Kína NK. 60.évforduló ünnepsége - China 60th Anniversary, 01 Oct. 2009
A Kína T anulmány
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Transcript of A Kína T anulmány
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A Kína Tanulmány
A legnagyobb epidemiológiai vizsgálat a táplálkozás és a
krónikus betegségek összefüggésében
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Heath Trends since 1950Heath Trends since 1950• Overweight, obesity, NIDDM• Dementias (AD = ‘Type 3 diabetes’)• Hypertension: 25% of US adults (USDA 2000)• Pre-hypertension: 30% of US adults• (AR)MD• Eosinophilic GI disorders; ‘explosive growth’ (Noel
et al ’04)
• Non-tobacco related cancers: 100% increases• lymphoma, leukaemia, melanoma, germ cell
tumours in teens & young adults (NCIC ‘04)
• ADD/ADHD/dysphasia/dyspraxia (U. Washington ’05)
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Rising health costsRising health costs
£ billion 1960 1970 1980 1990 1994
EU 5 17 107 291 410 US 10 31 108 390 617
UK 1 2 13 33 46
WHO 2000WHO 2000
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Rising health costsRising health costs
£ billion 1960 1970 1980 1990 1994
EU 5 17 107 291 410 US 10 31 108 390 617
UK 1 2 13 33 46
% GDP 1960 1970 1980 1990 1994 EU 3.7 5.4 7.2 7.3 7.8 US 5.2 7.3 9.3 12.7 14.3 UK 3.9 4.5 5.6 6.0 6.9
WHO 2000WHO 2000
20062006
19.719.7
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Iatrogenic Deaths (USA)Iatrogenic Deaths (USA)
• Total > 250,000 / year (3rd leading c.o.d)
• 7,000 - medication errors (in hospitals)• 20,000 - other hospital errors• 80,000 - hospital-acquired infections • 106,000 - adverse effects of drugs• 12,000 - unnecessary surgery
Starfield B et al: JAMA 284:483-5 2000
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Reduced energy Reduced energy expenditureexpenditure
1600
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60 65 70 75 80 85 90 95Year
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DoH ’98, USDA ’02, NIH ’03, NCHS ‘04
1940 50 60 70 80
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Obesogenic culture (AHA ’03)
Avge US adult sedentary 8 hours / day, < 2,000 steps / day (NYS Public Health Assocn ‘05)
Amish 16,000 steps /day: obesity 9% women, 0% men (Bassett et al ’04)
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Positive energy balancePositive energy balance
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60 65 70 75 80 85 90 95Year
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DoH ’98, USDA ’02, NIH ’03, NCHS ‘04
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1952
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1952
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2001
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The Western Diet
• High fat & refined carbs• High calorific density• Low micronutrient / calorie ratios Type
B malnutrition
• Foods which are energy-dense & low fibre: do not satiate ‘passive over-eating’ (‘up-sizing’) overweight
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Hardee’s ‘Monster Thickburger’Hardee’s ‘Monster Thickburger’
1420 calories, 107 g fat: $5.491420 calories, 107 g fat: $5.49
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PepsiPepsi
PizzaPizza
Real World Pyramid
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Dietary shift 1950 - 1997Dietary shift 1950 - 1997
• World consumption of calories from meat increased 36%• “ “ calories from vegetable oil increased 46.2% • US & EU “ sugars and starches increased 35%
• World consumption of calories from complex carbohydrates fell 38%
• UK consumption of fresh vegetables fell 24%
• Per capita income closely related to energy availability • In countries where per capita income increased, so did average
caloric consumption • High-income nations derive most energy from sugars and fats –
poorer nations catching up rapidly
(USDA, Worldwatch, FSA, Drewnowski ’77 & ‘03)
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Nutrition in children & AdolescentsNutrition in children & Adolescents
• Most commonly eaten foods: bread, savory snacks, crisps, chips, boiled, mashed and jacket potatoes, biscuits, chocolate confectionery.
• 5 veg / fruit per day: < 50%• 0 fruit per day: 20 - 30%• 0 veg per day: 4%• Dieting: 15% girls, 3% boys
National Diet & Nutrition Survey National Diet & Nutrition Survey 20002000
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DIETARY SHIFTDIETARY SHIFT
• Flavonoids 75%
• Vit C 50-60%
• Omega-3 50%
• Methyl groups 95%
• Carotenoids 40%
• Phospholipids 50% since 1900
• Selenium 50% ” 1960 (UK)
• Prebiotic fiber 50% ” 1960 (Fr)
• Sterols 66% ” 1960 (SA)
since Stone Age
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% Depletion Vitamins% Depletion Vitamins
C E A B1 B2 C E A B1 B2 NiacinNiacin FolateFolate B6 B12 B6 B12------------------------------------------------------------------------------------------------------------------------------------------37 68 55 32 31 27 34 54 1737 68 55 32 31 27 34 54 17%
(USDA 1997)
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Fat - but Fat - but starvingstarving
• W.H.O. ‘02: ‘Globally, overweight greater health problem than underweight.’
• W.H.O./F.A.O ’03: ‘Poor diet the major cause of degenerative disease’.
• U.N. ’06: Overweight but malnourished• 40-60% hospital admissions malnourished (1-3)
• 25-30% malnourished in the community J Nutr Hlth Ageing 3:133-139, ‘99
• > > 3.6 million malnourished in UK (BANT ’07)
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MICRONUTRIENTSMICRONUTRIENTS CALORIESCALORIESMALNUTRITIONMALNUTRITION
TYPE A
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MICRONUTRIENTSMICRONUTRIENTS CALORIESCALORIESMALNUTRITIONMALNUTRITION
TYPE A
TYPE B
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