Abstract
This chapter proposes that the major challenge for human health in the twenty-first century is chronic diseases and chronic conditions. This is a global problem, burdening health care systems and economies worldwide. WHO statistics show that almost 70% of deaths annually are caused by chronic diseases, especially cardiovascular disease, cancer, chronic respiratory diseases, and diabetes. Factors contributing to the increase in chronic illnesses worldwide are aging populations, rapid urbanization, and the globalization of unhealthy lifestyles. This global burden of chronic disease is felt most strongly in minority and low-income populations and in developing countries. The first order of interventions includes community-based public health interventions, for example, initiatives to ban tobacco and alcohol advertising, replace trans fats with polyunsaturated fats, and increase breastfeeding. The chapter also introduces functional medicine and the Pathways approach to chronic conditions, two perspectives integrating a holistic evolutionary systems-based approach, with attention to lifestyle variables, affective regulation, early trauma, and environmental influences. The example of obesity is utilized to illustrate the influence of lifestyle, nutrition, stress, trauma, and the human biome on chronic conditions.
This chapter was written with the assistance of co-author, Jennifer Heintzman, Ph.D., College of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
CVD here includes primarily coronary heart disease and stroke, high blood pressure, and heart failure.
References
Abegunde, D., Mathers, C., Adam, T., Ortegon, M., & Strong, K. (2007). The burden and costs of chronic diseases in low-income and middle-income countries. The Lancet, 370(9603), 1929–1938. https://doi.org/10.1016/s0140-6736(07)61696-1
Adeyl, O., Smith, O., & Robles, S. (2007). Public policy and the challenge of chronic noncommunicable diseases. Washington, DC: The World Bank Publications. Retrieved from http://siteresources.worldbank.org/INTPH/Resources/PublicPolicyandNCDsWorldBank2007FullReport.pdf
Ahima, R. S. (Ed.). (2016). The metabolic syndrome: A textbook. Cham, Switzerland: Springer.
American Psychological Association. (2015). 2015 Stress in America. Retrieved from http://www.apa.org/news/press/releases/stress/2015/snapshot.aspx
Anderson, G., & Horvath, J. (2004). The growing burden of chronic disease in America. Public Health Reports, 119(3), 263–270. https://doi.org/10.1016/j.phr.2004.04.005
Australian Institute of Health and Welfare. (2015). Chronic diseases. Retrieved from http://www.aihw.gov.au/chronic-diseases/
Baldofski, S., Rudolph, A., Tigges, W., Herbig, B., Jurowich, C., Kaiser, S., et al. (2016). Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in pre-bariatric patients. International Journal of Eating Disorders, 49(2), 180–185. https://doi.org/10.1002/eat.22484
Benyshek, D. C., & Watson, J. T. (2006). Exploring the thrifty genotype’s food-shortage assumptions: A cross-cultural comparison of ethnographic accounts of food security among foraging and agricultural societies. American Journal of Physical Anthropology, 131, 120–126.
Bland, J. (2015). Functional medicine: An operating system for integrative medicine. Integrative Medicine, 14(5), 18–20.
Centers for Disease Control and Prevention. (2014). CDC national health report: Leading causes of morbidity and mortality and associated behavior risk and protective factors—United States, 2005–2013. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6304a2.htm
Centers for Disease Control and Prevention. (2016a). Chronic disease overview. Retrieved from https://www.cdc.gov/chronicdisease/overview/
Centers for Disease Control and Prevention. (2016b). The four domains of chronic disease prevention: Working toward health people in healthy communities. Retrieved from https://www.cdc.gov/chronicdisease/pdf/four-domains-factsheet-2015.pdf
Cox, A., West, N., & Cripps, A. (2015). Obesity, inflammation, and the gut microbiota. The Lancet, Diabetes and Endocrinology, 3(3), 209–215. https://doi.org/10.1016/S2213-8587(14)70134-2
D’Argenio, A., Mazzi, C., Pecchioli, L., Di Lorenzo, G., Siracusano, A., & Troisi, A. (2009). Early trauma and adult obesity: Is psychological dysfunction the mediating mechanism? Physiology and Behavior, 98(5), 543–546. https://doi.org/10.1016/j.physbeh.2009.08.010
de Campora, G., Giromini, L., Larciprete, G., Li Volsi, V., & Zavattini, G. C. (2014). The impact of maternal overweight and emotion regulation on early eating behaviors. Eating Behavior, 15(3), 403–409. https://doi.org/10.1016/j.eatbeh.2014.04.013
de Campora, G., Larciprete, G., Delogu, A. M., Meldolesi, C., & Giromini, L. (2016). A longitudinal study on emotional dysregulation and obesity risk: From pregnancy to 3 years of age of the baby. Appetite, 96, 95–101. https://doi.org/10.1016/j.appet.2015.09.012
DiBaise, J., Zhang, H., Crowell, M., Krajmalnik-Brown, R., Decker, G., & Rittmann, B. (2008). Gut microbiota and its possible relationship with obesity. Mayo Clinic Proceedings, 83(4), 460–469. https://doi.org/10.4065/83.4.460
Everly, G. S., & Lating, J. M. (2013). A clinical guide to the treatment of the human stress response. New York, NY: Springer.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Apitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventative Medicine, 14(4), 245–258.
Foster, J. A., Rineman, L., & Cryan, J. F. (2017). Stress and the gut-brain axis: Regulation by the microbiome. Neurobiology of Stress, 7, 124–136. https://doi.org/10.1016/j.ynstr.2017.03.001. Retrieved from http://ac.els-cdn.com/S2352289516300509/1-s2.0-S2352289516300509-main.pdf?_tid=d9f07b0e-6a62-11e7-91de-00000aacb35e&acdnat=1500236025_c38207bff794182cb2a6ae0e474f6e30
Fuemmeler, B. F., Dedert, E., McClernon, F. J., & Beckham, J. C. (2009). Adverse childhood events are associated with obesity and disordered eating: Results from a U.S. population-based survey of young adults. Journal of Traumatic Stress, 22(4), 329–333. https://doi.org/10.1002/jts.20421
Gallup Inc. (2014). The “40-hour” workweek is actually longer—By seven hours. Gallup.com. Retrieved from http://www.gallup.com/poll/175286/hour-workweek-actually-longer-seven-hours.aspx
Gowey, M. A., Reiter-Purtill, J., Becnel, J., Peugh, J., Mitchell, J. E., Zeller, M. H., et al. (2016). Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity. Appetite, 99, 211–218. https://doi.org/10.1016/j.appet.2016.01.020
Grisanti, R., & Weatherby, D. (2008). Implementing functional diagnostic medicine into your clinic. Functional Medicine University. Retrieved from http://www.functionalmedicine.net/pdf/lesson3_insider_guide.pdf
Grundy, S. M. (1998). Multifactorial causation of obesity: Implications for prevention. American Journal of Clinical Nutrition, 67(3 Suppl), 563S–572S.
Hamilton, M., Healy, G., Dunstan, D., Zderic, T., & Owen, N. (2008). Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior. Current Cardiovascular Risk Reports, 2(4), 292–298. https://doi.org/10.1007/s12170-008-0054-8
Han, T. S., & Lean, M. E. J. (2016). A clinical perspective of obesity, metabolic syndrome, and cardiovascular disease. JRSM Cardiovascular Disease, 5, 1–13. https://doi.org/10.1177/2048004016633371
Hughes, K. (2014). A case study discussion of the new era of applying the functional medicine model to patient care when managing detox-related health concerns. The Institute for Functional Medicine. Retrieved from http://congress.metagenics.com.au/postcongress/media/presentation-slides/3-kristi-hughes-functional-medicine.pdf
Hyman, M. (2007). Systems biology, toxins, obesity, and functional medicine. Alternative Therapies in Health and Medicine, 13(2), 134–139.
Hyman, M. (2010). Environmental toxins, obesity, and diabetes: An emerging risk factor. Alternative Therapies in Health and Medicine, 16(2), 56–58.
Jones, D., & Quinn, S. (2016). Introduction to functional medicine (1st ed.). Gig Harbor, WA: The Institute for Functional Medicine. Retrieved from https://p.widencdn.net/wzl55z/Intro_Functional_Medicine
Lambert, E. A., Straznicky, N. E., Dixon, J. B., & Lambert, G. W. (2015). Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? American Journal of Physiology: Heart and Circulatory Physiology, 309(2), H244–H258. https://doi.org/10.1152/ajpheart.00096.2015
Levi, J., Segal, L. M., Rayburn, J., & Martin, A. (2015). The state of obesity: Better policies for a healthier America: 2015. Obesity Policies Series: Trust for America’s Health and the Robert Wood Johnson Foundation. Retrieved from http://stateofobesity.org/files/stateofobesity2015.pdf
Ley, R. (2009). Obesity and the human microbiome. Current Opinion in Gastroenterology, 26(1), 5–11. https://doi.org/10.1097/MOG.0b013e328333d751
Martínez-Martínez, L. A., Mora, T., Vargas, A., Fuentes-Iniestra, M., & Martínez-Lavín, M. (2014). Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: A review of case-control studies. Journal of Clinical Rheumatology, 20(3), 146–150. https://doi.org/10.1097/RHU.0000000000000089
McGrady, A. (2010). The effects of biofeedback in diabetes and hypertension. Cleveland Clinic Journal of Medicine, 77(Suppl 3), S68–S71. https://doi.org/10.3949/ccjm77.s3.12
McGrady, A., & Moss, D. (2013). Pathways to illness, pathways to health. New York, NY: Springer.
Monteiro, R., & Azevedo, I. (2010). Chronic inflammation in obesity and the metabolic syndrome. Mediators of Inflammation, Vol. 2010, Article ID 289645. doi:10.1155/2010/289645
Neilsen. (2016). The total audience report: Q1 2016. Nielsen.com. Retrieved from http://www.nielsen.com/us/en/insights/reports/2016/the-total-audience-report-q1-2016.html
Nesse, R., & Stearns, S. (2008). The great opportunity: Evolutionary applications to medicine and public health. Evolutionary Applications, 1(1), 28–48. https://doi.org/10.1111/j.1752-4571.2007.00006.x
Physical Activity Council. (2016). 2016 participation report (1st ed.). Physical Activity Council. Retrieved from http://www.physicalactivitycouncil.com/pdfs/current.pdf
Pratt, M., Norris, J., Lobelo, F., Roux, L., & Wang, G. (2012). The cost of physical inactivity: Moving into the 21st century. British Journal of Sports Medicine, 48(3), 171–173. https://doi.org/10.1136/bjsports-2012-091810
Randall, S., & Ford, H. (Eds.). (2011). Long term conditions: A guide for nurses and health professionals. Chichester, West Sussex: Wiley-Blackwell
Speakman, J. (2013). Evolutionary perspectives on the obesity epidemic: Adaptive, maladaptive, and neutral viewpoints. Annual Review of Nutrition, 33(1), 289–317. https://doi.org/10.1146/annurev-nutr-071811-150711
United States Department of Health and Human Services. (2012). What are the health risks of overweight and obesity? Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks
United States Department of Health and Human Services & United States Department of Agriculture. (2015). Dietary guidelines for Americans, 2015–2020 (8th ed.). Retrieved from https://health.gov/dietaryguidelines/2015/guidelines/chapter-2/current-eating-patterns-in-the-united-states/
United States Department of State. (n.d.). Infectious and chronic disease. Retrieved from http://www.state.gov/e/oes/intlhealthbiodefense/id/index.htm
Valavanis, J. K., Mougiakakou, S. G., Grimaldi, K. A., & Nikita, K. S. (2010). A multifactorial analysis of obesity as CVD risk factor: Use of neural network based methods in a nutrigenetics context. BMC Bioinformatics, 11, 453. https://doi.org/10.1186/1471-2105-11-453
Williamson, D. F., Thompson, T. J., & Anda, R. F. (2002). Body weight and obesity in adults and self-reported abuse in childhood. International Journal of Obesity, 26(8), 1075–1082. doi:10.1038/sj.ijo.0802038.
Wooley, J. D., Gorno-Tempini, M. L., Werner, K., Rankin, K. P., Ekman, P., Levenson, R. W., et al. (2004). The autonomic and behavioral profile of emotional dysregulation. Neurology, 63(9), 1740–1743.
World Health Organization. (1992). Twenty steps for developing a healthy cities project. Geneva, Switzerland: World Health Organization, Regional Office for Europe.
World Health Organization. (2003). Diet, nutrition, and the prevention of chronic diseases: Report of a joint WHO/FAO expert consultation. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/dietphysicalactivity/publications/trs916/en/gsfao_introduction.pdf
World Health Organization. (2011). Global status report on non-communicable diseases 2010. Geneva, Switzerland: World Health Organization.
World Health Organization. (2013). Global action plan for the prevention and control of NCDs 2013–2020. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/nmh/events/ncd_action_plan/en/
World Health Organization. (2015). Non-communicable diseases: Fact sheet. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/mediacentre/factsheets/fs355/en/
World Health Organization. (2016a). Management of non-communicable diseases. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/ncds/management/en/
World Health Organization. (2016b). Non-communicable diseases and their risk factors. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/ncds/en/
World Health Organization. (2016c). Controlling the global obesity epidemic. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/nutrition/topics/obesity/en/
World Health Organization. (2017). Obesity and overweight: Fact sheet. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/
Young-Hyman, D. L., Peterson, C. M., Fischer, S., Markowitz, J. T., Muir, A. B., & Laffel, L. M. (2016). Depressive symptoms, emotion dysregulation, and bulimic symptoms in youth with type 1 diabetes: Varying interactions at diagnosis and during transition to insulin pump therapy. Journal of Diabetes Science and Technology, 10(4), 845–851. https://doi.org/10.1177/1932296816645118
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
McGrady, A., Moss, D. (2018). Chronic Illness, Global Burden, and the Pathways Approach. In: Integrative Pathways. Springer, Cham. https://doi.org/10.1007/978-3-319-89313-6_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-89313-6_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-89311-2
Online ISBN: 978-3-319-89313-6
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)