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Questions and Answers

Which factor most significantly contributes to the equalization of atherosclerosis risk between males and females around the ages of 50-55?

  • Decreased participation in physical activity by males.
  • Increased consumption of processed foods by females.
  • The cessation of estrogen production in females after menopause. (correct)
  • Increased testosterone levels in males.

How does having a family history of Coronary Heart Disease (CHD) and Diabetes Mellitus (DM) primarily increase an individual's risk for related health issues?

  • By altering the individual's blood type to a more susceptible variant.
  • By shortening the individual's telomeres, leading to premature aging.
  • By predisposing the individual to similar lifestyle choices as their relatives.
  • By increasing the likelihood of inheriting genetic factors that contribute to these conditions. (correct)

What aspect of Type A personality is most closely linked to an increased risk of cardiovascular diseases?

  • Preference for solitary activities.
  • Chronic impatience and time urgency. (correct)
  • Inclination to avoid competitive environments.
  • Tendency to over-analyze situations.

At what age do the provided risk factors for atherosclerosis and osteoporosis begin to significantly increase for both men and women?

<p>Atherosclerosis after 45 for men, Osteoporosis after 55 for women. (A)</p> Signup and view all the answers

How do genetic factors contribute to the risk of developing atherosclerosis?

<p>By predisposing individuals to dyslipidemia. (C)</p> Signup and view all the answers

Which strategy would be MOST effective in promoting long-term physical activity habits within a community?

<p>Creating urban environments that prioritize walking and cycling. (D)</p> Signup and view all the answers

What is the recommended minimum duration and frequency of moderate physical activity for health benefits?

<p>30 minutes per day, at least 5 days per week (B)</p> Signup and view all the answers

A community health program aims to reduce cardiovascular disease risk. Which initiative represents a secondary prevention strategy?

<p>Screening individuals with a family history of hypertension. (C)</p> Signup and view all the answers

A patient diagnosed with diabetes is participating in a tertiary prevention program. What would be the primary focus of this program?

<p>Preventing long-term complications such as neuropathy. (A)</p> Signup and view all the answers

Which of the following workplace interventions would MOST effectively promote physical activity among sedentary workers?

<p>Offering exercise breaks and fitness programs. (A)</p> Signup and view all the answers

Which of the following is the MOST accurate definition of a non-communicable disease (NCD)?

<p>An impairment in body function or structure that necessitates modification in a person’s lifestyle or has persisted for a long length of time. (D)</p> Signup and view all the answers

After the Second World War, what was the PRIMARY reason for the rise of NCDs, especially in developed countries?

<p>Medical achievements like vaccinations and antibiotics led to improved life conditions and increased lifespan. (C)</p> Signup and view all the answers

What is the estimated percentage of cardiovascular diseases and type 2 diabetes that are considered preventable?

<p>80% (B)</p> Signup and view all the answers

Which of the following statements BEST describes the current global burden of Non-Communicable Diseases (NCDs)?

<p>NCDs are becoming increasingly prevalent in developing countries, often coexisting with infectious diseases. (B)</p> Signup and view all the answers

According to the information provided, what percentage of cancers are considered preventable?

<p>30% (C)</p> Signup and view all the answers

What is the FIRST cause of death globally?

<p>Cardiovascular Diseases (B)</p> Signup and view all the answers

Based on the information provided, what are the estimated prevalence rates of hypertension and diabetes mellitus (DM) in Egypt, respectively?

<p>26.3% hypertension, 16.6% DM (B)</p> Signup and view all the answers

What is the projected trend for mortality and disease burden related to NCDs if they are not addressed effectively?

<p>Mortality and disease burden will increase. (B)</p> Signup and view all the answers

Which of the following is a consequence of the demographic transition described?

<p>Increased life expectancy and proportion of the elderly. (B)</p> Signup and view all the answers

During the epidemiological transition, what is the observed shift in mortality patterns?

<p>From communicable diseases to non-communicable diseases . (A)</p> Signup and view all the answers

Which dietary pattern is characteristic of the nutritional transition described in the content?

<p>High in total fat, sugar, and other refined carbohydrates. (D)</p> Signup and view all the answers

What is a major limitation imposed by the multi-factorial nature of risk factors for non-communicable diseases (NCDs)?

<p>It limits opportunities to have specific interventions for prevention and control. (A)</p> Signup and view all the answers

According to the content, what is the likely health outcome for individuals who migrate from a low-risk culture to a high-risk culture?

<p>Increased risk for NCDs. (C)</p> Signup and view all the answers

What is the relationship between urbanization and the prevalence of non-communicable diseases (NCDs), as suggested in the content?

<p>Progressive urbanization increases the prevalence of NCDs. (B)</p> Signup and view all the answers

The context defines a risk factor as any attribute, characteristic, or exposure that does what?

<p>Increases the likelihood of developing a disease or injury. (C)</p> Signup and view all the answers

Why is it important to identify high-risk groups, even if the risk factors are non-modifiable?

<p>To implement targeted interventions and monitoring. (B)</p> Signup and view all the answers

Which dietary habit is least likely to increase the risk of atherosclerosis and coronary heart diseases?

<p>Inadequate calcium intake. (B)</p> Signup and view all the answers

A sedentary lifestyle is most directly associated with which health risk?

<p>Physical inactivity. (A)</p> Signup and view all the answers

Which psychological state is least likely to be classified under mental stress, according to the provided information?

<p>Optimism. (C)</p> Signup and view all the answers

Increased alcohol consumption is associated with an increased risk of which condition?

<p>Dyslipidemia. (D)</p> Signup and view all the answers

Which lipid level change would be least expected in a patient with dyslipidemia?

<p>Increased HDL-C. (B)</p> Signup and view all the answers

Hypertension is identified as a major risk factor for which non-communicable disease?

<p>Coronary Heart Disease (CHD). (A)</p> Signup and view all the answers

If a patient has high proportions of dietary fat, excess sugar consumption, and heavy salt consumption, which condition is least likely to be a direct result of these factors?

<p>Osteoporosis. (C)</p> Signup and view all the answers

Which of the following is not described as a modifiable risk factor?

<p>Age. (A)</p> Signup and view all the answers

Which of the following conditions is NOT typically associated with a higher prevalence in individuals with diabetes?

<p>Gout (D)</p> Signup and view all the answers

Central adiposity is a significant risk factor for several conditions. Which of the following is LEAST directly associated with central adiposity?

<p>Type 1 Diabetes (D)</p> Signup and view all the answers

Hyperuricemia is a known risk factor for which of the following conditions?

<p>Gout (D)</p> Signup and view all the answers

What is the primary focus of interventions defined as primary prevention?

<p>Modifying adverse levels of risk factors that are already present. (B)</p> Signup and view all the answers

The MPOWER package is a set of policies and strategies designed to prevent what?

<p>Tobacco use (C)</p> Signup and view all the answers

Which of the following dietary recommendations is aimed at preventing cardiovascular diseases?

<p>Increased consumption of fish (C)</p> Signup and view all the answers

Which of the following is the LEAST appropriate component of a policy aimed at preventing smoking, as part of the MPOWER package?

<p>Subsidizing tobacco advertising to promote informed choices (D)</p> Signup and view all the answers

What type of approach is most effective for policies and strategies designed to facilitate physical activity?

<p>Multisectoral (B)</p> Signup and view all the answers

Which of the following strategies would be MOST effective for a city aiming to promote cycling as a primary mode of transportation, thereby aligning with urban design principles for public health?

<p>Creating dedicated, protected bicycle lanes separated from vehicular traffic on major roads. (D)</p> Signup and view all the answers

A community health center is developing a secondary prevention program focused on cardiovascular disease. Which action would be the MOST effective in identifying individuals who would benefit from early intervention?

<p>Implementing routine blood pressure and cholesterol screenings at local workplaces. (D)</p> Signup and view all the answers

In designing a workplace intervention to promote physical activity, which strategy would likely be MOST effective in achieving long-term engagement among employees?

<p>Providing access to a well-equipped gym facility with personalized training programs. (A)</p> Signup and view all the answers

Considering the influence of sex on atherosclerosis risk across the lifespan, what is the MOST accurate description of the risk differential between males and females?

<p>Males have a significantly elevated risk of atherosclerosis before menopause in females, after which the risk becomes approximately equal. (D)</p> Signup and view all the answers

A patient with established hypertension, diabetes, and a history of stroke is participating in a cardiac rehabilitation program. Which of the following is the PRIMARY focus of this tertiary prevention strategy?

<p>Preventing further strokes and improving the patient's functional independence and quality of life. (D)</p> Signup and view all the answers

If a patient has a family history of both Coronary Heart Disease (CHD) and Diabetes Mellitus (DM), which intervention strategy would most comprehensively address their heightened risk?

<p>Implementing intensive lifestyle modifications focusing on diet and exercise, combined with regular monitoring for early signs of both conditions. (D)</p> Signup and view all the answers

In the context of Type A personality and cardiovascular health, which behavioral modification strategy would be MOST effective in reducing cardiovascular risk?

<p>Practicing mindfulness and relaxation techniques to mitigate impatience and time urgency. (C)</p> Signup and view all the answers

Which component of school-based programs would MOST effectively foster a lifelong commitment to physical activity among students?

<p>Offering a diverse range of physical activities that cater to varied interests and abilities. (D)</p> Signup and view all the answers

Given the age-related considerations for atherosclerosis and osteoporosis, what comprehensive screening strategy would be MOST appropriate for an individual at age 60?

<p>Annual bone density scans and lipid panels due to the increased risk of both conditions post-menopause and with advancing age. (C)</p> Signup and view all the answers

Considering the interplay between genetic factors and lifestyle choices in the development of dyslipidemia, what is the MOST effective approach to manage this condition in an individual with a strong family history?

<p>Personalized lifestyle modifications including diet, exercise, and stress management, guided by regular lipid panel monitoring. (C)</p> Signup and view all the answers

What is the most significant challenge presented by the multi-factorial nature of risk factors for NCDs in terms of public health intervention?

<p>It limits the ability to implement targeted and highly effective prevention strategies. (B)</p> Signup and view all the answers

How does the demographic transition, characterized by increased life expectancy, most directly exacerbate the challenges posed by NCDs?

<p>It increases the proportion of elderly individuals who are more susceptible to NCDs. (C)</p> Signup and view all the answers

What is the most far-reaching consequence of the nutritional transition towards diets high in total fat, sugar and refined carbohydrates, and low in fibers?

<p>A significant rise in obesity and degenerative non-communicable diseases. (D)</p> Signup and view all the answers

What is a critical implication of international communication and migration of populations across different cultures concerning NCD risk?

<p>Individuals migrating from low-risk cultures to high-risk cultures are more prone to adopting lifestyles that increase NCD risk. (D)</p> Signup and view all the answers

How does progressive urbanization most directly contribute to the increasing prevalence of NCDs?

<p>By increasing exposure to environmental toxins, promoting sedentary lifestyles, and altering dietary patterns. (C)</p> Signup and view all the answers

Considering the global shift in disease burden, what critical challenge do developing countries face regarding healthcare systems?

<p>Addressing a dual burden of both infectious and non-communicable diseases amidst resource constraints. (A)</p> Signup and view all the answers

Why is identifying individuals with non-modifiable risk factors for NCDs still considered crucial in public health, despite the inability to alter these factors?

<p>To implement targeted surveillance, early detection, and tailored interventions to mitigate their impact. (B)</p> Signup and view all the answers

Given the complex interplay of genetic, environmental, cultural, and behavioral risk factors, what represents the most formidable obstacle to controlling NCDs through public health programs?

<p>The implementation of interventions that address the multifaceted and deeply-rooted nature of these risk factors. (B)</p> Signup and view all the answers

Given the preventable nature of many non-communicable diseases (NCDs), what represents the most significant obstacle in reducing their global impact?

<p>The complex interplay of socio-economic factors, lifestyle choices, and healthcare access. (B)</p> Signup and view all the answers

What is a critical implication of increased life expectancy on the prevalence and management of non-communicable diseases (NCDs)?

<p>An increased demand for long-term healthcare services and resources to manage chronic conditions. (D)</p> Signup and view all the answers

Considering the shift in mortality patterns during the epidemiological transition, which long-term public health strategy would be most effective in addressing the rise of NCDs?

<p>Integrating preventive interventions that target lifestyle behaviors and environmental factors. (A)</p> Signup and view all the answers

Considering the estimated prevalence rates of hypertension and diabetes mellitus (DM) in Egypt, what would be the most effective public health strategy to address these conditions?

<p>Implementing nationwide screening programs combined with lifestyle modification interventions and improved access to care. (C)</p> Signup and view all the answers

Which of the following factors presents the MOST significant challenge in reducing the global burden of non-communicable diseases (NCDs)?

<p>The difficulty in translating knowledge about risk factors into effective prevention strategies. (B)</p> Signup and view all the answers

Considering the definition of non-communicable diseases (NCDs), which scenario exemplifies the complex interplay between different NCDs?

<p>A patient with type 2 diabetes developing cardiovascular complications and subsequently experiencing cognitive decline. (D)</p> Signup and view all the answers

What is the most critical strategic priority for healthcare systems in addressing the rising burden of non-communicable diseases (NCDs)?

<p>Implementing comprehensive, integrated approaches focusing on prevention, early detection, and chronic disease management. (D)</p> Signup and view all the answers

How does inadequate calcium intake primarily elevate the risk of osteoporosis, particularly in menopausal women?

<p>By accelerating bone resorption due to decreased estrogen levels, further exacerbated by low calcium availability. (B)</p> Signup and view all the answers

How might advancements in medical treatments, such as those that occurred after the Second World War, paradoxically contribute to the increasing prevalence of non-communicable diseases (NCDs)?

<p>By significantly increasing life expectancy, allowing more individuals to live long enough to develop chronic conditions. (C)</p> Signup and view all the answers

In what way does chronic mental stress, characterized by anxiety and lack of social support, most significantly contribute to the pathogenesis of cardiovascular diseases?

<p>By chronically activating the sympathetic nervous system, leading to sustained hypertension and increased myocardial oxygen demand. (C)</p> Signup and view all the answers

How does dyslipidemia, characterized by elevated LDL-C and decreased HDL-C, directly contribute to the development of coronary heart disease (CHD)?

<p>By promoting the accumulation of cholesterol within arterial walls, initiating and accelerating the atherosclerotic process. (D)</p> Signup and view all the answers

In what specific manner does heavy salt consumption elevate the risk of hypertension?

<p>By increasing extracellular fluid volume and cardiac output, which results in elevated blood pressure levels. (B)</p> Signup and view all the answers

How does a sedentary lifestyle most directly contribute to the pathogenesis of atherosclerosis?

<p>By impairing the body's ability to effectively metabolize lipids, leading to increased LDL cholesterol and decreased HDL cholesterol levels. (B)</p> Signup and view all the answers

How does alcohol consumption potentially raise the likelihood of developing certain types of cancer?

<p>By acting as a solvent for carcinogens, facilitating their entry into cells and increasing their carcinogenic potential. (D)</p> Signup and view all the answers

In what manner does excess sugar consumption most directly contribute to the development of obesity-related diseases?

<p>By increasing hepatic lipogenesis and triglycerides synthesis, resulting in elevated circulating fatty acids and visceral fat accumulation. (B)</p> Signup and view all the answers

What is the most direct mechanism through which smoking increases the risk of atherosclerosis and coronary heart disease (CHD)?

<p>By causing oxidative stress and inflammation, which leads to endothelial dysfunction and accelerates plaque development. (D)</p> Signup and view all the answers

What is the most critical distinction between interventions designed for primary prevention and those addressing existing risk factors?

<p>Primary prevention aims to prevent the onset of risk factors, while interventions manage or modify existing risk factors. (C)</p> Signup and view all the answers

Within the MPOWER package, which policy primarily aims to change the social acceptability of smoking, especially among youth?

<p>Enforcing bans on tobacco advertising, promotion and sponsorship. (D)</p> Signup and view all the answers

When creating policies to boost activity, what considerations would ensure long-term effectiveness?

<p>Implementing a combination of educational, environmental, and policy changes. (B)</p> Signup and view all the answers

How do the recommended dietary adjustments specifically target the biological mechanisms underlying cardiovascular disease?

<p>By reducing the consumption of foods that elevate LDL cholesterol and promote arterial plaque formation. (C)</p> Signup and view all the answers

Which of the following population demographics would most benefit from policies designed to reduce salt levels in processed foods?

<p>Elderly individuals with pre-existing hypertension. (C)</p> Signup and view all the answers

Considering the link between central adiposity and health risks, which intervention strategy would most comprehensively address both the direct and indirect consequences of increased abdominal fat?

<p>Implementing a combined dietary and exercise program targeting weight loss and metabolic improvement. (C)</p> Signup and view all the answers

Which of the following monitoring activities would be most insightful for assessing the long-term effectiveness of a national tobacco control program?

<p>Conducting regular surveys on smoking prevalence across different age groups. (B)</p> Signup and view all the answers

Given the multifaceted approach needed to promote physical activity, which initiative would likely yield the most sustainable impact at a community level?

<p>Developing accessible walking trails and parks while implementing workplace wellness programs. (C)</p> Signup and view all the answers

Flashcards

Epidemiological Transition

Shift in mortality from communicable to non-communicable diseases.

Nutritional Transition

Large shift in dietary patterns high in fat/sugar and low in fiber.

Multi-factorial Nature of NCD Risk Factors

Multiple risk factors associated with specific diseases, limiting specific interventions for prevention and control

Challenges to Public health programs

Risk factors related to genetics, environment, culture, and behavior impacting public health programs.

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Migration and NCD Risk

Individuals moving from low-risk to high-risk cultures adopt new lifestyles, increasing NCD risk.

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Urbanization and NCDs

Increase in urbanization correlates with increase in NCD prevalence.

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Risk Factor

Attribute, characteristic, or exposure increasing the likelihood of disease or injury.

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Non-Modifiable Risk Factors

Risk factors that cannot be changed (e.g., genetics).

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Age and Atherosclerosis

Risk of atherosclerosis increases with age, particularly after 45 in males and 55 in females.

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Sex Differences in Atherosclerosis

Before menopause, males have a significantly higher risk of atherosclerosis, but this risk equalizes after menopause, possibly due to estrogen's protective effects.

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Osteoporosis Risk and Sex

Females are at higher risk, especially after menopause.

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Family History Risk Factors

A family history of Coronary Heart Disease (CHD) and Diabetes Mellitus (DM) increases an individual's risk.

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Genetic Factors in Dyslipidemia

Genetic factors contribute to dyslipidemia, which can also increase risks of some diseases.

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NCD Definition

Impairment in body function or structure needing lifestyle changes, persisting for a long time.

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Examples of NCDs

Cardiovascular diseases (Hypertension, Coronary disease, Stroke), Cancer, Diabetes, Respiratory diseases, Obesity, Dyslipidemia, Renal diseases, Accidents, Nervous and mental disorders, Musculoskeletal disorders, Degenerative disorders, Sarcopenia & Frailty.

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NCDs rise post-WWII

Medical achievements like vaccination, antibiotics, and improved living conditions shifted the disease burden.

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NCDs in Developing Nations

Developed countries saw NCDs rise, then developing countries faced a 'double burden'.

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Major NCD Causes of Death

CVDs, Cancers, Chronic Respiratory Diseases, and Diabetes cause 36 million deaths yearly.

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NCD Preventability

80% of CVDs & Type 2 DM, and 30% of cancers are preventable.

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CVD as a Cause of Death

Globally the first, in developed countries the second, in developing countries the fourth.

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NCD Prevalence in Egypt

Hypertension: 26.3%, DM: 16.6% (Egyptian Health Issues Survey, 2020).

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Modifiable Risk Factors

Factors that can be changed to reduce health risks.

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Diet Lifestyle Risk Factors

High dietary fat, excess sugar, heavy salt, inadequate calcium.

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Sedentary Lifestyle

A lifestyle with little to no exercise.

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Mental Stress Factors

Depression, anger, fear, anxiety, and lack of social support.

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Alcohol Risk

Increases risk of dyslipidemia, hypertension, and cancers.

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Dyslipidemia

High total cholesterol, high LDL-C, high triglycerides, low HDL-C.

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Hypertension Risk

Major risk for CHD and other non-communicable diseases

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Smoking Risk

Smoking increases risk of CHD and lung cancer..

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Lifetime Activity

Encouraging regular physical activity throughout life, tailored to individuals of all ages and abilities.

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Fitness Resources in Healthcare

Medical centers should have resources for fitness assessments and exercise plans.

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Urban Design for Activity

Creating urban areas that encourage walking/cycling and reduce car use.

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Secondary Prevention

Focuses on screening, early treatment of conditions like diabetes and hypertension.

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Tertiary Prevention

Aims at preventing long-term complications and rehabilitating those with disabilities.

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Diabetes complications

Increased occurrence of hypertension, obesity and CHD in diabetics

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Central Adiposity Risk

Increased risk of Type 2 DM & CHD associated with abdominal fat.

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Hyperuricemia Risk

Elevated uric acid levels increase risk of coronary heart disease.

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Primary Prevention

Actions to lessen risk factors to stop diseases from occurring.

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Lifestyle Modification

Changing behaviors to reduce risk factors.

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Comprehensive prevention programs

Population-wide interventions for risk factor reduction

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MPOWER Package

Monitor, Protect, Offer, Warn, Enforce, Raise.

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Healthy diet recommendations

Fish, Poultry, Legumes, Vegetables, Fruits, Whole grain

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Sex and Atherosclerosis Risk

Higher risk of atherosclerosis occurs in males; risk in females increases post-menopause.

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Sex and Osteoporosis Risk

Females have higher risk, especially after menopause.

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Family History: NCD Risk

Increases risk of CHD and DM.

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Type A Personality

Aggression, competition, impatience, and time urgency, characteristic of people with elevated stress levels.

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Genetic Factors: Dyslipidemia

Play a role in dyslipidemia.

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Diet Risk Factors

Dietary choices increasing disease risks.

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High Dietary Fat

Too much fat in the diet.

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Excess Sugar

Consuming too much sugar.

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Heavy Salt Consumption

Consuming excessive amounts of salt.

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Inadequate Calcium Intake

Not enough calcium in the diet.

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Physical Inactivity

Lack of physical activity.

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Mental Stress

Feelings of depression, anger, fear, anxiety, or lack of social support.

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Promoting Lifetime Activity

Encouraging exercise habits for all ages and abilities throughout life.

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Medical Centers & Fitness

Medical centers should provide staff for fitness and exercise guidance.

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Urban Design

Urban planning that prioritizes walking and cycling over car use.

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Screening High-Risk Individuals

Screening high-risk individuals to diagnose underlying conditions early.

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Preventing Long-Term Complications.

Preventing long-term complications from existing conditions like diabetes.

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Non-Communicable Diseases (NCDs)

Diseases that impair body function or structure, requiring long-term lifestyle changes.

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Common NCD Examples

Cardiovascular diseases (like hypertension, coronary disease, stroke), cancer, diabetes, and respiratory diseases.

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Medical Achievements

Vaccinations, antibiotics, and improved living conditions decreased deaths from communicable diseases.

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Double Burden of Disease

Many developing countries face both infectious and non-infectious diseases simultaneously.

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NCDs' Death Toll

CVDs, cancers, chronic respiratory diseases, and diabetes account for 36 million deaths each year.

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NCDs: Preventable Mortality

80% of CVDs and type 2 diabetes, and 30% of cancers.

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CVDs Deaths Globally

Globally the first cause of death.

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NCD Prevalence (Egypt, 2020)

Hypertension: 26.3%, Diabetes: 16.6%.

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Demographic Transition

Shift in a population's mortality and life expectancy, often with an increasing proportion of elderly individuals.

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Multi-factorial Risk Factors

The presence of multiple interacting factors that contribute to the risk of developing a specific disease.

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International Migration & NCDs

The movement of people between countries or regions with different cultural norms, sometimes leading to changes in lifestyle and disease risk.

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Risk factor (NCDs)

Any factor that increases the probability of developing a disease or injury.

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High-Risk Group Identification

Identifying individuals or groups at higher risk of developing a disease due to certain characteristics.

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MPOWER: Monitor

Monitor tobacco use & prevention policies.

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MPOWER: Protect

Protect people from tobacco smoke in public places.

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MPOWER: Offer

Give ways to help people stop using tobacco.

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MPOWER: Warn

Tell people about tobacco's dangers.

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MPOWER: Enforce

Stop tobacco advertising, promotion, and sponsorship.

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MPOWER: Raise

Raise tobacco taxes and prices.

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Heart-Healthy Diet

A diet high in fish, poultry, legumes, vegetables, fruits, and whole grains; low in salt, saturated fats, trans-fatty acids, and free sugars.

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Promoting Physical Activity

It requires a broad approach involving multiple sectors to make physical activities easier and more accessible for everyone.

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Study Notes

  • Non-communicable diseases (NCDs) involve impairment in body function or structure, requiring lifestyle modifications that persist over time.

Examples of Non-Communicable Diseases

  • Cardiovascular diseases (Hypertension, Coronary disease, Stroke)
  • Cancer
  • Diabetes
  • Respiratory ailments (Asthma, Emphysema, Bronchitis)
  • Obesity
  • Dyslipidemia
  • Renal issues (Nephritis, Nephrotic syndrome)
  • Accidents
  • Nervous and mental disorders (Mania, Depression, Cognitive impairment)
  • Musculoskeletal problems (Arthritis, Osteopenia/Osteoporosis)
  • Degenerative disorders
  • Sarcopenia & Frailty

Magnitude of the Problem

  • Historically, communicable diseases were the primary cause of death worldwide.

Past

  • Medical advancements like vaccinations and antibiotics improved living conditions.
  • NCDs became major health issues in developed countries.
  • Developing countries faced a double burden of infective and non-infective diseases due to poor environments and inadequate healthcare.

Present

  • Four diseases (CVDs, Cancers, Chronic respiratory diseases, Diabetes) cause 36 million deaths annually.
  • These diseases are largely preventable.
  • 80% of CVDs and type 2 diabetes can be prevented.
  • 30% cancers are preventable.

Causes of Death

  • CVDs are the 1st cause of death globally.
  • Cancer is the 2nd cause of death in developed countries, and the 4th cause in developing countries.

Estimated Prevalence in Egypt

  • Hypertension: 26.3% ("Egyptian Health Issues Survey, 2020")
  • Diabetes: 16.6% ("Egyptian Health Issues Survey, 2020")

Future

  • Increasing life expectancy paired with NCD prevalence poses a serious challenge.
  • Without intervention, mortality and disease burden from NCDs will continue to increase.

Challenges for Prevention of NCDs

Demographic Transition

  • Mortality decreases, increasing 11 life expectancy and the proportion of elderly people.
  • NCDs are often associated with aging.

Epidemiological Transition

  • Mortality shifts from communicable to non-communicable diseases.
  • This is largely due to the use of immunizations and antibiotics.
  • NCDs have specific genetic, environmental, and behavioral risk factors.

Nutritional Transition

  • There is a substantial change in nutrition towards diets:
  • High in total fat, sugar, and refined carbohydrates.
  • Low in polyunsaturated fatty acids and fibers.
  • Accompanied by 11 sedentary lifestyles, leading to a rise in obesity and degenerative NCDs.

Multi-Factorial Nature of Risk Factors for NCDs

  • The multiplicity of risk factors impacts ability to intervene and control the disease.
  • Types of risk factors are difficult to control using technology.
  • Immunizations and antibiotics are technologies used to prevent communicable diseases.
  • Risk factors are linked to genetics, environment, culture, and behavior.

International Communications & Migration

  • Individuals migrating from low-risk cultures (rural areas) to high-risk cultures (urban areas) adopt the new culture's lifestyle and increase 11 their risk for NCDs.
  • Progressive 11 urbanization is linked to increased 11 NCD prevalence.

Risk Factors

  • Any attribute, characteristic, or exposure that increases ↑↑ the likelihood of developing a disease or injury.

Non-Modifiable Risk Factors

  • These cannot be changed, but are important to identify in high-risk groups.

Age

  • Increased 11 risk of atherosclerosis, osteoporosis, and NCDs.
  • Atherosclerosis risk increases after > 45 years in males and > 55 years in females.
  • Osteoporosis risk increases after > 65 years.
  • NCDs risk increases after > 55 years (After menopause).

Sex

  • Males generally have a higher risk.
  • Males have a higher risk of atherosclerosis (MI).
  • Before menopause the ratio of male to female risk is 10:1
  • After menopause the risk equalizes (age 50-55)
  • This may be due to the protective effect of estrogen against atherosclerosis.
  • Osteoporosis is more common in females.

Family History

  • There is a higher risk in individuals with a family history of coronary heart disease (CHD) and diabetes mellitus (DM).

Genetic Factors

  • Play a role in dyslipidemia.

Type A Personality

  • Includes aggression, competition, impatience, and time urgency.

Modifiable Risk Factors

Lifestyle Risk Factors

Diet

  • High proportions of dietary fat is associated with atherosclerosis, coronary heart diseases, breast and colon cancer.
  • Excess consumption of sugar leads to obesity and dental diseases.
  • Heavy salt consumption can lead to hypertension.
  • Inadequate calcium intake can lead to osteoporosis, "especially among menopausal women”.

Physical Inactivity

  • Is related to a sedentary lifestyle.

Mental Stress

  • Depression, anger, fear, and anxiety, along with a lack of social support, contribute to mental stress.

Smoking

  • Smoking can lead to coronary heart disease (CHD) and lung cancer.

Alcohol

  • ↑↑ Increases the risk of dyslipidemia - Hypertension and some types of cancers.

Diseases (as Risk Factors)

  • Dyslipidemia ↑↑ increases Total Cholesterol, ↑↑ LDL-C (low density lipoprotein cholesterol), and ↑↑ Triglycerides, and HDL-C (high density lipoprotein cholesterol)
  • Hypertension is a major risk factor for some non-communicable diseases like CHD.
  • Type 2 diabetes: Diabetics have a higher prevalence of Hypertension, Obesity and Coronary heart disease (CHD).
  • Obesity: Central adiposity ↑↑ increases the risk of Type 2 DM and CHD.
  • Gout: Hyperuricemia is a risk for. CHD.

Prevention

Primary Prevention

  • Interventions are defined to modify adverse levels of risk factors once they are present.

Lifestyle modification:

  • Comprehensive prevention programs (Population-based interventions)

Policies and strategies include:

  • Preventing smoking (MPOWER package)
  • Dietetic recommendations to prevent cardiovascular diseases and facilitate healthy eating
  • Policies and strategies to facilitate physical activity
  • Policies and strategies to address harmful use of alcohol

Policies and strategies designed to prevent smoking (MPOWER package):

  1. Monitor tobacco use & tobacco-prevention policies.
  2. Protect people from tobacco smoke in public places and workplaces.
  3. Offer help to people who want to stop using tobacco.
  4. Warn people about the dangers of tobacco.
  5. Enforce bans on tobacco advertising, promotion, & sponsorship.
  6. Raise tobacco taxes and prices.

Dietetic recommendations to prevent cardiovascular diseases and facilitate healthy eating:

  • Include ↑↑ fish, ↑↑ poultry, legumes and vegetables, fruits and whole grains.
  • Reduce ↓↓ salt levels, ↓↓ industrially produced trans-fatty acids, saturated fats and free sugars.

Policies and strategies designed to facilitate physical activity:

  • Requires a multisectoral approach:

Health sector:

  • Health professionals should encourage exercise habits throughout patients' lifetimes.
  • Advise 30 min of moderate PE/day for at least 5 days/ week minimum.
  • Medical centers should have staff & facilities for fitness and exercise prescription.

Education sector:

  • Implement school based programs and physical education.
  • Provide greater opportunities for physical activities during school day.

Urban Design and Transport

  • Design urban environment: That encourages people to rely less on personal cars and prioritize walking and cycling
  • Enforce security & road safety legislations.
  • Designing natural recreational spaces

Workplaces

  • Exercise breaks for sedentary workers.
  • Fitness programs in workplace.

Secondary Prevention

  • Occurs As HTN - DM - Obesity - Hypercholesterolemia

Actions

  • Screening of high-risk individuals.
  • Early and Proper treatment (DM - HTN).
  • Reassure the patient.
  • Follow up & assessment at periodic intervals.

Tertiary Prevention

  • Focuses on prevention of long term complications and rehabilitation of individuals with disability.

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