The diseases of affluence

Despite the problems to be discussed in this chapter, which are major causes of premature death, people in developed countries have a significantly greater life expectancy than those in developing countries.

The major causes of death in developed countries today are heart disease, high blood pressure, strokes and cancer. These are not just diseases of old age, although it is true to say that the longer people live, the more likely they are to develop cancer. Heart disease is a major cause of premature death, striking a significant number of people aged under 40. This is not solely a Western phenomenon. As countries develop, so people in the prosperous cities begin to show a Western pattern of premature death from these same diseases.

Diet is, of course, only one of the differences between life in the developed countries of Western Europe, North America and Australasia and that in developing countries; there are a great many other differences in environment and living conditions. In addition, genetic variation will affect susceptibility to nutritional and environmental factors, and there is evidence that nutritional status in utero and infancy affects responses to diet in adult life.

It can be assumed that human beings and their diet have evolved together. Certainly, we have changed our crops and farm animals by selective breeding over the last 10,000 years, and it is reasonable to assume that we have evolved by natural selection to be suited to our diet. The problem is that evolution is a slow process, and there have been major changes in food availability in developed countries over the last century. As recently as the 1930s (very recent in evolutionary terms) it was estimated that up to one-third of households in Britain could not afford an adequate diet. Malnutrition was a serious problem, and the provision of 200 mL of milk daily to schoolchildren had a significant effect on their health and growth.

Foods that were historically scarce luxuries are now commonplace and available in surplus. Sugar was an expensive luxury until the middle of the nineteenth century; traditionally, fat was also scarce, and every effort was made to save and use all the fat (dripping) from a roast joint of meat.

There are thus two separate, but related, questions to be considered:

  • Is diet a factor in the aetiology of diseases of affluence that are major causes of premature death in developed countries?
  • Might changes in average Western diets reduce the risk of developing cancer and cardiovascular disease?
Your Heart and Nutrition

Your Heart and Nutrition

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