The global nutrition transition, which embraces major changes in how food is produced, distributed and consumed, is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: ‘metabolic capacity,’ which promotes glucose homeostasis, and ‘metabolic load’, which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under selective pressure to maximise reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.
Humanity, like all other species of Earth before and with us, is evolving — and evolution, for humans as for all species, is neither predictably linear nor solely Darwinian. Earth’s nearly four billion years of evolutionary experience reveals reliable patterns that give us hope, inspiration and valuable guidance for getting ourselves through the unprecedented confluence of enormous crises in which we humans quite suddenly find ourselves. Here we see the evolutionary Big Picture, including the amazingly complex lives of our remotest bacterial ancestors, who had Earth to themselves for fully half of evolution, and much of whose experience we seem to be mirroring now. They engaged in hostilities, generated global crises of hunger and pollution as great as ours today, and solved them without benefit of brain! Along the way they invented electric motors, atomic piles and the first World Wide Web of DNA exchange; then, in the greatest of all evolutionary ventures, formed cooperatives that became nucleated cells. These cooperatives were the basis for the evolution of our own hundred-trillion-celled human bodies, which role model amazingly sustainable economies. Learning from newly revealed problems and solutions in biological evolution, we too are finding out how to survive and even thrive into a better future despite — perhaps because of — our greatest challenges. That would indeed be cause for celebration.
It all started last week, when I had another flare of my recurrent joint problems, which are usually triggered from stress at the workplace that appears to be going from bad to worse. I have been trying to wean myself off steroids for the inflammation in my joints over the year, but each time I… Read More
Table of Contents
What you do with your fork impacts everything | Mark Hyman | TEDxChicago
What is the best diet for humans? | Eran Segal | TEDxRuppin
Microbiome: Gut Bugs and You | Warren Peters | TEDxLaSierraUniversity
Why is the Science of Nutrition Ignored in Medicine? | T. Colin Campbell | TEDxCornellUniversity
The food we were born to eat: John McDougall at TEDxFremont
Debunking the paleo diet | Christina Warinner | TEDxOU
Sugar — the elephant in the kitchen: Robert Lustig at TEDxBermuda 2013 Read More
This working paper is meant to provide a quick reference guide to and portrait of the underlying principles that support current public health practice; it is not intended to be the definitive treatise on this topic. It defines the perspective that CPHA will use to develop its policy options.
The relationship between human beings and the ecosystems of which they are a part is profound. The links between health and the environment are as old as human culture. Human evolution takes place within ecosystems, and there are deep psy- chological, social and cultural connections to ecosystems that go well beyond mere physiological needs.
In the late 20th and early 21st centuries, myriad threats to the health of the Earth’s environment have become apparent. There is a growing recognition that the Earth is itself a living system and that the ultimate determinant of human health (and that of all other species) is the health of the Earth’s life-supporting systems. The ecosystem-based ‘goods and services’ that we get from nature are the ecological determinants of health. Among the most important of these are oxygen, water, food, fuel, various natural resources, detoxifying processes, the ozone layer and a reasonably stable and habitable climate.
Public health in the 21st century must augment its scope to address the natural world; encompass concepts such as One Health and Ecohealth; and specifically target the health challenges of human-induced global climate change, resource deple- tion, ecotoxicity and loss of biodiversity.
Our knowledge of the health impacts of global ecological change is surprisingly limited. What we know is imprecise, pre- liminary and often speculative; we have some idea of the big picture, but the details are lacking. Even in the case of climate change, we have only a modest sense of the potential health impacts, although this has been the focus of some well-resourced research over the past few decades, both globally and in Canada.
We do know that the indirect health effects of global ecological change – those mediated through natural and human systems – are likely to be much greater than the direct effects (such as heat waves), although they are harder to quantify and attribute directly to a specific global change. This difficulty in quantifying the indirect health effects is part of the uncertainty with which we must deal.
The key human forces driving changes in ecosystem functioning are population growth and urbanization, economic growth and development, technological changes and advances, and social changes and movements aligned to these forces. Under- lying and shaping these drivers are societal and cultural values, which for the past 200 to 300 years have emphasized ‘progress’ or modernization, transforming human societies from rural and agrarian to secular, urban and industrial. The long history of modernization helps us to understand our current social, political, economic and cultural conditions, and, perhaps, to anticipate a post-modern society that enables us to stabilize and reverse these harmful ecological changes.
We will need some fundamental shifts in societal values, and with that new principles, and new ways of knowing, measuring and governing. Fortunately, we do not have to invent these from scratch as we have precedents and newly-emerging practices that can help provide a foundation for the new future we need to create. The fields of health promotion and Ecohealth offer conceptual and procedural guidance to catalyze a transformation toward public health equity for future populations.
If we understand the forces that shape us and the future we face, we are better equipped to make choices, express our values in a vision and then work to create it. Within public health, we need to explore scenarios of plausible futures, and help people create visions describing their preferred future.
CPHA’s vision of healthier, more sustainable, more just societies and communities will not be achieved in isolation from wider social processes. Realizing any such vision will demand transitions both within and outside public health and the larger health sector, including an explicit re-engagement with the values of public health.
This report makes explicit the links between health and the local economy, their interdependence, and the action that local authorities and their partners can take to ensure that health and wellbeing are key considerations in local and regional economic development strategies.
06 Feb 2019
Ensuring that the local economy benefits everyone – sometimes known as ‘inclusive growth’ – is a priority for local government.
The concept of inclusive growth was originally developed by economists working in developing countries, when organisations such as the World Bank realised that economic growth was not always resulting in the reductions in inequality and increases in living standards that had been expected.
There is increasing evidence that the benefits of wealth and a flourishing economy will not simply ‘trickle down’ to the poorest sections of society.
Much of the work that Government can do to improve the economic prosperity of a country takes place at the national level. But the way local authorities tackle issues of local economic development can also make a positive difference to the wellbeing of the communities they serve.
Across the country, local authorities, supported by their public health teams, are making valiant efforts, in the face of significant financial constraints, to make this aspiration come true.
The issues discussed here and the many examples of good practice will help ensure that, when it comes to our work of economic development, nobody is left behind.
Obesity is still increasing in prevalence in almost all countries and is an important risk factor for poor health and mortality. The current approach to obesity prevention is failing despite many piecemeal efforts, recommendations, and calls to action. This Commission following on from two Lancet Series on obesity looks at obesity in a much wider context of common underlying societal and political drivers for malnutrition in all its forms and climate change. The Commission urges a radical rethink of business models, food systems, civil society involvement, and national and international governance to address The Global Syndemic of Obesity, Undernutrition, and Climate Change. A holistic effort to reorient human systems to achieve better human and planetary health is our most important and urgent challenge.
Purpose of the review Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues.
Recent findings Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior.
Summary The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
Keywords Total environment . Social determinants . Cumulative exposures . Life course . Health disparities