Prevention Of Non-communicable Diseases Research Articles

Breastfeeding and Non-Communicable Diseases: A Narrative Review

Introduction: Breastfeeding plays a fundamental role in newborns’ and infants’ health. Breast milk’s protective power against malnutrition and its positive effect on neurological and physical development are well established and are reflected in the policy statements of all major pediatric health entities. However, breastfeeding also plays an important role in the prevention of so-called non-communicable diseases, such as obesity, hypertension, dyslipidemia, and autoimmune diseases. Methods: This narrative review aims to analyze the effect of breastfeeding and breast milk on the development of non-communicable diseases, with a special focus on weight excess, dyslipidemia, allergy, and gastrointestinal diseases. This narrative review was carried out through three steps: executing the search, examining abstracts and full texts, and analyzing results. To achieve this, the databases PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, and Google Scholar were explored to collect and select publications from 1990 to 2024 to find pertinent studies in line with this review’s development. The search included randomized placebo-controlled trials, controlled clinical trials, double-blind, randomized controlled studies, and systematic reviews. A total of 104 manuscripts were ultimately included in the analysis. Results: Breastfeeding is associated with a decreased vulnerability to early viral infections or chronic inflammatory conditions during preschool years, a reduced incidence of weight excess, and likely lower cholesterol concentration, besides having a small protective effect against systolic blood hypertension. Conclusions: Pediatricians must promote breastfeeding, support the mother–infant dyad, and consider breast milk as a real “health voucher” that can last lifelong. However, further studies are needed to better define the extent and duration of breastfeeding’s protective power in this context.

Assessing the Lifestyle-related Determinants among Employees Working in the IT Sector of Pune City

Abstract Background: The rising prevalence of non-communicable diseases (NCDs) among Indian IT professionals is concerning due to prolonged sitting, sedentary work hours, irregular sleep, limited diet variety, excessive consumption of ultra-processed foods, and heightened stress. This study aimed to assess lifestyle determinants in the IT population to predict future NCD risks. Methods and Materials: A cross-sectional study with 208 participants aged 21-60 years was conducted in Pune. Ethical approval and consent were obtained. Data from various IT sectors used a modified questionnaire incorporating Perceived Stress and IPAQ scales and inquiries on sleep patterns, BMI, ultra-processed food consumption, and substance use. Results: The participants had a mean age of 31.30 ± 6.26 years with a gender ratio of 1.63:1. The mean BMI was 24.41 ± 3.87 kg/m2, 31.3% were overweight, and 9.6% were obese. Before sleep, 89.5% engaged with electronic devices. The majority of participants experience stress, with 63.5% reported moderate stress and 3.4% high stress. Only 6.7% were physically active, and 56.3% were inactive. Gender showed no significant correlation with stress levels, consumption of ultra-processed foods, and Body Mass Index (BMI) study components. Participants were found to be actively engaged in substance abuse, with 15.4% smoking 6-10 cigarettes daily and about 20.2% consuming alcohol twice a week. Conclusion: Because of their lifestyle, this population will be at a high risk of major chronic NCDs and should be targeted for an early intervention program. It’s essential to prioritize preventive actions like adopting a more active lifestyle, implementing stress management techniques, and embracing healthier dietary choices to safeguard the well-being of individuals in this demographic.

The Explo’Santé mixed methods protocol: an interventional research school health promotion project in France

BackgroundAccording to WHO, “noncommunicable diseases (NCDs) kill 41 million people” annually, as the primary cause of death globally. WHO’s Global Action Plan for the prevention and control of NCDs 2013–2020 (extended) tackles this issue and its implications regarding inequalities between countries and populations. Based on combined behavioural, environmental and policy approaches, health promotion aims to reduce health inequities and address health determinants through 3 strategies: education, prevention and protection. It is a well-known fact that long-term efficiency in health promotion, that is to say the promotion of health and well-being, involves interventions and programmes which target / involve children [1]. As a focal point in communities and a key environment for children, school is an important setting to implement health promotion programmes, especially integrated approaches and interventions targeting Life Skills (LS). Indeed, LS contribute to health and well-being, particularly for pupils. This article presents the research protocol of a French integrated school-based health promotion interventional research programme which intends to support the health promoting schools (HPS) approach in France: Explo’Santé. It results from a partnership between the University of Lyon and the French League against Cancer.MethodsExplo’Santé is an observational study based on a mixed methods research design, which aims to evaluate the effects of a health promotion programme, to elicit its implementation process and identify contextual factors. This 3-year, complex programme targets primary school pupils aged 8 to 10. It incorporates health education sessions, to develop pupils’ LS and health literacy (HL), and to promote healthy environments. Teachers and French League prevention officers are trained to support skill development and programme sustainability. Data collection includes quantitative data via questionnaires, to assess programme impact on approximately 700 pupils, as well as 36 teachers, and 6 prevention officers, as well as qualitative data collected via focus groups with pupils, and interviews with teachers, parents, prevention officers, and school heads, to understand the barriers and promoting factors to the implementation of the programme, the differences in process and effects in different contexts, and its potential for sustainability.DiscussionExplo’Santé was designed to contribute to school-based health promotion strategies, by including key players, promoting partnerships, targeting multiple levels of impact and effect, and to ensure every step is research-based and informed. Finally, this study aims to identify the elements which would enable Explo’Santé to become a model in France and internationally.

Prevalence of selected chronic diseases, health seeking behaviour and associated factors among the elderly workers of a selected district of Sri Lanka

Introduction: Sri Lankan demographic transition has shifted the country to a fast-ageing population. Consequently, elderly in labour force will be noteworthy. Ageing increases the prevalence of non-communicable diseases. Hence, its prevalence, health seeking behaviour and associated factors need to be sought to improve the health of elderly workforce. Objectives: To describe the sociodemographic and work-related characteristics of elderly workers, health status, health seeking behaviour and association between the health seeking behaviour and sociodemographic and work-related characteristics in Gampaha District of Sri Lanaka Methods: A community-based descriptive cross-sectional study was conducted using multistage cluster sampling in Gampaha District, Sri Lanka among 835 elderly workers who met the operational definition and eligibility criteria. Data were collected using a pretested interviewer-administered questionnaire, covering sociodemographic and occupational details, and information on chronic illnesses and health-seeking behaviour. Bivariate analysis was carried out using Chi--squared test, considering a p-value of 0.05 as statistically significant. Results: Majority of the workers (78.4%; n=655) were having at least one chronic illness and the occupation of 58% of them was affected by their chronic illness. For acute and chronic illness, 48.1% were taking treatment from private medical centres. The healthcare seeking behaviour for chronic conditions among the elderly was influenced by factors such as educational level, income, marital status, living arrangements, skill level and working patterns. Conclusions & Recommendations: The findings emphasize the need for policies and interventions that address socio-demographic disparities in healthcare access by promoting family support, insurance schemes, and adopting the health care facility provision according to the workplaces and working patterns.

Burden of diabetic peripheral neuropathy in a rural demography of India is revealed by biothesiometry: a reliable screening tool

Background: Diabetes mellitus (DM) is the most prevalent non-communicable disease in the world estimated to be 4.4% in 2030 globally. Among its complications, diabetic peripheral neuropathy (DPN) is the common disorder manifested as ‘glove and stocking sensation’ in the lower extremities. Aim to study the prevalence and to grade DPN in patients attending OPD. Methods: Patients coming to the general surgery and plastic surgery outpatient department were selected. A total of 331 patients will be asked history by a simple questionnaire and symptoms are graded by modified neuropathy symptom score (MNSS) and clinical examination are done and graded by diabetic neuropathy examination (DNE) and vibration perception threshold (VPT) is measured by biothesiometry. Results: Among the DPN patients, 57.40% are asymptomatic and 12.08% are having severe symptoms by MNDS score and about 27.49% having increased risk for pronation for foot ulcer by DNE score and about 43.2% having risk for foot ulcer by biothesiometry average from the most common site for loss of sensation involving over 1st, 3rd, 5th metatarsal head to the least involved site as midfoot. Conclusions: This study reveals the impact of DPN in a rural area, so by implementing this type of screening method reduces the development of foot ulcers by about 60% in asymptomatic patients and leg amputations by 85% in patients with severe stage of DPN with proper foot care.

Literacy among tobacco users and healthcare professionals about tobacco harm reduction strategies: a scoping review protocol

ObjectiveThe proposed review identifies and describes the extent of Tobacco Harm Reduction (THR) strategies in Pakistan. It also examines the awareness and understanding of these strategies among healthcare professionals and tobacco users in Pakistan.IntroductionTobacco consumption poses a significant threat to human health and is a leading cause of non-communicable diseases. Over the last two decades, the prevalence of tobacco use has increased in low-and middle-income countries (LMICs), which has considerably contributed to the increasing prevalence of Non-Communicable Diseases (NCDs). Tobacco is consumed in various forms, including manufactured cigarettes, hookah/shisha, chewing tobacco, and dipping tobacco. Tobacco use can be reduced and prevented through various strategies adopted by many countries worldwide. One prominent strategy is THR. THR involves the use of safer nicotine products in recommended doses to cope with the symptoms of withdrawal and increase tobacco users’ chances of quitting smoking. In Pakistan, the concept of tobacco harm reduction (THR) is not widely recognized by healthcare professionals and tobacco users.Inclusion and exclusion criteriaLiterature available on Pakistani adults and adolescents (aged 13 years and above) will be included. Literature available as free full text will be included regardless of the publication date. Furthermore, literature available in English or Urdu will be considered eligible. Also, literature available in any form of publication, such as research studies, reviews, organizational websites or blogs, will be considered eligible. Literature that includes Pakistani data mixed with data from any other country will be excluded.MethodsThe literature search will use PubMed, CINAHL, ProQuest Theses & Dissertations, EBSCO Dentistry and Oral Sciences, and PsycInfo databases for online and gray literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram will record the included and excluded literature. Two independent reviewers will screen all the retrieved literature. After confirming the eligibility criteria, data from included records will be extracted on an Excel sheet that will record the important characteristics of the literature source and the main findings. Meta-synthesis of collated data will be performed, and the results will be presented as narrative summaries and frequency tables.Systematic review registrationhttps://osf.io/dashboard.

Modelling the case for cost-effectiveness of interventions to improve medication adherence in patients with difficult to control asthma

Background Asthma is a prevalent non-communicable disease in high-income countries, affecting more than 10% of their populations. While often symptomatically mild it accounts for 2-3% of primary care appointments, 60,000 hospital admissions, and 1,200 deaths annually in England. Importantly, a significant proportion of these events are the result of poor adherence to prescribed and effective treatments, with 60% of hospital admissions attributed to suboptimal compliance. This study aims to support the development and commissioning of interventions by establishing the value case for improving medication adherence. Methods A probabilistic cohort decision model was developed with the aim of estimating the long-term health impacts and resultant costs to the healthcare system of different levels of population medication adherence for those with difficult-to-control asthma. The model applies a Markov structure based on the Global Initiative for Asthma (GINA) guidelines to define the level of asthma control. Informative parameters are drawn from existing published literature supplemented by expert input where required. Results Improved adherence is associated with reduced asthma exacerbations and better overall health of the cohort, measured in life years and quality-adjusted life years (QALYs). For instance, an educational intervention that increased adherence from 50% to 70% reduced exacerbations by 1.75 over 20 years, while increasing QALYs by 0.20, and reducing the healthcare costs by £989. Conclusions Significant economic and health benefits can be achieved with effective interventions to improve treatment adherence in asthma. This study provides a value case for developing and commissioning such interventions.

Lifestyle-Related Factors for Improving Diet Quality

Background/Objectives: Diet quality is important for the prevention of non-communicable diseases (NCDs), which are now responsible for leading causes of death worldwide. Although health professionals often recommend diet improvement for the treatment and management of many NCDs, patients continually struggle to make dietary changes and maintain them long-term. This may be due to an interplay of many factors that affect dietary quality. This paper discusses some lifestyle-related factors that may offer additional points of intervention for health professionals to use to increase diet quality. Methods: This review examines the effects of exercise, sleep, mindfulness practice, meal socialization, social media use, and tobacco and alcohol use on diet quality. Studies examining the effects of these factors on diet were found by searching PubMed, CINAHL, and Google Scholar. Results: Evidence suggests that a positive relationship between exercise, adequate sleep, and all forms of mindfulness have positive effects on diet quality. Meal socialization’s effects on diet quality were nuanced. Individuals tend to eat similarly to those they share a meal with. However, food quantity intake may be affected by the physical characteristics of individuals with whom people share a meal. Social media use was found to have negative effects on diet quality in those who used it excessively and was found to promote disordered eating patterns. Both tobacco and alcohol use were found to have negative impacts on diet quality. Conclusions: Using these findings, health professionals may be able to educate people about lifestyle-related factors that can improve diet quality.

Bioelectrical Impedance Analysis as a Helpful Tool in Pediatric Obesity Monitoring: A Case Report

Background and Clinical Significance: Childhood obesity and its associated complications are an emerging public health problem; thus, non-communicable chronic disease prevention should be implemented as early as possible. On the other hand, obesity management in children is a challenge in terms of achieving fat tissue reduction without any adverse outcomes on overall development. This is why close cooperation with young patients and their parents is crucial for success. Moreover, non-invasive but detailed monitoring guaranties insight in this process’s progress and safety. As obesity is a chronic disease with a tendency for recurrence, further follow-up should also be considered. Case Presentation: We present a case of a 10-year-old boy who was referred to a dietitian due to concerns about a diagnosis of obesity and metabolic complications including abnormal lipid profile and liver function. During the dietary consultation, body composition assessment with bioelectrical impedance analysis was conducted, which confirmed obesity. A detailed interview allowed for the identification of improper dietary patterns. The implemented lifestyle education and qualitative diet modifications led to fat mass reduction without any significant muscle loss after just one month. The metabolic profile was also improved. The patient remained under the care of a dietitian for the next 4 years with constant body composition monitoring, which enabled the relevant parties to address if body mass gain was a part of his normal development or if he suffered from obesity recurrence. The patient and his parents benefited from an individualized, patient-centered approach including dietary education, overall lifestyle modification, and detailed body composition monitoring. This way, the patient succeeded in fat content reduction with the constant assessment of the safety of this process. Moreover, the dietary education impacted the whole family’s lifestyle. Conclusions: This case emphasizes the role of body composition assessment in children. Obesity and metabolic complications resulting from an improper lifestyle can affect pediatric patients. Bioelectrical impedance analysis is a non-invasive tool that can improve the safety and effectiveness of nutritional interventions and could be included in routine pediatric obesity assessment.

PENINGKATAN KUALITAS KESEHATAN MASYARAKAT DI DESA PERAMPUAN LOMBOK BARAT MELALUI PEMERIKSAAN KESEHATAN

The prevalence of non-communicable diseases including high blood pressure and Diabetes Mellitus (DM) continues to increase among the public. However, awareness and understanding of the importance of checking blood pressure and blood gluocose is still low in rural areas, including in Perampuan Village in West Lombok Regency, West Nusa Tenggara Province. Therefore, increasing awareness about the importance of checking pressure and blood gluocose for village communities through outreach is relevant. This activity aims to increase the awareness of the Perampuan Village community about the importance of health checks to reduce the prevalence of hypertension and DM. Implementation of community service activities begins with identifying community needs through a preliminary survey. The planning stage includes determining objectives, outreach materials, location and time of activities. Pre-implementation activities include making outreach materials (posters) and preparing examination materials. In carrying out the core activities, blood pressure and blood glucose checks, consultations, and distribution of vitamins are carried out. This counseling and health examination can increase the awareness of the people of Perampuan Village, West Lombok Regency about blood pressure and DM.

Burden and attributable risk factors of non-communicable diseases and subtypes in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021.

Understanding based on up-to-date data on the burden of non-communicable diseases (NCDs) is limited, especially regarding how subtypes contribute to the overall NCD burden and the attributable risk factors across locations and subtypes. We aimed to report the global, regional, and national burden of NCDs, subtypes, and attributable risk factors in 2021, and trends from 1990 to 2021 by age, sex, and socio-demographic index (SDI). We used data from the Global Burden of Disease Study 2021 to estimate the prevalence, deaths, and disability-adjusted life years (DALYs) for NCDs and subtypes, along with attributable risk factors. Estimates were presented with 95% uncertainty intervals (UI). Relationships between NCD DALYs and SDI across regions and countries were estimated using smoothing splines models. In 2021, NCDs accounted for 7.3 trillion global cases, 43.8 million deaths, and 1.73 billion DALYs. Global age-standardized rates showed NCD prevalence at 91034.0, deaths at 529.7, and DALYs at 20783.0 per 100000 population, with changes of -0.1%,-27.9%, and -19.4% from 1990, respectively. Subtypes with the highest age-standardized DALYs were cardiovascular disease (5056), neoplasms (2954), and other NCDs (1913 per 100000 population), with diabetes and kidney diseases increasing by 25.6% since 1990. Regionally, Oceania had the highest age-standardized DALYs (28782.0) in 2021, while Southern Sub-Saharan Africa saw the largest increase (+8.0%) since 1990. Nationally, Nauru reported the highest age-standardized DALYs (42754.3), with Lesotho experiencing the largest increase since 1990 (+38.4%). Cardiovascular diseases had the highest age-standardized DALYs among subtypes across 16 of 21 regions and 159 of 204 countries. Key risk factors globally were high systolic blood pressure (contributing to 12.8% of age-standardized DALYs), dietary risks (10.0%), and tobacco usage (9.9%), with the most significant increase in high body-mass index (+57.8%). High systolic blood pressure was the biggest attributable risk factor for NCDs in 9 regions and 101 countries. Age-standardized data reveal higher NCD prevalence in women and greater mortality and DALYs in men, with DALYs spiking post-45 for both sexes. Men have higher DALYs attributed to most risk factors, excluding those from unsafe sex, intimate partner violence, low physical activity, and high body-mass index. Age-standardized DALYs of NCDs generally decline with the SDI spectrum. Dominant NCD risk factors follow gender-age and SDI-based trajectories. Despite declining age-standardized prevalence, death rates, and DALYs for NCDs, they remain a major health issue. Emphasis on managing cardiovascular diseases, cancers, diabetes, kidney diseases, and mental disorders is essential. The burden of NCDs is more severe in low-SDI countries and among males. Prevention efforts should prioritize blood pressure control, dietary improvements, and tobacco reduction, tailoring interventions according to gender-age-based and SDI-development-based trajectories of dominant risk factors.

Usage of Virtual Reality Technology in Physiotherapy in Germany: Results from a Survey

With an aging population and an increasing prevalence of non-communicable diseases, Germany’s healthcare system is facing significant challenges that require innovative solutions such as digitalization. Among digital technologies, virtual reality (VR) has shown promise in various healthcare settings; however, its use in physiotherapy practice is unknown. This study aimed to assess the frequency and use of therapeutic VR among physiotherapists in Germany and to identify barriers to its adoption. A cross-sectional survey of 296 physiotherapists was conducted, with responses indicating that only 2.7% had used therapeutic VR in the past year. Most physiotherapists were unfamiliar with VR therapy, suggesting that lack of awareness is the primary barrier. Despite limited current use, a significant proportion of physiotherapists were open to integrating VR technologies in the future. Our findings highlight the need for increased information about therapeutic VR within the physiotherapy community and suggest potential growth as awareness and institutional support increases. Future strategies should focus on promoting the benefits of VR and integrating it into reimbursement frameworks to facilitate wider adoption in patient care.

The role of nutrients in the prevention of noncommunicable diseases

The role of nutrients in the prevention of non-communicable diseases (NCDs) is reviewed. Diseases such as osteoporosis, arterial hypertension, dementia, visual impairment and others are sensitive to a deficiency of certain macro and micronutrients, while their progression is accelerated. The role of micronutrients such as vitamin D, B vitamins, carotenoids, as well as lutein, omega-3 fatty acids in slowing the development of NCDs with age has been noted. The data on the effect of the Mediterranean diet and the DASH diet on blood pressure levels are presented. It is indicated that the greatest effect of nutritional interventions is more pronounced in populations with low baseline intake of these nutrients.

At-Home Immersive Virtual Reality Exergames to Reduce Cardiometabolic Risk Among Office Workers: Protocol for a Randomized Controlled Trial.

The worldwide rise in the prevalence of noncommunicable diseases has increased the recognition of the need to identify modifiable risk factors for preventing and managing these diseases. The office worker, as a representative group of physically inactive workers, is exposed to risk factors for metabolic syndrome, which is a primary driver of noncommunicable diseases. The use of virtual reality (VR) exergames may offer a potential solution to the problem of increasing noncommunicable disease prevalence, as it can help individuals increase their physical activity levels while providing a more immersive experience. This exploratory study aims to examine the interventional efficacy of at-home immersive VR exergames on metabolic syndrome biomarkers among office workers. Additionally, it seeks to investigate the impacts of at-home immersive VR exergames on the active and sedentary behaviors of office workers. A 3-arm, single-blinded pilot randomized controlled trial will be conducted to examine the therapeutic effects of at-home immersive VR exergames. A total of 120 Chinese office workers, engaging in less than 150 minutes per week of moderate to vigorous intensity physical activity, will be recruited via a convenience sampling method. The participants, who will be tested over a 12-week period, will be randomly assigned to one of three groups: (1) the VR exergame intervention group, (2) the regular physical activity control group, and (3) the nonexercise control group. Throughout the 12-week trial, three categories of variables will be collected across the three groups: clinical risk factors associated with metabolic syndrome, active and sedentary behaviors, and demographics. To analyze variance among the groups, a mixed linear model will be applied to assess the efficacy of each group. Differences in metabolic syndrome clinical risk factors among all groups will be used to evaluate the effects of at-home immersive VR exergames. Changes in active and sedentary behaviors will also be used to determine the impacts of VR exergames on metabolic syndrome. The ethics committee of Guangzhou University, China, approved this study on September 25, 2024. Participant recruitment will begin in early 2025 and continue for approximately 3 months. Data will be analyzed after the 12-week trial is completed, with full results expected to be presented in early 2026. This study explores an emerging topic by applying an at-home immersive VR exergame intervention, potentially contributing to understanding the effects of an exergame program on metabolic syndrome risk among office workers. ClinicalTrials.gov NCT06556784; https://clinicaltrials.gov/study/NCT06556784. PRR1-10.2196/64560.

Non-Communicable Diseases Among Orang Asli in Malaysia: A Scoping Review of Prevalence and Associated Factors

Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes, chronic respiratory diseases, and cancer, pose significant public health challenges globally and in Malaysia. The Orang Asli, an indigenous community in Malaysia, faces unique health challenges due to socioeconomic disparities and lifestyle changes. This scoping review synthesizes existing literature on the prevalence and determinants of NCDs among the Orang Asli, aiming to identify research gaps and inform public health strategies. We conducted a systematic search across databases including PubMed, Scopus, Google Scholar, and Web of Science, identifying 15 relevant studies from an initial pool of 573 records, following PRISMA guidelines. The review reveals significant variability in the prevalence of hypertension (3.3% to 57.2%), diabetes mellitus (0.8% to 25%), and dyslipidaemia (1.5% to 41.4%) among the Orang Asli. Other conditions such as gout and asthma were noted with prevalences of 2.7% and 0.4%, respectively. Factors associated with NCD prevalence include older age, female gender, lower education levels, poor dietary habits, physical inactivity, smoking, obesity, genetic predispositions, and the impacts of urbanization and modernization. Addressing the NCD burden requires multifaceted strategies, including culturally sensitive health promotion, improved healthcare access, and the preservation of traditional practices. This review underscores the urgent need for targeted interventions to mitigate the rising NCD burden in this vulnerable population.

Trends in Socioeconomic Inequalities in the Prevalence of Chronic Non-Communicable Diseases in China: Evidence from Shaanxi Province During 2003-2013.

Background: The link between chronic non-communicable diseases (NCDs) and poverty in underdeveloped countries is debated. This study aims to examine socioeconomic inequalities related to NCDs and assess the contributing factors to these disparities. Methods: The study utilized data from the National Health Services Survey in Shaanxi Province for 2003, 2008, and 2013, having 71,766 respondents. The concentration index (CI) was employed to rigorously quantify the degree of socioeconomic inequality in the prevalence of non-communicable diseases (NCDs). The CI decomposition identified the contribution of each variable, while the horizontal inequity (HI) index was calculated annually to assess changes in inequality. Additionally, a Probit model was employed to examine the significant determinants contributing to the occurrence of NCDs. Results: The results show a significant increase in NCD prevalence with age, particularly for individuals aged 60 and above, who experienced a 286.55% rise from 2003 to 2013. Higher education levels are associated with decreased NCD prevalence, as evidenced by a 74.13% reduction for those with high school education or above. Additionally, wealthier individuals had a 15.31% lower prevalence of NCDs, indicating that higher socioeconomic status correlates with a reduced likelihood of chronic diseases. Conclusions: The study finds that NCD prevalence significantly increases with age, while higher education levels and greater wealth are associated with reduced prevalence. These findings highlight the need to target older populations and lower socioeconomic groups for effective NCD prevention and management. Policies should focus on improving educational opportunities and socioeconomic conditions to reduce the burden of NCDs, particularly among older and economically disadvantaged groups.

The case of Wellness Valley: promoting physical activity and exercise medicine for a sustainable health care system

ABSTRACT Today’s health care systems primarily focus on treating noncommunicable diseases (NCDs) rather than preventing them. Currently, this approach is not sustainable and requires innovative transformations to face the challenges posed by the aging population, the increasing NCD prevalence, widespread physical inactivity, and growing obesity rates. Regular physical activity and exercise improve quality of life and are effective for the prevention and treatment of numerous NCDs and to reduce health care costs. Physical activity promotion and exercise medicine thus represent cost-effective solutions for a sustainable model of health. The Wellness Valley initiative in Emilia-Romagna, Italy, exemplifies this model by fostering active, healthy lifestyles. In Wellness Valley, physical activity is promoted through multi-stakeholder initiatives of education and engagement, and exercise medicine is supported in the medical community through continuous education and dedicated infrastructure, such as certified health-promoting gyms. With these initiatives in place, the population of Wellness Valley is more physically active compared to the Italian national average. Overall, shifting health models toward preventative strategies centered on healthy active lifestyles and exercise can increase physical activity levels and contribute to alleviating the growing burden of NCDs on health care systems.

Risk factor clusters for non-communicable diseases in adolescents in Eastern Cape, South Africa

Background: The increasing prevalence of non-communicable diseases (NCDs) among adolescents in South Africa is a growing public health concern.Aim: To examine the clustering of NCD risk factors, with a focus on gender, socio-economic status (SES) and perceived stress among adolescents.Setting: The study involved adolescents from eight schools in Buffalo City Metropolitan Municipality and Amatole district, Eastern Cape.Methods: A stratified random sample of 266 adolescents (aged 12 years–18 years) was assessed for anthropometric, physiological, and perceived stress measures. Data included body mass index (BMI), blood pressure (BP), cholesterol, glucose levels, and perceived stress (via the Perceived Stress Scale). Analysis involved descriptive statistics, Chi-square tests, t-tests, and k-means clustering.Results: Females (n = 155) showed a higher prevalence of NCD risk factors, with 80.2% classified as overweight or obese compared to 19.8% of males, and 77.2% had elevated cholesterol versus 22.8% of males. Perceived stress was higher in affluent schools (59.8%) despite fewer metabolic risks. K-means analysis identified four health profiles with significant SES and health differences (p 0.001). Cluster 1 (high SES) showed elevated BP, BMI, and stress, while Clusters 2–4 (low SES) varied in risks, with Cluster 4 showing the highest BP and metabolic risks despite low stress.Conclusion: These results highlight unique health profiles and risk factors across socio- economic contexts, with female adolescents from lower socio-economic backgrounds facing greater metabolic risks.Contribution: This Study provides original insights into the interplay between gender, SES and perceived stress in shaping NCD risk among South African adolescents.

Fructose catabolism and its metabolic effects: Exploring host-microbiota interactions and the impact of ethnicity.

Important health disparities are observed in the prevalence of obesity and associated non-communicable diseases (NCDs), including type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) among ethnic groups. Yet, the underlying factors accounting for these disparities remain poorly understood. Fructose has been widely proposed as a potential mediator of these NCDs, given that hepatic fructose catabolism can result in deleterious metabolic effects, including insulin resistance and hepatic steatosis. Moreover, the fermentation of fructose by the gut microbiota can produce metabolites such as ethanol and acetate, both which serve as potential substrates for de novo lipogenesis (DNL) and could therefore contribute to the development of these metabolic conditions. Significant inter-ethnic differences in gut microbiota composition have been observed. Moreover, fructose consumption varies across ethnic groups, and fructose intake has been demonstrated to significantly alter gut microbiota composition, which can influence its fermenting properties and metabolic effects. Therefore, ethnic differences in gut microbiota composition, which may be influenced by variations in fructose consumption, could contribute to the observed health disparities. This review provides an overview of the complex interactions between host and microbial fructose catabolism, the role of ethnicity in shaping these metabolic processes and their impact on host health. Understanding these interactions could provide insights into the mechanisms driving ethnic health disparities to improve personalized nutrition strategies. KEY POINTS: Dietary fructose consumption has increased substantially over recent decades, which has been associated with the rising prevalence of obesity and non-communicable diseases (NCDs) such as type 2 diabetes and metabolic dysfunction-associated steatotic liver disease. Pronounced disparities among different ethnic groups in NCD prevalence and dietary fructose consumption underscore the need to elucidate the underlying mechanisms of fructose catabolism and its health effects. Together with the well-known toxic effects of hepatic fructose catabolism, emerging evidence highlights a role for the small intestinal microbiota in fermenting sugars like fructose into various bacterial products with potential deleterious metabolic effects. There are significant ethnic differences in gut microbiota composition that, combined with varying fructose consumption, could mediate the observed health disparities. To comprehensively understand the role of the gut microbiota in mediating fructose-induced adverse metabolic effects, future research should focus on the small intestinal microbiota. Future research on fructose - microbiota - host interactions should account for ethnic differences in dietary habits and microbial composition to elucidate the potential role of the gut microbiota in driving the mentioned health disparities.

Scoping Review of Knowledge, Attitude and Practices Related to NCD Risk Factors Among Medical Undergraduates, India

India is witnessing an epidemiologic transition from infectious diseases to non-communicable diseases (NCDs). Prevention of the NCD risk factors is an effective way, and future doctors play a vital role in preventing the disease epidemics. Undergraduate medical education forms the basis of knowledge development, including NCD risk factors. With this backdrop, the scoping review aimed to map available evidence on the knowledge, attitude, perception and practices related to NCD risk factors amongst medical undergraduates in India. A systematic search was conducted using key terms from five electronic databases of peer-reviewed articles. Two reviewers independently screened all articles for eligibility and assessed the quality of included studies. Studies were included if they reported on the medical students’ knowledge, attitude, perception and practice related to NCD risk factors. Thirteen studies on undergraduate medical students in India were included in the systematic review. Twelve of these reported on students’ knowledge about NCD risk factors, nine explored their attitude towards NCD risk factor prevention, and eleven studies were on the practice of NCD prevention. The studies revealed a high level of knowledge about NCD risk factors. Still, their attitude and practices about NCD reduction were deficient. An overall rise in health-risking behaviour and a fall in health-promoting behaviour was observed by various studies. The level of physical activity among girls was significantly lower compared to the boys. Studies show many few students take patient history or counsel their patients to quit unhealthy lifestyle habits. Various studies found a rise in health-risking behaviour and a fall in health-promoting behaviour among medical students, which suggest creating an enabling environment and conducive climate for promoting healthy behaviour that can then be taught to their patients.