EPIDEMIOLOGY
Study of distribution and determinants of health-related states among specified
populations and the application of that study to the control of health problems.
Epidemiology is based on two fundamental assumptions. First, the occurrence of
disease is not random (i.e., various factors influence the likelihood of developing
disease). Second, the study of populations enables the identification of the causes
and preventive factors associated with disease.
The epidemiologic triad (or epidemiologic triangle), views the occurrence of
disease as the balance of host, agent, and environment factors.
The host is the actual or potential recipient or victim of the disease. Hosts have
characteristics that either predispose them to or protect them from disease. Those
characteristics may be biological (e.g., age, sex, and degree of immunity),
behavioral (e.g., habits, culture, and lifestyle), or social (e.g., attitudes, norms, and
values). The agent is the factor that causes disease. Agents may be biological
(e.g., bacteria and fungi), chemical (e.g., gases and natural
or synthetic compounds), nutritional (e.g., food additives), or physical (e.g.,
ionizing radiation). The environment includes all external factors, other than the
host and agent, that influence health. The environment may be categorized as the
social environment (e.g., economic, legal, and political), the physical environment
(e.g., weather conditions), or the biological environment (e.g., animals and plants).
To illustrate the epidemiologic triad, a case of lung cancer may be considered. The
host is the person who developed lung cancer. He or she may have had the habit
of smoking for many years. The agents are the smoke and the tars and toxic
chemicals contained in the tobacco. The environment may have been the
workplace where smoking on the job was permitted and sites where cigarettes or
other tobacco products were readily available.
OBJECTIVES:
Identify the etiology or cause of disease determine the extent of disease, study the
progression of the disease, evaluate preventive and therapeutic measures for a
disease or condition.
Nutritional epidemiology is the application of epidemiological methods to the
study of how diet is related to health and disease in humans at the population level.
Nutritional exposures have been studied in relation to a wide variety of health
outcomes, such as infectious diseases, chronic diseases, cancer, and congenital
malformations. Epidemiologists investigate how nutrition affects the occurrence of
disease by collecting data on and comparing large groups of people. Statistical
methods are employed to estimate the extent to which a factor influences risk of
disease in a population. This estimate is often expressed as a measure of
association. Epidemiological methods are also used to estimate the nutritional
status of populations.
In epidemiological research, diet can be studied at different levels comprising
intake of nutrients, foods, food groups, and/or patterns. These exposures can be
measured by directly ascertaining what people eat (e.g., through the administration
of questionnaires), by measuring markers of intake in biological specimens, or by
estimating body size and the relative size of body compartments.
NUTRITIONAL EPIDEMIOLOGY
Nutritional epidemiology examines the role of nutrition in the etiology of disease,
monitors the nutritional status of populations, develops and evaluates interventions
to achieve and maintain healthful eating patterns among populations, and examines
the relationship and synergy between nutrition and physical activity in health and
disease.
