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June 6, 2013

We're headed toward a public health crisis, but you can help.

While the numbers of cardiovascular disease-related deaths in the United States have been decreasing, other numbers tell a different story about the future of heart disease. Whereas some 10 percent of the population now has type 2 diabetes, the Centers for Disease Control and Prevention predict that 30 percent of the population will have type 2 diabetes by the year 2050 if the current trajectory holds. Given a diabetic's high risk for developing cardiovascular disorders, the number of excess cases of coronary heart disease is expected to rise substantially during the next 25 years as increasing numbers of diabetic children reach middle age. This new demand will strain the health care delivery system and the economic resources of the entire country. And, even more alarming, this next generation may be the first that is less healthy than their parents.

"Her baby will suffer from malnutrition to the same degree as offspring born to women experiencing famine in an underdeveloped country. This should not be happening anywhere in the world."

– Dr. Thornburg.

An enormous body of evidence points to intrauterine nutrition as a dominant culprit in these disturbing health trends. Both low birth weight and excessive birth weight lead to hypertension, metabolic disease, coronary heart disease and heart failure in later life. It is now well established that maternal diet is a powerful determinant of the quality of fetal growth. Acquiring all the nutrients needed to properly construct robust organs is a difficult task for a fetus. If the flow of nutrients becomes inadequate, the fetus is designed to make life-changing compromises in organ integrity that impart vulnerability for disease in later life.

A colleague recently shared a story about an unemployed, single pregnant woman in Portland, Ore., who was unable to afford wholesome food such as fruits, vegetables and whole grains. On most days, her food intake consisted of a fast food hamburger bought with deep discount coupons. Her baby will suffer from malnutrition to the same degree as offspring born to women experiencing famine in an underdeveloped country. This should not be happening anywhere in the world.

Good nutrition must be a high priority for pregnant women to ensure the health of future generations. Every woman of reproductive age should know the elements of a healthy diet and should have access to wholesome foods. Regular, consistent nutritional advice from a primary care provider is highly likely to have an impact and lead to behavior change in pregnant patients.

The OHSU Bob and Charlee Moore Institute for Nutrition & Wellness advocates for change in the training of health care professionals so they will have the knowledge and confidence to provide solid nutritional advice to patients. Along with OHSU alumni and Moore Institute Steering Committee members Susan Bagby, M.D. '71, Eric Orwoll, M.D. '79, Jonathan Purnell, M.D. '86, and Mary Stenzel-Poore, Ph.D. '87, we are creating a network for sharing knowledge and strategies about nutrition and healthy lifestyles. We're also supporting public policies that promote improved nutritional health in the community, and institute representatives are deeply involved in policy considerations at every level.

Please join the conversation and help reduce the prevalence of chronic diseases across the lifespan in current and future generations by promoting healthy, nutrient-rich diets based on whole-foods in early life – before conception, during pregnancy and lactation, and in infancy and early childhood.

Contact us at mooreinstitute@ohsu.edu or visit: www.ohsu.edu/mooreinstitute 

By Kent L. Thornburg, Ph.D., director of the OHSU Bob and Charlee Moore Institute for Nutrition & Wellness, professor of medicine and associate chief for research in the Division of Cardiovascular Medicine

This article first appeared in the Spring 2013 issue of Bridges, a magazine for alumni of the OHSU School of Medicine.