Lifestyle – the way we live may be chosen or we may have limited choice. It may be chosen in the sense that we may know the right thing to do but choose to do the wrong one. We may have limited choice as the resources to live the kind of lifestyle we want to live may be limited. But whether we are rich or poor, we can prevent non-communicable diseases (NCDs). ODIRI UCHENUNU writes on the life course approach in preventing NCDs.
From the moment we wake up in the morning till our heads hit the pillow again at night, our lives are filled with questions. Most are easily answered and soon forgotten, but some questions are harder to ask because we are so afraid that the answer will not be pleasurable especially questions on health.
To some of us, we do not want to hear anything about non-communicable diseases (NCDs) because the thought of it can give us hypertension. But then, we need to address the issue before it is too late.
The World Health Organisation has said four types of non-communicable diseases which are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes make the largest contribution to mortality in majority of low and middle-income countries. These four diseases are the world’s biggest killers as about 36 million deaths are recorded annually. In Nigeria, it is estimated that more than 30 percent of healthcare cost will go for the management of NCDs in the next 10 years.
Non-communicable diseases (NCDs) are medical conditions which by definition are chronic in nature, none contagious and cannot be transmitted from one person to another. They reduce the quality of life of the affected individuals and can also lead to death. In the global situation, NCDs represent a major threat to human health and development in the 21st century. They account for 60 percent of all deaths globally and 43 percent of global disease burden and 80 percent of total deaths due to NCDs occur in developing countries.
Cardiovascular diseases (CVDs) are diseases involving the heart, blood vessels or as a result of poor blood supply due to a diseased vascular supply. Heart disease currently accounts for the lion’s share of deaths from NCDs, with WHO saying that 48 percent of non-communicable disease fatalities are attributable to cardiac illness. CVD has become the single largest cause of death worldwide, representing nearly 30 percent of all deaths and about 50 percent of NCDs death.
Cancer on the other hand is the rapid growth and division of abnormal cells in a part of the body. They outlive normal cells and have the ability to metastasize. Infectious agents are responsible for some cancers, for instance almost all cervical cancers are caused by human papilloma virus infection. However, for the vast majority of cancers, risk factors are environmental or lifestyle-related, thus cancers are mostly preventable NCDs. A little more than one in five non-communicable disease deaths are due to cancer.
The World Cancer Research Foundation (WCRF) has documented that around seven million of the 12 million cancer cases diagnosed each year are in developing countries and that figure is also predicted to rise dramatically. Addressing the UN high-level meeting on the prevention and control of NCDs in 2011, the Nigerian minister of health was quoted as saying that 100,000 new cases of cancer are diagnosed each year in Nigeria.
Greater than 30 percent of cancer is preventable by avoiding risk factors like tobacco use, being overweight or obese, low fruit and vegetable intake, physical inactivity, alcohol, sexually transmitted infections, and air pollution.
Chronic respiratory diseases are diseases of the airways and other structures of the lung like asthma, chronic obstructive pulmonary disease (COPD), respiratory allergies, occupational lung disease and pulmonary hypertension. They account for 4.2m deaths (7 percent) of all deaths worldwide and 21 percent of NCD deaths.
The good news about NCDs is that they are largely preventable. We just need to concentrate on the food we eat, our risk behaviours such as tobacco use and physical inactivity.
Professor Akin Osibogun of the Lagos University Teaching Hospital (LASUTH) says we can do something about NCDs if we are determined, adding that some of the diseases which are related to our choices can be controlled if we alter those choices of ours.
Osibogun said, “Evidence from the field study conducted in Lagos State shows that only about 20 percent of Lagosians eat fresh fruits, only 6.6 percent eat fresh vegetables, 29 percent eat cooked vegetables. Fish and meat remain the most frequent source of protein as egg, chicken and milk appear expensive. Cassava and rice are the main sources of carbohydrate with rice now in the lead.
“73 percent are using vegetable oils that may be rich in cholesterol while 25 percent use cholesterol-free vegetable oil, 10 percent of respondents always add extra salt to their food on the table. Over 20 percent are addicted to watching television, movies and music. Most people do overwork by carrying files home after office hours, leading to faulty adaptation to the stresses and strain of life caused by over action in an attempt to meet these difficulties and conflicts between self-esteem and needs.”
Osibogun urged all to be moderate in all things, promote active travel like walking and cycling, promote sports in schools and communities, adding that every ward should have sports centre, and roads should have pedestrians in mind.
He recommended that we should all abstain from sex or use protection, avoid having sex with sex workers, raise awareness on the health benefits of fruits and vegetables, promote awareness on the risks of excessive consumption of fats and salt and prevent obesity in children through a combination of dietary advice.
He said, “If you smoke, make a plan to stop, drink alcohol only in moderation, avoid use of recreational drugs and reduce stresses in your life by looking at the balance between your work and your home/leisure time.”
He however advised that we must recognize our limitations, set realistic targets for ourselves. He said we must learn to change those things we can and have the wisdom to accept those we cannot, we must thank God for that which He has done in our lives and be at peace with self and neighbours.
Dr Chika Ndiokwelu, country representative, international confederation of dietetic associations, while speaking with Leadership correspondents presented a life course approach that addresses these cumulative risks and many opportunities for intervention.
On tobacco control, Ndiokwelu urged the Federal Government to monitor tobacco use and formulate tobacco prevention policies. She said, “Policies like protecting people from tobacco smoke in public places and work places, enforcing bans on tobacco advertising, promotion and sponsorship and raising tobacco taxes and prices should be formulated. We can offer help to people who want to stop using tobacco and warn people about the dangers of tobacco.”
On promoting healthy diet, she advised exclusive breast feeding, adding that mothers should ensure optimal feeding for their infants and young children. She said government needed to develop a national policy and action plan on food and nutrition, including plan on food and diet related non-communicable diseases.
She said Nigerians needed to reduce salt levels, eliminate industrially produced trans-fatty acids, decreasing saturated fats, limit free sugars.
By: Odiri Uchenunu
Leadership News
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