CHRONIC DISEASE · 10 Heartburn & Acid Reflux 11 Stress. Common "Side Effects" of Food 12 Insomnia...
Transcript of CHRONIC DISEASE · 10 Heartburn & Acid Reflux 11 Stress. Common "Side Effects" of Food 12 Insomnia...
CHRONIC DISEASE A "Side Effect" of Food?
Delali Hevi, MD
Board Certified- Obesity Medicine
Board Certified- Internal Medicine
Member- Obesity Medicine Association
No conflicts to declare
Common "Side Effects" of Food 1 Allergy
2 Food-Drug Interactions
3 Bad Breath
4 Body Odor
5 Diarrhea
6 Constipation
7 Gas, Flatulence, Abdominal Bloating, Frequent Urination
9 Edema, Swelling, Water Retention
10 Heartburn & Acid Reflux
11 Stress
Common "Side Effects" of Food
12 Insomnia
13 Sleepiness
14 Gastritis, Peptic Ulcers
15 High Blood Pressure
16 High Cholesterol (Hyperlipidemia)
17 Kidney Stones
18 Migraine & Headache
19 Arthritis, Gout
20 Acne
21 Candidiasis
Common "Side Effects" of Food 22 Memory & Cognition Impairment
23 Tooth Decay (Dental Caries)
24 Tooth Staining
25 Nausea
26 Photosensitivity
27 Tears
28 Thirst
29 Yellow Skin Pigmentation (Carotenemia)
30 Fertility Problems in Men
31 Weight Gain
For todays talk our main concern is with chronic
diseases
One cannot talk about chronic disease without
talking about....
OBESITY-The Mother of all Chronic
Diseases
Obesity is directly linked to almost all NCD's
It has been demonstrated that weight loss leads to an improvement and/or
even reversal of many NCD's
Courtesy of nairaland
.com
Obesity-Definition
“Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”
-Obesity Medicine Association
Obesity is a disease when...
•Excessive body fat is caused by genetic factors, developmental errors,
infections, hypothalamic injury, adverse reactions to medications, nutritional
imbalance, or unfavorable environmental factors
•Multiple adipose tissue endocrine and immune dysfunctions contribute to
metabolic disease (a.k.a. “sick fat” disease)
•Multiple pathogenic physical forces from excessive body fat cause stress
damage to other body tissues (fat mass disease)
Big advantage of the recognition of obesity as a
disease-Removal of stigma
Up until recently people with excess weight were generally thought to be...
Lazy
Lacking in self control/morals
Greedy
Dirty
Unattractive
Unhealthy
Depressed
"Check your Statistacs"
1 in 2 Americans has a chronic disease, and one in four has multiple chronic
diseases
27 percent of kids now have a chronic disease, up from just 13 percent in 1994
Chronic disease is responsible for seven out of every ten deaths
Spending on chronic disease worldwide will reach $47 trillion by 2030.
This is equivalent to the GDP of the six largest economies in the world.
This generation is the first in which kids are expected to live shorter
lifespans than their parents.
1 in 5 Americans struggles to pay medical bills, and three in five
bankruptcies are due to medical expenses.
50 million Americans (approximately 1 in 6) have an autoimmune disease
(more than cancer and heart disease combined)
Nearly 1 in 3 Americans have either prediabetes or diabetes. (100 Million)
At any given moment, roughly half of the adults in the U.S., including 9 out of 10 adults over age 60, are taking at least one prescription drug
Almost a third of adults take two or more drugs.
Almost 30 percent of all teens are now on a prescription drug, as are 20 percent of young children.
America spent just under $310 billion on pharmaceutical drugs in 2015 (IMS Health 2016)
Chronic disease will generate $47 trillion in
healthcare costs globally by 2030 if the epidemic is
unchecked (Duff-Brown, 2017).
That is more than the annual GDP of the six
largest economies in the world.
Overweight and obesity epidemic in Ghana—a systematic review
and meta-analysis. Richard Ofori-Asenso et al. BMC Public
Health (2016)
Forty-three (43) studies involving a total population of 48,966 sampled
across all the ten (10) regions of Ghana were selected for the review.
Findings Nearly 43% of Ghanaian adults are either overweight or obese.
Overweight=25.4%
Obese=17.1%
Urban obesity= 16.7%
Rural obesity= 8.0%
Female obesity=21.8%
Male obesity= 6.0%
At the regional level...
Greater Accra= 55.2%
Ashanti= 43.4%
Central=36.9%
Northern= 32.4%
These patterns generally mimic the levels of urbanization.
About 45.6% of adult diabetes patients in Ghana are either overweight or obese.
What is the link between diet, obesity and
consequently chronic disease?
Mismatch between genetics and
environment
Human beings have evolved over millions of years; our genes
and biology have adapted to allow us to survive and thrive in a
particular environment.
When the environment changes faster than our genes can
adapt, a mismatch occurs which can lead to ill health.
Timeline of Man's Existence On Earth
99.5 yards represents the time we were
hunter-gatherers
Plant-animal subsistence ratios and macronutrient energy estimations in
worldwide hunter-gatherer diets. Cordain et al. The American Journal of
Clinical Nutrition, Volume 71, Issue 3, 1 March 2000
Group of Anthropologists from USA and Australia
Sought to study the diets of our ancestors
Studied/analyzed the economic subsistence data for 229 hunter-gatherer
societies from all around the world using all 3 subsistence categories
(gathered plant foods, hunted animal foods, and fished animal foods)
Findings Whenever and wherever it was ecologically possible, hunter-
gatherers consumed high amounts (45–65% of energy) of animal food.
Most (73%) of the worldwide hunter-gatherer societies derived >50% of their subsistence from animal foods
Only 14% of these societies derived >50% of their subsistence from gathered plant foods.
0.0% of the societies studied were 100%
Vegetarian!
Comparison of the two diets Hunter/Gatherer
Meat
Fish
Wild fruits and vegetables
Nuts and seeds
A few starchy plants and tubers
All of the above were organic
Modern
Bread
Grain based desserts
Sugar sweetened beverages
Pizza
Alcohol
Chicken
Comparison of the two diets Hunter/Gatherer
Naturally anti-inflammatory
Low in calories
High in nutrients
Modern
Pro-inflammatory
High in calories
Low in nutrients
Human beings evolved to seek calorie dense foods because food was
seasonal and scarce; our bodies efficiently stored food as fat in times of
plenty, and then burned those fat stores for energy when food was scarce
Fast forward to today...
In modern times... Food is available in abundance
Can be delivered to your door... No effort or activity required
Food is geared towards convenience and cost effectiveness at the expense of nutritional value
Our soils have been so depleted of nutrients that even 'healthy' fruits and vege's may be nutritionally suboptimal
The CARDIA study Fast-food habits, weight gain, and insulin resistance; 15-year
prospective analysis.
Published in the Lancet, 2005
INTERPRETATION/CONCLUSION: Fast-food consumption has strong positive associations with weight gain and insulin resistance, suggesting that fast food increases the risk of obesity and type 2 diabetes.
Food Quality
70% to 80% of the processed and manufactured foods available in a
conventional grocery store contain one or more ingredients derived from
genetically engineered (GMO) organisms Grocery Manufacturers’ Association position on GMOs
What is GMO? A GMO (genetically modified organism) is a plant, animal, microorganism
or other organism whose genetic makeup has been modified in a
laboratory using genetic engineering or transgenic technology.
This creates combinations of plant, animal, bacterial and virus genes that
do not occur in nature or through traditional crossbreeding methods.
Most common GMO's Corn
Soybean and canola cooking oils
High-fructose corn syrup
A variety of meals and flours
Factory farm raised meat, fish, or eggs
Added ingredients designed to increase protein content, alter cooking and
baking properties, or add other attributes to a given food product.
Factory Farm Raised Meat Genetically modified to grow rapidly
Fed with GMO grain
Given growth hormone
Prophylactic antibiotics-given to all
Lower in omega-3 fatty-acids, vitamin E, beta-carotene, antioxidants and
conjugated linoleic acid, or CLA.
Food & The Gut Microbiome Estimated over 100 trillion bacteria in the intestinal tract (10X the number of
human cells)
Gut flora (bacteria, fungi, viruses, and parasites) play a very prominent role in human immunity, digestion, vitamin production, absorption, hunger, and neurologic processes
Gut flora can send impulses through the vagus nerve to the brain and influence behavior, hunger, mood. E.g. candidal overgrowth can send impulses to the brain that cause carbohydrate and sugar cravings...contributing to obesity
What Factors Can Alter the Gut Flora? Genetically modified foods
Meats raised with antibiotics
Antibiotics
High carb/high sugar diets
Artificial sweeteners
Stress
What can be done? Limit antibiotic use to when it is absolutely necessary
Avoid the factors mentioned in the previous slide
Intake of prebiotics, probiotics, fermented foods
Misguided Food Policy/ Guidelines There has been a war on fat that many obesity specialists believe has
actually spearheaded the obesity epidemic
This war is not based on actual science, but on "common sense" and
"consensus"
The origin of the 'fat phobia' lies in an experiment conducted in Russia in
1910 in which they fed rabbits high fat/cholesterol diets and noticed that
there was an increase in atherosclerosis over the controls
FLAW?- rabbits are herbivores!!!
My only take-home from this study is that if you feed any animal (including
humans) a diet that they are not genetically adapted to, there will be
problems
Ancel Keys, PhD-Physiologist in the
1950's Heavily promoted his theory that dietary fat led to hyperlipidemia which led to
heart disease
Had strong influence among the politicians of the day
Viciously discredited/maligned anyone who disagreed with him
His theory contributed in large part to the drafting of the low fat food policy that was adopted worldwide
The problem with Ancel Keys Theory Not based on solid scientific evidence
Based on his "7 Countries Study"… he actually studied 22 countries!
The fact is that dietary cholesterol has very little influence on serum cholesterol levels
The fact is that dietary fat is NOT the primary driver of obesity
Courtesy of the Journal of Food and Nutrition Research 2016. Food consumption and the actual statistics of
cardiovascular diseases: an epidemiological comparison of 42 European countries
Courtesy of the Journal of Food and Nutrition Research 2016. Food consumption and the actual statistics of
cardiovascular diseases: an epidemiological comparison of 42 European countries
Ghana's Burden of Chronic Non-Communicable Diseases: Future
Directions in Research, Practice and Policy. GMJ.
A de-Graft Aikins et. al
Chronic NCDs contribute significantly to the nation's disease burden. They
constitute both a public health and a developmental issue that should be of
urgent concern not only for the Ministry of Health, but also for the Government of
Ghana.
The government needs to give high priority to policies and funded programs for
the prevention and control of chronic diseases.
Public-private partnerships with the pharmaceutical industry should aim to
ensure availability, affordability and accessibility of low-cost generic drugs for the
management of chronic diseases. Researchers need to focus efforts on
implementation research questions relevant to Ghana.
Thank You!