Hi there, I'm Mrs. Kemp, and welcome to today's lesson, all about non-communicable diseases and their risk factors.

This fits into the health and disease unit.

So, let's get started then.

Well, our main outcome for today is "I can describe the effects of lifestyle factors on the incidents of non-communicable diseases at local, national, and also global levels." These are some of the key terms that we're going to be using today, and if you would like to read those over in more detail, please do pause the video now.

We've got three learning cycles for today, risk factors for non-communicable diseases, interpreting data on non-communicable diseases, and the importance of peer review.

Of course, we will be starting with risk factors for non-communicable diseases.

Okay, now an example of a non-communicable disease is osteoporosis, okay? It's non-communicable 'cause it cannot be passed from organism to organism, so from one person to another.

We can see in that image there, that where we have normal bones, okay, it is porous, there are some little holes in it, but they're quite densely packed.

Somebody with osteoporosis then, they've actually got much larger holes in them and they experience a decrease in their bone density, and that means that actually, they're more likely to break bones, especially in older life.

Non-communicable diseases often have certain lifestyle, environmental and genetic factors that will increase your risk of developing them.

These are some of the ones that we know for osteoporosis.

So, if you are female and over the age of 50, if you have been a heavy drinker and also if you smoke, if you have a family history, so other people in your family also have osteoporosis, and last but not least, eating disorders.

So if you have experienced disordered eating in your life such as anorexia, you are more likely to have osteoporosis.

So all of these things are known as risk factors, because what they do is they increase your chance of developing this non-communicable disease.

We can actually categorise those risk factors into certain groups.

So we can put them into lifestyle, genetic, or environmental.

So let's think of some of the examples that we just looked at, and also extra ones for osteoporosis.

So, heavy drinking and smoking, because you are deciding to do that yourself, that would fit into a lifestyle factor.

Genetic then, the fact that you are female, you have two X chromosomes, that is gonna put you into a risk factor for being genetic.

And environmental, for example, we've got lead here.

Exposure to certain metals, especially lead, can lead to you getting osteoporosis and other non-communicable diseases, and we've put that into environmental.

That just depends on where about you are.

Onto our first check of the day then.

"Which of the following is an environmental factor that may increase your risk of developing a non-communicable disease?" A, air pollution, B, diet, or C, family history.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you realise that air pollution was our environmental factor? Excellent.

Really well done.

So, when we have these risk factors, actually, the more risk factors that you have.

So if you are exposed to lead, you also drink heavily, you're female and over 50, you've got a genetic history, a family history of having that disease, you are much more likely to develop that non-communicable disease, or actually other non-communicable diseases that are also associated with those risk factors.

Another example of a non-communicable disease then is actually cardiovascular disease.

This is a disease that affects our cardiovascular system.

So things like high blood pressure, is able to damage those small blood vessels like your arteries that carry around the blood.

Smoking, because that can also narrow those blood vessels.

High cholesterol, which again would be narrowing those blood vessels, increasing your risk of a blood clot.

Diabetes, which can damage those blood vessels.

And also, an inactive lifestyle.

So not carrying out any kind of form of exercise of any kind.

All of these things are able to damage those blood vessels and therefore lead to a type of cardiovascular disease.

It could be something like coronary heart disease, so those arteries that supply the heart with blood.

if they become damaged for any of those reasons there, then it can lead to a heart attack.

"Which of the following are non-communicable diseases?" A, athlete's foot, B, osteoporosis, or C, tuberculosis.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay.

Did you get osteoporosis? Excellent.

Well done.

Athlete's foot of course is caused by a fungus, so it's communicable, and tuberculosis is caused by bacteria, which is also communicable.

All right then, onto our first task of the day.

And if you get your worksheets out, you can record your answers on there.

So, first of all, "Categorise the common risk factors for non-communicable diseases into lifestyle, genetic, and environmental risk factors." I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you put under lifestyle, excessive alcohol consumption, lack of exercise, smoking, and an unbalanced diet? Genetic would be family history, and whether or not your male or female, so the sex.

Environmental, exposure to lead, exposure to air pollution.

Excellent.

Really well done.

Okay, onto our second learning cycle of the day then.

This is interpreting data on non-communicable diseases.

So, scientists will always look for correlations.

A correlation is a pattern in the data, and they want to do that to help to explain an observation.

Okay, so somebody might have a look at something and think, "Hmm, this looks a bit funny.

I wonder what the reason is." All right? This would be the very start of an epidemiological disease study, okay? So this is how it all begins, somebody noticing something.

It could be like a local observation.

So somebody might notice that actually, within the farming communities that live in an area, there is a real increase in the number of people with skin cancer, okay? So that would be the observation that actually on a local level, in a small area, let's say, Yorkshire, then they've noticed that actually, there seems to be an increased risk of a particular disease.

Now, cancers are non-communicable diseases, okay? They cannot be spread from organism to organism.

The scientists would then come up with a hypothesis.

A hypothesis is a statement of what they think is happening.

Some of the risk factors farmers experience that increase chances of developing cancer, are things like exposure to UV light and also exposure to a range of toxic chemicals.

So, the scientists might be thinking, "Okay, for my hypothesis, which of these factors do I think is more likely to be causing this increased risk of skin cancer?" Now, the likelihood is in this case, it's probably going to be that exposure to UV light, okay? UV light is much more likely to be affecting people that are working outdoors.

So anyone like a farmer or a builder, they're gonna have an increased risk of skin cancer because they're outside a lot more and therefore getting a lot more UV light.

Scientists would then collect the data from that local area, and they compare these to the national figures, all right? A report in 2020 actually found that outdoor workers such as farmers, were twice as likely to develop skin cancer.

So by comparing that to other studies, they could see that actually, there does seem to be a correlation or a pattern in the fact that people are working outside and also developing skin cancer.

They could then compare these to global figures.

So globally in 2019, 1.

6 billion workers were occupationally exposed to UVR, so ultraviolet radiation.

Occupationally just means whilst they were at work.

This represents 28.

4% of the working age population.

Men in particular, and also older people form the majority of this group, okay? So we are thinking about jobs that maybe traditionally men would do, such as building or being a farmer.

So we might see higher numbers of men in those categories.

Between 2000 and 2019, deaths and years of life lost due to premature death from skin cancer almost doubled.

So we are seeing a trend of increasing numbers in people with skin cancer, and also, unfortunately then, meaning that people are dying earlier than they should.

Okay.

Can you order the statements to show how scientists would carry out an epidemiological study? So A, compare local data with national data, B, local observation, C, hypothesis, and D, compare data globally.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay.

Have you got number one, local observation, number two, hypothesis, number three, compare that local data with national data, and number four, compare data globally? Excellent.

Well done.

Okay, so the government legislation and recommendations may be given after a scientific study.

Okay, so we've studied the number of people with skin cancer who are working outside.

We've seen that there does seem to be a trend that if you work outside you're more likely to get skin cancer.

So what would the government then say to try to bring those numbers down? So what could they do? Can you think of any recommendations for people working outdoors? Okay, things like wearing protective clothing, so making sure that your skin is covered, making sure that you've got a hat on, and also wearing a very high factor sun cream most of the time, okay? Both of these things would be good advice to somebody that is working for you, or someone that you know that works outdoors.

Now, if we have a look at cancer incidence rates then across England, okay, we might see different trends and we might see different reasons for these trends, okay? So, we can have a little look at this graph and you can see that the colours give you an idea about the number of cancer incidents.

So, as the lighter blue colours, they've got a lower incidence, the darker blue, they've got a higher incidence of the number of cancer rates.

And looking at it then, it seems that the northeast has the highest cancer rates.

We could think about some different factors that could affect that then.

Some different risk factors, things like diet, lifestyle, education, income levels, all of these things do have an impact on your risk of getting cancer.

There might also be some reason in those areas that you are having a higher level of exposure to radiation.

Potential family medical history are additional risk factors for cancer as well, that may be any scientists studying this would need to take into account.

When we're talking about a balanced diet then, this is a reminder of what we have in a balanced diet, okay? We should make sure that we've got carbohydrates.

So, high levels of carbohydrates can be found in things like bread, rice, pasta, and potatoes.

We should be getting a healthy level of fats and lipids.

Things like olive oil are a really good example.

Avocado, really good example of some healthy fats.

Proteins then from things like beans, meat, eggs, and fish.

Vitamins, so we found a range of different vitamins, things like vitamin C and D in fruits and vegetables.

Minerals such as iron and zinc that are found in a range of foods.

Again, including fruits and vegetables.

And fibre.

Fibre, we really need to make sure that we are upping our fibre in our diets.

You can get fibre from fruits and vegetables, but also from whole grains.

So making sure that you are eating brown pasta, brown bread, these are all going to up your levels of fibre in your diet.

And of course we should also be making sure that we're drinking lots of water and staying away from those fizzy drinks.

Okay, let's do a quick check then.

So, the lowest rates of cancer are where? And the highest rates of cancer are where? Having a look at this graph, where do you think the highest and the lowest rates are? I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, we can see that the lowest rates are in London there, that's the pales blue colour.

And the highest rates appear to be in the northeast.

Okay, onto our next task of the day then.

You could get your worksheet out, this is Task B.

So, there's a graph here that's showing the number of young people in the UK dying from bowel cancer is increasing.

We've got some different risk factors there on the X axis like eating too little fibre, eating processed meat, obesity, drinking alcohol, and too little physical exercise.

Cancer Research collected data from bowel cancer patients in the UK between 2015 and 2019.

They found some common risk factors and published them in a medical journal.

Experts are calling for further restrictions on alcohol to reduce the number of cases.

Okay, number 1, "Using the information below, write a paragraph explaining how the public could reduce their risk of developing bowel cancer." And number 2, "Are experts right to call for further restrictions on alcohol to reduce the number of cases of bowel cancer?" I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, so number 1, our paragraph.

So let's hope that you've got quite a few of these things in there.

"The first three risk factors are all related to a balanced diet.

People with a low fibre intake, high processed meat intake, and high BMI, should aim to eat a more balanced diet, including more whole foods and limit their intake of ultra processed foods such as sausages and crisps.

Brown rice and pasta will help to increase their fibre intake.

A more balanced diet should help people to maintain a healthy weight.

People should also drink less alcohol and increase their exercise each week." For number 2, "There are much bigger risk factors that contribute to developing bowel cancer than alcohol consumption.

Therefore, experts should be calling for measures that would lead to people eating more fibre, eating less processed meat, and being a healthy weight.

Reducing alcohol consumption will reduce the number of cases, therefore, the experts are not wrong, but they could also give additional advice about diet." If you need to add anything else then, please do that now.

Okay, onto our final learning cycle of the day, the importance of peer review.

So, companies and wellness brands often claim to help or even solve many health issues, but can we trust them? We've all seen those adverts, haven't we, that say, "This cereal or this spread will lower your cholesterol," "These vitamins will prolong your life." Are these claims actually valid? Okay, we need to think about that, not necessarily just buy into everything that companies tell us.

Now, before any health claim is made, scientific study should have been carried out.

This isn't always the case, and so we should be on alert for this.

Then, before being published, an independent panel of reviewers should actually evaluate, so look for the good things and bad things in their conclusion, and decide whether or not it should be accepted.

This is called peer review, okay? So the scientists that have their peers, so the people that are on the same level as them studying the same area, that's who we would call peers.

What would the reviewer look for then? They're going to be looking, is the method reliable, and has it produced valid results? So, to look to see if actually it's reliable, have they used a representative sample size? Okay, have they used lots and lots of people, or have they used a study of say, 100 people, 10 people? This is not enough in order to make a sweeping general statement about population.

These kinds of non-communicable diseases often develop over a really long time, and so, therefore, we should be trying to look for long-running studies.

Have they followed someone throughout their adult life? Have they followed someone just for six months? It's too little time, six months, in order to make a real claim about how that's going to help somebody, over 10 years.

Have they also looked to control other factors such as BMI? So, have they used people within the same BMI? Have they used people from lots of different BMIs? We would need to take that into account.

The reviewer would then evaluate the data to see if they make the same conclusions.

Now, scientists might say here, "Eating too little fibre in your diet is the greatest risk for bowel cancer." Okay, so looking at our graph again that we looked at earlier, then we can see that that is quite a high risk.

And so the reviewer would probably say from that statement, "I agree." But it might be the case that there may actually be some bias in the research, and the reviewer would want to try to tease that out.

For example, if a fizzy drink company funded this research, it may actually be more lucrative.

They might get more money for reporting on the data around exercise and not diet.

So by saying that too little physical activity, okay, is going to increase your risk of bowel cancer, and not reporting on eating too little fibre, processed meat, obesity, actually, they might make it seem as if drinking fizzy drinks isn't such a problem.

When we know that actually, there is a definite correlation between drinking fizzy drinks and also an increase in BMI.

And obviously, if you're drinking things like fizzy drinks, you're maybe less likely to be paying attention to other parts of your diet, and therefore things like eating too little fibre might put you into that category as well.

So it's really important that anyone that is reviewing the information, they look at where the money is being funded from and if their actual conclusion is valid.

It's important this information is then shared with policy makers and the public.

So people that are often working for the government, for example.

Policy makers can help to embed strategies to help to improve the health of different communities.

For example, promoting healthy eating in schools, so things like five a day, or now they're moving to 30 different kinds of fruits and vegetables in a week.

These are the types of things that can be easy for the public to follow, in order to increase their health.

It might make individuals then make better choices for their own lifestyles.

So they might go out exercising, or they might try to increase the fibre in their diet, and hopefully this would then lead to a healthier population.

Okay, "Why is peer review important?" A, to check the method is reliable, B, to agree with all the conclusions, and C, to look for bias in the conclusion.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, did you get to check the method is reliable? Excellent.

Well done.

We should have also had C, to look for bias in the conclusion.

Brilliant.

Okay, onto our final task of the day then, Task C.

"A sugar tax was introduced to reduce consumption of fizzy drinks and therefore reduce obesity." We can see along the bottom there we've got the different years, we've got the solid blue bars that represent volume sold of fizzy drinks in billion litres.

And then on the right-hand side for our purple line, this is the total sugar sold, and that's per 10,000 tonnes.

Policy makers have decided that the sugar tax has worked as the total amount of sugar being sold through fizzy drinks has been reduced.

Can you evaluate this claim? Remember, we want to look for reasons for this statement, and if there's anything that actually goes against this statement.

I'll give you a moment to think about it, but if you need more time, please pause the video.

Okay, "So the data shows that the total amount of sugar consumed through fizzy drinks has decreased.

However, the volume of fizzy drinks being consumed has increased year on year.

We don't know if people are consuming more sugar in other ways.

Obesity levels are increasing year on year, therefore, other action is needed to improve people's health.

The sugar tax is not enough." Okay, you may have given a slightly different conclusion there at the end, and that's okay as long as you've backed it up with some of the data.

Okay, so, risk factors such as obesity can increase your risk of developing a non-communicable disease.

These risk factors can be categorised into genetic, environmental, and lifestyle factors.

The more risk factors you have, the more likely you are to develop a non-communicable disease.

Scientists will often collect and interpret data on non-communicable diseases, locally, nationally, and globally, to find ways to advise the public on health through legislation.

Any scientific study should be peer reviewed before publishing, to ensure it is reliable and unbiased and has identified the correct correlation.

I hope you've enjoyed the lesson today.

I've really enjoyed learning with you, and hope to see you again soon.

Bye.