Metabolic Risk Factors of NCDs !!

What are Metabolic Risk Factors?

  • Metabolic refers to biochemical process involved in the normal functioning of the body.
  • Metabolic risk factors are the most common cause of the NCDs.
  • They are also the cause and effect of each other.
  • Metabolic risk factors include factors like:
    • High blood pressure
    • High fasting blood sugar
    • High cholesterol level
    • Elevated blood lipids
    • Obesity
  • These metabolic risk factors have its root in:
    • Unhealthy food
    • Inactivity
    • Unhealthy lifestyle
    • Smoking
    • Alcohol consumption
    • Unplanned urbanization etc.
  • It is also necessary to know that metabolic risk factors lead to some major metabolic changes in the body which increase the risk of NCDs like:
    • High blood pressure
    • Overweight and obesity
    • Hyperglycemia i.e. high blood glucose
    • Hyperlipidemia i.e. high level of fat

Status quo of NCD’s

  • Out of 57 million global deaths in 2008, 36 million i.e. 63% deaths were due to NCDs, primarily cardiovascular diseases, diabetes, cancers and chronic respiratory diseases.
  • NCDS have become the major health challenge not only in developed country but also in developing and low-income countries.
  • Overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides and insulin resistance.
  • Increase in Body Mass Index (BMI) gradually increases the risks of Coronary Heart Diseases (CHD), ischemic stroke and type 2 diabetes mellitus.
  • Global action plan for prevention and control of NCDs 2013-2020 by WHO also targets the reduction of the raised blood pressure by 25% to prevent the CVDs as they are the major cause.
  • The plan also targets to halt the raise of the obesity as prevention for the NCDs.

Global Trend of Metabolic Risk Factors:

1. Elevated blood pressure/hypertension

  • Elevated blood pressure is the leading metabolic risk factor in terms of deaths attributable.
  • 19% of global deaths are attributable to elevated blood pressure.
  • Raised blood pressure is also associated with 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS.
  • At present (2018), Africa had the highest prevalence of raised blood pressure with an average of 46% for both sexes
  • While on the other hand, WHO region of Americas had the lowest prevalence of raised blood pressure with an average of 35% for both sexes
  • The prevalence of hypertension decreased by 2.6% in high-income countries in between 2000-2010 but increased by 7.7% in low/middle income countries. Almost three times as many people with hypertension live in low/middle–income countries (1.04 billion) than in high-income countries (694 million).
  • It was also estimated that in 2010, the worldwide prevalence of hypertension was 1.39 billion persons, representing 31% of all adults.
  • The major risk of the raised hypertension includes CVDs

2. High blood sugar/diabetes

  • In 2012, diabetes was directly accountable for 1.5 million deaths. While in 2014, its prevalence was estimated to be 8.5%
  • Eastern Mediterranean Region had the highest prevalence of diabetes (14% for both sexes) and Europe and Africa had the lowest prevalence (7% for both sexes)

3. High cholesterol level

  • Raised cholesterol is estimated to cause 2.6 million deaths which was 4.5% of the total death and 29.7 million disability adjusted life years.
  • The prevalence of elevated total cholesterol in the WHO Region of Europe is 54% for both sexes which is the highest, followed by the WHO Region of the Americas 48% for both sexes and 22.6% and 29.0% on African region and the South East Asian region respectively.
  • The World Health Report 2002 estimates that around 8% of all disease burden in developed countries is caused by raised blood cholesterol. Likewise, total blood cholesterol is responsible for 60% of CHD and around 40% of ischemic stroke in developed countries.

4. Obesity

  • Overweight and obesity kills at least 2.8 million people each year
  • An estimated 35.8 million (2.3%) of global DALYs are caused by overweight or obesity.
  • Moreover, obesity is rising as a serious threat to the world population. It has doubled between 1980 and 2008.
  • Among adults of 20+ age, 35% of them were overweight (BMI ≥ 25 kg/m2) in 2008.
  • In 1980, 5% men and 8% women were obese (BMI ≥30 kg/m2) compared to 10% obese men and 8% obese women in 2008.
  • Worldwide, more than half a billion adults above the age of 20 are obese. It includes 205 million men and 297 million women.
  • According to WHO, Americas had the highest prevalence of overweight (62% in both sexes) and obesity (26%). On the other hand, South East Asia region had the lowest prevalence of overweight (14% in both sexes) and obesity (3%).
  • While comparing men and women of all WHO regions, women were more likely to be obese than men.
  • According to the most recent National Health and Nutrition Examination Survey, 18.5% of children and nearly 40% of adults had obesity in 2015–2016 in America

Implications of Metabolic Risk Factors:

A) Non-communicable disease

  • The most certain outcome of the metabolic risk factors is the occurrence of the non-communicable disease
  • Raised blood pressure, blood sugar level and cholesterol are the major cause for the CVDs
  • Such risk factors lead to the other NCDs as well
  • According to WHO projection, in the next decade, NCDs will be primarily responsible for significantly amplified number of deaths. WHO estimates that these death will increase by 15% globally between 2010 and 2020.

B) Impact on the development

  • Beside health such risk factor also affects the development as well
  • They are the reason for high mortality and morbidity
  • There is certainly the loss of human capital in a country
  • Also the country is bound to spend much on the treatment of the NCDs than in any other sector.

C) Poverty

  • Increases the financial burden
  • The MRF leading to the NCDs is also the cause of the disability
  • There runs the vicious cycle of poverty and NCDs.

Measures to Mitigate Metabolic Risk Factors:

1. Health education

  • Awareness regarding the risk factors is necessary
  • People should be made aware about the healthy way of living, physical activity and the consequences of the NCDs
  • Behaviour Change Communication (BCC) approach is necessary

2. Reduced use in the alcohol and tobacco

  • Use of alcohol and tobacco comes more under the behavioral factor but however it has impact on the metabolic factors as well
  • Advertisement or all those activities that promote the consumption of alcohol and tobacco needs to be discouraged
  • Alleviate tax on such product to discourage the use of such products

3. Focus on the healthy diet

  • Diet intervention is the key intervention
  • Healthy diet needs to be promoted
  • Risk of Raised blood pressure, blood glucose level cholesterol, obesity all can be minimized by the right diet
  • Avoid the consumption of the fast food junks and take away food
  • Make people aware and conscious about their diets

4. Early diagnosis and treatment

  • Early diagnosis and treatment would further intervene the disease progression
  • It reduces the chronicity and prevents disability
  • Though the NCDs can never be cured early diagnosis can surely reduce the severity and prevent from early disability and death
  • Treatment of blood pressure and cholesterol at right time can prevent from the other CVDs, stroke arthrosclerosis, etc.

References and for More Information:

https://www.nhlbi.nih.gov/health-topics/metabolic-syndrome

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469019/

http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/

https://www.ashjournal.com/article/S1933-1711(16)30489-2/pdf

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31919-5.pdf?code=lancet-site

http://www.who.int/gho/ncd/risk_factors/blood_glucose_text/en/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671591/

http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/

https://stateofobesity.org/obesity-rates-trends-overview/

http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/

http://apps.who.int/iris/bitstream/handle/10665/44579/9789240686458_eng.pdf;jsessionid=4E60D2B33DF292C34FA60360F1971EB6?sequence=1

https://www.healthline.com/health/metabolic-syndrome#outlook

http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

http://apps.who.int/iris/bitstream/handle/10665/94384/9789241506236_eng.pdf;jsessionid=1EF4560E6464B48E49B0C4B8B1667D39?sequence=1

About Kusum Wagle 215 Articles
Hello and greetings everyone! I am Kusum Wagle, MPH, WHO-TDR Scholar, BRAC James P. Grant School of Public Health, Bangladesh. I have gained profound experiences in public health sector under different thematic areas of health, nutrition, sexual and reproductive health, maternal and newborn health, research etc., targeting diverse audience of different age groups. I have performed diverse roles ranging from lecturer in the public health department of colleges, nutrition coordinator, research coordinator and consultant, in different programs, projects and academic institutions of Nepal. I also hold immense experience in working closely and persistently with government organizations, non-government organizations, UN agencies, CSOs and other stakeholders at the national and sub-national level. I have successfully led and coordinated different projects involving multi-sector participation and engagement. Moreover, I am also regularly involved in the development of different national health related programs and its guidelines.