ABSTRACT
During this century chronic diseases associated with diet have supplanted acute infectious diseases as the major causes of death in developed countries. The same diet-associated chronic diseases have replaced nutritional deficiencies as the major public health nutritional problems. Although there have been decreases in coronary heart disease (CHD) mortality over the past 25 years and mortality from stroke over the past 50 years, chronic diseases associated with nutrition remain widely prevalent. Five of the 10 leading causes of death in the United States are associated with diet (coronary heart disease, cancer, stroke, diabetes, and atherosclerosis) and three more with alcohol (accidents, suicide, and chronic liver disease) (1). Nutritional factors also contribute to obesity, hypertension, osteoporosis, diverticular disease, constipation, and dental disease. These chronic conditions not only are major causes of mortality but also decrease the quality of life by contributing to long-term morbidity. The etiology of most chronic diseases is multifactorial, and diet is just one determinant. Nevertheless, since the burden of suffering is so large from these diseases, much progress could be made in combating them if the public as a whole made relatively modest dietary changes.
