Prevention of Chronic Disease at Every Stage of Life
February 28, 2009 by rainier
Prospects for healthy ageing are affected by nutrition at every stage of life. A pregnant woman requires adequate nutrition because fetal malnutrition and low birth weight can lead to increased risk of chronic diseases such as hypertension, coronary heart disease, adult onset diabetes and autoimmune thyroid disease . Malnutrition during infancy can also contribute to these consequences. Fetal iodine deficiency and iron deficiency in early childhood can have lasting consequences for cognitive development. The risk of osteoporosis at an older age is strongly influenced by bone density at puberty based on adequacy of calcium and vitamin D intake in childhood and by the adequacy of these nutrients throughout life . Regardless of predisposing factors, dietary and other environmental factors influence morbidity and mortality at every age. Because of the cumulative effect of adverse factors throughout life, it is particularly important for older persons to adopt dietary and lifestyle practices that minimize further risk of ill-health and maximize their prospects for healthy ageing.
Prevention of chronic disease through proper nutrition plays a significant role in each phase of prevention.
• Primary prevention involves risk-factor modification to prevent the occurrence of disease, for example by increasing dietary fibre and reducing animal fat intakes to diminish the incidence of colorectal cancer.
• Secondary prevention involves screening for a disease before it becomes symptomatic, for example routine use of serum cholesterol testing to assess risk of coronary heart disease (CHD) combined with appropriate follow-up intervention, for example decreasing intake of animal fats or increasing intake of plant foods.
• Tertiary prevention involves treating and minimizing the complications of a disease once it has occurred, for example reducing the risk for a future coronary event by eating fish weekly and increasing intake of antioxidant sources, including larger quantities of a particular variety of fruits and vegetables and possibly antioxidant supplements.
While nutritional interventions have been shown to be effective in terms of primary and secondary prevention, changes in dietary patterns early in life are likely to be even more beneficial. As a first step, an individual’s dietary patterns should be identified. Where diagnostic capabilities are available, appropriate and affordable, a health practitioner can also identify early features of chronic disease and offer nutritional advice and support, for example for older adults with abdominal obesity, glucose intolerance, hypertension or dyslipidaemias. As awareness of preventive nutrition measures increases, premature deaths related to chronic diseases should decrease. The leading causes of death associated with diet include coronary heart disease, stroke, cancer, diabetes, influenza and other infectious diseases. Furthermore, alcohol consumption is strongly associated with suicide, accidental injury and chronic liver disease. Several other diseases derived substantially from lifestyle factors contribute significantly to morbidity and mortality and are indirectly linked to nutrition. For example, obesity aggravates chronic obstructive pulmonary diseases such as chronic bronchitis, and emphysema induced by smoking and air pollutants. Moreover, these patients are often malnourished, further promoting decline of pulmonary function and increasing mortality.
The rising prevalence of chronic diseases in ageing populations is a substantial burden not only for health care systems but also for social and family structures due to dependency resulting from osteoporotic fractures, visual impairment, arthritic immobility and vascular or other dementias. Scientific advances are gradually uncovering nutritional components of many of these problems.
