North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives

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Costs for Each Person
actual
8,160
Centers for Medicare and Medicaid Services
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Costs for Each Person
13,100
projected
8,160
2009
2018
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
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in 9 years
20
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Cost by Country
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Infant Mortality
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Life Expectancy by Country
WHO, 2004
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Life Expectancy by Country
U.S.
WHO, 2004
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Cumulative Increases in Insurance Premiums,
Inflation, and Workers Earnings
157
37
29
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Bureau of Labor Statistics
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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Doctor Day, January 1, 2226
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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present
100,000 BC
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present
100,000 BC
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present
100,000 BC
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present
100,000 BC
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present
100,000 BC
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Milk
present
100,000 BC
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Milk
Sugar
present
100,000 BC
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Milk
Sugar
HFCS
present
100,000 BC
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Obesity Trends Among U.S. Adults1985
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Obesity Trends Among U.S. Adults1986
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Obesity Trends Among U.S. Adults1987
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Obesity Trends Among U.S. Adults1988
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Obesity Trends Among U.S. Adults1989
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Obesity Trends Among U.S. Adults1990
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Obesity Trends Among U.S. Adults1991
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Obesity Trends Among U.S. Adults1992
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Obesity Trends Among U.S. Adults1993
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Obesity Trends Among U.S. Adults1994
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Obesity Trends Among U.S. Adults1995
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Obesity Trends Among U.S. Adults1996
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Obesity Trends Among U.S. Adults1997
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Obesity Trends Among U.S. Adults1998
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Obesity Trends Among U.S. Adults1999
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Obesity Trends Among U.S. Adults2000
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Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2002
(BMI ?30, or 30 lbs overweight for 54 person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2007
No Data lt10 1014
1519 2024 2529
30
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Percent Who Are Obese U.S. vs Pittsburgh
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Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
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Percent of adults who are overweight or obese
86
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Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
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Life Expectancy in the U.S.
2-5 year decline in life expectancy
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Diabetes Among Adults in the U.S.,BRFSS 1990
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Diabetes Among Adults in the U.S.,BRFSS 1992
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Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
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Diabetes Among Adults in the U.S.,BRFSS 1997
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Diabetes Among Adults in the U.S.,BRFSS 1998
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Diabetes Among Adults in the U.S.,BRFSS 1999
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Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
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Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
91
82
71
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Sources Stampfer, 2000 Platz, 2000 Hu, 2001
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How did we get this way?
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5-a-day 1 million
Food Marketing 25 Billion
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Texas Double Whopper
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Western Diet Pattern
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Prudent Diet Pattern
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Western vs Prudent

• A Western diet has significantly higher risk of
• Type II diabetes
• Cancer
• Cardiovascular disease
• Premature death
• Alzheimers disease
• Erectile dysfunction

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Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
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Morbidity
Lifespan in years
0
?
76
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critical illness
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
91
End of Life Benefits
Morbidity
Lifespan in years
92
End of Life Benefits
Morbidity
Lifespan in years
93
End of Life Benefits
Morbidity
Lifespan in years
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End of Life Benefits
Morbidity
Lifespan in years
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Lung cancer and vegetable intake
Relative risk
Vegetable intake grams/day
Am Inst for Cancer Research, 1997
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Stomach cancer and vegetable intake
Relative risk
Vegetable intake grams/day
Am Inst for Cancer Research, 1997
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Stomach cancer and fruit intake
Relative risk
Fruit intake grams/day
Am Inst for Cancer Research, 1997
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Unpaired Electrons
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• DNA in each cell gets a hit by a free radical
  every 10 seconds
• Each cell gets 10,000 hits/day

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Where do free radicals come from?

• Most are produced by our own bodies
• UV light
• burned food
• toxic chemicals
• Industrial
• automobile pollution
• unknown sources

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Cigarette Smoke

• One puff of smoke contains
• 100,000,000,000,000,000
• free radical species
• Tobacco is responsible for 31 of all cancers

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If you are a smoker
-14.5 yrs
-13.2 yrs
MMWR 199746444-51
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How do we protect our selves?
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Phytochemicals

• Carotenoids
• Beta-carotene
• Lycopene
• Lutein
• Zeaxanthin
• Organosulfurs
• Flavinoids

• Phytosterols
• Alkaloids
• Tannins
• Saponins
• 100,000 more we have yet to identify

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Western Diet Pattern
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Prudent Diet Pattern