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Global Health BSc 2018/19 - CDMM2 > Nutrition - 2.15-2.19 > Flashcards

Nutrition - 2.15-2.19 Flashcards

1
Q

What is the epidemiology of obesity?

A

2.1 billion are overweight/obese BUT 850 million are hungry due to malnutrition
A greater proportion of women are overweight

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2
Q

What is double burden?

A

Famine and obesity coexist in a country e.g. India

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3
Q

What should be noted about what multinational food companies want?

A

Prioritize profit not public health

Market has somewhat saturated in HICs so have moved to LMICs

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4
Q

What do multinational food companies undermine?

A 
Culture
Meals
Family
Community life
Local economies
National identities
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5
Q

How does the food industry influence nutrition and health?

A

Hyperpalatable foods - stimulates neural circuits that are similar to drug addiction
Increased rates of obesity and decreases nutritional quality
Aggressive lobbying of regulators + governments
Tactical targeting of minorities + emerging economies
Undisclosed conflicts of interest
Deceptive marketing to children
TV and internet advertising advocating

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6
Q

What is the definition of nutrition transition?

A

A shift in nutritional consumption and energy expenditure that coincides with economic, demographic and epidemiological changes
Specifically term is used for transition of developing countries from traditional diets high in cereal and fibre to more Western pattern diets high in sugar, fat and animal-source foods
It is population dependent NOT time

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7
Q

Who proposed the nutrition transition?

A

Popkin, 2002

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8
Q

What are the 5 stages in the nutrition transition model?

A

1) Hunter-gatherers
2) Famine
3) Industrialisation
4) NCDs
5) Behavioural change/desired societal

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9
Q

Which stages are most countries in?

A

Most are from stage 3 to 4

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10
Q

Name factors linked to nutrition transition

A

Rising income
Urbanisation - soft drinks
Foreign direct investment
Globalisation + economic development
Global food marketing, emergence of multinational food corporations in developing countries
Technological + transportation advancement
Socioeconomic factors
Psychosocial factors - obesity used to be a sign of wealth

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11
Q

Give an example of a foreign direct investment

A

Mexico’s trade agreement with the US = rapid rise in soft drink consumption
Strong correlate of greater exposure to unhealthy foods

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12
Q

What is the epidemiological transition?

A

Shift from high prevalence of infectious diseases associated with malnutrition + poor environmental sanitation to a pattern of high prevalence of NCDs associated with urban/industrial lifestyles

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13
Q

What is the demographic transition?

A

High mortality + fertility to low mortality + fertility

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14
Q

Name 3 impacts of nutrition transition

A

Increased childhood + adult obesity
Increased risk of NCDs
Unhealthy commodities, their produces + markets that power them are leading risk factors

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15
Q

What is the fattest country in the EU?

A

UK

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16
Q

What are the 4 main types of NCDs that account for 80% of all NCD deaths?

A

CVD
Cancer
Chronic respiratory diseases
Diabetes

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17
Q

Give a case study whereby a country implemented a legislation to combat obesity

A

Mexico 2014 implemented a tax on sugary drinks + junk food OR
UK 2018 Soft drinks industry levy - paid by producers and importers of soft drinks that contain sugars

18
Q

What are the possible solutions to big food industry + nutrition transition? (x3)

A

Individual regulation
Partnerships with industry - make healthier foods + marketing
Public health interventions

19
Q

Give a case study of a HIC that has a low prevalence of obesity

A

South Korea
Much lower prevalence of obesity (5%) than expected for its income level
Implemented large-scale training of housewives in preparing traditional low-fat, high-veg cuisine and strong social marketing

20
Q

What are the different indicators of obesity? (x5)

A

Visceral fat tissue - waist + hip circumference; waist-to-hip ratio
Skinfolds
Calf circumference
Fat mass %

21
Q

What is the global epidemiology of diabetes?

A

Worldwide 422 million have diabetes

Before 2000, DM wasn’t in top 10 GBD but in 2016 was 7th leading cause of death (1.6 million deaths)

22
Q

What are the causes of obesity and T2DM?

A

Western diet (Popkin, 2012) -Increased consumption of animals and less legumes
Obesogenic environment - Urban design (Rundle, 2007); sedentary lifestyle
Food corporations - 80% of US food stores are supermarkets
Inequality + poverty, food security + double burden
Epigenetics - >150 loci associated with T2DM + obesity

23
Q

Who led the study about the urban design?

A

Rundle, 2007
Built environments provide a context in which physical activity + nutritional behaviours occur - can be supportive, inhibitive or neutral towards physical activity + healthy diets

24
Q

Why are there not more effective interventions in place to tackle diabetes and obesity?

A

Conflicts of interest - multinational food corporations are too powerful especially in lobbying in governments

25
Q

Why is blood pressure an important continuous risk factor?

A

Increased risk of IHD in ALL age groups as SBP + DBP increases; Lancet, 2002 showed continuous relationship between BP + IHD risk
Lower BP is good regardless of starting BP or CVD risk

26
Q

What is the epidemiology of hypertension?

A

1.3 billion people affected worldwide, by 2025 1.56 billion

HTN kills 8 million per year

27
Q

What are the health effects of raised blood pressure?

A

Increased risk of IHD

28
Q

What did Ezzati et al. show?

A

High BP caused highest DALY

29
Q

Why is the number of people with raised BP increasing?

A

Change due to change in population size + age structure

Mean BMI is increasing globally in both men and women, Lancet 2016

30
Q

What are the 4 priorities?

A

CVD
Diabetes
COPD
Cancer

31
Q

What is the global impact of the 4 priorities?

A

Account for 87% of all deaths

50% of NCD DALYs

32
Q

What are the 5 priority interventions?

A

Tobacco control
Salt reduction
Improved diets + physical activity
Reduction in hazards

33
Q

Why don’t the interventions work in HICs?

A

Cochrane study showed that multiple risk factor interventions had no statistical significance on the effect of CHD mortality (North Karelia study in Finland)
People will change their lifestyle due to social networks so advertising campaigns won’t have much effect

34
Q

What is the biggest debate regarding the top 4 priorities?

A

Whether or not to include mental health
Mental disorders are strongly associated with many other health conditions + depression associated with worse adherence + prognosis

35
Q

What are the missing causes of NCDs?

A

Infections e.g. HBV, HCV
Occupational exposures e.g. asbestos
Environmental exposures e.g. household from solid fuels, ambient particulates

36
Q

What are the causes of the causes of NCDs?

A 
Urban design
Development
Poverty
Socioeconomic status
Agriculture
37
Q

What are the 3 strands of GH and NCDs?

A

Combating climate change
Sustainable development
Preventing NCDs - smart development choices can reduce pollution/injury which can improve health

38
Q

What is the definition of COPD?

A

Reduction in FEV1/FVC ratio

But there is disagreement as it underestimates the young; overestimates the old

39
Q

Who is COPD more common in?

A

Those aged over 40

Men > women

40
Q

What are the risk factors of COPD?

A 
Genetics
Gender 
Full lung growth failure
Smoking
Hx of TB
41
Q

What is the epidemiology of COPD?

A

3rd most common cause of death - 2013

42
Q

Can household air pollution from solid fuel use explain the burden of COPD in LICs?

A

No - there is no ecological, significant association between COPD and solid fuel use - results are similar in LICs and HICs
An explanation is urgently needed

Global Health BSc 2018/19 - CDMM2 (5 decks)

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