《慢性病的环境因素分析教材课程》由会员分享，可在线阅读，更多相关《慢性病的环境因素分析教材课程（55页珍藏版）》请在金锄头文库上搜索。
1、Environmental Drivers of Chronic Disease Based on the report Environmental Threats to Healthy Aging by Jill Stein MD, Ted Schettler MD, MPH, Maria Valenti and Ben Rohrer 2010,Greater Boston Physicians for Social Responsibility (www.psr.org/Boston) and The Science and Environmental Health Network (ww
2、w.sehn.org),What We Will Cover,Environmental factors are key drivers of many common chronic diseases Environmental factors alter key biological pathways leading to chronic disease Important environmental determinants of health include: Food system/nutrition and diet Toxic chemicals Built environment
3、 / physical activity Psychological air and water pollution. Industrialized food supply. Destruction of critical natural habitats, stressing ecosystems. Climate change. How we live, eat, work, play and socialize have substantially changed: Built environments have increased social isolation for many p
4、eople; reduced physical activity. Growing income gap increases disease risk. Diseases of civilization - obesity, diabetes, cardiovascular disease, hypertension.,Profound Public Health Impact Of Environmentally-Driven Western Disease Cluster,Obesity/overweight 2/3 US adults, prevalence x2 in 25 yrs h
5、ttp:/www.cdc.gov/chronicdisease/resources/publications/AAG/obesity.htm Pre/Diabetes 40% US adults, prevalence DM x2 over 20 yrs Cowie 09, http:/apps.nccd.cdc.gov/DDTSTRS/default.aspx Cardiovascular disease still leading cause of death. Hypertension increasing. http:/www.cdc.gov/nchs/FASTATS/lcod.htm
6、, Hajjar 03 Metabolic syndrome = early signs of other cluster diseases; 35% adults, 55%60 yrs Ford ES 05 Alzheimers disease 84 yrs old, 5.3M Alzheimers Assoc.,Alzheimers Disease/dementia,Not an inevitable feature of normal aging. Progressive impairment of memory and multiple other cognitive function
7、s, severe enough to interfere with daily functioning. Expected to triple by mid-century to over 13 million. Likely caused by varying combinations of genetic and environmental factors. Annual costs in US over $150 billion.,Parkinsons Disease,Progressive movement disorder that includes tremors, stiffn
8、ess, and slow movement. May lead to severe disability. Likely caused by variable combinations of genetic and environmental factors. About 50,000 new cases annually in US.* Prevalence in US expected to double by 2030.*,* Due to the lack of registries and baseline data on Parkinsons Disease, the figur
9、es used here are estimates.,Alzheimers and Parkinsons Diseases,Characterized by: abnormal protein deposits chronic inflammation abnormal oxidative stress Many neuroscientists are beginning to think of some neurodegenerative diseases along a continuum, without clearly distinct boundaries in clinical
10、or pathological manifestations,Continuum of Age-Associated Cognitive Impairment,Environment Drives Chronic Disease,Early life experiences can influence later-life health and disease. Multiple factors interact to influence health 115-126.,Insulin Signaling = Normal Metabolism,Disrupted Insulin Signal
11、ing = Inflammatory Metabolism,Altered Pathways,Environment Drives Chronic Disease,Environmental Factors,Chronic Disease,Food System/Diet,Novel Nutrients Are Pervasive, Promote Inflammatory Metabolism,Whats “Novel” in the Western Diet?,“Hypothetical scheme of fat, fatty acid (6, 3, trans and total) i
12、ntake (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 AP Simopoulos, The
13、 importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine Sept. 19, 2007,Sustainable Food & Transportation Solutions: The Cuba Example,Green Space Reduces Stress, Mortality, Improves Cognitive Function,Shortens post surgical recovery time, reduces need for pain medications. Ulri
14、ch 84 Attention deficits improve after a walk in the park. Effect = methylphenidate. Taylor 08 Access to green space reduces the effect of poverty on mortality by 50%. Mitchell 08,Environmental Factors Disrupt Insulin Signaling, Drive Inflammatory Metabolism,Obesity,Endocrine Disruptors - BPA, dioxi
15、ns, PCBs, some pesticides,Inactivity,Saturated fat,High Glycemic Carbohydrates,Air Pollution,Antioxidants,Lead, other heavy metals,Some Pesticides,Altered Pathways,Environment Drives Chronic Disease,Environmental Factors,Chronic Disease,Socio-Economic Stress,Depression, poverty, violence, inadequate
16、 health care,Socioeconomic, Psychosocial Stressors,Stress, depression risk for CVD, AD Sesso, Kario, Ownby People with lower SE status are at risk for exposure to multiple environmental hazards damage. Lead + stress cognitive impairment Glass 2009 Lead + air pollution CV autonomic dysfunction Park 2008,People who live in neighborhoods that lack social cohesion, sidewalks, or safety limit their exerc
