慢性病的环境因素分析ppt课件

1、Jill Stein MD, Ted Schettler MD, MPH, Maria Valenti and Ben Rohrer 2021Greater Boston Physicians for Social Responsibility (/Boston)and The Science and Environmental Health Network ()opportunity.uuGrowing income gap increases disease risk. uDiseases of civilization - obesity, diabetes

2、, u cardiovascular disease, hypertension. Alzheimers ParkinsonsObesity/overweight 2/3 US adults, prevalence x2 in 25 yrs /chronicdisease/resources/publications/AAG/obesity.htmPre/Diabetes 40% US adults, prevalence DM x2 over 20 yrs Cowie 09, /DDTSTRS/default.aspxCardiovascula

3、r disease still leading cause of death. Hypertension increasing. /nchs/FASTATS/lcod.htm, Hajjar 03Metabolic syndrome = early signs of other cluster diseases; 35% adults, 55%60 yrs Ford ES 05Alzheimers disease 84 yrs old, 5.3M Alzheimers Assoc.uAnnual costs in US over $150 billion.Environment

4、Drives Chronic DiseaseToxic exposuresoxidative stressObesity, hypertension,Cardiovascular disease, diabetesAlzheimers, dementia, ParkinsonsLow birth weightbuiltenvironmentdiseasestressenergychemicalsnutrientsAltered PathwaysEnvironment Drives Chronic DiseaseEnvironmental FactorsChronic DiseaseCLASSI

5、CAL CONCEPTOF INFLAMMATIONInflammatory Disease. NEJM 1999, 340(2); 115-126. blood sugar artery disease triglycerides blood sugar artery disease triglyceridesEnvironment Drives Chronic Disease Novel Nutrients Are Pervasive, Promote Inflammatory Metabolism“Hypothetical scheme of fat, fatty acid (6, 3,

6、 trans and total) intake (as percentage of calories from fat) and intake of vitamins E and C (mg/d). Data were extrapolated from cross-sectional analyses of contemporary hunter-gatherer populations and from longitudinal observations and their putative changes during the preceding 100 years 75. From

7、AP Simopoulos, The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy 56 (2002) 365-379.Years% of calories from fatmg/day Plasma Insulin,mg/dlTime, minsINSULINEMIC RESPONSELow glycemic foodHigh glycemic foodEvolutionary Recent marked Recent marked Rec

8、ent markedContextdecline increaseincreaseOmega-3, (Omega-6) blood sugar artery disease triglyceridesSaturated fatAntioxidants High Glycemic CarbohydratesFructose Reduced exposure to pesticides Environment Drives Chronic Diseaseupolycarbonate blood sugar artery disease triglyceridesEndocrine Disrupto

9、rs -BPA, dioxins, PCBs, some pesticides Saturated fatHigh Glycemic CarbohydratesAir PollutionAntioxidants Omega-3 Fructose SomePesticidesLead, other heavy metalsEnvironment Drives Chronic DiseaseCuba- lost fossil fuelsbiking, walking, local plant-based food physical activity 50%obesity 50% mortality

10、: DM 51%, CVD 35%, stroke 20%, all cause 18% Franco M et al. Impact of Energy Intake, Physical Activity, and Population-wide Weight Loss on Cardiovascular Disease and Diabetes Mortality in Cuba, 1980-2005. AJE 166, 12; Sept. 19, 2007Sustainable Food & Transportation Solutions:The Cuba Example bl

11、ood sugar artery disease triglyceridesObesityEndocrine Disruptors -BPA, dioxins, PCBs, some pesticides InactivitySaturated fatHigh Glycemic CarbohydratesAir PollutionAntioxidants Omega-3 Fructose Lead, other heavy metalsSomePesticidesEnvironment Drives Chronic Disease blood sugar artery disease triglyceridesObesityEndocrine Disruptors -BPA, d