D S A P Lifestyle diseases About diet, smoking, alcohol and physical activity uk
Diet D S A P Obesity has become 30-40 times more prevalent in the past 50 years in Denmark. This means that: 40% of Danes are overweight i.e. have a BMI score of 25 or more. 15% of Danes are obese, i.e. have a BMI score of over 30. Obesity increases the risk of associated diseases such as hypertension, diabetes, breathing difficulties when sleeping and orthopaedic disorders. Obesity that starts during childhood of adolescence and continues into adulthood compounds the risk of associated diseases. The risk of being overweight If you are overweight, you risk developing : Type 2 diabetes, cardiovascular diseases, certain cancers, hypertension, strokes (apoplexy), gall stones and osteoarthritis. If you are obese, there is also increased risk of complications resulting from anaesthesia and surgery, including impaired wound healing. People who are overweight die earlier than people with normal weight profiles. Studies in the US has indicated that 40-year-olds with a BMI score of over 30 can expect to die 6-7 years earlier than people with normal weight profiles. What is a healthy diet? A healthy diet contains important nutrients that are required to prevent disease, and sufficient calories to meet the daily requirement. Your diet should include fruit, vegetables and whole wheat products and a low content of saturated fatty acids. You should eat fish several times a week. 2
In 2005, the Danish Nutrition Council (now defunct) published new dietary guidelines in accordance with the Nordic recommendations: Eat fruit and vegetables 6 a day Eat fish and fish products Eat potatoes, rice or pasta and wholemeal bread every day Go easy on the sugar especially fizzy drinks, sweets and cake Go easy on fats especially dairy products and meat Eat a varied diet remain at a normal weight Quench your thirst with water Take exercise at least 30 min. a day What do we do at Aleris-Hamlet? At Aleris-Hamlet we assess the nutritional condition of everyone who seeks treatment. If their BMI is over 30, we recommend they lose weight. When they are admitted to hospital, their diet is adjusted accordingly. We notify the patient s GP in a note in the patient s medical record and the patient is advised to seek treatment for possible overweight with the GP. Patients referred to Aleris Hamlet for obesity treatment are offered a full medical examination, advice from a dietician, and possibly also surgical treatment. 3
Smoking D S A P A survey in December 2010 showed that 24% of people over 15 years of age are smokers. 20% smoke every day. Young people smoke more than adults. Each year almost 14,000 Danes die from smoking. Smoking is the factor which causes most damage to your health. The risks involved in smoking Smokers have an greater risk of developing : cancer, cardiovascular disease and chronic lung disease (COPD). Smoking is a contributory factor in circulatory diseases, i.e. arteriosclerosis, cardiac embolism and circulatory disorders in the legs and cerebral haemorrhages. Smokers die on average 10 years earlier than nonsmokers. Smoking is also a contributory factor in the development of type 2 diabetes and and increases the risk of developing complications associated with diabetes. Smoking also causes poor circulation, which can prevent the healing of stomach ulcers and causes impaired wound healing after an operation. Recommendations Ensure that neither smokers nor non-smokers are exposed to passive smoking Help smokers to quit smoking Help smokers to reduce smoking in connection with surgery or other therapies Before surgery If you wish to prepare yourself for surgery, prevent unnecessary complications and ensure that your recovery is as successful as possible, you should: Stop smoking entirely at least 6 weeks before surgery Smokers experience more complications than non-smokers and people who stop smoking at least 6 weeks before surgery. Complications vary but include: 4
Impaired wound healing Pulmonary insufficiency Greater risk of infection The risk of complications is greater the more you smoke and the longer you have smoked. What do we do at Aleris-Hamlet? Anyone who wishes to be treated at Aleris-Hamlet is asked about their tobacco consumption. Smokers are informed of the risks and encouraged to quit smoking. Patients are recommended to seek help to quit smoking from their GP. People who are to undergo surgery are recommended to stop smoking 6 weeks before the operation. According to the Aleris-Hamlet smoking policy, smoking is strictly prohibited on hospital premises. Smokers among the staff are offered a quit smoking course. FAQ about smoking Is there a difference between cigarettes, cigars and pipe-smoking? No, it is the quantity of tobacco, rather than the type, that is significant. If there is less than 6 weeks until surgery, is it worthwhile for me to give up smoking? Yes, you can count on it being well worth your while. There is not quite the same guarantee that post-surgical complications will be reduced than if you stopped smoking more than 6 weeks before the surgery. If you stop smoking permanently, this will be beneficial for your general condition of health and help to get you back on your feet faster after surgery. Does smoking have any effect on minor surgical operations, e.g. dental surgery and certain types of cosmetic surgery? Yes, there is also a greater risk of complications after procedures of these types. Source: Danish Health and Medicines Authority, www.sst.dk 5
Alcohol D S A P Alcohol is a stimulant and intoxicant which can cause dependency Heavy alcohol consumption can lead to many different types of social, mental and physical damage and injury. Light use may have positive effects on the circulation. Danes drink on average 12 litres of pure alcohol each year. Alcohol and health A heavy consumption of alcohol is associated with increased illness and early death. Regardless of the kind of alcohol you drink, you risk damaging your health. Women can generally tolerate less alcohol than men and the damage occurs earlier. Cirrhosis of the liver People who drink more than 5 units of alcohol a day are estimated to have 14-20 times greater a risk of developing cirrhosis of the liver Cancer There is an increased risk of developing cancer in the organs which come into direct contact with alcohol, e.g. mouth, throat, oesophagus and liver. Other disorders A heavy consumption of alcohol over a longer period of time presents a risk of weakening the immune defence system, disrupted sleep patterns, hormone imbalance, osteoporosis, cerebral haemorrhages, dementia, epilepsy, hypertension, muscular damage, oesophageal varices and chronic inflammation of the pancreas (pancreatitis). Before surgery If you wish to prepare yourself for surgery, prevent unnecessary complications and ensure that your recovery is as successful as possible, you should: Stop drinking alcohol entirely at least 4 weeks before surgery, if you normally drink more than 4 units a day. 6
Patients who drink more than 4 units a day are at a greater risk of developing complications in connection with surgery. Complications vary but include: Pulmonary insufficiency Infections Impaired wound healing Prolonged hospital admission What do we do at Aleris-Hamlet? Anyone who wishes to be treated at Aleris-Hamlet is asked about their alcohol consumption. We refer to The Danish Health and Medicines Authority s recommendations. People whose alcohol consumption exceeds the Danish Health and Medicines Authority s recommendations should be informed of the risks and encouraged to reduce their alcohol consumption. Patients are recommended to seek help from their GP. Aleris-Hamlet offers in-patients a glass of red or white wine at mealtimes. Aleris-Hamlet s alcohol policy stipulates that staff may not ingest alcohol on the hospital premises or during working hours. The Danish Health and Medicines Authority s 7 statements about alcohol 1. Drinking alcohol is never completely safe 2. You should not drink alcohol for your health s sake 3. You have a low risk of getting ill due to alcohol at a consumption of 7 units per week for women and 14 for men 4. You have a high risk of getting ill due to alcohol at a consumption of more than 14 units per week for women and more than 21 for men 5. You should stop before 5 units on the same occasion 6. If you are pregnant, you should not drink alcohol. If you are planning a pregnancy, you should avoid alcohol to be on the safe side 7. Older people should be very careful when drinking alcohol 7 14 LOW RISK ALCOHOL COMSUMPTION and max. units per week 14 21 HIGH RISK RISK-BAROMETER Source: Danish Health and Medicines Authority, www.sst.dk 7
Physical activity D The term physical activity covers any form of muscular effort which increases how much energy your body uses. Exercise can include unstructured activity and more focused regular training. S A P The benefits of physical activity Current research into the benefits of physical activity on the body indicates that: People who are normally inactive, can improve their condition of health and physical well-being by exercising on a regular basis. People of all ages children, adults, senior citizens, women and men can achieve positive physiological changes as a result of physical activity Physical activity does not necessarily have to be strenuous to benefit health. Physical activity benefits physical functions in many different ways. The beneficial effects on the heart, circulation and muscles are wellknown. However, it is also worth noting that exercise also benefits the metabolism, hormonal (endocrine) system and immune system Many of the positive effects of physical activity both stamina and weight training disappear within weeks. If a person ceases entirely to engage in physical activity, the effects disappear within 2-8 months. Physical activity also has sociopsychological benefits, such as a zest for life, surplus of energy, social well-being, self-confidence and action competence. There is also a proven link between physical activity and cognitive processes as a precondition for learning in children. Exercise as treatment For some patients the risk of becoming ill is greater. For them, physical activity may be part of their treatment. Physical training is especially useful in the treatment of high blood pressure, high cholesterol, insulin resistance and obesity. Physical training is also significantly beneficial to patients who have a cardiac condition, COPD (also known as smoker s lungs ) and arteriosclerosis in the legs and osteoarthritis. 8
The Danish Health and Medicines Authority s recommendations Children and adolescents: at least 60 min. a day Adults: at least 30 min. a day Senior citizens: at least 30 min. a day The obese: at least 30 min. a day Children and adolescents: 1. Take exercise at least 60 min. a day Activity should be moderate to high intensity and constitute more than short bursts of ordinary day-to-day activities. If the recommended 60 minutes are subdivided, each activity must take at least 10 minutes. 2. At least 30 min. of high-intensity physical activity three times a week is required to maintain or improve physical fitness and muscular strength. Activities should include some which increase bone strength and mobility. Adults (18-65 years) 1. Take exercise at least 30 min. a day Activity should be moderate to high intensity and constitute more than short bursts of ordinary day-to-day activities. If the recommended 30 minutes are subdivided, each activity must take at least 10 minutes. 2. At least 20 min. of high intensity physical activity twice a week is required to maintain or improve physical fitness and muscular strength. Activities should include some which increase bone strength and mobility. Senior citizens (65+) 1. Take exercise at least 30 min. a day Physical activity should be of moderate intensity and constitute more than short bursts of ordinary day-to-day activities. If the recommended 30 minutes are subdivided, each activity must take at least 10 minutes. 2. At least 20 min. of physical activity twice a week is required to maintain or improve physical fitness and muscular strength 3. Stretching exercises lasting at least 10 min. at least twice a week are required to maintain or improve physical mobility. Regular training to maintain or improve balance is also required. What do we do at Aleris-Hamlet? Anyone who seeks treatment at Aleris- Hamlet is advised on the importance of exercise, if this is directly related to the disease. We will ask questions about exercise habits and the patient is informed of the possibility to receive a prescription for exercise if referred by their GP. 9
The Aleris-Hamlet LIFESTYLE DISEASES brochure, which is about diet, smoking, alcohol, physical exercise and stress) is available from the Alerris-Hamlet website. It provides general information on and advice on minimising the effects of lifestyle diseases. Hard copies of the latest version of the Aleris-Hamlet LIFESTYLE DISEASES brochure are available at the hospital. Learn more National Institute of Public Health: Giv borgerne et KRAM 2006 (Danish Health Examination Survey - a lifestyle diseases survey) The Danish Health and Medicines Authority s website: www.sst.dk 10
For your own notes 11
Aleris-Hamlet Hospitaler - West Aalborg Sofiendalsvej 97 DK - 9200 Aalborg SV Tel. +45 3637 2750 aalborg@aleris-hamlet.dk Aarhus Brendstrupgårdsvej 21 A, 1. sal DK - 8200 Aarhus N Tel. +45 3637 2500 aarhus@aleris-hamlet.dk Esbjerg Bavnehøjvej 2 DK - 6700 Esbjerg Tel. +45 3637 2700 esbjerg@aleris-hamlet.dk Herning Poulsgade 8, 2. sal DK - 7400 Herning Tel. +45 3637 2600 herning@aleris-hamlet.dk Aleris-Hamlet Hospitaler - East Copenhagen Gyngemose Parkvej 66 DK - 2860 Søborg Tel. +45 3817 0700 kobenhavn@aleris-hamlet.dk Ringsted Haslevvej 13 DK - 4100 Ringsted Tel. +45 5761 0914 ringsted@aleris-hamlet.dk Parken Øster Allé 42, 2. & 3. sal DK - 2100 København Ø Tel. +45 3817 0700 parken@aleris-hamlet.dk www.aleris-hamlet.dk Customer service phone operating hours West East Monday - Thursday 8 am - 6 pm 8 am - 6 pm Friday 8 am - 3 pm 8 am - 4 pm Saturday - Sunday Closed Closed Aleris-Hamlet Hospitals 9 th edition November 2017. Prepared by VBB/KJK/BMI. To be revised in November 2020. Approved by Quality Management