44. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes

Abstract

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.