This is the Chapter 3 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch. 3: Health-risk behaviour

Health behaviour:

• Health behaviour Kasl and Cobb (1966a): They defined it as any activity undertaken by a person believing themselves to be healthy for purposes of preventing disease or detecting it at an asymptomatic stage
• Health behaviour Harries and Guten (1979): They used the same definition but includex behaviour of “unhealthy” people
  • Crucial assumption --> behaviour motivated with the goal of health
• Health behaviour Matarazzo (1984):
  • Behavioural pathogen: damaging to health
  • Behavioural immunogen: health-protective
• Almeda seven: behaviours reduce the development disease and mortality. Increases awareness of behaviours and diseases.
  • Women performed 6 out of 7, lived 7/11 more years

1. Sleeping (7 to 8 hours)
2. Not smoking
3. Alcohol (no more than 1 to 2 per day)
4. Exercise (regular basis)
5. Not eating between meals
6. Breakfast
7. Weight (no more than 10% overweight)

Heath-risk behaviour:

• 8 risk factors account for 61% of cardiovascular deaths:

1. Alcohol
2. Tobacco
3. High blood pressure
4. High BMI
5. High cholesterol
6. High blood glucose
7. Low fruit and vegetable intake
8. Physical inactivity

• Behaviours associated with mortality:
  • Heart disease: tobacco/high-cholesterol diet/lack of exercise
  • Cancer: tobacco/alcohol/diet/sexual behaviour
  • Stroke: tobacco/high-cholesterol/alcohol
  • Pneumonia: tobacco/vaccination
  • HIV: unsafe sexual intercourse
• Disability-adjusted life years: years lost due to ill health/disability/early health --> it's a combination of mortality and morbidity

Smoking/drinking/drug use:

• Morbidity: cost associated with an illness, such as disability or injury
• Age-specific mortality: deaths per 100,000, per annum, certain age groups --> (example) compare formal smokers with current smokers

Smoking:

• Worldwide, 9% of deaths
• Interventions are effective when combining age-relevant risk information and support

Alcohol:

• Social use of alcohol is widespread
• Recommended levels of drinking:
  • Women: no more than 2 drinks per day on average
  • Men: not more 3 drinks per day on average
  • Not exceed 4 drinks on one occasion
  • Don’t drink in specific situations (pregnant/driving/...)
  • Abstain drinking at least once a week

Condom use:

• Prior to HIV, sexual behaviour was under-researched
• Condom use begins to decline after 6 months within any given relationship
• Barriers to safe sex:
  • Alcohol --> tendency towards general risk-taking behaviours
  • Social desirability bias: tendency to answer questions about oneself/one’s behaviour in a way that meets social (or interviewer) approval
  • Women:
    • They expect male objection to condom use
    • Difficulty/embarrassment of raising this issue with a partner
    • Worry suggesting they or the partner has STDs
    • Lack of self-efficacy of condom use
• Interventions: target health beliefs, but also interpersonal/communication/negotiating skills

Unhealthy diet:

• Cancer deaths: 30% attributed to smoking cigarettes/ 35% poor diet (high-fat foods/high levels salt/low levels fibre)

Fat intake:

• Excessive fat intake --> CHD/heart attack
• Cholesterol: (fat) present in our own bodily cells
  • Serum cholesterol: Normal circulating cholesterol --> is synthesised to produce steroid hormones and it's involved in the production of bile (necessary for digestion) --> it's increased by fatty diet and by age.
  • Fatty foods cholesterol: fat-like substance, contains lipoproteins that very in density:
    • Low-density lipoproteins (LDLs): can lead formation plaques in arteries (bad cholesterol)
    • High-density lipoproteins (HDLs): increase the processing and removal of LDLs by the liver (good cholesterol)
• Ratio of total cholesterol: HDL + LDL + 20% of even lower density triglycerides --> desirable ratio = 4.5:1
• Coronary Artery disease (CAD):
  • Atherosclerosis: if a fat molecule (good store of energy) is not metabolised during exercise --> plaques are laid down on artery walls, which thickens and restricts blood circulation to the heart
  • Arteriosclerosis: increased blood pressure causes artery walls to lose elasticity and to harden --> affecting on the ability of the cardiovascular system to adapt to increased blood flow
• Governmental policy documents “healthy eating/dietary targets”:
  • Maximum of a 30% of food energy (calories) derived from fat intake, from which maximum of 11 % can come from saturated fats

Salt:

• High blood pressure
  • Normotensive: normal blood pressure
  • Hypertensive: high blood pressure
  • Systolic blood pressure: maximum blood pressure on artery walls --> occurring left vertical output/contraction (measured in relation to diastolic blood pressure)
    • Diastolic blood pressure: minimum pressure of blood wall arteries between heartbeats
• Effects persist even when performing physical activity, and obesity and other health behaviours are controlled --> need to monitor salt intake from early childhood

Obesity:

• Body mass Index (BMI): weight (kg) divided squared height (m)
  • Normal weight: BMI between 20-24.9
  • Mildly obese: BMI between 25-29.9 (Grade 1)
  • Moderate/clinically obese: BMI between 30-39.9 (Grade 2)
  • Severely obese: BMI between 40-greater (Grade 3)

Consequences:

• Underweight --> largest global cause of mortality
• Obesity:
  • Hypertension
  • Heart disease
  • Type 2 diabetes
  • Osteoarthritis
  • Respiratory problems
  • Lower back pain
  • Some forms of cancer
  • Psychological ill health --> low self-esteem/isolation (from experience of stigmatising behaviour)

Prevalence:

• 1999 --> 31% of EU adult population is overweight
• Social learning theory: influence significant others’ behaviour
• Theories of associative learning: food choice associated with receiving intrinsic and extrinsic rewards or reinforcers --> (examples) pleasure eating with family or stress reduction from “comfort eating”

Causes:

• Obesity: energy intake that grossly exceeds energy output
• Genetics:
  • Greater number of fat cells
  • Low metabolic rates
  • Deficiencies hormone responsible appetite regulation and control
    • Leptin: produced by fatty (adipose) tissue. It signals the hypothalamus of the CNS that helps regulate weight --> leptin injection does not consistently reduce the eating behaviour
• Agonist: simulates effects of neurotransmitters --> it reduces hunger
  • Insufficient to cure overweight, since obesity is attributed to the interaction of physiological and environmental factors