Diet and Non-Communicable Diseases: An urgent need for new paradigms

Diet and Non-Communicable Diseases: An urgent need for new paradigms

The health of every individual both male and female in any part of the continents in this world is defined by two keys areas; diet and physical activity. Diet is the sum of food consumed by a person or other organism. The word diet often implies the use of specific intake of nutrition for the purposes of optimal health or weight management reasons.

Physical activity on the other hand encompasses any bodily movement produced by skeletal muscles that requires energy expenditure.  According to WHO, Physical inactivity (lack of physical activity) has been identified as the fourth leading risk factor for global mortality (6% of deaths globally).

The relationship between diet and physical activity is a closely related one. It is important to note that the energy imbalance is as a result of the that the energy intake doesn't correspond to the energy output.

The emergence of Non-Communicable Diseases have become one major cause of deaths across the globe. They are diseases that have a prolonged course, that does not resolve spontaneously, and for which a complete cure is rarely achieved. Cardiovascular disease (CVD), Chronic Respiratory disease, Cancer, Diabetes and Mental Health conditions are typical examples of Non-Communicable diseases.

Non-communicable diseases (NCDs) have emerged as the leading cause of human mortality and morbidity in low-, middle- and high-income countries. NCDs are not considered only as social burden; the economic costs of NCDs are also accelerating worldwide. By the year 2030, when the Sustainable Development Goals (SDGs) should have attained their targets, cardiovascular disease will be the leading cause of death across the planet, exceeding mortality from Human Immunodeficiency Virus (HIV), Tuberculosis (TB), malaria, and maternal and child undernutrition combined.

NCDs kills 40 million people each year, equivalent to 70% of all deaths globally. Approximately 15 million people die from NCDs between the ages of 30 and 69 years; over 80% of these premature deaths occur in low income countries. (WHO, 2017). Out of the 38 million deaths due to NCDs in 2012, more than 40% were premature, affecting people under 70 years of age.

The continent of Africa recorded 10.1 million deaths in 2008 with 2.86 million of the total deaths emanating from NCDs which represents 28.3%. It is projected that by 2030 NCDs will escalate by 68% and account for 50.1% of the total number of deaths.

Aside from the role of genetics, the dominant risk factors for non-communicable diseases are behavioural; they relate to unhealthy diets, inadequate physical activity, exposure to tobacco smoke (and air pollutants), and excessive alcohol consumption. Lifestyle and behavioural modifications can either delay the onset of NCDs or avoid it completely.

However, because the risk factors are embedded in behavioural, cultural, and political realities, modifying the up-stream drivers is very difficult and requires the engagement of different sectors of government and other groups.

Contemporary Drivers of Non-Communicable Diseases (NCDs) 

In ancient times, human beings trekked long miles in search of wild fruits and food. This doesn't compare the luxury we enjoy today as a result of technology.

Whereas diet and exercise are preventable risks factors of NCDs, the hard-to-prevent and major drivers of NCDs are increasing wealth, urbanization, air pollution, the information revolution, and global marketing. Most of these drivers have not received much attention in the public health arena.

Global marketing has created a social network where food can be be exported to any country across the globe. European diets has grossly invaded the African markets and has paved the way for NCDs to strike its consumers. A lot of junk foods and high caloric dense diets have replaced healthy diets because of their ready availability. Most of these diets lack the essential micronutrients like Vitamin A, zinc etc. and they gradually contribute to micronutrient malnutrition.

Urbanization is a global trend which is also evident in the emerging economies as their populations become wealthier. Employment rather than farming has become the norm. Sedentary jobs have shackled most people behind an office desk which are precursors for diseases like hypertension, diabetes etc. Vehicles have substituted the most commonest means of transportation, walking.

Challenges in tackling NCDs 

The epidemiological transition to chronic, progressive, debilitating diseases was identified decades ago and has been well documented everywhere.

The first most difficult hurdle to surmount in dealing with NCDs is the task of engaging asymptomatic people, in this case people who do not view themselves, or their children, as being patients or having an illness.

Another critical challenge is the absence of engagement in policy by the Public Health establishment. The plan to reduce cost and achieve cost effectiveness can be successful by reducing the prevalence of behavioural risk factors and making budgetary allocation at the onset of an intervention.

In both developed and developing countries, medical clinics are designed to treat and manage sick people. People rarely show up at the clinics to have their blood pressure or blood sugar checked.

Strategies for Control of NCDs 

Addressing the consequences of NCDs holistically will require a concerted, multidisciplinary and multisectoral effort. Some of them include;

-Legislation, taxation, code of practice. (eg. on tobacco, food labelling, advertising)

-Health Promotion: This covers the area of diet, physical activity, fruits and vegetables consumption.

-Diet and Nutrition (including exclusive breastfeeding)

-Genetic counseling

-Targeted and opportunistic screening (Health facilities, schools, workplaces, homes)

-The foods industry should be encouraged to offer a portfolio of nutritious food products and food supplements to fill the nutrients gaps.

The world is gradually moving from slim and active workforce to obese and lazy workforce. Individual behaviour change is very key in tackling the upsurge of NCDs which has claimed the lives of many across the globe.

NCDs have long lasting effect that cannot be completely treated or cured but only managed. It is imperative for every single individual to avoid certain lifestyle behaviours like smoking, alcohol consumption etc. which are precursors of NCDs.

By: Angmortey Kwabena Raphael 
(Public Health Nutritionist)
University of Health and Allied Sciences