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Lifestyle diseases About diet, smoking, alcohol and physical activity

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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 associ-ated 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 overweightIf you are overweight, you risk developing :Type 2 diabetes, cardiovascular diseases , certain cancers, hyperten-sion, strokes (apoplexy), gall stones and osteoarthritis.

If you are obese, there is also in-creased risk of complications result-ing 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.

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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.

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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 smokingSmokers have an greater risk of developing : cancer, cardiovascular disease and chronic lung disease (COPD). Smoking is a contribu-tory 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 non-smokers.

Smoking is also a contributory factor in the development of type 2 diabetes and and increases the risk of devel-oping complications associated with diabetes.

Smoking also causes poor circula-tion, 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 surgeryIf you wish to prepare yourself for surgery , prevent unnecessary compli-cations and ensure that your recov-ery is as successful as possible, you should:

Stop smoking entirely at least 6 weeks before surgery

Smokers experience more complica-tions than non-smokers and people who stop smoking at least 6 weeks before surgery. Complications vary but include:

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• 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 recom-mended 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 smok-ing policy, smoking is strictly prohib-ited 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

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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 healthA 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 liverPeople who drink more than 5 units of alcohol a day are estimated to have 14-20 times greater a risk of develop-ing cirrhosis of the liver

CancerThere is an increased risk of develop-ing cancer in the organs which come into direct contact with alcohol, e.g. mouth, throat, oesophagus and liver.

Other disordersA 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 surgeryIf you wish to prepare yourself for surgery , prevent unnecessary compli-cations 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.

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Patients who drink more than 4 units a day are at a greater risk of developing complications in connection with sur-gery. 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 Author-ity’s recommendations. People whose

alcohol consumption exceeds the Danish Health and Medicines Author-ity’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 stipu-lates that staff may not ingest alcohol on the hospital premises or during working hours.

1. Drinking alcohol is never completely safe2. You should not drink alcohol for your

health’s sake3. 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

The Danish Health and Medicines Authority’s 7 statements about alcohol

Source: Danish Health and Medicines Authority, www.sst.dk

ALCOHOL COMSUMPTIONand max. units per week

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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.

The benefits of physical activity Current research into the benefits of physical activity on the body indicates that:

• People who are normally inac-tive, 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 physiologi-cal changes as a result of physical activity

• Physical activity does not necessar-ily 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 well-known. 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 ef-fects disappear within 2-8 months.

• Physical activity also has socio-psychological 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 pre-condition for learning in children.

Exercise as treatmentFor some patients the risk of becom-ing ill is greater. For them, physical activity may be part of their treatment. Physical training is especially useful in the treatment of high blood pres-sure, high cholesterol, insulin resist-ance 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 osteo-arthritis.

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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 recom-mended 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 recom-mended 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 recom-mended 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 main-tain 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.

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The Aleris-Hamlet LIFESTYLE DISEASES brochure, which is about diet, smoking, alcohol, physical exer-cise 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 moreNational 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

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For your own notes

Aleris-Hamlet Hospitals ©

9th edition November 2017. Prepared by VBB/KJK/BMI.

To be revised in November 2020. Approved by Quality Management

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