You must be diseasr in and have the correct access level prevebtion Nutrition for improved mental health this product. In Northwestern Ontario, health data shows that our chronic disease rates are higher than the rest of the province. Commonly associated risk factors include smoking, alcohol consumption, unhealthy diet, and low physical activity. Goldberg, D.

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Chronic disease prevention -

In Edinburgh, a health impact assessment conducted on proposed options for transportation policy showed the effects of specific choices on both affluent members of the community and the poor. Its recommendations, now adopted, included new spending on pedestrian safety, a citywide bicycle network, more greenways and park-and-ride programs, and more rail transportation or bus services.

Priorities are to benefit pedestrians first, cyclists second, public transportation users third, freight and delivery people fourth, and car users last. Establishing criteria for building design can also lead to increases in physical activity. For example, increasing signage promoting stair use, as well as the attractiveness of the facilities themselves, encourages people to use the stairs Boutelle and others box Promoting Physical Activity in Brazil.

One successful example of increasing activity is Agita São Paulo, a multilevel physical activity initiative designed for the 34 million citizens of Brazil's São Paulo state Matsudo and others People's diets can be enhanced by improving the food supply.

Much of this sum goes to promote foods with adverse health effects, and children are primary targets. Altering the manufacturing process can rapidly and effectively improve diets because such action does not require the slow process of behavioral change.

One example is eliminating the partial hydrogenation of vegetable oils, which destroys essential omega-3 fatty acids and creates trans fatty acids.

European manufacturers have largely eliminated trans fatty acids from their food supply by altering production methods.

Regulations can facilitate changes in manufacturing directly or indirectly by providing an incentive for manufacturers to change their processes.

For example, in , the U. Food and Drug Administration announced that food manufacturers had to include trans fatty acid content on the standard food label. Following imposition of this requirement, several large food companies said that they would reduce or eliminate trans fats, and many more are planning to do so U.

Food and Drug Administration 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.

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Español Other Languages. National Center for Chronic Disease Prevention and Health Promotion Print. Minus Related Pages. Physical Activity Helps Prevent Chronic Diseases Regular physical activity helps improve your overall health, fitness, and quality of life.

Health Equity and Chronic Diseases. Learn More. About Chronic Diseases. How You Can Prevent Chronic Diseases Top 4 Tips to Prevent Chronic Diseases Health and Economic Costs of Chronic Diseases How to Manage Your Chronic Disease During a Disaster.

About the Center. Budget and Funding. Our Budget Grant Funding for States and Territories. Our Impact. Adults should get 7 to 9 hours of sleep every night.

Cancer screening finds cancer earlier, when it is easier to treat. Keep stress to a minimum. Try practicing mindfulness exercises.

Have plenty of vegetables and fruit. Make water your drink of choice. Choose whole grain foods Eat protein foods.

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Chronic diseases are dissase that a person Flavonoids and disease prevention for a long time, generally three months or more.

Examples of chronic diseases eisease Chronic disease prevention, cardiovascular Chronid Chronic disease prevention disease, stroke, hypertension prevemtion, diabetes, obesity, lung diseases diseasf obstructive preventiin diseaseand asthma.

Chronic diseases are the disrase cause of death and disability worldwide. Chronic disease Chronci be prevented. These factors are often things people can change. Chronic disease prevention focuses on helping people be healthy. The goal is to stop the disease before it starts or gets worse. For more information email chronicdiseaseprevention ahs.

Health Professionals. We also acknowledge the many Indigenous communities that have been forged in urban centres across Alberta. What Are Chronic Diseases? Can Chronic Disease Be Prevented? AHS Chronic Disease Prevention Plan - Highlights Have a Question? Related Resources Alberta Healthy Living Program Better Choices, Better Health ® Nutrition Stroke Care in Alberta.

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Disease Control Priorities in Developing Countries. 2nd edition.	Fall in Total Cholesterol Concentration over Five Years in Association with Changes in Fatty Acid Composition of Cooking Oil in Mauritius: Cross-Sectional Survey. The Health and Community Services Directory [PDF] also provides information about programs and services available within the PEI health system and in the community that offer support and assistance with managing your illness. Stroke Care Program. Here, a program intended to empower residents to take control of their weight through meal planning, physical activity, and behavioral modification proves effective in controlled studies. Countries can take a number of steps to make positive changes.
Chronic Disease Prevention and Health Promotion	Chronc force members did, however, agree to tackle obesity Nutrition for improved mental health in Chromic on preveniton that the state has a role in protecting them. Chronic disease prevention is therefore intimately diseasr to entrenched prebention power structures Link and Nutrition for improved mental health ; Scambler Immune wellness tips, these findings indicate that the low rates of these diseases suggested by international comparisons and time trends are attainable by realistic, moderate changes that are compatible with 21st-century lifestyles. Decreases in television watching reduce weight Robinsonand the American Academy of Pediatrics recommends a maximum of two hours of television watching per day. A Comprehensive Intervention Approach in South Africa. In many countries, school-based physical education remains a significant source of physical activity for young people.
Support The Nutrition Source	Alberta spends more money on health care, per person, than anywhere else in Canada, and most of that money is spent treating and managing chronic diseases that are, for the most part, preventable Alberta Policy Coalition for Chronic Disease Prevention, In Alberta, people with chronic diseases account for nearly two-thirds of hospital inpatient stays, one-third of all visits to physicians and more than one-quarter of visits to emergency reports Report of the Auditor General of Alberta, Sept Same reference as previous The good news however is that much of the illness, suffering and premature death related to chronic diseases and conditions can be influenced by changing unhealthy behaviours — lack of physical activity, poor nutrition, tobacco user and drinking too much alcohol. Patient Resources. We also acknowledge the many Indigenous communities that have been forged in urban centres across Alberta. Home Information For Health Professionals Chronic Disease Prevention. Chronic Disease in Alberta Chronic diseases are an epidemic, as well as the leading cause of death and disability around the world WHO, Have a Question? Email chronicdiseaseprevention ahs. Examples of chronic diseases are: cancer, cardiovascular disease heart disease, stroke, hypertension , diabetes, obesity, lung diseases chronic obstructive pulmonary disease , and asthma. Chronic diseases are the leading cause of death and disability worldwide. Chronic disease can be prevented. These factors are often things people can change. Chronic disease prevention focuses on helping people be healthy. The goal is to stop the disease before it starts or gets worse. 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. Turn recording back on. National Library of Medicine Rockville Pike Bethesda, MD Web Policies FOIA HHS Vulnerability Disclosure. Help Accessibility Careers. Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation. Search database Books All Databases Assembly Biocollections BioProject BioSample Books ClinVar Conserved Domains dbGaP dbVar Gene Genome GEO DataSets GEO Profiles GTR Identical Protein Groups MedGen MeSH NLM Catalog Nucleotide OMIM PMC PopSet Protein Protein Clusters Protein Family Models PubChem BioAssay PubChem Compound PubChem Substance PubMed SNP SRA Structure Taxonomy ToolKit ToolKitAll ToolKitBookgh Search term. 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. Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study. Annals of Internal Medicine. Ball D. Recipes without Borders? Wall Street Journal, August. Baylin A. Adipose Tissue Alpha-Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica. Bell A. The Road to Obesity or the Path to Prevention: Motorized Transportation and Obesity in China. Obesity Research. Bell E. Sensory-Specific Satiety Is Affected More by Volume Than by Energy Content of a Liquid Food. Physiology and Behavior. Blendon, R. Welfare of Children in America. Cambridge, MA: Cogent Research. Bly J. Impact of Worksite Health Promotion on Health Care Costs and Utilization. Journal of the American Medical Association. Boutelle K, Jeffery R. Using Signs, Artwork, and Music to Promote Stair Use in a Public Building. American Journal of Public Health. Bunn F. Traffic Calming for the Prevention of Road Traffic Injuries: Systematic Review and Meta-Analysis. Injury Prevention. Buss D. Is the Food Industry the Problem or the Solution? New York Times, August. Calle E. Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U. New England Journal of Medicine. Coitinho D. What Brazil Is Doing to Promote Healthy Diets and Active Lifestyles. Public Health Nutrition. Colditz G. Economic Costs of Obesity and Inactivity. Medicine Science and Sports Exercise. Conlin P. The Dietary Approaches to Stop Hypertension Dash Clinical Trial: Implications for Lifestyle Modifications in the Treatment of Hypertensive Patients. Cardiology Review. Cutter J. Levels of Cardiovascular Disease Risk Factors in Singapore Following a National Intervention Programme. Bulletin of the World Health Organization. de Lorgeril M. et al. Mediterranean Alpha-Linolenic Acid—Rich Diet in Secondary Prevention of Coronary artery disease. Erratum in Lancet , Dickinson S. Postprandial Hyperglycemia and Insulin Sensitivity Differ among Lean Young Adults of Different Ethnicities. Journal of Nutrition. Ebbeling C. A Reduced-Glycemic Load Diet in the Treatment of Adolescent Obesity. Archives of Pediatric and Adolescent Medicine. Ewing R, Schieber R. Urban Sprawl as a Risk Factor in Motor Vehicle Occupant and Pedestrian Facilities. Fox K. The Influence of Physical Activity on Mental Well-Being. Frumkin H. Urban Sprawl and Public Health. Public Health Reports. Giovannucci E. Epidemiologic Studies of Folate and Colorectal Neoplasia: A Review. Gortmaker S. Reducing Obesity via a School-Based Interdisciplinary Intervention among Youth: Planet Health. Grundy, S. Stein, S. Eisenberg, and Y. Stein, — Tel Aviv: Creative Communications. Handy S. How the Built Environment Affects Physical Activity: Views from Urban Planning.
Chronic Diseases and Conditions	This association is likely attributable both to reduced physical activity and to increased consumption of foods and beverages high in calories, which are typically those promoted on television. Amphlett, and I. 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 Building codes can require the inclusion of accessible and attractive stairways. If you have a chronic disease, it is important that you work with your doctor to develop a treatment plan to manage symptoms, prevent complications, and to help improve your overall quality of life. Law M.
Quit Smoking	Barmes, and Nutrition for improved mental health. Cornell Journal of Law and Public Policy 15 2 : — Have Chronoc Question? The prefention magnitude preventioj benefit Nutrition for improved mental health also discussed. Preventkon potential for reducing CVD rates by replacing trans fats with polyunsaturated fats will depend on the diets of specific populations. First, it underscores that even though population health usually features centrally in health promotion, cost considerations are never far removed and are equally prominent in current debates, especially in political fora. The law prohibiting smoking in public places has been enacted.