Impact of noncommunicable diseases on direct medical costs and worker productivity, Saudi Arabia

Background: The prevalence of noncommunicable diseases (NCDs) has been increasing in Saudi Arabia. Aim: Our objective was to estimate the effect of NCDs on direct medical costs and workforce productivity in Saudi Arabia. Methods: To estimate direct medical costs, we estimated the unit cost of treating 10 NCDs, then multiplied the unit cost by disease prevalence and summed across diseases. To estimate workforce productivity losses, we multiplied gross domestic product per person in the labour force by the loss in productivity from each NCD and the prevalence in the labour force of each NCD. Results: We estimated annual direct medical costs of 11.8 billion international dollars (Int$) for the 10 NCDs assessed (13.6% of total annual health expenditure). We estimated workforce productivity losses of Int$ 75.7 billion (4.5% of gross domestic product). Conclusion: The economic burden of NCDs in Saudi Arabia – particularly the effect on worker productivity – is substantial.

Impact of Measures Aiming to Reduce Sugars Intake in the General Population and Their Implementation in Europe: A Scoping Review

Objectives: Implementing public health measures is necessary to decrease sugars intake, which is associated with increased risk of noncommunicable diseases. Our scoping review aimed to identify the types of measures implemented and evaluated to decrease sugars intake in the population and to assess their impact.Methods: Following a review of systematic reviews (SRs) published in 2018, we systematically searched new SR (May 2017–October 2020) in electronic databases. We also searched the measures implemented in Europe in the NOURISHING database. Two researchers selected the reviews, extracted and analysed the data.Results: We included 15 SRs assessing economic tools (n = 5), product reformulation and labels/claims (n = 5), and educational/environmental interventions (n = 7). Economic tools, product reformulation and environmental measures were effective to reduce sugar intake or weight outcomes, while labels, education and interventions combining educational and environmental measures found mixed effects. The most frequently implemented measures in Europe were public awareness, nutritional education, and labels.Conclusion: Among measures to reduce sugar intake in the population, economic tools, product reformulation, and environmental interventions were the most effective, but not the more frequently implemented in Europe.

American Medical Sociology and Health Problems in the Global South

COVID-19 has focused global attention on disease spread across borders. But how has research on infectious and noncommunicable disease figured into the sociological imagination historically, and to what degree has American medical sociology examined health problems beyond U.S. borders? Our 35-year content analysis of 2,588 presentations in the American Sociological Association’s (ASA) Section on Medical Sociology and 922 articles within the section’s official journal finds less than 15 percent of total research examined contexts outside the United States. Research on three infectious diseases in the top eight causes of death in low-income countries (diarrheal disease, malaria, and tuberculosis [TB]) and emerging diseases—Ebola, Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS)—was nearly absent, as was research on major noncommunicable diseases. Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) received much more focus, although world regions hit hardest received scant attention. Interviews suggest a number of factors shape geographic foci of research, but this epistemic parochialism may ultimately impoverish sociological understanding of illness and disease.

Anti-SARS-CoV-2 Antibody Level among Renal Transplant Recipients: A Case Report from Nepal

Globally, SARS-CoV-2 has caused significant public health burden, mainly in patients with underlying comorbidities including both communicable and noncommunicable diseases. Solid organ transplant recipients under immunesupressive medication are also amongst the high risk group. There is only sparse data on immunity against SARS-CoV-2 infection among renal transplant recipients. In this case report, we present the level of anti-SARS-CoV-2 antibody of three kidney transplant recipients after vaccination against COVID-19 virus. All three cases had received two doses of Oxford-AstraZeneca COVID-19 vaccine AZD1222 (ChAdOx1). Serological analysis showed protective level of circulating antibodies in the blood of all three cases. Although two out of three patients in the study acquired COVID-19 infection after immunization, they recovered with mild clinical course. Hence, we conclude that despite immune-suppressed status of transplant recipients, COVID-19 vaccination could protect them against severe illness.

Increased Salt Intake Decreases Diet-Induced Thermogenesis in Healthy Volunteers: A Randomized Placebo-Controlled Study

High salt intake ranks among the most important risk factors for noncommunicable diseases. Western diets, which are typically high in salt, are associated with a high prevalence of obesity. High salt is thought to be a potential risk factor for obesity independent of energy intake, although the underlying mechanisms are insufficiently understood. A high salt diet could influence energy expenditure (EE), specifically diet-induced thermogenesis (DIT), which accounts for about 10% of total EE. We aimed to investigate the influence of high salt on DIT. In a randomized, double-blind, placebo-controlled, parallel-group study, 40 healthy subjects received either 6 g/d salt (NaCl) or placebo in capsules over 2 weeks. Before and after the intervention, resting EE, DIT, body composition, food intake, 24 h urine analysis, and blood pressure were obtained. EE was measured by indirect calorimetry after a 12 h overnight fast and a standardized 440 kcal meal. Thirty-eight subjects completed the study. Salt intake from foods was 6 g/d in both groups, resulting in a total salt intake of 12 g/d in the salt group and 6 g/d in the placebo group. Urine sodium increased by 2.29 g/d (p < 0.0001) in the salt group, indicating overall compliance. The change in DIT differed significantly between groups (placebo vs. salt, p = 0.023). DIT decreased by 1.3% in the salt group (p = 0.048), but increased by 0.6% in the placebo group (NS). Substrate oxidation indicated by respiratory exchange ratio, body composition, resting blood pressure, fluid intake, hydration, and urine volume did not change significantly in either group. A moderate short-term increase in salt intake decreased DIT after a standardized meal. This effect could at least partially contribute to the observed weight gain in populations consuming a Western diet high in salt.

LIFESTYLE DISORDERS IN CHILDREN: AN AYURVEDIC OVERVIEW

Lifestyle Disorders (LSD) are common problems among upper-middle and higher society children. Lifestyle has long been associated with the development of many chronic diseases. It affects both genders. WHO has recognized Noncommunicable diseases (NCDs), especially diabetes, obesity, cardiovascular disease, cancer, and chronic lung disease, have everyday lifestyle linked risk factors like lack of physical activity, unhealthy diet and feeding habits and harmful use of alcohol. Worldwide, the current scenario of NCDs is the primary cause of morbidity and mortality, even in young children. According to WHO Report 2004, these account for nearly 60% of deaths and 47% of the global burden of illness. The rise in NCDs is substantially accelerating in most developing countries like India. In India, 53% of the deaths in 2008 were due to NCDs, and cardiovascular disease (CVDs) alone accounted for 24% of deaths (WHO). In 2005 India experienced the highest loss in potentially productive years of life globally, and the leading cause of death was cardiovascular disease. The cumulative loss of national income for India due to NCDs mortality for 2006-2015 was around USD237 billion. By 2030, this productivity loss is estimated to double to 17.9 million years lost. These major NCDs are preventable through effective Ayurvedic interventions by judiciously treating lifestyle-related modifiable risk factors. This review confers the current scenario of NCDs in children and their Ayurvedic Management.

Maternal BMI, breastfeeding and perinatal factors that influence early childhood growth trajectories: a scoping review

Obesity rates among children are rapidly rising internationally and have been linked to noncommunicable diseases in adulthood. Individual preventive strategies have not effectively reduced global obesity rates, leading to a gap in clinical services regarding the development of early perinatal interventions. The objective of this scoping review is to explore the relationship between maternal BMI and breastfeeding behaviors on child growth trajectories to determine their relevance in developing interventions aimed at preventing childhood obesity. The scoping review was guided and informed by the Arksey and O’Malley (2005) framework. A systematic search was performed in four databases. Studies included in the final review were collated and sorted into relevant themes. A systematic search yielded a total of 5831 records (MEDLINE: 1242, EMBASE: 2629, CINAHL: 820, PubMed: 1140). Results without duplicates (n = 4190) were screened based on relevancy of which 197 relevant-full-text articles were retrieved and assessed for eligibility resulting in 14 studies meeting the inclusion criteria. Data were extracted and charted for the studies and six themes were identified: (1) healthy behaviors, lifestyle, and social economic status; (2) parental anthropometrics and perinatal weight status; (3) genetics, epigenetics, and fetal programming; (4) early infant feeding; (5) infant growth trajectories; and (6) targeted prevention and interventions. Early life risk factors for child obesity are multifactorial and potentially modifiable. Several at-risk groups were identified who would benefit from early preventative interventions targeting the importance of healthy weight gain, exclusive breastfeeding to 6 months, and healthy lifestyle behaviors.