PBH: 101.

23 Introduction to Public
Health

Lecture 10: Introduction to non-communicable diseases &

Obesity.

Course instructor
Nandeeta Samad (NdS)
LECTURER,
DEPARTMENT OF PUBLIC HEALTH
SCHOOL OF HEALTH AND LIFE SCIENCE
NORTH SOUTH UNIVERSITY
(BSc amd MSc, INFS, University of Dhaka, MPH, United Kingdom)
• Noncommunicable diseases (NCDs), also known as
chronic diseases, tend to be of long duration and are the
result of a combination of genetic, physiological,
environmental and behaviours factors.
 Risk Population

Children, adults and the elderly are all vulnerable to the risk
factors contributing to NCDs, whether from unhealthy diets,
physical inactivity, exposure to tobacco smoke or the harmful
use of alcohol.

Unhealthy diets and a lack of physical activity may show up in

people as raised blood pressure, increased blood
glucose, elevated blood lipids. These are called metabolic
risk factors that can lead to cardiovascular disease, the
leading NCD in terms of premature deaths (30-69years).
 Risk factors
Modifiable behavioural risk factors
Modifiable behaviours, such as tobacco use, physical inactivity, unhealthy
diet and the harmful use of alcohol, all increase the risk of NCDs.

Tobacco accounts for over 7.2 million deaths every year (including
from the effects of exposure to second-hand smoke), and is projected to
increase markedly over the coming years.
4.1 million annual deaths have been attributed to excess
salt/sodium intake.
More than half of the 3.3 million annual deaths attributable to
alcohol use are from NCDs, including cancer.
1.6 million deaths annually can be attributed to insufficient
physical activity.
 Metabolic risk factors
Metabolic risk factors contribute to four key metabolic changes
that increase the risk of NCDs:
raised blood pressure
overweight/obesity
hyperglycemia (high blood glucose levels) and
hyperlipidemia (high levels of fat in the blood)

In terms of attributable deaths, the leading metabolic risk factor

globally is elevated blood pressure (to which 19% of global
deaths are attributed), followed by overweight and obesity and
raised blood glucose.
 Socioeconomic impacts of NCDs
NCDs threaten progress towards the 2030 Agenda for Sustainable
Development, which includes a target of reducing premature deaths
from NCDs by one-third by 2030.

• Poverty is closely linked with NCDs. Vulnerable and socially

disadvantaged people get sicker and die sooner than people of
higher social positions, especially because they are at greater risk of
being exposed to harmful products, such as tobacco, or unhealthy
dietary practices, and have limited access to health services.

• In low-resource settings, lengthy and expensive treatments for NCDs

quickly drain household resources, thus, force millions of people into
poverty annually and stifle development.
 Prevention and control of NCDs
Reducing the common modifiable risk factors. Monitoring
progress and trends of NCDs and their risk is important for guiding
policy and priorities.
A comprehensive approach is needed requiring all sectors,
including health, finance, transport, education, agriculture, planning
and others, to collaborate to reduce the risks associated with NCDs
Promoting interventions to prevent and control them.
Management of NCDs includes detecting, screening and treating
these diseases, and providing access to palliative care for people in
need.
Primary health care (PHC) approach to strengthen early
detection and timely treatment.
 Obesity
Obesity is a medical condition in which excess body fat
has accumulated to an extent that it may have a negative
effect on health.
Obesity is defined as having a body mass index (BMI) of
30 or more.
 BMI (Body Mass Index)
BMI (Body Mass Index) is a calculation that takes a
person’s weight and height into account.
BMI = kg/m2 where kg is a person's weight in kilograms
and m2 is their height in meters squared.
 Causes of Obesity
• eating a poor diet of foods high in fats and calories
• having a sedentary (inactive) lifestyle
• not sleeping enough, which can lead to hormonal changes that
make you feel hungrier and crave certain high-calorie foods
• genetics, which can affect how your body processes food into
energy and how fat is stored
• growing older, which can lead to less muscle mass and a
slower metabolic rate, making it easier to gain weight
• pregnancy (weight gained during pregnancy can be difficult to
lose and may eventually lead to obesity)
• Certain medical conditions may also lead to weight gain.
 Risk Factors of Obesity
• Genetics: Some people possess genetic factors that make it difficult for them to lose
weight.

• Environment and community: Your environment at home, at school, and in your

community, can all influence how and what you eat and how active you are. If your
neighborhood is unsafe, maybe you haven’t found a good place to play, walk, or run.

• Psychological: Depression can sometimes lead to weight gain, as people turn to

food for emotional comfort. Certain antidepressants can also increase risk of weight
gain.

• Smoking: It’s a good thing to quit smoking, but quitting can also lead to weight gain.
For that reason, it’s important to focus on diet and exercise while you’re quitting.

• Medications: steroids or birth control pills can also put you at greater risk for weight
gain.
 Complications of Obesity
• type 2 diabetes
• heart disease
• high blood pressure
• certain cancers (breast, colon)
• stroke
• gallbladder disease
• fatty liver disease
• high cholesterol
• sleep apnea and other breathing
problems
• arthritis
• infertility
 Preventing Obesity

Lifestyle and behavior changes

Aim for moderate exercise (walking, swimming, biking)
for 20 to 30 minutes every day or 300 minutes a week
Eat well by choosing nutritious foods like fruits,
vegetables, whole grains, and lean protein.
Eat high-fat, high-calorie foods in moderation.
• Counseling
To cope with any anxiety, depression, or emotional eating
issues.
 Treatment for Obesty
• Medical weight loss
Medications are usually prescribed only if other methods of weight loss
haven’t worked and if you have a BMI of 27 or more in addition to obesity-
related health issues.
Prescription weight loss medications either prevent the absorption of fat or
suppress appetite. These drugs can have unpleasant side effects. For
example, the drug orlistat (Xenical)

• Weight loss surgery

• commonly called “bariatric surgery” requires a commitment from
patients that they will change their lifestyle.

*Candidates for weight loss surgery will have a BMI of 40 or more, or have
a BMI of 35 to 39.9 along with serious obesity-related health problems.