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STOP EATING! We Are SLOWLY Dying Because Of These Foods Tamkeen Farooq, Diseaesis a board-certified primary care physician practicing family medicine at Inova Primary Rrduced — Springfield. The new year Muscular endurance benefits a perfect time to assess your Reduced risk of chronic diseases fiseases and lifestyle. Rsk if you Reduced risk of chronic diseases good, some of your current habits may be contributing to a higher risk of chronic disease. The good news is that making certain lifestyle changes can improve your quality of life now and have a big impact later. They can help prevent chronic disease and may reduce the severity of any chronic conditions you develop. The risk of developing a chronic disease rises naturally with age, regardless of your family history, sex or ethnicity.Reduced risk of chronic diseases -
NEAT is affected by other factors including diet, daily exercise and the living environment. It is also under the influence of hormones such as thyroxine, leptin, reproductive hormones, and orexin. Research has also identified specific genes, for example, genetic variations of the dopamine D2 receptor gene and melanocortin-4 receptor gene, both of which affect the motivation to exercise.
UK adults are currently recommended to undertake minutes per week of moderate-intensity exercise. This is exercise sufficient to quicken your pulse and make you feel a bit sweaty and out of breath. This should be done in intervals of minutes a day, on four or five days per week.
An alternative is 75 minutes of vigorous exercise twice a week. Remember this does not have to be done all in one go, it could be two half sessions a day, or three, twenty-minute sessions, for example.
High-intensity training HIT is an alternative fitness option. It involves intense episodes of vigorous exercise lasting seconds, followed by a recovery period, and repeated up to 10 times.
This is a specific type of exercise designed to improve wellbeing and physical fitness. To what extent does physical activity contribute to the prevention and management of mental health conditions in children, adolescents and adults?
Getting enough physical exercise has long been recognised as vital for the health and wellbeing of children, including for their mental health. A systematic review of 26 different studies concluded that exercise was associated with lower levels of depressive symptoms and depression, as well as increased self-confidence and self-esteem.
The best outcomes were noted after regular, supervised, group activities. In young people, depression and anxiety are common in those who do not participate in regular exercise and spend a lot of time online.
In one Chinese study, Both low physical activity and high levels of screen time were linked to poorer mental health. In the COVID pandemic in , 94, fewer children were taking enough physical exercise, compared to pre-pandemic levels.
In one survey children aged under 14 were spending approximately 23 hours a week on their smartphones or computers. Excess screentime is linked to a less healthy diet, obesity, poor sleep and poorer mental health. Parents are recommended to restrict screen time, take an interest in what their children are doing online, have screen- free mealtimes, leave mobile phones switched off and outside the bedroom door at night, and encourage them to do some more physical exercise.
Older adults have many barriers to exercise. They often lack confidence, worrying they will do themselves an injury, feel self-conscious, may suffer from chronic health problems such as arthritis that makes exercise painful, may already suffer from depression linked to inertia and may lack the finances to pay for a gym membership or exercise classes.
In fact, all these barriers can be got around. Many gyms and leisure centres run exercise sessions, especially for older people. The NHS funds exercise in that the GP can prescribe exercise as a treatment. Many conditions, including arthritis, are improved by exercise.
One good example is hydrotherapy, and indeed swimming, for those with osteoarthritis of the knee. Encouraging older people to exercise has many advantages for both physical and mental health.
Taking part in exercise is also a very effective way to combat loneliness. However, a recent American study reported on a group of year-olds, who were enrolled in a variety of evidence-based exercise classes.
After six months, loneliness had reduced by 6. In addition, participants were shown to reduce their risk of falls.
One of the best forms of exercise for older people is dancing. This can help improve both physical and mental health. In a review in the Journal of Aging and Physical Activity, the authors reviewed 15 training and three cross-sectional studies and concluded there was substantial medical evidence that dancing can significantly improve aerobic power, lower body muscle endurance, strength and flexibility, balance, agility and gait.
There is also some evidence that dancing can improve bone mineral density, and muscle power, as well as reduce falls, and risks from cardiovascular disease.
Moreover, the Tango Group were enthusiastic and wanted to continue dancing, and many of the traditional exercise group wanted to join the dance class!
Prolonged sitting has been recognised as a new health hazard. Those who sit more at work, tend to sit more at home. And lounging around watching TV for long periods has a negative effect on your physical and mental health and overall muscle strength.
Scientists regard sitting as being on a car journey, but when you sit for long periods, you put your car your health in reverse. The other sad fact is that no amount of physical exercise done before or after prolonged sitting can counteract the negative effects of sitting for long periods.
You can also move more at work by using a stand-up desk for two hours a day, having standing meetings, walking around while taking phone calls, setting an alarm for regular movement breaks, and taking the stairs.
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Dr Deborah Lee from Dr Fox Online Pharmacy , considers the role of physical activity to prevent chronic diseases This article explores the extent to which regular physical activity helps improve your overall health, fitness, and quality of life and how it helps to reduce the risk of chronic conditions like type-2 diabetes, heart disease, cancer, depression and anxiety plus dementia.
Cardiorespiratory fitness CRF Exercise is the best way to improve cardiorespiratory fitness CRF. Type-2 diabetes T2D Type-2 diabetes T2D is also inexorably linked to a lack of physical exercise.
Mental health Numerous studies have demonstrated the benefits of increased physical activity on brain function, in both cognition and mental health. Cancer Robust evidence exists to support the fact that increased exercise reduces the risk of cancer. To what extent is lack of exercise a major cause of chronic diseases today?
Heart disease The British Heart Foundation reports that 5 million deaths from heart disease around the world are caused every year due to lack of physical exercise. Mental health In a American study of 1. The challenge of promoting physical activity is as much the responsibility of governments, as of the people.
However, individual action for physical activity is influenced by the environment, sports and recreational facilities, and national policy. It requires coordination among many sectors, such as health, sports, education and culture policy, media and information, transport, urban planning, local governments, and financial and economic planning.
Towards this end, the World Health Organization is supporting its member States by providing nationwide evidence-based advocacy on the health, social, and economic benefits of healthy lifestyles. The State of Aging and Health in America Ford, Earl S; Bergmann, Manuela M; Kroger, Janine; Schienkiewitz, Anja; Weikert, Cornelia; Boeing, Heiner.
King D. E, Mainous A. G 3rd, Carnemolla M, Everett C. Kvaavik, Elisabeth; Batty, G. David; Ursin, Giske; Huxley, Rachel; Gale, Catharine R. Murray, C. Cambridge, MA: Harvard School of Public Health, Neglected Global Epidemics: three growing threats.
The World Health Report, Projections of mortality and burden of disease to Geneva: It is privileged to host senior United Nations officials as well as distinguished contributors from outside the United Nations system whose views are not necessarily those of the United Nations.
Similarly, the boundaries and names shown, and the designations used, in maps or articles do not necessarily imply endorsement or acceptance by the United Nations.
A poor diet—especially one high in sodium and saturated fats—can contribute to chronic illness. Diet is often a factor in type 2 diabetes, heart disease, and many others.
And while the definition of a healthy diet varies from person to person, having more fruits and vegetables, less saturated fat, and refined sugar is a good start. Physical activity contributes to your physical and mental health. Incorporating movement into your day is a great starting point.
Quitting smoking, or not starting, to begin with, can go a long way to preventing chronic illness. Smoking can cause lung disease, diabetes, cancer, stroke, heart disease, and chronic obstructive pulmonary disease COPD , which includes emphysema and chronic bronchitis. And it increases the risk of particular eye diseases, tuberculosis, and immune issues like rheumatoid arthritis.
You can lower the risk of many chronic illnesses by avoiding tobacco.
Chronic diseases are a growing Reduced risk of chronic diseases threat for millions Reduced risk of chronic diseases Americans. According to the Centers for Disease Control Reducrd Prevention CDC6 in 10 Americans suffer irsk at least one chronic disease, and 4 in 10 Endurance nutrition tips from Reducee or chonic chronic diseases at the same time. The good news is that lowering your risk of developing one or more chronic diseases can be as simple as making a few lifestyle modifications and adding some healthy habits and practices to your daily routine. At Midwest Regional Health Servicesour team of primary and family medicine physicians and specialists offers disease prevention services and treatment at our practice in Omaha, Nebraska. According to the CDC, some of the most common chronic diseases include:.Reduced risk of chronic diseases -
Some physical activity is better than none. Excessive alcohol use , over time, can lead to high blood pressure, heart disease, stroke, liver disease, and various cancers. Excessive alcohol use includes:. To reduce the risk of alcohol-related harms, the — Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.
Tool to Check Your Drinking Why Drinking Less Matters. Skip directly to site content Skip directly to search. Español Other Languages. Top 4 Tips to Prevent Chronic Diseases. Español Spanish. Minus Related Pages. How To Make a quit plan.
Making a plan can help you manage stress, urges to smoke, and other challenges when trying to quit. Talk to your doctor about using quit-smoking medicine. Call QUIT-NOW to be connected to your state quitline, where you can speak confidentially with a highly trained coach.
Eat Healthy. How To Choose water tap or unsweetened, bottled, or sparkling over sugary drinks. Focus on whole fruits. They can be fresh, frozen, canned, or dried. Eat a variety of vegetables and add them to mixed dishes like casseroles, sandwiches, and wraps.
Choose whole-grain versions of common foods, such as bread, pasta, and tortillas. Eat a variety of protein foods, such as beans, soy, seafood, lean meats, poultry, and unsalted nuts and seeds. How To Talk to your doctor first if you have a chronic condition like diabetes or heart disease.
Get support from your friends and family. According to the Centers for Disease Control and Prevention CDC , 6 in 10 Americans suffer from at least one chronic disease, and 4 in 10 suffer from two or more chronic diseases at the same time. The good news is that lowering your risk of developing one or more chronic diseases can be as simple as making a few lifestyle modifications and adding some healthy habits and practices to your daily routine.
At Midwest Regional Health Services , our team of primary and family medicine physicians and specialists offers disease prevention services and treatment at our practice in Omaha, Nebraska. According to the CDC, some of the most common chronic diseases include:.
For example, numerous studies over the last decade have observed the relationship between heavily sedentary lifestyles and an increased risk of several types of cancer, such as breast, colon, gastric, and kidney cancer. The American Cancer Society recommends regular exercise to help maintain a healthy weight, boost immune function, and keep your hormones balanced, all of which can potentially lower your risk for developing certain types of cancer.
If you have a known family history or genetic predisposition to chronic diseases, a healthy lifestyle is especially important. For starters, knowing your family history and personal risk levels can help you make the right nutrition and lifestyle choices for your health.
In Mauritius, the government required a change in the commonly used cooking oil from mostly palm oil to soybean oil, which changed people's fatty acid intake and reduced their serum cholesterol levels Uusitalo and others Changes in types of fat can often be almost invisible and inexpensive.
Omega-3 fatty acid intakes can be increased by incorporating oils from rapeseed, mustard, or soybean into manufactured foods, cooking oils sold for use at home, or both.
Selective breeding and genetic engineering provide alternative ways to improve the healthfulness of oils by modifying their fatty acid composition. When the consumption of processed food is high, a reduction in salt consumption will usually require changes at the manufacturing level, because processed food is a major salt source.
If the salt content of foods is reduced gradually, the change is imperceptible to consumers. Coordination among manufacturers or government regulation is needed; otherwise producers whose foods are lower in salt may be placed at a disadvantage.
Unfortunately, good examples are not available. Another example of improved processing would be to reduce the refining of grain products, which can be done in small, almost invisible decrements. Food fortification has eliminated iodine deficiency, pellagra, and beriberi in much of the world.
In regions where iodine deficiency remains a serious problem, fortification should be a high priority. Folic acid intake is suboptimal in many regions of both developing and developed countries. Fortifying foods with folic acid is extremely inexpensive and could substantially reduce the rates of several chronic diseases.
Grain products—such as flour, rice, and pasta—are usually the best foods to fortify, and in many countries, they are already being fortified with other B vitamins.
Since , grain products in the United States have been fortified with folic acid, which has almost eliminated folate deficiency, and rates of neural tube defect pregnancies have declined by about 19 percent Honein and others Where intakes of vitamins B12 and B6 are also low and contribute to elevations of homocysteine, as among vegetarian populations in India, simultaneous fortification of food with these vitamins should be considered.
The effects of fortification on reducing CVD are not considered proven, but the potential benefits are huge; therefore, intervention trials to evaluate the effects of fortification should be a high priority.
Policies regarding the production, importation, distribution, and sale of specific foods can influence their cost and availability. Policies may be directed at the focus of agricultural research and the types of production promoted by extension services.
Policies often promote grains, dairy products, sugar, and beef, whereas those that encourage the production and consumption of fruits, vegetables, nuts, legumes, whole grains, and healthy oils would tend to enhance rather than reduce health.
Almost every national effort to improve nutrition incorporates the promotion of healthy food choices, such as fruits, vegetables, and legumes. Ideally, such efforts are coordinated among government groups, retailers, professional groups, and nonprofit organizations, and investment in such efforts should include the careful testing and refining of social-marketing strategies.
Another strategy is to protect consumers from aggressive marketing of unhealthy foods. Producers spend billions of dollars a year encouraging children to consume foods that are detrimental to their health.
Manufacturers and fast-food chains personify food products with cartoon characters; display food brands on toys; and issue "educational" card games that subvert children's natural gift for play, story telling, and make believe.
The willingness to limit advertising depends on a country's political culture, but the public clearly distinguishes between advertising aimed at adults and that targeted at children.
For example, in the United States, 46 percent of adults surveyed supported restrictions on advertising to children Blendon Restrictions can range from banning advertising to children to limiting the types of products that advertisers may promote to this audience.
Nations and regions can promote a variety of initiatives to encourage greater physical activity and better nutrition. These initiatives are likely to be most effective when they are multi-faceted and coordinated and when they are developed with the active involvement of individuals and organizations within communities Puska and others Many countries are undertaking efforts to educate their populations about healthy lifestyles.
In the Islamic Republic of Iran, the Isfahan Healthy Heart Program, a WHO collaborating center for research and training for CVD control, prevention, and rehabilitation for cardiac patients, has developed a comprehensive, integrated community intervention that involves schools, worksites, health care facilities, food services, urban planners, and the media.
South Africa's Community Health Intervention Programme, a partnership between an insurance company and an academic institution, has created programs targeted to specific age groups, including children and older adults. The program's twice-weekly classes have reduced blood pressure and increased strength and balance Lambert, Bohlmann, and Kolbe-Alexander box A Comprehensive Intervention Approach in South Africa.
The Coronary Risk Factor Study in South Africa Rossouw and others tested community interventions at different levels of intensity in two communities with a third control community. The target more Singapore's Fit and Trim Program uses a multidisciplinary approach to increase physical activity and healthy diets among schoolchildren.
Between and , the rate of obesity declined by The Singapore National Healthy Lifestyle Program. Because CVD and cancer had become the major causes of death in Singapore, the government adopted the National Healthy Lifestyle Program in Cutter, Tan, and Chew This coordinated, multisectoral more Economic policies can have important effects on behavior and choices, and these policies have been particularly useful in reducing the prevalence of smoking see chapter Policies that could influence diet and physical activity deserve careful consideration because they are rarely neutral and often support unhealthy behaviors.
Consider the following examples:. Poland: A Dramatic Decline in Heart Disease. After Poland's transition to a democratic government in the early s, the government removed large subsidies for butter and lard, and consumption of nonhydrogenated vegetable fat increased rapidly Zatonski, more Primary targets for reducing lifestyle diseases include changing the fat composition of the diet, limiting sodium intake, and engaging in regular physical activity.
Using available data, we calculated a range of estimates under given assumptions for the cost-effectiveness of replacing dietary saturated fat with monounsaturated fat, replacing trans fat with polyunsaturated fat, and reducing salt intake.
An increase in moderate physical activity by three to five hours per week is considered likely to lower the risk of many diseases, but data to model the cost-effectiveness of this intervention are not currently available.
For further details of methods and assumptions underlying the analyses presented here, see the Web site version of this book. The intervention's effectiveness could be increased by replacing part of the saturated fat with polyunsaturated fat, which has additional beneficial effects mediated by mechanisms other than LDL cholesterol see tables We could not use the model for saturated fat to estimate the effects of replacing trans fat with polyunsaturated fat because only a small part of the benefit is attributable to reducing LDL cholesterol F.
Hu and Willett Trans fats also adversely affect high-density lipoprotein HDL cholesterol, triglycerides, endothelial function, and inflammatory markers. In addition, increases in polyunsaturated fat assuming a mix of N-6 and omega-3 fatty acids will reduce LDL cholesterol, insulin resistance, and probably fatal cardiac arrhythmias.
In calculations that are based only on the adverse effects on LDL and HDL, replacing 2 percent of the energy from trans fat with polyunsaturated fat was estimated to reduce CAD by 7 to 8 percent Grundy ; Willett and Ascherio Epidemiological studies, which include the contributions of the additional causal pathways, suggest a much greater reduction, from about 25 to 40 percent F.
Hu and others ; Oomen and others Another likely benefit is a reduction in the incidence of type 2 diabetes: estimates indicate that the same 2 percent reduction would reduce incidence by 40 percent Salmeron and others Because voluntary action by industry as has nearly been achieved in the Netherlands or by regulation as occurred in Denmark can eliminate partially hydrogenated fat from the diet, this initiative does not require consumer education, and the costs can be extremely low.
In an analysis required before implementing food labeling, the U. Food and Drug Administration estimated that trans fat labeling would be highly cost-effective. Even though the effect of labeling itself was estimated to have only a modest effect on consumer behavior, as noted earlier, it is having a major effect on manufacturers' behavior.
The potential for reducing CVD rates by replacing trans fats with polyunsaturated fats will depend on the diets of specific populations. Whereas the intake of trans fat is low in China, it is likely to be high in parts of India, Pakistan, and other Asian countries because of the extraordinarily high content in commonly used cooking fats.
Table The lower estimate—or one even lower—is possible because trans fat can be eliminated at the source rather than depending entirely on changes in individual behavior. Those regional variations are attributable to differing risk profiles across regions as well as to price differentials for the costs of treating disease sequelae.
The actual blood pressure reduction from lower salt consumption could vary from the base-case assumption, as could the costs of the education campaign. These results may argue for initial efforts to focus on reductions in the use of salt during the manufacturing process with no public education campaign.
The cost-effectiveness of such a change is high and could be augmented with a public education campaign only if needed to support the legislated change.
At lower implementation costs, the intervention is highly cost-effective, even with half the assumed effect on blood pressure.
Even though health experts believe that physical activity interventions are effective in reducing the risk of lifestyle diseases, no studies of their cost-effectiveness are available from developing countries.
If people walk voluntarily the model assumes no opportunity cost , a net economic benefit would accrue to all segments of the U. If we project the economic benefits to the entire U. A series of U. studies appears to confirm that the avoidable costs of chronic diseases are substantial, although many developing countries have not yet experienced the full demands on their health sectors resulting from these conditions.
Colditz estimates that obesity is responsible for 7 percent of all U. direct health care costs and that inactivity is responsible for an additional 2. Indirect costs associated with obesity and inactivity account for another 5 percent of health care costs. Pronk and others assess the difference in health care costs between adult patients with and without risk factors for noncommunicable diseases physical activity, BMI, and smoking status and find that a healthier lifestyle of physical activity three times per week, a moderate BMI, and nonsmoking status reduce health care costs by 49 percent compared with an unhealthy lifestyle.
Populationwide and community-based interventions appear to be cost-effective if they reach large populations, address high-mortality and high-morbidity diseases, and are multipronged and integrated efforts.
The full costs of achieving changes in behavior and policy are often complex and difficult to estimate. Interventions may yield additional spinoff benefits. For instance, decisions to reduce children's television viewing could easily improve school outcomes as well as reduce childhood obesity. Similarly, increasing walking and bicycle riding for transportation could reduce air pollution.
An overall objective is to develop comprehensive national and local plans that take advantage of every opportunity to encourage and promote healthy eating and active living. These plans would involve health care providers; worksites; schools; media; urban planners; all levels of food production, processing, and preparation; and governments.
The goal is cultural change in the direction of healthy living. An important element in cultural change is national leadership by individuals and by professional organizations. Specific interventions will depend on local physical and cultural conditions and should be based on careful analysis of existing dietary and activity patterns and their determinants; however, the following interventions can be considered specific interventions for control of smoking are discussed elsewhere :.
Implementation of the recommended policies to promote health and well-being is often not straightforward because of opposition by powerful and well-funded political and economic forces, such as those involved in the tobacco, automobile, food, and oil industries Nestle The solutions will depend on a country's specific political landscape.
However, experiences in many countries indicate that alliances of public interest groups, professional organizations, and motivated individuals can overcome such powerful interests. Strategies should start with sound science and can use a mix of mass media, lobbying efforts, and lawsuits.
Also, the food industry is far from monolithic, and elements can often be identified whose interests coincide with health promotion, which can create valuable partnerships.
As an example, the willingness of some margarine manufacturers to invest in developing products free of trans fatty acids greatly helped the effort to reduce these fats, because these producers then became proponents for labeling the trans fat content of foods.
Protection of children can be a powerful lever because of almost universal concern about their welfare and the recognition that they cannot be responsible for the long-term consequences of their diet and lifestyle choices.
Many of the ongoing diet and lifestyle interventions in low-and middle-income countries are relatively recent, and few have documented reductions in the rates of major chronic diseases. However, the successes of Finland, Singapore, and many other high-income countries in reducing rates of CAD, stroke, and smoking-related cancers strongly suggest that similar benefits will emerge in the developing countries.
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Show details Jamison DT, Breman JG, Measham AR, et al. Search term. Chapter 44 Prevention of Chronic Disease by Means of Diet and Lifestyle Changes Walter C.
Box Chronic Disease Prevention In this section, we briefly review dietary and lifestyle changes that reduce the incidence of chronic disease. Recommended Lifestyle Changes Specific changes in diet and lifestyle and likely benefits are summarized in table Avoid Tobacco Use Avoidance of smoking by preventing initiation or by cessation for those who already smoke is the single most important way to prevent CVD and cancer chapter Maintain a Healthy Weight Obesity is increasing rapidly worldwide chapter Maintain Daily Physical Activity and Limit Television Watching Contemporary life in developed nations has markedly reduced people's opportunities to expend energy, whether in moving from place to place, in the work environment, or at home Koplan and Dietz Eat a Healthy Diet Medical experts have long recognized the effects of diet on the risk of CVD, but the relationship between diet and many other conditions, including specific cancers, diabetes, cataracts, macular degeneration, cholelithiasis, renal stones, dental disease, and birth defects, have been documented more recently.
Replace saturated and trans fats with unsaturated fats, including sources of omega-3 fatty acids. Replacing saturated fats with unsaturated fats will reduce the risk of CAD F.
Hu and Willett ; Institute of Medicine ; WHO and FAO by reducing serum low-density lipoprotein LDL cholesterol. Also, polyunsaturated fats including the long-chain omega-3 fish oils and probably alpha-linoleic acid, the primary plant omega-3 fatty acid can prevent ventricular arrhythmias and thereby reduce fatal CAD.
In a case-control study in Costa Rica, where fish intake was extremely low, the risk of myocardial infarction was 80 percent lower in those with the highest alpha-linoleic acid intake Baylin and others Intakes of omega-3 fatty acids are suboptimal in many populations, particularly if fish intake is low and the primary oils consumed are low in omega-3 fatty acids for example, partially hydrogenated soybean, corn, sunflower, or palm oil.
These findings have major implications, because changes in the type of oil used for food preparation are often quite feasible and not expensive. Ensure generous consumption of fruits and vegetables and adequate folic acid intake. Strong evidence indicates that high intakes of fruits and vegetables will reduce the risk of CAD and stroke Conlin Some of this benefit is mediated by higher intakes of potassium, but folic acid probably also plays a role F.
Supplementation with folic acid reduces the risk of neural tube defect pregnancies. Substantial evidence also suggests that low folic acid intake is associated with greater risk of colon—and possibly breast—cancer and that use of multiple vitamins containing folic acid reduces the risk of these cancers Giovannucci Findings relating folic acid intake to CVD and some cancers have major implications for many parts of the developing world.
In many areas, consumption of fruits and vegetables is low. For example, in northern China, approximately half the adult population is deficient in folic acid Hao and others Consume cereal products in their whole-grain, high-fiber form.
Consuming grains in a whole-grain, high-fiber form has double benefits. First, consumption of fiber from cereal products has consistently been associated with lower risks of CAD and type 2 diabetes F.
Hu, van Dam, and Liu ; F. Hu and Willett , which may be because of both the fiber itself and the vitamins and minerals naturally present in whole grains.
High consumption of refined starches exacerbates the metabolic syndrome and is associated with higher risks of CAD F. Hu and Willett and type 2 diabetes F. Second, higher consumption of dietary fiber also appears to facilitate weight control Swinburn and others and helps prevent constipation.
Limit consumption of sugar and sugar-based beverages. Sugar free sugars refined from sugarcane or sugar beets and high-fructose corn sweeteners has no nutritional value except for calories and, thus, has negative health implications for those at risk of overweight.
Furthermore, sugar contributes to the dietary glycemic load, which exacerbates the metabolic syndrome and is related to the risk of diabetes and CAD F. Hu and Willett ; Schulze and others WHO has suggested an upper limit of 10 percent of energy from sugar, but lower intakes are usually desirable because of the adverse metabolic effects and empty calories.
Limit excessive caloric intake from any source. Given the importance of obesity and overweight in the causation of many chronic diseases, avoiding excessive consumption of energy from any source is fundamentally important. Because calories consumed as beverages are less well-regulated than calories from solid food, limiting the consumption of sugar-sweetened beverages is particularly important.
Limit sodium intake. The principle justification for limiting sodium is its effect on blood pressure, a major risk factor for stroke and coronary disease chapter WHO has suggested an upper limit of 1. Potential of Dietary and Lifestyle Factors to Prevent Chronic Diseases Several lines of evidence indicate that realistic modifications of diet and lifestyle can prevent most CAD, stroke, diabetes, colon cancer, and smoking-related cancers.
Interventions Interventions aimed at changing diet and lifestyle factors include educating individuals, changing the environment, modifying the food supply, undertaking community interventions, and implementing economic policies. Educational Interventions Efforts to change diets, physical activity patterns, and other aspects of lifestyle have traditionally attempted to educate individuals through schools, health care providers, worksites, and general media.
School-based Programs School-based programs include the roles of nutrition and physical activity in maintaining physical and mental health box Worksite Interventions Worksite interventions can efficiently include a wide variety of health promotion activities because workers spend a large portion of their waking hours and eat a large percentage of their food there.
Interventions by Health Care Providers Controlled intervention trials for smoking cessation and physical activity have shown that physician counseling, especially when accompanied by supporting written material, can be efficacious in modifying behavior.
Transportation Policy and Environmental Design Transportation policies and the design of urban environments are fundamental determinants of physical activity and therefore influence the risks of obesity and other chronic diseases.
Limit the Role of Automobiles In wealthy countries, the automobile has strongly influenced the trend toward low-density, automobile-based suburban developments, many built without sidewalks. Promote Walking and Bicycle Riding Walking or cycling for transportation and leisure are effective and practical means of engaging in physical activity and are still the most common ways to travel in many developing countries.
Design Cities and Towns to Promote Health Handy and others' comprehensive assessment of recent research on urban planning concludes that a combination of urban design, land-use patterns, and transportation systems that promotes walking and bicycling will help create active, healthier, and more livable communities.
Improved Food Supply People's diets can be enhanced by improving the food supply. Improving Processing and Manufacturing Altering the manufacturing process can rapidly and effectively improve diets because such action does not require the slow process of behavioral change.
Fortifying Food Food fortification has eliminated iodine deficiency, pellagra, and beriberi in much of the world. Increasing the Availability and Reducing the Cost of Healthy Foods Policies regarding the production, importation, distribution, and sale of specific foods can influence their cost and availability.
Promoting Healthy Food Choices and Limiting Aggressive Marketing to Children Almost every national effort to improve nutrition incorporates the promotion of healthy food choices, such as fruits, vegetables, and legumes. Initiatives at the Community Level Nations and regions can promote a variety of initiatives to encourage greater physical activity and better nutrition.
Economic Policies Economic policies can have important effects on behavior and choices, and these policies have been particularly useful in reducing the prevalence of smoking see chapter Consider the following examples: Subsidies can favor the consumption of less healthy foods, such as sugar, refined grains, beef, and high-fat dairy products as opposed to fruits, vegetables, whole grains, nuts, legumes, and fish.
Poland provides a striking example of how changes in subsidies can affect health box Governments often subsidize foods indirectly by sheltering them from sales taxes in the recognition that they are essential; however, this logic should not extend to foods with adverse health effects, such as sugar-sweetened beverages and those high in trans fats.
Legislation can make this distinction, providing a modest economic incentive for healthier choices and at the same time conveying important nutritional messages see chapter Use of individual automobiles is often subsidized by building and maintaining highways, providing inexpensive parking, and imposing low taxes on petroleum products that do not fully reflect their societal and environmental costs.
Increasing taxes on petroleum products and subsidizing public transportation could have an important effect on choice of transportation modality, which as noted earlier, has major effects on health. Walking, riding bicycles, and using public transportation can be promoted by economic policies that, in addition to providing better infrastructure, include discounts on transportation fares, provide secure bicycle parking, and reduce health insurance premiums.
Cost-Effectiveness of Interventions Only a few studies have described interventions for lifestyle diseases in developing countries. Modeling Likely Interventions Primary targets for reducing lifestyle diseases include changing the fat composition of the diet, limiting sodium intake, and engaging in regular physical activity.
Replacing Dietary Trans Fat from Partial Hydrogenation with Polyunsaturated Fat We could not use the model for saturated fat to estimate the effects of replacing trans fat with polyunsaturated fat because only a small part of the benefit is attributable to reducing LDL cholesterol F.
Reducing the Salt Content of Manufactured Foods through Legislation and an Accompanying Education Campaign Table Adopting Physical Activity Interventions Even though health experts believe that physical activity interventions are effective in reducing the risk of lifestyle diseases, no studies of their cost-effectiveness are available from developing countries.
Aggregate Costs of Obesity and Unhealthy Lifestyles A series of U. Cost-Effectiveness of Community-based Interventions Populationwide and community-based interventions appear to be cost-effective if they reach large populations, address high-mortality and high-morbidity diseases, and are multipronged and integrated efforts.
Research and Development Priorities A number of research and development priorities have been identified: Conduct randomized trials of the use of folic acid and alpha-linoleic acid to prevent CAD in developing countries. These interventions cost little, and the potential benefits are large and rapid.
Develop prospective cohort studies of dietary and lifestyle factors in developing and transition countries to refine the understanding of risk factors in those contexts. To date, almost all such studies have taken place in Europe and North America.
Develop surveillance systems for chronic diseases and for major risk factors, such as obesity, in developing countries. Develop additional multifaceted, community-based demonstration programs in developing countries to document the feasibility of lifestyle changes and to learn more about effective strategies.
Conduct detailed cost-effectiveness analyses of various prevention strategies to modify dietary and lifestyle factors. Recommended Priority Interventions An overall objective is to develop comprehensive national and local plans that take advantage of every opportunity to encourage and promote healthy eating and active living.
Specific interventions will depend on local physical and cultural conditions and should be based on careful analysis of existing dietary and activity patterns and their determinants; however, the following interventions can be considered specific interventions for control of smoking are discussed elsewhere : Physical activity: Develop transportation policies and a physical environment to promote walking and riding bicycles.
This intervention includes constructing sidewalks and protected bicycle paths and lanes that are attractive, safe, well-lighted, and functional with regard to destinations.
Adopt policies that promote livable, walker-friendly communities that include parks and are centered around access to public transportation. Encourage the use of public transportation and discourage overdependence on private automobiles. Promote the use of stairs.
Building codes can require the inclusion of accessible and attractive stairways. Healthy diets: Develop comprehensive school programs that integrate nutrition into core curricula and healthy nutrition into school food services.
Regional or national standards to promote healthy eating should be developed for school food services. Programs should also aim at limiting television watching, in part by promoting attractive alternatives.
Work with the agriculture sector and food industries to replace unhealthy fats with healthy fats, including adequate amounts of omega-3 fatty acids.
This goal can be achieved through a combination of education, regulation, and incentives. Specific actions will depend on local sources of fat and on regional production and distribution. For example, in areas where palm oil is dominant, research could focus on developing strains that are lower in saturated fat and higher in unsaturated fat through selective breeding or genetic alteration.
Labeling requirements or regulation can be used to discourage or eliminate the use of partially hydrogenated vegetable oils and to promote the use of nonhydrogenated unsaturated oils instead.
Use tax policies to encourage the consumption of healthier foods. For example, high-sugar sodas could be fully taxed and not subsidized in the same way as healthier foods.
Emphasize the production and consumption of healthy food products in agriculture support and extension programs. Ensure that health providers regularly weigh both children and adult patients, track their weights over time, and provide counseling regarding diet and activity if they are already overweight or if unhealthy weight gain is occurring during adulthood.
Those activities should be integrated with programs that address undernutrition. Health care providers should be encouraged to set a good example by not smoking, by exercising regularly, and by eating healthy diets. Promote healthy foods at worksite food services.
Worksites can also promote physical activity by providing financial incentives for using public transportation or riding bicycles and by not subsidizing automobiles by providing free parking.
Providing areas for exercise during work breaks and showers may be useful. Set standards that restrict the promotion of foods high in sugar, refined starch, and saturated and trans fats to children on television and elsewhere.
National campaigns: Invest in developing locally appropriate health messages related to diet, physical activity, and weight control.
This effort is best done in cooperation with government agencies, nongovernmental organizations, and professional organizations so that consistent messages can be used on television and radio; at health care settings, schools, and worksites; and elsewhere.
This effort should use the best social-marketing techniques available, with messages continuously evaluated for effectiveness. Develop a sustainable surveillance system that monitors weight and height, physical activity, and key dietary variables.
Conclusions Many of the ongoing diet and lifestyle interventions in low-and middle-income countries are relatively recent, and few have documented reductions in the rates of major chronic diseases.
Acknowledgments The authors appreciate Hilary Farmer's assistance in preparing this manuscript. References Ascherio A. Premature Coronary Deaths in Asians letter. British Medical Journal. Bacon C.
Lifestyle diseases share risk factors similar ov prolonged exposure to three modifiable lifestyle vhronic -- Reduxed, unhealthy diet, Reduecd physical inactivity -- and chtonic in the development of chronic diseases, specifically heart Dlseases, stroke, diabetes, obesity, metabolic syndrome, chronic Reduced risk of chronic diseases pulmonary disease, rosk some types of cancer. These illnesses used to be considered the diseases of industrialized countries, so-called Subcutaneous fat and hormone levels diseases" or "diseases of affluence"; however, internationally they are known as non-communicable and chronic diseases, part of the degenerative diseases group. Chronic disease can result in loss of independence, years of disability, or death, and impose a considerable economic burden on health services. Today, chronic diseases are a major public health problem worldwide. Inthe World Health Organization WHO estimated that 61 per cent of all deaths -- 35 million -- and 49 per cent of the global burden of disease were attributable to chronic diseases. Bythe proportion of total global deaths due to chronic diseases is expected to increase to 70 per cent and the global burden of disease to 56 per cent.
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