HP252 test 3 part 2

1910-1950: era of vitamin discovery and recommended daily allowances
1960-1970: commodity crops, foritification, using food as a delivery system fat v sugar protein v calories
1980-1990: Chronic diseases, dietary guidline and action onf hunger
2000-2010: COmplex effects, food dietary patterns, the double burden
2020-: the future diest risk pathways new dietary complexities, public health, etc

happened in the 1960's
initial rise in urbanization, mechanization, motorization and computerization didn't lead weight gain
move less-stay lean phase (1910-1960)
-reduction in energy intake trhoug the 1960's to match reduced expenditure
eat more-gain wieght phase
-Rise in refined carbohydrates, fats and calories (environmental
push factors)
• Increased supply of cheap, palatable, energy-dense foods
• Improved distribution systems increasing access and
convenience
• Persuasive and pervasive food marketing

“Obesity is the result of people responding normally
to the obesogenic environments that they find
themselves in.”
”Obesogenic environments arise because businesses
and governments are responding normally to the
broader economic and political environments that
they find themselves in.”

most people would benefit from eating MORE
health promoting foods

most people would benefit from eating LESS
less harmful foods

fruits: 2 cups
vegs: 3 cups
whole grains: at least 1/2 of grains are whole
dairy: 3 cups
plant proteins: 1 serving per day
seafood: 2-4 ounce serving per week
heart healthy oil: 2-3 teaspoons per day

death from too few: nut/seeds, seafoods omega-3's, vegs, fruits, whole grains
death from eating tooo much: sodium, processed meat, surgary beverages, unprocessed red meat

-medical tailored meal programs
-medically tailored food programs
-producr prescription/voucher programs
-population-level healthy food programs
-snap wic emergency food programs

Proximal determinants
• Behaviors driven by obesogenic drivers within food and
physical activity environments
• Distal determinants
• Systemic drivers that set the conditions for businesses and
individuals
• Taxation
• Regulations
• Social and economic policies
• Moderators may be powerful, but not drivers
• Accentuate or attenuate effect of drivers

measures how closely food and beverage choices align with the Dietary Guidelines. A higher total score indicates a higher
quality diet.

immune system is overactive so it attacks healthy cells common

gout build up of uric acid

infection in the body travels to joint main treatment is antibodies

most common

43% are 65 or older, 88% are 45 or older
62% of people are female
greater impact on people of color than white community

Painful, chronic disease of joints that includes
damage to all joint tissues including cartilage, bone,
muscle, etc.
• It results from an interplay of genetic, metabolic,
biomechanical, and biochemical factors
• Knee is the most affected joint
always moving and carries alot of weight

-pain
-swelling
-stiffness
-crepitus (grinding sound)
-deformity
-movement restriction (usually loss of knee flexion)

age, overweight, female sex, previous injury, family history, occupations involing standing or kneeling

Xray (reduced or no gap)
Knee MRI ( local cartilage loss, lesions in bone, menisus tear)
critieria clinical (greater then 50, stiffness for less then 30 mins, crepitus, bony tenderness, bony enlargement, no palpable warmth need at least 3/6)
criteria ( joint pain with actiivty,greater than 45, brief morning stiffness, addtional symtpoms

-drugs (oral, topical, injections COX-2 inhibitors)
-arthritis education
-structured land-based exercise programs (PT, mind-body exercise)
-weight management
-self management programs
-partial joint replacement
-total joint replacement

Mechanical and Structural Factors and Metabolic Factors (inflammation) where most treatment focuses on
Psycho-social factors and Nervous system response