Life course approach to prevention and control of non-communicable diseases

Mikkelsen, Bente; Williams, Julianne; Rakovac, Ivo; Wickramasinghe, Kremlin; Hennis, Anselm; Shin, Hai‐Rim; Farmer, Mychelle; Weber, Martin; Berdzuli, Nino; Borges, Carina Barbosa; Huber, Manfred; Breda, João

doi:10.1136/bmj.l257

Cited by 102 publications

(113 citation statements)

References 13 publications

(12 reference statements)

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“…Many governments are not keeping pace with the growing burden of lifestyle-related chronic diseases and associated demands on health services. Baird et al ( 54 ) and Mikkelsen et al ( 55 ) have emphasized the importance of adopting a life course approach that recognizes the opportunity to promote health, prevent and control NCDs at key stages throughout the life course, from preconception through to adulthood. Focusing on key life stages throughout the life course of the individual and implementing targeted lifestyle modifications and awareness programs can reduce the prevalence of prioritized risk factors for communities identified in this study, and break the risk cycle and the current intergenerational transmission of CDL in communities.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Socio-Behavioral-Metabolic Risk Profiles and Associated Factors for Chronic Diseases of Lifestyle in Urban and Rural Communities in Central South Africa

Zyl

Rooyen

Joubert

et al. 2020

Front. Public Health

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Background: The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Chronic diseases of lifestyle (CDL) are a group of diseases that share similar modifiable risk factors that can result in long-term disease processes. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL. Aim: To determine the socio-behavioral-metabolic risk profiles and identify associated factors for the following CDL: obesity, cardiovascular disease, hypertension, and type 2 diabetes mellitus in rural and urban communities in central South Africa. Methodology: This cross-sectional study included adults aged 25–65 years in the rural Southern Free State and urban Mangaung. Social determinants, behavioral and metabolic risk factors, and inflammatory biomarkers for CDL were determined. Results: In total, 575 rural (mean age: 42 years; 71% female) and 429 urban (mean age: 44 years; 76% female) participants were included in the study. More than 20% of participants in both communities reported being previously diagnosed with cardiovascular diseases; with reported hypertension and diabetes mellitus more prevalent among rural participants. Insufficient intake of fruit and vegetables, alcohol use, and high blood pressure were among the top five risk factors in both communities. Physical inactivity ranked among the top two risk factors in the urban community; while alcohol and tobacco use was significantly higher in the rural community. Fibrinogen was the most prevalent inflammatory marker in both communities (32.9 rural vs. 48.3% urban). High sensitivity C-reactive protein (Hs-CRP), only available for rural participants, was high with increased levels in more than 80% of participants. In both communities, being female, having high blood pressure and increased fibrinogen levels were associated with obesity. Conclusion: This study illustrated the high prevalence of socio-behavioral-metabolic risk factors for CDL, and identified similarities and distinct differences in the risk profiles of rural and urban communities. Considering the CDL risk profiles of communities can assist in prioritizing health needs and contribute to the development of tailor-made community-based primary health care prevention, intervention, and health promotion programs.

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Section: Discussionmentioning

confidence: 99%

A Comparison of the Socio-Behavioral-Metabolic Risk Profiles and Associated Factors for Chronic Diseases of Lifestyle in Urban and Rural Communities in Central South Africa

Zyl

Rooyen

Joubert

et al. 2020

Front. Public Health

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“…190,191 However, besides sexual and reproductive health, the majority of adolescents do not perceive a need for NCD prevention, nor do they routinely access health care. [192][193][194] Therefore, there is a need for strategies that seek to identify ways to improve the health of younger populations, which are not purely within the context of either the health sector, or the household, or educational establishments. 192,194 Such strategies would need to be multisectoral, recognizing the interactions between environmental and economic factors, social norms and personal choice.…”

Section: Prioritizing Adolescents and Youthmentioning

confidence: 99%

Understanding the rise of cardiometabolic diseases in low- and middle-income countries

Miranda

Barrientos‐Gutiérrez

Corvalán

et al. 2019

Nat Med

212

178

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Increases in the prevalence of non-communicable diseases (NCDs), but in particular cardiometabolic diseases such as cardiovascular disease, stroke and diabetes, and their major risk factors, have not been uniform across settings; for example, cardiovascular disease mortality has declined over recent decades in high-income countries but increased in low-and middle-income countries (LMICs). The factors contributing to this rise are varied and are contributed to by the environmental, social, political and commercial determinants of health, among other factors. This Review focuses on understanding the rise of cardiometabolic diseases in LMICs, with particular emphasis on obesity and its drivers, together with broader environmental and macro determinants of health, and the LMIC-based responses to counteract cardiometabolic diseases.

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“…Given the contribution of unrecorded alcohol in European high-income countries, unrecorded alcohol consumption should be included in the usual monitoring and surveillance systems for risk factors for non-communicable disease [39,40]. Since alcohol is also an important risk factor for injury and communicable disease [41], there is even more reason for systematic monitoring.…”

Section: Unrecorded Monitoring: Consistent Assessment Requiredmentioning

confidence: 99%

Unrecorded Alcohol Consumption in Seven European Union Countries

Manthey¹,

Probst²,

Kilian³

et al. 2020

Eur Addict Res

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Introduction: Unrecorded alcohol, that is, alcohol not reflected in official statistics of the country where it is consumed, contributes markedly to overall consumption of alcohol. However, empirical data on unrecorded alcohol consumption are scarce, especially in high-income countries. This study measures the contribution of unrecorded alcohol in 7 member states of the European Union. Methods: Two categories of unrecorded consumption were assessed in general population surveys (reducing alcohol related harm Standardized European Alcohol Survey; n = 11,224): homemade alcohol and cross-border shopping. Country-specific logistic regressions were used to link respondent characteristics to odds of acquisition of unrecorded alcohol. Total per capita alcohol consumption was estimated under different assumptions of calculating unrecorded alcohol consumption. Results: Individuals with higher drinking levels were more likely to acquire unrecorded alcohol in all 7 countries. In some countries, male sex and more affluent social class were also positively linked to acquisition of unrecorded alcohol. There was a substantial contribution of unrecorded alcohol to overall consumption in 5 out of 7 member states (Croatia, Finland, Greece, Hungary, Portugal), but not in Poland or Spain. In Greece, up to two-thirds of all alcohol consumed was estimated to be unrecorded. Conclusion: Unrecorded alcohol contributes to overall consumption even in high-income countries, and thus needs to be monitored. In monitoring, as many categories of unrecorded alcohol as possible should be clearly defined (e.g., surrogate alcohol) and included in future surveys.

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Life course approach to prevention and control of non-communicable diseases

Abstract: A successful approach to reducing the burden of non-communicable disease requires action at all stages of life, argue Bente Mikkelsen and colleagues

Cited by 102 publications

References 13 publications

A Comparison of the Socio-Behavioral-Metabolic Risk Profiles and Associated Factors for Chronic Diseases of Lifestyle in Urban and Rural Communities in Central South Africa

A Comparison of the Socio-Behavioral-Metabolic Risk Profiles and Associated Factors for Chronic Diseases of Lifestyle in Urban and Rural Communities in Central South Africa

Understanding the rise of cardiometabolic diseases in low- and middle-income countries

Unrecorded Alcohol Consumption in Seven European Union Countries

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