Chronic Diseases

Common misconceptions:
- Only affects rich countries; in fact 80% of all chronic diseases are found in
low and middle-income countries.
- Affect rich people; mostly effect poor people.
- Developing countries should control communicable diseases first;
developing countries have a double burden therefore require a double
response.
- Primarily affect old people; almost half people affected are under 70.
- Cant be prevented; significant portions of heart disease, stroke, cancer and
diabetes can be prevented.
The main risk factors for the global burden of disease are:
- Underweight
- Unsafe sex
- High blood pressure
These affect high, middle and low- Tobacco
income countries
- Alcohol
British doctors study discovered link between smoking and decreased life
expectancy.
Obesity
BMI = Weight/(Height)^2
The NZ burden of obesity study set out to:
- Estimate burden of mortality in 1997, due to higher than optimal BMI.
- Estimate mortality that could be avoided by feasible changes in mean
population BMI by 2011.
The study was restricted to deaths because the data is simple and easily available.
The diseases considered were: Diabetes, Cancers, Stroke and IHD.
-It was found that obesity was a major cause of mortality due to diabetes and IHD.
The data from the study was used to set up 2 different scenarios:
1) Business As Usual Predicted change in burden of obesity based on historical
trends.
2) Intervention Predicts the change in burden of obesity if known interventions
are used.
The study found:
- High BMI is a major modifiable cause of premature death in New Zealand.
- About 400 lives could be saved with moderate interventions that slow increase
of BMI.
Determinants of obesity
-Genetic
Difficult to modify
-In Utero effects
-Adverse environment and energy imbalance. (Diet and Exercise).

Prevention Strategies
Diet
-

Policies to bring healthier food

products in food industry.
School lunches modified
Regulate fast food advertisements
Reduction in portion size
Food labelling with ingredients
Food taxes and subsidies

Physical Activity
- Access to cycling lanes.
- Walking school buses
- Increase access to recreational
facilities
- Increased parking fees
- Increased PE in schools
- Fun runs and community events