Mia's Health

01/04/2025

UNDERSTANDING IRON METABOLISM

Define the following terms:
a. ferritin is A huge protein. light and heavy chains. can store up to 4500 atoms of iron
in spherical cavity.
b. Transferrin is a protein that tightly binds one or two ferric (Fe+3) molecules and transports the iron through plasma.
c. Hemosiderin - insoluble intracellular protein that contains iron and is formed by
phagocytic digestion of blood.
d. total iron binding capacity - total transferrin available for binding Fe+3.
INCREASES with Anemia
e. percent saturation - serum iron divided by TIBC x 100

Describe the transport of iron across the apical membrane of the enterocyte and the export of iron across the basolateral membrane of the enterocyte.

a. iron is absorbed in duodenum
b. regulation of intestinal iron is critical, humans have no physiologic pathway for excretion of iron.
c. iron must pass from gut lumen through apical and basolateral membranes to reach plasma.
pH of gastric juices help dissolve ingested iron.

Ferric iron (3+) is
reduced to ferrous iron (2+) by brush-border ferrireductase that is coupled to a transporter protein.

Divalent metal transporter 1 (DMT1) is a protein that transfers iron
across the apical membrane via proton-coupled process. Also transports manganese, cobalt, copper, zinc, cadmium, lead.

iii. Iron in enterocyte stored as ferritin. May be lost with desquamation of
enterocyte
iv. on basolateral side exporter is called ferroportin.
1. requires hephaestin to convert 2+ → 3+ to load into transferrin.

Hephaestin acts as a ferroxidase, meaning it oxidizes ferrous iron (Fe2+) to ferric iron (Fe3+). This oxidation is essential for iron to be transported across the basolateral membrane of intestinal cells and bind to transferrin, a protein that carries iron in the blood.

3. Describe the hepcidin iron exporter regulator and how it is involved in hereditary hemochromatosis and anemia of chronic disease.
a. Hepcidin negatively affects iron exporting. Works by binding to ferroportin and
causing it to be endocytosed into the cell.
b. High hepcidin in anemia of chronic disease → decreased iron release out of
macrophages → low iron % saturation
c. Low hepcidin in hereditary hemochromatosis → increased iron absorption

Describe the symptoms of iron deficiency, the lab values and as they change with progressively more severe iron depletion, and name five conditions associated with iron
deficiency.
a. S/s
i. anemia, fatigue, pallor, poor exercise tolerance, pica/pagophagia, restless
leg syndrome, koilonychia (spoon nails), plummer-vinson syndrome.

27/03/2025

8 out of 10 people die in Fiji from NCDS! In the Pacific Islands region, non-communicable diseases (NCDs) account for around 75% of all deaths, and many of these deaths are premature, with the majority occurring before age 60.

27/03/2025

Solomon Islands, Samoa and Cook Islands are on the rise to physical inactivity which could be why there is a rise in mortality, ... premature mortality. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00150-5/fulltext

27/03/2025

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00150-5/fulltext
Figure 1 Map of (A) age-standardised prevalence of insufficient physical activity among adults aged 18 years and over in 2022, (B) data coverage and representativeness, and (C) country progress during 2010–22 toward the global target of a 15% relative reduction in insufficient physical activity prevalence among adults aged 18 years and over between 2010 and 2030

27/03/2025

Which country will be the most improved to achieve healthy physical activity levels.

27/03/2025

Us Girls need exercise the most, especially to help emotionally regulate! Have girls in sports because its proven worldwide girls during puberty are less physically active : aged 11 to 17

Globally, there are notable age and gender differences in levels of physical inactivity.

Women are less active than men by an average of 5 percentage points. This has not changed since 2000.
After 60 years of age physical inactivity levels increase in both men and women.
81% of adolescents (aged 11–17 years) were physically inactive.
Adolescent girls were less active than adolescent boys, with 85% vs. 78%, not meeting WHO guidelines.

Levels of physical inactivity globally
WHO regularly monitors trends in physical inactivity. A recent study (1) found that nearly one third (31%) of the world’s adult population, 1.8 billion adults, are physically inactive. That is, they do not meet the global recommendations of at least 150 minutes of moderate-intensity physical activity per week. This is an increase of 5 percentage points between 2010 and 2022. If this trend continues, the proportion of adults not meeting recommended levels of physical activity is projected to rise to 35% by 2030.

27/03/2025

ALL IN 1 - helpful health resources SMOKING RESOURCES: Quitline: Australian Government quit support website which provides access to a ‘cost of
smoking calculator’ – www.quitnow.gov.au
• RACGP: Smoking cessation: - a guide for health professionals – www.racgp.org.au/yourpractice/guidelines/smoking-cessation
• Cancer Council: To***co in Australia: Facts and issues (4th edition) –
www.tobaccoinaustralia.org.au
• US Department of Health and Human Services: Treating To***co Use and Dependence:
2008 Update – www.ncbi.nlm.nih.gov/books/NBK63952
• UK National Centre for Smoking Cessation and Training – www.ncsct.co.uk
• Australian Association of Smoking Cessation Professionals – http://aascp.org.au
• Start the conversation campaign: Motivation for GPs to offer smoking cessation support –
www.starttheconversation.org.au
• Lung Foundation Australia – http://lungfoundation.com.au
– Lung age estimator: Motivational tool to help quit smoking – http://lungfoundation.com.
au/health-professionals/clinical-resources/copd/primary-care-respiratory-toolkit/
– Lung health checklist – http://lungfoundation.com.au/patient-area/checklist
– PiKo-6 or COPD-6 to screen for COPD and identify whether diagnostic spirometry
testing should be considered – http://lungfoundation.com.au/wp-content/
uploads/2014/02/Instruction-sheet-Piko-6-and-COPD-6.pdf
• Quit phone apps (applications):
– My Quitbuddy: Provides a countdown for quitting and stats to track quitting progress,
such as number of days smoke-free, ci******es avoided and money saved.
– Quit for you – Quit for Two: Provides support and encouragement to help patients give
up smoking.
(Both can be downloaded from Apple iTunes online and Google play stores. Visit www.
quitnow.gov.au/internet/quitnow/publishing.nsf/Content/news_lp for more inform NUTRITION RESOURCES: Heartline (1300 36 27 87): Heart Foundation’s telephone service provides information on
CVD management, nutrition and healthy eating, blood pressure, smoking cessation and
physical activity, as well as a range of resources.
• Nutrition Australia: An independent, member-based organisation that aims to promote the
health and wellbeing of all Australians – www.nutritionaustralia.org
• Eat for health: A Government and NHMRC initiative designed to provide a range of
information and resources on nutrition – www.eatforhealth.gov.au
• HEAL Program: A lifestyle modification program designed to improve nutrition and physical
49 Smoking, nutrition, alcohol, physical activity (SNAP)
A population health guide to behavioural risk factors in general practice
activity and promote self-management for people who are overweight or obese with, or
who are at risk of developing, a chronic disease – NUTRIwww.essa.org.au/for-gps/heal-program
• Road to Good Health: Part of the Life! Program, a group-based healthy lifestyle
program to help Aboriginal and Torres Strait Islander peoples make sustainable lifestyle
changes, like choosing healthier food and drink and being more physically active – www.
healthinfonet.ecu.edu.au/key-resources/programs-projects?pid=1281
• Food phone apps (applications):
– 8700: NSW Health app designed to help make informed food choices when out and
about – www.8700.com.au
– Foodswitch: BUPA app designed to find out what’s in packaged food to help make
better choices when grocery shopping – www.bupa.com.au/health-and-wellness/
tools-and-apps/mobile-apps/foodswitch-app HEALTHIER WEIGHT RESOURCES NHMRC: Clinical Practice Guidelines for the Management of Overweight and Obesity in
Adults, Adolescents and Children in Australia provides information on the management of
obesity – www.nhmrc.gov.au/guidelines/publications/n57
• WHO: ‘Obesity’ webpage provides general information and facts relating to overweight
and obesity – www.who.int/topics/obesity/en
• Healthy Kids website: A ‘one stop shop’ of information about healthy eating and
physical activity for parents and carers, teachers and childcare workers, health and other
professionals, and young children and teens –– www.healthykids.nsw.gov.au/default.aspx
• Talking with parents about weight: An online professional development training to support
health professionals to raise and constructively discuss child overweight and obesity with
parents of overweight or obese children – www.talkingaboutweight.org (free access to
health practitioners in WA).
• LiveLighter: A campaign targeting adults aged 25–64 that aims to raise awareness of the
health effects of overweight and obesity and motivate and support individuals and families
to make changes to adopt a healthier diet and more active lifestyle. The campaign was
originally developed in WA and is now also being delivered in Victoria and the
ACT – https://livelighter.com.au
• The Better Health Program (WA) or Go 4 Fun (NSW): Provides evidence-based healthy
lifestyle program for children aged 7–13 who are above a healthy weight, and their
families. The program runs for 10 weeks – www.betterhealthprogram.org (WA) or
www.go4fun.com.au (NSW)
• Weight phone apps (applications):
– The 10,000 steps program has a phone application called ‘iSteplog’ – https://itunes.
apple.com/us/app/isteplog/id332045716?mt=8
– Shapeup app from the Federal Government – www.shapeup.gov.au/tools-to-shape-up
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HEALTHIER WEIGHT RESOURCES NHMRC: Clinical Practice Guidelines for the Management of Overweight an… See more
Welcome to the Healthy Weight Guide | Healthy Weight Guide
shapeup.gov.au
Welcome to the Healthy Weight Guide | Healthy Weight Guide
The Healthy Weight Guide can help you to achieve and maintain a healthy weight using information and tools that will guide you to:
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NUTRITION RESOURCES: Heartline (1300 36 27 87): Heart Foundation’s telephone service provides information on
CVD management, nutrition and healthy eating, blood pressur… See more
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SMOKING RESOURCES: Quitline: Australian Government quit support website which provides access to a ‘cost of
smoking calculator’ – www.quitnow.gov.au
• RACGP: Smoking cessation: - a guide for health professionals – www.racgp.org.au/yourpractice/guidelines/smoking-cessation
• Cancer Council: To***co in Australia: Facts and issues (4th edition) –
www.tobaccoinaustralia.org.au… See more
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Did you know that Heartline (1300 36 27 87) is a telephone service staffed by trained healthcare
professionals who provide information on CVD management, nutrition and healthy eating,
blood pressure, smoking cessation and physical activity. Information on relev
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How much muscle do you have? how much do you weigh?
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Reduce OH Resource Department of Health: Australian guidelines to reduce health risks from drinking alcohol –
www.alcohol.gov.au/internet/alcohol/publishing.nsf/Content/guidelines
Physical ACTIVITY RESOURCES Heart Foundation:
– Walking groups: Large network of free community-based walking groups led by volunteer
community members –www.heartfoundation.org.au/active-living/walking/Pages/welcome.aspx
– Heartmoves: Designed to safely build strength and fitness, as well as improve balance,
this program focuses on delivering low-to-moderate intensity exercise in small groups.
Heartmoves caters for all adults and is specifically designed to be safe for people who
have or are at risk of developing a chronic disease – www.heartmoves.org.au
• Shape Up Australia: A Federal Government initiative to help Australians reduce their waist
measurements and improve their overall health and wellbeing – http://shapeup.gov.au
• Physical Activity Australia: Formerly Kinect/VicFit, this organisation promotes physical activity,
active living and the reduction of sedentary lifestyles by engaging with the fitness industry,
building best practice instructor standards and program accreditation, and developing
evidence-based physical activity initiatives – www.physicalactivityaustralia.org.au
• Healthy Active: A Federal Government website that provides a range of information and
initiatives on healthy eating, regular physical activity and overweight and obesity –
www.healthyactive.gov.au
• Lungs in action: A community-based exercise maintenance program for people who have
completed pulmonary or heart failure rehabilitation – http://lungsinaction.com.au
• Lift for Life: Evidence-based resistance training program for people with, or at risk of, type 2
diabetes or other chronic diseases – www.liftforlife.com.au
• Beat It: A tailored exercise and lifestyle management program for those with or, at risk of,
diabetes or other chronic disease – www.australiandiabetescouncil.com/what-s-on/beat-it
• Lifestyle modifications programs:
– Life!: Lifestyle modification program funded by the Victorian Government and provided
by Diabetes Australia (Victoria) that helps patients reduce their risk of type 2 diabetes and
CVD, and encourages participants to adopt healthy behaviours and a more active lifestyle
– www.lifeprogram.org.au
– Aboriginal Life!: Aims to identify people at high risk of developing type 2 diabetes using the
Diabetes Risk Test (type 2 diabetes risk assessment tool for Aboriginal and Torres Strait
Islander Victorians) – call 1300 KOORIE (1300 566 743)
– My Healthy Balance: a free online, healthy lifestyle program designed by health
professionals for people who are overweight or at risk of developing a chronic health
condition and are seeking to live a healthier lifestyle – http://myhealthybalance.com.au/
About_My_Healthy_Balance
– The HEAL Program: See Nutrition section – www.essa.org.au/for-gps/heal-program
• COTA (Council on the Ageing) Living Longer Living Stronger program – www.lllswa.org.au
• COTA SA Strength for Living Factsheet – www.cotasa.org.au/Programs/life/Strength_for_
Life_Factsheet.aspx CARDIOVASCULAR RISK OF EVENT RESOURCES Australian absolute risk CVD calculator – www.cvdcheck.org.au
• Australian cardiovascular risk charts – www.heartfoudation.org.au/
sitecollectiondocuments/aust-cardiovascular-risk-charts.pdf
• Healthy and Active Australia: A website that provides a range of information and initiatives
on healthy eating, regular physical activity and overweight and obesity –
www.healthyactive.gov.au
• State based health coaching services – Refer to Chapter 4 for a list of some of the
services available in Australia.
• Better Health Channel: Phone App designed to help locate Victorian health services, –
www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/services_and_support?open GP RESOURCES FOR MEDICARE AND HEALTH ASSESSMENTS Health assessments:
– A health assessment item under MBS can be utilised to undertake a comprehensive
assessment of a patient with complex care needs. Health assessments can also
be utilised with specific groups (eg. Aboriginal and Torres Strait Islander peoples,
refugees and aged care residents) so needs are addressed in a targeted and culturally
appropriate manner.
– The Department of Health has an MBS health assessment resource kit for use in
general practice. This includes a link to health assessment templates –
www.health.gov.au/internet/main/publishing.nsf/Content/mha_resource_kit
– For health assessments for people aged 45–49 who are at risk of developing chronic
disease – www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_
mbsitem701_703_705_707
– For health assessments for people aged 40–49 with a high risk of developing type 2
diabetes – : www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_
mbsitem_type2diabetes
– For Healthy Kids and Get Set 4 Life (includes Healthy Kids Check factsheet):
www.health.gov.au/internet/main/publishing.nsf/Content/Healthy_Kids_Check
• Management plans:
– GP management plans and Team Care Arrangements under Medicare’s CDM GP
services (formerly Enhanced Primary Care) may be appropriate for patients with
chronic and complex care needs. While they are not appropriate for patients who are
merely ‘at risk’ of disease, they can be an important tool for managing risk factors
and interventions for those patients who already have chronic medical conditions and
complex needs.
– The Department of Health has more information – www.health.gov.au/internet/main/
publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement Helpful Resource for smoking, alcohol consumption, physical activity and diet. https://www.racgp.org.au/getattachment/bb78b780-1c37-498a-8ba3-b24a1a4288d9/Smoking-nutrition-alcohol-physical-activity-SNAP.aspx

27/03/2025

Helpful Resource for smoking, alcohol consumption, physical activity and diet.

27/03/2025

CARDIOVASCULAR RISK OF EVENT RESOURCES Australian absolute risk CVD calculator – www.cvdcheck.org.au
• Australian cardiovascular risk charts – www.heartfoudation.org.au/
sitecollectiondocuments/aust-cardiovascular-risk-charts.pdf
• Healthy and Active Australia: A website that provides a range of information and initiatives
on healthy eating, regular physical activity and overweight and obesity –
www.healthyactive.gov.au
• State based health coaching services – Refer to Chapter 4 for a list of some of the
services available in Australia.
• Better Health Channel: Phone App designed to help locate Victorian health services, –
www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/services_and_support?open

New Australian Guideline for assessing and managing cardiovascular disease risk and CVD risk calculator based on the latest evidence for the primary prevention of cardiovascular disease in Australia.

27/03/2025

Physical ACTIVITY RESOURCES Heart Foundation:
– Walking groups: Large network of free community-based walking groups led by volunteer
community members –www.heartfoundation.org.au/active-living/walking/Pages/welcome.aspx
– Heartmoves: Designed to safely build strength and fitness, as well as improve balance,
this program focuses on delivering low-to-moderate intensity exercise in small groups.
Heartmoves caters for all adults and is specifically designed to be safe for people who
have or are at risk of developing a chronic disease – www.heartmoves.org.au
• Shape Up Australia: A Federal Government initiative to help Australians reduce their waist
measurements and improve their overall health and wellbeing – http://shapeup.gov.au
• Physical Activity Australia: Formerly Kinect/VicFit, this organisation promotes physical activity,
active living and the reduction of sedentary lifestyles by engaging with the fitness industry,
building best practice instructor standards and program accreditation, and developing
evidence-based physical activity initiatives – www.physicalactivityaustralia.org.au
• Healthy Active: A Federal Government website that provides a range of information and
initiatives on healthy eating, regular physical activity and overweight and obesity –
www.healthyactive.gov.au
• Lungs in action: A community-based exercise maintenance program for people who have
completed pulmonary or heart failure rehabilitation – http://lungsinaction.com.au
• Lift for Life: Evidence-based resistance training program for people with, or at risk of, type 2
diabetes or other chronic diseases – www.liftforlife.com.au
• Beat It: A tailored exercise and lifestyle management program for those with or, at risk of,
diabetes or other chronic disease – www.australiandiabetescouncil.com/what-s-on/beat-it
• Lifestyle modifications programs:
– Life!: Lifestyle modification program funded by the Victorian Government and provided
by Diabetes Australia (Victoria) that helps patients reduce their risk of type 2 diabetes and
CVD, and encourages participants to adopt healthy behaviours and a more active lifestyle
– www.lifeprogram.org.au
– Aboriginal Life!: Aims to identify people at high risk of developing type 2 diabetes using the
Diabetes Risk Test (type 2 diabetes risk assessment tool for Aboriginal and Torres Strait
Islander Victorians) – call 1300 KOORIE (1300 566 743)
– My Healthy Balance: a free online, healthy lifestyle program designed by health
professionals for people who are overweight or at risk of developing a chronic health
condition and are seeking to live a healthier lifestyle – http://myhealthybalance.com.au/
About_My_Healthy_Balance
– The HEAL Program: See Nutrition section – www.essa.org.au/for-gps/heal-program
• COTA (Council on the Ageing) Living Longer Living Stronger program – www.lllswa.org.au
• COTA SA Strength for Living Factsheet – www.cotasa.org.au/Programs/life/Strength_for_
Life_Factsheet.aspx

27/03/2025

HEALTHIER WEIGHT RESOURCES NHMRC: Clinical Practice Guidelines for the Management of Overweight and Obesity in
Adults, Adolescents and Children in Australia provides information on the management of
obesity – www.nhmrc.gov.au/guidelines/publications/n57
• WHO: ‘Obesity’ webpage provides general information and facts relating to overweight
and obesity – www.who.int/topics/obesity/en
• Healthy Kids website: A ‘one stop shop’ of information about healthy eating and
physical activity for parents and carers, teachers and childcare workers, health and other
professionals, and young children and teens –– www.healthykids.nsw.gov.au/default.aspx
• Talking with parents about weight: An online professional development training to support
health professionals to raise and constructively discuss child overweight and obesity with
parents of overweight or obese children – www.talkingaboutweight.org (free access to
health practitioners in WA).
• LiveLighter: A campaign targeting adults aged 25–64 that aims to raise awareness of the
health effects of overweight and obesity and motivate and support individuals and families
to make changes to adopt a healthier diet and more active lifestyle. The campaign was
originally developed in WA and is now also being delivered in Victoria and the
ACT – https://livelighter.com.au
• The Better Health Program (WA) or Go 4 Fun (NSW): Provides evidence-based healthy
lifestyle program for children aged 7–13 who are above a healthy weight, and their
families. The program runs for 10 weeks – www.betterhealthprogram.org (WA) or
www.go4fun.com.au (NSW)
• Weight phone apps (applications):
– The 10,000 steps program has a phone application called ‘iSteplog’ – https://itunes.
apple.com/us/app/isteplog/id332045716?mt=8
– Shapeup app from the Federal Government – www.shapeup.gov.au/tools-to-shape-up

The Healthy Weight Guide can help you to achieve and maintain a healthy weight using information and tools that will guide you to:

27/03/2025

NUTRITION RESOURCES: Heartline (1300 36 27 87): Heart Foundation’s telephone service provides information on
CVD management, nutrition and healthy eating, blood pressure, smoking cessation and
physical activity, as well as a range of resources.
• Nutrition Australia: An independent, member-based organisation that aims to promote the
health and wellbeing of all Australians – www.nutritionaustralia.org
• Eat for health: A Government and NHMRC initiative designed to provide a range of
information and resources on nutrition – www.eatforhealth.gov.au
• HEAL Program: A lifestyle modification program designed to improve nutrition and physical
49 Smoking, nutrition, alcohol, physical activity (SNAP)
A population health guide to behavioural risk factors in general practice
activity and promote self-management for people who are overweight or obese with, or
who are at risk of developing, a chronic disease – NUTRIwww.essa.org.au/for-gps/heal-program
• Road to Good Health: Part of the Life! Program, a group-based healthy lifestyle
program to help Aboriginal and Torres Strait Islander peoples make sustainable lifestyle
changes, like choosing healthier food and drink and being more physically active – www.
healthinfonet.ecu.edu.au/key-resources/programs-projects?pid=1281
• Food phone apps (applications):
– 8700: NSW Health app designed to help make informed food choices when out and
about – www.8700.com.au
– Foodswitch: BUPA app designed to find out what’s in packaged food to help make
better choices when grocery shopping – www.bupa.com.au/health-and-wellness/
tools-and-apps/mobile-apps/foodswitch-app