Studies show growing problems of non-communicable diseases in low-, middle-income countries

Feb 5 2011

"Obesity rates have doubled worldwide since 1980," according to a study published Friday as part of a series in the Lancet that also looked at global blood pressure and cholesterol trends, ABC News reports (Carolo, 2/4). "The data show that in 2008 one in three adults in the world was overweight (BMI ≥25 kg/m2) and one in nine adults was obese (BMI ≥30 kg/m2). Since 1980 the average body mass index (BMI) has increased in all regions, but now middle income countries have caught up with high income countries," BMJ News writes.

"The research, supported by the Bill & Melinda Gates Foundation and the World Health Organization, shows that systolic blood pressure is currently highest in low-income and middle-income countries. Between 1980 and 2008 mean systolic blood pressure declined markedly in high-income countries by 7.3 mm Hg, whereas it increased in low-income countries by 3.3 mm Hg. ... Increases in systolic pressure happened in some middle-income and low-income countries, including parts of Oceania, East Africa, South Asia, South East Asia, and West Africa," the journal writes (Wise, 2/4). Western countries continued to have the highest average cholesterol levels while Africa had the lowest, according to the Associated Press (Cheng, 2/3).

"Our results show that overweight and obesity, high blood pressure, and high cholesterol are no longer Western problems or problems of wealthy nations. Their presence has shifted towards low- and middle-income countries, making them global problems," said Majid Ezzati, of the School of Public Health at Imperial College London, who led the studies, according to a Lancet press release (2/3). "Experts warned the increasing numbers of obese people could lead to a 'global tsunami of cardiovascular disease,'" the AP writes, adding "obesity is also linked to higher rates of cancer, diabetes and is estimated to cause about three million deaths worldwide every year" (2/4).

In an accompanying Lancet Comment, Sonia Anand and Salim Yusuf of McMaster University in Hamilton, Ontario, explore what the findings will mean for low- and middle-income countries. "Considering all risk-factor trends together, the forecast for cardiovascular disease burden in low-income and middle-income countries over the next few decades is dismal and comprises a population emergency that will cost tens of millions of preventable deaths, unless rapid and widespread actions are taken by governments and health-care systems worldwide," they write (2/4).

The study findings present an "opportunity to implement policies that lead to healthier diets, especially lower salt intake, at all levels of economic development, as well as looking at how we improve detection and control through the primary healthcare system," Ezzati said, noting that he hoped such discussions will be part of the conversation at the High-level Meeting of the U.N. General Assembly on Non-Communicable Diseases in September, according to the press release (2/3). Reuters writes that the scheduled U.N. meeting will examine "the rising threat of so-called non-communicable, or chronic, diseases like heart disease, cancer and diabetes, particularly in poorer countries" (Steenhuysen/Kelland, 2/3).

In related news, VOA News examines the findings of a WHO study which found "most people with high cholesterol levels are not getting the treatment they need" (Schlein, 2/2). "Researchers at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle sifted through data from England, Germany, Japan, Jordan, Mexico, Scotland, Thailand and the U.S.; the data were collected over various time periods, but used comparable measures and methodologies," TIME's "Healthland" blog reports (Mayer, 2/2). "Mexico fared best, diagnosing and treating to the point of controlling nearly 60 percent of cases of people with high total blood cholesterol. But at the other end of the spectrum, 78 percent of those found to have high cholesterol in Thailand had not been diagnosed," PostMedia News/Canada.com reports (Edwards, 2/2).

IOM President Calls For Global Collaboration Against Growing Burden Of Noncommunicable Diseases In Low-, Middle-Income Countries

Whether wealthy or poor, the growing global burden of noncommunicable diseases (NCDs) demands that countries around the world come together to prevent or effectively treat such diseases, Institute of Medicine President Harvey Fineberg said on Wednesday during a Center for Strategic & International Studies event in Washington.

According to the WHO, noncommunicable diseases lead to the deaths of 38 million annually, with approximately 80 percent of these deaths occurring in low- and middle-income countries. In India and Pakistan combined "mortality from noncommunicable disease is more than twice the mortality of all infectious diseases," Fineberg said. "Even in sub-Saharan Africa, where the burden of HIV/AIDS is so predominant, a country like Nigeria has almost as many deaths from noncommmunicable diseases as from all infectious diseases."

In addition to causing early death, noncommunicable diseases create a great economic burden on countries. According to Fineberg, "between the years 2005 and 2015, its been estimated that the three countries of China, India and Russia may lose between $200 and $550 billion in national income just because of the three conditions of heart disease, stroke and diabetes." 

The economic and social implications of noncommunicable diseases and what can be done to drive down their global prevalence will be front and center at the U.N.'s first High-level Meeting on the Prevention and Control of Non-communicable Diseases in September. In addition to raising the level of attention to the global burden of noncommunicable diseases, Fineberg said he will be looking for the meeting to generate some concrete plans on  addressing the diseases, including the financial support needed.

"Fundamentally, when you look at the task the world has assigned to the WHO and the U.N. more broadly and you compare that to the resources that have been made available to execute on that strategy the discrepancy is stark and very, very dangerous. We've simply unfunded and over asked what we expect from our global agencies," Fineberg said. He also touched upon the benefits of prevention versus treatment in noncommunicable diseases; the need for strategies to ensure NCD prevention plans don't place greater strains on regions already facing healthcare worker shortages and the lessons that can be drawn from the global response to other diseases, such as HIV/AIDS (Jennifer Evans, Kaiser Daily Global Health Policy Report, 2/4).

Breast, Colon, Lung Cancers On Rise In Developing Countries, Report Says

Marking World Cancer Day on Thursday, the American Cancer Society released a study that found "cancers that are usually more common in developed countries such as lung and breast cancer, are now on the rise in developing countries and will continue to increase unless preventive measures are taken immediately," CNN's "The Chart" blog reports (Bixler, 2/4).

"Obese people are thought to be at higher risk for many so-called 'fat cancers,' including breast and colon cancer," the Associated Press/Miami Herald writes. "For decades, health officials have worried about the impact of cigarette smoking - another nasty habit common in industrialized countries - on lung cancer deaths in developing countries," the news service continues. "But now, they say, it's becoming increasingly urgent that those nations also do something about overeating and poor health habits" (Stobbe, 2/4).

"Undertaking 150 minutes a week of moderate physical activity can reduce the risk of breast and colon cancers, according to the new Global Recommendations on Physical Activity for Health released by WHO" on Thursday, according to a WHO press release (2/3).