Lifestyle interventions

Type 2 diabetes is at epidemic proportions among Aboriginal people in Canada – around 15% of the Aboriginal population from 15 years and older. During the 1980s, healthcare providers at the local hospital in Kahnawake Mohawk Territory near Montreal, Quebec, noticed high rates of diabetes among people with cardiovascular

As the number of children with obesity continues to grow, the health implications of the condition are becoming increasingly evident: an unprecedented epidemic of type 2 diabetes is emerging in obese and overweight young people. At the time of diagnosis of diabetes, cardiovascular disease may already be present, even in young adults. The close association between type 2 diabetes and cardiovascular disease led to the hypothesis that the two may arise from a common antecedent, the metabolic syndrome – a cluster of metabolic disorders.

We can take advantage of the metabolic syndrome: it can be used as a simple and effective tool to assess health risks in people with type 2 diabetes and those without the condition. We can benefit from the universal availability of the tools needed to make a diagnosis – at no further cost. Given the excessive levels of death and disability suffered by people with type 2 diabetes and its associated conditions, it is of the utmost importance that early and appropriate steps are taken once a diagnosis of the metabolic syndrome is made. Fortunately, there

Over a few million years, human genes gradually evolved, enabling us to survive frequent periods of famine. Our genes are still essentially the same; but we are currently exposed to lifestyles for which we are not programmed. We were

Indigenous Australians have poorer health than the rest of the Australian population; for Aboriginal people, life expectancy is about 20 years less than for the general population. Significantly though, the low expectation of life in Indigenous Australians is less associated with high child mortality, as occurs in many groups in developing countries; the big differences are among young to middle-aged adults.

Although diabetes-related amputations are preventable, for too many people around the world, losing a limb or part of a limb is a tragic consequence of having diabetes. The high rates of these amputations are an indication of inadequacies in the delivery of health care, which create enormous challenges for those attempting to access high quality foot education and care. In this article, Margaret McGill focuses on current recommendations for health-care providers and makes a call for an individualized approach to diabetes foot care.

A newspaper columnist in the UK recently grumbled that, ‘The anti-smoking groundswell seems to have come from nowhere. Why didn’t it occur in 2000 or 1996 or 1986?’ He admitted to being a smoker, and wondered why he was becoming a ‘social pariah’. The reality, of course, is that the health risks of smoking have been known for more than a generation; that the health community has long been demanding a public policy approach to effective tobacco control, and that political change – especially concerning sensitive and contested issues – takes time.

Tobacco consumption is the second leading risk factor for death worldwide. It is estimated that currently 4.9 million people die each year due to tobacco-related diseases and, if current trends in tobacco consumption continue, this death toll will double in 20 years. As research continues into the effects of tobacco on health, the list of conditions that are caused or compounded by tobacco has expanded. There is nowadays evidence that almost every organ in the body is affected by tobacco smoking. Effective control of tobacco consumption has been seen in

Compared to people without the condition, people with diabetes are at increased risk from vascular diseases – including heart attack and stroke. This risk is further increased in people with diabetes who smoke; smokers with the condition should be advised by their health carers to stop smoking as a matter of urgency. But giving up the habit is not easy. Successful cessation requires people to surmount a number of difficulties, including strong physical, psychological and behavioural

In the 1950s, the relationship between dietary habits and cardiovascular disease was explored for the first time in an epidemiological study: the Seven Countries Study, which is considered a milestone of research in cardiology and nutrition. It was found that cardiovascular disease was 50% less common in the populations living in the Mediterranean area than in those living in northern Europe or the USA. The marked difference in the diets of the respective populations largely accounted for this disparity in rates of cardiovascular disease. In this article, Gabriele Riccardi