The Alchemy of Nutrition and Environment to Age with Grace and Tranquility
Getting older is only better than the alternative. Everyone’s goal is to age, surrounded by family and friends, in the best of health until the last day. The chances of the ideal scenario depend upon genetics, environment, nutrition and sometimes luck. The 6 leading risk factors for non-communicable diseases (NCD) globally are high blood pressure, tobacco smoking (including second-hand smoke), household air pollution, diet low in fruits, alcohol use, and high body-mass index.
To reduce premature mortality from NCD, targets have been set for tobacco and alcohol use, salt intake, obesity, and raised blood pressure and glucose. Using data collected from 16,721 persons living in Switzerland between 1977 and 1993, Martin-Diener and colleagues evaluated the impact of 4 risk factors (smoking status, alcohol consumption, physical activity and diet - measured by ‘no reported fruit consumption’) on mortality over 31 years of follow-up. Living an unhealthy lifestyle significantly increased the risk of dying after 65y of age. Combining 4 risk factors increased all-cause mortality 2.5 fold. The risk was greatest in those over 75y.
The most common triad of conditions in the US is hypertension, hypercholesterolemia and heart disease – all nutrition-related. Economic assessments show that improving nutrient status (omega-3s, B vitamins, dietary fiber, chromium, lutein & zeaxanthin, calcium & vitamin D, and magnesium) can help reduce the risk of nutrition-related health care expenses. Because of low fiber intake, if only 50% of the adult US population increased dietary fiber intake by 3 g/d, the annual medical cost savings would exceed $2 billion. Imagine the reduced strain which could be achieved just by adding fiber!
Those living in the US are fortunate to have good air quality with low levels of particulate matter. This isn’t always the case (see today’s photo from China). Unfortunately, millions of Americans are deficient in vitamins A, C, D, E, B6, B12, folate, and iron (CDC Report, Fig 1). Untold many more millions have suboptimal nutrient status.
The US spends more than its OECD peers on health-care. Governments can help create environments supportive of long-term health but ultimately the choice is individual. People choose their lifestyle. And live with the consequences of these choices. Poor health may be mitigated by medicines but quality and longevity of life depend upon how we treat our bodies.
Beaglehole R, Bonita R, Ezzati M, Alleyne G, Dain K, Kishore SP, Horton R. NCD countdown 2025: accountability for the 25 x 25 NCD mortality reduction target. 2014 Lancet doi: 10.1016/S0140-6736(14)61091-6
Lim SS et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. 2012 Lancet doi: 10.1016/S0140-6736(12)61766-8
Martin-Diener E, Meyer J, Braun J, Tarnutzer S, Faeh D, Rohmann S, Martin BW. The combined factors on survival of four main behavioural risk factors for non-communicable diseases. 2014 Prev Med doi: 10.1016/j.ypmed.2014.05.023
Bauer UE, Briss PA, Goodman RA, Bowman BA. Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. 2014 Lancet doi: 10.1016/S0140-6736(14)60648-6
Shanahan C, de Lorimer R. Smart Prevention – Health Care Cost Savings Resulting from the Targeted use of Dietary Supplements: An economic case for promoting increased intake of key dietary supplements as a means to combat unsustainable health care cost growth in the United States. Frost & Sullivan and CRN Foundation, 2014.
Mobley AR, Miller Jones J, Rodriguez J, Slavin J, Zelman KM. Identifying practical solutions to meet America’s fiber needs: Proceedings from the Food & Fiber Summit. 2014 Nutrients doi: 10.3390/nu6072540
Lorenzoni L, Belloni , Sassi F. Health-care expenditure and health policy in the USA versus other high-spending OECD countries. 2014 Lancet doi: 10.1016/S0140-6736(14)60571-7