Ever wondered what is meant by Non-Communicable Diseases? Well here you go

What is a non-communicable disease?

Over the last twenty years or so, the world of medicine has been filled with the term non-communicable diseases or NCD’s, warning that they have become very popular and in fact is the leading cause of ill health and death in many countries, especially in first world countries. NCD’s are well entrenched within what is known as the Social Determinants of Heath, shared below:

Social Determinants of Health

• Poverty
• Urbanisation
• Inequality
• Limited access to healthcare
• Education levels

So, what exactly then is a non-communicable disease? A non-communicable disease is any disease or condition that cannot be spread or transmitted from person to person. Such a disease can either progress slowly over time, or appear suddenly and last for a very long time. A non-communicable disease is different from a communicable disease that is easily spread between people. Communicable diseases on the other hand, can be spread between people in various ways such as by touching, coming into contact with bodily fluids or even by vectors such as mosquitos.

Non-communicable diseases can affect a person of any age, but are generally more common amongst older adults. Over the years, researchers have noticed that non-communicable diseases are affecting people younger and younger in age. It used to be more common in people older than at least 60 years in age, but in recent times, people as young as in their twenties are being diagnosed with non-communicable diseases that used to be seen in old age only.

The most common non-communicable diseases include:

1. Diabetes Mellitus
2. Hypertension
3. Cardiovascular Diseases (Heart and related blood vessels)
4. Cerebrovascular Diseases (Brain and related blood vessels)
5. Respiratory or Lung Diseases
6. Cancers

These diseases kill 41 million people each year, equivalent to 71% of all deaths globally. NCDs also disproportionately affect people in low and middle- income countries where more than three quarters of global NCD related deaths – 31.4 million – occur.

Why have these diseases become so common?

It is believed that (and has been proven) that most of the non-communicable diseases are related to lifestyle and lifestyle habits and choices. This means that the type of foods you eat daily, not living an active life (incorporating vigorous physical activity into your daily routine), smoking tobacco and tobacco products and drinking too much alcohol, can increase your risk of developing a non-communicable disease. These factors are called risk factors - they increase your risk of developing a disease. Having a parent diagnosed with one of these lifestyle related diseases, also significantly increases your own risk of developing the same disease. This is called genetic predisposition.

Eating habits and choices that does not incorporate a good balance of nutritious fruit and vegetables, healthy proteins such as lean meats and fish, and healthy portions of carbohydrates such as breads, rice and pastas, limited amounts of legumes such as beans and peas, may lead to being overweight or obese. The way food is prepared - whether it is fried versus grilled, what is added to the food, like butter or ghee, also affects the number or amount of calories the food may contain. The food we eat on a daily basis is a very big factor in the development of obesity, hypertension, high cholesterol (known as hypercholesterolemia) and diabetes. More than any other risk factor for the development of non-communicable diseases, obesity has become the most common, all over the world.

Obesity is also linked to inactivity or living a sedentary life. It is recommended to perform at least 30 minutes of vigorous activity into your daily routine. Vigorous activity is any activity that will increase your heart rate, and at least make you break out into a sweat. This activity can be anything from brisk walking, running, cycling, dancing or even vigorous household activities such as vacuuming.

There are other categories of non-communicable diseases that are not directly related to lifestyle and habits. These include a range of gynecological diseases, other diseases related to specific organs such as liver, kidney, brain for example; genetic disorders, childhood specific disorders, many autoimmune diseases, several cancers etc. (There are many, many more - so be sure to research your disease or diagnosis very carefully).

How can the common non-communicable diseases be prevented?

Yes, it is possible to prevent these diseases. It is also possible to change the progression of the disease once you are diagnosed with the disorder.

The way in which you can prevent these non-communicable diseases is by decreasing your risks. That means:

• Eat a healthy, balanced, nutritious diet, every day
• Incorporate at least 30 minutes of vigorous physical activity into your daily routine
• Do not smoke or use any tobacco products
• Drink only one (and no more), or No alcohol at all

You can also prevent certain non-communicable diseases by screening for them regularly. This means:

• Females: obtain a pap-smear and mammograph regularly to prevent cervical cancer and breast cancer
• Health screening checks should include: checking your Body Mass Index (or BMI), check your blood pressure, check your glucose or sugar levels, check your cholesterol level
• Males: check your prostate health by obtaining a Prostate Specific Antigen (PSA)
• Other screening should include: screening for colorectal cancer, osteoporosis and HIV.

What do I do once diagnosed with a lifestyle related non-communicable disease?

Some of the risks are modifiable (meaning they can be changed or altered), and some of the risks are non-modifiable (which means you cannot change them). Modifiable risks include diet, exercise, not smoking tobacco and not drinking alcohol. Non-modifiable risks include age and genetic predisposition or family history.

Living a healthy balanced lifestyle can significantly change your risk of ill-health or even dying if diagnosed with a lifestyle related non-communicable disease.

Taking medication prescribed by a medical doctor, correctly and regularly, will also decrease your risk of poor health outcome or death. This is called compliance. Being compliant with medical advice and medication, together with regular health checkups will assist you in living a quality life if diagnosed with a non-communicable disease such as diabetes, hypertension or high cholesterol.

NCDs disproportionately affect, low- and middle-income countries (LMIC), Poor and marginalised populations, women (in certain conditions like cervical cancer).

Many countries (including South Africa) face:

What are the Challenges faced in Addressing NCDs

• Weak prevention strategies
• Limited early screening programs
• Poor health literacy
• Fragmented health systems
• Insufficient policy implementation

Global Solutions and Responses Should Include

Prevention - recommended by the World Health Organisation

• Health promotion
• Lifestyle modification
• Tobacco and alcohol control

Early Detection - which is pertinent, this should include

• Screening programs
• Risk assessment

Treatment, of Course:

• Integrated primary healthcare
• Chronic disease management

Policy Interventions - at National levels

• Sugar taxes, Sin taxes
• Smoking and alcohol regulation
• Food regulation and strict policies of displaying ingredients on food packages
• Urban planning for physical activity - making the environment easier for physical activity will make individuals become more physical active