Public health nutrition
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Selenium is of fundamental importance to human health. It is an essential component of several major metabolic pathways, including thyroid hormone metabolism, antioxidant defence systems, and immune function. The decline in blood selenium concentration in the UK and other European Union countries has therefore several potential public health implications, particularly in relation to the chronic disease prevalence of the Western world such as cancer and cardiovascular disease. ⋯ It is well recognised that dietary selenium is important for a healthy immune response. There is also evidence that Se has a protective effect against some forms of cancer; that it may enhance male fertility; decrease cardiovascular disease mortality, and regulate the inflammatory mediators in asthma. The potential influence of Se on these chronic diseases within the European population are important considerations when assessing Se requirement.
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Public health nutrition · Apr 2001
ReviewHealthy lifestyles in Europe: prevention of obesity and type II diabetes by diet and physical activity.
The prevalence of obesity is increasing rapidly in all age groups in most EU-countries and is one of the fastest growing epidemics, now affecting 10-40% of the adult population. Obesity increases the risk of serious co-morbidities such as type 2 diabetes, cardiovascular disease, certain cancers and reduced life expectancy, and these complications may account for 5-10% of all health costs in EU countries. The risk of diabetes is particularly increased by obesity, and 80-95% of the increase in diabetes can be attributed to obesity and overweight with abdominal fat distribution. ⋯ Ad libitum consumption of diets low in fat and high in protein and complex carbohydrates, with a low glycaemic index, contributes to the prevention of weight gain in normal weight subjects. It also causes a spontaneous weight loss of 3-4 kg in overweight subjects, and has beneficial effects on risk factors for diabetes and CVD. To prevent obesity and diabetes there are grounds for recommending the combination of increasing daily physical activity level to a PAL-value of at least 1.8 and reducing dietary fat content to 20-25 energy-% in sedentary subjects, and to 25-35% in more physically active individuals.
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Public health nutrition · Apr 2001
ReviewFactors affecting energy and macronutrient requirements in elderly people.
(i) to describe energy and macronutrient requirements in healthy and diseased elderly patients from knowledge acquired about the age-related changes in energy balance (ii) to describe changes in body composition and the consequences of physical activity and exercise programs. ⋯ Further studies are required to enable calculations of energy and macronutrient requirements of individuals, especially diseased. More work has to be done to understand the energy imbalance in the elderly (healthy and diseased). Careful evaluations of physical activity and exercise programs are necessary.
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Public health nutrition · Apr 2001
ReviewCalcium and vitamin D nutrition and bone disease of the elderly.
Osteoporosis, a systemic skeletal disease characterized by a low bone mass, is a major public health problem in EC member states because of the high incidence of fragility fractures, especially hip and vertebral fracture. In EC member states the high incidence of osteoporotic fractures leads to considerable mortality, morbidity, reduced mobility and decreased quality of life. In 1995 the number of hip fractures in 15 countries of EC has been 382,000 and the estimated total care cost of about 9 billion of ECUs. ⋯ In conclusion, in Europe a low calcium intake and a suboptimal vitamin D status are very common in the elderly. Evidence supports routine supplementation for these people at risk of osteoporosis, by providing a daily intake of 700-800 mg of calcium and 400-800 IU of vitamin D. This is an effective, safe and cheap means of preventing osteoporotic fractures.