Progression Of Non-communicable Diseases Research Articles

Dietary fat consumption frequency and body mass index of middle-age adults in Mumbai city, India during COVID-19 pandemic

Obesity and COVID-19 are global pandemics listed by World Health Organization, which need urgent attention. Obesity involves low grade chronic inflammation, which is characterised by sustained pro-inflammatory innate immune responses mediated through activation of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome/IL-1 axis, and is a strong risk factor for Diabetes and Heart diseases(1). Dietary fats provide energy, satiety, source of fat-soluble vitamins and essential fatty acids – Omega 3 (n-3) and Omega 6 (n-6) fatty acids, but must be consumed in right amounts and ratios. Essential fatty acids (EFA) deficiency and n-6/n-3 imbalance is linked with chronic illnesses such as, heart attacks, cancer, insulin resistance, stroke, obesity, and diabetes(2). Excess dietary fat intake and imbalance of fatty acids, contribute to obesity, inflammation, comorbidities and faster disease progression. A cross-sectional survey aimed to understand the fatty food frequency of overweight and obese middle age adults from Mumbai, India during the COVID-19 outbreak. Using purposive sampling, 100 adults (30-60 years), a questionnaire (demographics, anthropometrics and fat food frequency questionnaire) was administered. Data was analysed using SPSS 26.0. As per BMI standards, 60.2% participants were overweight, 12.6% were obese and 27.1% had normal BMI. For visible fat consumption, sunflower oil (47.6%), ghee (38.8%), rice bran oil (34%) groundnut oil (11.7%) and invisible fats – milk (100%). Other dairy products, nuts and oilseeds were consumed weekly. twice a week, majority (92.3%) consumed packaged high fat foods as compared to eating deep-fried items (58.9%). We concluded that excess dietary fat intake is high risk factor for obesity and related comorbidities diabetes, and hypertension. High BMI increases the risk for non-communicable diseases (NCDs) such as obesity, cardiovascular disease (CVD), insulin resistance and type 2 diabetes. People with co-morbidities are high risk groups for COVID-19 infection susceptibility. Hence, managing weight could be a cost-effective preventive strategy to help in delaying the onset and progression of NCDs, thereby lowering the susceptibility to COVID-19. Our findings have important implications in working towards adopting healthy fats and reducing mortality and reducing the global burden of pandemic. High dietary fat intake is a modifiable risk factor for overweight and obesity. Comorbidities increased risk for COVID-19 infection, disease severity and mortality. Hence, there is a need to understand the dietary fat consumption patterns in obesity and COVID-19. Dietary carbohydrate, sugar and fat quality in relation to obesity and pandemic such as, COVID-19 could be explored in future studies.

Chrononutrition in the Prevention and Management of Metabolic Disorders: A Literature Review.

The concept of time-restricted eating (TRE) or time-restricted feeding (TRF) promotes daily periods of feeding and fasting to determine whole-body physiology. Chronic misalignment of circadian rhythms or chrono-disruption is related to an increased risk of diverse metabolic disorders. The progression of non-communicable diseases seems to be affected by the timing of meals. As a result, intermittent fasting is a promising approach for their management. The aim of the present literature review is to examine and scrutinize the TRE protocols in the fields of prevention and management of metabolic disorders. This is a thorough literature review of the reported associations among circadian rhythm, metabolic disorders, diabetes mellitus, obesity, TRE, TRF, dietary habits, circadian disruption, cardiovascular diseases, atherosclerosis, and non-alcoholic fatty liver to find the already existing clinical studies from the last decade (2014-2024) in the most precise scientific online databases, using relevant specific keywords. Several inclusion and exclusion criteria were applied to scrutinize only longitudinal, cross-sectional, descriptive, and prospective clinical human studies. The currently available clinical findings remain scarce and suggest that chrononutrition behaviors such as TRE or TRF may promote several metabolic benefits, mainly in body weight control and fat loss. Improvements in glucose levels and lipid profiles are currently quite controversial since some clinical studies show little or no effect. As far as liver diseases are concerned, the efficacy of intermittent fasting seems to be stronger in the management of non-alcoholic fatty liver disease due to body weight decline and fat loss. Even if there has been a gradual increase in clinical studies in the last few years, providing promising perspectives, currently, there is no conclusive evidence for the role of chrononutrition in metabolic disorders. Future studies should be well-designed with longer duration and larger sample sizes. Moreover, it is important to examine the best timing of the eating window and its feasibility.

Potential of White Jack Bean (Canavalia ensiformis L. DC) Kefir as a Microencapsulated Antioxidant.

Oxidative stress plays a major role in the pathogenesis and progression of noncommunicable diseases. Kefir is a fermented food that has been reported to repress oxidative stress. This study aimed to assess the antioxidant activity, bioactive composition, and encapsulation efficiency of white jack bean (WJB) kefir. The following procedures were conducted: WJB was prepared and converted into juice using water solvent. The sterilized WJB juice was then fermented with kefir grain (10%) for 24∼72 h. Every 24 h, the kefir was evaluated for antioxidant activity, and the dominant bioactive component suspected to be the source of the antioxidant activity was identified. The final stage was the encapsulation process. WJB kefir showed high antioxidant activity, inhibiting DPPH radicals by 90.51±4.73% and ABTS radicals by 86.63±2.34% after 72 h of fermentation. WJB kefir contained 0.35±0.01 mg GAE/g total phenolics and 0.08 mg/g total flavonoids. The LC/MS identification suggested that the bioactive antioxidant components of the WJB kefir were from the alkaloid, saponin, phenolic, and flavonoid groups. The encapsulation with maltodextrin using freeze drying resulted in microencapsulation of WJB kefir with a particle size of 6.42±0.13 μm. The encapsulation efficiency was 79.61%, and the IC50 value was 32.62 ppm. The encapsulation method was able to maintain the antioxidant stability of the kefir and extend its shelf life. WJB kefir, a nondairy, lactose-free kefir, can be used as an antioxidant functional food.

Can ChatGPT provide appropriate meal plans for NCD patients?

ObjectivesDietary habits significantly affect health conditions and are closely related to the onset and progression of non-communicable diseases (NCDs). Consequently, a well-balanced diet plays an important role in lessening the effects of various disorders, including NCDs. Several artificial intelligence recommendation systems have been developed to propose healthy and nutritious diets. Most of these systems use expert knowledge and guidelines to provide tailored diets and encourage healthier eating habits. However, new advances in large language models such as ChatGPT, with their ability to produce human-like responses, have led individuals to search for advice in several tasks, including diet recommendations. This study aimed to determine the ability of ChatGPT models to generate appropriate personalized meal plans for patients with obesity, cardiovascular diseases, and type 2 diabetes. MethodsUsing a state-of-the-art knowledge-based recommendation system as a reference, we assessed the meal plans generated by two large language models in terms of energy intake, nutrient accuracy, and meal variability. ResultsExperimental results with different user profiles revealed the potential of ChatGPT models to provide personalized nutritional advice. ConclusionAdditional supervision and guidance by nutrition experts or knowledge-based systems are required to ensure meal appropriateness for users with NCDs.

The impact of chronic stress on intracellular redox balance: A systems level analysis.

Chronic psychosocial stress is implicated in the onset and progression of noncommunicable diseases, and mechanisms underlying this relationship include alterations to the intracellular redox state. However, such changes are often investigated in isolation, with few studies adopting a system level approach. Here, male Wistar rats were exposed to 9.5 weeks of chronic unpredictable mild stress and redox status assays were subsequently performed on cardiac, hepatic, and brain tissues versus matched controls. The stressed rats displayed an anxious phenotype, with lowered plasma corticosterone levels (p= 0.04 vs. Controls) and higher plasma epinephrine concentrations (p= 0.03 vs. Controls). Our findings showed organ-specific redox profiles, with stressed rats displaying increased myocardial lipid peroxidation (p= 0.04 vs. Controls) in the presence of elevated nonenzymatic antioxidant capacity (p= 0.04 vs. Controls). Conversely, hepatic tissues of stressed rats exhibited lowered nonenzymatic antioxidant capacity (p< 0.001 vs. Controls) together with increased superoxide dismutase (SOD) activity (p= 0.05 vs. Controls). The brain displayed region-specific antioxidant perturbations, with increased SOD activity (p= 0.01 vs. Controls) in the prefrontal cortex of the stressed rats. These findings reveal distinct stress-related organ-specific vulnerability to redox perturbations and may provide novel insights into putative therapeutic targets.

Natural Coumarin Derivatives Activating Nrf2 Signaling Pathway as Lead Compounds for the Design and Synthesis of Intestinal Anti-Inflammatory Drugs.

Nrf2 (nuclear factor erythroid 2-related factor 2) is a transcription factor related to stress response and cellular homeostasis that plays a key role in maintaining the redox system. The imbalance of the redox system is a triggering factor for the initiation and progression of non-communicable diseases (NCDs), including Inflammatory Bowel Disease (IBD). Nrf2 and its inhibitor Kelch-like ECH-associated protein 1 (Keap1) are the main regulators of oxidative stress and their activation has been recognized as a promising strategy for the treatment or prevention of several acute and chronic diseases. Moreover, activation of Nrf2/keap signaling pathway promotes inhibition of NF-κB, a transcriptional factor related to pro-inflammatory cytokines expression, synchronically promoting an anti-inflammatory response. Several natural coumarins have been reported as potent antioxidant and intestinal anti-inflammatory compounds, acting by different mechanisms, mainly as a modulator of Nrf2/keap signaling pathway. Based on in vivo and in vitro studies, this review focuses on the natural coumarins obtained from both plant products and fermentative processes of food plants by gut microbiota, which activate Nrf2/keap signaling pathway and produce intestinal anti-inflammatory activity. Although gut metabolites urolithin A and urolithin B as well as other plant-derived coumarins display intestinal anti-inflammatory activity modulating Nrf2 signaling pathway, in vitro and in vivo studies are necessary for better pharmacological characterization and evaluation of their potential as lead compounds. Esculetin, 4-methylesculetin, daphnetin, osthole, and imperatorin are the most promising coumarin derivatives as lead compounds for the design and synthesis of Nrf2 activators with intestinal anti-inflammatory activity. However, further structure-activity relationships studies with coumarin derivatives in experimental models of intestinal inflammation and subsequent clinical trials in health and disease volunteers are essential to determine the efficacy and safety in IBD patients.

Long-term Weight Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program: Randomized Controlled Trial.

BackgroundLong-term weight loss in people living with obesity can reduce the risk and progression of noncommunicable diseases. Observational studies suggest that digital coaching can lead to long-term weight loss.ObjectiveWe investigated whether an eHealth lifestyle coaching program for people living with obesity with or without type 2 diabetes led to significant, long-term (12-month) weight loss compared to usual care.MethodsIn a randomized controlled trial that took place in 50 municipalities in Denmark, 340 people living with obesity with or without type 2 diabetes were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (n=200) or a control (n=140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention consisted of an initial 1-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. The primary outcome was change in body weight from baseline to 12 months.ResultsData were assessed for 200 participants, including 127 from the intervention group and 73 from the control group, who completed 12 months of follow-up. After 12 months, mean body weight and BMI were significantly reduced in both groups but significantly more so in the intervention group than the control group (–4.5 kg, 95% CI –5.6 to –3.4 vs –1.5 kg, 95% CI –2.7 to –0.2, respectively; P<.001; and –1.5 kg/m2, 95% CI –1.9 to –1.2 vs –0.5 kg/m2, 95% CI –0.9 to –0.1, respectively; P<.001). Hemoglobin A1c was significantly reduced in both the intervention (–6.0 mmol/mol, 95% CI –7.7 to –4.3) and control (–4.9 mmol/mol, 95% CI –7.4 to –2.4) groups, without a significant group difference (all P>.46).ConclusionsCompared to usual care, digital lifestyle coaching can induce significant weight loss for people living with obesity, both with and without type 2 diabetes, after 12 months.Trial RegistrationClinicalTrials.gov NCT03788915; https://clinicaltrials.gov/ct2/show/NCT03788915

NON-COMMUNICABLE DISEASES: THE CONCEPT OF A GENERAL CONTINUUM (FIRST REPORT)

A new look at the systematic and gradual development of non-communicable diseases within the general continuum is presented in the article from the perspective of systemic medicine. The purpose of the study was to deepen the knowledge of the etiopathogenesis of non-communicable diseases by conceptualizing a model of gradual development and staging of the progression of comorbidity with the recognition of systematicity within the general continuum. Materials and methods. General scientific and theoretical methods, logical methods and rules of a normative nature were used to identify, generalize the issues of the emergence and progression of comorbid pathology in non-communicable diseases. The synthesis of knowledge and the conceptual mapping of the results were then carried out in the so-called general continuum of non-communicable diseases. Results. The results of a systemic medical analysis, according to which a novel approach is proposed with the recognition of the systemic and gradual development of noncommunicable diseases within a general continuum, were presented. The newest universal pathogenetic mechanism for the occurrence and progression of non-communicable diseases was also identified. This is mitochondrial dysfunction, which organically complements the theory of the cardiovascular continuum. Conclusion. 1) Mitochondrial dysfunction is a universal pathogenetic component of the quantum level of the pathogenesis of non-communicable diseases, which organically complements the theory of the cardiovascular continuum. 2) The concept of a common continuum model is proposed for their consideration of non-communicable diseases based on the systemic and gradual nature of their development. The cardiovascular continuum is a part of this general non-communicable disease continuum. 3) Evaluation of all existing comorbid pathology is important in the management of patients with non-communicable diseases in order to determine the correct, adequate, individual preventive and therapeutic approach in accordance with the requirements of 4P medicine.

Non-Communicable Diseases in Afghanistan and Ghana

Non-communicable diseases are a challenge to public health worldwide. Decades ago, the consensus was that non-communicable diseases were the problem of developed and wealthy nations. However, recent studies indicate that developing countries are on the edge of emerging increases in non-communicable diseases due to various factors such as the consumption of unhealthy food, lack of physical activities, poor access to primary healthcare services, and loosened policies on tobacco use. Non-communicable diseases cause increased mortality and have significant financial impact due to treatment costs. The conditions also decrease the capacity and productivity of the human workforce in the community who cannot adequately contribute when under treatment in the late stages of the disease. Multiple societal and economic factors contribute to poor outcomes from non-communicable diseases including increasing globalization and urbanization. The two countries reviewed, Afghanistan and Ghana, have worsened population health due to aforementioned factors. In low and middle-income countries such as Afghanistan and Ghana, the unparalleled progression of globalization and urbanization and lifestyle factors have contributed to fast track the prevalence and progression of non-communicable diseases. This literature review aims to overview the impact of non-communicable diseases in Afghanistan and Ghana and suggest potential strategies to improve overall population health outcomes.

Diet and Non-Communicable Diseases: Part II Cancer, Diabetes Mellitus, Kidney Diseases, Alzheimer’s Disease, Arthritis

Several global studies have shown that diet plays an important role as a modifiable lifestyle factor in the development and progression of non-communicable diseases. A proper diet with a balanced percentage of macronutrients, viz. carbohydrates, proteins, and fats. It is also selective in the choice of macronutrients, preferring those that are plant-based, and avoiding refined carbohydrates, animal-based proteins, and saturated fats and trans-fats. It is also rich in needed micronutrients viz. vitamins and minerals, and adequate intake of water. This manuscript deals with the important role of a prudent diet in five major non-communicable diseases.

Abdominal Obesity A Stepping Stone to Non Communicable Diseases in South Asia

This article provides an overview of the relationship between abdominal obesity (AO) and Non-Communicable Diseases (NCDs) in South Asia. A literature review has been conducted using key words: Abdominal obesity, Non-Communicable Diseases, Adipokines and South Asia, searching Scopus, Pubmed, Google scholar and Medline databases. South Asians suffer from abdominal obesity that results in systematic inflammation giving rise to excess production of harmful adipokines that eventually leads to the occurrence of NCDs. The incidence of NCDs related mortality ranges between 44 per cent - 84 per cent. Impaired developments during pregnancy may also have a linkage with AO and NCDs. Adipokines and fat derivatives produced in abundance by the abdominal fat tissues have a crucial implication in the progression of NCDs. South Asians have unhealthy metabolic profile leading to several forms of NCDs. Further research needs to be done in the population groups suffering from abdominal obesity to derive interventional strategies to prevent as well as manage NCDs in clinical settings.

Addressing the Challenge of Potentially Hazardous Elements in the Reduction of Hypertension, Diabetes and Chronic Kidney Disease in the Caribbean.

Background.Environmental surveys have characterized trace elements such as lead (Pb), cadmium (Cd) and arsenic (As) as potential risk factors for non-communicable diseases. There have been few studies conducted in the Caribbean region to explore, define or clarify such findings locally. Furthermore, local pollution control efforts are often juxtaposed against more seemingly immediate economic concerns in poor communities.Objectives.The present commentary is a call to action for the evaluation of potentially hazardous elements as potential risk indicators and/or factors of common noncommunicable diseases in the Caribbean.Discussion.Findings from Jamaican studies have identified exposure to potentially hazardous elements (PHE) via water, food, and other anthropogenic activities to the detriment of the resident population. Several attempts have been made to abate toxic metal exposure in children with relative success. However, high levels of PHE have been noted in vulnerable populations such as patients with hypertension, diabetes mellitus and chronic kidney disease. Currently, there is low priority towards infrastructure building within the Caribbean region that would promote and sustain long term monitoring and better inform environmental polices impacting chronic diseases.Conclusions.Further investigations are needed to clarify the role that PHE play in increasing the risk or progression of non-communicable diseases, especially in vulnerable groups.Competing Interests.The authors declare no competing financial interests.

Narrative review of current COPD status in Japan.

Chronic obstructive pulmonary disease (COPD) causes morbidity and mortality worldwide. Due to the improvement in environmental sanitation and medical care, the general life span has increased in the past decades in Japan. However, many older patients with COPD develop a wide range of comorbidities, and the impairments in the activities of daily living result in frailty and increase social and economic burdens. Population-based studies have shown that the prevalence of COPD is approximately 10% among subjects aged ≥40 years, but more than 80% of COPD patients are underdiagnosed. The Ministry of Health, Labour, and Welfare in Japan proposed the National Health Promotion in the 21st century, termed Health Japan 21 (the second term), in 2013 to prevent the onset and progression of noncommunicable diseases (NCDs), including COPD. The government, medical society, and community have been attempting to increase the recognition of COPD and promote smoking cessation. Additionally, Japanese cohorts have revealed distinct clinical features in Japanese patients with COPD, including lower rates of patient-reported exacerbations, less frequent coexisting cardiovascular disease and metabolic syndrome, and lower use of inhaled corticosteroids in Japan compared to the Western countries. Moreover, the poor adherence to inhaled medications is found in approximately 20% of subjects, and rehabilitation is performed in 26% of hospitalized patients with COPD. Therefore, more efforts should be made to improve adherence and access to pulmonary rehabilitation. Overall, Japanese COPD patients share common clinical and social features with COPD patients in other countries. Further international corroboration may help establish better comprehensive management of the disease.

Impact of lifestyle on health-related quality of life among young university students: a cross-sectional study.

Lifestyle is strongly involved in the pathogenesis and progression of non-communicable diseases, and has a great impact on quality of life. The goal of the present study was to analyze the lifestyle and body composition (BC) of young university students during the pandemic, and their relationship with health-related quality of life (HrQoL). Observational cross-sectional study conducted in the Universidad Europea de Madrid, Spain. A total sample of 56 healthy university students was recruited. Activity, sitting time, adherence to Mediterranean diet and BC were measured. Regarding BC, only 5% and 10.7% of the subjects had health risk values for waist circumference and waist-to-height ratio, respectively. The mean daily sitting-time was 8.26 hours, while 19.64% of the subjects spent . 10 hours per day sitting. 92.86% of the subjects complied with the World Health Organization 2020 physical activity recommendations. The mean PREDIMED score was 7.41, while 51.8% of the subjects had low adherence to the Mediterranean diet. Regarding HrQoL, 22 subjects (39.2%) and 26 subjects (46.4%) were in the lowest quintile of physical component summary and mental component summary, respectively, according to the reference values for their age range. There was a negative correlation between physical function and sitting time (r = -0.38). There were high levels of sedentary behavior and low HrQoL values, with a negative moderate correlation between these variables. The findings from the present study especially highlight the importance of implementing public health programs targeting reduction of sitting time among university students.

Factors associated with the progression and prevention of noncommunicable diseases in community-dwelling Filipino adults: A cross-sectional study.

Noncommunicable diseases (NCDs) are an important cause of disability and death in Muntinlupa, Manila, Philippines. However, there is little community-based research on lifestyle behaviors that affect the progression of NCDs or on the hindrances to NCD prevention.This cross-sectional study investigated the lifestyle behaviors associated with the progression and prevalence of NCDs and clarified factors associated with health promotion for the NCDs prevention among 168 Filipino adults aged 50 years and above in the community setting.The prevalence of diabetes, cardiovascular disease, cancer, chronic respiratory disease, hypertension, and overweight/obesity found 13.1%, 8.9%, 1.8%, 4.2%, 59.5%, and 36.9%, respectively. Of 63 adults who underwent blood tests, high blood glucose and abnormal lipids found 20.6% and 80.9%, respectively. Filipino adults ate breakfast, lunch, and dinner more than 5 days a week, Merienda 4.2 days a week, and a midnight snack 1.7 days a week. The mean frequencies of physical activity at vigorous, moderate, and light intensity levels were 2.6 times a week, 1.9 times a week, and 3.8 times a week, respectively. Men were more likely to be smokers than women. Mean frequencies of alcohol consumption were 0.6 days a week. Filipino adults who practiced diet control, regular physical activities, no smoking, limited alcohol intake, stress control, and regular health checkups were 68.3%, 34.1%, 35.9%, 35.3%, 32.9%, and 24.6%, respectively. Hypertension was positively associated with the duration of tobacco use and frequency of salt intake. Overweight/obesity was positively associated with the frequency of Merienda. Diet control was positively related with internal Multidimensional Health Locus of Control scale. Smoking and alcohol control were significantly related with income level.Community-dwelling Filipino adults in this study had a high prevalence of NCD progression and insufficient awareness of preventative behaviors. Diet control is associated with self-awareness of health and smoking and alcohol control are associated with economic status. These findings ought to contribute to develop the effective strategies for NCD prevention in community-dwelling Filipino adults.

Risk of Dysglycemia in Pregnancy amongst Kenyan Women with HIV Infection: A Nested Case-Control Analysis from the STRiDE Study

Introduction Gestational diabetes is a common complication, whose incidence is growing globally. There is a pressing need to obtain more data on GDM in low- and middle-income countries, especially amongst high-risk populations, as most of the data on GDM comes from high-income countries. With the growing awareness of the role HIV plays in the progression of noncommunicable diseases and the disproportionate HIV burden African countries like Kenya face, investigating the potential role HIV plays in increasing dysglycemia amongst pregnant women with HIV is an important area of study. Methods The STRiDE study is one of the largest ever conducted studies of GDM in Kenya. This study enrolled pregnant women aged between 16 and 50 who were receiving care from public and private sector facilities in Eldoret, Kenya. Within this study, women received venous testing for glycosylated hemoglobin (HbA1c) and fasting glucose between 8- and 20-week gestational age. At their 24-32-week visit, they received a venous 75 g oral glucose tolerance test (OGTT). Because of the pressing need to assess the burden of GDM within the population of pregnant women with HIV, a nested case-control study design was used. Pregnant women with HIV within the larger STRiDE cohort were matched to non-HIV-infected women within the STRiDE cohort at a 1 : 3 ratio based on body mass index, parity, family history of GDM, gestational age, and family history of hypertension. The measurements of glucose from the initial visit (fasting glucose and HbA1c) and follow-up visit (OGTT) were compared between the two groups of HIV+ cases and matched HIV- controls. Results A total of 83 pregnant women with HIV were well matched to 249 non-HIV-infected women from the STRiDE cohort with marital status being the only characteristic that was statistically significantly different between the two groups. Statistically significant differences were not observed in the proportion of women who developed GDM, the fasting glucose values, the HbA1c, or OGTT measurements between the two groups. Discussion. Significant associations were not seen between the different measures of glycemic status between pregnant women with and without HIV. While significant differences were not seen in this cohort, additional investigation is needed to better describe the association of dysglycemia with HIV, especially in Kenyan populations with a higher prevalence of GDM.

Football - Novel Approaches to Tackle Diabetes.

Balanced diet and regular physical activity are of key importance to the prevention of the development and progression of non-communicable diseases. In 2050, 50% of the European population is expected to be obese. Cardiovascular diseases, diabetes mellitus, cancer, as well as joint impairments, will further increase. Therefore, programmes are critical to the improvement of the population's health status in the long run. New ways have to be found that allow addressing more people than with the current approaches. Football has a great potential to attract people at risk for or with already existing non-communicable diseases, such as type 2 diabetes, to participate in health-promoting programmes. The novel football version, walking football was developed for elderly players, aiming at avoiding injuries and physical overload. The present article gives a brief overview on the metabolic effects of recreational football, particularly walking football, as well as health-promoting programmes offered by professional football clubs in humans at risk for or with already existing non-communicable diseases.

Role of Caspase-1 in the Pathogenesis of Inflammatory-Associated Chronic Noncommunicable Diseases.

Caspase-1 is the first and extensively studied inflammatory caspase that is activated through inflammasome assembly. Inflammasome is a cytosolic formation of multiprotein complex that aimed to start inflammatory response against infections or cellular damages. The process leads to an auto-activation of caspase-1 and consequent maturation of caspase-1 target molecules such as interleukin (IL)-1β and IL-18. Recently, the role of caspase-1 and inflammasome in inflammatory-induced noncommunicable diseases (NCDs) like obesity, diabetes mellitus (DM), cardiovascular diseases (CVDs), cancers and chronic respiratory diseases have widely studied. However, their reports are distinct and even they have reported contrasting role of caspase-1 in the development and progression of NCDs. A few studies have reported that caspase-1/inflammasome assembley has a protective role in the initiation and progression of these diseases through the activation of the noncanonical caspase-1 target substrates like gasdermin-D and regulation of immune cells. Conversely, others have revealed that caspase-1 has a direct/indirect effect in the development and progression of several NCDs. Therefore, in this review, we systematically summarized the role of caspase-1 in the development and progression of NCDs, especially in obesity, DM, CVDs and cancers.

Implementation of non-communicable disease policies: a geopolitical analysis of 151 countries

SummaryBackgroundMost countries have endorsed WHO non-communicable disease (NCD) best buy policies, but we know very little about global implementation patterns and about the geopolitical factors affecting implementation. We aimed to assess global implementation based on analysis of multiple geopolitical datasets.MethodsWe used the 2015 and 2017 WHO NCD progress monitor reports to calculate aggregate implementation scores for 151 countries, based on their implementation of 18 WHO-recommended NCD policies. We ranked all countries and used descriptive statistics to analyse global trends. We used linear regression to assess the associations between policy implementation and World Bank geographic region, risk of premature NCD mortality, percentage of all deaths caused by NCDs, World Bank income group, human capital index, democracy index, and tax burden.FindingsIn 2017, the mean NCD policy implementation score was 49·3% (SD 18·4%). Costa Rica and Iran had the joint-highest implementation scores (86·1% of all WHO-recommended policies). Scores were lowest in Haiti and South Sudan (5·5%). Between 2015 and 2017, aggregate implementation scores rose in 109 countries and regressed in 32 countries. Mean implementation rose for all of the 18 policies except for those targeting alcohol and physical activity. The most commonly implemented policies were clinical guidelines, graphic warnings on tobacco packaging, and NCD risk factor surveys. Our multiple linear regression model explained 61·1% of the variance in 2017 aggregate scores (p<0·0001), but we found evidence of a high degree of collinearity between the explanatory variables.InterpretationImplementation of WHO-recommended NCD policies is increasing over time. On average, countries implemented just under half of the NCD policies recommended by WHO in 2017. Nutrition-related policies saw gains, while those related to alcohol and physical activity were the most likely to have been dropped. Aggregate implementation scores tended to be highest in high-income countries that invest in health care and education.FundingNational Institute for Health Research, Imperial College London, University of Oxford.

Addressing Risks Throughout the Life-cycle to Reduce Non-communicable Disease in Bangladesh (P10-085-19)

ObjectivesThe rapidly increasing burden of non-communicable diseases (NCD) constitutes a major public health challenge undermining future social and economic development. Using Bangladesh as a case study, we review gaps in health and nutrition behavior throughout the life-cycle and suggest possible policy and program solutions MethodsWe utilized a conceptual framework lightly adapted from the WHO Package of Essential Non-communicable Disease Interventions for Primary Health Care in Low Resource Settings. This framework guided the review of secondary literature using peer-reviewed articles and grey literature including reports, policy documents, and policy briefs. ResultsRisk factors identified include sub-optimal breastfeeding and complementary feeding with caregivers frequently resorting to prepackaged junk food for children, particularly in urban settings. For older children, many schools are unable to promote physical activity and do not include life-skills training. There is also high promotion of tobacco products to adolescents and adults, with little regulation, resulting in high use rates. Adults who have NCD also have poor control and knowledge of their condition, leading to inadequate care.Among infants, risks could be reduced through better enforcement of restrictions on the marketing of breastmilk substitutes and the mandated provision of six-month maternity leave for working women. For older children, additional taxes on junk foods partnered with improved communication campaigns on consumption of locally available, nutritious, and low-cost complementary foods could nudge diets into healthier patterns. Life skill training in school would improve the nutrition and health knowledge of the population, promote better diets, and discourage tobacco and substance abuse. Bangladesh has no wide-spread community-based tobacco cessation program or peer-educator program for adults suffering from NCD to learn more about their condition along with encouraging regular care-seeking. ConclusionsCurrent policies and programs need to realize the changing dimensions that influence NCDs in Bangladesh. A multisectoral life course approach is needed to address the risk factors to halt the progression of NCD. Funding SourcesThe program was funded by the Netherlands government under Netherland Fellowship program (Former NFP, currently known as OKP). The preparation of this abstract was funded by the EU.