Beyond Obesity and Lifestyle: A Review of 21st Century Chronic Disease Determinants

Table 2

Lifestyle and environmental determinants (“anthropogens”) for chronic disease. Numbers refer to chronic disease categories (from Table 1) for which there is supporting evidence referred to in the text.

Determinants	Decreases risk	Increases risk	Moderators
Nutrition; 1, 2, 3, 4, 5, 6	Fruit/vegetables; Dietary fibre; Whole grains; Food variety; Seafood; Healthy eating patterns	High total energy; High energy density; Excess processed foods; High GI foods; Sat./trans fats; Sugars; Salt; Excessive alcohol; Sugared soft drinks; Processed/red meat	Binge eating/drinking; Social/holiday eating; “Restrained” eating; Feasting; Culture; Habits
(In)Activity; 1, 2, 3, 6, 7, 8, 9	Aerobic exercise; Resistance exercise; Stretching; Stability; Leisure activity; Incidental activity	Sitting/sedentary work; Overexercise	Fear of crime; Fatigue/laziness; Discomfort/injury/; Early experiences; Energy-saving devices; Obesity; Habits
Stress, anxiety, and depression; 1, 3, 4, 9	Exercise/fitness; Healthy nutrition; Perceived control; Self-efficacy; Coping skills; Meaning	Overload; “Learned helplessness”; Early trauma; Boredom; Caffeine/drug use	Peer/social/pressure; Uncontrollable thoughts; Worry; Fear of the unknown; Obesity
Technology-induced-pathology; 7, 10		Motor vehicle use; Machinery; TV/small screens; Repetitive actions; Noise pollution; Processed foods; Weapons of war	Peer/social pressure; Legislation/regulation; Habits
Inadequate sleep; 1, 3, 6, 10	REM sleep; Bed-time; Hypersomnia; Nutrition; Exercise/fitness	Stress; Entertainment; Sleep disorders; Overheating; Interactive media; Alcohol/drugs	Activity before sleep; Stress; Anxiety/depression; Obesity; habits
Environment; 2, 3, 6, 9, 10	Political/economic; structure; Recreational space; “Green” exposure; Infrastructure for walking and cycling; Plant-based; nutrition	Passive influences; Second-hand smoke; Particle pollution; Endocrine disrupting; Chemicals (EDCs); Home chemicals; Drug-immunity (e.g., antibiotics)	Social proof; “Tipping point”; Social/peer pressure; Cultural influences; Habit
Occupation; 1, 2, 8, 10	Social justice; Work equality; Security of employment	Work stress; Shift-work; Hazard exposure; Conflict	Peer pressure; Bullying
Drugs, smoking, and alcohol; 1–10	Appropriate medication	Recreational drugs; Cigarette smoking; Alcohol use; Iatrogenesis	Stress, anxiety, and depression; Peer/social pressure; Addiction; Binge drinking; Habit
Over- and underexposure; 1, 2, 3	Sunlight; light; stimulation	Sunlight (excess); Sunlight (inadequate); Low humidity/; asbestos; Radiation	Peer/social pressure; Cultural influences; Habit
Relationships; 1, 3, 6	Companionship; Peer support; Maternal support in childhood; “Love”	Interpersonal conflict; Loneliness; Lack of support	Peer pressure; Early experience
Social factors; 1–10	Trust; Income security; Market regulation; SE status; Education	Inequality; Poverty; Deregulated markets	Stress; Bullying; Cognitive processes; Peer/social pressure