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Non-communicable diseases (NCDs) are a group of pathological diseases that are primarily caused by poor lifestyle behaviours. Currently, non-communicable diseases (NCDs) are the world's leading cause of disability and death. According to data from the World Health Organization, chronic non-communicable diseases (NCDs) like diabetes, cancer, obesity, and respiratory conditions are responsible for about half of the global disease burden and about 60% of the 56.5 million deaths that occur each year. The main risk factors for non-communicable diseases (NCDs) include age, sedentary and inactive lifestyle, alcohol and tobacco use, obesity, and poor and unhealthy food choices. One of the controllable aspects impacting the onset of non-communicable diseases is lifestyle. Several online browsers and data collection tools, such as Research Gate, Krishikosh, and Academia were used to search articles. Primary prevention and surveillance, health promotion, management and health care are the three fundamental pillars of the prevention strategy. Thus, it is crucial to start initiatives to educate the public about the need to lead a healthy lifestyle to maintain good health and lower the prevalence of NCDs. Non-communicable diseases can be prevented or reversed with a wholesome diet, regular exercise, nutritional supplements, and adequate sleep duration and quality. Numerous studies have focused on the relationship between the prevalence of non-communicable diseases and the consumption of specific foods.
Keywords: Chronic diseases; obesity; risk factors; prevention; diabetes; Non-communicablediseases; lifestyledisorders; Chronicdiseases; riskfactors
anddiabetes lifestylethatincludesunhealthyeatinghabits(6).The Highlights underlyingmechanismcontrollingthestartandcourse • Non-communicablediseases(NCDs):leading ofthemajorityofdiseaseshasalsobeenidentifiedas causeofdeathworldwide.
alterationsinthemevalonatepathwayandhormone • Riskfactorsincludeobesity,unhealthydietary balance(7,8).Anothermisconceptionisthatitisacol- choices,asedentarylifestyle,tobaccoandalco- lectionofdiseasesthatexclusivelyaffecttheelderly. holconsumption..
Fromchildhoodtoadulthood,theriskfactorsforNCDs • Management and Prevention include lifestyle buildupandbecomeapparentafterdecadesofexpo- modifications sure.Thecomponentsareinterconnectedandcreatea seriesofeventsthatbeginwithsocioculturalelements 1.Introduction thatimpactbehaviour,likeeconomicstatusandsur- Long-lasting and slowly progressing medical condi- roundingsandendwiththeemergenceofbiological tionsarereferredtoasnon-communicablediseases riskfactorsthatresultinnon-communicablediseases. (NCDs) or chronic diseases. Many factors, including Itiscommonforthebiologicalriskfactorstogroupto- genetic,physiological,behaviouralandenvironmen- gether.Forinstance,obesityislinkedtohypertension, talfactors,contributetomostnon-communicabledis- insulinresistance,andhyperlipidaemia,allofwhich eases(NCDs)(1). However,thehighestgrowthisex- are factors in the development of diabetes and car- pectedtooccurinhighlypopulatedareasoflow-and diovasculardisease. Furthermore,oneoftheconse- middle-incomeclasses. NCDsarethemostcommon quencesofuntreateddiabetesiscardiovasculardis- causesofdeathinmostcountriesintheAmericas,the ease(9).
EasternMediterranean,Europe,South-EastAsia,and Thefocusofnutritionresearchhasshiftedinrecent the Western Pacific, except in Africa. NCDs account decades from examining the impacts of individual forapproximately80%ofdeathsinlow-andmiddle- foodsandnutrientstoexaminingdietarypatterns,pre- incomecountries.By2030,communicable,maternal, sumingthatcombinationsoffoodsandnutrientscan perinatal,andnutritionaldiseasesareexpectedtosur- haveantagonisticorsynergisticeffectsbeyondthose pass NCDs as the most common causes of death in ofindividualcomponents(10).Inthisregard,anum- Africancountries(2).
ber of dietary patterns have been linked to positive NCDs, whichincludeobesity, diabetes, cardiovascu- healthoutcomes(11).Forinstance,theMediterranean lar disease, chronic respiratory diseases and some diet,alsoknownastheMedDiet,isthetraditionalfood typesofcancer,areaglobalconcernandaccountfor andlifestyleofpeoplefromMediterraneannationsand over71%ofalldeathsworldwide(3). Adiethighin mayhelpreducechronicdiseasesandsuddendeath saturated fat and poor in fresh fruit and vegetables, (12,13,14).Accordingtothe2015–2020DietaryGuide- sedentarylifestyles,tobaccouseandexcessivealco- linesforAmericans,MedDietisoneofthehealthiest hol use are among the few behavioural risk factors eatingpatternsthatshouldbefollowed(15,16). thatthesediseaseshaveincommon.Duetorisingur- banizationandthegrowinginternationalizationofthe 2.MaterialsandMethods food,tobaccoandalcoholsectors,theseriskfactors For this scoping review, a search for original or re- aremorecommonincountrieswithlowormiddlein- viewed works was conducted until 2024 using the comesandaretypicallyconcentratedinmetropolitan electronicdatabasesScopus,PubMed,Krishikosh,Re- areas(4). AmongotherNCDs,obesity,stroke,stress searchGateandGoogleScholar.“Non-communicable andatherosclerosisarecausedbyshiftinglifestylepat- diseases”, “lifestyle disorders”, “chronic diseases”, terns(5).
“obesity”,“riskfactors”,“prevention”and“diabetes” A healthy diet, regular exercise, nutritional supple- werethesearchtermsused.Theauthorscarefullyse- mentsandenoughsleepdurationandqualitycanall lectedandreviewedeachofthereferencesthatwere helppreventand/orreversenon-communicabledis- provided.
eases. Numerousresearchershaveinvestigatedthe linkbetweentheincidenceofspecificNCDsandthe consumptionofparticularfoods.Nowadays,foodpref- 3.ResultsandDiscussions erenceshavechangedsignificantlyfromthepastdue TheWorldHealthOrganization’sstatisticsshowthat tothegrowthofthesocialeconomyandtheriseinliv- chronic non-communicable diseases (NCDs), such ingstandards.Chinesephysiciansareatahigherriskof asdiabetes,cancer,obesity,andrespiratorydiseases, gettingchronicdiseasesbecauseoftheiroccupation, account for approximately 60% of the 56.5 million whichmakesthemmorelikelytoleadanunhealthy deathsthatoccurannuallyandalmosthalfofthedis- easeburdenworldwide.
ofstomachcancertypicallydecreaseswitheconomic development,theincidenceoflung,colonandrectal, breast,andprostatecancerstypicallyrisesinparallel 3.1 DifferenttypesofNon-communicableDiseases (23).
3.1.1 CardiovascularDiseases Hypertension(highbloodpressure),coronaryheartdis- 3.1.4 ChronicRespiratoryDiseases ease(heartattack),cerebrovasculardisease(stroke), Globally,chronicrespiratorydiseases(CRDs)andnon- peripheralvasculardisease,heartfailure,rheumatic communicablediseases(NCDs)aretheleadingcauses heartdisease,congenitalheartdisease,andcardiomy- ofdeathandmorbidity.Viegietal.(2020)(24)reported opathiesarealltypesofheartandbloodvesseldisor- that495,000peoplediedfromasthma,while3.2mil- dersthatareknownascardiovasculardisorders(CVD). lionpeoplediedfromchronicobstructivepulmonary Amongnon-communicablediseases,theseCVDsare disease(COPD).Theseventhmostcommoncauseof themostcontributing(17).Itisestimatedthatthese yearsoflifelost(YLLs)wasCOPD.545millionCRDswere diseases,especiallyheartattacksandstrokes,claim reportedoverall,withroughly50%ofthosecasesbe- thelivesof17millionpeopleyearworldwide.Riskfac- ingrelatedtoCOPDand50%toasthma.Therewere62 torsforCVDsincludealcoholconsumption,smoking, millionCRDincidentcases,primarilyfromCOPD(29%) physicalinactivity,andpoordiet.Unfortunately,the and asthma(69%). Whilesmoking, particulatemat- increaseinlifeexpectancyinemergingnationsisim- terpollution,ambientozonepollution,occupational pactedbytheharmcausedbytheseriskfactors(18,19). exposuretoparticulatematter,gases,andfumes,as wellassecond-handsmoke,aresignificantriskfactors 3.1.2 Diabetes for COPD, smoking and a high body mass index are Diabetesisaseriouspublichealthissuethatisbecom- relevantriskfactorsforasthma.AccordingtoYLLfore- ingepidemicinscopeonaglobalscale.Chronicnon- casts,agingandpopulationexpansionwillresultinan communicablediseasesarebecomingmoreandmore increaseinthenumberofNCDsby2040,withCOPD commonaroundtheworldatastartlingrate.Diabetes predictedtobecomethefourthmostcommoncause. andhypertensionaretwoofthemainriskfactorsfor cardiovascular disease, which claims the lives of al- 3.1.5 AbdominalObesity(AO) most18millionpeopleannually.Currently,312million Excessfataccumulationintheabdomenareacanbe adultsworldwideareobese,whileover1.7billionare referredtoasabdominalobesity.Ithasapositivecor- overweight.Furthermore,atleast155millionchildren relationwithnon-communicablediseases(NCDs)and areoverweightorobeseglobally(20).Type2diabetes is a prevalent health problem among South Asians isbecomingmorecommonatearlierages,including (25).Anincreaseinwaistcircumferencehasbeenseen someobeseandoverweightchildrenbeforepuberty, between1960and2000,particularlyamongwomen. andalargeportionofthisincreaseindiabeteswilloc- EvenamongthosewithnormalBMIs,AOhasexperi- curindevelopingnations.Peopleinthemiddle,pro- encedagreaterchangethanoverallobesityduetoa ductiveyearsoftheirlives,betweentheagesof35and higherriskofNCDs(26).Adiposetissuesthatcoverthe 64, are most commonly impacted in developing na- posteriorpartoftheabdominalwallandlinktothe tions. AtBMIlevelsthataretypicallyregardedasac- intestinemakeupmesentericfat,whichiscreatedby ceptableforwhiteindividualsinNorthAmericaand theperitoneumfoldingtwice. Itismadeupofanet- Europe,thechancesoftype2diabetesmellitustend workofbloodarteriesthatensureasteadyflowoffatty torisesignificantlyinAsiannations. Prevalenceesti- acidandlipidmoleculesandpermittheaccumulation matesofobesityworldwide,whicharenowataround offatintheabdominalarea(27).Studiesshowthata 250million,wouldbesignificantlyimpactedbypro- high-caloriedietandsedentarylifestyleincreasethe posalstoadoptparticularclassificationsofobesityin amountoflipogenicactivityinmesentericfattissues Asians(e.g.,BMI23foroverweightand25or27kg/m2 comparedtosubcutaneousfatandotherbodyparts. forobesity)(21).
Comparedtootherpartsofthebody,thisonehasa veryactivemetabolismandmayconstantlyabsorbfat. 3.1.3 Cancer Increasedcirculationoffreefattyacidsduetoexcess Oneoftheleadingcausesofdeathworldwideiscancer. fatdepositioncausesatherogenesis,hyperlipidaemia, Onlycardiovasculardiseasestypicallysurpassitinthe hypertension,andcardiovasculardiseases.Addition- industrialized world, but the global increase results ally,highbloodlevelsoffreefattyacidsmaypromote from developing nations. In 2000, there were more hepaticlipidproduction,leadingtoinsulinresistance than7millioncancer-relateddeathsandover10mil- (28).
lionnewcasesworldwide(22). Whiletheincidence 3.2 RiskFactorsofNon-CommunicableDiseases (SSB)consumptionandlong-termweightgain,type2 Prospectivecohortstudiesandrandomizedtrialshave diabetesmellitusandCVDriskhasrevealedthatSSBs demonstratedthedetrimentaleffectsofdietaryandbe- playaroleintheobesitypandemic(35).
haviouralriskfactorsonnoncommunicablediseases, aswellasthemetabolicandphysiologicalconditions 3.2.3 TobaccoUse thatmediatetheseeffects.Thesefindings,alongwith Tobaccouseisamajorpublichealthissue,andboth data from risk-factor surveillance, have been used smokingandsmokelesstobaccousearewidespread. to determine the mortality and disease burden at- Oneinsixdeathsfromnon-communicablediseases tributabletoriskfactors,bothgloballyandbyregion (NCDs)isattributabletotobaccouse,asignificantmod- andcountry.
ifiableriskfactorsharedbydiabetes,cancer,cardio- vasculardiseaseandchronicrespiratoryconditions. 3.2.1 PhysicalInactivity Eachyear,tobaccosmoking—bothdirecttobaccouse Thefailuretomeetthenecessaryamountsofphysical andsecond-handsmoke—causesthedeathsofabout activityforhealthisreferredtoasphysicalinactivity. 6millionpeople.Accordingtodatafrommultiplestud- Aroundtheworld,alargenumberofpeopledonoten- ies, tobacco users are 12 times more likely to have gageintherecommendedminimumof30minutesof lung cancer, 1.5 times more likely to have a stroke, regular,moderate-intensityphysicalactivityonaver- 1.4timesmorelikelytohavechronicobstructivepul- ageoftheirdailylives(29).Nowadays,physicalinactiv- monarydisease(COPD)and2-3timesmorelikelyto ityisreferredtoasapandemicthatrequiresimmediate developcoronaryheartdisease(CHD).Therisksare attention(30).Oneoutofeveryfouradultsworldwide age-gradient,withyoungeragegroupshavingahigher issedentary,accordingtoresearch.Thepercentageof relativerisk(5–6times),andtheyarecomparablefor adolescentswhoarenotphysicallyactiveisover80% menandwomen.Theyalsorapidlydeclineafterquit- worldwide. Peoplewhoarephysicallysedentaryare tingsmoking(36).
20–30%morelikelytodiethanthosewhoareactive, accordingtoresearch.Globaleffortsarecurrentlyun- 3.2.4 AlcoholConsumption derwaytoreducetheprevalenceofphysicalinactivity Eightdistinctmalignanciesaredirectlyrelatedtoal- by10%bytheendof2025(31).Thegreateststrategy cohol (to varying degrees), and the risk rises with toenhancephysicalactivityistoexercise,whilethere theamountofalcoholconsumed. Alcoholconsump- areotherways(32).Physicalinactivityinterventions tionisalsocorrelatedwithmanycardiovascularcon- mustbeplannedinordertopreventandmanageNCDs. sequences, such as atrial fibrillation, haemorrhagic Exerciseisimportantfortreatingnoncommunicable strokeandhypertension.Theassociationismorecom- diseases(33,34).Ithasbeenshowntoimprovecogni- plicatedforothercardiovascularevents.Additionally, tive,emotional,socialandpsychosocialfunctioningas alcoholisassociatedwithpancreatitisandmanyliver wellasphysiologicalfunctioning.
diseases,includingfattyliver,alcoholichepatitisand cirrhosis.Therelationshipiscomplicatedfordiabetes 3.2.2 Diet aswell.Accordingtoconservativeestimates,alcohol Eating a diet high in sodium, trans fats, red or pro- useaccountsfor3.4%,5.0%and2.4%oftheworldwide cessedmeatandsugar-sweetenedbeverages,while NCD-relatedburdenoffatalities,netyearsoflifelost deficientinwholegrains,nuts,seeds,fruit,vegetables, (YLL),andnetdisabilityadjustedlifeyears(DALYs),re- fibre, legumes, omega-3fattyacids, PUFA,milkand spectively.Theburdenishighestforlivercirrhosisand calciumindicatedietaryrisk.Consumingasufficient cancer(37).Lowandmiddle-incomecountries’health amountoffruitsandvegetableseachdayislinkedto systemsarefacingchallengesduetotherisingpreva- lowerrisksofcardiovasculardiseases,stroke,type2 lenceofunderlyingriskfactorsandthegrowingbur- diabetesandseveralformsofcancer, whicharethe denofnon-communicablediseases(NCDs).Threeage leadingcausesofmortalityandmorbidity.Transfatty groups—under35(young),35–59(middle-aged)and acidintakeraisestheriskofcoronaryheartdiseaseby 60yearsandolder(elderly)—wereexaminedforage 28%anddeathfromanycauseby34%.Adultsshould effects. As people age, the prevalence of certain bi- consumelessthan5gofsaltperday,whichisequiv- ologicalriskfactors(hypertension,hyperlipidaemia) alentto2gofsodiumperday,accordingtoWHOrec- andbehaviouralriskfactorsforNCDs—suchassmok- ommendations. Consumingtoomuchsaltisassoci- ing,drinking,andasedentarylifestyle—increases.Men atedwithnegativehealtheffects,includinganelevated andwomen60yearsofageandolderhadthehighest riskofhypertension,whichcanresultinheartdisease prevalenceofthemajorityofbehaviouralriskfactors. andstroke. Epidemiologicresearchthathighlighted Forbothsexes,themiddle-agedhadthehighestpreva- theconnectionbetweenSugar-sweetenedbeverages lenceofdiabetesandoverweight/obesity,whereasthe elderlyhadthehighestprevalenceofhypertensionand setofnineglobaltargetswithamajoreffectonNCD hyperlipidaemia(38).
management and prevention are supported by the ImplementationRoadmap.TheUnitedNations2030 3.2.5 Excessweightandobesity AgendaforSustainableDevelopmentacknowledges Arisingpublichealthconcernisobesity.In2016,650 non-communicablediseasesasasignificantworldwide millionadultswereobeseandover1·9billionadults concern.By2030,theAgendaaimstocutthenumber wereoverweight,muchexceedingthenumberofpeo- of premature deaths from NCDs by one-third. WHO ple who had normal weight. Obesity is linked to a isamajorleaderincoordinatingandadvancingthe higherriskofmanymajornon-communicablediseases, worldwideefforttocombatNCDs(1).
includingastype2diabetes,coronaryheartdisease, stroke,asthmaandmanymalignancies,inadditionto loweringlifeexpectancyandqualityoflife. Earlyre- 4.Conclusion searchrevealedthatmetabolicallyhealthyobesityis The largest cause of death globally is non- linkedtoanegligibleincreaseindiseaserisk,particu- communicable diseases, which are mostly brought larlywhenpairedwithhighactivity(39). on by poor lifestyle choices. The majority of risk factorslinkedtoNCDsincludedietsdeficientinwhole 3.3 Management and Prevention of Non- grains,cereals,fruitsandvegetables,nuts,legumes, CommunicableDiseases MUFA,PUFA,asedentarylifestyle,excessivealcohol ThenecessitytoprioritiseNCDpreventionandcontrol and tobacco use and obesity. Potential preventive should be emphasised in light of the projected bur- measuresformanagingNCDsincludelifestylemodifi- denofNCDsandourcurrenthealthcaresystem.The cationsandcontrollingthemajorriskfactorsforthe goalofoureffortsshouldbetotracktheprevalenceof disease.ToreducetheprevalencerateofNCDs,both NCDsandtheriskfactorsassociatedwiththem.Certain governmentalandindividualeffortsareneeded. NCDsshareriskfactorsthatshouldbeaddressedfor theleastresourceswhileproducingthegreatestpossi- 5.AuthorsContribution bleresults.Thethreemainpillarsoftheapproachare All authors wrote, reviewed and approved this managementandhealthcare,healthpromotionand manuscriptforpublication.
primarypreventionandsurveillance(40).Toestablish economic,politicalandenvironmentalconditionsthat preventNCDsandtheirassociatedrisks,aswellasto 6.ConflictofInterest empowerindividualstoactbothindividuallyandcol- Theauthorsdeclarethattheresearchwasconducted lectivelytopreventriskybehaviour,healthpromotion intheabsenceofanycommercialorfinancialrelation- policiesthatprioritizediseasepreventionarerequired. shipsthatcouldbeconstruedasapotentialconflictof Itisnecessarytomaintainupdatesonrisktrendsand interest.
assesstheanticipatedresultsofinterventiontactics. TheincidenceofNCDsandtheeffectivenessofinter- ventionsareinfluencedbyseveralfactors,including