This document discusses non-communicable diseases (NCDs), which are medical conditions that are not caused by infectious agents. NCDs include chronic diseases like heart disease, cancer, diabetes, and more. The document outlines that NCDs are the leading cause of death globally, with risk factors like lifestyle and environment increasing risks. It also discusses key NCDs like cancer, cardiovascular disease, diabetes, and chronic kidney disease in more detail.

1. BY
DR. PAWAN KUMAR
MMH COLLEGE GHAZIABAD

2. non-communicable disease (NCD
A non-communicable disease (NCD) is a medical
condition or disease that is not caused by infectious
agents (non-infectious or non-transmissible). NCDs
can refer to chronic diseases which last for long
periods of time and progress slowly. Sometimes, NCDs
result in rapid deaths such as seen in certain diseases
such as autoimmune diseases, heart
diseases, stroke, cancers, diabetes, chronic kidney
disease, osteoporosis, Alzheimer's disease, cataracts,
and others.

3. While sometimes referred to as synonymous with
"chronic diseases", NCDs are distinguished only by
their non-infectious cause, not necessarily by their
duration, though some chronic diseases of long
duration may be caused by infections. Chronic
diseases require chronic care management, as do all
diseases that are slow to develop and of long duration.

4. NCDs are the leading cause of death globally. In 2012,
they caused 68% of all deaths (38 million) up from 60%
in 2000.About half were under age 70 and half were
women. Risk factors such as a person's background,
lifestyle and environment increase the likelihood of
certain NCDs. Every year, at least 5 million people die
because of tobacco use and about 2.8 million die from
being overweight. High cholesterol accounts for roughly
2.6 million deaths and 7.5 million die because of high
blood pressure.

5. Risk factors
Risk factors such as a person's background; lifestyle and
environment are known to increase the likelihood of
certain non-communicable diseases. They include
age, gender, genetics, exposure to air pollution, and
behaviors such as smoking, unhealthy
diet and physical inactivity which can lead
to hypertension and obesity, in turn leading to
increased risk of many NCDs. Most NCDs are
considered preventable because they are caused by
modifiable risk factors.

6. The WHO's World Health Report 2002 identified five
important risk factors for non-communicable disease
in the top ten leading risks to health. These are raised
blood pressure, raised cholesterol, tobacco use, alcohol
consumption, and overweight. The other factors
associated with higher risk of NCDs include a person's
economic and social conditions, also known as the
"[social determinants of health]."

7. It has been estimated that if the primary risk factors
were eliminated, 80% of the cases of heart disease,
stroke and type 2 diabetes and 40% of cancers could be
prevented. Interventions targeting the main risk
factors could have a significant impact on reducing the
burden of disease worldwide. Efforts focused on better
diet and increased physical activity have been shown
to control the prevalence of NCDs .

8. Environmental diseases
Environmental diseases
NCDs include many environmental diseases covering a
broad category of avoidable and unavoidable human
health conditions caused by external factors, such as
sunlight, nutrition, pollution, and lifestyle choices.
The diseases of affluence are non-infectious diseases
with environmental causes. Examples include:

9.  Chronic obstructive pulmonary disease (COPD)
caused by smoking tobacco
 Diabetes mellitus type 2
 Lower back pain caused by too little exercise
 Malnutrition caused by too little food, or eating the
wrong kinds of food (e.g. scurvy from lack of Vitamin
C)
 Skin cancer caused by radiation from the sun
 Obesity

10. Inherited diseases
 Genetic disorders are caused by errors in genetic
information that produce diseases in the affected
people. The origin of these genetic errors can be:
 Spontaneous errors or mutations to the genome:
 A change in chromosome numbers, such as Down
syndrome.
 A defect in a gene caused by mutation, such as Cystic
fibrosis.
 An increase in the amount of genetic information,
such as Chimerism or Heterochromia

11. Cystic fibrosis is an example of an inherited disease
that is caused by a mutation on a gene. The faulty gene
impairs the normal movement of sodium chloride in
and out of cells, which causes the mucus-secreting
organs to produce abnormally thick mucus. The gene
is recessive, meaning that a person must have two
copies of the faulty gene for them to develop the
disease. Cystic fibrosis affects the respiratory, digestive
and reproductive systems, as well as the sweat glands.
The mucus secreted is very thick and blocks
passageways in the lungs and digestive tracts.

12.  Inherited genetic errors from parents:
 Dominant genetic diseases, such as Huntingtons,
require the inheritance of one erroneous gene to be
expressed.
 Recessive genetic diseases require the inheritance of
erroneous genes to be expressed and this is one reason
they work together.

13. Global health
Referred to as a "lifestyle" disease, because the majority
of these diseases are preventable illnesses, the most
common causes for non-communicable diseases (NCD)
include tobacco use (smoking), alcohol abuse, poor diets
(high consumption of sugar, salt, saturated fats, and
trans fatty acids) and physical inactivity. Currently, NCD
kills 36 million people a year, a number that by some
estimates is expected to rise by 17–24% within the next
decade

14. Historically, many NCDs were associated with
economic development and were so-called a "diseases
of the rich". The burden of non-communicable
diseases in developing countries has increased
however, with an estimated 80% of the four main types
of NCDs — cardiovascular diseases, cancers, chronic
respiratory diseases and diabetes — now occurring in
low- and middle-income countries

15. Action Plan for the Global Strategy for the Prevention
and Control of non-communicable Diseases and with
two-thirds of people who are affected by diabetes now
residing in developing nations, NCD can no longer be
considered just a problem affecting affluent estimation
of the economic impact of chronic non-communicable
diseases in selected countries.

16. New WHO report: deaths from non-communicable
diseases are on the rise, with developing world hit
hardest. As previously stated, in 2008 alone, NCD's
were the cause of 63% of deaths worldwide; a number
that is expected to rise considerably in the near future
if measures are not taken.

17. If present growth trends are maintained, by 2020,
NCDs will attribute to 7 out of every 10 deaths in
developing countries, killing 52 million people
annually worldwide by 2030. With statistics such as
these, it comes as no surprise that international
entities such as the World Health Organization &
World Bank Human Development Network have
identified the prevention and control of NCDs as an
increasingly important discussion item on the global
health agenda.

18. Thus, should policy makers and communities mobilize
"and make prevention and targeted treatment of such
diseases a priority," sustainable measures can be
implemented to stagnate (and eventually even reverse) this
emerging global health threat. Potential measures
currently being discussed by the(World Health
Organization)-Food and Agriculture Organization includes
reducing the levels of salt in foods, limiting inappropriate
marketing of unhealthy foods and non-alcoholic beverages
to children, imposing controls on harmful alcohol use,
raising taxes on tobacco, and curbing legislation to curb
smoking in public places.

19. Key diseases
Cancer For the vast majority of cancers, risk factors are
environmental or lifestyle-related, thus cancers are
mostly preventable NCD.[1 Greater than 30% of cancer is
preventable via avoiding risk factors including: tobacco,
being overweight or obesity, low fruit and vegetable
intake, physical inactivity, alcohol, sexually transmitted
infections, and air pollution. Infectious agents are
responsible for some cancers, for instance almost
all cervical cancers are caused by human
papillomavirus infection.

20. Cardiovascular disease The first studies on
cardiovascular health were performed in 1949 by Jerry
Morris using occupational health data and were
published in 1958. The causes, prevention, and/or
treatment of all forms of cardiovascular disease remain
active fields of biomedical research, with hundreds of
scientific studies being published on a weekly basis. A
trend has emerged, particularly in the early 2000s, in
which numerous studies have revealed a link between
fast food and an increase in heart disease.

21. Diabetes Type 2 Diabetes Mellitus is a chronic
condition which is largely preventable and manageable
but difficult to cure. Management concentrates on
keeping blood sugar levels as close to normal
("euglycemia") as possible without presenting
undue patient danger. This can usually be with close
dietary management, exercise, and use of appropriate
medications (insulin only in the case of type 1 diabetes
mellitus. Oral medications may be used in the case of
type 2 diabetes, as well as insulin).

22. Chronic kidney disease Although chronic kidney disease
(CKD) is not currently identified as one of WHO's main
targets for global NCD control, there is compelling
evidence that CKD is not only common, harmful and
treatable but also a major contributing factor to the
incidence and outcomes of at least three of the diseases
targeted by WHO (diabetes, hypertension and CVD).CKD
strongly predisposes to hypertension and CVD; diabetes,
hypertension and CVD are all major causes of CKD; and
major risk factors for diabetes, hypertension and CVD
(such as obesity and smoking) also cause or exacerbate
CKD.

23. These studies include those conducted by the Ryan
Mackey Memorial Research Institute, Harvard
University and the Sydney Center for Cardiovascular
Health. Many major fast food chains, particularly
McDonald's, have protested the methods used in these
studies and have responded with healthier menu
options.