Universidade Federal Fluminense, Brazil
Title: Why did we not be able to halve the concomitant pandemics of obesity, diabetes, and coronary heart disease?
Jose Mario Franco de Oliveira, MD, Ph.D. is an Associate Professor of Medicine in the Department of Medicine of Universidade Federal Fluminense, in the State of Rio de Janeiro, Brazil. He is a Certified, Nephrologist, Preventative Cardiologist, and Adult Intensive Care Unit Physician. He has published numerous articles and letters to the editor in journals like The New England Journal of Medicine, The British Medical Journal, Hypertension, American Journal of Hypertension, Journal of the American Society of Nephrology, and etc. He is also a reviewer for a number of journals & a Deputy Editor for Diabetes at The British Medical Journal.
The pandemics of obesity and its complications like diabetes, and coronary heart disease, not to mention other diseases like cancer, hypertension, and chronic kidney diseases could well be defined as a modern plague largely brought on by lifestyle (Des Spence, The BMJ April 29th 2013). The panacea of Non-Communicable Diseases has been the biggest drug industry’s win with polypharmacy based namely on poorly surrogates outcomes easily achieved on short-term or biased clinical trials, such as pre-hypertension, microalbuminuria, carotid intima thickness and etc……… The complexities of promoting healthy diets and healthy lifestyles even at the workplaces, and childhood are reduced to policies of `Overdiagnosis, Overtreatment and Polyphramacy under the Paradigm of ``The Lower the Better``, with the artificial creation of ``new`` diseases like `pre-hypertension` and `pre-diabetes`. For this so close companions as Obesity, Type 2 Diabetes, and Coronary Heart Disease the affluent evidence points against intensive glycaemic control in diabetes, useless for micro, and macrovascular disease, these last ones the most disabling and more prevalent obese and diabetic complications. Recent Evidence, also points to less polypharmacy for hypertension and dyslipidaemia (JNC8th Hypertension Report and The BMJ Criticism to the New US Statins Guidelines). And Finally, Healthy Lifestyles, and Diets with at most 5% or less of Sugar daily consumption also should make easier the fight against all these Non-Communicable Diseases like the pandemics of Obesity, Diabetes, and Coronary Heart Disease.