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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
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1985

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

obesity trends among u s adults brfss 1986
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1986

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

obesity trends among u s adults brfss 1987
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1987

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

obesity trends among u s adults brfss 1988
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1988

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

obesity trends among u s adults brfss 1989
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1989

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

obesity trends among u s adults brfss 1990
No Data <10% 10%–14%Obesity Trends* Among U.S. AdultsBRFSS, 1990

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

obesity trends among u s adults brfss 1991
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1991

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

obesity trends among u s adults brfss 1992
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1992

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

obesity trends among u s adults brfss 1993
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1993

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

obesity trends among u s adults brfss 1994
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1994

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

obesity trends among u s adults brfss 1995
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1995

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

obesity trends among u s adults brfss 1996
No Data <10% 10%–14% 15%–19%Obesity Trends* Among U.S. AdultsBRFSS, 1996

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

obesity trends among u s adults brfss 1997
No Data <10% 10%–14% 15%–19% ≥20Obesity Trends* Among U.S. AdultsBRFSS, 1997

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

obesity trends among u s adults brfss 1998
No Data <10% 10%–14% 15%–19% ≥20Obesity Trends* Among U.S. AdultsBRFSS, 1998

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

obesity trends among u s adults brfss 1999
No Data <10% 10%–14% 15%–19% ≥20Obesity Trends* Among U.S. AdultsBRFSS, 1999

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

obesity trends among u s adults brfss 2000
No Data <10% 10%–14% 15%–19% ≥20Obesity Trends* Among U.S. AdultsBRFSS, 2000

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

obesity trends among u s adults brfss 2001
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%

slide18
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 adults brfss 2003
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%

percent of adults who are overweight or obese1
Percent of adults who are overweight or obese

65%

2/3 of adults are

overweight or

obese

excess body weight and reduction of lifespan
Excess Body Weight and Reduction of Lifespan

-3.1

-3.3

-5.8

-7.1

Ann Intern Med. 2003;138:24-32

slide27
Diabetes Among Adults in the U.S.,BRFSS 1990

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

slide28
Diabetes Among Adults in the U.S.,BRFSS 1991-92

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

slide29
Diabetes Among Adults in the U.S.,BRFSS 1993-94

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

slide30
Diabetes Among Adults in the U.S.,BRFSS 1995-96

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

slide31
Diabetes Among Adults in the U.S.,BRFSS 1995

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

slide32
Diabetes Among Adults in the U.S.,BRFSS 1997-98

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

slide33
Diabetes Among Adults in the U.S.,BRFSS 1999

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

slide34
Diabetes Among Adults in the U.S.,BRFSS 2000

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

slide35
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
Lifetime Risk of Diabetes for Children Born in 2000

Venkat Narayan, JAMA 2003;290:1884

diabetes and reduction in lifespan
Diabetes and Reduction in Lifespan

-14.3 yrs

-11.6 yrs

JAMA 2003;290:1884-1890

life expectancy in the u s
Life Expectancy in the U.S.

2-5 year decline

in life expectancy

lifetime risk for chronic diseases
Lifetime Risk for Chronic Diseases

NCI Canada, 2.0; Lancet 1999;353:89

slide41
How People Died in 2003

Cancer

24 %

Accidents

Suicide

Infections

Kidney failure

Lung failure

Others…

40%

Cardiovascular

Disease

36%

slide42
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

percent of selected chronic diseases that are likely avoidable
Percent of Selected Chronic Diseases That Are Likely Avoidable

91%

82%

71%

70%

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

slide47
5-a-day =

$1 million

Food Marketing = $25 Billion

lung cancer and vegetable intake
Lung cancer and vegetable intake

Relative risk

Vegetable intake grams/day

Am Inst for Cancer Research, 1997

stomach cancer and vegetable intake
Stomach cancer and vegetable intake

Relative risk

Vegetable intake grams/day

Am Inst for Cancer Research, 1997

stomach cancer and fruit intake
Stomach cancer and fruit intake

Relative risk

Fruit intake grams/day

Am Inst for Cancer Research, 1997

slide68
Free radicals can:
    • Disrupt or destroy cells
    • Damage DNA, lipid membranes, mitochondria, and proteins
    • Disrupt vital functions
cancer deaths by age in 2001
Cancer deaths by age, in 2001

80% of all cancers occur after age 55

where do free radicals come from
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
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
Cancer death and smoking

Relative risk

Number of cigarettes/day

if you are a smoker
If you are a smoker…

-14.5 yrs

-13.2 yrs

MMWR 1997;46:444-51

phytochemicals
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
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
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
low vs high health risks and life expectancy cumulative
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 7 th day adventists
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
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
What Can I Expect if I Reduce My Health Risks?

10 to 20 years of extended, high-quality living

slide87
Compression of Morbidity

Morbidity

Lifespan in years

0

76

Chronic

disability

Ann Intern Med, 2003:139:455-459

slide88
Compression of Morbidity

Morbidity

Lifespan in years

0

76

86

?

Chronic

disability

slide89
Reductions of Near Death Morbidity

Morbidity

Lifespan in years

Morbidity

Lifespan in years

with a healthy lifestyle
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
Randomized Results

www.culpritandcure.com

slide98
Spontaneous or

inherited mutation

Abnormal

cell

Normal

cell

Repair

Carcinogen

Tumor

Metastasis

Cell proliferation

slide99
Spontaneous or

inherited mutation

Abnormal

cell

Normal

cell

Repair

Activated

carcinogen

Tumor

Metastasis

Cell proliferation

slide100
Risk of death by body weight and activity

Risk of CVD/cancer death

Hu, NEJM 2004;352:2694

slide101
Risk of dementia (Alzheimer’s) by risk factors:

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

Risk of dementia

Neurology, 2005,64:277-281

percentage of all trips made from home by walking 1977 1995
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
Modal Travel in Urban Areas:Europe and North America Percent of Trips by Mode

Transportation Quarterly 1997; 51-31

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