MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES

SCHOOL OF PUBLIC HEALTH AND SOCIAL

SCIENCES

PQ 600: SPECIAL PUBLIC HEALTH

COURSE FACILITATOR: DR ANNA KESSY

INDIVIDUAL ASSIGNMENTS

FULL NAME: ANITHA ONESMO

REGISTRATION NUMBER: HD/MUH/T.719/2020

DATE OF SUBMISSION: 04-5-2021

In 2015, 17 Sustainable Development Goals (SDGs) were endorsed by world leaders under the
2030 Agenda for Sustainable Development. Nutrition and NCDs are mentioned explicitly in 2
targets .SDG target 2.2, By 2030,end all forms of malnutrition, including achieving ,by 2025,the
internationally agreed targets on stunting and wasting in children under 5 years of age, and
address the nutritional needs of adolescent girls ,pregnant and lactating women and older persons
(SDG 2.2 and SDG 3.4) and SDG target 3.4 By 2030, reduce by one third premature mortality
from non-communicable diseases through prevention and treatment and promote mental health
and well-being and hold great potential to facilitate the achievement of many others(Johnston,
2016).Since the nutrition related NCDs are well indicated in the sustainable development goals
therefore much emphasis is highly needed.

Nutrition related Non-Communicable Diseases refers to the nutrient-related diseases and

conditions that cause illness in humans. According to the WHO’s Global NCD Progress Monitor
and the 2016 Global Nutrition Policy Review, governments are making some progress in their
response to address dietary risk factors and increased prevalence of NCDs, but not enough to
meet the global targets set. Both sources find that while a majority of countries have policies in
place to reduce obesity and diet-related NCDs, implementation of these policies is low.
Moreover, when measures are passed through Parliament, they tend to be “passive” and focused
mainly on information dissemination rather than “active” structural reform initiatives that aim to
increase the availability of and access to diverse, safe, nutritious foods that contribute to healthy
diets for all population groups(‘United Nations System Standing Committee on Nutrition NON-
COMMUNICABLE DISEASES ’, 2018).

RISK FACTORS ENCOUTERED IN NUTRITION RELATED NON-COMMUNICABLE

DISEASES

The dominant risk factors for non-communicable diseases are behavioral; they relate to
unhealthy diets, inadequate physical activity, exposure to tobacco smoke (and air pollutants), and
excessive alcohol use.

The major NCDs related to diet are cardiovascular diseases and diabetes mellitus (DM). There
are also several others: respiratory diseases, mental health disorders, lower extremity arthritis
secondary to obesity, several cancers, and dental caries. The key diet-related risk factors for
CVD and DM include overweight/obesity, hyperglycemia, elevated blood lipids, and
hypertension(Kljakovic, 1994). The following are the modifiable risk factors of nutrition related
non communicable diseases.

Malnutrition(obesity)

Obesity is a well-recognized NCD risk factor due to its links to diet-related NCDs, including
cardiovascular diseases, certain cancers and diabetes. Worldwide, 1.9 billion adults are currently
overweight or obese. The last four decades saw a tenfold rise in child and adolescent obesity,
with 38 million children under five being overweight in 2017, constituting an increase of 8
million since 2000. This trend has the potential to negate much of the work that has been done to
increase life expectancy around the world. Less obvious but no less concerning is the impact of
stunting on NCDs. Stunting, which is a direct cause of short height and sub-optimal cognitive
and physical function is now also recognized as a risk factor for becoming overweight and
developing NCDs later in life. Globally, 151 million children are stunted(‘United Nations
System Standing Committee on Nutrition NON-COMMUNICABLE DISEASES ’, 2018).

Smoking

Smoking and tobacco are considered as number one enemy of public health. Smoking
tobacco significantly increases the chance of developing cardiovascular disease. Smoking
damages and narrows the arteries, making angina pectoris and heart attack more likely. Angina
pectoris is a condition characterized by pain or discomfort in the center of the chest, caused by
the heart muscle not getting enough blood. Nicotine also makes the heart beat faster and
increases blood pressure, meaning the heart has to work harder to pump blood around the
body(Agarwal et al., 2016).

Alcohol use

11.5% of all global drinkers are episodic, heavy users.2.5 million people die from alcohol
consumption per year, the majority of adults consume at low-risk levels. It is estimated that
worldwide consumption of alcohol has remained relatively stable(Centres for Disease Control
and Prevention, 2012).Use of alcohol has a longterm health effect and as a result it can lead to
nutrition related NCDs such as cancer.
Physical inactivity

Physical inactivity is an important risk factor for nutrition related NCDs. Not exercising
regularly increases a person’s chances of being overweight, of having high blood pressure and of
developing other conditions that make cardiovascular disease more likely. 31% of the world’s
population does not get enough physical activity. Many social and economic changes contribute
to this trend such as Aging populations, Transportation, and Communication technology(Centres
for Disease Control and Prevention, 2012).

Low intake of fruits and vegetables

Low intake of fruits and vegetables are found to be associated with NCD’s, inadequate intake of
fruit and vegetable can result into NCDs which are associated with the low intake of vitamins
which have a crucial role to play as a result nutrition related NCDs such as diabetes and
cardiovascular diseases.

Hypertension and Excessive Sodium Intake

Sodium, through hypertension, is a major cause of cardiovascular disease deaths and disability.
About 10% of cardiovascular disease is caused by excess sodium intake. 8.5 million deaths could
be prevented over 10 years if sodium intake were reduced by 15%. Therefore, excessive intake
of the salt has great effect to the NCDs.

METHODS USED IN PREVENTION AND CONTROL OF NUTRITION RELATED NON-

COMMUNICABLE DISEASES.

Breastfeeding

For lactating mothers, it is believed that breastfeeding to a baby for example, has been shown to
have multiple benefits for both children and their mothers, including protecting against the onset
of overweight and NCDs. Longer periods of breastfeeding are associated with a reduction in the
odds of overweight/obesity (26%) and of type II diabetes (35%) in children and with lower rates
of breast cancer, ovarian cancer, type II diabetes and post-partum depression in mothers(‘United
Nations System Standing Committee on Nutrition NON-COMMUNICABLE DISEASES ’,
2018).
Supportive policies and regulatory frameworks

Policies and regulatory bodies can change a food system reform process and create healthy food
environments imperative. These include investments in production, supply chain logistics and
procurement policies, restrictions on advertising and other forms of promotional marketing of
unhealthy foods (in general, and specifically in schools), front-of-package labelling, and fiscal
measures that favour healthy foods example taxation of sugar- sweetened beverage. Enacting
such measures in national Food Based Dietary Guidelines and embedding them in legislation
helps to protect the right to food and to promote the highest attainable level of health as a result
controlling the nutrition related non communicable diseases.

Use of life course approach

Nutrition needs and nutrition related risks change throughout the life course. Therefore, policies
and programmes should follow a life course approach. This approach begins preferably before
conception or in the first 1,000 days between conception and a child’s second birthday, as during
this period pivotal physical growth, lifestyle, eating habits, and development processes occur.
The report of the Commission on Ending Childhood Obesity (ECHO) outlines a suite of
interventions relevant to the life course approach, comprising recommendations for children in
the following 6 areas: promoting the intake of healthy foods; promoting physical activity;
providing preconception and pregnancy care; promoting appropriate infant and young child
feeding (early initiation of breastfeeding, exclusive breastfeeding in the first 6 months, and
continued with safe and adequate complementary foods up to 2 years or beyond); promoting
activities which support health, nutrition and physical activity for school-aged children; and
promotion of weight management during childhood. Through the use of this approach the
nutrition related non communicable diseases shall be controlled since it starts even before
conception.

Changing of life style

Making changes in your lifestyle is a proven method for reducing your risk of developing nutrition
related disease. While there are no guarantees that a healthy lifestyle will keep disease away, these
changes will certainly improve your health in other ways, such as improving your physical and
emotional well-being. Also, because some risk factors are related to others, making changes in one
area can benefit other areas. A good example is a Heart disease is preventable 80%-90% of the time
due to lifestyle changes. Making these changes can help prevent heart attacks and strokes therefore
preventing and controlling nutrition related NCDs.

Promotion of diets low in fats and sugar, less alcohol and increased physical activity

Physical activity plays a very vital role in prevention and control of the NCDs that are the results
of the nutrition related therefore to see substantial health benefits, experts recommend that adults
do at least 150 minutes of moderate to high-intensity exercise per week. If this is not
possible, any amount of physical activity is always preferable to none at all. This will help in
burning out the fats as result making a body free from diseases(Agarwal et al., 2016).

Tobacco control

Soon after quitting smoking, health benefits such as improved circulation, better taste and smell
and a stronger immune system can usually be noticed. Doctors and other health professionals are
able to offer advice on how to quit smoking. As a result, this will help an individual to properly
prevent himself/herself against the diseases due to the control of the smoking habits.

Physical activity

Regular physical activity is proven to help prevent and manage noncommunicable diseases such
as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain
healthy body weight and can improve mental health, quality of life and well-being.

All physical activities are beneficial and can be done as part of work, sport and leisure or
transport (walking, wheeling and cycling), but also through dance, play and everyday household
tasks, like gardening and cleaning.

Reducing salt intake to prevent hypertension and cardiovascular disease

There is compelling evidence that dietary salt intake is the major cause of raised blood pressure
(BP) and that a reduction in salt intake from the current level of ≈ 9 - 12 g/day in most countries
to the recommended level of < 5 g/day lowers BP. A public health campaign plays a more
important role in encouraging consumers to use less salt coupled with widespread replacement of
salt with substitutes that are low in sodium and high in potassium as a result NCDs due to salt
intake shall be minimized and controlled.

CONCLUSION

Addressing NCDs and diets in a consistent and coherent way creates cost effective opportunities
to simultaneously tackle the multiple burdens of malnutrition and their related NCDs. In order to
meet state obligations in human rights frameworks, policy makers should not focus solely on
curative options, but rather should identify opportunities to start at the root of the problem such
as improving diet quality and reducing malnutrition. This strategy is also the most effective and
efficient as reversal and treatment of overweight, obesity and NCDs is very expensive and has a
low success rate.

The “Best buys are the best methods for prevention and control of non-communicable diseases”
since are the cost-effective interventions included in the GAP for the Prevention and Control of
NCDs, and include strategies for improving diet quality and for increasing physical activity.
REFERENCES

Agarwal, D. et al. (2016) ‘Risk factors of Non-Communicable Diseases in India: A Systematic

Review’, International Journal of Medical Research Professionals, 2(5), pp. 5–10. doi:
10.21276/ijmrp.2016.2.5.002.

Centres for Disease Control and Prevention (2012) ‘Overview of non-communicable diseases
and related factors’, pp. 1–96. Available at:
https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/new-8/overview-of-
ncds_ppt_qa-revcom_09112013.pdf.

Johnston, R. B. (2016) ‘Arsenic and the 2030 Agenda for sustainable development’, Arsenic
Research and Global Sustainability - Proceedings of the 6th International Congress on Arsenic
in the Environment, AS 2016, pp. 12–14. doi: 10.1201/b20466-7.

Kljakovic, M. (1994) ‘A comparison of the respiratory care given to asthmatic and nonasthmatic
children in a general practice’, New Zealand Medical Journal, 107(980), pp. 240–242.

‘United Nations System Standing Committee on Nutrition NON-COMMUNICABLE

DISEASES ’, (2018), (May).