Flashcards in Lecture 3 - Metabolic Syndrome & Population Health Deck (16):
Compare 'incidence' and 'prevalence'
Incidence: rate at which new cases occur in a population during a specific period
Prevalence: proportion of people in a specific population with a given disease at a point in time
What is a 'Risk Factor'?
Something that increases one's changes of getting a disease
• Something you do (e.g. smoking)
• Unavoidable (e.g. old age)
What is nosology?
Branch of medical science dealing with the classification of disease
Why was population health important for medicine in the 19th century?
Fundamental to modern medicine, through the measuring of diseases and conditions in populations
Challenged the idea that every individual's sickness is unique to that individual
Describe the first epidemiological study
John Snow, Cholera Epidemic in London, 1850's
He mapped cases of cholera and traced the source back to the water pump in Broad strew
What are the questions to be asked when looking at disease epidemiologically?
Briefly describe metabolic syndrome
• Chronic condition
• Triggered by weight gain
• Associated with middle-aged, overweight females
• Predisposes to DM
Describe the trends in obesity in the US from 1985 - 2010
1985: mostly < 10% of people 30 lbs overweight
2010: most states with 30 lbs overweight prevalence of 25-29%
Differences of prevalence between ethnicities: black higher than hispanic, which is higher than white
Compare prevalence of obesity between countries
Different countries have vastly different prevalences of obesity
Highest: US: 30%
Lowest: South Korea & Japan: 3.2%
Describe the connection between inequality and obesity
More adults are obese in more unequal rich countries:
• US very unequal, most obese
• Japan quite equal, least obese
'Diabetes is a disease of poverty amidst affluence'
What are some possible explanations for the rising prevalence of metabolic syndrome / obesity
• Increasing inequality
• Nutrition transition (i.e. changing diets)
Describe the HFCS story
• The growing of corn in the US was heavily subsidised in the second half of the 20th century
• HFCS55 emerges
• The use of HFCS55 in sweet drinks and fast food as a cheaper replacement for sugar lead to a decrease in the price of fast food
• 80% of supermarket products contain HFCS55
• Foods with HFCS55 are cheaper, tastier and easier
What is the problem with fructose?
Fructose bypasses the usual complex digestion and goes straight to the liver
It is contended that metabolic shunting produces more rapid insulin resistance
Results in a huge increase in sugar load in the body which is not broken down
Describe the Palm oil story
Palm oil imported in deal on free trade
New technologies in the mid 70's made it possible to use for commercial fat (frying oil, margarine, bread etc)
Features of palm oil:
• Very dense and saturated
• More stable (longer shelf life)
• Good mouth-feel
• Doesn't biodegrade in the body
Effects on the body:
• Increased BP
• Increased cholesterol
• Increased body fat
What were the economic ramifications of Palm oil and HFCS55?
• Fall in food prices
• Higher profits from food
• Dramatic ecological changes (new deadly salmonella → antibiotic resistance through overuse)
• Changing food production practices