Pharmacogenomics and nutrigenomics: synergies and differences

D Ghosh, M A Skinner, W A Laing
<span title="2007-01-10">2007</span> <i title="Springer Nature"> <a target="_blank" rel="noopener" href="https://fatcat.wiki/container/3haaffocqfae5co5f7reco5eam" style="color: black;">European Journal of Clinical Nutrition</a> </i> &nbsp;
Box 3.3. Global strategy on diet, physical activity and health World Health Assembly recommendations for diet are: 1 achieve energy balance and a healthy weight; 2 limit energy intake from total fats and shift consumption away from saturated fats to † unsaturated fats and towards the elimination of trans-fatty acids; 3 increase consumption of fruits and vegetables, and legumes, whole grains and nuts; 4 limit the intake of free sugars; ‡ 5 limit salt (sodium) consumption from all sources and
more &raquo; ... re that salt is iodised. In addition, the World Health Assembly recommends that individuals engage in adequate levels of physical activity throughout their lives. † These fats (found in margarine and hydrogenated vegetable oils) also raise cholesterol levels. ‡ The reference to iodising salt (adding iodine) has been added to tackle iodine deficiency (Box 3.1), rather than chronic disease. Although the main constituents of a healthy diet are well known, there is an enormous gap between existing dietary guidelines and what people actually eat (Box 3.4). Box 3.4. What people eat in Europe and the USA According to dietary surveys in 14 European Union states, by 1999 less than 50% of the population in most countries was meeting recommended dietary targets for particular types of foods. Guidelines for fat and saturated fat intake were met by more than half the population in only one country (Portugal), and fruit and vegetable guidelines were met by more than half the population in only a few other Mediterranean countries. In all 14 countries, less than half the 17 GeneWatch UK January 2006 GeneWatch UK January 2006 changes to: fewer people smoking (leading to an estimated 29,715 fewer deaths); lower cholesterol levels, due to dietary changes (an estimated 5,770 fewer deaths) and the use of the cholesterol-lowering drugs called statins (an estimated 2,135 fewer deaths); and lower blood pressure (leading to an estimated 5,870 fewer deaths without using medication, and 1890 fewer 27 deaths from using blood pressure-lowering medication). The study concluded that policies should prioritise population-wide tobacco control and healthier diets. Health inequalities play a significant role in life expectancy and chronic disease, including diet-related diseases. Lack of food, famine and malnutrition are still the biggest problems for poor people in the poorest countries. However, in most middle-income countries the poorest people are now those at the 11 highest risk of obesity and chronic diseases, such as heart disease and diabetes. In Argentina, for example, the diet of the poor has shifted since the 1960s, from a varied balanced one, to one which depends on only 22 basic products, which are selected to satisfy the appetite but 28 are high in fats and sugars. There has also been a major movement from rural areas into the cities, reducing both time and opportunities for exercise. Poor women often allow children and other family members to eat the more nutritious foods and fill up on bread and sweetened teas. Many mothers are obese but also anaemic and lacking in essential micronutrients and iron. It is also common to find 29 overweight or obese mothers with malnourished children. Even in the UK, poorer families tend to eat less healthily, consuming less fruit and vegetables and wholemeal bread and more white bread and processed meat products. Women in low-income groups are particularly likely to skip meals and go short of essential nutrients. Children in low-income families 30 also tend to eat more saturated fat and sugar and fewer vitamins, minerals and dietary fibre. These differences in diet are not primarily due to lack of information about what is healthy or unhealthy, but are more likely to be due to the much lower cost per calorie of foods high in fat and 31 sugar. Other factors include food industry marketing practices (Section 3.2): 'value' and 'economy' 28,30 32 19 GeneWatch UK January 2006 49 McLibel trial (in which McDonald's sued two London activists for criticising their food, labour 50 practices and adverse impact on the environment); the book 'Fast Food Nation' (about the fast food 51 industry in the USA); and the film 'Supersize Me'.
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