Globalization of Risks for Chronic Diseases Demands Global Solutions

2004 ◽  
Vol 3 (1) ◽  
pp. 213-233 ◽  
Author(s):  
Derek Yach ◽  
Robert Beaglehole

AbstractDebates about globalization and health focus almost exclusively on communicable diseases. However, chronic diseases— especially cardiovascular diseases, cancer, chronic respiratory diseases and diabetes—now constitute the bulk of the global burden of disease. This chapter provides updated information on trends in the major macro-determinants of chronic diseases such as urbanization, globalization, and aging. Further, it summarizes evidence of the impact of known risk factors for chronic diseases such as tobacco, diet/nutrition, physical activity, and alcohol. Reasons for failure to invest in prevention are outlined and the importance of implementing available knowledge about preventive and therapeutic strategies is stressed.

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Antoine Raberin ◽  
Philippe Connes ◽  
Jean-Claude Barthélémy ◽  
Pia Robert ◽  
Sébastien Celle ◽  
...  

Background. Cardiovascular diseases remain as the leading cause of morbidity and mortality in industrialized countries. Ageing and gender strongly modulate the risk to develop cardiovascular diseases but very few studies have investigated the impact of gender on cardiovascular diseases in the elderly, which represents a growing population. The purpose of this study was to test the impact of gender and physical activity level on several biochemical and clinical markers of cardiovascular risk in elderly individuals. Methods. Elderly individuals (318 women (75.8±1.2 years-old) and 227 men (75.8±1.1 years-old)) were recruited. Physical activity was measured by a questionnaire. Metabolic syndrome was defined using the National Cholesterol Education Program Expert Panel’s definition. Polysomnography and digital tonometry were used to detect obstructive sleep apnea and assess vascular reactivity, respectively. Blood was sampled to measure several oxidative stress markers and adhesion molecules. Results. The frequency of cardiovascular diseases was significantly higher in men (16.4%) than in women (6.1%) (p<0.001). Body mass index (25.0±4.3 vs. 25.8±3.13 kg.m−2) and glycaemia (94.9±16.5 vs. 101.5±22.6 mg.dL−1) were lower, and High Density Lipoprotein (HDL) (74.6±17.8 vs. 65.0±17.2 mg.dL−1) was higher in women compared to men (p<0.05). Oxidative stress was lower in women than in men (uric acid: 52.05±13.78 vs. 59.84±13.58, advanced oxidation protein products: 223±94 vs. 246±101 μmol.L−1, malondialdehyde: 22.44±6.81 vs. 23.88±9.74 nmol.L−1). Physical activity was not associated with lower cardiovascular risk factors in both genders. Multivariate analyses showed an independent effect of gender on acid uric (β=0.182; p=0.020), advanced oxidation protein products (β=0.257; p<0.001), and HDL concentration (β=−0.182; p=0.026). Conclusion. These findings suggest that biochemical cardiovascular risk factors are lower in women than men which could explain the lower cardiovascular disease proportion observed in women in the elderly.


BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.


Author(s):  
Matteo Vecchio ◽  
Alessandra Bertone ◽  
Francesca Geni ◽  
Pasquale Esposito

Background Schengen Agreement grants easier international movements within Europe, and the still ongoing enlargement of Schengen Area (Romania, Croatia and Bulgaria will probably join it in the next few years) is expected to enhance migratory fluxes towards Italy. According to European Centre for Social Welfare Policy and Research, there is a “widespread lack of information about migrants’ health needs and access to services”, which is necessary to provide them better health care. It is known that both Italians and immigrants mainly suffer of chronic pathologies, but more specific data are poor in Italy. Therefore, the aim of the study is to analyse the epidemiology of chronic diseases (CD) in undocumented immigrants in the province of Pavia (Northern Italy), in which irregular immigration is a spreading phenomenon. Methods Data were collected from patients referring to STP (Strangers Temporarily Present) Clinic, which is managed by volunteer doctors and medical students, and provides free health care for irregular immigrants in Pavia province. According to WHO indications we classified CD in: hypertension, cardiovascular diseases, cancer, chronic respiratory diseases, diabetes and degenerative osteoarthropaties. Data are expressed as absolute number; OR [95%CI] and chi squared test were used for prevalence correlations. Results Complete data were available for 259 patients (156 women, 103 men), with mean age 46.4±16.9 years, visited for the first time at STP Clinic 2.9±1.7 years ago. Patients were Caucasians (164), Africans (75), Americans (14) and Asians (6). Total number of CD cases was 203. CD were diagnosed in 140 subjects, of whom: 95 (45.9% of patients with CD) affected by only 1 CD; 43 (36.7%) by 2-3 CD; 2 (0.8%) by 4 or more CD. Hypertension affects the largest group of patients: 61 (23.6% of all subjects), followed by: osteoarthropaties: 53 (20.5%); diabetes and cardiovascular diseases, each of them 26 (10.0%); cancer: 24 (9.3%); respiratory diseases: 13 (5.8%). Prevalence of CD is influenced by age: the probability of being affected in patients >65 years of age is significantly higher than in the group between 18 and 65 years: OR 2.62 [1.21-5.67; p=0.01]. Conclusion Chronic diseases prevalence in irregular immigrants (54.1%) is considerably higher than the epidemiologic expectancy among Italian population of the same area (36.9%). These results show that Pavia province Health System’s efforts should focus on prevention and follow-up of CD also – even more – in undocumented immigrants.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Fornari ◽  
P A Cortesi ◽  
F Madotto ◽  
S Conti ◽  
G Crotti ◽  
...  

Abstract Background Cardiovascular diseases (CVDs) are still the leading cause of mortality, morbidity and disability in Europe. Consequently, an exhaustive estimation of CVDs burden and cardiovascular risk factors impact is crucial for healthcare planning and resource allocation. In Italy, data on CVDs burden are sparse. This study aims to assess the global Italian CVDs burden and to analyze time changes from 1990 to 2017 within the country and in comparison to other European states. Methods We used data from the 2017 Global Burden of Diseases (GBD) study to estimate CVDs prevalence, mortality and disability-adjusted life-years (DALYs) in Italy from 1990 to 2017. We also analyzed burden attributable to CVDs-related risk factors. Finally, Italian estimations were compared to those of the other 28 European Union countries. Results CVDs were still the first cause of death (34.8% of total mortality) in Italy in 2017. A significant decrease in CVDs burden was observed since 1990: age-standardized prevalence (-12.7%), mortality rate (-53.75%), and DALYs rate (-55.54%) all decreased. Similar patterns were observed also in the majority of European countries. Despite these trends, all-ages CVDs prevalent cases increased from 5.75 million to 7.49 million. More than 80% of CVDs burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high LDL cholesterol, and impaired kidney function. Conclusions Data showed a decline in cardiovascular mortality and DALYs, which reflects the success in terms of reducing disability, premature death and early incidence of CVDs. However, the burden of CVDs is still high, as population aging and the increased prevalent cases require more access to care and generate more years lived with disability, which in turn leads to higher costs for the National Health Service and society. More efficient prevention strategies at community and individual level are needed. Key messages Despite decreasing trends in CVDs mortality and DALYs, the burden of CVDs is still high in Italy. A joined approach of the National Health System stakeholders is needed to keep reducing the CVDs burden.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract The burden of non-communicable chronic diseases (NCDs) represents a public health issue of gigantic proportion at global level. Among others, diet has been demonstrated to be a key element to maintain health and prevent NCDs. Today's world is facing the so-called “double burden of malnutrition”, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NCDs due to a substantial shift toward unhealthy diet high in sugars and ultra-processed foods and concomitant inadequate accessibility of nutritious foods. While interventions to improve diet quality and nutrition knowledge are of paramount importance in order to decrease the burden of NCDs over the next decades, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Food and nutrition section, the EUPHA Chronic diseases section, the EUPHA Health promotion section, in collaboration with the World Health Organization (WHO), aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs, obesity and nutrition-related risk factors as well as ongoing interventions aimed to reduce the double burden of malnutrition. The objectives of the present workshop are the following: To quantify the global burden and temporal trends of NCDs risk factors; To assess the impact of nutrition-related risk factors on NCDs; To provide examples of advocacy activities and actions at global level to improve nutrition education and dietary behaviors; To promote translatable information at global level and drive implementation of knowledge into policy and practice. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. Given the many actors involved, the workshop will provide a unique occasion to discuss about potential policy approaches in the context of the conference. Key messages There is science-based evidence demonstrating that healthy nutrition is a key factor to maintain global health and prevent chronic non-communicable diseases. Governmental and non-governmental efforts are currently working to counteract malnutrition worldwide.


2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Zdzisława Chmiel ◽  
Grażyna Hejda ◽  
Monika Binkowska-Bury

Introduction. A World Health Organization (WHO) conference on a “second wave” epidemic of cardiovascular diseases, directly linked to arterial sclerosis (AS), predicts that in 2020 cardiovascular diseases will most likely be the leading cause of death in the world. The development of AS begins in youth and progresses with age. It’s intensity depends on the risk factors involved, such as: smoking, hypertension, obesity and fat and sugar disorders in the body. Aim. The aim of this study was to establish the risk factors of cardiovascular diseases and their existence, among the youth of the upper gymnasium school. Material and methods. The research was conducted using 511 volunteer students from upper and lower gymnasium schools, between 16-19 years of age. Our research methods included: a diagnostic questionnaire, the measurement of blood pressure (BP) and anthropometric measurements. In the statistical study, we used chi-square independence testing, the V-Kramer test and the tau-b Kendall test; the level of changes α = 0.05 – was used. Results. Over a half of the study group (52.5%) was characterised with the lack of recommended physical activity, much more common in girls than boys (p = 0.000), just like smoking (p = 0.009) which was declared by 39.7% of the interviewed youth. In turn, a heightened value of systolic and diastolic pressure occurred more often in boys (19.6%) than in girls (12.1%); (p = 0.000 vs. p = 0.003). Excessive body mass was noted in 15.7% of the respondents, also more often in boys than in girls (p = 0.02), and abdominal obesity occurred in 10.2% of the respondents, with no significant differences between the sexes. 42.3% of the respondents showed one, 29.9% showed two and 18.8% showed three atherosclerosis risk factors. 9.0% of the study group showed 4 and more such risk factors. Accumulation of atherosclerosis risk factors occurred significantly more often in girls than in boys (p = 0.002). Conclusions. In all the respondents at least one atherosclerosis risk factor was found, and in over half of the study group, more frequently in girls than in boys, an accumulation of two or more risk factors was observed. Lack of recommended physical activity was the most frequent atherosclerosis risk factor occurring in the youth.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chorong Park ◽  
Britta A Larsen ◽  
Yuhe Xia ◽  
Simona Kwon ◽  
Victoria V Dickson ◽  
...  

Introduction: Physical activity (PA), sedentary behavior (SB) and sleep form the finite 24-hour day; changes to one behavior result in changes to the others. Little is known about how shifting the balance of time spent in these behaviors affects cardiovascular (CV) risk factors. The purpose of this study is to model the effects of changes in PA, SB and sleep on body mass index (BMI), waist circumference (WC) and blood pressure (BP) in Asian American women, who have elevated CV risk. Methods: Normotensive middle-aged Asian American women completed 7 days of hip and wrist actigraphy monitoring (Actigraph, GT3X and GT9X) to assess 24-hour activity. Total sleep time was identified using the Cole-Kripke algorithm with sleep diaries, and moderate-to-vigorous PA (MVPA), light PA and SB were classified by Freedson’s cut-points from wake time. Isotemporal substitution models were used to test effects of replacing 30 mins of each behavior with the others on BMI, WC and BP adjusting for age, education and comorbidity. Results: Data from 75 women were included (age=61.4±8.0, 57% college educated, median comorbidities=1[IQR=0-2]). On average, their days were composed of 0.5 hrs MVPA, 6.2 hrs light PA, 10 hrs SB and 5.3 hrs sleep (2.1 hrs non-wear time). In partition models, where all behaviors were entered simultaneously, more MVPA and sleep were associated with lower BMI and WC. In isotemporal substitution models that held total wear time constant (Table 1), replacing 30 mins SB with an equal amount of MVPA or sleep decreased BMI by 1.7 and 0.6 and WC by 4.1 and 1.2 cm. Replacing 30 mins light PA with MVPA or sleep decreased BMI by 1.9 and 0.9 and WC by 4.5 and 1.6 cm. None of the modeled behavior changes affected BP. Conclusion: These findings suggest that substituting 30 mins of SB or light PA with MVPA or sleep could significantly reduce Asian American women’s BMI and WC. Future studies should test the impact of behavioral interventions that promote these changes on CV risk in Asian American women.


Author(s):  
Lilian Messias Sampaio Brito ◽  
Luis Paulo Gomes Mascarenhas ◽  
Deise Cristiane Moser ◽  
Ana Cláudia Kapp Titski ◽  
Monica Nunes Lima Cat ◽  
...  

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n6p678 The aim of this study was to investigate the impact of physical activity (PA) and cardiorespiratory fitness (CRF) levels on the prevalence of overweight and high blood pressure levels in adolescents. In this observational, cross-sectional study, 614 boys aged 10-14 years were assessed for height, body mass, body mass index (BMI), waist circumference (WC) and blood pressure (BP). CRF was assessed using a run test (Léger Test) and subjects were then grouped according to their CRF level. PA level was assessed through a questionnaire (The Three Day Physical Activity Recall) and classified into two groups, namely > 300 minutes of PA/week and < 300 minutes of PA/week. Maturational stage was evaluated according to the development of pubic hair (self-assessment) as proposed by Tanner. We used statistical descriptive analysis, univariate and multivariate analyses in the total participants and subjects were divided by age. Fifty percent of the sample performed < 300 minutes of PA/week and 67.6% had unsatisfactory CRF levels. There was a higher prevalence of unsatisfactory CRF levels among subjects with altered BMI (overweight), WC (abdominal obesity) or BP (high blood pressure) for all age groups. PA history, however, did not show any significance. A total of 31% of participants were overweight, 24.8% had abdominal obesity and 15.4% had increased BP. Unsatisfactory CRF levels were found to be a better predictor for the diagnosis of cardiovascular diseases (CV) risk factors than PA history, regardless of age group. 


Sign in / Sign up

Export Citation Format

Share Document