Can Noncommunicable Diseases Be Prevented? Lessons from Studies of Populations and Individuals

MRC-HPA, Centre for Environment and Health and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.
Science (Impact Factor: 33.61). 09/2012; 337(6101):1482-7. DOI: 10.1126/science.1227001
Source: PubMed


Noncommunicable diseases (NCDs)—mainly cancers, cardiovascular diseases, diabetes, and chronic respiratory diseases—are responsible
for about two-thirds of deaths worldwide, mostly in low- and middle-income countries. There is an urgent need for policies
and strategies that prevent NCDs by reducing their major risk factors. Effective approaches for large-scale NCD prevention
include comprehensive tobacco and alcohol control through taxes and regulation of sales and advertising; reducing dietary
salt, unhealthy fats, and sugars through regulation and well-designed public education; increasing the consumption of fresh
fruits and vegetables, healthy fats, and whole grains by lowering prices and improving availability; and implementing a universal,
effective, and equitable primary-care system that reduces NCD risk factors, including cardiometabolic risk factors and infections
that are precursors to NCDs, through clinical interventions.

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    • "Another major development with practical applications from the information systems underlying such physiological and biochemical phenomena, is the realization that energy metabolism is tightly regulated by a web of biological oscillators distributed in peripheral tissues, and entrained by environmental changes that follow a circadian rhythm dictated by the SCN [10] [23] [24] [25] In this review we will attempt to use a systems biology approach to explore such interactions as a whole to get at least some partial answers to two fundamental questions regarding the role of ER stress on disease: [1] how dependent is the UPR and subsequent events referred above, to its state of synchrony with the SCN and peripheral oscillators? And, [2] How could modifiers of the activity of SCN, (for example, by means of changing food intake, exercise, and drugs) be used to modulate ER stress and systemic inflammation to ameliorate or even prevent NCDs? In answering the above questions, we will first delve into the relationships between chronic inflammation, the ER and the UPR, and NCDs. "
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    ABSTRACT: Non-communicable diseases (NCDs) such as cardiovascular disease, cancers, diabetes and obesity are responsible for about two thirds of mortality worldwide, and all of these ailments share a common low-intensity systemic chronic inflammation, endoplasmic reticulum stress (ER stress), and the ensuing Unfolded Protein Response (UPR). These adaptive mechanisms are also responsible for significant metabolic changes that feedback with the central clock of the suprachiasmatic nucleus (SCN) of the hypothalamus, as well as with oscillators of peripheral tissues. In this review we attempt to use a systems biology approach to explore such interactions as a whole; to answer two fundamental questions: (1) how dependent are these adaptive responses and subsequent events leading to NCD with their state of synchrony with the SCN and peripheral oscillators? And, (2) How could modifiers of the activity of SCN for instance, food intake, exercise, and drugs, be potentially used to modulate systemic inflammation and ER stress to ameliorate or even prevent NCDs?
    Full-text · Article · Jan 2015
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    • "Annually, 36 million deaths (more than two-thirds of total deaths in the world) are caused by non-communicable chronic diseases (NCDs) including cardiovascular diseases (17.3 million deaths), cancers (7.6 million), chronic respiratory diseases (4.2 million), and diabetes (1.3 million).1 In high-income countries, the health care burden of NCDs remains high; however, the death rates of NCDs have been decreasing over the last few decades.2 For example, the age-adjusted mortality for coronary heart disease decreased by more than 50% between 1980 and 2000 in the U.S.3 The prevention and management of major risk factors contributed to a 44% reduction in coronary heart disease mortality, while treatments contributed 47% to the reduced mortality.4 "
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    ABSTRACT: Currently, non-communicable chronic diseases are a major cause of morbidity and mortality worldwide, and a large proportion of chronic diseases are preventable through risk factor management. However, the prevention efficacy at the individual level is not yet satisfactory. Chronic disease prediction models have been developed to assist physicians and individuals in clinical decision-making. A chronic disease prediction model assesses multiple risk factors together and estimates an absolute disease risk for the individual. Accurate prediction of an individual's future risk for a certain disease enables the comparison of benefits and risks of treatment, the costs of alternative prevention strategies, and selection of the most efficient strategy for the individual. A large number of chronic disease prediction models, especially targeting cardiovascular diseases and cancers, have been suggested, and some of them have been adopted in the clinical practice guidelines and recommendations of many countries. Although few chronic disease prediction tools have been suggested in the Korean population, their clinical utility is not as high as expected. This article reviews methodologies that are commonly used for developing and evaluating a chronic disease prediction model and discusses the current status of chronic disease prediction in Korea.
    Full-text · Article · Jul 2014 · Yonsei Medical Journal
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    • "Tobacco and alcohol use, salt intake and unhealthy diet, high blood pressure, and physical inactivity and obesity have been reported to be major determinants of NCDs [5,6,20,36]. The relative importance of these risk factors in explaining the NCD burden is debatable and thus findings on comparative risk assessment are helpful in understanding the role of NCD determinants. "
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    ABSTRACT: Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.
    Full-text · Article · Sep 2013
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