2 results
A life course approach to diet, nutrition and the prevention of chronic diseases
- I Darnton-Hill, C Nishida, WPT James
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- Journal:
- Public Health Nutrition / Volume 7 / Issue 1a / February 2004
- Published online by Cambridge University Press:
- 02 January 2007, pp. 101-121
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- Article
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Objective:
To briefly review the current understanding of the aetiology and prevention of chronic diseases using a life course approach, demonstrating the life-long influences on the development of disease.
Design:A computer search of the relevant literature was done using Medline-‘life cycle’ and ‘nutrition’ and reviewing the articles for relevance in addressing the above objective. Articles from references dated before 1990 were followed up separately. A subsequent search using Clio updated the search and extended it by using ‘life cycle’, ‘nutrition’ and ‘noncommunicable disease’ (NCD), and ‘life course’. Several published and unpublished WHO reports were key in developing the background and arguments.
Setting:International and national public health and nutrition policy development in light of the global epidemic in chronic diseases, and the continuing nutrition, demographic and epidemiological transitions happening in an increasingly globalized world.
Results of review:There is a global epidemic of increasing obesity, diabetes and other chronic NCDs, especially in developing and transitional economies, and in the less affluent within these, and in the developed countries. At the same time, there has been an increase in communities and households that have coincident under- and over-nutrition.
Conclusions:The epidemic will continue to increase and is due to a lifetime of exposures and influences. Genetic predisposition plays an unspecified role, and with programming during fetal life for adult disease contributing to an unknown degree. A global rise in obesity levels is contributing to a particular epidemic of type 2 diabetes as well as other NCDs. Prevention will be the most cost-effective and feasible approach for many countries and should involve three mutually reinforcing strategies throughout life, starting in the antenatal period.
Feast and famine: Socioeconomic disparities in global nutrition and health
- I Darnton-Hill, ET Coyne
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- Journal:
- Public Health Nutrition / Volume 1 / Issue 1 / March 1998
- Published online by Cambridge University Press:
- 01 March 1998, pp. 23-31
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Objective:
To review current information on under- and over-malnutrition and the consequences of socioeconomic disparities on global nutrition and health.
Design:Malnutrition, both under and over, can no longer be addressed without considering global food insecurity, socioeconomic disparity, both globally and nationally, and global cultural, social and epidemiological transitions.
Setting:The economic gap between the more and less affluent nations is growing. At the same time income disparity is growing within most countries, both developed and developing. Concurrently, epidemiological, demographic and nutrition transitions are taking place in many countries.
Results:Fully one-third of young children in the world's low-income countries are stunted because of malnutrition. One-half of all deaths among young children are, in part, a consequence of malnutrition. Forty per cent of women in the developing world suffer from iron deficiency anaemia, a major cause of maternal mortality and low birth weight infants. Despite such worrying trends, there have been significant increases in life expectancy in nearly all countries of the world, and continuing improvements in infant mortality rates. The proportion of children malnourished has generally decreased, although actual numbers have not in sub-Saharan Africa and south Asia. Inequalities are increasing between the richest developed countries and the poorest developing countries. Social inequality is an important factor in differential mortality in both developed and developing countries. Many countries have significant pockets of malnutrition and increased mortality of children, while obesity and non-communicable disease (NCDs) prevalences are increasing. Not infrequently it is the poor and relatively disadvantaged sectors of the population who are suffering both. In the industrialized countries. cardiovascular disease incidence has declined, but less so in the poorer socioeconomic strata.
conclusions:The apparent contradicitions found represent a particular point in time (population responses generally lag behind social and environmental transitions). They do also show encouraging evidence that interventions can have a positive impact, sometimes despite disadvantageous circumstances. However, it seems increasingly unlikely that food production will continue to keep up with population growth. It is also unlikely present goals for reducing protein-energy malnutrition prevalence will be reached. The coexistence of diseases of undernutrition and NCDs will have an impact on allocation of resources. Action needs to be continued and maintained at the international, national and individual level.