Table of Contents
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/
https://www.healthline.com/health/metabolic-syndrome#outlook
http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)