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Health Care Review

HEALTH AND DISEASE

The concept of Health is somewhat difficult to understand. When we say a person is healthy, it means to the lay man that the person is normally doing his activities and does not outwardly show any signs of any disease in him. However, for the medical man at walk in clinic Thunder Bay it denotes the conformity to certain standards like physical measurements, biochemical norms and rates, physiological standards, etc. Even these standards vary with race, rest, exercise, food, habits, starvation, climate, altitude, latitude, etc. It has been extremely difficult for scientists concerned with human biology to lay definite criteria for health and define the term Health in a specific manner.

From the history of medicine we know that there have been various systems of medicine or healing arts evolved in different parts of the world during different civilizations. But in no system has there been a clear-cut definition of health.

In the oxford dictionary health means the state of being free from sickness, injury or disease, bodily conditions; something indicating good bodily condition. A few decades ago this meaning was conveyed in the definition of health but recently the World Health Organization have considered it necessary to give a direction towards the achievement of a robust and happy and active bodily and mental condition capable of continuous productive ability and, therefore, have defined health as follows:

"Health is a state of complete physical, mental and social well being and not merely an absence of disease or infirmity." (WHO---1948) it will be seen that even after having this definition it will be difficult to conceptualise and standardise positive health with specific clear-cut attributes and criteria for measurement. A person may be enjoying mental equanimity and enthusiasm for doing anything. He may also be physically able to do any amount of work, but he may be having some minor dysfunction or deficiency or even a mild infection causing a very minor disturbance which however does not upset his normal activities.

For example, Hyper pigmentation on the skin or lack of pigmentation on the skin; angular stomatitis due to B complex deficiency; a ring-worm patch on the skin, etc. In these conditions strictly speaking the person cannot be called 'health' but for outward purpose he will appear healthy and he will also be fully active. Similarly, under the mental component there are ever so many stresses and strains that an individual is exposed to and depending on his own mental make-up he is either able to overcome the strain or suffers from worry and depression. If in spite of his worry he is able to function normally others may take him to be healthy, whereas the worry may normally be making him mentally unsound.

Social well-being is very much related to the mental adjustment of the individual to others around him in the family or in the community. Sometimes it may so happen that a person may find it had to adjust with his group and may, therefore, be under a mental strain. But he may be doing his work normally from which others would judge him to be healthy. It is only if he reaches a break-point and behaves either in a withdrawn manner or becomes aggressive that his mental condition will become manifest to be seen and experienced by others.

We have, therefore, to understand that the term health is not an abstract thing but a relative concept. In it we see a continuum of freedom from sickness to better health and positive health. When we say positive health we refer to a condition in which the body has sufficient reserve nutrition and resistant factors to prevent the invasion of the body by any micro-organism or by the deprivation of any nutritional factors causing a deficiency pathology and, therefore, completely free from disease.

Disease is a little less difficult to define than Health. It denotes the condition of the human body in which something has gone wrong and has upset the Norman functions of the body including the mind. As in health there is also a continuum from a predisposition or premonition of illness which may or may not be experienced or noticed even by the individual concerned, to a definite condition of illness manifested by signs or symptoms and impairment of body functions.

This continuum may further extend from mild sickness to severe sickness and death or recovery from sickness back to a debilitated condition and later to a normal condition.

As has been pointed out in the previous paragraphs the normally of health of person may shift towards positive health depending on the improvement of health by wholesome food, wholesome water proper living conditions, proper work atmosphere, good personal hygiene, etc., or the deterioration of health due to faulty or inadequate food, infection through food, water or air, skin or due to external injuries, accident etc.

For maintenance of good health the following things are essential:

1. Adequate quantities of proper nutrition 2. Adequate quantities of safe drinking water 3. Proper shelter with adequate ventilation and lighting 4. Proper clothing 5. Proper work, exercise and rest and recreation 6. Proper social conditions for a harmonious existence and work 7. Proper security from fear of any kind 8. Proper sexual behavior 9. Personal hygiene 10. Provision and utilization of health services.

Disease can be due to say one or more of the following causes:

1. Genetic traits 2. Congenital deformity or malformation 3. Cancer 4. Malnutrition 5. Poisons

The above are the direct causes.

The science of epidemiology employs various methods and approaches to explore, investigate, identify and establish the cause of disease as against maintenance of health in the individual, in the community and in a geographical area. Modern epidemiology has revealed a multiple causation theory for most of the diseases. The direct or immediate causes may be congenital, traumatic, infection or cancerous growth, etc. But besides these direct causes, many indirect and predisposing causes have been described,

For example, tuberculosis is caused by the tubercule bacilli, called myco bacterium tuberculosis, this is the direct cause. The other causes which predispose a person to the infection by tubercule bacillus may be overcrowding, poor nutrition, bad ventilation, heavy work, fatigue, etc. It may be appreciated that these causes are socio-economic causes. The economic factors arising out of poor means of livelihood, inadequate food, etc., are also inter-related with human and social factors like bad ways of living, customs, habits, beliefs, superstitions, etc. Taking another example, malnutrition may be due to either lack of availability of nutritious food in adequate quantities or the wrong practices of preparation of food in which nutrients may be wasted. The economic factors may be the cause for non-accessibility and the social factors may be the cause of wastage of nutrition even after the food stuffs are available or on the contrary over eating and addiction to alcohol, etc., causing metabolic disorder. In the rural countryside we have a lot of locally available food resources but the habits may be such that the people do not know what can be eaten and how, for deriving nutrition.

The human and social factors are very predominant determinants in any society or community. In affluent countries many of the metabolic diseases like obesity, heart diseases, diseases due to air pollution, etc., are on the increase due to social customs. In the poor countries the large number of communicable diseases and nutritional deficiencies are due to poor sanitation, poor hygiene and low and faulty intake of food. These are again in turn due to economic and social factors.

Study of human behavior is extremely important in public health and in any community oriented programme. The mere opening and establishment of hospitals or clinics or treatment centers by any government or voluntary agencies does not immediately ensure that all the people will use the facilities whenever they fall sick. For a person to seek treatment for a particular illness from a doctor or an institution the following stages of human behavior are expected to take place.

Social psychology has a very prominent place as a diagnostic tool in the beginning of the programme and also as a tool of evaluation where the programme is under progress or at its termination. For example, in the control of Cholera or any gastro enteric infection, it will be futile to introduce any sanitation programme unless the people know the causative factor and the mode of transmission of infection. There may be need to improve the water supply, provide proper excreta disposal, food hygiene and personal hygiene. All these things involve a scientific awareness of the reasoning behind each measure or practice and a change of behavior accordingly.

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Think Fat Loss, Not Weight Loss

Weight loss is one of the hottest topics ever. Everyone seems to be trying to lose weight nowadays. Most diet programs are about weight loss and body weight is often used as an indicator of fitness progress. But, this is an incorrect approach.

Your ultimate goal should always be to lose fat and reducing excess body fat is what you should be concerned about. Weight loss and Fat loss is NOT the same thing! Many people confuse the two terms, often believing that they mean the same, when in fact weight loss and fat loss are very different from one another. This article will help you understand how weight loss is different than fat loss and how fat loss is far superior to weight loss in almost all ways.

What Is Weight Loss?

(Weight Loss = Muscle Loss + Fat Loss + Water Loss)

Weight loss is attempting to lower your total body weight. It simply refers to a lower number on a scale.

Your body weight is composed of all the parts of your body such as muscles, fat, bones, water, organs, tissues, blood, water etc. When you lose weight, you lose a little bit of... fat, muscle and water.

You lose fat but very little and along with the fat you lose muscle and some amount of water. The higher you reduce your calorie intake, the faster you drop weight and the more muscle mass you lose.

Do know your muscle matters? Loss of muscle affects your health and your overall appearance.

When you lose weight too quickly, your body cannot maintain its muscle. Because muscle requires more calories to sustain itself, your body begins to metabolize it so that it can reserve the incoming calories for its survival. It protects it fat stores as a defense mechanism to ensure your survival in case of future famine and instead use lean tissue or muscle to provide it with calories it needs to keep its vital organs such as your brain, heart, kidneys and liver functioning. If you reach a point where you have very little fat or muscle, your body will metabolize your organs to keep your brain functioning leading to heart attack, stroke and liver and kidney failure.

As the body loses more muscle mass, the body's overall metabolic rate decreases. The metabolic rate is the rate at which the body burns calories and is partly determined by the amount of muscle you have.

So the more muscle you have, the higher your metabolic rate; the less muscle you have, the lower your metabolic rate and fewer calories you burn. This explains why it is crucial to protect your metabolic rate and not have muscle loss.

Loss of muscle also leads to loss of tone underneath the skin leaving you soft and unshapely with no form or contour. If you lose weight too rapidly, your skin won't have time to adjust either. Also muscle is what gives you strength and loss of it means a weak body.

With weight loss you shrink in size and become a smaller version of yourself with a fragile frame with saggy skin.

Weight loss works in the short run to make you smaller but is temporary, almost everyone rebounds and regains the weight. This forces you to find another diet. And then another one, and another one - because eventually they'll all fail.

What Is Fat Loss?

(Fat Loss = Loss Of Stored Body Fat)

Fat loss is attempting to lower your total body fat - i.e. the percentage of your total body weight that is made up of fat.

The right approach for fat loss is to exercise smartly and eat intelligently in a way that maintains muscle and focuses on fat loss exclusively.

The muscle you have is not there forever. If you don't feed it and don't use it - you lose it. A proper plan with right combination of resistance and cardiovascular training with adequate progression and a right nutrition plan to support it can help you achieve this. Exercise only boosts the burning process but doesn't just melt the fat away on its own - if you do not create a deficit and feed the body too much - it won't touch the stored fuel reserves. On the hand if you drastically cut your calories and do not feed your muscle properly or don't exercise and use your muscle, you will lose it. Fat loss is about finding that right balance.

With fat loss you maintain the muscle and keep the metabolic rate running high. You also develop stronger connective tissue, tighter skin and stronger bones and joints. With fat loss you transform your body.

Fat loss is a lifestyle approach where you give your body what it needs without depriving and shocking it with threat of starvation. You get to see slow but permanent steady progress.

It may sound odd, but it's possible to get thinner without actually seeing a change in your weight. This happens when you lose body fat while gaining muscle. Your weight stays the same, even as you lose inches.

Let us see how this happens.

Fat tissue is very loose and not dense. It occupies a lot of space in your body. Whereas muscle is more dense and takes up less space. When you lose fat, this space is freed and you can notice inch loss. If you are following a consistent strength training program then gain in lean muscle tissue will balance out this loss of fat and weight stays the same. Since muscle takes less space than fat, you lose inches and start to look more toned, lean and shapely.

Consistent strength training program then gain in lean muscle tissue will balance out this loss of fat and weight stays the same. You can even reduce your anxiety during this pandemic. Since muscle takes less space than fat, you lose inches and start to look more toned, lean and shapely.

Myth: "Getting fit" means "Losing weight."

Truth: Getting fit means lowering your body fat percentage!