Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Linda D. Browning, PhD, MPH RD¹, Michael P. Anastario, MA¹, and Paula K. Ivey-Henry, PhD, MSc². (1) Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, 3 - 034U, Boston, MA 02120, 617 525-7515, lbrowning@partners.org, (2) Society Human Dev and Hlth, Harvard School of Public Health, 677 Huntington Avenue, Kresge Bldg, Boston, MA 02115

Diabetes II has tripled in genetically vulnerable and progressively younger groups during the last twenty years. Historically a rare disorder, prevention and treatment of diabetes focused on individual choice and behavior. Currently an epidemic, surveillance efforts shift to identify population characteristics where diabetes II is common in order to suggest control efforts. Rapidly transitioning food supplies, processing technologies, and changing cultural norms may be affecting a number of endocrine pathways and metabolic disturbances underlying this epidemic. Insulin, an established growth-promoting hormone, is released in “overfeeding” experiments where carbohydrate and/or fat increase fat deposition, insulin resistance, and diabetes II, as well as other metabolic disorders. We evaluated long-term dietary trends with diabetes prevalence by time series analysis using annual USDA food balance data, (shown to be comparable to 10-year CSFII and HANES dietary data), and annual BRFSS age-adjusted diabetes II prevalence data. A significant effect between periods (pre 1989 versus post) was found for percent calories from carbohydrate on diabetes prevalence but not for fat or protein. After taking the first difference of the diabetes series, there was a significant positive association post-1989% carbohydrates intake (b=. 13) versus pre-1989 percent carbohydrate intake (b =-.05)(t=2.3; p<.05), which held for neither fat (t=-.6, p=.6) nor protein (t=1.3, p=.2). The emergence of metabolic disease and divergence of modern diets from evolved species-typical patterns suggest thresholds to human metabolic adaptability. Investigation of metabolic adaptability within populations, as well as timely annual surveillance of food distribution systems, seem imperative to continuing national health and food security.

Learning Objectives: Participants attending this session will be able to

1.Recognize the comparability of energy intake estimates for the three major national dietary surveillance systems 1970-2000 (CSFII, HANES, and USDA ERS Food Balance Sheets. 2.Recognize patterns of diabetes II as a chronic disease epidemic and physical activity estimates in the U.S. population 1980-2000 using Center’s for Disease Control (CDC) Behavioral Risk Factor Survey (BRFSS).
• Identify 4 conditions in human populations associated with diabetes II becoming common in those populations.
• Discuss the value and limitations of trend analysis in understanding the natural history of chronic disease and tracking community policy changes.

Keywords: Dietary Assessment, Disease Data

Presenting author's disclosure statement:

Any relevant financial relationships? No