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Nutrition in Population and public health

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Professor Lynch’s seminar placed the context of nutrition and in particular early life nutrition in an overall population health perspective. He traced some of the evidence for the historical importance of nutrition on improvements in population health in several countries since the 1850s. He then traced the links between the role adult diet plays in various chronic diseases, through the evidence suggesting the developmental origins of adult nutrition, and discussed how the current research focus of his early life nutrition group at UniSA is attempting to characterize diet in children under 3 and examine associations with physiological risk factors such as blood pressure and cholesterol, as well as cognitive functioning at ages 15-16

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Nutrition in Population and public health

  1. 1. Scientific Seminar Series – 2010 #4 Professor John Lynch
  2. 2. Why bother about child diet? A population health perspective over the lifecourse John Lynch Professor of Public Health Epidemiology NHMRC Australia Fellow University of South Australia University of Bristol
  3. 3. Life Expectancy Selected Countries 1860-2005
  4. 4. Life Expectancy Selected Countries 1860-2005
  5. 6. AIHW (2005)
  6. 7. AIHW (2005)
  7. 9. Weaver. Current Pediatrics (2006) Mortality of breast fed and artificially fed infants during the summer diarrhea epidemic in Paris 1898
  8. 10. Thomas McKeown 1912-1988 1976 1988
  9. 11. 1840 1860 1880 1900 1920 1940 1960 4000 3500 3000 2500 2000 1500 1000 500 0 Tubercle Bacillus Identified (Koch, 1882) Chemotherapy BCG vaccination Respiratory Tuberculosis: Mean Annual Death Rates, England and Wales, 1840-1970 Death Rate (per million) Year McKeown and Record. Pop Studies (1962) 25% deaths
  10. 12. 1974 2004
  11. 13. 1974 2004
  12. 14. Average Height of Military Conscripts in Europe (1960-1990) Steckel (2000) Height (cm) France Germany Sweden Netherlands Denmark Norway Italy Spain Portugal
  13. 15. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  14. 16. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  15. 19. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1.
  16. 20. <ul><li>N = ~ 7000 </li></ul><ul><li>Two dietary patterns ascertained from their association with lipid levels </li></ul><ul><li>These two patterns were associated with 1.5-2.0 relative risk of CHD </li></ul><ul><li>after adjustment for health behaviours, social class, blood pressure and BMI </li></ul>1. Adult diet patterns predict chronic diseases
  17. 21. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Food Patterns & Preferences Childhood 1. 2.
  18. 22. 2. There is some tracking of adolescent diet into adult diet <ul><li>Aged 3-18 at baseline and are now 24-39 </li></ul>
  19. 23. 2. The importance of “taste preference” <ul><li>Am J Prev Med (2008) N= ~ 1500 </li></ul><ul><li>Taste preference was the strongest predictor of fruit and vegetable intake after control for social class, energy intake, education, and baseline fruit and vegetable consumption </li></ul>
  20. 24. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1. 2. Food Patterns & Preferences 3. Food Patterns
  21. 25. 4. Diet in late childhood tracks from diet in early childhood <ul><li>2005 study showed consistent patterns between ages 4 and 7 </li></ul><ul><li>2008 study expanded to include ages 3, 4, 7 and 9. It found greater variability especially from age 3-9 but nevertheless, demonstrated moderate levels of tracking </li></ul>2005 2008
  22. 26. Saturated fat restricted diet from infancy to age 15 = 1mmHg lower systolic blood pressure Hypertension (2009)
  23. 27. Blood pressure measured 25 years previously was more important than current BP for CHD; both recent and past important for stroke mortality. Both past and current levels of cholesterol are equally important for CHD but not stroke. Boshuizen, et al. AJE (2006)
  24. 28. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood Food Patterns 1. 2. 3. Food Patterns & Preferences Maternal Paternal Factors Weaning / Toddler diet Food environment In-utero environment 4? Breastfeeding
  25. 29. Maternal Paternal Factors Weaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood 4. 5. 5.
  26. 30. Am J Clinical Nutrition (2010) Am J Clinical Nutrition (2009) 4.
  27. 31. Maternal Paternal Factors Weaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood 4. 5. 5.
  28. 32. 5.
  29. 33. Maternal Paternal Factors Weaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood Availability in food supply Availability in the home Knowledge Food parenting practices
  30. 34. Chronic Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  31. 35. <ul><li>Characterizing diet 0-3 – how? Index vs PCA vs Nutrient </li></ul><ul><li>Is diet 0-3 associated with physiological risk factors at ages 15-16? </li></ul><ul><li>Is diet 0-3 associated with cognitive functioning at ages 15-16? </li></ul>Early Life Nutrition Group at UniSA in collaboration with ALSPAC at U Bristol

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