Continuous Update Project Integrating cancer and NCD prevention - - PowerPoint PPT Presentation

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Continuous Update Project Integrating cancer and NCD prevention - - PowerPoint PPT Presentation

Oct 25, 2023 381 likes •617 views

Continuous Update Project Integrating cancer and NCD prevention Ricardo Uauy, MD, PhD Institute of Nutrition INTA University of Chile and London School of Hygiene and Tropical Medicine London UK UICC World Cancer Congress 28 August, 2012

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Ricardo Uauy, MD, PhD Institute of Nutrition INTA University of Chile and London School of Hygiene and Tropical Medicine London UK UICC World Cancer Congress 28 August, 2012

Integrating cancer and NCD prevention

Continuous Update Project

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Life expectancy at birth (2008)

80-85 75-80 70-75 65-70 60-65 55-60 < 55 NA

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Demographic Transition 1890-2030 (% pop > 65 yrs old)

% aged > 65

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Global population is increasing and growing

  • lder leading to increasing cancer rates
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Deaths attributable to 16 leading risk factors: all countries, 2008

3000 6000 7000 8000 1000 2000

Deaths (000)

4000 5000 Low mortality – Developing High mortality – Developing Developed countries Adapted from World Health Report 2008 Blood pressure Tobacco Use Cholesterol Underweight Unsafe sex Fruit & vegetable High body mass Index Physical inactivity Alcohol Unsafe water, hygiene Indoor smoke/fuels Iron deficiency Urban air pollution Zinc deficiency Vitamin A deficiency Unsafe health/injections

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Deaths in low and middle-income countries

Communicable ¡ diseases, ¡maternal, ¡ perinatal ¡and ¡ nutri3onal ¡condi3ons ¡ NCDs ¡below ¡age ¡70 ¡ (preventable) ¡ NCDs ¡

  • ver ¡age ¡70

¡ Injuries ¡

10 million 20 million 30 million 40 million 50 million 60 million

Total number of deaths in LMICs (millions)

Source: ¡WHO, ¡2008 ¡

h1p://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html ¡

14 million premature deaths due to NCDs (CVDs and Cancer)

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Projected deaths averted by income group if global goal for 2006-15 is achieved

Goal: 2% reduction in NCDs death rates per year, over next 10 yrs

36 Million lives can be saved

WHO Chronic Disease report 2005

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Causes of Chronic Diseases

WHO Chronic Disease report 2005

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EXPERT REPORT PROCESS Key features

q Rigorous methodology q Systematic reviews q Review of evidence separate from

judgement

q Panel of international experts q Predetermined criteria for judgements q Flexibility

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2007 WCRF/AICR Report Recommendations

  • Based on evidence relating to cancer
  • Compared to recommendations for other chronic disease
  • Recommendations are consistent with prevention of obesity,

diabetes, CHD, and nutritional deficiencies

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The Panel emphasises the importance of not smoking and

  • f avoiding exposure to tobacco

smoke

Recommendations from the 2007 WCRF/ AICR Expert Report

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Germany: The Melander family of Bargteheide Food expenditure for

  • ne week US $500
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Ecuador: The Ayme family of Tingo Food expenditure for one week US $31.55

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Chad: The Aboubakar family of Breidjing Camp Food expenditure for one week US $1.23

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Diets of Rural Chinese Children 1991-2006

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Continuous Update Project

q Keep evidence, conclusions and

recommendations updated into the future

q Same principles and rigorous methodology

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Pre Pregnancy BMI Maternal Glucose Insulin Placental Fetal blood flow Fetal growth restriction Fetal Macrosomia

Weight gain with limited length gain

Early Adiposity rebound Early Pubertal maturation

Central Obesity Metabolic syndrome

High BMI Obesity

Hormonal responses

Hormonal responses Epigenetic changes

Pre-natal Post-natal

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Conclusions.

  • There is an association between thinness in

infancy and the presence of impaired glucose tolerance or diabetes in young adulthood.

  • Crossing into higher categories of body-mass

index after the age of two years is also associated with these disorders.

Bhargava SK et al NEJM 350: 865-875 2004

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IMPACT OF OFFSPRING SIZE AND GROWTH ON CANCER RISK

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Promotion of Healthy Living at all

stages of the Life Course Age

D e v e l

  • p

m e n t

  • f

D i s e a s e

Fetal Life Adult Life Adolescence Infancy and Childhood

Breast Feeding SES Growth rate Physical Activity Food behaviour TV viewing Sugary drinks PEM Micronutrients Infection Tallness Obesity Sendentarism Inactivity Smoking Physical Activity Food behaviour TV viewing Sugary drinks Established adult risky behaviours Diet/Physical activity, Tobacco, Alcohol Biological risks Socioeconomic status Environmental conditions SES Mother’s early Nutrition Organ Growth birth weight Body composition

Cumulative risk

  • f Cancer & other NCDs

Genetic susceptibility to disease Elderly

Cancer Prevention as part of NCD Control with a Life Course Perspective

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Conclusions

q WCRF/AICR 2007 Expert Report and CUP most

authoritative

q Early life events seem to have a major impact, but detailed

understanding needs further research

q 2007 Expert Report recommendations represent more than

a nutritional cancer reduction programme, but if followed, together with tobacco avoidance, would reduce risk of main NCDs while also being consistent with avoiding undernutrition

q CUP keeps Report updated into the future and maintains

currency of conclusions and recommendations