China's 400 million chronic disease population, in addition to being related to tobacco and alcohol, eating habits such as rice and steamed buns are also important causes

Introduction

There are 400 million people diagnosed with various chronic diseases in my country, and chronic diseases account for 68.6% of the disease burden. It can be said that my country is a country with a large number of chronic diseases.

The so-called chronic diseases are a general term for non-communicable diseases caused by long-term accumulation and other reasons. They include many types, such as respiratory diseases, including chronic bronchitis, tuberculosis, emphysema, etc.; cardiovascular diseases, including coronary atherosclerosis, heart disease, hypertension, congenital heart disease, heart failure, etc.; tumor diseases, including lung cancer, gastric cancer, esophageal cancer and other diseases.

In recent years, the incidence of chronic diseases such as cardiovascular cancer and diabetes in my country has been on the rise, attracting widespread attention from the outside world.

The guest of this interview is Professor Zuofeng Zhang, Chair of the Department of Epidemiology at the UCLA School of Public Health.

Professor Zhang is an internationally renowned epidemiologist and has extensive research in chronic disease management. He has previously studied the relationship between tobacco and alcohol and various chronic diseases, as well as the connection between tea drinking and chronic diseases.

01 How to prevent and manage chronic diseases?

Ye Shuisong: In China, there are a large number of people suffering from hypertension, diabetes and obesity, which poses great challenges to the management of chronic diseases in the future. What suggestions do you have for this?

**Zhang Zuofeng: **Among all chronic diseases, cardiovascular disease accounts for the largest proportion, followed by cancer, obstructive pulmonary syndrome, diabetes, and neuropsychiatric diseases. Together, these account for 80% - 90% of the total number of chronic diseases. There are five different ways to prevent these five conditions.

To sum up, it is "no smoking, less drinking, more exercise, balanced nutrition, and avoid air pollution." If these five major diseases and five protective factors can be combined, it will be beneficial to the protection and prevention of chronic diseases.

If we want to manage chronic diseases, for example, those who already have heart disease, high blood pressure, diabetes, chronic obstructive pulmonary disease or poor mental health, how should we manage these people?

First of all, there is already a relatively standardized treatment method for the clinical management of heart disease and stroke.

Second, the management of high blood pressure is very important. There may be quite a few people who have high blood pressure but don't know it. This is because they don't have the habit of measuring their blood pressure. I suggest that every family can prepare a blood pressure tester, especially those with elderly people over 50 years old. When you feel headache, dizziness, or poor sleep, you can measure your blood pressure and pay attention to regular testing. Now the blood pressure meter can be connected to the mobile phone, and the test results can be displayed on the mobile phone. Everyone can pay attention to whether their blood pressure is normal every day.

Those who have never measured their blood pressure in the past and do not know their blood pressure are recommended to measure their blood pressure themselves, because high blood pressure is the disease with the highest mortality rate among all diseases, but high blood pressure is very easy to control.

The first thing is to detect and find high blood pressure. It is very effective for patients with high blood pressure to control it in the early stage and use high blood pressure drugs, and this drug has very little effect on the liver and kidneys. Many people worry that "high blood pressure cannot be treated with drugs, and once you take drugs, you have to take them for life." In fact, the damage caused by high blood pressure is greater than the damage caused by drugs. Therefore, it is very important to control blood pressure at a normal level.

I suggest that every family should try to have a physical examination once a year if conditions permit. Physical examination can actually help you identify diseases at an early stage.

The third is the problem of diabetes. People with diabetes must measure their blood sugar. Many people don’t know if they have diabetes because they don’t monitor their blood sugar index. In the United States, about 20%-30% of people have high blood sugar but don’t know it. If you don’t know if you have diabetes, you can’t manage it.

So if you have some symptoms of diabetes, such as thirst, increased urination, obesity, easy hunger, sometimes fainting due to low blood sugar, etc., it is best to test your blood sugar. If you are diagnosed with diabetes, you should manage it in time. Especially the management of early diabetes, that is, before diabetes, the blood sugar is higher than the normal value and lower than the diagnostic value. We call this stage prediabetes. If you control it at this stage, diabetes can be prevented.

How to control it? Eat less rice, less steamed bread, eat more vegetables, exercise more, and lose weight. In this way, diabetes can be prevented more effectively. Generally speaking, if the weight returns to normal, the blood sugar will also return to normal. So we must seize this "window of prevention". If some symptoms appear, regularly measure blood sugar to detect it in the early stage.

Fourth, the management of obstructive pulmonary syndrome, which we also call "emphysema" and "chronic bronchitis". Obstructive pulmonary syndrome is difficult to improve, but you can prevent it from getting worse. In this case, patients need to avoid inhaling polluted air and keep the air at home clean; in addition, avoid passive smoking to prevent the disease from developing too quickly.

Fifth, prevention of neurological diseases. First, exercise more. The mental state after exercise is different from the mental state before exercise, so increase physical activities appropriately. Secondly, eat well. Eating well and eating poorly also have different mental states. Try to avoid excessive drinking. Drinking too much will affect your mental state. Finally, don't smoke. Smoking itself is irritating. Don't smoke, don't drink, do moderate physical activities, and eat a reasonable diet.

For the management of neurological diseases, it is better to do prevention rather than discuss management. Many chronic diseases can be prevented by seizing the prevention window.

However, chronic diseases need to be managed after illness, among which the management of diabetes, cardiovascular disease, and hypertension is very important. Hypertension is also related to salt. Reducing salt intake can also reduce hypertension and prevent chronic diseases. Smoking and drinking are also risk factors. If you control these factors, many diseases can be prevented.

It is much better to manage yourself than to be managed.

02 Differences in chronic diseases between different genders

Ye Shuisong: Are the types and probabilities of chronic diseases different among different genders?

Zhang Zuofang : Generally speaking, chronic diseases have certain gender influences. There are two aspects of gender influence: First, both women and men have some unique diseases. For example, men have prostate cancer but women do not, women have ovarian cancer and endometrial cancer but men do not. This is what we call gender-specific.

These specific diseases are closely related to female and male sex hormones.

At the same time, living habits also have a certain impact. Men do more "bad things" and women do less. Here, "bad things" means being more exposed. For example, the number of Chinese men who smoke is 6 to 8 times higher than that of women. This is not only harmful to oneself, but also to one's family.

Smoking and drinking are limited for Chinese women.

Men also drink a lot. When drinking, they often think that they must act like "heroes" at the table. This is a bad view and habit.

In addition, men usually do some heavy work, some heavy, high-exposure work, and high risk of occupational diseases, while women usually do other work in logistics, offices, etc. This is also a factor that leads to gender differences and causes different chronic diseases in both sexes.

Of course, genes are also a major factor, and the differences in chromosomes between men and women can also affect chronic diseases.

03 The relationship between tea drinking and chronic diseases

Ye Shuisong: You have done a lot of research on the relationship between tea drinking and chronic diseases. China is a major tea-consuming country. What do you think about the relationship between green tea and chronic diseases?

**Zhang Zuofeng: **The impact of green tea on cancer is the focus of our research. We have been cooperating with the Jiangsu Provincial Center for Disease Control and Prevention since 2003 and continued until 2010, mainly studying the relationship between the four major tumors in Chinese people and drinking green tea.

This study was large in scale, involving many cases and controls. We found that indoor air pollution had a greater impact on all four types of cancer, including passive smoking, indoor ventilation, and firewood used for cooking in rural areas, all of which can cause the four types of cancer.

In addition to changing cooking habits, asking smokers to quit smoking and reducing passive smoking, are there other protective measures? Professor Yang Zhongshu of New Jersey State University proposed that air pollution is so serious, especially outdoor air pollution, which we cannot control. Can we fight against this environmental impact by improving immunity? Professor Yang is a very experienced green tea researcher. Can green tea protect us from tumors?

Through a collaborative study with the Jiangsu Provincial Center for Disease Control and Prevention, we found that indoor air pollution increases the risk of these four types of cancer, and we are also investigating which foods have a protective effect. This includes drinking tea. Drinking two or more cups of tea a day can reduce the risk of these four types of cancer, and has a protective effect on lung cancer, vascular cancer, stomach cancer, and liver cancer.

Therefore, we believe that tea drinking may be a protective factor. By comparing the effects of tea drinking and air pollution, we found that "tea drinking has a greater protective effect for people in severe air pollution environments." Therefore, if conditions permit, you can drink more tea.

But from another perspective, I personally have another doubt, that is, tea inevitably has pesticide problems. If you drink too much tea, the exposure to pesticides will also increase relatively. Therefore, this is a contradictory issue.

In the future, the country will impose restrictions on the concentration of pesticides in tea. With these restrictions, drinking tea will be relatively safe. Of course, people who have the conditions can choose to drink organic tea, which does not contain pesticides. But at present, the price of organic tea is high, which is too costly for ordinary people.

In addition to tea, we also found that eating raw garlic can also prevent these four tumors. Garlic has a shell, which can reduce the impact of pesticides. Eating a few cloves of raw garlic every day may have a protective effect against tumors. Not only that, garlic and green tea can effectively prevent cardiovascular disease and tumors.

In addition, foreign studies have also found that not only green tea, but also black tea or dark tea has a protective effect on tumors.

This article is a work supported by Science Popularization China Starry Sky Project

Team/Author: Deep Science

Reviewer: Gao Chao, Associate Researcher, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.