Diet and Health Implications for Reducing Chronic Disease Risk (1989) / Chapter Skim
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27 Overall Assessment and Major Conclusions
27 Overall Assessment and Major Conclusions
Pages 651-664
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From page 651... ...
In recent decades, scientists have identified many dietary factors that influence the incidence and course of specific chronic diseases and have attempted to define the pathophysiological mechanisms (AMA, 1982; Ahrens et al., 1979; Goldstein and Brown, 1984; Levy et al., 1979; NRC, 1980, 1982~. Simultaneously, scientists, public health policymakers, the foot} industry, consumer groups, and others have been engaged in a debate about how much and what kind of evidence justifies giving dietary advice to the public and how best tO control risk factors on which there is general agreement among scientists (Ahrens, 1985; Council on Scientific 651 Affairs, 1979; Blackbum, 1979; CAST, 1977; Connor, 1979; Habicht et al., 1979; Grobstein, 1983; Gussow and Thomas, 1986; Harper, 1978; Hegsted, 1978; NRC, 1980, 1982; O'Connor and Campbell, 1986; Olson, 1979; Palmer, 1983; U.S.
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From page 652... ...
In some cases, there is conclusive evidence that a particular dietary factor plays a role in the etiology of a particular chronic disease, but that is the exception rather than the ruse. Despite such limitations, a large body of evidence has emerged in the past four decades concerning chronic diseases and their relationship to general dietary patterns or specific dietary components.
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From page 653... ...
summarize the relevant epidemiologic, clinical, and laboratory data pertaining to each nutrient or dietary factor and specific chronic diseases, including cardiovascular diseases, specific cancers, diabetes, hypertension, obesity, osteoporosis, hepatobiliary disease, and dental caries. Nutrient interactions and mechanisms of action are discussed where applicable.
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From page 654... ...
MAJOR CONCLUSIONS AND THEIR BASES Following are the general conclusions drawn from the committee's in-depth review followed by specific conclusions pertaining to the major dietary components and specific chronic diseases. Each section begins with a brief discussion of the findings that served as a basis for the conclusions.
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From page 655... ...
However, the evidence is not sufficient for drawing conclusions about the influence of dietary patterns on osteoporosis and chronic renal disease. ~ Most chronic diseases in which nutritional factors play a role also have genetic and other environmental determinants, but not all the environmental risk factors have been clearly characterized and susceptible genotypes usually have not been identified.
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From page 656... ...
Lowering saturated fatty acid intake is likely tO reduce serum total and LDL cholesterol levels and, consequently, CHD risk. ~ The few epidemiologic studies on dietary fat and cancer that have distinguished between the effects of specific types of fat indicate that higher intakes of saturated fat as well as total fats are associated with a higher incidence of and mortality from cancers of the colon, prostate, and breast.
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From page 657... ...
Monounsaturated Fatty Acids (MUFAsJ · Clinical studies indicate that substitution of MUFAs for SFAs results in a reduction of serum total cholesterol and LDL cholesterol without a reduction in HDL cholesterol. Dietary Cholesterol · Clinical, animal, and epidemiologic studies indicate that dietary cholesterol raises serum total cholesterol and EDL cholesterol and increases the risk of atherosclerosis and CHD.
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From page 658... ...
Much of the evidence on protein and chronic diseases derives indirectly from epidemiologic studies that examined the effects of high fat diets on the risk of atherosclerotic cardiovascular diseases or cancer. In contrast, many animal experiments have measured the effect of high animal-protein intake on serum total cholesterol or on tumor yield.
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From page 659... ...
caloric intake, assessing energy balance, and separating the effects of caloric intake per se from the effect of specific macronutrients on body weight. The committee has analyzed the association between energy balance (energy intake and energy expenditure and body weight and obesity and has examined obesity as an independent risk factor for atherosclerotic cardiovascular diseases, hypertension, NIDDM, and certain cancers.
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From page 660... ...
Epidemiologic evidence suggests that blacks, people with a family history of hypertension, and all those over age 55 are at a higher risk of hypertens~on. · Epidemiologic and animal studies indicate that the risk of stroke-related deaths is inversely related to potassium intake over the entire range of blood pressures, and the relationship appears to be dose dependent.
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From page 661... ...
Most of the attention has been directed to the role of calcium and magnesium in regulation of blood pressure, the association of calcium and phosphorus intake with peak bone mass and deveiopment of osteoporosis, and the relationship of calcium to colon cancer. This evidence derives from epidemiologic studies, cross-sectional studies, many clinical metabolic studies, a few recent intervention trials with calcium supplements, a large number of animal experiments pertaining to calcium intake and bone diseases, and a few experiments on calcium intake and carcinogenesis.
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From page 662... ...
DIET AND HEALTH Conclusions · Coffee consumption has been associated with slight elevations in serum cholesterol in some epidemiologic studies. Epidemiologic evidence linking coffee consumption to the risk of CHD and cancer in humans is weak and incons~stent.
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From page 663... ...
1986. Dietary guidelines for healthy American adults: a statement for physicians and health professionals by the nutrition committee, American Heart Association.
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From page 664... ...
1977. Dietary Goals for the United States, 2nd ed.
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