Pirogianni, V. et al. (2010). Fitness and weight cycling in relation to body fat and insulin sensitivity in normal‐weight young women. J. Am. Diet Assoc. 110 (2): 280–284.3 Benjamin, E.J., Muntner, P., Alonso, A. et al. (2019). Heart disease and stroke statistics–2019 update: a report from the American Heart Association. Circulation 139 (10): e56–e528.
4 Chatterjee, S., Khunti, K., and Davies, M.J. (2017). Type 2 diabetes. Lancet 389 (10085): 2239–2251.
5 Cooper, C.B., Neufeld, E.V., Dolezal, B.A., and Martin, J.L. (2018). Sleep deprivation and obesity in adults: a brief narrative review. Br. Med. J. Open Sport Exerc. Med. 4 (1): e000392.
6 Global Burden of Disease Cancer Collaboration Authors. (2019). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability‐adjusted life‐years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 5 (12): 1749–1768.
7 Hruby, A. and Hu, F.B. (2015). The epidemiology of obesity: a big picture. Pharmacoeconomics 33 (7): 673–689.
8 Hruby, A., Manson, J.E., Qi, L. et al. (2016). Determinants and consequences of obesity. Am. J. Public Health 106 (9): 1656–1662. doi: 10.2105/AJPH.2016.303326.
9 Institute for Health Metrics and Evaluation (IHME). (2018). Findings from the Global Burden of Disease Study 2017. Seattle, WA: IHME. http://ghdx.healthdata.org/gbd‐results‐tool.
10 International Diabetes Federation. (2020). Type 2 diabetes prevention.https://idf.org/our‐activities/care‐prevention/prevention.html.
11 Krekoukia, M., Nassis, G.P., Psarra, G. et al. (2007). Elevated total and central adiposity and low physical activity are associated with insulin resistance in children. Metabolism 56 (2): 206–213.
12 Ley, S.H., Ardisson Korat, A.V., Sun, Q. et al. (2016). Contribution of the nurses' health studies to uncovering risk factors for type 2 diabetes: diet, lifestyle, biomarkers, and genetics. Am. J. Public Health 106 (9): 1624–1630.
13 Li, Y., Gu, M., Jing, F. et al. (2016). Association between physical activity and all cancer mortality: dose‐response meta‐analysis of cohort studies. Int. J. Cancer 138 (4): 818–832.
14 Mahabir, S., Willett, W.C., Friedenreich, C. et al. (2018). Research strategies for nutritional and physical activity epidemiology and cancer prevention. Cancer Epidemiol Biomarkers Prev. 27 (3): 233–244. doi: 10.1158/1055‐9965.EPI‐17‐0509.
15 Mensah, G.A., Roth, G.A., and Fuster, V. (2019). The global burden of cardiovascular diseases and risk factors: 2020 and beyond. J. Am. Coll. Cardiol. 74 (20): 2529–2532.
16 Nassis, G.P. and Sidossis, L.S. (2009). Thighs and heart disease. Exercise, muscle mass, and insulin sensitivity. Br. Med. J. 339: b4249.
17 National Cancer Institute. (2017). Tobacco. www.cancer.gov/about‐cancer/causes‐prevention/risk/tobacco.
18 NCD Risk Factor Collaboration. (2016). Trends in adult body‐mass index in 200 countries from 1975 to 2014 : a pooled analysis of 1698 population‐based measurement studies with 19.2 million participants. Lancet 387 (10026): 1377–1396.
19 Popkin, B.M., Adair, L.S., and Ng, S.W. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutr. Rev. 70 (1): 3–21.
20 Rehm, J., Soerjomataram, I., Ferreira‐Borges, C., and Shield, K.D. (2019). Does alcohol use affect cancer risk? Curr. Nutr. Rep. 8 (3): 222–229.
21 Schols, A. and Sidossis, L.S. (2011). Abnormal body composition and early biomarkers of metabolic complications. Curr. Opin. Clin. Nutr. Metab. Care 14 (6): 517–519.
22 Schwenk, R.W., Vogel, H., and Schurmann, A. (2013). Genetic and epigenetic control of metabolic health. Mol. Metab. 2 (4): 337–347.
23 Shekhar, H.U., Chakraborty, S., Mannoor, K., and Sarker, A.H. (2019). Recent advances in understanding the role of genomic and epigenomic factors in noncommunicable diseases. Biomed. Res. Int. 2019: 1649873.
24 van der Valk, E.S., Savas, M., and van Rossum, E.F.C. (2018). Stress and obesity: are there more susceptible individuals? Curr. Obes. Rep. 7 (2): 193–203.
25 World Health Organization. (2017). Cardiovascular diseases (CVDs). https://www.who.int/news‐room/fact‐sheets/detail/cardiovascular‐diseases‐(cvds).
26 Yu, E., Rimm, E., Qi, L. et al. (2016). Diet, lifestyle, biomarkers, genetic factors, and risk of cardiovascular disease in the nurses' health studies. Am. J. Public Health 106 (9): 1616–1623.
CHAPTER 3 Components of an Unhealthy Lifestyle
Unhealthy Diets
Research has long linked specific nutrients (e.g., refined carbohydrates and added sugars, saturated and trans fatty acids [TFAs] and sodium), foods and food groups (e.g., sweets, sugary soft drinks, red meat, and processed meats), and specific dietary patterns (e.g., Western diet) with a number of diseases and conditions: CVD, cancer, diabetes, hypertension, liver and gallbladder diseases, and obesity. Moreover, diets low in whole grains, fruits and vegetables, nuts and seeds, and ω‐3/ω‐6 fatty acids seem to be the leading dietary risk factors of mortality the last two decades.
Regarding specific nutrients, high TFA intake increases the risk of all‐cause mortality, total CHD, and CHD mortality. Historically, studies on saturated fatty acids (SFAs) suggest positive associations with total and low‐density lipoprotein (LDL) cholesterol, coagulation markers, insulin resistance, and inflammation. Some studies have suggested that a long‐term diet high in SFAs could increase the risk for CVD and some cancers. However recent data do not fully support a direct connection between SFA and CVD.
An increased amount of dietary salt is an important risk factor for the development of hypertention and increased overall CVD risk. On the other hand, there is an inverse relation between fiber intake and all‐cause mortality. According to the WHO, approximately 3% of deaths worldwide are attributable to low fruit and vegetable consumption. Insufficient intake of fruits and vegetables increases the risk for gastrointestinal cancer, ischemic heart disease, and stroke. Most of the benefit of consuming fruits and vegetables comes from reduction in CVD risk, but fruits and vegetables also prevent cancer. Moreover, high consumption of red and processed meat has been associated with all‐cause mortality and with several types of cancer, diabetes, and CVD mortality. However, the consumption of whole‐grain cereals has been linked to improvements of metabolic syndrome (MetS) and its components: obesity, dyslipidemia, hypertension, and hyperglycemia or T2DM. According to the World Cancer Research Fund, up to 40% of cancers can be prevented by improving diet and increasing physical activity.
Therefore, shifting our diet from animal‐based foods to predominantly plant‐based foods may result in better health outcomes. In the following sections, we will focus on the most important components of an unhealthy diet.
Excess Caloric Intake
Experimental studies have demonstrated that excess caloric intake
