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No Data <10% 10%–14%. Obesity Trends* Among U.S. Adults BRFSS, 1985. (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman). No Data <10% 10%–14%. Obesity Trends* Among U.S. Adults BRFSS, 1986. (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman).

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Obesity Trends* Among U.S. Adults BRFSS, 1985

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No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)


Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity Trends* Among U.S. AdultsBRFSS, 2002

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC


Obesity* Trends Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


History of Weight Control


History of Weight Control


History of Weight Control


Percent of adults who are overweight or obese


Percent of adults who are overweight or obese

65%

2/3 of adults are

overweight or

obese


Excess Body Weight and Reduction of Lifespan

-3.1

-3.3

-5.8

-7.1

Ann Intern Med. 2003;138:24-32


Diabetes Among Adults in the U.S.,BRFSS 1990

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1991-92

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1993-94

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1995-96

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1995

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1997-98

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.


Diabetes Among Adults in the U.S.,BRFSS 1999

Source: Mokdad et al., Diabetes Care 2001;24:412.


Diabetes Among Adults in the U.S.,BRFSS 2000

Source: Mokdad et al., J Am Med Assoc 2001;286:10.


Diabetes Among Adults in the U.S.,BRFSS 2001

Source: Mokdad et al., J Am Med Assoc 2001;286:10.


Lifetime Risk of Diabetes for Children Born in 2000

Venkat Narayan, JAMA 2003;290:1884


Diabetes and Reduction in Lifespan

-14.3 yrs

-11.6 yrs

JAMA 2003;290:1884-1890


Life Expectancy in the U.S.

2-5 year decline

in life expectancy


Lifetime Risk for Chronic Diseases

NCI Canada, 2.0; Lancet 1999;353:89


How People Died in 2003

Cancer

24 %

Accidents

Suicide

Infections

Kidney failure

Lung failure

Others…

40%

Cardiovascular

Disease

36%


How People Died in 2003

CVD

Cancer

Other

Up to 70% of all

causes of death are

lifestyle related and

preventable

The Culprit and The Cure, 2005


National prevalence of lifestyle related health risks

CDC, BRFSS, 2002


Percent of Selected Chronic Diseases That Are Likely Avoidable

91%

82%

71%

70%

Sources: Stampfer, 2000; Platz, 2000; Hu, 2001


How did we get this way?


5-a-day =

$1 million

Food Marketing = $25 Billion


Advertising


Type of Fat and Risk of Coronary Heart Disease

CVD risk

Hu, New Eng J Med1997


347,877 lives


Lung cancer and vegetable intake

Relative risk

Vegetable intake grams/day

Am Inst for Cancer Research, 1997


Stomach cancer and vegetable intake

Relative risk

Vegetable intake grams/day

Am Inst for Cancer Research, 1997


Stomach cancer and fruit intake

Relative risk

Fruit intake grams/day

Am Inst for Cancer Research, 1997


Unpaired Electrons


  • Free radicals can:

    • Disrupt or destroy cells

    • Damage DNA, lipid membranes, mitochondria, and proteins

    • Disrupt vital functions


  • DNA in each cell gets a “hit” from a free radical every 10 seconds

  • Each cell gets 10,000 hits/day


Cancer deaths by age, in 2001

80% of all cancers occur after age 55


Where do free radicals come from?

  • Most are produced by our own bodies

  • UV light

  • burned food

  • toxic chemicals

  • Industrial

  • automobile pollution

  • unknown sources


Cigarette Smoke

One puff of smoke contains:

100,000,000,000,000,000

free radical species

Tobacco is responsible for 31% of all cancers


Cancer death and smoking

Relative risk

Number of cigarettes/day


If you are a smoker…

-14.5 yrs

-13.2 yrs

MMWR 1997;46:444-51


How do we protect our selves?


Carotenoids

Beta-carotene

Lycopene

Lutein

Zeaxanthin

Organosulfurs

Flavinoids

Phytosterols

Alkaloids

Tannins

Saponins

100,000 more we have yet to identify

Phytochemicals


Our Current (Western) Lifestyle

  • Little Physical Activity

  • Red meat

  • Processed meat

  • Butter

  • Potatoes

  • Refined grains

  • High fat dairy foods


Adopt and Maintain A Healthy Lifestyle

  • Learn Why lifestyle is important

  • Learn What a healthy lifestyle is

  • Learn How to maintain good behaviors for life


Difference in Years of Life Between High and Low Health Risk

Frazier, Arch Intern Med. 2001;161:1645


Low vs High Health Risks and Life Expectancy (cumulative)

Age

Frazier et al,Arch Intern Med. 2001;161:1645


Real and Possible Changes in Life Span (7th Day Adventists)

?

?

Fraser et al. Arch Intern Med, 2001;161:1645-1652


Real and Possible Changes in Life Span (Mormon High Priests and wives)

?

?

Mormon High Priests and Wives, Enstrom, UCLA, 1989


What Can I Expect if I Reduce My Health Risks?

10 to 20 years of extended, high-quality living


Compression of Morbidity

Morbidity

Lifespan in years

0

76

Chronic

disability

Ann Intern Med, 2003:139:455-459


Compression of Morbidity

Morbidity

Lifespan in years

0

76

86

?

Chronic

disability


Reductions of Near Death Morbidity

Morbidity

Lifespan in years

Morbidity

Lifespan in years


With a Healthy Lifestyle

  • Life span can increase

  • Chronic disability can be delayed from 7-12 years

  • The amount of near death morbidity is reduced by 75%

  • Health care costs are also dramatically reduced


Randomized Results

www.culpritandcure.com


Wall Thickening with a Western Lifestyle


Spontaneous or

inherited mutation

Abnormal

cell

Normal

cell

Repair

Carcinogen

Tumor

Metastasis

Cell proliferation


Spontaneous or

inherited mutation

Abnormal

cell

Normal

cell

Repair

Activated

carcinogen

Tumor

Metastasis

Cell proliferation


Risk of death by body weight and activity

Risk of CVD/cancer death

Hu, NEJM 2004;352:2694


Risk of dementia (Alzheimer’s) by risk factors:

(high blood pressure, cholesterol, smoking, or diabetes)

Risk of dementia

Neurology, 2005,64:277-281


Percent

9.3%

10

8.5%

9

7.2%

8

7

5.5%

6

5

4

3

2

1977

1983

1990

1995

Percentage of All Trips Made From Home by Walking, 1977 - 1995

1

0


Modal Travel in Urban Areas:Europe and North America Percent of Trips by Mode

Transportation Quarterly 1997; 51-31


CHIP 6 week data


BMI


Systolic Blood Pressure Reductions mm/Hg


Diastolic Blood Pressure Reductions mm/Hg


Total Cholesterol Reductions mg/dl


HDL Cholesterol Reductions mg/dl


LDL Cholesterol Reductions mg/dl


Triglyceride Changes mg/dl


Glucose Reductions mg/dl


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