Santosh Jain Passi
Our country is afflicted with the dual burden of disease – non-communicable diseases (NCDs) posing a major public health challenge. On one end are the nutritional deficiencies/infectious diseases associated with poverty, deprivation and poor environmental conditions; while on the other are the NCDs caused due to dietary excesses/imbalances and metabolic disturbances.The epidemic of NCDs is mainly attributed to modernisation, urbanisation, sedentary lifestyles and longevity. There is an upsurge in the incidence of overweight/obesity, cardiovascular diseases, type 2 diabetes mellitus, cancers, respiratory diseases and mental illnesses. The World Health Organisation (WHO) has highlighted that if “business as usual” continues, globally by 2030, the annual mortality due to NCDs will touch 55 million mark.
As per the WHO report (2015), in India, 60 per cent deaths are caused by NCDs; and that one out of four Indians are at a risk of dying from one of the NCDs before the age of 70 years. Dr Poonam Khetrapal Singh, Regional Director, WHO-SEAR has remarked that the NCDs are afflicting younger generations and, thus, hampering socioeconomic development. Due to huge loss of potentially productive years (35-64), there is massive economic loss at the household, national and international levels.
The NCD burden can, however, be reduced immensely through appropriate preventive/curative actions. Healthy dietary practices, increased physical activity, weight management, abstinence from tobacco/substance use and alcohol abuse play an important role in their prevention/management. More than 80 per cent of the CVDs and T2DM; and 33 per cent of the cancers can be averted through lifestyle modifications; nutritionally balanced diet being inevitably important.
For maintaining an ideal body weight, total energy intake and energy expenditure need to be balanced; and the diet should be adequate in protein. There is a close link between quality/quantity of dietary fat and NCDs. A high intake of fat/oil – particularly saturated fat, poses profound risk for CHD, cancer, T2DM and hypertension. Replacing saturated fat with PUFA rich oils can significantly lower the CHD rates. Dietary fat also impacts glucose tolerance and insulin sensitivity. Consumption of MUFA containing oils (like olive, mustard and groundnut oils) confer numerous health benefits including reduced risk of CHD and lung/oesophageal/breast/colorectal cancer. On the contrary, trans fats elevate CHD risk through undesirable effect on serum lipids.
In the prevention/management of NCDs, increased consumption of vegetables (2-3 servings/day) and fruits (2 servings/day) is imperative for providing adequate amount of dietary fibre, phytochemicals, antioxidants and various vitamins/minerals. Dietary fibre plays an important role through its impact on atherogenic lipoproteins, blood pressure and thrombogenesis.
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