Med J Aust171p280(1999 Sep 6)
The last half century has seen a steady increase in the incidence and prevalence of chronic inflammatory diseases with further increases expected. According to the Marshall Pathogenesis, a number of factors are to blame:
Manifestations of both arteriosclerosis1) 2) and cardiac disease3) can be observed in mummies of ancient Egypt. Ötzi the Neolithic Iceman who lived around 3300 BC was found to have arthritis.4) Yet, it is only recently that rates of certain chronic diseases have appeared to escalate.
At the beginning of the twentieth century, infectious diseases were the leading cause of death worldwide. In the United States, three diseases — tuberculosis, pneumonia, and diarrhoeal disease — caused 30% of deaths.5) By the end of the twentieth century, in most of the developed world, mortality from infectious diseases had been replaced by mortality from chronic illnesses such as heart disease, cancer and stroke.6)
According to a recent Nature paper there were 36 million deaths from “noncommunicable diseases” in 2008, or 63% of all deaths worldwide.7)
In 2000, approximately 125 million Americans (45% of the population) had chronic conditions and 61 million (21% of the population) had multiple chronic conditions.10)
According to a 2004 report:
In 2004, almost half of all Americans, or 133 million people, live with a chronic condition. … People with chronic conditions account for 83 percent of health care spending and those with five or more chronic conditions have an average of almost fifteen physician visits and fill over 50 prescriptions in a year.
Partnership for Solutions National Program Office, Robert Wood Johnson Foundation
The rate of chronic health conditions among children in the United States increased from 12.8% in 1994 to 26.6% in 2006, particularly for asthma, obesity, and behavior and learning problems, according to results of a new prospective study published in the 2010 paper in Journal of the American Medical Association.11)
Related article: Th1 Spectrum Disorder
According to a 2012 JAMA paper, the most common chronic condition experienced by adults is multimorbidity, the coexistence of multiple chronic diseases or conditions.12) In patients with coronary disease, for example, it is the sole condition in only 17% of cases.13) Almost 3 in 4 individuals aged 65 years and older have multiple chronic conditions, as do 1 in 4 adults younger than 65 years who receive health care.14) Adults with multiple chronic conditions are the major users of health care services at all adult ages, and account for more than two-thirds of health care spending.15)
A Dutch survey of 212,902 patients' records found the following:16)
A separate Dutch analysis found that the prevalence of chronic diseases doubled between 1985 and 2005 with the proportion of patients with four or more chronic diseases increased in this period by approximately 300%.17)
Chronic diseases are the largest cause of death in the world. In 2002, the leading chronic diseases—cardiovascular disease, cancer, chronic respiratory disease, and diabetes—caused 29 million deaths worldwide.18) Worldwide annual mortality due to chronic disease is expected to increase in real numbers as well as relative to deaths from injuries and diseases traditionally understood to be infectious such as polio, rubella, tuberculosis, etc.
In the United States, the number of people with chronic conditions is projected to increase steadily for the next 30 years.19) Partnership for Solutions National Program Office estimates that it will reach 157 million by 2010 while another estimate says that figure will be 140 million.
Obesity rates worldwide have doubled in the last three decades, even as blood pressure and cholesterol levels have dropped, according to several studies published in a 2011 issue of Lancet.22) In 1980, about 5 percent of men and 8 percent of women worldwide were obese. By 2008, the rates were nearly 10 percent for men and 14 percent for women. That means 205 million men and 297 million women were obese. An additional 1.5 billion adults were overweight.
Another team concluded in a recent meta-analysis that if Americans keep gaining weight at the current rate, 75 percent of U.S. adults will be overweight and 41 percent obese by the year 2015. A 2002 paper concluded that “the prevalence of obesity is increasing globally, with nearly half a billion of the world’s population now considered to be overweight or obese.”23)
Obesity is likely to continue to increase, and if nothing is done, it will soon become the leading preventable cause of death in the United States.
Youfa Wang, MD, PhD 24)
In a 2010 paper, Boyle predicted that one-third of the U.S. population will have diabetes by 2050. In a 2002 paper, Edwin Gale concluded that the incidence of childhood diabetes (type I diabetes) began to steadily increase at almost the same time – from the 1950s onwards.25) This increase had been identified in a range of developed countries including the United States, Sardinia, and Northern Europe.26)
According to a 2009 paper in Diabetes care, the number of people with diabetes in the United States is expected to double over the next 25 years. That would bring the total by 2034 to about 44.1 million people with the disease, up from 23.7 million today.27)
Psychiatric disorders which are on the increase globally, already rank among the leading causes of disability, and are expected to take over first place within the next few years. Indeed, the World Health Report 2001 cites depression as causing the largest amount of disability worldwide and in 2004 Ustun stated that depression was the fourth leading cause of disease burden but represents the largest amount of non-fatal burden globally.28) Further, a study of mood disorders among the populations in 30 European countries estimates that, in a typical year, about 165 million people — 38% of the total population of these countries — will have a fully developed mental illness.29)
According to the 2010 Canadian Community Health Survey (CCHS), the number of Canadians reporting a diagnosis of Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivities has increased markedly since 2005.
|CCHS 2005||CCHS 2010||% change|
|Chronic Fatigue Syndrome||333,816||413,370||24%|
|Multiple Chemical Sensitivities||598,585||784,798||31%|
It has been predicted that atherosclerosis will be the primary cause of death in the world by 2020.30)
Related article: Diseases associated with low levels of 25-D
Members of societies that do not supplement their food chains with vitamin D have naturally low levels of 25-hydroxyvitamin D (25-D).31) 32) However when whole populations are given large amounts of vitamin D, the only members of that population who remain “deficient” are those whose immune systems are fighting disease by actively downregulating 25-D. In other words, the more rigorously vitamin D is added to milk, juice, snack bars, and breakfast cereals, the less likely it is that someone has low levels of vitamin D but no chronic disease.
For this reason, data which identifies vitamin D “deficiency” is actually pointing to incidence of disease. In a 2009 paper, Saintonge et al showed that the prevalence of low levels of 25-D - and therefore the rate of chronic disease - is between 2% and 14% among a cohort of 2,955 Americans 12 to 19 years of age.33)
According to Dr. Roger Bouillon of the University of Leuven, “over one billion” people worldwide have vitamin D “deficiency.”34)
The accuracy of this estimate is debatable. If this figure includes those populations that do not supplement with vitamin D, Dr. Bouillon's figure may be an overestimate: healthy people who do not supplement with vitamin D have naturally low levels of 25-D. However, it does seem likely that a large fraction of the world's population suffers from chronic disease of one kind or another.
A study published in 2008, controlling for age and other factors, found that Americans' serum levels of 25-D declined “5-9 nmol/L” in 1988-1994 as compared to 2000-2004 in most males, but not in most females.35) A 2010 study found that 90% of the pigmented populace of the United States (Blacks, Hispanics, and Asians) and nearly 75% of the white population have levels of 25-D lower than 30 ng/ml. This proportion has doubled in these same population within the last 10 years.36)
While it has been widely hypothesized that lifestyle factors, including a poor diet and a lack of exercise, are driving what the World Health Organization has termed “an obesity epidemic,” even the most ambitious obesity intervention programs, which have gone to great lengths to increase rates of exercise and improve eating habits of a population, have been failures.37) 38)
According to the Marshall Pathogenesis, the primary cause of chronic inflammatory disease is microbes and factors which directly influence pathogens. Indeed, there is growing evidence that chronic diseases are not due to predominantly lifestyle factors. A number of factors have contributed to the creation of an epidemic of Th1 inflammatory diseases.
As discussed in the article Mistaking correlation for causation in vitamin D studies, observational studies are inherently problematic. However, there is a trove of research that suggests that pathogens play a key role in everything from rate of mortality to intelligence to whether a society chooses facist or democratic rule.
Main article: War – a crucible for chronic disease
War offers a number of circumstances which contribute to the incidence and prevalence of chronic disease as evidenced by epidemiological studies. Circumstances include:
Perhaps it is more than coincidence that those diseases for which there is a demonstrated association with war – cancers, hypertension, obesity, and many of the other forms of cardiovascular disease – saw an increase in the aftermath of World War II, particularly in the United States. Given the discrepancy with which the genders have traditionally enlisted, it would be speculative to suggest that war plays a role in the onset of predominantly “male” chronic diseases, but that possibility may be worth further study.
In recent years, there has been a dramatic increases in the incidence and prevalence of chronic disease. For this reason, there has been a commensurate increase in the percentage of people who take prescription drugs. Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44 percent to 48 percent, says a 2010 CDC report.
This said, the premium the U.S. spends on health care does not appear to lead to better longevity.47)
Even though pharmaceutical companies have spent more on the research and development of new drugs, the number of new drugs approved has declined in the last several decades.48)
Meanwhile, the market capitalization of the top-tier pharmaceutical companies has decline. From January 2001 and September 2009, the cumulative loss in market capitalization for these companies over the period is $626 billion.
To state the obvious, these data seems to suggest that new approaches are warranted.
Karesh - global trade and food
Obesity Has Nearly Doubled Worldwide Since 1980: Report http://www.businessweek.com/lifestyle/content/healthday/649633.html
U.S. Obesity Epidemic Continues to Spread - http://bit.ly/poceHQ
National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants
The number of adults with Type 2 diabetes more than doubled over the past three decades, according to research released Saturday by the British medical journal The Lancet.
Calling the findings “stark,” the study's authors estimated that 347 million adults globally had the disease in 2008 compared to 153 million in 1980.
The authors concluded that population growth accounted for much of the increase, but rises in obesity rates and other diabetes risk factors were responsible for nearly a third of the growth.
The United States had one of the highest rates of diabetes among high-income countries. Others in that top-ranking bracket included Spain, New Zealand and Greenland.
U.S. Rates of Autism, ADHD Continue to Rise: Report http://www.drugs.com/news/u-s-rates-autism-adhd-continue-rise-report-31534.html
One in six U.S. children now has a developmental disability such as autism, learning disorders or attention-deficit/hyperactivity disorder (ADHD), according to new research from the U.S. Centers for Disease Control and Prevention.
That number appears to be on the rise. In 1997-1999, about 12.8 percent of kids were diagnosed with a developmental disability. That number rose to 15 percent in 2006-2008 – or an additional 1.8 million U.S. children.
Much of the bump up in cases seems driven by rising rates of autism and ADHD, experts say