Textbook of Lifestyle Medicine - Labros S. Sidossis

Скачать книгу

for cancer onset include consumption of tobacco products, excessive alcohol intake, unhealthy body weight, physical inactivity, and certain infections and occupational/environmental chemical exposures.

       Key Point

      The major risk factors for cancer onset include use of tobacco products, excessive alcohol intake, unhealthy body weight, physical inactivity, and certain infections and occupational/environmental chemical exposures.

      Tobacco use accounts for approximately six million deaths on an annual basis. At least 50 of the chemicals contained in tobacco have a well‐established causal effect on cancer development. Tobacco smoking causes malignancies in lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix. Second‐hand smoking can also cause lung cancer. Additionally, smokeless tobacco products, such as oral or chewing tobacco, have been shown to cause oral, esophageal, and pancreatic neoplasms. Interestingly, the majority of smokers globally (i.e., 80% of 1 billion) live in regions of low or middle income.

      There is a dose–response relationship between alcohol intake and cancer development, and the risk of several cancer types is further exacerbated when increased alcohol consumption is combined with smoking. Alcohol use accounted for about 6% of all cancers and 4% of all cancer deaths in the United States in 2020.

      Infection‐related factors, exposure to carcinogens derived from occupational environment or environmental pollution, and ultraviolet and ionized radiation can also increase the risk for developing cancer. Infectious agents such as helicobacter pylori, human papilloma virus (HPV), hepatitis B and C, and Epstein–Barr virus accounted for 20% of cancer cases in 2020, and their prevalence was substantially greater in developing countries. Air, water, and soil contamination with carcinogens plays a role in the total burden of the disease. Contamination of foods with carcinogenic chemicals, such as aflatoxins and dioxins, is another means by which humans are exposed to carcinogens. Exposure to occupational carcinogens mainly affects specific population groups whose working environment incurs exposure to carcinogenic chemicals, such as asbestos. Exposure to ionized and ultraviolet radiation can also aggravate the risk of developing certain types of neoplasms. There is a dose–response relationship between the extent to radiation exposure and risk of carcinogenesis, and a greater risk of cancer onset when the exposure occurs at a young age.

      More than 80% of US health‐care costs are spent in the treatment of preventable chronic diseases and conditions, such as T2DM, obesity, osteoporosis, heart disease, hypertension, stroke, and many types of cancer. Preventing even a small fraction of chronic disease cases could significantly improve people's health and alleviate the pressure on health‐care systems around the world.

       Key Point

      Preventing even a small fraction of chronic disease cases could significantly improve people’s health and alleviate the pressure on health-care systems around the world.

      Take‐Home Messages

       NCDs, also known as chronic diseases, usually have a long duration, and they are the result of a combination of genetic, physiological, environmental, and behavioral factors.

       There are four types of NCDs: CVDs (e.g., heart attacks and stroke), cancers, CRDs (e.g., chronic obstructive pulmonary disease and asthma), and diabetes.

       The genetic predisposition of a disease explains only part of the disease risk, while lifestyle factors such as unhealthy diet, physical inactivity, excessive stress, and environmental factors (e.g., access to health‐care systems) are also key contributors.

       The “globesity” phenomenon has an important contribution to the global incidence of most major NCDs.

       The human body has been programmed to preserve energy, and this has deleterious effects when people are found in an obesogenic environment.

       Exposure to an obesogenic environment affects the onset of T2DM, irrespective of existing genetic factors.

       It has been estimated that up to 50% of cancer incidence is preventable.

      Self‐Assessment Questions

      1 List the types of NCDs.

      2 Which are the main adverse effects of obesity?

      3 Why is the prevalence of obesity rising in modern societies?

      4 Genome‐wide association studies:assess how genes can be modified to combat chronic diseasesexamine similarities in the entire DNA sequence of different people, as regards specific SNPs, and the presence of a certain abnormality across this populationinvestigate interactions between diet and genesinvestigate how people with a certain genetic background respond to different dietary manipulations (e.g., increased saturated fat intake)none of the above

      5 Which of the following are modifiable risk factors for obesity?dietgenesagesexphysical activitystressall of the above

      6 T1DM is characterized by:defects in liver glucose productioninefficient use of insulin from the bodydefective production of insulininability of glucose transportation in the adipose tissuea and bnone of the above

      7 What is T2DM, and how is lifestyle linked to its development?

      8 Which of the following are possible consequences of diabetes?cardiovascular diseaseretinopathykidney failurenerve damageamputation of lower limbsall of the above

      9 Which of the following are CVDs?strokecancerheart failurediabetesischemic heart diseaseasthma

      10 Which are the main contributors to CVDs?

      11 Which are the major risk factors for cancer onset?

      12 Excess alcohol intake increases the risk of malignancies developed in:the lungsthe oral cavitythe brainthe larynxthe liver

      1 American Diabetes Association. (2020). Classification and diagnosis of diabetes: standards of medical care in diabetes–2020. Diabetes Care 43 (Suppl 1): S14–S31.

      2 Anastasiou, C.A., Yannakoulia, M., Pirogianni, V. et al. (2010). Fitness and weight cycling in relation to body fat and insulin sensitivity in normal‐weight young women. J. Am. Diet Assoc. 110 (2): 280–284.

      3 Benjamin, E.J., Muntner, P., Alonso, A. et al. (2019). Heart disease and stroke statistics–2019 update: a report from the American Heart Association. Circulation 139 (10): e56–e528.

      4 Chatterjee, S., Khunti, K., and Davies, M.J. (2017). Type 2 diabetes. Lancet 389 (10085): 2239–2251.

      5 Cooper, C.B., Neufeld, E.V., Dolezal, B.A., and Martin, J.L. (2018). Sleep deprivation and obesity in adults: a brief narrative review. Br. Med. J. Open Sport Exerc. Med. 4 (1): e000392.

      6 Global Burden of Disease Cancer Collaboration Authors. (2019). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability‐adjusted life‐years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 5 (12): 1749–1768.

      7 Hruby, A. and Hu, F.B. (2015). The epidemiology of obesity: a big picture. Pharmacoeconomics 33 (7): 673–689.

      8 Hruby, A., Manson, J.E., Qi, L. et al. (2016). Determinants and consequences of obesity. Am. J. Public Health 106 (9): 1656–1662. doi: 10.2105/AJPH.2016.303326.

      9 Institute for Health Metrics and Evaluation

Скачать книгу