Do we need to insure and ensure every Canadian have essential nutrients?

What this the utility and the need for a far more robust national patient self-management education strategy? The following are my preliminary findings on how nutrition might be related to the following list of common medical conditions.
Parkinson’s disease.
Breast cancer.
Prostate cancer.
Rheumatoid arthritis.
Valvular heart disease.
Atrial fibrillation.
Inflammatory bowel disease.
Deep vein thrombosis.
Type I diabetes.
Post-herpetic neuralgia
According to “Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three” published by BMJ,
“For adolescents and children, a potential protective effect on severe asthma was associated with consumption of fruit ≥3 times per week (OR 0.89, 95% CI 0.82 to 0.97; OR 0.86, 95% CI 0.76 to 0.97, respectively). An increased risk of severe asthma in adolescents and children was associated with the consumption of fast food ≥3 times per week (OR 1.39, 95% CI 1.30 to 1.49; OR 1.27, 95% CI 1.13 to 1.42, respectively), as well as an increased risk of severe rhinoconjunctivitis and severe eczema. Similar patterns for both ages were observed for regional analyses, and were consistent with gender and affluence categories and with current symptoms of all three conditions.
Conclusions If the association between fast foods and the symptom prevalence of asthma, rhinoconjunctivitis and eczema is causal, then the findings have major public health significance owing to the rising consumption of fast foods globally.”
According to “Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis” – 2017
“Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies.”
Parkinson’s disease
According to The Emerging role of Nutrition in Parkinson’s Disease published in Frontier in Neuroscience,
“Nutrients that may be associated with a decreased risk or progression of PD
The health benefits associated with the intake of phytochemicals present in fruits and vegetables leads to decreased functional decline associated with aging and may slow the progression of PD (Liu, 2003). Epidemiological studies found that high intake of fruits, vegetables and fish was inversely associated with PD risk (Gao et al., 2007; Okubo et al., 2012). Dietary patterns, characteristic of a Mediterranean diet, are emerging as a potential neuroprotective alternative for PD (Alcalay et al., 2012).
Nutrients that may be associated with an increased risk or progression of PD
Dairy Products
Dairy product consumption and drinking milk may increase one’s risk of PD independently of calcium intake (Hellenbrand et al., 1996b; Chen et al., 2002; Park et al., 2005; Kyrozis et al., 2013), particularly in men (Chen et al., 2007a). Nonetheless, a positive association between milk consumption and PD risk was also observed in women in one study (Saaksjarvi et al., 2013).”
According to Dietary patterns and schizophrenia: a comparison with healthy controls published in Neuropsychiatry and Treatment,
We derived two dietary patterns by principal component analysis; namely, the “vegetable” dietary pattern and the “cereal” dietary pattern. In the “cereal” dietary pattern, the high tertile was associated with a significantly increased risk of schizophrenia (P5.5 vs. ≤2.5 servings/day HR = 0.89, 95% CI = 0.83-0.96; ptrend = 0.006). Intake of total vegetables was especially associated with lower risk of estrogen receptor negative tumors (HR per 2 additional servings/day as a continuous variable = 0.84, 95%CI = 0.77-0.93; pheterogeneity = 0.02). Among molecular subtypes, higher intake of total fruits and vegetables (HR per 2 additional servings/day as a continuous variable) was most strongly associated with lower risk of human epidermal growth factor receptor 2 (HER2)-enriched (HR = 0.79, 95%CI = 0.67-0.93), basal-like (HR = 0.84, 95%CI = 0.72-0.97) and luminal A (HR = 0.94, 95%CI = 0.89-0.99), but not with luminal B tumors (pheterogeneity = 0.03). In conclusion, our findings support that higher intake of fruits and vegetables, and specifically cruciferous and yellow/orange vegetables, may reduce the risk of breast cancer, especially those that are more likely to be aggressive tumors.”
Prostate cancer:
According to Prostate cancer and vegetable consumption. Review article by Chan R, et al. Mol Nutr Food Res. 2009.,
“Epidemiological studies have shown marked variations in prostate cancer incidence and mortality across different geographic regions, leading to the rising interest in the role of nutrition in prostate cancer risk. There is also a large body of evidence that a diverse diet, rich in vegetables, can reduce the risk of prostate cancer.”
According to Dietary intake of vegetables, fruits, and meats/beans as potential risk factors of acute myeloid leukemia: a Texas case-control study. By Yamamura Y, et al. Nutr Cancer. 2013.
“Overall, AML risk was significantly decreased among those who consumed the most dark green vegetables, seafood, and nuts/seeds; and it was significantly increased among greatest consumers of red meat. Among men, AML risk was lowest among those whose consumption was in the highest quartile for fruits [odds ratio (OR) = 0.25, 95% confidence interval (CI) = 0.10-0.69], poultry (OR = 0.28, 95%CI = 0.10-0.78), and seafood (OR = 0.39, 95%CI = 0.16-0.96) compared to those in the lowest. Among women, risk was lowest among those whose consumption was in the highest quartile of dark-green vegetables (OR = 0.28, 95%CI = 0.12-.68), orange vegetables (OR = 0.40, 95%CI = 0.17-.96) and nuts/beans (OR = 0.26, 95%CI = 0.11-0.60). Based on these findings, interventions can be developed to modify intake of specific dietary components to reduce cancer risk.”
Rheumatoid arthritis:
According to The role of diet in rheumatoid arthritis by Marta Skoczyńska and Jerzy Świerkot, Rheumatologia
“Rheumatoid arthritis (RA) is a systemic connective tissue disease which develops in the course of an autoimmune inflammatory process triggered by environmental factors in a genetically predisposed person. One of the environmental factors is the diet. RA patients’ adherence to a healthy diet remains low, despite plentiful data confirming positive effects of some foods, e.g. fish rich in n-3 polyunsaturated fatty acids (PUFAs), as well as the negative influence of unhealthy eating patterns, such as high consumption of fats and sugars, on RA incidence, activity and treatment response.”
According to Harvard Medical School, “scientists believe that most people with psoriasis inherit one or more of certain genes that can affect the immune system in a way to make them prone to psoriasis…But it is not enough to have a genetic connection. Flare-ups often occur when certain triggers start the psoriasis process. The most common is stress. Mental stress causes the body to release chemicals that boost the inflammatory response. Scientists suspect this is the mechanism for stress-induced psoriasis flare-ups.”
A 2017 study from the Journal of the American Academy of Dermatology found that people with psoriasis that covers 10% of their body or more are 64% more likely than those without psoriasis to develop type 2 diabetes.
Valvular heart disease:
According to A plant-based diet and heart failure: case report and literature review, published in Journal of Geriatric Cardiology,
“Our report adds to the growing body of evidence that plant-based foods are beneficial for cardiovascular health. This evidence includes several population-based cohort studies that have demonstrated an inverse relationship between increased consumption of plant-based foods and incidence of heart failure.[2]–[5] Furthermore, plant-based diets may improve blood pressure,[6]–[8] glycemic control,[9] and obesity,[6],[7] additional risk factors for heart failure.[10]
Plant-based diets may slow the progression of atherosclerosis, a risk factor for heart failure, and may even reverse atherosclerosis.[11]–[14]”
Atrial Fibrillation:
Eating several servings of nuts every week may help lower the risk of developing the heart rhythm irregularity, atrial fibrillation, also known as heart flutter, finds research published online in the journal Heart.
According to Fruit, vegetable, and fish consumption and heart rate variability: the Veterans Administration Normative Aging Study, published in American Journal of Clinical Nutrition,
“Conclusion: These findings suggest that higher intake of green leafy vegetables may reduce the risk of cardiovascular disease through favorable changes in cardiac autonomic function.”
Inflammatory Bowel Disease:
According to Consumption of vegetables and fruit and the risk of inflammatory bowel disease: a meta-analysis. Review article, Li F, et al. Eur J Gastroenterol Hepatol. 2015.
“This meta-analysis indicates that consumption of vegetables and fruit might be associated inversely with the risk of UC and CD, and the results need to be further confirmed.”
Deep Venous Thrombosis
According to “Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology.” Circulation. 2007; 115:188-195,
“Diets rich in fruits, vegetables, and fish may reduce the risk of DVT while diets high in red and processed meats may increase the risk of DVT.
The influence of diet on the development of a first time deep vein thrombosis (DVT) was assessed over a 12 year period in almost 15,000 black and white patients from North Carolina, Mississippi, Minnesota, and Maryland. Increased intake of fruits and vegetables was associated with approximately a 40% to 50% lower risk of DVT. Eating fish one or more times per week was associated with a 30% to 45% lower risk of DVT. Consumption of red meat and processed meat was associated with about a 10% to 20% increase in the risk of DVT but the quintile with the highest consumption of red and processed meet had a two fold increase in DVT risk.”
Type I Diabetes:
According to “Diet, Growth, and the Risk for Type 1 Diabetes in Childhood
A matched case-referent study” American Diabetic Association.
“Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhood-onset type 1 diabetes by different mechanisms.
Dietary intake of certain nutrients and possible toxic food components is of interest in the search for triggers or promoters of the autoimmune β-cell destruction that may lead to type 1 diabetes (1–3). Studies of infant diet indicated that short breast-feeding duration and early introduction of cow’s milk proteins may be causally related to the development of childhood diabetes (4) and progressive β-cell autoimmunity before the age of 4 years (5). Some studies also found that high intake of cow’s milk later in childhood is associated with increased risk of diabetes (6,7). In a previous population-based case-referent study, our group showed a dose-response relationship between the risk of developing childhood diabetes and the frequency of intake of foods rich in protein, carbohydrates, and nitrosamines (8).”
According to Epilepsy Society,
“A balanced diet from different food groups helps the body and brain to function, helping us to stay healthy. This may help reduce the risk of seizures for some people with epilepsy. Making your own meals gives more control over what you eat, and some things can help make cooking safer if you have seizures. There are no specific foods that generally trigger seizures, as epilepsy is very individual.”
According to Vegetable and fruit intake and non-Hodgkin lymphoma survival in Connecticut women, Leuk Lymphoma, 2010 Jun.
“Our study suggests that increasing vegetable and citrus fruit consumption could be a useful strategy to improve survival in NHL patients.”
According to Tuberculosis and nutrition, Lung India, 2009 Jan-Mar.
“Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host’s susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis.”
Post-herpetic neuralgia:
“A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation,” says Dr. Fred Tabung, a visiting researcher with the Department of Nutrition at Harvard’s T.H. Chan School of Public Health. “But your diet is also one of the best ways to reduce it.”
“Inflammation insight
Inflammation has a good-guy/bad-guy role in your health. When you are injured or get infected, your body signals the immune system to send white blood cells to the affected areas to repair the injury or fight the infection.
When the injury heals or the infection goes away, inflammation normally goes away too. However, sometimes your immune system gets turned on and stays on after the “crisis” has passed.
Over time, this can damage healthy cells and organs and cause constant pain in muscles, tissues, and joints. Chronic inflammation also can raise your risk for heart disease, diabetes, certain cancers, and even Alzheimer’s disease.”
In conclusion:
I believe nutrition, physical and mindfulness training are three self-management perspectives requiring perhaps a more urgent public attention than a national drug plan. For starters, there needs to be greater awareness of the importance of nutrition. I believe a national nutrition education strategy supported by a essential nutrition insurance plan is more beneficial than even an universal pharmaceutical plan. What do you think about promoting, incentivizing and/or insuring the consumption of one pound of non-starchy vegetables and fruits per day for every adult Canadian?
A recently published WHO/FAO report recommends a minimum of 400g of fruit and vegetables per day (excluding potatoes and other starchy tubers) for the prevention of chronic diseases such as heart disease, cancer, diabetes and obesity, as well as for the prevention and alleviation of several micronutrient deficiencies, especially in less developed countries.
Hippocrates considered nutrition one of the main tools that a doctor can use. More than that, dietary measures play a lead part in the original oath of Hippocrates. In modern translations of the oath, the central importance of diet is often somewhat hidden. English Wikipedia for example turns it into: “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing.”
But the original Greek oath, literally translated, says: “I will apply dietetic and lifestyle measures to help the sick to my best ability and judgment; I will protect them from harm and injustice.”
The dietetic and lifestyle measures are just one word in Greek, διαιτήμασί (pronounce as “deaytimasy”). You may recognise the word “diet” in there. It means as much as a lifestyle regime, with a focus on diet. Exercise is also part of it. Sometimes it is just translated as: dietetic measures.”
A large Health Maintenance Organization
in the US uses food as a way to treat illness. “Geisinger’s program (paying for patients food) can look like a bargain. Over the course of a year, the company will spend about $1,000 on each Fresh Food Pharmacy patient. The health system tracks hemoglobin A1C levels in the pilot participants, and it is also assessing the number of medical visits and illnesses along with the overall cost of caring for these patients. “A decrease in hemoglobin A1C of 1 point saves us [about] $8,000,” says David Feinberg, the president and CEO of Geisinger Health System.”
In my experience, much of medication prescribed in fact perpetuate the widespread delusion that what the mind wants to eat is more important than what the body needs. Type 2 diabetes is only but one of a multitude of consequences of poor dietary habits. Targeting glucose level with a myriad of prescription drugs so that I can continue to eat what my mind wants and omit what the body needs sets the stage for even more serious health challenges to come. (See below – Nutrition)
What is the responsibility of an insured in an insurance system?
Universal health insurance is fundamentally different from other forms of insurance in that it is not conditional on the behavior of the insured; it may not cover non-essential services but endeavours to cover all other services regardless of claimants behaviour. This is not so with other forms of insurance. Life insurance do not cover suicidal death. Driving while under the influence of drugs or alcohol can cause a claim to be denied. Property insurance company may deny coverage for a house with dangerous wiring or at risk plumbing systems.
I don’t believe denying the sick of healthcare on the basis of behaviour is rational or progressive. With the national healthcare expenditure (public and private ) being $250 Billion on a tax revenue of little over $300 Billion; I also believe the long term success of Universal and/or privatized health care pivots on the collective behaviour of its insure
Presently Canadians are formally educated by schools and informally, by marketing forces. The above system have collectively resulted in a culture where Approximately four in five Canadian adults have at least one modifiable risk factor for chronic disease (self-reported tobacco smoking, physical inactivity, unhealthy eating and harmful use of alcohol) – (Health Canada)
30 percent of Ontarians are with diabetes or prediabetes.
“Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population”. – (Canadian Mental Health Association)
65 percent of students reported experiencing overwhelming anxiety in the previous year (up from 57 per cent in 2013)- (University and College Health Association 2016)
“By age 40, about 50% of the population will have or have had a mental illness.” – (CAMH)
In 2016, Canadians’ spending on vegetable is <5% compared to spending on processed food and beverages. ($4.9 vs 102.9 Billions)
I think a nationalized nutrition education program involving collaborations between healthcare system, educators and private corporations is also urgently needed to complement a national nutrition insurance program.
According to Review article by Aune D, et al. Int J Epidemiol. 2017. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies.
“Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.”

No comments:

Post a Comment

What is happiness, complacency and oneness

I am grateful for my life and my life as a family physician. I tell my patients happiness are transient moments and so are sadness. T...