Chapter

Diseases of overnourished societies and the need for dietary change

J.I. Mann and A.S. Truswell

in Oxford Textbook of Medicine

Fifth edition

Published on behalf of Oxford University Press

Published in print May 2010 | ISBN: 9780199204854
Published online May 2010 | e-ISBN: 9780199570973 | DOI: http://dx.doi.org/10.1093/med/9780199204854.003.1104

Series: Oxford Textbooks

Diseases of overnourished societies and the need for dietary change

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The nutritional problems of a country depend more upon the stage of technical and economic development than geographical location. People in affluent societies do not have to worry about the problems of getting food and keeping it uninfected. Food is cheap for them, and they can eat their favourite foods all year round: the diet is energy-dense, high in fat and often also in sugar. There are multiple sources of nutritional advice and concerns, with breakthroughs and scares, science and pseudoscience, about all food. Nutrition related disorders are the principal causes of death and serious morbidity and reliable advice regarding nutrition is an important component of the care of individuals and public health.

Obesity (see Chapter 11.5) is the most obvious and important nutritional disease in affluent societies, with comorbidities including type 2 diabetes, coronary heart disease, hypertension, some cancers, gallstones, osteoarthritis, and obstructive sleep apnoea. Obese people may also be disadvantaged by social, economic, and psychological effects. Particular dietary constituents promote or protect against coronary heart disease by their effect on cardiovascular risk factors, and some promote or protect against various cancers.

While those at the highest personal risk are likely to show the greatest individual benefit from dietary and lifestyle changes, rates of many chronic disease will best be reduced if changes are made by the population at large. The main purpose of such recommendations is to reduce the risk of morbidity and mortality from these disease in those who are in the prime of life. Even greater reduction in morbidity and mortality and an improvement in life expectancy may occur in succeeding generations if they have reduced lifetime exposure to risk factors related to lifestyle.

Dietary guidelines for which there is almost complete agreement are: ◆ Eat a nutritionally adequate diet composed of a variety of foods. ◆ Ensure a low intake of saturated (less than 10% total energy) and trans unsaturated (less than 1% total energy) fats. Goals for total fat intake vary from 15 to 35 % total energy. ◆ Adjust energy balance for body weight control—if necessary fewer energy dense foods which are generally high in fats and or sugar and smaller serving sizes, more exercise. ◆ Eat plenty of wholegrain cereals, vegetables and fruits. ◆ Intake of salt and foods rich in salt should be restricted to a maximum of 100mmol/l day (6gNaCl). ◆ Drink alcohol in moderation (1 to 2 drinks/day), if you do drink.

Chapter.  10538 words. 

Subjects: Dietetics

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