Prevention Of Chronic Non-communicable Diseases Research Articles

[Primary prevention of chronic non-communicable diseases and acetylsalicylic acid: ambiguity of opinions].

Chronic noninfectious diseases (cardiovascular, bronchopulmonary, oncological diseases and diabetes mellitus) are presently the most common cause of death worldwide, with cardiovascular diseases (CVD) being predominant. For this reason, the key goal of a physician is not only to treat but also to prevent diseases. Acetylsalicylic acid (ASA) is considered one of the most effective drugs for secondary prevention of CVD. However, the use of ASA for primary prevention is still debated. Results of many studies of ASA are inconsistent. Some studies have suggested that using ASA in patients aged 40-70 with a high 10-year risk of CVD and a low risk of bleeding may reduce the incidence of CVD. Administration of ASA to patients with a high or medium risk of CVD is also considered.

An international Delphi consensus study to define motivational communication in the context of developing a training program for physicians.

Poor health behaviors (e.g., smoking, poor diet, and physical inactivity) are major risk factors for noncommunicable chronic diseases (NCDs). Evidence supporting traditional advice-giving approaches to promote behavior change is weak or short lived. Training physicians to improve their behavior change counseling/communication skills is important, yet the evidence for the efficacy and acceptability of existing training programs is lacking and there is little consensus on the core competencies that physicians should master in the context of NCD management. The purpose of this study is to generate an acceptable, evidence-based, stakeholder-informed list of the core communication competencies that physicians should master in the context of NCD management. Using a modified Delphi process for consensus achievement, international behavior change experts, physicians, and allied health care professionals completed four phases of research, including eight rounds of online surveys and in-person meetings over 2 years (n = 13-17 participated in Phases I, III, and IV and n = 39-46 in Phase II). Eleven core communication competencies were identified: reflective listening, expressing empathy, demonstrating acceptance, tolerance, and respect, responding to resistance, (not) negatively judging or blaming, (not) expressing hostility or impatience, eliciting "change-talk"/evocation, (not) being argumentative or confrontational, setting goals, being collaborative, and providing information neutrally. These competencies were used to define a unified approach for conducting behavior change counseling in medical settings: Motivational Communication. The results may be used to inform and standardize physician training in behavior change counseling and communication skills to reduce morbidity and mortality related to poor health behaviors in the context of NCD prevention and management.

Insulin Delivery with a Needle-Free Insulin Injector Versus a Conventional Insulin Pen in Chinese Patients with Type 2 Diabetes Mellitus: A 16-Week, Multicenter, Randomized Clinical Trial (the FREE Study)

Background: Insulin therapy is poorly accepted by patients with type 2 diabetes mellitus (T2DM). A needle-free insulin injector has been developed for patients who fear injections or are reluctant to initiate insulin therapy when it is clearly indicated. Objective To evaluate the glucose-lowering effect, tolerability, patient satisfaction and compliance with insulin treatment via a needle-free insulin injector (NFII) compared with insulin treatment via a conventional insulin pen (CIP) in patients with T2DM. Methods: A total of 427 patients with T2DM were enrolled in a prospective, multicenter, randomized, open-label study, and were randomly assigned 1:1 to receive 16 weeks’ treatment with basal insulin or premixed insulin administered either by a NFII or CIP. Findings: In the 412 patients who completed the study, the adjusted mean reduction of HbA1c from baseline at week 16 in the NFII group was 0.55% (95% CI -0.71, -0.39), which was non-inferior and statistically superior to the HbA1c reduction in the CIP group (0.26%, 95% CI -0.42, -0.11). Patients in the NFII group showed significantly higher treatment satisfaction scores than those in the CIP group (mean scores, 8.17 ± 1.78 vs 7.21 ± 2.22, respectively; p<0.0001). The occurrence of hypoglycemia was similar in the two groups, and the NFII group showed reduced incidences of skin scratches, indurations and lower VAS pain scores. Interpretation: Insulin therapy through needle-free injector showed a greater glycemic-lowering effect and a significantly enhanced level of patient satisfaction with insulin treatment compared with conventional insulin therapy through needle injections. In addition, the needle-free injector also had a better safety profile. Trial registration: ClinicalTrials.gov (NCT03243903) Funding Statement: Beijing QS Medical Technology Co., Ltd, China. This work was also supported by Grants 2016YFC1305600, 2016YFC1305603 from the Major Chronic Non-communicable Disease Prevention and Control Research. Declaration of Interests: Linong Ji receives consulting fees from Beijing QS Medical Technology Co. He also reports grants and personal fees from Novo Nordisk, Merck, Bristol-Myers Squibb, Novartis, Sanofi, MSD, AstraZeneca, and Roche, and personal fees from Eli Lilly, Takeda, Bayer, and Boehinger Ingelheim, outside the submitted work. The other authors have nothing to disclose. Ethics Approval Statement: Before the study was commenced, approval was received from the Ethics Committee of Peking University People’s Hospital, and the study was conducted in accordance with the moral, ethical, and scientific principles of the declaration of Helsinki and the provisions of good clinical practice (GCP) in China. Written informed consent was obtained from all participants.

Quality assessment of the secondary prevention of chronic noncommunicable diseases during the public dispancery observation in regions of the Russian Federation

Quality assessment of the secondary prevention of chronic noncommunicable diseases during the public dispancery observation in regions of the Russian Federation

Importance of elevated uric acid levels in the development and prevention of chronic non-communicable diseases

Importance of elevated uric acid levels in the development and prevention of chronic non-communicable diseases

[Poverty as a determinant of food quality in Argentina. Results of the Argentine Study of Nutrition and Health (EANS)].

Introduction: socio-economic differences lead to food and nutritional inequalities. Diet is a modifiable risk factor by public health activities, on the way to the prevention of chronic non-communicable diseases. Objective: to estimate food inequalities in Argentina based on the socioeconomic level of the population, analyzing the consumption of different food groups. Methods: Argentine data from the Latin American Study of Nutrition and Health. Sample: 1,266 individuals stratified by gender, socioeconomic level and geographic region. Intake: 2 24-hour reminders with the multi-step technique. Analysis: with the NDS Software average consumption values of 11 food groups were analyzed by socioeconomic level and country region. Results: the population with lower socioeconomic status consumes significantly less fruits, vegetables and dairy products than the population with medium to high socioeconomic level. Fruits: 59 vs. 79.1 and 106.3 g/d, respectively; p = 0.000. Vegetables: 82.3 g/d vs. 112 and 118 g/d; p = 0.000. Dairy products: 114 g/d vs. 165 and 137 g/d; p = 0.000). On the contrary, it consumes a greater volume of soft drinks and industrial juices (680 mL/d vs. 527 and 590 mL/d, respectively; p = 0.000), infusions with added sugar (568 mL/d vs. 385 and 309 mL/d; p = 0.000), bread (85 g/d vs. 75.5 and 66.7 g/d; p = 0.012) and pastries (159 g/d vs. 147 and 122 g/d; p = 0.008). Conclusions: Social vulnerability is an important determinant for diet quality. Interventions designed to reduce social inequalities as linked to nutrition and health are essential.

Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅  − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

ANÁLISIS DEL ÍNDICE DE MASA CORPORAL (IMC) Y EL NIVEL DE ACTIVIDAD FÍSICA EN ADULTOS MAYORES DE LA CIUDAD DE BARRANQUILLA: UN ESTUDIO CORRELACIONAL

Antecedentes: La actividad física y la alimentación sana son determinantes para el cuidado del peso corporal, como también para la prevención de enfermedades crónicas no transmisibles, especialmente en la población adulta mayor. Objetivo: determinar el Índice de Masa Corporal (IMC) y el nivel de actividad física de adultos mayores del Centro de Vida Conidec, Barranquilla y establecer relación entre ambas. Metodología: Estudio de enfoque cuantitativo, de tipo correlacional y transversal, con una muestra intencional de 130 adultos mayores del Centro de Vida Conidec, Barranquilla, Colombia (48% masculino y 52% femenino), entre los 65 y 85 años (x̄=66,2), haciendo uso del IPAQ-E para la medición de la actividad física y antropometría (peso y talla) para determinar el Índice de Masa Corporal (IMC). Resultados: Se apreció una tendencia de la muestra hacia indicadores de masa corporal asociados al sobrepeso (60,8%), como también al nivel de actividad física bajo (76,2%). Es notoria una correlación negativa entre el índice de Masa Corporal (IMC) y el nivel de actividad física del adulto mayor del Centro de Vida Conidec, Barranquilla, asociada al sobrepeso y la inactividad física (74%). Conclusión: Esta investigación resulta de gran interés en materia de gerontología y geriatría, y fundamentalmente para la sociedad adulta mayor del contexto barranquillero que participa de las actividades que se realizan en los Centros de Vida promovidos por la Alcaldía de Barranquilla, pues permiten el desarrollo de talleres basados en la enseñanza-aprendizaje sobre la importancia de la buena alimentación y los beneficios de la actividad física.

Association of suboptimal health status with intestinal microbiota in Chinese youths.

Suboptimal health status (SHS), a physical state between health and disease, is a subclinical and reversible stage of chronic disease. Previous studies have shown alterations in the intestinal microbiota in patients with some chronic diseases. This study aimed to investigate the association between SHS and intestinal microbiota in a case‐control study with 50 SHS individuals and 50 matched healthy controls. Intestinal microbiota was analysed by MiSeq 250PE. Alpha diversity of intestinal microbiota in SHS individuals was higher compared with that of healthy controls (Simpson index, W = 2238, P = .048). Beta diversity was different between SHS and healthy controls (P = .018). At the phylum level, the relative abundance of Verrucomicrobia was higher in the SHS group than that in the controls (W = 2201, P = .049). Compared with that of the control group, nine genera were significantly higher and five genera were lower in abundance in the SHS group (all P < .05). The intestinal microbiota, analysed by a random forest model, was able to distinguish individuals with SHS from the controls, with an area under the curve of 0.79 (95% confidence interval: 0.77‐0.81). We demonstrated that the alteration of intestinal microbiota occurs with SHS, an early stage of disease, which might shed light on the importance of intestinal microbiota in the primary prevention of noncommunicable chronic diseases.

Impact of nutritional risk factors on chronic non-communicable diseases

Abstract Background modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCD). Among various risk factors, poor nutrition quality has been identified as a leading determinant of NCD. Methods The Global Burden of Diseases (GBD) Study provided a comprehensive comparative risk assessment (CRA) of risk factor for NCD, quantifying the impact of behavioural, environmental and occupational, and metabolic risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. Special focus on nutritional risk factors will be dedicated, discussing the proportion of disease-specific burden attributable to each dietary risk factor and the level of intake associated with the lowest risk of mortality. Results In 2017, over 30 million deaths were attributable to risk factors. When ranked, high systolic blood pressure was the leading risk factor, accounting for more than 10 million deaths, followed by, high fasting plasma glucose, and high body-mass index. A total of 11 million deaths were attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits were the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Besides the major aforementioned factors, underrated dietary risk factors, such as low calcium intake, have been found important contributors to cancer burden in certain developed countries. Interpretation The combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in NCD at the global level. These data provide a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations.

Dietary polyphenol intake and socioeconomic status in adult russian/siberian population

Abstract Background Polyphenol consumption from polyphenol-rich foods (tea, coffee, fruits, vegetables at all) is inverse associated with the risk of cardiovascular- and other noncommunicable chronic diseases and varies in different regions due to dietary habits, as well as by socioeconomic factors. Methods Participants: the Siberian urban population (Novosibirsk, HAPIEE study, 9324 (4,249 men and 5,075 women) aged 45-69 years. Dietary data collected using a 141-item food frequency questionnaire. Data on the polyphenols were taken from the Phenol-Explorer database (version 3.6). Total polyphenols (TPH) were considered as a sum of all individual classes: flavonoids, phenolic acids, stilbenes, lignans and other polyphenols and their food sources. Socioeconomic status included gender, educational, occupational and marital status. Results The main sources of TPH were tea, coffee, fruits, vegetables and rye bread. Average total polyphenol consumption was 1273 (647) in men and 1203 (626) mg/day in women (P &amp;lt; 0,05). By occupational status, consumption of TPH in unemployed men was lower - 1139 (442) mg/day vs 1282 (648) in employed, working pensioners and unemployed pensioners (P &amp;lt; 0,05). The consumption of TPH in women: in unemployed pensioners: 1176 (613) vs 1220 mg/day in employed and working pensioners. The main polyphenols intake in all occupational groups were flavonoids (66,1-67,6 % total polyphenols), followed by phenolic acids (21,4-22,3%). TPH consumption in groups with less education than primary in men was lowest: 1052 (476) mg/day vs 1273 (646) (P &amp;lt; 0,05 vs men with higher education). In men and women with high education was highest consumption of lignans. The maximum consumption of polyphenol compounds was established in groups of married men and women:1279 (646) and 1231 (632) mg/day, respectively, P &amp;lt; 0,05 vs single individuals. Conclusions The consumption of polyphenol compounds in the Siberian urban population is determined by the socioeconomic status. Key messages The main individual classes of polyphenols consumed in all educational and marital status groups were the same as in the employment group: flavonoids, followed by phenolic acids. Recommendations for consumption of polyphenol compounds for the prevention of chronic non-communicable diseases in Siberia should consider the socioeconomic status of the population.

Adopting healthy habits through the collaboration of health, education and culture systems

Abstract Background The ’Adopt healthy habits’ program is a health promotion program that links the health system, education system and the City of Zagreb library. It is based on the association of mental, physical and emotional health factors. It is done through work in smaller groups, using educational interactive materials and methods with selected books in accordance with the topic of the workshop and with the practice of applying the adopted knowledge. Methods of work The methodological basis of the programs are health workshops conducted in the libraries of the City of Zagreb in cooperation with the primary schools. They imply working with students by acting on risk factors: obesity, physical inactivity, smoking and low self-esteem. The skills used are promoting health, cognitive-behavioral methods, health education, kinesiology, nutrition and bibliotherapy. Objectives Educating students about the importance and ways of adopting healthy habits and gaining self-esteem and reducing the occurrence of risky behaviors. Long-term objectives are improvement of the psychophysical development of students, increase of the population of the City of Zagreb with balanced dietary habits and regular physical activity and normal body mass index and reduction of the occurrence of chronic non-communicable diseases in adulthood. Results In the period from 2015 to 2018, a total of 141 workshops were conducted through which 3,106 pupils were educated. The workshops were conducted in 12 primary schools of the City of Zagreb and 5 of the related city libraries. Conclusions Interactive approaches in the creative environment proved to be the most appropriate in educative work with children. It is necessary to continue to implement this form of primary prevention on a wider population. Key messages Adopting healthy habits in childhood is the basis for primary prevention of chronic non-communicable diseases. Multidisciplinary approach to health education in youth assures a more permanent adoption of positive health behavior.

Strategies for the prevention of chronic non-communicable diseases: a modern look at the problem

One of the most significant and urgent targets of modern healthcare is an effective control of chronic non-communicable diseases. These diseases lead not only to premature death, but also to permanent incapacitation and worsening of life quality. Prophylactic measures have proven to be the most effective method for control of chronic non-communicable diseases. However, in addition to well-known prevention tactics: population, high-risk and secondary prevention strategies, there are currently other approaches. The presented review provides a brief comparison of two “classical” prevention strategies. We analyzed the contribution of each of them to world healthcare, and justified the need for a complex approach to prevention. We studied possible transformation of present strategies and considered other promising approaches developed by some authors. Particular attention is paid to assessing the possibilities and feasibility of genetic information using to define the disease risks and personalize medical prevention.

The use of pricing policy in the primary prevention of chronic noncommunicable diseases: taxes on sugary drinks

The use of pricing policy in the primary prevention of chronic noncommunicable diseases: taxes on sugary drinks

Proximate Composition, Minerals and Antioxidant Activity of Artichoke Leaf Extracts

In this study, leaf extracts from the Green Globe cultivar of artichoke (Cynara scolymus L.), a herbaceous plant of the Asteraceae family, were analyzed to determine the levels of basic nutrients, selected macroelements (K, P, Ca, Mg, and Na) and microelements (Zn, Fe, Mn, Cr, Pb, Cd, and Ni), and their ratios. The antioxidant activity (aa) of the extract was evaluated using ABTS˙+ and DPPH˙+ radicals and the ferric reducing antioxidant power assay (III) (FRAP). Total polyphenolic content was also determined. Macroelement concentrations in the artichoke leaf extract can be presented in descending order as follows: K > P > Ca > Mg > Na. Microelement content in the extract was as follows: Zn > Fe > Cr > Mn. We determined the ratios of elements in artichoke leaf extracts and compared them against the recommended dietary allowance, adequate intake, or tolerable upper intake level. Mean total phenolic content in artichoke leaf extracts was high – 2795 mg CAE/100 g dry matter (DM). The ABTS˙+ assay showed a very high ability of artichoke extract to scavenge free radicals (79.74%), and the antioxidant capacity measured at 1060.8 Trolox/1 g DM. The results show that artichoke extract is a valuable source of minerals and antioxidants that could have applications in the prevention of chronic non-communicable diseases caused by oxidative damage.

1644-P: Novel Subgroups of Prediabetes and Their Clinical Outcomes: A Data-Driven Analysis

The progression of prediabetes to diabetes and the reversion of them to NGT are highly heterogeneous. To develop a refined classification of prediabetes, we used data-driven K-means clustering in patients diagnosed with IGT and IFG according to WHO 1999 criteria in Pinggu Study (a prospective population-based survey for diabetes in suburban Beijing, n=628), NHANES III study (a cross-sectional population-based survey in the U.S., n=1532) and Beijing Prediabetes Reversion Program (BPRP, a RCT to evaluate the efficacy of lifestyle and/or pioglitazone on prediabetes reversion, n=1905). Based on five variables including HbA1c, BMI, age, HOMAIR and HOMAB, we identified four replicable clusters across all three datasets including high glucose group (HGG), lean group (LG), early-onset group (EOG) and insulin resistant group (IRG) (Figure). HRG had significant higher 1-year diabetes progression rate (15.4% in BPRP and 25.6% in Pinggu study) and the LG had the lowest diabetes progression rate (7.1% in BPRP and 11.1% in Pinggu Study). In BPRP, HGG treated with Intensive lifestyle plus pioglitazone had significant higher reversion rate to NGT and EOG treated with intensive life style plus placebo had least reversion rate compared to other treatment. Our study provides risk stratification for prediabetes and can potentially facilitate clinical decision, representing a first step towards precision management. Disclosure X. Zou: None. Z. Zhu: None. Y. Luo: None. Y. Li: None. X. Zhou: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp &amp; Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp &amp; Dohme Corp., Novartis AG, Roche Pharma, Sanofi. Funding The Major Chronic Non-Communicable Disease Prevention and Control Research of China; Beijing Science and Technology Committee; National Natural Science Foundation of China

1521-P: An Efficacy Evaluation on Prediabetes Management Using a Machine Learning-Based Risk Stratification Approach

The progression of prediabetes towards diabetes was heterogeneous, suggesting a demand for individualized management. We aim to investigate whether stratifying participants with prediabetes according to their progression risk could affect the response to interventions. We developed a 1-year diabetes progression risk evaluating model with a panel of diabetes risk factors using a machine learning method (i.e., Bagging algorithm with 300 decision trees) in prediabetes participants in Pinggu Study (a prospective population-based survey in suburban Beijing, n=622). The model training phase was conducted on 2/3 randomly selected participants and the validation phase was conducted on other 1/3. This model successfully predicted the 1-year progression of prediabetes participants in Pinggu study (internal ROC AUC 1.000, external ROC AUC 0.883). In Beijing Prediabetes Reversion Program (BPRP, a multi-central RCT to evaluate the efficacy of lifestyle and/or pioglitazone on prediabetes reversion, n=1897), subjects were divided into tertiles as high, medium and low risk groups according to their progression probability predicted by the model. Pioglitazone plus intensive lifestyle significantly increased reversion and reduced diabetes progression only in high risk group. This study suggests personalized treatment on prediabetes according to their progression risk is necessary. Disclosure X. Zou: None. Z. Zhu: None. Y. Luo: None. Y. Li: None. X. Zhou: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp &amp; Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp &amp; Dohme Corp., Novartis AG, Roche Pharma, Sanofi. Funding The Major Chronic Non-Communicable Disease Prevention and Control Research of China; Beijing Science and Technology Committee; National Natural Science Foundation of China

From End Treatment to Source Prevention: Socio-Ecological Approaches to Promote Research on the Environment and Non-Communicable Chronic Diseases with Special Reference to China.

Globally, the pandemic of non-communicable chronic diseases (NCDs) has become a critical public health problem. Although NCD prevention has been shifting from individual behavioral interventions to broad environmental interventions, it is still necessary to promote research on the environment and NCDs as a whole. Therefore, this conceptual paper aimed to develop a general and novel framework to advance this line of research. The framework uses socio-ecological approaches that emphasize source prevention rather than the end treatment. Specifically, this framework comprehensively covered integrative research approaches, prioritized areas, urgent efforts, innovative methodologies, and improved funding. The framework used China as a typical context, where its public health policies, similar to other nations, still focus on the end treatment of NCDs, placing emphasis on biomedical approaches and technologies. China’s relevant efforts may furnish new insights and approaches concerning NCD prevention, and these efforts may benefit the improvement of global health and well-being. Such social-ecological research efforts can help to accelerate a shift from existing individual interventions to environmental interventions, thereby ultimately achieving the effective source prevention of NCDs in China and around the globe.

Dietary Polyphenols-Important Non-Nutrients in the Prevention of Chronic Noncommunicable Diseases. A Systematic Review.

The improvement of the social and economic conditions of society has eliminated the threat of death from the majority of infectious diseases. However, the rapid progress of civilization has created new possibilities for the appearance of factors with adverse effects for the health of society. This has led to increased morbidity from certain diseases, the presence of which had not been observed several centuries ago. Chronic noncommunicable diseases (e.g., cancers, cardio-vascular disorders, diabetes, obesity, neurodegenerative diseases) result from an inappropriate relationship between people and their environment. The common characteristic for all chronic diseases is a “new” form of inflammation, very often called metaflammation, which is considered as a subclinical, permanent inflammation. As a result, metabolic cascade, including cellular oxidative stress, atherosclerotic process, and insulin resistance, occurs, which slowly generates significant deterioration in the organism. Polyphenols are the major group of non-nutrients, considering their diversity, food occurrence, and biological properties. The current review aims to present a wide spectrum of literature data, including the molecular mechanism of their activity and experimental model used, and summarize the recent findings on the multitude of physiological effects of dietary polyphenols towards the prevention of several chronic diseases. However, despite several studies, the estimation of their dietary intake is troublesome and inconclusive, which will be also discussed.

Introduction and Executive Summary of the Supplement, Role of Milk and Dairy Products in Health and Prevention of Noncommunicable Chronic Diseases: A Series of Systematic Reviews

ABSTRACTMilk and dairy products contain multiple nutrients and contribute significantly to meet the nutritional requirements for protein, calcium, magnesium, phosphorus, potassium, zinc, selenium, vitamin A, riboflavin, vitamin B-12, and pantothenic acid. However, consumption of dairy is decreasing and moving away from the advised level in many countries and the potential benefits of milk and dairy products for health have come under question. This, in spite that numerous studies report health benefits associated with dairy consumption. The present supplement aims to assess and summarize scientific evidence regarding the impact of dairy intake on health and all-cause mortality, and on the prevention of diverse chronic diseases, mainly from meta-analyses of observational studies and randomized controlled trials (RCTs). There seem to positive associations between moderate maternal milk intake during pregnancy and infant birth weight, length and bone mineral content during childhood. Moreover, consumption of dairy products in older subjects may reduce the risk of frailty and decrease the risk for sarcopenia. The highest consumption of dairy products did not show a clear association with total osteoporotic fracture and hip fracture risk; however, a diminished risk of vertebral fracture was found. Analysis of the differences between high and low dairy consumption and for dose-response found no association between dairy product consumption and risk of all-cause mortality. Total and low-fat dairy consumption is associated with a reduced risk of developing metabolic syndrome and current evidence supports that consumption of dairy does not adversely affect the risk of cardiovascular outcomes and may even have a subtle protective effect. Moreover, evidence has been provided of an inverse association between the consumption of dairy products and ischemic heart disease and myocardial infarction. Also, the evidence suggests that dairy consumption, particularly low-fat dairy and yogurt is associated with a lower risk of type 2 diabetes. Likewise, moderate compared with medium consumption of dairy is associated lower risk for colorectal and bladder cancer and has no association with prostate cancer. Finally, consumption of milk or dairy products did not show a proinflammatory effect on healthy subjects, overweight/obese individuals, or individuals with other metabolic abnormalities, and fortification of dairy products with phytosterols and ω-3 fatty acids seems to be a good approach to improve cardiometabolic risk biomarkers. In conclusion, the systematic reviews and meta-analyses of the present supplement support adequate milk consumption at various stages of life and in the prevention/control of various noncommunicable chronic diseases.