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“The EPIC Formula”
• Don’t smoke• Eat a diet rich in fruit and vegetables, whole
grains and low in red meat• Exercise at least 3.5 hr/week• Body mass index less than 30
Reduction in risk: EPIC-Potsdam
4 Healthy behaviours
Any chronic disease 78% (72% to 83%)
Heart Attack 83% (47% to 93%)
Stroke 50% (-18% to 79%)
Diabetes 93% (88% to 95%)
Cancer 36% (5% to 57%)
Ford et al Arch Int Med 2009
Trends in lung cancer rates –men and women
0
2000
4000
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12000
14000
16000
18000
1961-65 1966-70 1971-75 1976-80 1981-85 1986-90 1991-95 1996-00 2001-05 2006-10 2011-15 2016-20
Nu
mb
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cases (
5 y
ears
)
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20.0
40.0
60.0
80.0
100.0
120.0
140.0
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200.0
ES
R p
er
100,0
00
Male numbers
Female numbers
Male rate
Female rate
“.....expresses the extent to which one has a feeling of confidence that the stimuli deriving from one's internal and external environments in the course of living are structured, predictable and explicable, that one has the internal resources to meet the demands posed by these stimuli and, finally, that these demands are seen as challenges, worthy of investment and engagement."
Sense of coherence....
For the creation of health....
....the social and physical environment must be:• Comprehensible• Manageable• Meaningful
00-046
-1.2
-1
-0.8
-0.6
-0.4
-0.2
0 10 20 30 40 50
Months of Orphanage Rearing
*linear trendline
Evening Cortisol Levels Increase withMonths of Orphanage Rearing *
The Founders’ Network
STRESS AND GRADE OF EMPLOYMENT: MEN
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2008
-8.3
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10-1
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12-1
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4.30
16-1
6.30
18-1
8.30
20-2
0.30
22-2
2.30
nmol
/l Higher GradeLower Grade
Salivary Cortisol
Time of DaySteptoe et al. 2003, Psychosomatic Medicine, 65, 461-470
Attachment theory
• Ainsworth– Deep emotional connection that infant develops with
primary caregiver– Reflects an “internal working model”expressing the
infant’s expectations of parental behaviour in meaningful situations
– Basis for development of later relationships• Increasingly recognised as determinant of later
emotional, cognitive and social outcomes
“Serve and return”
“The ‘instruction’ to attend to the primary caregiver is genetic, the outcome depends on what happens”
Balbernie, 2001
Education allows social networks to become richer, self esteem to develop and a sense of control is enhanced. Resources to manage the environment become established
Effective nurturing, consistent parenting allows a sense of control to develop. The environment becomes structured and understandable
Through having a sense of purpose, health related behaviours become easier to adopt
Comprehensible
Manageable
Worthwhile
Opportunity, decent Opportunity, decent housing, social networks, housing, social networks, self esteem and sense of self esteem and sense of
controlcontrol
Consistent parenting, Consistent parenting, safe, nurturing early safe, nurturing early
years, supportive years, supportive educationeducation
Health related Health related behavioursbehaviours
Opportunity, decent Opportunity, decent housing, social networks, housing, social networks, self esteem and sense of self esteem and sense of
controlcontrol
Consistent parenting, Consistent parenting, safe, nurturing early safe, nurturing early
years, supportive years, supportive educationeducation
Health related Health related behavioursbehaviours
Comprehensible
Manageable
Worthwhile
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