Chronic Disease Chronic diseases and conditions—such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems. As of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One in four adults had two or more chronic health conditions. Health risk behaviors are unhealthy behaviors you can change. Four of these health risk behaviors—lack of exercise or physical activity, poor nutrition, tobacco use, and drinking too much alcohol—cause much of the illness, suffering, and early death related to chronic diseases and conditions. https://www.cdc.gov/chronicdisease/overview/index.htm All graphics in this resource have been attributed CC0 1.0 Universal (CC0 1.0) Public Domain Dedication, waiving all of his/her rights to the work worldwide under copyright law.

Leading Causes of Death in 2015 Which of these are diet-related? Heart disease (#1 cause of death) Cancer (#2 cause of death) Stroke (#5 cause of death) Diabetes mellitus (#7 cause of death) = 53.5% of all deaths in the US, 2015 About half of all American adults—117 million individuals—have one or more preventable chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. These include cardiovascular disease, high blood pressure, type 2 diabetes, some cancers, and poor bone health. More than two-thirds of adults and nearly one-third of children and youth are overweight or obese. These high rates of overweight and obesity and chronic disease have persisted for more than two decades and come not only with increased health risks, but also at high cost. In 2008, the medical costs associated with obesity were estimated to be $147 billion. In 2012, the total estimated cost of diagnosed diabetes was $245 billion. https://health.gov/dietaryguidelines/2015/guidelines/introduction/nutrition-and-health-are-closely-related/ SOURCE: NCHS, Health, United States, 2016, Figure 8. Data from the National Vital Statistics System (NVSS).

Relationships between OBESITY STROKE & HEART ATTACK HYPERTENSION DIABETES ATHEROSCLEROSIS GALLBLADDER DISEASE SOME CANCERS Relationships between Chronic Diseases Having one chronic disease is often a risk factor for other chronic diseases. When one person has two or more chronic conditions at the same time, it is called “comorbidity”. When the risk factors for one chronic disease are reduced through healthy diet, the risk for several other chronic diseases is likely reduced as well.

RISK FACTORS X CANCER HYPER-TENSION TYPE 2 DIABETES OSTEO- POROSIS ATHERO-SCLEROSIS OBESITY STROKE Diet high in fat, saturated fat, trans fat X Excessive alcohol intake Low fiber intake Low vitamin & mineral intake High sugar intake High salt or pickled foods intake Genetics Age Sedentary lifestyle Smoking Stress Environmental factors Chronic disease diet risk factors (in light blue) are interrelated. Heart disease, diabetes, obesity, cancers, stroke, and gastrointestinal diseases are affected by a diet high in fat, saturated fat, and/or trans fats. At-risk diets are also low in complex carbohydrates and fiber as well as low in vitamin and mineral intake. Other risk factors include genetics, age, a sedentary lifestyle, smoking, and stress.

Cardiovascular Heart Disease (CHD) ATHEROSCLEROSIS cholesterol deposits (PLAQUE) that can clog the arteries, leading to heart attacks & stroke Possible causes: high cholesterol, smoking, hypertension - See how atherosclerosis works in the Interactive Cardiovascular Library: https://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=athero HYPERTENSION High blood pressure (force of blood flowing through vessels) Risk factor for heart attacks & stroke Often comorbid with obesity, diabetes, high cholesterol Can be caused by excess sodium in diet HEART ATTACK Blood flow (carrying oxygen) to heart muscle is severely reduced or cut off completely STROKE Blood clots in artery, cutting off oxygen to brain The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease. Many forms of heart disease can be prevented or treated with healthy lifestyle choices. Risk factors for developing heart disease include: Aging increases your risk of damaged and narrowed arteries and weakened or thickened heart muscle. Men are generally at greater risk of heart disease. However, women's risk increases after menopause. A family history of heart disease increases your risk of coronary artery disease, especially if a parent developed it at an early age. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. Heart attacks are more common in smokers than in nonsmokers. A diet that's high in fat, salt, sugar and cholesterol can contribute to the development of heart disease. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the vessels through which blood flows. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis. Diabetes increases your risk of heart disease. Both conditions share similar risk factors, such as obesity and high blood pressure. Excess weight typically worsens other risk factors. Lack of exercise also is associated with many forms of heart disease and some of its other risk factors, as well. Unrelieved stress may damage your arteries and worsen other risk factors for heart disease. Not regularly washing your hands and not establishing other habits that can help prevent viral or bacterial infections can put you at risk of heart infections, especially if you already have an underlying heart condition. Poor dental health also may contribute to heart disease. Caused by: Stroke – Blood clots in the a artery and cuts off oxygen to the brain Heart Attack - Blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely Hypertension – Blood pressure higher than 140 over 90 mmHg https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118

Types of Diabetes Type 1 Diabetes Type 2 Diabetes Gestational Diabetes Results from the body’s failure to produce insulin; insulin injections required Type 2 Diabetes Pancreas doesn’t produce enough insulin to control glucose levels OR cells don’t respond to insulin Gestational Diabetes Occurs when pregnant woman’s body does not secrete extra insulin required, leading to increased blood sugar levels Type 1 diabetes, your body can’t make its own insulin through the pancreas. You’ll need to take insulin to help your body use the sugar in your blood. You can also help to keep your blood sugar level in a healthy range with proper diet and exercise. Type 2 diabetes, the most common type of diabetes, is a disease that occurs when your blood glucose, is too high. Blood glucose is your main source of energy and comes mainly from the food you eat. Insulin is a hormone made by the pancreas, which helps glucose get into your cells to be used for energy. Cells often do not recognize the insulin in the body due to being overweight and is referred to as being insulin resistant. Gestational diabetes occur during pregnancy where the placenta secretes a hormone that builds sugar in your blood and the pancreas cannot make enough insulin. Once the baby is born the woman does not have diabetes. https://medlineplus.gov/diabetes.html

Obesity More than 1/3 (36.5%) of US adults have obesity Obesity-related conditions include: heart disease Stroke Type 2 diabetes certain types of cancer The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 That's more than 78 million people — more than the populations of Spain, Italy and the United Kingdom. Add the number of adult Americans who are overweight to that figure and the statistic is staggering: More than two-thirds of the population are not at a healthy weight. Source for Map: Source: Behavioral Risk Factor Surveillance System, 2016 *Sample size <50 or the relative standard error (dividing the standard error by the prevalence) ≥ 30%

Cancer and Nutrition To reduce the risk of cancer: Maintain a healthy weight Eat a variety of vegetables, fruits, whole grains, and legumes Limit calorie dense foods Limit processed meats Consume less salt The general guidelines that can help reduce your risk of cancer are to: Keep a healthy weight, limit calorie-dense, nutrient deficient foods, eat vegetables, fruits, whole grains and legumes. Eat moderate meat portions. Limit alcohol. Consume less salt. Nutrition guidelines for cancer prevention are similar to those for preventing other diseases such as heart disease and diabetes.

Gastrointestinal Disorders Irritable bowel syndrome (IBS) Crohn’s Disease Bowel Control Problems Gas Lactose intolerance Diarrhea Diverticulosis and Diverticulitis Acid Reflux (GER & GERD) https://www.crohnsandcolitis.com/crohns https://www.mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758 https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940 The primary causes for gastrointestinal disorders include: Eating a diet low in fiber and eating a diet high in fat not enough physical activity not enough fluid consumption stress Eating large amounts of dairy products Resisting the urge to have a bowel movement, possibly due to pain from hemorrhoids Overusing laxatives (stool softeners) that, over time, weaken the bowel muscles Taking antacid medicines containing calcium or aluminum Taking certain medicines (especially antidepressants, iron pills, and strong pain medicines such as narcotics) Being pregnant

Celiac Disease Estimated to affect 1 in 100 people worldwide Celiac disease is a serious genetic autoimmune disorder where the ingestion of gluten leads to damage in the small intestine Estimated to affect 1 in 100 people worldwide  2.5 million Americans are undiagnosed and are at risk for long-term health complications Intolerance to gluten (wheat, rye, barley) Gluten = general name for storage protein (prolamins) found in these grains An autoimmune condition triggered and sustained by the ingestion of gluten in genetically predisposed individuals Causes an inflammatory damage of the mucosa of the small intestine with resulting malabsorption of nutrients Many people who avoid gluten for health or weight loss purposes do not have an official diagnosis of celiac disease.