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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Diseases of overnourished societies and the need for dietary change

Chapter:
Diseases of overnourished societies and the need for dietary change
Author(s):

J.I. Mann,

A.S. Truswell

DOI:
10.1093/med/9780199204854.003.1104

The nutritional problems of a country depend more upon the stage of technical and economic development than geographical location. People in affluent societies do not have to worry about the problems of getting food and keeping it uninfected. Food is cheap for them, and they can eat their favourite foods all year round: the diet is energy-dense, high in fat and often also in sugar. There are multiple sources of nutritional advice and concerns, with breakthroughs and scares, science and pseudoscience, about all food. Nutrition related disorders are the principal causes of death and serious morbidity and reliable advice regarding nutrition is an important component of the care of individuals and public health.

Obesity (see Chapter 11.5) is the most obvious and important nutritional disease in affluent societies, with comorbidities including type 2 diabetes, coronary heart disease, hypertension, some cancers, gallstones, osteoarthritis, and obstructive sleep apnoea. Obese people may also be disadvantaged by social, economic, and psychological effects. Particular dietary constituents promote or protect against coronary heart disease by their effect on cardiovascular risk factors, and some promote or protect against various cancers.

While those at the highest personal risk are likely to show the greatest individual benefit from dietary and lifestyle changes, rates of many chronic disease will best be reduced if changes are made by the population at large. The main purpose of such recommendations is to reduce the risk of morbidity and mortality from these disease in those who are in the prime of life. Even greater reduction in morbidity and mortality and an improvement in life expectancy may occur in succeeding generations if they have reduced lifetime exposure to risk factors related to lifestyle.

Dietary guidelines for which there is almost complete agreement are:

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