Preventing NCDs: Where to Apply Resources?
Want to stay healthy and active into your 80’s? Of course the answer is yes. Researchers say it can be accomplished by promoting behaviors that prevent molecular and metabolic dysfunction. In other words, adopting healthy nutrition and physical activity behaviors.
Inflammation is a normal defensive response to infection and injury. Chronic, low-grade inflammation is believed to contribute to the development of several non-communicable diseases (NCD), especially obesity, type 2 diabetes and cardiovascular diseases. Nutrients can help modulate the magnitude of the inflammatory response. Vitamins A and B6 have anti-inflammatory potential. Increasing the amount of omega-3 fatty acids (relative to omega-6 polyunsaturated and saturated fatty acids) in the diet can suppress production of pro-inflammatory signaling molecules.
Labonte and colleagues measured red blood cell (RBC) membrane fatty acid concentrations in a cross-sectional sampling of 744 native Canadians living in northern Quebec. They report that almost half of the population had elevated C-reactive protein concentrations (CRP > 3.0 mg/L). The prevalence was higher in those with high waist circumference (vs normal) and metabolic syndrome (vs none). Age was not a factor. RBC omega-3 fatty acid docosapentaenoic acid (DPA) quartiles were inversely correlated with CRP concentrations.
Non-alcoholic fatty liver disease (NAFLD) has been described as the natural history of affluent life. This description could also be applied to obesity and related chronic diseases. With 20 to 40% of Western populations having NAFLD and a prevalence approaching 75% among obese or individuals with diabetes, medical research needs to overcome its obsession with curative medicine to focus on prevention science.
Chronic disease prevention is at a tipping point. More nutritional assessments will help identify populations with nutrient deficiencies or excesses. New imaging and minimally invasive assessment techniques will drive down costs and increase consumer acceptance. Maps (like today's image) will help visualize prevalence and where subpopulations at risk are found. With data, regions can be prioritized to receive resources to initiate programs and change behaviors to prevent chronic diseases .
Fontana L, Kennedy BK, Longo VD, Seals D, Melov S. Medical research: Treat ageing. 2014 Nature doi: 10.1038/511405a
Labonte ME, Dewailly E, Lucas M, Couture P, Lamarche B. Association of red blood cell n-3 polyunsaturated fatty acids with plasma inflammatory biomarkers among the Quebec Cree population. 2014 Eur J Clin Nutr doi: 10.1038/ejcn.2014.125
Calder PC. n-3 fatty acids, inflammation and immunity: new mechanisms to explain old actions. 2013 Proc Nutr Soc doi: 10.1017/S0029665113001031
Burch D, Does diagnosing fatty liver and chronic kidney disease do more good than harm? 2014 PLoS Med doi: 10.1371/journal.pemed.1001681
Yach D, Calitz C. New opportunities in the changing landscape of prevention. 2014 JAMA doi: 10.1001/jama.2014.8900