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NCBI Bookshelf. Disease Control Priorities in Developing Countries. Walter C. Willett, Jeffrey P. Coronary artery disease CAD, ischemic stroke, diabetes, and some specific cancers, which until recently were common only in high-income countries, are now becoming the dominant sources of morbidity and mortality worldwide WHO In addition, rates of cancers and cardiovascular disease CVD among migrants from low-risk to high-risk countries almost always increase dramatically. In traditional African societies, for example, CAD is virtually nonexistent, but rates among African Americans are similar to those among Caucasian Americans. These striking changes in rates within countries over time and among migrating populations indicate that the primary determinants of these diseases are not genetic but environmental factors, including diet and lifestyle. Thus, considerable research has been aimed at identifying modifiable determinants of chronic diseases. Prospective epidemiological studies, some randomized prevention trials, and many short-term studies of intermediate endpoints such as blood pressure and lipids have revealed a good deal about the specific dietary and lifestyle determinants of major chronic diseases. Most of these studies have been conducted in Western countries, in part because of the historical importance of these diseases in the West, but also because they have the most developed research infrastructure. A general conclusion is that reducing identified, modifiable dietary and lifestyle risk factors could prevent most cases of CAD, stroke, diabetes, and many cancers among high-income populations Willett
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