Top Chronic Conditions in the United States

Chronic diseases pose a significant burden to the U.S. population and can have a profound effect on day-to-day life. A chronic disease is defined as one that According to the CDC, lasts at least one year, requires ongoing medical care, and may limit daily activities.₁ Nearly 60 percent of adults in the United States have at least one chronic condition, and 40 percent have two or more.₁ Although studies vary, the top chronic conditions in the United States are:₁

Heart disease
Cancer
Stroke
Chronic lower respiratory diseases (such as chronic obstructive pulmonary disease)
Alzheimer’s disease.

More than four trillion dollars are spent annually on healthcare costs in the United States due to chronic conditions, in addition to the resulting disability and poor quality of life.₁

Mechanisms Linking the Top Chronic Conditions

While each chronic condition is unique, several similarities exist, including some risk factors and mechanisms underlying their development. Inflammation is a common thread underlying many chronic conditions. Oxidative stress, an imbalance between antioxidants and pro-oxidants, is also a characteristic of the top chronic conditions. Inflammation and oxidative stress can cause damage to cells and tissues in the body, ultimate affecting many organs and systems.

Compounds that act as antioxidants, reducing oxidative stress, can help alleviate conditions marked by oxidative imbalance. Similarly, anti-inflammatory compounds are critical to reducing the symptoms, severity, and even preventing the development of chronic inflammatory conditions.

Interventions to Reduce Chronic Disease Load

Plant-based Diet

Consuming a plant-based diet, full of fruits and vegetables and low in processed, sugary and salty foods and saturated fats can greatly reduce the risk of developing some chronic conditions, including cognitive impairment, cardiometabolic impairments, cardiovascular illnesses, cancer, diabetes, and obesity._2,3 This has been attributed to the naturally high content of nutrients and bioactive compounds such as antioxidants, anthocyanins, flavonoids, polyphenols, carotenoids, sulfur compounds, and lignans._2,4,5 These components can modulate systemic inflammation, oxidative stress, influence the gut-brain axis, and support the central nervous system._2,3

Plant-based diets tend to contain more dietary fiber than other diets that more closely align with the Standard American Diet. Dietary fiber is an often-overlooked component of mitigating disease risk, but it provides several benefits to the body. Fiber exerts its protective effects in the intestines by slowing the absorption of fat and cholesterol, although the positive effects do not stay there. Dietary fiber can lower low-density lipoprotein (LDL) cholesterol which helps to reduce the risk of conditions including stroke and diabetes.₆ Fiber also affects the gut-brain axis and can change the biochemistry of other major organs such as the liver and kidneys.₆ High intake of fiber can help reduce the risk of heart diseases and lower blood pressure while also reducing inflammatory markers, an important risk factor in cancer development.₆

Limiting sugar-sweetened beverages as much as possible can also help reduce the risk of certain cancers.₇ When consumption of sugars, such as fructose from high fructose corn syrup, outpaces how quickly the body can metabolize and use it, it will be stored in the form of triglycerides, which has a detrimental effect on metabolic health when levels get too high. High sugar consumption also contributes to inflammation which is involved in the pathogenesis many of the chronic conditions that afflict Americans.

Omega-3 Fatty Acids

Not only is the amount of fat in the diet an important consideration in the development of some chronic conditions, but the type of fat also matters. High saturated fat consumption has been linked to increased risk of several types of cancer, and high intake of omega-6 fatty acids has also been associated with a higher risk of tumor formation and inflammatory processes.₈ On the other hand, omega-3 fatty acids, a specific group of polyunsaturated fatty acids, have been associated with decreased cancer risk.₈ However, it is not just omega-3 fatty acids that matter; the ratio of omega-6 to omega-3 fatty acids is also important and should not exceed 4:1 for health-promoting effects. Saturated fats and omega-6 fatty acids are found in foods like butter, soybean oil, and corn oil, while omega-3 fatty acids are found in fish, cod liver oil, and walnuts.

Omega-3 fatty acids likely protect against cancer through several pathways including inhibiting proliferation and invasiveness, reducing oxidative stress, inhibiting the formation of new blood vessels, a critical step in malignant tumor development.₈ Omega-3 fatty acids, specifically docosahexaenoic acid (DHA), can also help reduce the risk of cardiovascular diseases through their anti-inflammatory effects, reducing pro-inflammatory eicosanoids and increasing pro-resolving mediators to ensure healthy inflammation resolution._8.9

B Vitamins

B vitamins are involved in many important cellular processes including energy metabolism, oxidative stress, DNA integrity, and DNA methylation. Together, these functions keep cells healthy, reduce inflammation, and preserve the integrity of DNA which is crucial for protecting against neoplastic events found in cancer development.₄ Maintaining adequate intake of B-vitamins, and in some cases supplementation, can help reduce the risk of certain types of cancer through protecting the stability of the genome and reducing oxidative stress.₄ In women, high intake of all B-vitamins, alone or in combination, was associated with a decreased risk of breast cancer.₄

The role of B vitamins in cellular processes
Energy metabolism cells must have sufficient energy to carry out normal functions. Too much cell death can affect organ health	Thiamine (B₁), Riboflavin (B₂), Niacin (B₃)
Reducing oxidative stress can alleviate/prevent inflammation and prevent damage to DNA	Pyridoxine (B₆), Riboflavin (B₂)
One carbon metabolism is critical to a stable genome and involved in DNA methylation	Folate (B₉), Cyanocobalamin (B₁₂)

Herbs and Medicinal Plants

Herbs and other dietary compounds can be effective tools in preventing the development of chronic diseases. Curcumin is a powerhouse anti-inflammatory nutrient for many inflammation-related conditions including cancer, Alzheimer’s disease, and diabetes.₁₀ It is also an antioxidant and can promote cardiac repair and improve endothelial function and heart health.₁₀ As it relates to cancer, curcumin works at every stage of tumorigenesis through several mechanisms, making it an extremely potent anti-cancer agent.₁₀

Many herbs and medicinal plants have been found to possess many properties that support the health of many systems in the body, including cinnamon, cocoa bean, garlic, ginger, Andrographis, onion, and tea.₁₁ For example, cocoa powder, which is full of flavonoids, can inhibit the development of cardiovascular diseases through increasing vasodilation and decreasing endothelial dysfunction.₁₁ And even though garlic may give you bad breath, it can decrease blood pressure, a major risk factor in heart disease.₁₁ Additionally, ginger is a rich source of potassium, a central player in blood pressure regulation, and can also decrease lipid levels including cholesterol (LDL and VLDL) and triglycerides, important contributors to heart disease.₁₁

Chronic diseases have many causes and can take a lifetime to develop, but daily decisions can add up to a lifetime of health-promoting effects that may prevent or reduce the risk of chronic diseases. Following a plant-based diet, full of high-fiber foods, omega-3 fatty acids, and vitamins can reduce the risk of developing many illnesses, including heart disease and cancer. Additionally, including herbs and medicinal plants can further reduce risk and work at the cellular level to alleviate underlying inflammation and oxidative stress.