Module 12: Nutrition Related Diseases

Overview

This module focuses on the idea that many of our health problems arise from the mismatch between our biology and tastes that developed from our primate and hominid past and our industrialized lifestyle. This idea was introduced in previous modules (4-6) and in this module we will explore these issues in more detail. We will focus on specific health issues such as diabetes, cancer, heart disease and obesity.

Objectives

1. To introduce and provide an overview of some of the current diet related diseases.

2. To review the physiology/biology of diet related diseases.

3. To explore and gain an understanding of the anthropological theories related to nutritional problems in contemporary societies.

4. To explore the lifestyle factors (cultural and social) associated with some diet-related diseases.

Activities

MODULE 12: DIET AND DISEASE
Using material from the web, readings and videos (see blackboard) prepare an  Issue Paper (~8 pages) or a clear Teaching Presentation/ power point on one of the diseases from the list (see below).

  • For the teaching presentation you will need to develop a coherent lecture plan – you should plan on developing a  power point presentation. You should include your notes in the note section of the slides as well as a bibliography slide and citations in the text of the appropriate slides.
  • If you choose to write an issue paper it should be a clearly written paper (approximately 8 pages long, double spaced) with appropriate citations in the text and a bibliography.

You should choose a very specific issue – such as the debate over the thrifty genotype and diabetes; cross cultural comparisons; gender differences; health disparities in terms of ethnic groups; the debate over school lunches and/or vending machines on the role of child hood obesity etc. You should also include a discussion of any anthropological theories or ideas associated with the illness/disease. You are required to obtain approval of your topic for the paper/presentation with GM. It will be valuable to discuss your progress and content prior to tuning it in. If you do this in a timely fashion I will provide feedback

Your presentation/paper should include :

  1. A description of the diet-related disease you chose.
  2. A discussion of the role that diet plays in the etiology of the disease.
  3. A discussion of the anthropological aspects (especially biocultural) and issues related to the diet-related illness/disease. This should include theory as well as the cultural and social factors associated with the disease.
    List of Illnesses/Diseases
  1. Obesity
    • child obesity
    • adult obesity
    • Specific ethnic group issues concerning obesity
    • International/global obesity issues (using specific country information)
  2. Diabetes
  3. Cancer
  4. Coronary Heart Disease
  5. Osteoporosis

Due Date: June 1 (in class) or June 6 @ 3:15 pm (you decide)

Points: 40 points

Grading guideline:      #1 = 10 points             #2=10 points   #3= 20 points

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Notes

Nutrition is often associated with promoting health s well as being related to diseases or ill-health. However there are no clear cut or well established relationships in many cases. This is partly due to the fact that many of these diseases which we call chronic, degenerative illnesses are multifactoral in etiology. At best we can say “ those who consume low-fat meats and dairy products, fruits and vegetables, and whole grains enjoy a longer, healthier life than those who do not.

Dietary Changes (especially with industrialization)
increase fats
increase meat (protein)
Increase refined/ simple carbohydrates
Increase salt


Diet- Related Diseases

Cancer
Fat – cancer relationship (Frisancho)
Dietary fat and protein promote tumor growth
Experimental studies – rats
Epidemiological evidence
Migrant studies
Japan
Samoa
Hawaii
See Frisancho diagram17.3:
Breast Cancer factors
Diet
Breast feeding
Fat cells & estrogen storage in body
Diverticulosis and Colon Cancer
Fiber factor
Fecal-Mutagen hypothesis
Frisancho diagram 17.4
Coronary Heart Disease
What is heart disease?
The term heart disease is a general term that covers a number of diseases, which affect the heart. This includes coronary artery disease, congestive heart failure and angina.
What causes heart disease?
Many lifestyle factors contribute such as cigarette smoking, alcohol intake, physical inactivity, and obesity. Serum cholesterol and hypertension play a major role the formation of heart disease.
Changeable risk factors include:
Hypertension
Obesity
Cholesterol levels
Diabetes
Smoking

Hypertension
What is Blood Pressure?
Blood Pressure is the force of blood against the wall of the arteries..
What is Hypertension?
Hypertension is another term for High Blood Pressure. High Blood Pressure is diagnosed as a measure of 140/90 on three separate occasions.
Why is High Blood Pressure Important?
High Blood Pressure makes the heart work too hard, it can make the walls of arteries harden, and it is a major risk factor for heart disease and stroke.
Dietary Link:
Salt intake
Weight/ obesity
Diabetes
What is Diabetes?
Diabetes is a condition that occurs when the pancreas is not producing insulin or when the body has lost its ability to use insulin.

Anthropological Issues
Health and Dietary Delocalization
Population Variation and Epidemiology of Diet Related Diseases:
Genetics or Lifestyle

Thrifty genotype/New World Syndrome – New World Syndrome for a set of non-infectious diseases that appear in elevated frequencies among Native American and admixed Native-American/European pops. Non-insulin dependent diabetes, gallstones, gall bladder cancer, increased obesity. Epidemiology shows the more Native American Ancestry a person has the greater the risk of developing these diseases, other factors being equal.

O’odham(Pima) 50% over 35 – adult onset diabetes (Type II)
diabetes related mortality 10.8 times higher than among Caucasian Americans. this change since 1940

Some researchers argue that there is a genetic susceptibility. They suggest that there was a genetic advantage involved in fat storage and utilization that enhanced survivability in pops with food shortages. These genes conferred changes in metabolism allowing more efficient uses of food and fat storage. Today the same genetic factors are proving disadvantageous bec of changes in diet. Inc in carbohydrates and fat in diet today lead to greater fat storage leading to obesity and inc. risk for other diseases.

Dietary link: native foods have significant effect on controlling blood glucose responses and flattening blood sugar levels ( study done with Pima foods, mesquite pods, lima beans, ‘Emory” oak acorns, tepary beans, in Australia to Caucasians). In contrast Western staples caused rapid and high blood sugar responses. Both diets contain equal amt of starch but the starch in Pima foods are “slow-release carbohydrates”. They contain high amounts of starch amylose which break down into simple sugars very slowly in human body. Western diet -high prop of amylopectin- a starch that breaks down relatively quickly.

Some of the traditional foods also high in mucilages – when these form a gel, or slime in stomach they create a physical barrier between carbohydrates and digestive enzymes that break them down thus slowing the conversion of carbohydrates into sugar. found in cholla buds, prickly pear fruit and pads, chia seeds, indian wheat, tansy mustard.

Industrialized societies: economic, class-structured systems
Differential health profile of different class, ethnic and gender groups.
See Kumanyika and Golden Article:
Time trend perspective – within Industrialized Society the “time frame” is not the same for all people.
“secular” change in disease etiology differs among different racial and ethnic groups – as well as economic groups and gender groups.

Why does the epidemiological transition or time trend hypothesis (kumanyika) seem more plausible than the genetic/racial differences hypothesis?

a. It is unlikely that a major disease will have a cause unique to a racial/ethnic group (sickle cell is the exception rather than the rule). Therefore we should expect most major chronic diseases to demonstrate many similarities across racial/ethnic groups.

b. Differences in environment (incl. cult. factors) are more likely than differences in genetic predisposition to produce differences in disease rates or manifestations.

c. Most common occurrence is variation in frequency among groups – less common is a disease unique to a group – i.e. physiological and biochemical characteristics remain the same.

Links:
Minority Health
http://www.kff.org/minorityhealth/index.cfm
Traditional Food, Health and Nutrition
http://www.kstrom.net/isk/food/foodmenu.html
American Diabetes Association:
http://www.diabetes.org/home.jsp
Native American Diabetes Project
http://www.laplaza.org/health/dwc/nadp/
Indigenous Health
http://www.healthinfonet.ecu.edu.au/frames.htm
http://www.healthinfonet.ecu.edu.au/frames.htm
http://americanindianhealth.nlm.nih.gov/

Hispanic-American Health
http://www.nlm.nih.gov/medlineplus/hispanicamericanhealth.html
http://www.mclibrary.duke.edu/subject/latino

African-American Health Issues
http://www.nlm.nih.gov/medlineplus/africanamericanhealth.html

Assignment (See assignments page)