44. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes
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Editors/Authors: Walter C. Willett, Jeffrey P. Koplan, Rachel Nugent, Courtenay Dusenbury, Pekka Puska, and Thomas A. Gaziano
Disease / Condition
Maternal & Neonatal Conditions
Chronic diseases such as coronary artery disease, ischemic stroke, diabetes, and certain cancers that until recently were common only in high–income countries, are becoming the dominant causes of morbidity and mortality worldwide. The primary determinants of these diseases are not genetic but environmental factors, including diet and lifestyle.
Most studies of major chronic diseases have been conducted in Western countries, where researchers have concluded that the diseases are the result of modifiable lifestyle factors, not the inevitable consequence of modern society. Prevention requires changes in behaviors related to smoking, physical activity, and diet. Investments are needed in education, food policies, and urban physical structure to support and encourage these changes.
Implementation of government policies to promote health is often not straightforward because of opposition by powerful, well–funded political and economic forces, such as those in the tobacco, automobile, food, and oil industries. However, experience shows that alliances of public interest groups, professional organizations, and individuals can overcome these interests.
Many countries are undertaking reforms to increase the health of their populations. Examples include: Singapore, which has a Fit and Trim Program for increasing physical activity and healthy diets among schoolchildren; the Republic of Korea, which is creating satellite communities around Seoul where expressways are being replaced with parks, sidewalks, and bikeways; and Poland, which has removed government subsidies that encouraged consumption of butter and lard.
- 44.1 The Insulin Resistance Syndrome
- 44.2 Success in Finland
- 44.3 The Planet Health Program
- 44.4 Live for Life
- 44.5 Reducing Automobile Use in Brazil
- 44.6 Walking and Cycling to School
- 44.7 Enhancing Urban Life in the Republic of Korea
- 44.8 Promoting Physical Activity in Brazil
- 44.9 A Comprehensive Intervention Approach in South Africa
- 44.10 The Singapore National Healthy Lifestyle Program
- 44.11 Poland: A Dramatic Decline in Heart Disease
- 44.1 Convincing and Probable Relationships between Dietary and Lifestyle Factors and Chronic Diseases
- 44.2 Incremental Cost-Effectiveness Ratios, Selected Interventions, by Region (US$/DALY averted)
- 44.3 Two-Way Sensitivity Analysis of the Costs of the Intervention to Reduce Saturated Fat Content and of the Relative Risk Reduction in CAD Events, South Asia (US$/DALY averted)
- 44.4 Two-Way Sensitivity Analysis of the Costs of the Intervention to Reduce Salt Content and Its Effectiveness, South Asia (US$/DALY averted)