296 Diet and Health
The WHO judges that there is convincing evidence for the increasing risks from:
- myristic and palmitic acid;
- trans-fatty acids;
- high sodium intake;
- overweight;
- high alcohol intake.
In regard to CHD, public health policy has tended to focus on two things: health
education as prevention, and improved medical treatment through drug, hospital
and surgical care. It has also urged behavioural change, in particular a reduction of
total fat intake and especially of saturated fats (mainly from animal meat and dairy
fats). This health promotion policy has had an effect: rates of heart disease are
declining in most affluent Western countries, after years of steady increase since
the immediate post-World War II period (see Tables 13.10 and 13.11).^86
The global picture is more complex, however.^87 For example, the steep rise in
CHD in the newly independent countries of Eastern Europe (such as Belarus,
Azerbaijan and Hungary) is worrying. Leaving the strictures of the Soviet era
means only that already high rates of CHD have risen further. Even in countries
considered to have a healthy diet, like Greece and Japan, social change is being
accompanied by changing patterns of diet-related disease: Greece’s CHD and
obesity rates are rising as it changes to a more Northern European diet high in
animal fats, following entry to the EU and increased tourism. Death rates from
CHD may have dropped in the US and Finland, but it should be remembered that
their morbidity and costs are still high, as was shown by the Global Burden of
Disease studies.
Table 13.10 Age-standardized deaths per 100,000 population from CHD selected
countries, 1968–1996: menMen 1968 1978 1988 1998
Finland 718 664 477 340
UK 517 546 434 297
Austria 327 349 262 226
US 694 504 292 224
Australia 674 409 315 202
Canada 543 457 296 200
Italya 230 249 172 150
Belgiuma 345 313 184 147
Spain 99 165 146 125
France 152 154 118 92
Japan 92 74 52 58Note: a latest statistics for 1994.