childhood cancers such as leukaemia and bone cancers are being reported with
increasing frequency. The Health Ministry of Malaysia (MOH, 2015) reported
4,414 deaths due to cancer in the year of 2013, ranking as the fourth principal
cause of death in hospitals of Malaysia.
Cancer is a condition where cells in a specific part of the body begin to grow
at an abnormal and uncontrollable rate.
Tumours are abnormal masses of tissue cells that have grown and multiplied
rapidly.
These tumours can be benign or malignant. What are the differences between
them? Let us check out Table 6.1 for the answer.
Non-life threatening growths which are Grow rapidly and spread from the original
localised they do not spread to other primary site, to form new secondary
parts of the body. tumorous growths at other parts of the
body through a process called metastasis.
However, they can become large and
interfere with blood and lymphatic The cancer cells can infiltrate cells within
circulation or they may obstruct other their vicinity and destroy blood vessels,
body functions. organs, nerves and lymphatic system.
Let us look at Figure 6.2 which shows you the difference between benign
tumours and malignant tumours.
Figure 6.2: The difference between benign cells (not cancer) and malignant cells (cancer)
Source: www.medicinenet.com
SELF-CHECK 6.2
Apart from these four, cancers are also specified by the organ in which they
breed. Can you think of some examples? Well, the answers are lung cancer,
breast cancer, prostate cancer, bowel cancer, brain cancer and others. Keep in
mind that the diagnosis and treatments vary for each type of cancer.
Experts believe that the causes of most types of cancers are multifactorial. Table
6.3 gives you the risk factors for cancer formation.
Table 6.3: Risk Factors for Cancer Formation
SELF-CHECK 6.3
2. Identify five abnormal changes in the body that may signal the
onset of cancer.
Strategy Description
Becoming an Being aware of safer options when seeking for medical treatment;
active
advocate for Awareness and avoidance of risk factors to yourself, family and
your health community;
Spreading consciousness about role of responsible citizenship
within the community; and
Exercising voting rights for governance of safe, healthy
environment and legislation of sound health policies.
Do you know anyone around you who has diabetes mellitus? Chances are that
you will easily recall someone you know who has diabetes mellitus. It has
become one of the fastest growing disease conditions afflicting humans in the
modern era.
SELF-CHECK 6.4
SELF-CHECK 6.5
State the major difference between type 1 and type 2 diabetes mellitus.
The risk factors for diabetes mellitus stem from a mix of neglect of healthy
lifestyle choices and some elements of non-modifiable risk factors such as the
following:
From these five factors, we can observe that obesity, physical inactivity and high
blood sugar levels can be controlled and thus are classified under modifiable risk
factors. Conversely, we note that advancing age, genetic predisposition and
ethnicity are non-modifiable risk factors for diabetes mellitus.
ACTIVITY 6.5
Vigilance and conscious efforts to mitigate the latent risk factors are essential for
the disease prevention. The following are important aspects of prevention in
order to prevent onset of diabetes mellitus:
6.5 OSTEOPOROSIS
Now let us learn about osteoporosis. It is hoped that by reading this, you should
be able to link osteoporosis as a condition that is related to our lifestyle choices.
What do you know about osteoporosis? What can you say about it?
Gradual loss of mineral content, mainly calcium phosphate renders the bones to
be at greater risk of fracture and delayed healing. Women are particularly at
higher risks for osteoporosis soon after their body stops estrogen production at
menopause. Figure 6.4 shows you how osteoporosis looks like.
(a) Genetics;
(b) Body frame size;
(c) Gender;
(d) Race;
(e) Advancing age;
(f) Reduced peak bone mass;
(g) Low estrogen and testosterone levels;
(h) Physical inactivity;
(i) Inadequate dietary calcium intake;
(j) Smoking; and
(k) Alcohol consumption.
ACTIVITY 6.6
Take note that an important aspect of prevention includes making the right
lifestyle choices at the early stages to reduce the rate of bone mass loss in later
years. Some of the strategies include the following:
ACTIVITY 6.7
Identify five examples of local food products that contain high calcium
content, suitable for people to avoid osteoporosis.
Did you know that kidney disease have become the most common cause of
kidney failure that cause patients to undergo dialysis treatment, often for life?
Statistics released by MOH (2015) quote kidney diseases as the eighth most
common cause for hospital admissions in 2013, accounting for more than 5% of
all hospitalisations in Malaysia.
What are the functions of kidneys? The kidneys perform several life-sustaining
functions such as:
The sudden loss of kidney function is called acute kidney failure or acute kidney
injury. It is mainly attributed to the following three effects that disrupt the
functions of the kidneys:
Take note that kidney failure can be fatal, and requires urgent and intensive
treatment.
(e) Keep kidneys healthy by choosing to eat foods that are free from toxic
chemicals, and increase the portion of fresh foods and green vegetables;
(g) Control salt, potassium-rich foods and sugar intake in the diet;
ACTIVITY 6.8
Source: http://www.diabetes.fi
Early stages of type 2 diabetes seldom cause any symptoms. If you scored
1214 points in the risk assessment, you would be well advised to seriously
consider your physical activity and eating habits and pay attention to your
weight, to prevent yourself from developing diabetes. Please contact a
public-health nurse or your own doctor for further guidance and tests.
If you scored 15 points or more in the risk assessment, you should have
your blood glucose measured (both fasting value and value after a dose of
glucose or a meal) to determine if you have diabetes without symptoms.
Source: http://www.diabetes.fi
Based on your personal scores levels on each of the above scales, prepare an
action plan for healthy lifestyle activity for yourself.
People who do not practise healthy lifestyles will become more vulnerable to
non-communicable diseases which have long term effects on the body and
are difficult to control.
Some of the ways risk of CHD can be mitigated are managing stress, keeping
blood sugar and blood pressure under control and many more.
Cancer is a condition where cells in a specific part of the body begin to grow
at an abnormal and uncontrollable rate. They are four types of cancer namely
carcinomas, sarcomas, lymphomas and leukaemia.
Common risk factors for cancer include poor lifestyle choices, environmental
exposure to carcinogens, exposure to viruses linked to certain types of
cancers, chronic irritation and genetic predisposition to cancer.
Some of the signs and symptoms of cancer are sudden unexplained weight
loss, lumps in breasts or other body parts, moles that grow more than seven
millimetres in diameter and others.
Common risk factors for diabetes mellitus include obesity and physical
inactivity, high fasting blood sugar levels, advancing age, genetic
predisposition and ethnic predisposition.
Acute kidney failure results in the inability of the kidneys to filter the waste
matter in the blood, which leads to rapid deterioration in health of the victim.
Some of the signs and symptoms of kidney disease are decreased urine
output, drowsiness, confusion, nausea, chronic fatigue and others.
Some of the preventions for kidney disease are healthy lifestyles, regular
medical check-ups, be physically active, have an ideal weight, quit smoking
and others.
Centres for Disease Control and Prevention (CDC). (2015). Heart disease facts.
Retrieved from http://www.cdc.gov/heartdisease/facts.htm
Donatelle, R., Snow, C., & Wilcox, A. (1999). Wellness: Choices for health and
fitness (2nd ed.). Belmont, CA: Wadsworth.
Ministry of Health Malaysia (MOH). (2014). Health facts 2014. Retrieved from
http://goo.gl/5mmFjx
NHS Choices. (2013). Cancer information and useful links. Retrieved from
http://www.nhs.uk/conditions/Cancer/Pages/Introduction.aspx
INTRODUCTION
As discussed in the previous Topic 3, financial health and wellness is one of the
eight dimensions of the holistic model of health and wellness. Can you still
recall? Take note that each of the eight dimensions has to be pursued
individually but in tandem with the pursuit of the other seven dimensions.
What are you going to learn in this topic? Basically, this topic is organised into
four subtopics. In subtopic 7.1, we will be introduced to financial health and
financial wellness. It also discusses the importance of financial wellness in the
context of ones total health.
Then in subtopic 7.2, we will discuss the challenges to the attainment of financial
wellness particularly during ones passage to adulthood. Knowledge of past
challenges (which had been experienced by past generations) will enable one to
be better prepared to circumvent them as one travels through glitches in life.
Financial health is a term used to denote the state of ones personal financial
situation.
Take note that there are many dimensions of financial health, for example,
disposable income, savings and loan repayments. In addition, the concept is
embedded in the practices of organisations.
(c) Net worth (net amount of what the firm has after taking into consideration
the claim of lenders on what the firm has).
Apart from knowing the absolute amount of each item, it is also important to
know its relative composition. However, these items showed their respective
position at one point in time. Other important aspects to consider are dimensions
which show potential improvements or otherwise, of these items over time. This
dimension is essentially pictured by the profitability of the firm. This is because
profitability is an important determinant of the firms future finances or its
wellness.
Did you know that financial wellness is a new concept that came as an aftermath
of the global Great Recession of 2008 to 2009? The turmoil of the Great Recession
left many feeling vulnerable. Many people were ill-prepared to handle the
experience of personal financial crisis that ensued.
The two years of the Great Recession was not the only cause of the personal
financial crisis. The effect of the recession on individuals was compounded by
the widespread lack of appreciation of the basic underlying principles of good
personal finance practices. As a consequence, poor financial results were
experienced.
What are the impacts of the poor financial state? The impacts of the poor
financial state that resulted were compounded by widespread job losses,
declining asset values and great drops in value of savings. These adverse
phenomena left many in a state of financial distress. What does financial distress
mean?
(a) Strong financial foundation with little or no debt, with some emergency
savings fund and surplus income over expenditure;
(b) An ongoing plan that puts one on track to reach future financial goals; and
ACTIVITY 7.1
For our purpose, it makes sense to use it as building blocks for reaching personal
financial wellness. Let us review Maslows hierarchy of needs shown in Figure
7.1.
Overall, the pecking order of needs is described in Table 7.1; it starts from basic
to the most advanced.
SELF-CHECK 7.1
ACTIVITY 7.2
Let us reflect on this question: At what age do you think one is expected to be
financially independent? Well, one is expected to be financially independent as
one enters adulthood. This is because as a legal adult, he or she is a person who
has attained the age of majority and is therefore regarded as independent, self-
sufficient and responsible.
Did you know that adulthood can be identified by using a marker? The passage
from adolescence to adulthood is marked by the experience of particular life
events. So, what are they? Traditionally, the major markers have been identified
as these life events (see Figure 7.2).
In the past, up to the era of baby boomers (born between 1946 and 1964), the
passage to adulthood had been rather smooth. The emerging adults would have
acquired the finesse of adulthood primarily through direct guidance and support
from parents.
The more trying conditions faced by Millennials themselves have caused them to
be realistic about their relative positions. A research poll in 2014 revealed that
only 42% of the Millennials identify themselves as middle class, whereas 53%
of their fellow Millennials in an earlier poll (which was in 2008) had claimed
themselves to be so. In fact, more strikingly, 46% of them described themselves as
of lower than middle class in the recent survey (Pew Research Centre, 2014).
Late adolescence and the period that follows (often referred to as emerging
adulthood), have been noted as particularly important. It constitutes a stage for
continued development as individuals begin to make choices and engage in a
variety of activities that are potent influences for the rest of their lives.
Take note that as youth move into emerging adulthood, their choices and
challenges shift. This includes decisions related to the traditional markers of
adulthood as shown in Figure 7.2.
Recently, social scientists have found that the transition to adulthood is taking
longer to complete. This is because becoming an adult today (for Generation Y
and Millennials) is totally different from 30 years ago. This can be related to some
of the contributing factors which include the following (Richardson, 2015):
Even though emerging adults who had not moved out realised that they were
pulling clear of their adolescent struggles and starting to feel responsible for
themselves, they still had to cling to the lifeline of their accommodative parents
(Munsey, 2006).
According to Munsey, Arnett (2000) thus proposed a new period in lifespan that
he called emerging adulthood. This emerging adulthood has certain distinct
characteristics as described in the following Table 7.2.
Characteristic Description
Age of identity Young people are deciding who they are and what they want out of
exploration work, school and love.
Age of self- Freed of the parent and society-directed routines of school, young
focus people try to decide what they want to do, where they want to go and
who they want to be with before those choices get limited by the
constraints of marriage, children and a career.
Age of feeling Many emerging adults say they are taking responsibility for
in between themselves, but still do not completely feel like an adult.
Age of Optimism reigns. Most emerging adults believe they have good
possibilities chances of living better than their parents did and even if their
parents separate, they believe they will find a lifelong soulmate.
According to Arnett (2000), emerging adults pin their hopes from life a job that
is well paid and personally meaningful, and a lasting bond with a partner.
However, Arnett is pessimistic many might be headed for disappointment.
Most employers simply want someone who can get a job done. If happiness is the
positive difference between what you actually get and what you expect out of
life, then a lot of emerging adults are setting themselves up for unhappiness
(Munsey, 2006).
However, with college attendance, debt ensued. Add to it the rising costs of
living, food, accommodation and transportation. So, it is not a big surprise
that young people often do not settle into careers and family until after their
mid-twenties. The reason is that they simply do not have the money. The
dominating factor is that it is taking longer for young adults to transition into
adulthood. This transition period has been labelled as the emerging
adulthood by some or as in-between age by others (Richardson, 2015).
In Malaysia, the youth unemployment rate has remained high since the
Asian financial crisis of 1998. From a low of 6.7% in 1996, the youth
unemployment rate shot up to 11.3% in 2010.
Even graduate unemployment rate which did not exceed 2.3% in the early
1990s before the Asian financial crisis, has since not gone anywhere below
2.9%.
These figures have not yet taken into account the millions of young people
who are underemployed. In addition, the cost of living, housing, healthcare
and childcare are rising too, against the backdrop of increasing
unemployment and underemployment. Topping it up is the impending
shrinking of job opportunities among aspirants caused by higher retirement
age (Asia Pacific Youth Employment Network, 2012).
Therefore, this means later ages of entering marriage and parenthood, and
widespread acceptance (or at least tolerance) of premarital sex and
cohabitation following the invention of the birth control pills in the 1960s.
Take note that besides the four factors discussed just now, there are two other
factors that contributed to delayed adulthood too (refer to Figure 7.3). They are
described as follows:
Sports stars are also recognised as favourite celebrity role models for
many young individuals. Athlete role models are known to influence
adolescents behavioural intentions, especially with respect to relevant
products (see Figure 7.4).
Scenario Description
Scenario Have you experienced buying candy and chocolates that you have never
A planned to buy? However, you simply bought them upon noticing them at
the cashier while you were about to pay for things that you had planned to
purchase (see Figure 7.5).
Scenario Have you experienced buying things online and while you are doing so, your
B attention was directed to a display customers who purchase what you are
purchasing also purchase these (refer to Figure 7.6).
What can you conclude about these two scenarios? Well, for Scenario A,
retailers are emulating the display strategies and personal selling strategies
of brick and mortar retailers. As for Scenario B, beware of buying things
you have never planned to but impulsively did so because you have been
prompted.
ACTIVITY 7.3
Firstly, look at this finding from Financial Finesse (2013) taken from Yahoo
Finance website.
62% of those surveyed who are under 30, report that they have some
financial stress, and another 15% say that they have high or overwhelming
levels of financial stress.
How do we relate financial stress with financial wellness? Well, let us look at
financial wellness first. What does financial wellness mean? Simply put, financial
wellness may be defined as a state of being wherein a person can fully meet
current and ongoing financial obligations, feel secure about their financial future
and is able to make choices that allow him or her to harvest lifes enjoyment.
On the other hand, some who seem wealthy may not appear to have, or feel they
enjoy, a high level of financial well-being.
The goals and vision of a satisfying life differs greatly among individuals.
However, there are two common themes that come up consistently security
and freedom of choice whether in the present or in the future (Consumer
Financial Protection Bureau, 2015).
Now let us redirect our attention to the elements of financial wellness. There are
four elements of financial wellness as shown in Figure 7.7.
How do we relate these four elements to the two common themes of financial
wellness? Well, let us look at Table 7.4 for the answer.
Table 7.4: Relationship between Common Themes and Elements of Financial Wellness
Now, how do we balance this? Well, let us look at Figure 7.8 for an answer.
Table 7.5 gives you some dos and donts to improve your credit scores.
Dos Donts
SELF-CHECK 7.2
ACTIVITY 7.4
Share with your course mates whether you possess the elements of
financial wellness or not. Justify your answers.
Over the years employers have learned that improving the health and
wellness of their workforce yields benefits for both employers and employees
alike. Employers enjoy a healthier workforce that is more productive, has
fewer absences and makes fewer demands upon employer-sponsored health
insurance. Employees benefit from improved health and well-being, and
reduced medical expenses.
From these statements, we can conclude that financial wellness programmes can
educate employees about the financial risks they face and provide tools to
manage those risks.
Therefore, workplace financial wellness must meet the following criteria in order
to be marketed as a financial wellness benefit (not to be confused with financial
education or financial advice) (Financial Finesse, 2014):
(b) Designed and delivered by qualified experts who have extensive financial
planning experience;
(f) Integrate all employee benefits With guidance on how employees can
most effectively manage their benefits as part of their overall financial
plans; and
Last but not least, below are five elements you need to heed in your financial
budget (see Figure 7.9).
That marks the end of this topic. Hopefully, you have gained some insightful
knowledge on health and wellness, and is now able to come up with a plan to
stay healthy and well (physically and financially). Remember, health is wealth!
ACTIVITY 7.5
(a) Do you pay yourself first? Set aside a certain amount for
savings, retirement or investing before you do anything
else.
(d) Do you know the exact amount of your debt and the
payables?
Financial health is a term used to denote the state of ones personal financial
situation. There are many dimensions of financial health such as disposable
income, savings and loan repayments.
Financial fitness is just like physical fitness; one has to do things in certain
ways to be physically fit. Similarly, in order to be financially fit, one must
handle ones finances in a proper balanced manner managing ones
expenses, savings, debts and others in a befitting manner.
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20Adulthood%20English.pdf
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Retrieved from
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credit-scores-of-all-generations-300121178.html
Securian Financial Group. (2010). Financial wellness: Tuning in to the total health
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OR
Thank you.