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“Healthy” Western Diet and Lifestyle: A Recipe for Chronic Disease

Institute for Food Safety and Health. “Healthy” Western Diet and Lifestyle: A Recipe for Chronic Disease. Indika Edirisinghe. PhD iedirisi@iit.edu. Obesity Trends* Among U.S. Adults 1990, 2000, 2010. (*BMI  30, or about 30 lbs. overweight for 5’4” person). 2000. 1990. 2010.

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“Healthy” Western Diet and Lifestyle: A Recipe for Chronic Disease

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  1. Institute for Food Safety and Health “Healthy” Western Diet and Lifestyle: A Recipe for Chronic Disease IndikaEdirisinghe. PhD iedirisi@iit.edu

  2. Obesity Trends* Among U.S. Adults1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2000 1990 2010 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  3. Public health issues change…. • Leading causes of death today vs. early 1900?

  4. Diet – Disease Relationship Making Nutrition vital to the health of individuals and our society

  5. W H Y C A R E ? 30% >65% of deaths related to diet 3% 23% 7%

  6. Obesity Facts- USA The United States has the highest obesity rate in the world. Approximately 72.5 million American adults are obese. The US is also the biggest Big Mac consumer in the world. Obesity is expensive to treat. The total excess cost related to the current prevalence of adolescent overweight and obesity is estimated to be $254 billion. If current trends in the growth of obesity continue, total healthcare costs attributable to obesity could reach $861 to $957 billion by 2030.

  7. Obesity Facts- USA Obesity is one of the factors causing heart disease, stroke, and diabetes. Obese people are doing something the Obama administration can’t do: Creating well paying healthcare jobs by eating themselves to death. Lipitor maker Pfizer - Top diabetes drug maker McDonalds (MCD) owe a big thank you to obese people! 

  8. Factors affecting chronic disease mortalityA Global Issue Poor Dietary choices • Chronic • Diseases • Diabetes • Vascular disease • Hypertension • Some cancers • Pro-disease states • Oxidative Stress • Inflammation • Endothelial dysfunction • ThrombosisObesity Genetics Proteomics Metabolomics Microbiomics Sedentary Lifestyle

  9. Modern/Sedentary Lifestyle Obesity Western Diet/Meals Life style modification Dietary Strategies OXIDATIVE STRESS and INFLAMMATION • CRP • CRP • oxLDL • oxLDL • Thrombotic • Factors • Thrombotic • Factors  Insulin Resistant  NO  NO insulin glucose Endothelial Dysfunction Endothelial Dysfunction Insulin Resistance IRS-1 Disease and Disease Complications Metabolic Syndrome, Atherosclerosis, Diabetes, Hypertension, Stroke

  10. Modern Diet/Lifestyle Energy dense, Nutrient Poor High Fat, Sugar, Energy Reactive Oxygen Species (ROS) Metabolic Oxidative Stress Stimulates Inflammatory genes IL-6, IL-1, TNF alpha, MCP-1, PGs, LTs INFLAMMATION

  11. Technology development and it’s association with Obesity from 1990-2010

  12. Economy 1990-2010

  13. Serving sizes 20 Years ago 20 Years ago

  14. Serving sizes Yesterday- Today – Tomorrow ??

  15. Energy Balance • Excess energy is stored as fat- Fat is used for energy between meals • 1 pound of fat = 3500 kcalories Energy balance = Energy intake - Energy expenditure

  16. A shift in balance causes weight changes – Possible out comes …..?? Energy consumes > Energy expenditure - Positive energy balance Energy consumes < Energy expenditure - Negative energy balance Energy consumes = Energy expenditure – Neutral energy balance

  17. Energy consumes < Energy expenditure - Negative energy balance Energy consumes > Energy expenditure - Positive energy balance

  18. What Is a Healthful Body Weight? A healthful weight • Is appropriate for your age • Is maintained without constant dieting • Is acceptable to you • Is based on family history of body shape and weight • Promotes good eating habits and allows for regular physical activity

  19. What Is a Healthful Body Weight? Underweight: having too little body fat to maintain health Overweight: having a moderate amount of excess body fat

  20. What Is a Healthful Body Weight? Obesity: having an excess of body fat that adversely affects health Morbid obesity: body weight exceeding 100% of normal, creating a very high risk for serious health complications

  21. Fat Cell Development • Energy in exceeds energy out • Stored in fat cells of adipose tissue • Body fat • Number and size of fat cells • Periods in life when fat cell numbers increase • Cell proliferation • Energy out exceeds energy in • Fat cell size decreases; no change in number

  22. Fat Cell Development During growth, fat cells increase in number. When energy intake exceeds expenditure, fat cells increase in size. When fat cells have enlarged and energy intake continues to exceed energy expenditure, fat cells increase in number again. With fat loss, the size of the fat cells shrinks but not the number.

  23. Fat Cell Metabolism • Lipoprotein lipase (LPL) activity • Storage of triglycerides • Obese people vs. lean people • Activity in varying body regions • Men vs. women • Enzyme activity releasing and breaking down fat • Fat oxidation is not efficient

  24. Causes of Overweight & Obesity – Genetics & Epigenetics • Causative role of genetics • Genetic influences do seem to be involved • Genetics may determine predisposition to obesity • Genes interact with: • Diet and physical activity • Satiety and energy balance

  25. Causes of Overweight & Obesity – Genetics & Epigenetics • Obesity gene • Codes for the protein leptin • Acts as a hormone in hypothalamus • Promotes negative energy balance • Suppresses appetite • Increases energy expenditure • Locations of leptin secretion- stomach cells/Adipose tissues

  26. Causes of Overweight & Obesity – Environment • Encountered daily circumstances • Interaction between environment and genetics • Overeating • Present and past eating and activity patterns influence current body weight • Availability • Serving sizes • Restaurant food

  27. Body Mass Index (BMI) • Relative weight for height • BMI = weight (kg) height (m)2 • Health-related classifications • Healthy weight: BMI = 18.5 to 24.9 • Other classifications • Not a measure of body composition • Variations

  28. What Is a Healthy Weight? • A person’s health risk is dependent on three factors: • Amount and location of body fat (composition) • Body weight • Current health status (lifestyle, personal and family history etc.) Central Obesity Peripheral obesity

  29. What Is a Healthy Weight? Body Weight versus Body Fat • REAL issue is how much BODY FAT a person has • Measurement of bodyweight includes fat but also bone, muscle, water • Two people of the same sex, age, and height may both weigh the same but have different risk • The difference lies in body composition Men > 25% body fat (12-20% desirable) Women > 33% (20-30% desirable) Distribution of fat is also important

  30. Postprandial State Most People Spend ~12 hours per day in the Postprandial State Midnight Breakfast Breakfast Lunch Dinner Postprandial Post absorptive Fasting

  31. Postprandial State after 1 meal Modern/Western meal induces glucose spikes and prolonged elevation of lipids Oxidative stress Lipid Fatty acid metabolism Pro-inflammatory genes ROS Glucose metabolism Glucose Inflammation meal 8am 11am 2pm 6pm 11pm

  32. Postprandial State Most people spend 12 h a day in the postprandial state meal meal meal 8am 12pm 6pm 12am 8am

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