Abstract: Reduction of salt intake is an important and cost-effective way for reducing hypertension and the risk of cardiovascular diseases (CVDs). Current global salt intakes are estimated at around 10 g/day, well above the World Health Organization (WHO) recommended level of <5 g/day. The sub-Saharan Africa (SSA) region has a prevalence of hypertension of 46% among adults aged 25 and over and therefore strategies to reduce salt intake are necessary. This requires an understanding of salt intake behaviors in the population along with government commitment to increase awareness and take actions that would create an enabling environment. It is also important to have the food industry and other key stakeholders on board. A review of the developed WHO’s norms and guidelines, technical support provided to countries by WHO as well as country initiatives shows that countries in the African region are at different stages in the implementation of salt reduction interventions. For example, South Africa has enacted legislation to make the food industry reduce the salt content of a number of its products while Mauritius is requesting bakery owners to reduce salt in bread. A number of countries are currently undertaking studies to measure salt intake in the populations. Overall progress is slow as the region experiences a double burden of communicable and noncommunicable diseases, competing health priorities and limited resources for health.
Keywords: Africa; salt intake; sodium; non-communicable diseases (NCDs); cardiovascular
An overview of salt intake reduction efforts in the Gulf Cooperation Council ...Paul Schoenhagen
Globally, morbidity and mortality from non-communicable diseases (NCDs) are increasing steadily and at an alarming rate. High blood pressure is a major risk factor for cardiovascular disease (CVD) and salt reduction is an effective measure to decrease mortality rates. In the Eastern Mediterranean region, current salt intake is high, with an average intake of >12 g per person per day. Reducing the intake of salt has been identified as a priority intervention to reduce NCDs. Countries of the Gulf Cooperation Council (GCC) are showing a willingness to comply with the World Health Organization (WHO) recommendations and an eagerness to reduce the burden of NCDs. However, they face some challenges, including lack of political commitment, lack of experience, and shortage of qualified human resources. Salt intake reduction efforts
Salt intake reduction efforts: advances and challengesPaul Schoenhagen
The articles in this special issue of Cardiovascular Diagnosis and Therapy describe the efforts to reduce salt intake in different parts of the world, including South America, Africa, the Middle East, the Far East (China and Mongolia) and Australia, in addition to an overview of the work of the World Hypertension League in this domain. Sharing experiences from diverse regions and countries, these data will contribute to better understanding the challenges and opportunities encountered by the groups working in the field.
Diabetes in the Gulf: The policy challenge is a new Economist Intelligence Unit report, sponsored by Janssen. It assesses the current status and potential impact of diabetes in the six Gulf Co-operation Council states—Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE; reviews current approaches to tackling the disease in the region; and explores further possible opportunities to help combat diabetes.
NATIONAL IODINE DEFICIENCY DISORDER CONTROL PROGRAMpramod kumar
The document discusses India's National Iodine Deficiency Disorder Control Program. Key points:
- Iodine deficiency can cause developmental issues and goiter. India launched the program in 1962 to distribute iodated salt to populations at risk.
- Over 350 million people in India are at risk of iodine deficiency. The program aims to reduce prevalence of disorders to below 10% by 2012 through iodated salt distribution, education, and monitoring.
- It is implemented through central coordination and state-level cells. Achievements include banning non-iodated salt, establishing quality standards, and expanding production and distribution of iodated salt nationwide.
Developing a national salt reduction strategy for MongoliaPaul Schoenhagen
Background: The increase in prevalence of risk factors such as hypertension has contributed to an incremental rise in non-communicable diseases (NCDs) in Mongolia over recent decades, such that they now account for 80% of all deaths in the country. Salt reduction is one of the most cost-effective interventions to reduce the burden of NCDs.
Methods: In 2011, the Ministry of Health (MOH) instigated the development of a national salt reduction strategy for Mongolia. As part of a 2-week national consultation and training program on salt reduction, it established an inter-sectoral working party and organized a series of bilateral meetings and visits to factories. Actions arising included a baseline survey of population salt consumption patterns and the implementation of a series of pilot salt reduction initiatives.
Results: The results of the baseline assessment revealed that average daily intake of salt, based on 24 hour urine samples from a representative national sample (n=1,027), was 11.06±5.99 g in 2011, more than double the World Health Organization (WHO) five grams recommendation. Moreover, while most participants knew that salt was bad for health, few were taking efforts to reduce intake, and many were consuming highly salty meals and tea; salt in tea alone was estimated to contribute 30% of daily salt intake. A pilot Pinch Salt intervention to reduce salt consumption of factory workers was undertaken in Ulaanbaatar (UB) city between 2012 and 2013, and was associated with a reduction of 2.8 g of salt intake. Ongoing food industry initiatives have led to significant reductions in salt levels in bread, and companies producing processed meat have indicated a willingness to reduce salt. Relevant stakeholders have also supported the campaign by participating in annual World Salt Awareness Week events. The activities to date have demonstrated the potential for action and there is now a need scale these up to a national level to ensure that Mongolia is in a strong position to achieve a 30% reduction in population salt intake by 2025. The main goal of the Mongolian national salt reduction strategy is to create a social, economic and legal environment that supports salt reduction, including by influencing food supply, increasing partnerships between government and relevant stakeholders, and creating an enabling environment to support improved consumer choices. The strategy will be implemented from 2015 to 2025, with an interim review of progress in 2020.
Conclusions: Given that Mongolia has one of the highest rates of stroke in the world, which is strongly associated with population-wide blood pressure (BP) levels, the addition of a population-based stroke surveillance program would provide a reliable direct assessment of the impact of these salt reduction initiatives on the health of the Mongolian people. The results from this research would likely be widely generalizable to other populations experiencing similar lifestyle transitional changes.
K
Twenty two years of idd elimination efforts in sudanAlexander Decker
1) Sudan has been working to eliminate iodine deficiency disorders (IDD) since 1989 through their national IDD control program which adopted universal salt iodization (USI) as their strategy in 1994.
2) Despite three federal decrees since 1994 requiring salt fortification with iodine and three state laws prohibiting non-iodized salt, implementation has not been enforced.
3) The document proposes using existing national laws on standards, public health, and food inspection to issue a compulsory national salt standard along with strengthened monitoring between the Ministry of Health and standards organization.
The document discusses India's National Iodine Deficiency Disorder Control Programme. It notes that iodine deficiency can cause goiter and other health issues. The programme aims to provide iodized salt to at-risk regions, educate the public, and monitor iodine levels. Key objectives include assessing iodine deficiency, supplying iodized salt, education, and monitoring impacts. The programme was later expanded to promote universal iodized salt consumption and strengthen monitoring.
To support governments as they develop national food and nutrition plans and targets, we have produced a new policy brief in collaboration with NCD Alliance.
An overview of salt intake reduction efforts in the Gulf Cooperation Council ...Paul Schoenhagen
Globally, morbidity and mortality from non-communicable diseases (NCDs) are increasing steadily and at an alarming rate. High blood pressure is a major risk factor for cardiovascular disease (CVD) and salt reduction is an effective measure to decrease mortality rates. In the Eastern Mediterranean region, current salt intake is high, with an average intake of >12 g per person per day. Reducing the intake of salt has been identified as a priority intervention to reduce NCDs. Countries of the Gulf Cooperation Council (GCC) are showing a willingness to comply with the World Health Organization (WHO) recommendations and an eagerness to reduce the burden of NCDs. However, they face some challenges, including lack of political commitment, lack of experience, and shortage of qualified human resources. Salt intake reduction efforts
Salt intake reduction efforts: advances and challengesPaul Schoenhagen
The articles in this special issue of Cardiovascular Diagnosis and Therapy describe the efforts to reduce salt intake in different parts of the world, including South America, Africa, the Middle East, the Far East (China and Mongolia) and Australia, in addition to an overview of the work of the World Hypertension League in this domain. Sharing experiences from diverse regions and countries, these data will contribute to better understanding the challenges and opportunities encountered by the groups working in the field.
Diabetes in the Gulf: The policy challenge is a new Economist Intelligence Unit report, sponsored by Janssen. It assesses the current status and potential impact of diabetes in the six Gulf Co-operation Council states—Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE; reviews current approaches to tackling the disease in the region; and explores further possible opportunities to help combat diabetes.
NATIONAL IODINE DEFICIENCY DISORDER CONTROL PROGRAMpramod kumar
The document discusses India's National Iodine Deficiency Disorder Control Program. Key points:
- Iodine deficiency can cause developmental issues and goiter. India launched the program in 1962 to distribute iodated salt to populations at risk.
- Over 350 million people in India are at risk of iodine deficiency. The program aims to reduce prevalence of disorders to below 10% by 2012 through iodated salt distribution, education, and monitoring.
- It is implemented through central coordination and state-level cells. Achievements include banning non-iodated salt, establishing quality standards, and expanding production and distribution of iodated salt nationwide.
Developing a national salt reduction strategy for MongoliaPaul Schoenhagen
Background: The increase in prevalence of risk factors such as hypertension has contributed to an incremental rise in non-communicable diseases (NCDs) in Mongolia over recent decades, such that they now account for 80% of all deaths in the country. Salt reduction is one of the most cost-effective interventions to reduce the burden of NCDs.
Methods: In 2011, the Ministry of Health (MOH) instigated the development of a national salt reduction strategy for Mongolia. As part of a 2-week national consultation and training program on salt reduction, it established an inter-sectoral working party and organized a series of bilateral meetings and visits to factories. Actions arising included a baseline survey of population salt consumption patterns and the implementation of a series of pilot salt reduction initiatives.
Results: The results of the baseline assessment revealed that average daily intake of salt, based on 24 hour urine samples from a representative national sample (n=1,027), was 11.06±5.99 g in 2011, more than double the World Health Organization (WHO) five grams recommendation. Moreover, while most participants knew that salt was bad for health, few were taking efforts to reduce intake, and many were consuming highly salty meals and tea; salt in tea alone was estimated to contribute 30% of daily salt intake. A pilot Pinch Salt intervention to reduce salt consumption of factory workers was undertaken in Ulaanbaatar (UB) city between 2012 and 2013, and was associated with a reduction of 2.8 g of salt intake. Ongoing food industry initiatives have led to significant reductions in salt levels in bread, and companies producing processed meat have indicated a willingness to reduce salt. Relevant stakeholders have also supported the campaign by participating in annual World Salt Awareness Week events. The activities to date have demonstrated the potential for action and there is now a need scale these up to a national level to ensure that Mongolia is in a strong position to achieve a 30% reduction in population salt intake by 2025. The main goal of the Mongolian national salt reduction strategy is to create a social, economic and legal environment that supports salt reduction, including by influencing food supply, increasing partnerships between government and relevant stakeholders, and creating an enabling environment to support improved consumer choices. The strategy will be implemented from 2015 to 2025, with an interim review of progress in 2020.
Conclusions: Given that Mongolia has one of the highest rates of stroke in the world, which is strongly associated with population-wide blood pressure (BP) levels, the addition of a population-based stroke surveillance program would provide a reliable direct assessment of the impact of these salt reduction initiatives on the health of the Mongolian people. The results from this research would likely be widely generalizable to other populations experiencing similar lifestyle transitional changes.
K
Twenty two years of idd elimination efforts in sudanAlexander Decker
1) Sudan has been working to eliminate iodine deficiency disorders (IDD) since 1989 through their national IDD control program which adopted universal salt iodization (USI) as their strategy in 1994.
2) Despite three federal decrees since 1994 requiring salt fortification with iodine and three state laws prohibiting non-iodized salt, implementation has not been enforced.
3) The document proposes using existing national laws on standards, public health, and food inspection to issue a compulsory national salt standard along with strengthened monitoring between the Ministry of Health and standards organization.
The document discusses India's National Iodine Deficiency Disorder Control Programme. It notes that iodine deficiency can cause goiter and other health issues. The programme aims to provide iodized salt to at-risk regions, educate the public, and monitor iodine levels. Key objectives include assessing iodine deficiency, supplying iodized salt, education, and monitoring impacts. The programme was later expanded to promote universal iodized salt consumption and strengthen monitoring.
To support governments as they develop national food and nutrition plans and targets, we have produced a new policy brief in collaboration with NCD Alliance.
The document discusses policies that can help reduce sugar consumption to meet WHO guidelines. It provides examples of policies that have successfully reduced the availability of sugary products, increased the acceptability of alternatives, and raised awareness of sugar content. These include school nutrition standards in Australia that eliminated high-sugar "red" foods and drinks from schools, front-of-package labels in the Netherlands that led food companies to reformulate products, and soda taxes in Mexico and France that made sugary drinks less affordable.
Salt reduction initiatives Malaysia, seminar with media 2015Feisul Mustapha
Malaysia has implemented several salt reduction initiatives to help achieve its national target of reducing average salt intake to 6.0g per day by 2025. The initiatives include public awareness campaigns, reformulating processed foods to contain less salt, establishing research on salt intake levels, and pursuing regulatory requirements for salt labeling. Monitoring through repeated national surveys shows average salt intake remains high, around 8-9g per day, indicating more efforts are needed across multiple strategies to successfully reduce population salt consumption.
NSM-NCD2013 Symposium 2b - Global NCD Challenges - Diet and Physical Inactivityappfromlab
This document discusses challenges related to diet, physical inactivity, and non-communicable diseases (NCDs) in Malaysia. It notes that diet and physical inactivity are major risk factors for NCDs in Malaysia. It calls for strengthened government policies and regulations to improve diets and limit the influence of food industries. These include restrictions on marketing of unhealthy foods, front-of-package food labeling, and increased funding for prevention programs. The document also stresses the importance of multisectoral action and accountability to make progress on global and national targets for reducing NCDs.
This document discusses food and public health, with a focus on the prevention of chronic diseases through population-level interventions targeting nutrition and lifestyle. It summarizes the experience of the North Karelia Project in Finland, which demonstrated that comprehensive community programs can successfully change risk factors like diet, physical activity and smoking rates. As a result, the project saw major declines in cardiovascular disease and mortality in the region. The document advocates for public health strategies that combine personal responsibility with supportive public policies to make healthy choices easier. Partnerships between governments, civil society and the private sector are also emphasized.
Strengthening ncd surveillance in malaysia, asean ncd forum 2013Feisul Mustapha
Zainal Ariffin Omar and Feisul Idzwan Mustapha. Strengthening NCD Surveillance in Malaysia. 15 September 2013. Working paper presented at the ASEAN Regional Forum on NCDs. Manila, Philippines.
Half a century of growth and modernisation have increased average life expectancy in the Gulf by over 30 years. But it has also shifted lifestyle patterns, bringing new health challenges due to poor diet and sedentary lifestyles, with a sharp rise in diabetes, cancer and cardiovascular disease. Our new infographic, sponsored by Philips, explores how the state of health in the Gulf has shifted over the last 60 years and what the new challenges are for the region.
-
Post intervention assessment will be done after every three months to measure the
outcomes.
Arrange: -
Arrange follow up meeting and laboratory investigation after every three months.
Motivational support will be provided to participants.
Rewards will be given to participants as per their achievement.
Certificates will be provided to participants at the end of intervention.
Feedback will be taken from all stakeholders.
Sustainability plan will be prepared.
Report will be submitted to Ministry of Health/local government.
Publication of results.
The World Hypertension League: where now and where to in salt reductionPaul Schoenhagen
Abstract: High dietary salt is a leading risk for death and disability largely by causing increased blood pressure. Other associated health risks include gastric and renal cell cancers, osteoporosis, renal stones, and increased disease activity in multiple sclerosis, headache, increased body fat and Meniere’s disease. The World Hypertension League (WHL) has prioritized advocacy for salt reduction. WHL resources and actions include a non-governmental organization policy statement, dietary salt fact sheet, development of standardized nomenclature, call for quality research, collaboration in a weekly salt science update, development of a process to set recommended dietary salt research standards and regular literature reviews, development of adoptable power point slide sets to support WHL positions and resources, and critic of weak research studies on dietary salt. The WHL plans to continue to work with multiple governmental and non-governmental organizations to promote dietary salt reduction towards the World Health Organization (WHO) recommendations.
This document discusses reducing sodium (salt) in foods through cooperation between the food industry and health authorities. It summarizes the proceedings of two working group meetings on the topic. The group aims to identify ways to lower sodium levels in processed foods to improve public health. Members shared strategies for reducing sodium using the 3Rs approach and progress reports. The working group plans to establish sodium reduction targets for different food categories and provide consumers information on sodium content. The overall goal is to contribute to a national action plan and survey on delivering sodium reductions in Hong Kong foods.
This WHO guideline provides the following recommendations on potassium intake:
- Adults should increase their potassium intake from food to at least 90 mmol/day to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease.
- Children's potassium intake from food should be increased to control blood pressure as they age. The recommended intake of at least 90 mmol/day should be adjusted downward based on children's lower energy needs compared to adults.
- These recommendations aim to help countries develop public health programs and policies to increase potassium consumption and reduce noncommunicable diseases. If populations consume the recommended levels of sodium and potassium, the ratio between the two would be approximately 1:1, which is considered beneficial for health.
NSM-NCD2013 Keynote Address - Multi-Sectoral Approach(MSA) to Prevent Non-Com...appfromlab
This keynote address discusses the multi-sectoral approach to preventing non-communicable diseases. It notes the underlying determinants and common risk factors that lead to NCDs like heart disease, diabetes, cancer and chronic lung disease. A multi-sectoral approach is needed to address modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and harmful alcohol use. Challenges to operationalizing this approach include a lack of coordination across sectors and no shared targets or accountability. Establishing national plans and global targets in line with WHO guidelines can help define roles and facilitate a multi-sectoral response to reducing NCD burden.
The document discusses policies to reduce sugar consumption globally in order to address rising rates of obesity and related diseases. It provides examples of policies that have successfully influenced the availability, affordability, acceptability, and awareness of sugar. These include school nutrition standards in Australia that reduced the availability of sugary foods and drinks in schools, soda taxes in Mexico and France that increased the affordability of healthier alternatives, and marketing campaigns in the US that raised awareness of sugar content in foods and drinks. The document advocates for comprehensive, multi-pronged policies across sectors to meaningfully curb sugar intake worldwide.
The document summarizes the SHAKE Technical Package for Salt Reduction submitted by Karishma Ubale & Standee P Weah. The SHAKE package was designed by WHO to help countries develop, implement, and monitor salt reduction strategies. It outlines effective policies and interventions to reduce population salt intake, including surveillance of salt consumption, harnessing industry to reformulate foods, adopting food labeling standards, public education campaigns, and supporting salt reduction in community settings. The package provides tools and case studies to guide national salt reduction programs.
NCD Planning: Current Stats and Opportunities for StrokeFeisul Mustapha
The document discusses non-communicable diseases (NCDs) planning in Malaysia and opportunities for stroke prevention. It summarizes the 2014 UN General Assembly outcome document on NCDs which outlines national commitments and global assignments between 2014-2018. These include setting national NCD targets and developing multisectoral policies and plans. It also discusses Malaysia's national strategic plan for NCDs from 2010-2014 and efforts to strengthen chronic disease management at the primary care level through multidisciplinary care teams and clinical practice guidelines. Availability of essential medicines for NCDs and lessons learned from working with other sectors are also covered.
The SADC AIDS WATCH AFRICA (AWA) Summit was held to discuss progress and challenges in HIV/AIDS, TB, and malaria in the region. Key issues discussed included logistical, financial, and human rights barriers to testing and treatment, as well as the importance of nutrition in disease management. The Summit directed SADC countries to develop strategies to address these challenges, including lobbying for increased global health funding, promoting local drug production and procurement, and creating a SADC nutrition strategy. Ministers of Health were tasked with presenting recommendations on implementing solutions at the next SADC Summit in 2014.
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Analysing Research on Cancer Prevention and Survival: Recommendationsnzhempfoods
World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) champions the latest and most authoritative scientific research from around the world on cancer prevention and survival through diet, nutrition and physical activity to help people make informed lifestyle choices to reduce their cancer risk.
The document discusses policies that can help reduce sugar consumption to meet WHO guidelines. It provides examples of policies that have successfully reduced the availability of sugary products, increased the acceptability of alternatives, and raised awareness of sugar content. These include school nutrition standards in Australia that eliminated high-sugar "red" foods and drinks from schools, front-of-package labels in the Netherlands that led food companies to reformulate products, and soda taxes in Mexico and France that made sugary drinks less affordable.
Salt reduction initiatives Malaysia, seminar with media 2015Feisul Mustapha
Malaysia has implemented several salt reduction initiatives to help achieve its national target of reducing average salt intake to 6.0g per day by 2025. The initiatives include public awareness campaigns, reformulating processed foods to contain less salt, establishing research on salt intake levels, and pursuing regulatory requirements for salt labeling. Monitoring through repeated national surveys shows average salt intake remains high, around 8-9g per day, indicating more efforts are needed across multiple strategies to successfully reduce population salt consumption.
NSM-NCD2013 Symposium 2b - Global NCD Challenges - Diet and Physical Inactivityappfromlab
This document discusses challenges related to diet, physical inactivity, and non-communicable diseases (NCDs) in Malaysia. It notes that diet and physical inactivity are major risk factors for NCDs in Malaysia. It calls for strengthened government policies and regulations to improve diets and limit the influence of food industries. These include restrictions on marketing of unhealthy foods, front-of-package food labeling, and increased funding for prevention programs. The document also stresses the importance of multisectoral action and accountability to make progress on global and national targets for reducing NCDs.
This document discusses food and public health, with a focus on the prevention of chronic diseases through population-level interventions targeting nutrition and lifestyle. It summarizes the experience of the North Karelia Project in Finland, which demonstrated that comprehensive community programs can successfully change risk factors like diet, physical activity and smoking rates. As a result, the project saw major declines in cardiovascular disease and mortality in the region. The document advocates for public health strategies that combine personal responsibility with supportive public policies to make healthy choices easier. Partnerships between governments, civil society and the private sector are also emphasized.
Strengthening ncd surveillance in malaysia, asean ncd forum 2013Feisul Mustapha
Zainal Ariffin Omar and Feisul Idzwan Mustapha. Strengthening NCD Surveillance in Malaysia. 15 September 2013. Working paper presented at the ASEAN Regional Forum on NCDs. Manila, Philippines.
Half a century of growth and modernisation have increased average life expectancy in the Gulf by over 30 years. But it has also shifted lifestyle patterns, bringing new health challenges due to poor diet and sedentary lifestyles, with a sharp rise in diabetes, cancer and cardiovascular disease. Our new infographic, sponsored by Philips, explores how the state of health in the Gulf has shifted over the last 60 years and what the new challenges are for the region.
-
Post intervention assessment will be done after every three months to measure the
outcomes.
Arrange: -
Arrange follow up meeting and laboratory investigation after every three months.
Motivational support will be provided to participants.
Rewards will be given to participants as per their achievement.
Certificates will be provided to participants at the end of intervention.
Feedback will be taken from all stakeholders.
Sustainability plan will be prepared.
Report will be submitted to Ministry of Health/local government.
Publication of results.
The World Hypertension League: where now and where to in salt reductionPaul Schoenhagen
Abstract: High dietary salt is a leading risk for death and disability largely by causing increased blood pressure. Other associated health risks include gastric and renal cell cancers, osteoporosis, renal stones, and increased disease activity in multiple sclerosis, headache, increased body fat and Meniere’s disease. The World Hypertension League (WHL) has prioritized advocacy for salt reduction. WHL resources and actions include a non-governmental organization policy statement, dietary salt fact sheet, development of standardized nomenclature, call for quality research, collaboration in a weekly salt science update, development of a process to set recommended dietary salt research standards and regular literature reviews, development of adoptable power point slide sets to support WHL positions and resources, and critic of weak research studies on dietary salt. The WHL plans to continue to work with multiple governmental and non-governmental organizations to promote dietary salt reduction towards the World Health Organization (WHO) recommendations.
This document discusses reducing sodium (salt) in foods through cooperation between the food industry and health authorities. It summarizes the proceedings of two working group meetings on the topic. The group aims to identify ways to lower sodium levels in processed foods to improve public health. Members shared strategies for reducing sodium using the 3Rs approach and progress reports. The working group plans to establish sodium reduction targets for different food categories and provide consumers information on sodium content. The overall goal is to contribute to a national action plan and survey on delivering sodium reductions in Hong Kong foods.
This WHO guideline provides the following recommendations on potassium intake:
- Adults should increase their potassium intake from food to at least 90 mmol/day to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease.
- Children's potassium intake from food should be increased to control blood pressure as they age. The recommended intake of at least 90 mmol/day should be adjusted downward based on children's lower energy needs compared to adults.
- These recommendations aim to help countries develop public health programs and policies to increase potassium consumption and reduce noncommunicable diseases. If populations consume the recommended levels of sodium and potassium, the ratio between the two would be approximately 1:1, which is considered beneficial for health.
NSM-NCD2013 Keynote Address - Multi-Sectoral Approach(MSA) to Prevent Non-Com...appfromlab
This keynote address discusses the multi-sectoral approach to preventing non-communicable diseases. It notes the underlying determinants and common risk factors that lead to NCDs like heart disease, diabetes, cancer and chronic lung disease. A multi-sectoral approach is needed to address modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and harmful alcohol use. Challenges to operationalizing this approach include a lack of coordination across sectors and no shared targets or accountability. Establishing national plans and global targets in line with WHO guidelines can help define roles and facilitate a multi-sectoral response to reducing NCD burden.
The document discusses policies to reduce sugar consumption globally in order to address rising rates of obesity and related diseases. It provides examples of policies that have successfully influenced the availability, affordability, acceptability, and awareness of sugar. These include school nutrition standards in Australia that reduced the availability of sugary foods and drinks in schools, soda taxes in Mexico and France that increased the affordability of healthier alternatives, and marketing campaigns in the US that raised awareness of sugar content in foods and drinks. The document advocates for comprehensive, multi-pronged policies across sectors to meaningfully curb sugar intake worldwide.
The document summarizes the SHAKE Technical Package for Salt Reduction submitted by Karishma Ubale & Standee P Weah. The SHAKE package was designed by WHO to help countries develop, implement, and monitor salt reduction strategies. It outlines effective policies and interventions to reduce population salt intake, including surveillance of salt consumption, harnessing industry to reformulate foods, adopting food labeling standards, public education campaigns, and supporting salt reduction in community settings. The package provides tools and case studies to guide national salt reduction programs.
NCD Planning: Current Stats and Opportunities for StrokeFeisul Mustapha
The document discusses non-communicable diseases (NCDs) planning in Malaysia and opportunities for stroke prevention. It summarizes the 2014 UN General Assembly outcome document on NCDs which outlines national commitments and global assignments between 2014-2018. These include setting national NCD targets and developing multisectoral policies and plans. It also discusses Malaysia's national strategic plan for NCDs from 2010-2014 and efforts to strengthen chronic disease management at the primary care level through multidisciplinary care teams and clinical practice guidelines. Availability of essential medicines for NCDs and lessons learned from working with other sectors are also covered.
The SADC AIDS WATCH AFRICA (AWA) Summit was held to discuss progress and challenges in HIV/AIDS, TB, and malaria in the region. Key issues discussed included logistical, financial, and human rights barriers to testing and treatment, as well as the importance of nutrition in disease management. The Summit directed SADC countries to develop strategies to address these challenges, including lobbying for increased global health funding, promoting local drug production and procurement, and creating a SADC nutrition strategy. Ministers of Health were tasked with presenting recommendations on implementing solutions at the next SADC Summit in 2014.
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Analysing Research on Cancer Prevention and Survival: Recommendationsnzhempfoods
World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) champions the latest and most authoritative scientific research from around the world on cancer prevention and survival through diet, nutrition and physical activity to help people make informed lifestyle choices to reduce their cancer risk.
1) Dietary salt intake is linked to higher blood pressure and cardiovascular disease risk but has received less attention than other health issues. 2) Studies in the 1970s first showed the relationship between low salt intake and low blood pressure in an isolated Brazilian tribe. 3) The WHO raised concerns in 2003 about the global burden of chronic diseases related to diet and advocated for lower salt, saturated fat, and sugar intake. 4) The Dutch Health Council recommended a limit of 6 grams of salt per day in 2006, lower than the previous 9 gram limit, to reduce high national salt intake levels.
WHO ha rilasciato una nuova serie di parametri di riferimento globali per i livelli di sodio in oltre 60 categorie di alimenti che aiuteranno i paesi a ridurre il contenuto di sodio negli alimenti.
The document discusses promoting health and well-being in the Eastern Mediterranean Region. It outlines the 13th WHO General Programme of Work and Sustainable Development Goals, and the regional situation which includes the second highest maternal mortality and adolescent mortality rates as well as the steepest increases in diabetes, tobacco use, and obesity. It presents challenges such as inequities and the need for multisectoral approaches. Proposed frameworks for action are described for issues like obesity prevention, tobacco control, and environmental health to help monitor trends, fill policy gaps, and encourage consistency. The frameworks aim to use evidence-based interventions and multisectoral approaches to measure desired impacts by 2023 such as reducing childhood obesity and tobacco use.
South Africa has made progress in health since 1994 but still faces challenges. Life expectancy has increased from 49 years to 60 but health inequalities remain large between provinces. The quadruple burden of disease includes communicable diseases, chronic diseases, injuries, and HIV/AIDS. The National Health Insurance and re-engineering of primary health care aim to improve access and quality but face challenges in implementation. Continued efforts are needed to address social determinants of health and implement priority initiatives to reduce health inequities.
This document provides an overview of obesity and its prevalence in Malaysia. It discusses the major non-communicable diseases (NCDs) like heart disease, diabetes, cancers and chronic lung disease, and their common modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and alcohol use. It summarizes data from national health surveys showing increasing trends in obesity, diabetes, hypertension and hypercholesterolemia in Malaysia over time. It also discusses Malaysia's national strategic plan for NCD prevention and control from 2010-2014 and commitments under the WHO Global Action Plan to reduce NCDs.
Prevention and Control of Non-Communicable diseases (NCDs).pptxJaydeep Ghevariya
The document discusses the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS) in India. It aims to prevent and control common NCDs like cardiovascular diseases, diabetes, cancers and strokes through a comprehensive and multisectoral approach. Key activities include health promotion, screening, diagnosis and management of risk factors, and strengthening healthcare facilities. The program is implemented through primary, secondary and tertiary levels and focuses on both communicable and non-communicable diseases.
Similar to WHO’s supported interventions on salt intake reduction in the sub-Saharan Africa region (20)
Sodium content in processed foods in Argentina: compliance with the national lawPaul Schoenhagen
Background: Despite the body of evidence that documents the unfavorable effects of excessive sodium
consumption on blood pressure and cardiovascular health, public health efforts to decrease sodium consumption
have been limited to a few countries. Argentina is the first country in Latin America to regulate sodium content of
processed foods by means of a national law. The objective of this cross-sectional quantitative study is to provide a
baseline comparison against the reduction targets set by the national law before its entry into force.
Methods: Data were collected in February 2014 in a leading supermarket chain located in Buenos Aires.
Nutrient data from package labels were analysed for 1,320 products within 14 food groups during the study
period. To compare sodium concentration levels with the established maximum levels we matched the
collected food groups with the food groups included in the law resulting in a total of 292 products. Data
analysis was conducted using SPSS version 20 software.
Results: Food groups with the highest median sodium content were sauces and spreads (866.7 mg/100 g),
meat and meat products (750 mg/100 g) and snack foods (644 mg/100 g). Categories with the highest sodium
content were appetizers (1,415 mg/100 g), sausages (1,050 mg/100 g) and ready-made meals (940.7 mg/100 g).
We also found large variability within products from the same food categories. Products included in the
national law correspond to 22.1% (n=292) of the surveyed foods. From the 18 food groups, 15 showed
median sodium values below the established targets. Products exceeding the established maximum levels
correspond to 15.1% (n=44) of the products included in the analysis.
Conclusions: This study is the first analysis of food labels to determine sodium concentrations of processed
foods in Argentina and to provide a baseline against the national law standards. Upon the completion of
this analysis, maximum levels have been achieved by most of the food groups included in the law. Thus, the
introduction of further reductions for the existing maximum levels and the establishment of sodium targets for
all relevant product categories not included in the law should be considered as the next steps in the process.
Salt reduction and hypertension in China: a concise state-of-the-art reviewPaul Schoenhagen
Abstract: Hypertension (HTN) and its cardiovascular complications such as stroke and heart failure are a serious public health problem around the world. A growing number of studies confirm that salt plays an important role in the development of HTN. Increasing intake of salt leads to abnormal transport of sodium ions at the cellular level with activation of the sympathetic nervous system and renin-angiotensin-aldosterone system. Studies have shown that salt restriction can reduce blood pressure (BP) in patients with HTN, especially salt-sensitive HTN. Public health interventions to reduce salt intake, with the goal of decreasing adverse outcomes have been launched in numerous countries. In this review we will summarize the epidemiology of cardiovascular diseases and their risk factors, the relationship between salt and HTN, the effect of salt restriction on HTN and the current situation of prevention and treatment of HTN by salt reduction in China.
A new polymer-free drug-eluting stent with nanocarriers eluting sirolimus fro...Paul Schoenhagen
Background: Permanent polymers in first generation drug-eluting stent (DES) have been imputed to be a possible cause of persistent inflammation, remodeling, malapposition and late stent thrombosis. We aim to describe the in vivo experimental result of a new polymer-free DES eluting sirolimus from stent-plus-balloon (Focus np stent, Envision Scientific) compared with a bare-metal stent (BMS) (Amazonia CroCo, Minvasys) and with a biolimus A9 eluting stent (Biomatrix, Biosensors).
Goal attainments and their discrepancies for low density lipoprotein choleste...Paul Schoenhagen
Purpose: Low density lipoprotein cholesterol (LDL-C) is primary treatment target for patients with dislipidemia. The apolipoprotein B (apo B), an emerging biomarker for cardiovascular risk prediction, appears to be superior to the LDL-C. However, little is known about goal attainments and their discrepancies for LDL-C and apo B in Chinese patients with known CAD or DM.
Improved non-calcified plaque delineation on coronary CT angiography by sonog...Paul Schoenhagen
Purpose: To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP).
Hemodynamic assessment of partial mechanical circulatory support: data derive...Paul Schoenhagen
Partial mechanical circulatory support represents a new concept for the treatment of advanced heart failure. The Circulite Synergy Micro Pump®, where the inflow cannula is connected to the left atrium and the outflow cannula to the right subclavian artery, was one of the first devices to introduce this concept to the clinic. Using computational fluid dynamics (CFD) simulations, hemodynamics in the aortic tree was visualized and quantified from computed tomography angiographic (CTA) images in two patients. A realistic computational model was created by integrating flow information from the native heart and from the Circulite device. Diastolic flow augmentation in the descending aorta but competing/antagonizing flow patterns in the proximal innominate artery was observed. Velocity time curves in the ascending aorta correlated well with those in the left common carotid, the left subclavian and the descending aorta but poorly with the one in the innominate. Our results demonstrate that CFD may be useful in providing a better understanding of the main flow patterns in mechanical circulatory support devices.
Spontaneous coronary artery dissection (SCAD) is an infrequent and often missed diagnosis among patients presenting with acute coronary syndrome (ACS). Unfortunately, SCAD can result in significant morbidities such as myocardial ischemia and infarction, ventricular arrhythmias and sudden cardiac death. Lack of angiographic recognition from clinicians is a major factor of under-diagnosis. With the advent of new imaging modalities, particularly with intracoronary imaging, there has been improved diagnosis of SCAD. The aim of this paper is to review the epidemiology, etiology, presentation, diagnosis and management of SCAD.
microRNA-based diagnostics and therapy in cardiovascular disease—Summing up t...Paul Schoenhagen
This document discusses microRNAs (miRNAs) as potential biomarkers for cardiovascular disease diagnosis and therapy. It summarizes that miRNAs have been found to be specifically up or downregulated in different cardiovascular diseases and animal models. Circulating miRNAs have shown promise as biomarkers for conditions like myocardial infarction and coronary artery disease due to their stability and disease-specific expression patterns. Several miRNAs have been identified as biomarkers for acute myocardial infarction that may complement or improve upon existing protein biomarkers. Research is also exploring the potential of miRNA-based therapies for cardiovascular diseases.
Impact of statins and beta-blocker therapy on mortality after coronary artery...Paul Schoenhagen
Background: We conducted a retrospective cohort study of patients after first-time isolated coronary artery bypass graft surgery (CABG) and assessed the impact of a discharge regimen including beta-blockers and statin therapy and their relationship to long-term all cause mortality and major adverse cardiovascular events (MACE).
Methods: We identified patients age >18 years, undergoing first time isolated CABG from 1993 to 2005. Patients were identified using the Cardiovascular Information Registry (CVIR). We collected follow-up information at 30, 60, 90 days and yearly follow-up. The registry is approved for use in research by the institutional review broad.
Results: We identified 5,205 patients who underwent single isolated CABG between January 1993 and December 2005. The mean age was 64.5±9.7 years and over 70% were male. There was a significant difference in the low density lipoproteins (LDL) concentration between those with or without statin medications (134±41.9 mg/dL) (no statin) vs. 126±44.8 mg/dL (with statin), P=0.001. A discharge regimen with statin therapy was associated with and overall reduction in 30 day, 1 year and long-term mortality. In addition, overall the triple ischemic endpoint of death, myocardial infarction (MI) and stroke was also significantly lower in the statin vs. no-statin group. In addition, statin and beta-blockers exerted synergistic effect on overall mortality outcomes short-term and in the long-term. We note that the predictors of overall death include no therapy with statin therapy and age [hazard ratios (HR) 1.1, 95% CI: 1.04-1.078, P<0.001] and presence of renal failure (HR 2.0, P=0.005). The estimated 11-year Kaplan Meier curves for mortality between the two groups starts to diverge immediately post discharge after single isolated CABG and continue to diverge through out the follow-up period.
Conclusions: A post-discharge regimen of statins independently reduces overall and 1 year mortality. These results confirm those of earlier studies within a contemporary surgical population and support the current clinical guidelines.
Carotid intima-media thickness (CIMT) and carotid plaques in young Nepalese p...Paul Schoenhagen
Abstract
Background: Carotid intima-media thickness (CIMT) and carotid plaques are non-invasive surrogate markers of early evaluation of coronary artery disease (CAD) and sub clinical atherosclerosis. The objective of the study was to evaluate CIMT and carotid plaques in less than 45 years old Nepalese patients with angiographically proven CAD.
Methods: A total of 54 patients with angiographically documented CAD at less than 45 years of age were enrolled. CAD was confirmed by coronary angiography. Demographic profile was obtained. High resolution B-mode ultrasound was used to detect the CIMT and carotid plaques.
Results: The study population included 44 males and 10 females, with a mean ± SD age of 38.4±4.3 years (range, 25-44 years). Cardiovascular risks factors included smoking in 81%, Hypertension in 52%, diabetes in 19% and alcohol consumption in 78% of patients. Lipid profile (mean ± SD) was normal except for elevated triglyceride (TG) levels of 204±130.8 mg/dL. By angiography, 64.8% had single vessel disease, 26% had double vessel disease and 9.2% had triple vessel disease. Ultrasound detected either thickened CIMT or presence of plaques in 46 (85.2%) cases (group-A) and 8 (14.8%) had negative (normal) carotid study (group-B). Among the 46 patients with positive findings 63% had carotid plaques and 37% had thickened CIMT only. The majority (69%) of the carotid plaques were detected at the carotid bulbs. In total population, carotid plaque was detected in 53.7% of cases. There was no statistical significant difference of age, body mass index (BMI) and lipid level between group-A and group-B.
Conclusions: Increased CIMT and carotid plaques are detected in majority of the young Nepalese patients with angiographically documented CAD. The majority of carotid plaques are detected at the carotid bulbs. Routine carotid ultrasound study in young individuals with CAD risk factors appears worthwhile.
Impact of statins and beta-blocker therapy on mortality after coronary artery...Paul Schoenhagen
Abstract
Background: We conducted a retrospective cohort study of patients after first-time isolated coronary artery bypass graft surgery (CABG) and assessed the impact of a discharge regimen including beta-blockers and statin therapy and their relationship to long-term all cause mortality and major adverse cardiovascular events (MACE).
Methods: We identified patients age >18 years, undergoing first time isolated CABG from 1993 to 2005. Patients were identified using the Cardiovascular Information Registry (CVIR). We collected follow-up information at 30, 60, 90 days and yearly follow-up. The registry is approved for use in research by the institutional review broad.
Results: We identified 5,205 patients who underwent single isolated CABG between January 1993 and December 2005. The mean age was 64.5±9.7 years and over 70% were male. There was a significant difference in the low density lipoproteins (LDL) concentration between those with or without statin medications (134±41.9 mg/dL) (no statin) vs. 126±44.8 mg/dL (with statin), P=0.001. A discharge regimen with statin therapy was associated with and overall reduction in 30 day, 1 year and long-term mortality. In addition, overall the triple ischemic endpoint of death, myocardial infarction (MI) and stroke was also significantly lower in the statin vs. no-statin group. In addition, statin and beta-blockers exerted synergistic effect on overall mortality outcomes short-term and in the long-term. We note that the predictors of overall death include no therapy with statin therapy and age [hazard ratios (HR) 1.1, 95% CI: 1.04-1.078, P<0.001] and presence of renal failure (HR 2.0, P=0.005). The estimated 11-year Kaplan Meier curves for mortality between the two groups starts to diverge immediately post discharge after single isolated CABG and continue to diverge through out the follow-up period.
Conclusions: A post-discharge regimen of statins independently reduces overall and 1 year mortality. These results confirm those of earlier studies within a contemporary surgical population and support the current clinical guidelines.
Cardiac imaging in prosthetic paravalvular leaksPaul Schoenhagen
This document discusses cardiac imaging techniques used in the diagnosis and treatment of prosthetic paravalvular leaks (PVLs). Echocardiography, especially 3D transoesophageal echocardiography (TEE), plays a key role in initially diagnosing PVLs, guiding percutaneous closure procedures, and evaluating outcomes. While transthoracic echocardiography is often first used, TEE is needed to confirm clinically significant leaks. Additional techniques like CT, MRI, and angiography can provide further detail. Intraprocedural imaging with TEE and fluoroscopy helps interventional cardiologists properly position closure devices and confirm adequate sealing of leaks.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.