Topic 1 Activities PDF

A1.
01S
Student
Activity 1.1 Marks and Peters stories

Purpose
To provide an overview of some symptoms and treatments of cardiovascular disease
using personal accounts.
To provide an introduction to the topic.
To practise extracting relevant information when reading text.
Procedure
The two passages below are Marks and Peters own accounts of their experiences with
cardiovascular disease. As you read each account, note down relevant information about:
a symptoms
b diagnostic tests
c treatments
d any features of each persons lifestyle that you think might have contributed to
their development of the disease.
When identifying information in this way, try and be selective and concise in the notes
you make.
Marks story
By Mark Tolley
Im 21 now, but 6 years ago something momentous happened that changed my life.
On 28th July 1995, I was sitting in my bedroom playing on my computer when I started
to feel dizzy with a slight headache. Standing, I lost all balance and was feeling very
poorly. I think I can remember trying to get downstairs and into the kitchen before
fainting. People say that unconscious people can still hear. I dont know if its true but I
can remember my Dad phoning for a doctor and that was it. It took five minutes from
me being an average 15-year-old to being in a coma.
I was rushed to Redditch Alexandra Hospital where they did some reaction tests on me.
They asked my parents questions about my lifestyle (did I smoke, take drugs, etc.?).
Failing to respond to any stimulus, I was transferred in an ambulance to Coventry
Walsgrave Neurological Ward. Following CT and MRI scans on my brain it was
concluded that I had suffered a bleed on my brain. My parents signed the consent form
for me to have an operation lasting many hours. I was given about a 30% chance of
survival.
They stopped the bleed by clipping the blood vessels that had burst with metal clips,
removing the excess blood with a vacuum. I was then transferred to the intensive care
unit to see if I would recover. Within a couple of days I was conscious and day by day
regained my sight, hearing and movement (although walking and speech was still
distorted). They had shaved all my hair off!
I had a remarkably quick recovery considering the severity of the operation. I was
talking again (although slurred and jumbled) within 5 days. By the end of the week, I
was transferred back to Redditch Alexandra Hospital to continue the rest of my recovery.
There I received occupational therapy, physiotherapy, and speech and language therapy
to improve my co-ordination, speech and strength. Within 7 days I could walk aided and
talk better I was then discharged to complete my recovery at home. I was given a
wheelchair and was admitted for therapy as an outpatient. The occupational therapy
trained my ability to perform everyday tasks. They made me make tea, do jigsaws, etc.
to improve my cognitive skills.
Salters-Nuffield Advanced Biology, Harcourt Education Ltd 2005. University of York Science Education Group.
This sheet may have been altered from the original. 1 of 4
A1.01S
Activity 1.1 Marks and Peters stories Student
Another effect that the haemorrhage had on me was that the whole right-hand side of
my body was weakened (the haemorrhage happened on the left side of my brain) and
things that I took for granted before became a challenge. My left hand compensated for
the weakness and gradually I became stronger, albeit on my former weaker side!
Three weeks later I returned to Coventry Walsgrave for an angiogram, where an X-ray
dye was injected into my veins which showed up my blood vessels on a scan. However,
this showed that there was still a bleed occurring and so I was prepared for surgery
once again.
The operation was lengthy, but not an emergency. However, I was still warned of the
dangers of such surgery. The operation did not leave me with much disability this time,
and I woke up within a day of being transferred back into the intensive care unit again.
Speech and movement were regained quickly. I was discharged to outpatients within
3 weeks, after undergoing another angiogram, and MRI and CT scans on my brain.
Embarrassingly, they had shaved only half of my hair off this time!
The following Wednesday I was called back to the Coventry & Warwick Hospital where
my neurosurgeon held a clinic. He said that there was still a small bleed that needed to
be clipped. So I was transferred to Walsgrave for my third operation. This one not being
as severe, I woke up minutes after the operation was completed with my faculties fully
intact. I could talk and walk aided. Following more scans, the next week I was
discharged again to complete my recovery at home. This was now late October 1995.
Things such as stair climbing became easier and I no longer required my wheelchair.
I have had no further episodes of brain haemorrhage activity apart from occasional
headaches. I am on anti-convulsant tablets (phenytoin) as I am now at a much higher
risk from epileptic seizures because of the surgery (although I have not had a fit since
the operations). I completed physiotherapy in around November 1995, by doing
exercises that improved my stamina, motor skills and co-ordination.
Although I have never been told a full reason why I suffered my stroke, I am certain that
it was due to being born with weak blood vessels in my brain that gave way after years
of increasing pressure. Im glad I was at home when it happened; I could have been
swimming or walking in the countryside with nobody around!
Returning to school in November, I found reading, writing and walking a challenge. I
was treated differently from other students, which I found difficult as I wanted to fit back
into my normal routine.
I passed my GCSE exams with lots of effort and went on to the 6th Form. I did a 1-year
course in Health and Social Care which aided my recovery and gave me the strength and
confidence to go to college to further my education. The course also showed me how to
express myself in a way that would make everyone look beyond my disabilities.
I recovered the most in the first 2 years following the stroke, now it has been a gradual
improvement. I do sport and go dancing and play music like normal people my age. My
memory is back to normal, only faltering occasionally. Nobody knows about my stroke
unless they question the huge scar on my head, so I must have recovered pretty well!
I found online organisations such as Different Strokes helpful because I met some
people who were in the same boat as me. It really helps to share experiences.
Well thats my story. I go trekking around the world in 10 weeks time. I dont know
what the future has in store for me; I dont really want to know either. I just look
forward to it with hope.
Thank you for reading this.
Mark xx
A1.01S
Peters story
By Peter Kempson
I remember clearly the first time I held a hockey stick at school; football wasnt on the
sports programme, so it became hockey, rugby and cricket in each of the terms.
During my time at the school I developed a keen interest in all sports, representing the
school in hockey and athletics. It did not distract me from my school work but seemed
to make me more attentive and kept my mind more active.
After leaving school I still maintained my sporting interest, representing Bedfordshire at
hockey and taking part in the athletics team at my place of work.
In 1961, aged 23, I got the first indication of cardiovascular problems. I was told that I
had high blood pressure. I didnt really take much notice. Well you dont think much
about that at 23, do you? My father had died at the age of 53 from a heart attack but as
he was about 4 stone overweight, had a passion for fatty foods and smoked 60 full
strength cigarettes a day, I didnt compare his condition to mine.
Throughout the rest of my working life I continued to play sport, mainly hockey, and
was never overweight. I must admit that I probably drank too much at times and didnt
bother too much about calories and cholesterol in food.
As I got older I found it more difficult to keep fit during the summer break between the
hockey seasons and so reverted to road running. I ran my first marathon in Leeds at the
age of 42 and I subsequently did another five, including two in London.
All was going well I thought, until having a medical for a new job showed my blood
pressure reading to be 240 over 140. The doctor could not believe that I was still
walking around, let alone running, and sent me straight to my G.P. Since then I have
taken tablets for blood pressure and have also reviewed my dietary intake.
I did continue running and completed the Great North Run at the age of 63. A few
months later and thinking about doing the Great North Run again, I was running 8 miles
a week and playing hockey, when my 8 day holiday in Ireland became 3 days touring
and 12 days in hospital.
At 2 oclock in the morning of May 8th I woke up with a terrific pain in my chest. I was
sweating profusely and looking very pale. My wife rang the hotel reception and within
10 minutes a doctor had arrived, checked me over, and pronounced that I had had a
heart attack. Within an hour I was in intensive care and being closely monitored. At
5 am I had a second attack and a specialist inserted a temporary pacemaker to keep my
heart rate up as it was dropping below 40.
After 5 days in intensive care I was transferred to the general ward for recuperation. I
gradually increased my walks each day and was watched by the Lifestyle Nurse while I
climbed stairs. The nurse also discussed my lifestyle. Did I smoke? No. Did I eat fatty
foods? Yes. Did I exercise? Yes. Was I overweight? No. Did I have a history of cardiac
problems in my family? Yes! This then appeared to be the possible cause. I was told that
it was possible that had I not looked after myself I might have had a heart attack much
earlier in life.
After 10 days I was given a stress test which involved running on a treadmill to
determine my ability to cope with normal life. Having passed the test I was brought
home by the travel insurance company, escorted by a doctor.
On returning to Huddersfield I eventually had an angiogram and was told that I needed
a triple bypass operation, but that my heart might not be strong enough to take it. The
specialist at Leeds General, Mr McGoldrick, gave me a detailed analysis of the situation
and the operation, but the final decision was up to me.
A1.01S
I found it very difficult to walk more than 100 yards without using my Nitro-spray. This
was very difficult to cope with considering that 9 months earlier I had been so active.
The decision was easy, I would have the operation.
I have to say it was not pleasant, but I had decided that it was necessary and I would
cope with anything that happened if it would get me back to a decent lifestyle. Well the
operation, a quadruple bypass, was a success and after 8 days I was back home.
Recuperation involved plenty of walking and visits to the Cardiac Rehab. At that time I
was introduced to Heartline, which is a group of people who have suffered cardiac
problems, encouraging exercise and recuperation by being able to talk to others with
similar experiences. I go swimming once a week and have increased my distance from 2
lengths at first to 40 lengths after 12 weeks. Although I feel fit enough to resume running
I think I will put it on hold for a while. I dont think I will ever play hockey again.
There again, at 66 thats probably not a bad decision!
Peter Kempson
A1.02S
Student
Activity 1.2 Demonstrating mass flow

Purpose
To appreciate speed of diffusion in air.
To observe mass flow.
Safety You need

Wear eye protection. Dilute ammonium hydroxide
2 glass tubes
Undertake the experiment O C O
Bungs to fit glass tubes

in a fume cupboard. 16 small pieces of litmus paper
Glass or wooden rod
Procedure 2 small pieces of cotton wool
1 Your teacher/lecturer will set up a glass tube Forceps
with litmus paper as shown in Figure 1. Dropping pipette
Stopclock
2 In a fume cupboard add a few drops (about Clamp stand, boss and clamp or piece or
six) of ammonium hydroxide solution to a blue tack
small ball of cotton wool and then place it at
one end of the glass tube. Seal both ends of
the tube with rubber bungs. Immediately start
a stopclock. Ammonia is given off by the
solution and diffuses along the tube. The rubber bung
litmus paper changes colour from red to blue
in the presence of ammonia gas.
3 Record how long it takes each piece of
litmus paper to change colour. litmus paper (red)
4 Using a second tube without rubber bungs,

place the cotton wool with ammonium clamp stand
hydroxide at one end.
5 Using a large syringe, blow air gently through
the tube. Observe how quickly the litmus
paper changes colour when the syringe is Figure 1 Glass tube with litmus paper.
used.
Questions
Q1 Explain how the ammonia moves along the tube with sealed ends and comment on the speed
of diffusion.
Q2 Explain how each of these factors would affect the rate of diffusion:
a higher concentration of ammonium hydroxide
b higher temperature
c larger molecules replacing ammonium hydroxide.
Q3 Explain what is happening in the tube without bungs and how the model is similar to mass
flow in a transport system such as the mammalian circulatory system.
A1.03S
Student
Activity 1.3 Structure of the heart (Dissection)

Purpose
You need
To revise your knowledge of the structure of the Heart
heart. Dissecting board or tray
To relate heart structure to function. Dissecting instruments
To locate and compare the structure of the main Rubber tube
arteries leaving the heart with the main veins Clamp to seal blood vessel
entering the heart. Access to water supply
To observe the coronary arteries. Lab coat or apron to protect your clothes
Safety
Wear eye protection.
Wash your hands carefully after completing the dissection O C O
once all the equipment has been put ready to be disinfected.
Take care with sharp dissecting instruments.
Procedure
1 Before starting the dissection, use the textbook to help you label the heart diagram
on page 3.
2 Locate the four main blood vessels attached to the heart. The two thicker walled
vessels are the arteries; they leave the heart at the more rounded front (ventral) side.
The thinner walled veins enter the heart at the top of the back (dorsal) side. They are
often damaged on removal of the heart from the animal.
3 Looking at the front side of the heart, identify the following external features using
Figure 1 to help:
a) right and left atria
b) right and left ventricles
c) coronary arteries and veins.
4 Draw a sketch of the heart and show the position of the atria and ventricles.
pulmonary artery
Q1 Why are the right and left sides aorta
apparently on the wrong side? left atrium
Q2 a Can you distinguish coronary right atrium
arteries and veins?
b What are their functions?
c Make a sketch showing how
they branch across the surface
of the heart. left ventricle
right ventricle
Cut along this line Cut along this line

to view inside the to view inside the
right ventricle. left ventricle.
Figure 1 Ventral (front) view of the heart. The pulmonary vein and vena cava enter
the atria on the dorsal (back) side of the heart so are not visible on this diagram.
A1.03S
Activity 1.3 Structure of the heart (Dissection) Student
5 If your heart is undamaged you can identify which vessel is the aorta by attaching a
rubber tube to a water tap and inserting it into the pulmonary vein. Allowing water
to flow through the heart (gently!) it will emerge from the aorta. The same procedure
can be used with the anterior vena cava after clamping the posterior vena cava shut.
Q3 In this case from which vessel will the water emerge?
Q4 What does this tell us about the internal structure of the heart?
6 To inspect the internal structure of the heart, cut through the ventricle walls, along
the lines shown in Figure 1. This is best done with a sharp scalpel or a pair of sharp
scissors. Be careful at this stage only to cut through the ventricle walls, leaving the
walls of the atria intact.
Q5 Look carefully inside each ventricle and answer these questions:
a Which ventricle has thicker walls?
b Estimate their thickness.
c Suggest why the ventricle walls are of different thicknesses.
Q6 Locate and carefully observe the atrioventricular valves between the atrium and ventricle on
each side of the heart.
a Why is the valve in the right ventricle called the tricuspid valve?
b Why is the valve in the left ventricle called the bicuspid valve?
Q7 Locate the semilunar valves at the entrance to the aorta and pulmonary artery. Why are these
valves called semilunar?
Q8 Identify the tendons that stretch between the atrioventricular valves and the ventricle walls.
a What is the function of these valves and what is the role of the tendons in their operation?
b Work out how you can test your ideas about valves by inverting the heart and using some
water.
Q9 Cut open the atria and examine their internal structure. Explain the relative difference in size
between the atria and ventricles.
7 Locate the opening of the coronary vein in the wall of the right atrium.
8 Cut open the aorta and locate the opening to the coronary artery just above the
semilunar valve.
Q10 Examine the openings to the vena cava and pulmonary vein. Do these entry points to the
heart contain valves? If not, why not?
Q11 Describe the safety precautions you took during the practical.
A1.03S
Activity 1.3 Structure of the heart (Dissection) Student
Vertical section of the heart

Label the diagram. Add arrows to show the route of blood flow through the heart.
Figure 2 Vertical section of the heart.
This activity is a modification of one in King, T., Reiss, M. with Roberts, M. (2001) Practical Advanced
Biology, Cheltenham, Nelson Thornes.
A1.04S
Student
Activity 1.4 Structure of the heart (Simulated

dissection)
Purpose
To revise knowledge of the structure of the heart.
To relate heart structure to function.
To locate and compare the structure of the main arteries leaving the heart with the
main veins entering the heart.
To observe the coronary arteries.
Procedure
Complete the activity by referring to diagrams and photographs in textbooks and the
animation that accompanies this activity. There are also some useful websites in the
weblinks for this activity.
1 Draw a sketch of the external features of the heart viewed from the front (ventral)
side. The two thicker walled vessels are the arteries; they leave the heart at the front
(ventral) side. The thinner walled veins enter the heart at the top of the back (dorsal)
side. You should draw and label the following features:
the right and left atria
the right and left ventricles
the four main blood vessels
coronary arteries and veins.
2 Label the vertical section diagram of the heart on page 2. Add arrows to show the
route of blood flow through the heart.
Questions
Q1 Why are the right and left sides apparently on the wrong side?
Q2 What are the functions of the coronary arteries and veins?
Q3 If water were poured into the vena cava, through which vessel would it emerge from the heart?
Q4 What does this tell us about the internal structure of the heart?
Q5 Which ventricle has thicker walls?
Q6 Suggest why the walls of the left and right ventricle are of different thicknesses.
Q7 Why is the atrioventricular valve in the right ventricle called the tricuspid valve and the
atrioventricular valve in the left ventricle called the bicuspid valve?
Q8 What is the function of the atrioventricular valves?
Q9 Why are the valves at the entrance to the aorta and pulmonary artery called semilunar?
Q10 What is the function of the tendons that connect the atrioventricular valves and the ventricle
walls?
A1.04S
Activity 1.4 Structure of the heart (Simulated dissection) Student
Vertical section of the heart

Label the diagram. Add arrows to show the route of blood flow through the heart.
Figure 1 Vertical section of the heart.
A1.05S
Student
Activity 1.5 Investigating arteries and veins

Purpose
You need
To relate the structures of blood vessels to their Ring of artery and vein
functions.
Mass carrier
To practise some experimental skills, including 5 10 g masses
identification of variables, producing valid results,
Hook
presenting data, drawing conclusions and
Clamp stand, boss and clamp
considering safety.
Metre rule
Graph paper
Safety Prepared slide of artery and vein T.S.
Wear eye protection while stretching Prepared slide of lung or thyroid gland
blood vessels. T.S. to show capillaries
O C O
Microscope
Benches should be thoroughly cleaned Histology book for microscope images
with 1% Virkon or other suitable and notes
disinfectant. Drawing paper
Wash your hands after handling

tissue once cleaning up is finished.
Procedure
Part A: Elastic recoil in arteries and veins
1 Suspend a ring of artery from a hook on a clamp stand. Use a metre rule to record
the length of the ring once the mass carrier has been attached to the free end of the
ring.
2 Attach a 10 g mass (see Figure 1) and record the length of the ring after the mass is
added.
3 Remove the mass and record the length of the ring.
4 Repeat steps 2 and 3 using 20, 30, 40 and 50 g masses. Record the length with and
without the masses each time.
clamp stand
hook
ring of tissue
mass carrier metre rule
10 g masses
Figure 1 Measuring the length of the ring.
5 Calculate % change in length:

(new length original length)
% change in length 100
original length
A1.05S
Activity 1.5 Investigating arteries and veins Student
6 Enter your results into an appropriate table. Remember that a good table of results
should have:
an informative title
the first column containing the independent variable (the factor that is varied by
the experimenter; in this experiment it is the mass)
the second and subsequent columns containing the dependent variables (The
value of the dependent variable depends on the value of the independent
variable. In this case the length of the ring depends on how much mass is added,
so ring length is the dependent variable.)
informative column headings; each column should have a descriptive heading
units in the heading, not next to the numerical data
Additional columns can be added to include calculations based on raw data such as
% change in length, etc.
7 Plot two appropriate graphs, one for artery, one for vein. Remember that the most
appropriate type of graph should be chosen to represent data, e.g. bar chart, pie
chart, histogram or line graph.
A bar chart is used when the independent variable is non-numerical or discontinuous,
e.g. the different stages of mitosis.
A pie chart can be used to display data that are proportions or percentages.
A histogram is used when the independent variable is numerical and the data are
continuous, but classified into groups, e.g. number of leaves of different lengths.
A line graph can be used to show relationships in data which are not immediately
obvious from tables. Both the dependent and independent variables are continuous. The
independent variable normally goes on the x-axis.
Remember to include:
an informative title
sensible scales on each axis, if appropriate
labels on both axes
units on both axes, if appropriate
a key.
(For more detail on presenting data see Alan Cadogan (ed.) (2000) Biological
Nomenclature: Standard terms and expressions used in the teaching of biology,
3rd Edition, Institute of Biology ISBN 0900490365)
In this experiment plot % change in length against mass.
Values for adding and removing masses should be plotted on the same graph. (You
could colour-code the points to show which are adding and which removing masses.)
Part B: Histology of blood vessels

8 Examine slides of artery and vein. Identify the three main regions of the vessel wall,
and the tissues in these regions:
a) external, middle and inner layers of tissue
b) elastic and collagen fibres
c) smooth muscle.
9 Sketch a plan of a cross-section across both vessels to show the amount and
distribution of each type of tissue.
10 Annotate the sketch with notes on the three regions and other features of the vessel,
e.g. thickness of wall, tissues in the three regions.
11 Using H.P. (high power) examine a capillary in a section of an organ, e.g. lung or
thyroid.
A1.05S
Activity 1.5 Investigating arteries and veins Student
Questions
Q1 How do the results for artery and vein compare when looking at:
a % change in length on loading?
b return to the original length on unloading?
Q2 What are the main properties of:
a elastic fibres
b collagen?
Q3 Explain any trends or patterns in the data, supporting your ideas with evidence from the data
and your biological knowledge of the histology of arteries and veins.
Q4 Explain how the properties of arteries and veins that you have investigated link to the
functions of arteries and veins in the body.
Q5 State two ways in which the structure of a capillary is related to its function.
Q6 What is the role of smooth muscle in blood vessel walls?
Q7 Comment on any safety issues that should be considered when performing this experiment.
Q8 Suggest variables that should ideally be controlled in this experiment.
Remember that the independent variable is the factor that you vary. You may be able to choose the
range of values of the independent variable. The dependent variable depends on the value of the
independent variable. Any other variables that may affect the dependent variable should be
controlled (kept constant) where possible, in order to produce results that are reliable.
Q9 Suggest modifications to the experimental procedure that would ensure that more reliable
and valid results are produced. Remember that reliable and valid results are produced through
precise, repeatable measurements made with apparatus and experimental procedures that are
suitable for the task.
Reliability means that the same results are recorded if the activity is repeated. This
partly depends on the number of measurements or observations that were taken. Ideally,
a large number of replicates (repeat measurements) should be taken, and any readings
that vary considerably from the others should be repeated or discounted. A mean or
some other average (e.g. a median) can be calculated to be representative of the set of
results. The pressure of time usually puts a limit on the number of replicates that can be
taken.
Validity means that the experimenter succeeds in measuring what he or she intended to,
in other words that there is little or no difference between the actual values and the
recorded values.
Precision is the closeness of repeated measurements to each other. Precision involves
the choice of apparatus and the skill with which it is used. Precise readings are not
necessarily accurate. A faulty piece of equipment or an incorrectly used piece of
apparatus may give very precise readings (repeated values close together) but inaccurate
(not valid) results. To be accurate, a measurement should be close to the true value.
A1.06S
Student
Activity 1.6 The cardiac cycle

Purpose
To describe the sequence of events in a single heartbeat, the cardiac cycle.
Use the section on the cardiac cycle in your textbook or the

interactive tutorial that accompanies this activity to help you
complete this worksheet.
Procedure
1 Cut up the pictures on the separate sheet and stick these into the
correct boxes on the right to match the order of descriptions
below.
2 Complete the descriptions and make deletions as appropriate, i.e.
when you are provided with two alternatives separated by a /.
3 Add arrows to each diagram to show blood flow.
Atrial and ventricular diastole

Blood flows into the atria. Elastic recoil of the atrial walls generates
low pressure in the atria, helping to draw blood into the heart.
Initially the atrioventricular valves are open/closed.
As the ventricles begin to relax, blood tends to fall back from the
aorta and pulmonary artery causing the valves
to close. This causes the second heart sound dub.
Atrial systole
As the atria fill with blood, the pressure in the atria increases/
decreases, the atrioventricular valves are pushed open and blood
flows into the relaxing ventricles. The two atria contract
simultaneously, forcing the remaining blood into the ventricles.
Ventricular systole
After a slight delay, the ventricles contract. This increases/decreases
the pressure in the ventricles so the atrioventricular valves
open/close. This causes the first heart sound lub.
Blood is forced into the and
.
The semilunar valves are open/closed.
Blood begins to flow into the relaxing .
A1.07S
Student
Activity 1.7 Atherosclerosis

Purpose
To explain the events that lead to atherosclerosis.
To describe the blood-clotting process.
Effects of atherosclerosis
Atherosclerosis is the name given to the process that occurs within arteries, causing them
to narrow. This can lead to coronary heart disease. A patient may only be aware that
they have coronary heart disease when their blood flow is restricted causing angina
pain associated with a lack of oxygen in the heart muscle. Ultimately atherosclerosis can
result in thrombosis the blockage of an artery by a blood clot. If the blood supply to
the heart muscle cells is stopped, they are said to be ischaemic, i.e. without blood. The
cells will die if they are starved of oxygen and nutrients for an extended period.
Procedure
Cut up the table below to give a set of cards with key words and phrases written on
them. Sort the cards into a sequence that follows the events in the development of
atherosclerosis and thrombosis. Using the key words, create a complete description, a
flow chart or an annotated diagram of the processes of atherosclerosis and blood
clotting.
1 Fibrin 12 A blood clot forms

2 Hard plaque forms 13 Platelets in contact with
damaged artery wall
3 Tangled mesh 14 Artery narrows
4 Large white cells enter wall 15 Platelet plug forms
5 Platelets become sticky 16 Raising blood pressure
6 Inflammatory response 17 Artery wall damaged
7 Thrombin 18 Wall elasticity reduced
8 Cholesterol accumulates 19 Atheroma forms
9 Prothrombin 20 Traps blood cells
10 Calcium salts and fibrous 21 Fibrinogen
tissue accumulate
11 Cascade of chemical 22 Atherosclerosis
changes
A1.08S
Student
Activity 1.8 Conductive pathway of the heart

Purpose
To describe the normal electrical activity of the heart during a single heartbeat.
Procedure
Read your textbook and watch the interactive tutorial for Activity 1.8 before completing
this sheet.
1 Fill in the gaps to correctly identify the major parts of the hearts conduction system.
2 Draw an arrow to show the path taken by the wave of depolarisation as it spreads
across the atria.
3 Draw arrows of the route of the electrical impulse as it travels through the ventricles.
4 Draw arrows to show the direction of blood flow at the entry to each of the blood
vessels of the heart. Colour-code your arrows to show oxygenation, red for
oxygenated and blue for deoxygenated.
The __________ node

(_________) generates the
electrical impulse that
initiate contraction of the
heart muscle.
The __________________ is the

only point that the impulse can
pass through the non-conducting
layer between the atria and
ventricles.
The _____________
conducts the impulse
to the apex (base) of the The impulse spreads upwards through
heart. the ____________ into the ventricle
walls causing the muscle to contract
from the base upwards.
Figure 1 The conductive pathway of the heart.
Questions
Q1 Why is there a non-conducting layer between the atria and ventricles?
Q2 Why are impulses conducted to the base of the heart before moving up through the ventricle
walls?
Q3 Where are impulses temporarily delayed within the conduction system?
Q4 Why are these impulses delayed?
A1.09S
Student
Activity 1.9 What does an ECG show?

Purpose
To use ECG traces to calculate the heart rate.
To interpret ECG traces in relation to the normal electrical activity of the heart.
The electrocardiogram
The electrocardiogram (ECG) records the electrical activity of the heart. Normally a
patient will have 12 electrodes attached to their body, each giving a different view of the
heart, but in this activity only a single trace will be used.
A normal ECG trace
P wave R T wave
Q
S
QRS complex
Figure 1 ECG trace from a normal heart.
What does each wave represent?

The P wave is the result of a wave of electrical charge spreading across the atria. When
it reaches the atrioventricular node at the base of the right atrium there is a slight delay
shown by the time between the end of the P wave and the start of the QRS complex;
this allows the atria to contract.
The QRS complex is due to electrical charge spreading upwards through the ventricles.
The ST segment is the short period of time when no further electrical impulse can be
passed through the heart muscle.
The T wave is the period when the ventricles are relaxing and return to their resting
state.
In the ICT support there is a datalogging sheet on studying ECGs and a datalogging
sheet on using a heart-rate or ECG sensor.
Procedure
1 Using the textbook and/or the interactive tutorial in Activity 1.8, label the ECG trace
diagram (Figure 7) on page 3. Label each part of the trace and annotate the diagram
to indicate what is happening in the heart at each stage.
Using the ECG trace to measure heart rate

The ECG trace can be used to measure heart rate. The squared paper passing through an
ECG machine moves at a steady 25 mm per second. This means that 300 of the large
squares will pass through in 1 minute. One large square is equivalent to 0.2 seconds.
Heart rate can be determined by finding the average number of large squares between
two QRS complexes. This value is divided into 300 to give the heart rate. If four large
squares separated the QRS complexes the heart rate would be:
300 4 75 beats per minute
A1.09S
Activity 1.9 What does an ECG show? Student
Questions
Q1 What is the heart rate of the person whose ECG trace is shown in Figure 2?
5 large squares
Figure 2
Q2 Bradycardia can be perfectly normal for fit athletes, particularly during sleep. With training,
the amount of blood the heart can hold and pump out with each beat increases; therefore at rest
fewer beats are required to pump enough blood around the body to meet demand for oxygen and
nutrients.
Is the person whose ECG trace is shown in Figure 3 bradycardic, i.e. do they have a heart rate of
less than 60 beats per minute?
Figure 3
Q3 Calculate the heart rate using the trace in Figure 1.21c in your textbook. This is an example of
tachycardia, a heart rate of over 100 beats per minute, something most of us will experience with
exercise, fever or fear, although it can be one symptom associated with heart disease or other
medical conditions.
Q4 Which one of the waves is missing from the ECG trace in Figure 4? Where might there be a
problem within the heart? What could this problem be?
Figure 4
Q5 A patient who suffers chest pain, that may be due to development of atherosclerosis in the
coronary arteries giving rise to angina, will show abnormal-shaped waves on their ECG. During the
period of pain the ST segment lies below the normal position and there may be inversion of the T
wave. Sketch what an ECG trace with these features would look like.
A1.09S
Activity 1.9 What does an ECG show? Student
Extension questions
Q6 In patients with ischaemic heart disease, the PR interval on the ECG trace can be longer than
normal, over 0.2 seconds, due to a problem with conduction in the heart. Where might the
impulses be delayed to cause the extended PR interval?
Q7 In patients with pulmonary hypertension, blood pressure in the lungs is much higher than
normal. Their ECG trace has a large P wave, similar to the one in Figure 5. Suggest which part of
the heart will be enlarged in a person with this condition? Give at least one reason for your answer.
Q8 Each lead used with an ECG looks at the heart from a different angle. The positions of six
leads are shown in Figure 6. Mr Wilson, a patient who has had a heart attack, has abnormal ECG
traces from leads 1 to 4. From the position of the leads on the chest, suggest whether the damaged
heart muscle that caused the abnormal traces is in the anterior or posterior side of the heart, and
give a reason for your answer.
1 2
3 6
4 5
Position of
leads 1 to 6
Figure 5
Q9 Explain why the P wave is usually smaller

than the QRS complex wave on a normal ECG Figure 6
trace.
Figure 7
A1.10S
Student
Activity 1.10 Estimating risk

Purpose
To estimate risks and investigate peoples perceptions of risk.
To analyse quantitative data on mortality rates.
To distinguish between correlation and causation.
Estimating risks and analysing data

Q1 In the year 2000 there was a total of 537 877 deaths in England and Wales. Of these, 2837
were due to motor-vehicle accidents. For each of the causes of death in Table 1, estimate the number
of deaths occurring in 2000. (Note that there are causes of death other than those listed here.)
Table 1 Causes of death in England and Wales, 2000. Table 2 Causes of death in the UK, 2000.
Cause of death Estimated Actual Cause of death Number of

in England and number number in the UK deaths in
Wales of deaths of deaths 2000
in 2000 in 2000
All diseases of the 237 051
Accidental falls circulatory system
Appendicitis Coronary heart disease 124 373
Asthma Stroke 60 770
Cancer All cancers 150 920
Diabetes Lung cancer 31 681
Electrocution Breast cancer 12 791
Epilepsy Respiratory disease 103 548
Heart disease Accidents 12 960
Influenza
Sources:
Meningitis Office for National Statistics
General Register Office for Scotland
Motor-vehicle Northern Ireland Statistics and Research
accidents 2837 2837 Agency
Murder
Pregnancy
Railway accidents
Thalassaemia
Q2 Your teacher/lecturer will provide you with the actual number of deaths that occurred in 2000
due to each of the causes in Table 1. The figures come from the Office of National Statistics.
Compare your estimates with these figures. If there are discrepancies between your estimates and
the official statistics, try and explain why you may have overestimated or underestimated the risks.
Q3 It is not unusual for people to overestimate the risk of death from train accidents. Suggest
reasons for this overestimation.
Q4 It is not unusual for people to underestimate the risk to their health of smoking. Suggest
reasons for this underestimation.
Study the year 2000 causes of death data for the UK in Table 2 and then answer the
questions that follow. The total number of deaths in the UK during the year 2000 was
610 579.
A1.10S
Activity 1.10 Estimating risk Student
Q5 a Calculate the percentage of total deaths in the UK in 2000 that resulted from each of the
eight categories of disease in Table 2. (Hint: The number of deaths due to a particular
disease is divided by the total number of deaths for the year 2000 and multiplied by 100 to
give a percentage. So the % of total deaths in the year 2000 due to accidents is
12 960 610 579 100.)
b Use the 2000 data to estimate the probability of an average person dying from each of the
diseases in any year. Express your answers as 1 in ? values or as decimals. The population of
the UK in 2000 was 58 817 000. (See your textbook the section on risk if you need
help in getting started with the calculations.)
c The probabilities you have calculated are for the population as a whole. Why is it that the
probability for each individual will typically be very different?
Correlation and causation

A positive correlation between two variables occurs when an increase (or a decrease) in
one variable can be linked to an increase (or a decrease) in the other variable. For
example, an increase in the number of cigarettes smoked is positively correlated with the
incidences of lung cancer and coronary heart disease. This is a positive correlation
because as the number of cigarettes smoked increases, the incidences of these diseases
also increase. Similarly, the amount of alcohol in the bloodstream of drivers positively
correlates with the likelihood that they will have a car accident. In both of these cases
there is likely to be a causal link between the two variables. The more a person
smokes, the greater the amount of chemicals in the bloodstream that can cause damage
that results in lung cancer and coronary heart disease. The more alcohol a person
consumes, the slower their reaction times and the more likely they are to have an
accident. However, a strong correlation between two variables does not necessarily
prove a causal link between them.
Q6 Look at the data in Table 3 on the next page and then attempt the questions.
a Is there any correlation between the two sets of data? If yes, is it a positive or negative
correlation? It might help to draw a graph using the two sets of data or at least sort it. An
Excel file of the data is available with this activity.
b It is unlikely that sending televisions to countries with a short life expectancy would
increase peoples lifespan. Suggest a plausible explanation for the relationship between the
variables.
A1.10S
Activity 1.10 Estimating risk Student
Table 3 Life expectancy and television ownership in different countries.
Country Life People Country Life People

expectancy per expectancy per
television television
Argentina 70.5 4.0 Morocco 64.5 21.0
Bangladesh 53.5 315.0 Myanmar (Burma) 54.5 592.0
Brazil 65.0 4.0 Pakistan 56.5 73.0
Canada 76.5 1.7 Peru 64.5 14.0
China 70.0 8.0 Philippines 64.5 8.8
Colombia 71.0 5.6 Poland 73.0 3.9
Egypt 60.5 15.0 Romania 72.0 6.0
Ethiopia 51.5 503.0 Russia 69.0 3.2
France 78.0 2.6 South Africa 64.0 11.0
Germany 76.0 2.6 Spain 78.5 2.6
India 57.5 44.0 Sudan 53.0 23.0
Indonesia 61.0 24.0 Taiwan 75.0 3.2
Iran 64.5 23.0 Thailand 68.5 11.0
Italy 78.5 3.8 Turkey 70.0 5.0
Japan 79.0 1.8 Ukraine 70.5 3.0
Kenya 61.0 96.0 United Kingdom 76.0 3.0
Korea, North 70.0 90.0 United States 75.5 1.3
Korea, South 70.0 4.9 Venezuela 74.5 5.6
Mexico 72.0 6.6 Vietnam 65.0 29.0
Source:
Modified from Rossman, A.J. (1994) Televisions, Physicians and Life Expectancy, Journal of Statistics Education, 2(2).
A1.11S
Student
Activity 1.11 Analysis of cardiovascular

disease data
Purpose
To analyse quantitative data on cardiovascular disease.
To consider the effect of age and gender on the risk of cardiovascular disease.
Analysis of risk: haemorrhagic stroke

Mark had his haemorrhagic stroke in 1995 at the age of 15. In this type of stroke a blood
vessel in the brain bursts. With the correct data it is possible to calculate his risk, and to
see how risk is affected by age and gender. This data is for the year that Mark had his
stroke at age 15.
Table 1 No. of UK deaths from Table 2 Population of the UK in 1995 separated by gender and
haemorrhagic stroke in 1995. age group.
Age Male Female Gender

04 6 7 Females Males
59 6 4 Age group 1519 yrs 1 682 000 1 7780 000
1014 7 5
1519 8 6
2024 19 10
Q1 What was the chance of a 15-year-old male in the Q2 What was the chance of a 15-year-old female in
UK dying from a haemorrhagic stroke during 1995? the UK dying from a haemorrhagic stroke during 1995?
Express your answer as a probability. Express your answer as a probability.
Analysis of coronary heart disease data

Use the data on age-specific death rates from coronary heart disease over a number of
years in Table 3 to answer the questions that follow.
Table 3 Death rates per 100 000 population of England and Wales due to coronary heart disease.
Age/years 3544 4554 5564 6574

Men Women Men Women Men Women Men Women
1980 56 9 270 50 733 215 1621 688
1990 37 6 159 33 536 179 1352 594
2000 25 9 107 29 325 107 924 432
Q3 Comment on what happens to the average risk of Q5 a Compare the incidence of CHD deaths in men
death due to coronary heart disease as you get older. and women.
Q4 a Describe the trend in the number of deaths b Suggest reasons for any differences described.
from coronary heart disease between Q6 Use the data to produce an appropriate graph to
19802000. show clearly the gender differences for a particular year.
b Suggest reasons for this trend. Q7 a Has this gender difference changed over the
time period shown?
b Suggest reasons for any changes observed.
A1.12S
Student
Activity 1.12 Sudden death in athletes

Purpose
To illustrate how the predisposition for cardiovascular disease can be inherited.
To apply knowledge of atherosclerosis and blood clotting.
Procedure
The article describes how possession of one gene can increase the risk of developing the
disease without the presence of other risk factors.
Read the article and then answer the questions that follow.
Sudden Death in Athletes

by Warren Dolphin, Iowa State, 1996 Peregrine Publishers, All Rights Reserved
In November, 1995, Sergei Grinkov, an Olympic arteries were narrowed by accumulation of fatty
gold medalist in pairs figure skating, collapsed substances and that a blood clot formed and
and died of sudden cardiac arrest while training completely blocked a coronary artery, resulting in
at Lake Placid, NY. An abbreviated necropsy his death. Further information about the gene can
report appears in the June 29 issue of the medical be obtained from an article in the April 25 issue
journal Lancet. Grinkov had such severe of The New England Journal of Medicine.
cardiovascular disease that his coronary arteries
It is estimated that about 20% of individuals in the
looked like those of a 70-year-old. Although
US population carry the harmful form of the
Grinkov had never complained of any chest pain,
platelet antigen gene. The presence of this gene
evidence indicated that he had a heart attack
will not necessarily cause a heart attack, but it
about 6 hours before his death. What is puzzling
does increase the probability of attack. If
about this sudden death is that Grinkov was an
researchers can devise a simple test for the
athlete in good physical condition, did not smoke
presence of this gene, then those identified as
or use drugs, did not have high blood pressure or
carrying it may be able to adjust their lifestyles to
diabetes mellitus, nor did he have high
reduce the risk of cardiovascular problems.
cholesterol levels. However, his family medical
history was significant: his father had died In a large study of athletic death, Barry Maron, a
suddenly at age 52. cardiologist at the Minneapolis Heart Institute
Foundation, and his colleagues collected
Researchers at Johns Hopkins University read
information on 158 deaths in young athletes from
about Grinkovs death in the newspapers and
1985 to 1995. His groups report in the Journal of
wondered if it had any relationship to a genetic
the American Medical Association indicated that
flaw they had just described. Samples of
the most common cause of death among young
Grinkovs blood were obtained and DNA was
athletes was a condition known as hypertrophic
extracted from the white blood cells. Analysis of
cardiomyopathy (HCM) caused by mutations in
the DNA indicated that Grinkov had inherited a
any one of several genes. The effect of these
form of a gene, called the platelet antigen gene,
mutated genes is to produce an abnormally thick
which greatly increased his chances of heart
wall in the left ventricle. Only about 2% of those
attack. This form of the gene causes platelets to
in his study were thought to carry the gene for
be overly active in forming blood clots and may
the abnormal platelet antigen, indicating that
cause cholesterol to bind to endothelial cells
sudden cardiac failure may be due to a number
lining blood vessels. The Johns Hopkins
of factors.
researchers speculate that Grinkovs coronary
Questions
Q1 Explain in detail how possession of this form of the anti-platelet antigen gene affects the process of
atherosclerosis and can result in sudden death
Q2 Why might having an abnormally thick left ventricle wall create a problem? To find out more information about
cardiomyopathy you can visit the Cardiomyopathy Association website. See the weblinks for this activity.
To explore the personal side of this tragedy, use a search engine to look for references to Sergei
Grinkov. You should receive a listing of several hundred documents describing this obviously well-liked
person and the tragedy of his death.
A1.13S
Student
Activity 1.13 Measuring blood pressure

Purpose
You need
To measure blood pressure. A sphygmomanometer and stethoscope,
To explain the significance of high blood or a blood pressure monitor
pressure in cardiovascular disease.
Blood pressure
Blood pressure is one of the easiest and quickest measures used by the medical
profession to check the health of your heart and circulation system.
If you have ever had your blood pressure taken or seen it done on one of the many TV
hospital dramas, you will know that an inflatable cuff is generally put around your upper
arm and held loosely in place with velcro. Air is pumped into the cuff inflating it and
measurements are taken as the cuff is deflated.
Normal blood pressure is often quoted in books as 120/80 mmHg, but how many
people actually have this blood pressure? Find out by using a sphygmomanometer or
digital blood pressure monitor to determine the blood pressure of several members of
your group. Are they all the same? Are there any patterns within the values obtained?
The interactive tutorial that accompanies this activity can help you understand exactly what is
happening when blood pressure is measured. It can be used as an alternative to measuring
blood pressure with a sphygmomanometer, which is difficult to use.
Safety
Never use a sphygmomanometer or blood pressure monitor unsupervised.
Do not over-inflate the cuff or leave it inflated for longer than necessary.
Do not worry if your blood pressure seems too high or too low. This is not a definitive medical
measurement of blood pressure, just an estimate.
You should not use one of these monitors if:
You know you suffer from heart rhythm disorders, or you already suffer from severe
atherosclerosis unlikely unless you are a mature student or you have a cardiac pacemaker.
Procedure
1 Make yourself comfortable and try to relax before
having your blood pressure taken.
2 Remove any clothing with tight sleeves: it is important
that blood flow is not constricted. If you push up your
sleeve, make sure that it doesnt become so tight that it
impedes blood flow.
3 Most sphygmomanometers or digital meters have a cuff
that must cover the brachial artery in the upper arm.
The cuff must be closed firmly so that the artery is
well covered, as shown in Figure 1.
4 Try to lay your arm on a surface such as your lab
bench, ensuring that the cuff is at approximately the
same height as your heart. (Think why!) The palm of
your hand should be facing upwards.
Figure 1 Using a sphygmomanometer and
stethoscope to measure blood pressure.
A1.13S
Activity 1.13 Measuring blood pressure Student
Using a sphygmomanometer
5 With traditional sphygmomanometers use a stethoscope to listen for the sound of
blood flow in the brachial artery. The stethoscope is positioned on the inside forearm
below the elbow as shown in Figure 1.
6 Pump air into the cuff, inflating it until the pulse sound disappears.
7 Deflate the cuff until the sound of blood can be heard as it starts to push through the
artery.
8 Take a reading at this point. This first reading gives systolic pressure.
9 Further deflate the cuff. As the sound disappears take a second reading. This gives
diastolic pressure, a measure of the pressure in the artery when the heart is relaxed.
The overall blood pressure is given in mmHg. It is usually expressed as systolic over
diastolic e.g. 120/70 mmHg.
Unless you are an experienced nurse or paramedic, it is often difficult to recognise the
change in sound of blood flow. The animation lets you see what should happen.
Using a digital blood-pressure monitor (alternative method)

5 Digital blood-pressure monitors have a pre-set switch. This means that when you
start to inflate the cuff, you should set this switch at a value slightly higher than your
expected systolic pressure (the upper value). For instance, if you are young and
healthy, you will probably need to set the switch at 140. If you have doubts, your
teacher or lecturer will be able to advise you.
6 Press the start button to automatically inflate the cuff to the pre-selected pressure.
Most models continue to inflate past the pre-set value if you have set it too low.
7 When the monitor reaches the target inflation value, the air is automatically released
and the value in the digital display begins to count downwards.
8 When the monitor first detects your pulse, the majority of monitors will begin to
beep and a symbol will start to flash. Here, the monitor is determining the upper
value for your blood pressure, the systolic blood pressure. Notice that the beeping is
fairly regular. What do you think the beeps show?
9 As the pressure in the cuff continues to drop, there comes a point when the monitor
can no longer detect your pulse. This gives the lower value for your blood pressure,
the diastolic blood pressure. Can you think what has happened to your brachial
artery at this point?
10 When all the air has been released, the monitor will display both your systolic and
your diastolic blood pressures. Most machines will also show your pulse rate at the
same time.
11 You may wish to store these measurements using the monitors memory facility, so
that you can monitor changes in your blood pressure, perhaps in accordance with
exercise or possibly over a period of time.
Most peoples blood pressure falls within the range of 100140 mmHg for systolic
pressure and 6090 mmHg for diastolic pressure. Pressures below these values are
considered to be low pressure; above about 160/95 mmHg is classed as high blood
pressure. But remember that taking pressure measurements can cause anxiety which may
affect the measurement. Eating, smoking, drinking alcohol and sports can all affect your
blood pressure. Any high or low measurements made in the classroom should not be
regarded as indicative of a blood-pressure problem. Even with the blood-pressure
monitors that are widely available on the high street, unusual measurements should be
checked by a qualified health professional.
A1.13S
Activity 1.13 Measuring blood pressure Student
Questions
Q1 What do you think the beeps made by a digital pressure monitor at step 8 of the procedure
represent?
Q2 What is happening to blood flow in the brachial artery at step 9 (both procedures)?
Q3 Comment on your results if you have taken several readings from different people within the
group.
Q4 A person has a blood-pressure reading of about 170/95 mmHg. Would this be classed as high
blood pressure?
Q5 Why can elevated blood pressure increase the risk of cardiovascular disease?
Extension question
Q6 Blood pressure can vary between individuals and can change through the day. What effect
might posture and relaxation have on blood pressure? Plan an experiment that would let you check
out your idea.
A1.14S
Student
Activity 1.14 Blood pressure summary

Purpose
To draw together all the blood pressure ideas.
To introduce the use of concept maps.
Procedure
The concept map is one method of producing a summary of what you think you know
about a particular subject area, in this case blood pressure. The construction of the map
allows you to think through the ideas covered and clarify your understanding. A map
will often highlight errors or omissions. It can provide a useful tool in learning.
If you have never constructed a concept map you may need to read the
Exam/coursework support before getting started.
Starting with the idea of blood pressure, construct your own concept map.
You might include what blood pressure is, and what it is the result of, then expand out
from these ideas.
If you would like a helping hand use the template below.
is Blood pressure
is the result of
cardiac output
against is the result of of
blood vessel walls heart rate stroke volume blood vessels
is is that can vary in
whose elastic fibres allow amount of blood pumped

by left ventricle
changed by so that obese people have
stretching during longer blood vessels
during which we feel as a during is controlled by may may to raise
contract
arteriole walls
maintaining to reduce to raise
thus maintaining
Figure 1 Blood pressure concept map.
A1.15S
Student
Activity 1.15 Carbohydrate structure

Purpose
To describe condensation and hydrolysis reactions.
To distinguish between monosaccharides, disaccharides and polysaccharides in terms
of their structure and role in the diet.
Procedure
Complete the interactive tutorial that accompanies this activity or read the section on
carbohydrates in your textbook and then use what you have learned to complete this
worksheet.
Joining sugar units

1. Draw a ring around the H and OH which are removed when
the two glucose units are joined.
OH OH
2. Label the arrow with the
name of this reaction, and
write in the box the name of
the molecule which is removed.
3. Circle the GLYCOSIDIC

LINK formed between
O the two sugar units.
Splitting sugar units
O
In the box, write the formula
of the molecule that is added
in this reaction. 1. Label the arrow
with the name
of the reaction.
2. Draw the products of

the reaction here.
A1.15S
Activity 1.15 Carbohydrate structure Student
1 Complete the table below.
Name of disaccharide Sugar monosaccharides making up disaccharide
Building complex carbohydrates

2 Fill in descriptions of the molecules below.
O O O O
A monosaccharide A disaccharide A polysaccharide

is is is
3 On the diagram below, draw in 1,4 glycosidic links. Label one glucose monomer. On
that molecule draw in a hydroxyl group and side group in the correct position.
Joining glucose molecules to form starch and glycogen
O O O O O O O O
Structural formula of starch

Starch is a polymer made up of glucose monomers.
Branching glucose chains are possible when 1,4 and 1,6 glycosidic links are present.
4 On the diagram below, add the 1,4 and 1,6 glycosidic bonds. Label one 1,4 glycosidic
link and one 1,6 glycosidic link.
O O O O O
A1.15S
Activity 1.15 Carbohydrate structure Student
Starch is made up of amylose and amylopectin.

5 Fill in the table with information about these two molecules:
Name of molecule Type of glycosidic links present
6 In the box below, describe how the structure of glycogen is similar to that of starch.
7 Use information from the interactive tutorial and textbook to complete the table below:
Name of molecule Structure and chemical properties Biological role

Sweet, soluble, crystalline Monomer of polysaccharides
Monosaccharide Substrate for cell respiration in all
living organisms releasing energy
Insoluble polysaccharide formed

from two glucose polymers:
branched amylopectin with 1,4 and
1,6 glycosidic links and helical
amylose with 1,4 glycosidic bonds
only
Maltose
Sweet, soluble, crystalline

Disaccharide formed by
condensation reaction between
glucose and fructose
Glycogen
In the ICT support there is a data logging sheet on testing for sugars using a colorimeter.
A1.16S
Student
Activity 1.16 Biotechnology to the rescue

Purpose
You need
To reinforce the idea that disaccharides can be 2 cm3 lactase
converted into monosaccharides by hydrolysis.
8 cm3 sodium alginate solution (2%)
20 cm3 1.5% calcium chloride solution
Is there a use for lactose? Distilled water
Lactose is the disaccharide found in milk. It is not Glass rod
actually a very useful sugar: 10 cm3 syringe barrel
It cant be used in food products because many Clamp stand, boss and clamp
people are intolerant to lactose. Of the Thai,
Tea strainer
Chinese and Afro-Caribbean populations, 97%,
2 small beakers
90% and 73%, respectively, are reported to be
10 cm3 measuring cylinder
lactose-intolerant, often resulting in severe
digestive problems.
Lactose has low solubility, and tends to produce crystals at concentrations above 11%.
If lactose is used in food products, the crystals can produce an unpleasant sandy
texture.
Lactose is only 20% as sweet as sucrose. If it were to be used in foods, the large
amount needed to achieve sweetness would substantially increase the calorie content
of the food.
When cheese is made, the large quantities of liquid whey produced contain lactose
and protein. If whey is disposed of into the sewage system, its high nutrient content
encourages growth of microorganisms, and fines can be imposed on the industry for
this pollution.
How can enzymes help?

Hydrolysis of lactose yields the monosaccharides glucose and galactose which are much
sweeter sugars. The enzyme lactase can be used to hydrolyse lactose, and this process is
now used in the production of ice cream and sweetened, flavoured and condensed
milks. The syrup made from the products of hydrolysis of the lactose-rich whey from the
cheese industry can be made into a useful product: a hygroscopic (water-retaining) toffee
that has a low melting point. The toffee can be poured into chocolate cups at relatively
low temperatures, and because it is hygroscopic it can be used to coat biscuits without
making them become soggy. Milk treated with lactase is suitable for lactose-intolerant
people to drink.
In industry this process is carried out using immobilised enzymes. In the experiment that
follows, lactase is used to make lactose-free milk.
Enzyme immobilisation in alginate gel

fixes the enzymes into a solid gel that
can be made into a mesh or beads.
gel
enzyme
alginate bead
Figure 1 Enzyme immobilisation.
A1.16S
Activity 1.16 Biotechnology to the rescue Student
Safety
The products from the column should not be tasted unless the experiment has been
conducted in a food preparation area with equipment for food use only using food grade
reagents (including food grade enzyme) and observing strict hygiene rules.
Lactase is a relatively safe enzyme, but contact with or inhalation of any enzyme should
be protected against to avoid allergic reaction or sensitisation.
Procedure
1 Mix 2 cm3 lactase with 8 cm3 alginate gel solution. Stir gently with glass rod.
2 Pour 20 cm3 calcium chloride solution into a clean beaker.
3 Clamp a 10 cm3 plastic syringe barrel above the beaker of calcium chloride solution.
Position the syringe close to the top of the beaker.
4 Pour the alginate gel into the syringe, allowing the gel to drip slowly into the calcium
chloride solution. It is best to add about 2 cm3 of gel to the syringe at a time.
5 The gel beads must be left in the calcium chloride solution for 10 minutes to harden,
then strained in a tea strainer, and rinsed with distilled water.
Making a column of beads

6 Clamp a syringe barrel above a small beaker, and place a small piece of nylon gauze
in the bottom of the syringe (see Figure 2 below).
7 Attach a short length of rubber tubing to the syringe outlet, and screw a Hoffman clip
onto this to seal the end of the syringe. The Hoffman clip can be used to control the
flow of liquid from the syringe.
8 Pour the beads into the syringe barrel you can use a small spoon or spatula for
this.
milk
alginate plus
enzyme mixture
immobilised
lactase
syringe gauze
tip
glucose
test strip
calcium chloride
solution
milk dripping
through column
Figure 2 Making a column of immobilised lactase.
A1.16S
Activity 1.16 Biotechnology to the rescue Student
Hydrolysing the lactose

9 Pour the milk into the column. Adjust the clip so that the milk slowly drips into a
beaker.
10 Use a glucose test strip to test for glucose in the liquid collected from the column.
Glucose test strips are semi-quantitative; you can get a reading of glucose
concentration by comparing the colour produced with a colour scale.
If you have time, investigate the effect of the rate of flow of the milk over the beads on
the production of glucose.
How glucose test strips work

The detection of glucose using test strips (Figure 3) provides a quick and easy way for
diabetics to monitor their own blood and urine glucose levels. The advantage of this
method over some chemical methods is that it is specific for glucose; glucose can be
distinguished from the presence of other sugars.
The enzymes glucose oxidase and peroxidase

are immobilised onto a cellulose fibre pad.
Figure 3 Glucose test strip.
The test strip is dipped into the solution to be tested.

Two reactions take place:
1 catalysed by glucose oxidase
glucose oxygen water hydrogen peroxide gluconic acid
2 catalysed by peroxidase
hydrogen peroxide colourless chromagen dye coloured, oxidised chromagen dye water
The amount of coloured chromagen produced is a measure of the amount of glucose
which has reacted. A colour reference card gives an indication of the concentration of
glucose present in the solution.
Q1 Explain what happened to the milk as it passed through the column of beads. Use
biochemical detail and diagrams in your answer as appropriate.
A1.17S
Student
Activity 1.17 Lipids

Purpose
To recognise that glycerol with three fatty acids attached is a lipid and specifically a
triglyceride.
To describe the formation of ester bonds in condensation reactions.
To recognise differences between saturated and unsaturated lipids.
Procedure
Complete the interactive tutorial that accompanies this activity or read the section on
lipids in your textbook and then use what you have learned to complete this worksheet.
Fats and oils belong to a group of molecules called lipids. Lipids do not dissolve in
water, but do dissolve in non-polar solvents.
OH C
CH2OH O
OH C
CHOH
O
CH2OH
OH C
H2O
O
CH2O C
O
CHO C
O
CH2O C
Figure 1 Formation of a triglyceride.
A1.17S
Activity 1.17 Lipids Student
Questions
Q1 Label Figure 1 with the following: Name of reaction, number of H2O molecules removed in total, fatty acids,
glycerol, name of product, ester bond.
Q2 In Figure 1, circle and label the atoms removed during the formation of an ester bond between one fatty acid
and glycerol.
Q3 Using the information about joining and splitting sugar units in the section on carbohydrates in the textbook
and Activity 1.15, name the reaction that would split an ester bond to release a fatty acid.
_____________________________________________________________________________________________________
Q4 What do you think are the products of lipid digestion?
_____________________________________________________________________________________________________
Q5 Draw a simple diagram in the space below to show a monounsaturated fatty acid.
Table 1 Fatty acid information.
Name Formula No. of No. of double bonds Melting

carbons in hydrocarbon chain point/C
Lauric acid C12H24COOH 12 0 44.2
Palmitic acid C16H32COOH 16 0 63.1
Stearic acid C18H36COOH 18 0 69.6
Oleic acid C18H34COOH 18 1 13.4
Linoleic acid C18H32COOH 18 2 5
Arachnidonic acid C20H32COOH 20 4 49.5
Arachidic acid C20H40COOH 20 0 76.5
Q6 Referring to the data in Table 1, what effect does an increase in the number of double bonds have on the
melting point of a fatty acid?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Q7 What effect does an increase in the number of carbon atoms have on the melting point?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Q8 Explain why most polyunsaturated oils are liquid at room temperature.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
A1.18S
Student
Activity 1.18 Your energy budget

Purpose
To analyse data on energy budgets and diet.
To calculate body mass index (BMI) and explain its energy
significance. energy
intake
requirement
The calories that you need each day depend on:
the amount of energy your body uses when weight gain
completely at rest (basal metabolic rate)
the energy used as a result of eating (specific
energy energy
dynamic action)
requirement intake
the amount of physical activity (PA) you take part
in.
weight loss
Energy budgets energy energy

To analyse your energy budget you need to calculate requirement intake
energy expenditure and energy intake from food. The
calculations can be completed on the interactive tutorial no change in weight
that accompanies this activity, or by working through Figure 1 If the balance between energy consumed and
the sections on this worksheet. energy used is not equal, you will lose or gain weight.
Procedure
Calculating energy requirements
Calculating your basal metabolic rate (BMR)
There are various formulae for calculating basal metabolic rate (BMR). The formula used
here is the HarrisBenedict formula which takes height, mass and age into account.
Calculate your BMR:
Formula gives calorific requirements in kcal per day My height in cm
Adult females 447.593 (3.098 H) (9.247 M) (4.330 A) My mass in kg
Adult males 88.362 (4.799 H) (13.397 M) (5.677 A) My age in years
H height/cm; M mass/kg; A age/years My BMR
Although scientists normally use kilojoules (kJ) as the unit of energy, Calories (kcal) are
very widely used by the food industry for energy content of food. A Calorie is the same
as a kilocalorie. 1 kcal 4.18 kJ.
Calculating physical activity (PA)

Calculate your total daily calorific expenditure using the formula:
Daily energy expenditure during exercise (M E T)

M mass/kg; E energy expenditure/kcal per kg per min; T time/min
A1.18S
Activity 1.18 Your energy budget Student
To do this you need to:

1 Work out roughly how long you spend in minutes each day on the equivalent of the
activities below. If an activity you participate in, e.g. football, is not shown, select an
activity that you think would use about the same amount of energy per minute.
2 Work out the energy used for each activity each day and then sum these values to
give the total for each day. The values are energy used per kg of your mass.
3 Multiply the energy used by your mass to give your total energy expenditure during
physical activity per day.
Activity Energy Time Energy Activity Energy Time spent Energy

expenditure spent on used* expenditure on activity used*
/kcal per kg activity /kcal per /kcal per /min /kcal per
per min /min kg kg per kg
min
Running 12 0.14 Cycling 0.07
min per mile 5 mph
Running 9 min 0.19 Cycling
per mile 10 mph 0.12
Running 8 0.22 Cycling 0.17
min per mile 15 mph
Running 7 0.24 Swimming 0.09
min per mile crawl 25 m
per min
Running 6 0.28 Swimming 0.18
min per mile crawl 50 m
per min
Walking 20 0.03 Standing 0.014
min per mile
Walking 15 0.06 Driving 0.029
min per mile
Walking 11 0.014 Writing/ 0.014
min per mile deskwork
Sitting 0.014 Sleeping 0.014
(watching
TV)
Showering 0.06 My total energy expenditure per kg**
/kcal per kg
*Energy used energy expenditure/kcal per kg per min time/min.

**Sum of energy used in one day for all activities.
My daily energy expenditure in exercise (PA)

total energy expenditure per kg mass
Calculate specific dynamic action (SDA)

The amount of energy needed to digest, absorb, transport and metabolise your food can
be assumed to be 10% of your BMR and PA. This factor is included in the formula below
by multiplying PA BMR by 1.1.
A1.18S
Total daily energy expenditure

Use this formula to calculate your calorific needs for one day:
1.1 (BMR PA)
Calorific input from food

Use tables of nutritional values to analyse your diet for a typical day. Compare the total
energy input from food with the value that you calculated above, which is your total
daily energy requirement.
Do your daily energy requirements and daily energy input from food balance? If not,
which is greater and by what percentage?
Questions
Q1 Suggest how age, gender and body size may all affect BMR.
______________________________________________________________________________________
______________________________________________________________________________________
Q2 Suggest how environmental temperature may affect BMR.
______________________________________________________________________________________
______________________________________________________________________________________
Q3 When you diet, after a couple of weeks your BMR will slow down as your body attempts to
conserve energy. Use this to explain why exercise may be a more effective way of losing weight than
dieting.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Extension questions
Q4 Assume that an 80 kg person loses 1 kg of body fat for every 7700 kcal that their energy
expenditure is above intake. How long in minutes would they need to run at 6 min per mile in order
to lose 1 kg of body fat?
The smaller an animal, the larger their surface area compared with their volume. A
mouse loses a larger proportion of body heat through its surface than an elephant. A
baby will lose body heat more easily than an adult will.
Q5 Use the information above to suggest how the BMR of a baby per kg of its body mass
compares with that of an adult.
A1.18S
Calculate your BMI

Body mass index (BMI) is used to classify a persons body mass relative to their height.
It gives an indication of whether a person is underweight, normal weight, overweight or
obese.
BMI is calculated using the formula:
body mass/kg
BMI
height2/m2
Calculate your BMI and decide your category of bodyweight using the table below.
BMI Classification of
bodyweight
20 underweight
2024.9 normal
2529.9 overweight
3040 obese
40 severely obese
Questions
Q6 A fully grown adult has a daily energy requirement of approximately 3052 kcal, he has a
daily energy intake of about 3500 kcal. What will be the consequences for his body mass index if
he maintains this energy budget?
Q7 Edgar is 165 cm tall and weighs 70 kg. Work out his body mass index. What advice would
you give him regarding his weight?
Q8 Explain why doctors would advise patients with BMIs above 30 to reduce their weight.
A1.19S
Student
Activity 1.19 Are you getting enough

antioxidants?
Purpose
To highlight the importance of antioxidants in the diet.
Antioxidants
Antioxidants are chemicals that help prevent damage within cells by unstable radicals.
Chemical reactions within cells produce radicals. These are atoms or molecules with one
or more unpaired electrons. Radicals are oxidising agents they accept electrons from
other molecules that are oxidised (oxidation is loss of electrons). These reactions cause
damage to DNA, proteins and other molecules in the cell. The damage accumulates over
time and has been linked to the changes that occur with ageing and with diseases such
as coronary heart disease and cancer. Oxidised, low-density lipoproteins are thought to
be more readily taken up by the white blood cells involved in atherosclerosis.
The cell has antioxidant defences against radical damage. For example, oxidised DNA is
repaired by enzymes, and oxidised proteins are destroyed by proteases. Antioxidants in
the diet, such as vitamin C, vitamin E and beta-carotene (used by the body to make
vitamin A), also help prevent the damage caused by radicals in the cell by providing
hydrogen atoms whose electrons pair up with the unpaired electrons in the radicals.
To help reduce radical damage it is recommended that a healthy balanced diet contains
three portions of vegetables and two portions of fruit a day.
Some sources of radicals

Radicals are produced in many reactions within cells. Within mitochondria, respiration
reactions, which reduce oxygen to water, produce by-products with unpaired electrons,
namely superoxide (O2), hydrogen peroxide (H2O2), and hydroxyl radical (OH). Some
of these radicals leak in to the cells cytoplasm.
In a rat cell about 1012 oxygen molecules per day are converted in this way and about
2% of these molecules leak into the cell partially reduced. This is 2 1010 in a day.
The breakdown of fatty acids and other molecules within peroxisomes (membrane-
bound organelles in the cytoplasm that contain enzymes) produces hydrogen peroxide
as a by-product. The breakdown of this molecule is normally catalysed by the enzyme
catalase within the peroxisomes. However, occasionally some of the hydrogen peroxide
is not broken down and leaks into the cytoplasm.
Toxic chemicals in our diet are broken down by enzymes within the cytoplasm. This
avoids them having a toxic effect but some of the breakdown products are radicals.
Oxides of nitrogen (NOx) in cigarette smoke and other pollutants cause oxidation of
molecules in cells.
It is thought that some white blood cells destroy bacteria and virus-infected cells by
bombarding them with a mixture of oxidants including hydrogen peroxide. Although this
prevents infection it also releases radicals. Other researchers suggest that it is not radicals
involved in this process but enzymes.
A1.19S
Activity 1.19 Are you getting enough antioxidants? Student
Questions
Q1 a What are radicals?
b How are they formed within cells?
Q2 Will large numbers of radicals in the body increase the risk of developing CHD? Explain your
answer.
Q3 Explain how the Department of Health recommendation that everyone should eat five
portions of fruit and vegetables a day should protect against:
a coronary heart disease
b cancer.
Q4 Check below to find out how frequently you consume foods containing these important
health-promoting vitamins and decide if you are getting enough antioxidants.
How often do you eat these? Never Seldom 12 times 35 times Daily
per week per week
Vitamin C-rich foods:
1 Grapefruits, lemons, oranges
or pineapples
2 Strawberries, kiwi fruits or
honeydew melons
3 Orange, cranberry or tomato juice
4 Green, red or chilli peppers
5 Broccoli, Chinese cabbage
or cauliflower
6 Asparagus, tomatoes or potatoes
Beta-carotene-rich foods:
7 Carrots, sweet potatoes, pumpkins
8 Spinach, spring greens or chard
9 Cantaloupe melons, papayas or
mangoes
10 Nectarines, peaches or apricots.
Vitamin E-rich foods:
11 Wholegrain breads, cereals or
wheat germ
12 Crabs, shrimps or fish
13 Peanuts, almonds or sunflower
seeds
14 Oil, margarine, butter, mayonnaise
or salad dressing
Source: Brown, J.E. (1995) Nutrition Now, St Paul, West Publishing Company
Scoring: Several responses in the last two columns indicate adequate antioxidant vitamin
consumption. If you need to boost your intake, increase the overall amount of fruit,
vegetable and whole grains in your diet. Although nuts, seeds, oils, mayonnaise and
salad dressing all contribute vitamin E, they are high fat and should only be consumed in
moderation.
Q5 These sorts of tests are extremely popular and often found in food and other magazines. How a valid (giving
true results) and b useful do you think they are and why?
A1.21S
CORE
Student
Activity 1.21 Does caffeine affect heart rate?

Purpose
To investigate the effect of caffeine on the heart rate of Daphnia (water fleas).
Caffeine
Plants produce caffeine as an insecticide. Cocoa in South America, coffee in Africa and
tea in Asia have all been used for hundreds of years to produce pick me up drinks
containing caffeine. These days, caffeine is also used as a flavour enhancer in a wide
range of cola and other soft drinks. In addition, it has medicinal uses in aspirin
preparations, and is found in weight-loss drugs and as a stimulant in students exam-time
favourites like Pro-plus and Red Bull.
In humans, caffeine acts as a stimulant drug, causing increased amounts of stimulatory
neurotransmitters to be released. At high levels of consumption caffeine has been linked
to restlessness, insomnia and anxiety, causing raised stress and blood pressure. This can
lead to heart and circulation problems.
Safety
If a stroboscope is used to show the Daphnias heart rate and you know you suffer from
photosensitive epilepsy tell your teacher and take appropriate precautions.
Procedure
Making a hypothesis
What do you think will be the effect of caffeine on the heart rate of water fleas? Write
down your ideas and support your prediction by presenting biological knowledge which
supports the idea. You now have an idea (hypothesis) to test.
Planning
The beating heart of a water flea can be seen through its translucent body, by placing the
flea in a few drops of water in a cavity slide. A cover slip helps stop the water evaporating.
The following equipment will be available:

Culture of Daphnia (water fleas) Standard glassware (beakers, measuring
Cavity slides cylinders, etc.)
Dropping pipettes Stopclock
Distilled water Paper towels or filter paper
Caffeine tablets Microscope
Cotton wool
Produce a detailed plan for an experiment that allows you to test your hypothesis about
the effect of caffeine on the heart rate of water fleas.
In your plan, make sure you include the following:
Select suitable apparatus that will give you measurements which will validly test your
hypothesis. Explain why the apparatus is suitable and how the results will let you test
the hypothesis.
A1.21S
CORE
Activity 1.21 Does caffeine affect heart rate? Student
Include a risk assessment, identifying any risks and explaining any safety precautions
that need to be taken so as to reduce those risks.
Comment on the ethical issues that arise from using living organisms in the experiment
and explain how these will be taken into account in the practical method used.
Identify the dependent and independent variables, and indicate how relevant variables
will be controlled.
Show how you will ensure that reliable and valid results are produced, and describe
what you will do to ensure that measurements are precise, accurate and repeatable.
Identify any potential errors in readings that can be systematic (values differing from
the true value by the same amount) or random (values equally likely to lie above or
below the true value).
Performing the experiment

Either use the plan you have created after it has been checked by your teacher/lecturer
or use a method supplied by your teacher/lecturer.
Presenting your data

Present your data in an appropriate table and graph. See the features of a good table
and graph in the Maths/stats support.
If you have lots of repeated results, remember that you should work out mean values
and present these in your report. This also lets you comment on the significance of your
results. If the results that are used to calculate the means are very variable, this indicates
errors within the experiment and any differences between the treatment means may not
be significant. The range of values can be shown on the graph using bars on each point.
As an extension you might work out the standard errors and put these on the graph. NB:
you need to make it clear what any bars on a graph are showing.
Using results to draw conclusions

In the discussion of your results you should explain any trends and patterns in your
data. You should use evidence from the data when identifying patterns and trends. For
example, when you identify a trend in the results you should quote some data that
shows the trend. For instance, in an experiment investigating inhibition of the enzyme
catalase by copper sulphate you might report that there is a steady decrease in the
volume of oxygen produced with increasing copper sulphate concentration: at 0.25 M
copper sulphate the mean volume of oxygen produced was 0.57 cm3; with 2 M copper
sulphate the volume of oxygen produced had fallen to 0.27 cm3.
You should then attempt to explain any patterns and trends using your biological
knowledge. Remember that the hypothesis you suggested may not be correct. In this case,
the results will not show the patterns or trends that you expected. There may be a different
trend or no trend at all. This is perfectly OK. You may be able to suggest an alternative
explanation for the results you have obtained. Alternatively, you may still think the
original hypothesis is sound but there are concerns about the experimental method used
and the results obtained are not very valid, i.e. they may not be testing the hypothesis
appropriately. In this case, you cannot draw valid conclusions from the results and this
should be explained in your write up. A report on an experiment that does not produce
the expected results is often as valuable to other researchers as a report that supports the
original hypothesis. It allows other researchers to make informed decisions about the
methods they will use in the future and it may allow them to suggest alternative ideas.
A1.22S
Student
Activity 1.22 Healthy heart quiz

Purpose
To review ideas about risk factors for coronary heart disease.
Questions
Identify each of the following statements as true or false to test your knowledge of
heart disease and its risk factors.
Q1 The risk factors for coronary heart disease that you can do something about are: high blood
pressure, high blood cholesterol, smoking, obesity and physical inactivity.
Q2 A stroke is often the first symptom of high blood pressure, and a heart attack is often the
symptom of high blood cholesterol.
Q3 A blood pressure greater than or equal to 160/95 mmHg is generally considered to be high.
Q4 High blood pressure affects the same number of black people as it does white people.
Q5 The best ways to treat and control high blood pressure are to control your weight, exercise,
eat less salt (sodium chloride), restrict your intake of alcohol, and take any high blood pressure
medicine, if prescribed by your doctor.
Q6 A low blood cholesterol is needed to prevent heart attacks in adults.
Q7 The most effective dietary way to lower the level of your blood cholesterol is to eat foods low
in cholesterol.
Q8 Lowering blood cholesterol levels can help many people who have already had a heart attack.
Q9 The only children who need to have their blood cholesterol levels checked are from families at
high risk of heart disease.
Q10 Smoking is a major risk factor for four of the five leading causes of death including heart
attack, stroke, cancer and lung diseases such as emphysema and bronchitis.
Q11 If you have had a heart attack, quitting smoking can reduce your chances of having a
second attack.
Q12 Someone who has smoked for 30 to 40 years will not be able to quit smoking.
Q13 The best way to lose weight is to increase physical activity and eat fewer calories.
Q14 Eating five portions of fruit and vegetables a day will provide antioxidant vitamins that
reduce the risk of coronary heart disease.
Q15 Heart disease is the leading killer of men and women in the UK and in the USA.
A1.23S
Student
Activity 1.23 Functional foods and CHD

Purpose
To reinforce how changing diet can affect the risk of CHD.
Functional foods
This activity considers the development and trial of functional foods. These are foods
that contain an added ingredient that gives them a health-promoting property in addition
to their usual nutritional value, for example calcium added to orange juice or iron added
to breakfast cereal.
One of the most high profile functional foods is cholesterol-lowering margarine,
welcomed because high blood cholesterol is a known risk factor for coronary heart
disease.
If 2 g a day of plant sterol or stanol was added to the average daily portion of margarine,
there would be a reduction in the risk of heart disease of about 25%, an article in the
British Medical Journal concluded. The normal dietary intake of plant sterols, which are
found mostly in cooking oils and margarine, is 200400 mg a day. The normal intake of
plant stanols is negligible.
Benecol was the first cholesterol-lowering spread, and it contains plant stanols. Unilever
followed with Flora pro-Activ, which was launched in August 2000. The margarine is
enriched with plant sterols. These plant compounds are very similar, both lowering LDL
or bad cholesterol levels by reducing the amount we absorb from our small intestine.
They work by preventing LDL cholesterol entering the bloodstream from the digestive
system and liver.
How much enriched margarine do you

need to eat?
In one randomised, double-blind, placebo-controlled study the effects of a control spread
(Flora), three different concentrations of a sterol-enriched spread and butter were
compared. Eighty volunteers, all of whom had normal levels of cholesterol in their
blood, ate controlled quantities of each spread for 312 weeks. The table below lets you
examine the relationship between blood cholesterol and plant sterols.
Table 1 Changes in blood lipids (mmol per l) after use of plant sterol-enriched margarine, or butter, with respect
to control spread.
Control Change Change Change Change

spread with with with with
(Flora) 0.83 g 1.16 g 3.24 g butter
sterols sterols sterols
Total cholesterol 5.16 0.26 0.31 0.35 0.14
LDL cholesterol 3.05 0.20 0.26 0.30 0.12
HDL cholesterol 1.64 0.01 0.02 0.02 0.03
LDL:HDL 2.01 0.13 0.16 0.16 0.04
cholesterol ratio
Source: Hendriks, H.F.J., Weststrate, J.A., Van Vliet, T. and Meijer, G.M. (1999) Spreads enriched with three
different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly
hypercholesterolaemic subjects, European Journal of Clinical Nutrition 53, 319327. Macmillan Publishers Ltd.,
reprinted by permission.
A1.23S
Activity 1.23 Functional foods and CHD Student
Questions
Q1 Work out the percentage change relative to the control spread in total cholesterol, LDL
cholesterol, HDL cholesterol and the LDL:HDL cholesterol ratio for each concentration of sterols and
for butter.
Q2 The chosen control spread was Flora. To ensure a fair trial, in what way must it have been
similar to the sterol-enriched margarine?
Q3 Comment on:
a the percentage change in total cholesterol, LDL cholesterol and HDL cholesterol
composition for each of the three sterol-enriched spreads
b the effect of the butter on the total cholesterol, LDL cholesterol and HDL cholesterol
percentage change.
Q4 What effect would the change in the LDL cholesterol as a result of eating the sterol-enriched
spreads be expected to have on the chances of developing coronary heart disease?
Extension questions
Q5 Cholesterol and fat-soluble nutrients including certain vitamins are absorbed along similar
pathways so it was important for scientists to see whether the plant sterols reduced the absorption
of such nutrients. Some lowering of carotenoid absorption was found: the degree depended on the
level of sterol intake. A spread was developed that was enriched with 8% sterols. This provided
1.6 g of sterols per day (with typical usage levels). Suggest three vitamins whose absorption might
be affected by plant sterols.
Q6 Find out what is meant by a double-blind, placebo-controlled study.
Facts and figures

After extensive trials, including the one above, Unilever maintained that using such
products reduced LDL-cholesterol levels by between 1015% within a few weeks.
Interestingly, the Advertising Standards Agency scrutinised the studies submitted by
Unilever and found that people with a healthy diet and active lifestyles were likely to
reduce LDL-cholesterol levels by only 10% and concluded that their claim was
misleading!
Bodies such as the Food Standards Agency have signified broad approval of the use of
sterol-enriched spreads and concluded that their use would lead to a real reduction in
the risk of heart disease. Recent research has shown that raised cholesterol levels are no
longer thought to be as important by the general public as they were a few years ago.
Eighty per cent of adults in the UK still dont know their cholesterol levels, and even
fewer are aware of the significance of the difference between the cardio-protective, high-
density lipoprotein (HDL) good cholesterol and the dangerous, arterial-damaging, low-
density lipoprotein (LDL) cholesterol.
This gives you some insight into the problems of developing a novel food. Visit the Flora
pro-Activ website (see the weblinks for this activity) to find out more about how the
margarine works.
A1.24S
Student
Activity 1.24 Check your notes for Topic 1:

Lifestyle, health and risk
Purpose
To help you get your notes in order at the end of this topic.
Topic 1 summary
Make sure your notes cover the following points. The points are listed in the order they
appear within the topic. All the points are covered in the textbook but where there is
supporting information within activities this is indicated.
There are suggestions on making notes and on revision in the Exam/coursework support.
You should know the following points:
1 Why many animals have a heart and circulation. (Checkpoint question 1.1)
2 The structure of the mammalian heart. (Activities 1.3 and 1.4)
3 How the structures of blood capillaries, arteries and veins relate to their
functions. (Activity 1.5) (Checkpoint question 1.2)
4 That the cardiac cycle includes diastole, atrial systole and ventricular systole.
(Activity 1.6) (Checkpoint question 1.3)
5 The structure and operation of the mammalian heart in relation to its function.
6 The course of events that leads to atherosclerosis including endothelial damage,

inflammatory response, plaque formation and raised blood pressure. (Activity 1.7)
7 The blood-clotting process (thromboplastin release, conversion of prothrombin to

thrombin and of fibrinogen to fibrin) and its role in cardiovascular disease (CVD).
(Activity 1.7)
8 The symptoms of cardiovascular disease, i.e. coronary heart disease (CHD) and
stroke. (Checkpoint question 1.4)
9 The normal electrical activity of the heart, including the roles of the sino-atrial
node (SAN), the atrioventricular node (AVN) and the bundles of His. (Activity
1.8) (Checkpoint question 1.5)
10 How electrocardiograms (ECGs) can aid the diagnosis of CVD and other heart
conditions. (Activity 1.9)
11 Analysis of quantitative data on illness and mortality rates to determine health

risks. (Activity 1.10)
12 The difference between correlation and causation. (Activity 1.10)

13 Why peoples perceptions of risks are often different from the actual risks.
(Checkpoint question 1.6)
14 Risk factors for cardiovascular disease including age, gender, genetic inheritance,
high blood pressure, diet, smoking and inactivity. (Age and gender Activity
1.11. Genetic inheritance Activity 1.12. Diet Activities 1.18 and 1.19)
(Checkpoint question 1.7)
15 The meaning of blood pressure (Activities 1.13 and 1.14)

A1.24S
Activity 1.24 Check your notes for Topic 1: Student

Lifestyle, health and risk
16 The
1.20)
role of high blood pressure in cardiovascular disease. (Activities 1.7 and
17 The differences between monosaccharides, disaccharides and polysaccharides

(glycogen and starch amylose and amylopectin) in terms of their structure and
their role in providing and storing energy. (Activity 1.15) (b-glucose and cellulose
are not required at this stage.)
18 make
The structural formulae for a-glucose and maltose and the monomers which
up sucrose and lactose. (Activity 1.15)
19 How monosaccharides can join to form polysaccharides through condensation

reactions forming glycosidic bonds. (Activity 1.15)
20 How polysaccharides can be split through hydrolysis reactions. (Activity 1.15)

21 How glycerol can attach to three fatty acids in condensation reactions to form a
lipid and specifically a triglyceride. (Activity 1.17)
22 The differences between saturated and unsaturated lipids. (Activity 1.17)

23 How to calculate body mass indices (BMIs) using the formula BMI body mass
2
(kg)/height (m) and explain their significance. (Activity 1.18)
24 The possible significance for health of blood cholesterol levels and levels of
high-density lipoproteins and low-density lipoproteins (HDLs and LDLs).
25 practically.
How the effect of caffeine on heart rate in Daphnia can be investigated
(Activity 1.21)
26 How individuals, by changing their diet, taking exercise and not smoking, can
reduce their risk of CHD.

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A1.

Activity 1.1 Marks and Peters stories

Activity 1.1 Marks and Peters stories Student

Activity 1.1 Marks and Peters stories Student

Activity 1.1 Marks and Peters stories Student

Activity 1.2 Demonstrating mass flow

Safety You need

Bungs to fit glass tubes

4 Using a second tube without rubber bungs,

Activity 1.3 Structure of the heart (Dissection)

Wash your hands carefully after completing the dissection O C O

once all the equipment has been put ready to be disinfected.

Take care with sharp dissecting instruments.

Cut along this line Cut along this line

Activity 1.3 Structure of the heart (Dissection) Student

Activity 1.3 Structure of the heart (Dissection) Student

Vertical section of the heart

Figure 2 Vertical section of the heart.

Activity 1.4 Structure of the heart (Simulated

Q2 What are the functions of the coronary arteries and veins?

Q5 Which ventricle has thicker walls?

Q8 What is the function of the atrioventricular valves?

Activity 1.4 Structure of the heart (Simulated dissection) Student

Vertical section of the heart

Figure 1 Vertical section of the heart.

Activity 1.5 Investigating arteries and veins

Wash your hands after handling

Figure 1 Measuring the length of the ring.

5 Calculate % change in length:

Activity 1.5 Investigating arteries and veins Student

Part B: Histology of blood vessels

Activity 1.5 Investigating arteries and veins Student

Activity 1.6 The cardiac cycle

Use the section on the cardiac cycle in your textbook or the

Atrial and ventricular diastole

Activity 1.7 Atherosclerosis

1 Fibrin 12 A blood clot forms

Activity 1.8 Conductive pathway of the heart

The __________ node

The __________________ is the

Figure 1 The conductive pathway of the heart.

Activity 1.9 What does an ECG show?

A normal ECG trace

Figure 1 ECG trace from a normal heart.

What does each wave represent?

Using the ECG trace to measure heart rate

Activity 1.9 What does an ECG show? Student

Activity 1.9 What does an ECG show? Student

Q9 Explain why the P wave is usually smaller

Activity 1.10 Estimating risk

Estimating risks and analysing data

Cause of death Estimated Actual Cause of death Number of

Activity 1.10 Estimating risk Student

Correlation and causation

Activity 1.10 Estimating risk Student

Table 3 Life expectancy and television ownership in different countries.

Country Life People Country Life People

Activity 1.11 Analysis of cardiovascular

Analysis of risk: haemorrhagic stroke

Age Male Female Gender

Analysis of coronary heart disease data

Age/years 3544 4554 5564 6574

Activity 1.12 Sudden death in athletes