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Arquivos de Medicina

On-line version ISSN 2183-2447

Arq Med vol.20 no.3 Porto May 2006


Changing Epidemics

Ana Cristina Santos

Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto



The world is now facing a global change in the patterns of disease. Non-communicable diseases such as diabetes or cardiovascular disease are fasting replacing the traditional epidemics. These changes are affecting mainly developing countries, but its impact is fully observed in the developed world. Cardiovascular diseases are a main cause of death among Portuguese adults, and changes in the prevalence of modifiable risk factors such as obesity or tobacco consumption, could lead to important changes in the morbidity and mortality of such diseases. However, national estimates indicate that obesity and tobacco consumption are the two most common modifiable risk factors in our population and unfortunately their prevalence estimates are not expected to decrease in the next years.

Key-words: tobacco; obesity; epidemics.



Actualmente, o mundo enfrenta a uma mudança profunda nos padrões de doença. Doenças crónicas, como a diabetes ou a doença cardiovascular, estão a substituir rapidamente as epidemias tradicionais. O impacto destas mudanças é amplamente observado no mundo ocidental, estando também a afectar os países desenvolvidos. As doenças cardiovasculares são a principal causa de morte entre os adultos portugueses e mudanças na prevalência de factores de risco modificáveis, como a obesidade ou o consumo de tabaco, poderiam levar a mudanças importantes tanto na morbilidade como na mortalidade por estas doenças. No entanto, estimativas nacionais indicam que tanto o consumo de tabaco como a obesidade, são os factores de risco mais frequentes na nossa população, e infelizmente não se espera nos próximos anos uma diminuição nas estimativas de frequência destes dois factores de risco.

Palavras-chave: tabaco; obesidade; epidemia.



Texto completo disponível apenas em PDF.

Full text only available in PDF format.




1 -McKenna MT, Taylor WR, Marks JS, Koplan JP. Current issues and challenges in chronic disease control. In: Brownson RC, Remington PL, Davis JR, editors. Chronic disease epidemiology and control. 2nd ed. Washington: United Book Press; 1998: p.1-26.         [ Links ]

2 -Jackson Y, Dietz WH, Sanders C, et al. Summary of the 2000 Surgeon General's listening session: toward a National Action Plan on Overweight and Obesity. Obes Res 2002;10:1299-305.

3 -The World Health Report 2002 - Reducing risks, promoting healthy life. Geneva, World Health Organization, 2002:7-14.

4 -Alberti G. Noncommunicable diseases: tomorrow's pandemics. Bull World Health Organ 2001;79:907.

5 -Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Bull World Health Organ 2001;79:161-70.

6 -The World Health Report 1999 - Making a difference. The double burden: emerging epidemics and persistent problems. Geneva, World Health Organization,1999:13-27.

7 -World Health Organization. Obesity: preventing and managing the global epidemic. Geneva, World Health Organiza-tion;1997.

8 -Prentice AM, Jebb AS. Obesity in Britain: gluttony or sloth? BMJ 1995;311:437-9.

9 -U.S. Department of Health and Human Services. The Surgeon General's Call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.

10 -Blair SN, Nichaman M. The public health problem of increasing prevalence rates of obesity and what should be done about it. Mayo Clin Proc 2002;77:109-13.

11 -Peeters A, Barendregt JJ, Willekens F. Obesity in adulthood and its consequences for life expectancy: A life-table analysis. Ann Intern Med 2003;138:24-32.

12 -National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000;160:898-904.

13 -Allison DB, Fontaine KR, Manson JE, et al. Annual deaths attributable to obesity in the United States. JAMA 1999; 282:1530-8.

14 -Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: S518-S525.

15 -Castro JJ, Dias JA, Baptista F, et al. Secular trends of weight, height and obesity in cohorts of young Portuguese males in the district of Lisbon: 1960 to 1990. Eur J Epidemiol 1998;14:299-303.

16 -Ministério da Saúde. Instituto Nacional de Saúde. Inquérito Nacional de Saúde 1998-1999.

17 -Instituto Nacional de Estatística. Resultados definitivos. As Causas de Morte em Portugal 2000 [cited 2003 Jan 22]. Available from: URL:

18 -Molarius A, Seidell JC, Sans S, et al. Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA project. Am J Public Health 2000;90:1260-8.

19 -Townsend J, Roderick P, Cooper J. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income and health publicity. BMJ 1994;309:923-7.

20 -Molarius A, Seidell JC, Kuulasmaa K, et al. Smoking and relative body weight - an international perspective from the WHO MONICA project. J Epidemiol Community Health 1997;51:252-60.

21 -Winkleby MA, Kraemer HC, Ahn DK, Varady AN. Ethnic and socio-economic differences in cardiovascular disease risk factors. JAMA 1998;280:356-62.

22 -Mokdad AH, Serdula MK, Dietz WH, et al. The spread of the obesity epidemic in the United States, 1991-1998. JAMA 1999;282:1519-22.

23 -Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tob Control 1994;3:242-7.

24 -Cavelaars AEJM, Kunst AE, Geurts JJM, et al. Educational differences in smoking: international comparison. BMJ 2000; 320:1102-7.

25 -Borras JM, Fernandez E, Schiaffino A, et al. Pattern of smoking initiation in Catalonia, Spain, from 1948 to 1992. Am J Public Health 2000;90:1459-62.

26 -Fernandez E, Garcia M, Schiaffino A, et al. Smoking initiation and cessation by gender and educational level in Catalonia, Spain. Prev Med 2001;32:218-23.

27 -Bolego C, Poli A, Paoletti R. Smoking and gender. Cardiovasc Res 2002;53:568-76.

28 -The World Health Report 1999 - Making a difference. Combating the tobacco epidemic. Geneva, World Health Organization, 1999:65-79.

29 -Hennekens CH, Buring JE. Measures of disease frequency and association. In: Hennekens CH, Buring JE, editors. Epidemiology in Medicine. Boston: Little Brown; 1987. p.73-98.

30 -Towsend J. Price and consumption of tobacco. Br Med Bull 1996;52:132-42.

31 -Guindon GE, Tobin S, Yach D. Trends and affordability of cigarette prices: ample room for tax increases and related health gains. Tob Control 2002;11:35-43.

32 -Susan Anderson S, Hastings G, MacFadyen. Strategic marketing in the UK tobacco industry. Lancet Oncol 2002; 3:481-6.

33 -Chapman S. Recent advances: Tob Control. BMJ 1996; 313:97-100.

34 -Coller M, Harrison GW, McInnes MM. Evaluating the tobacco settlement damage awards: too much or not enough? Am J Public Health 2002; 92: 984-9.

35 -Santos AC, Barros H. Smoking patterns in a community sample of Portuguese adults, 1999-2000. Prev Med 2004;38:114-9.

36 -Santos AC, Barros H. Prevalence and determinants of obesity in an urban sample of Portuguese adults. Public Health 2003;117:430-7.

37 -Fraga S, Sousa S, Santos AC, Mello M, Lunet N, Padrão P, Barros H. Tabagismo em Portugal. Arq Med 2005:19:207-29.


Dr.ª Ana Cristina Santos

Serviço de Higiene e Epidemiologia

Faculdade de Medicina da Universidade do Porto

Alameda Prof. Hernâni Monteiro

4200-319 Porto


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