A global view on the development of non communicable diseases

Abstract

For a long time non communicable diseases (NCDs) were discussed as burden of the developed world. Recent alarming data show a reverse trend and a dramatic increase of NCDs in the developing world, in particular in highly populated transition countries. This is true for the main mortality triggering diseases such as CVD, cancer or diabetes. Almost 4 out of 5 NCD based deaths happen in low- and middle income countries. This development is multi-factorial and is based on some main trends such as globalization, supermarket growth, rapid urbanization and increasingly sedentary lifestyles. The latter leads to overweight or obesity, which again promotes NCDs similar as high blood pressure, high cholesterol and elevated blood glucose.

A high quality diet including functional food or functional ingredients, accompanied by physical activity and a non-smoking policy, is one of the most promising factors in primary and secondary prevention of NCDs.

Introduction

Of the 57 million global deaths in 2008, 63% or 36 million were due to non communicable diseases (NCDs) (Alwan et al., 2010) and annual NCD deaths are projected to further rise worldwide. NCDs which mainly comprise cardiovascular diseases (CVD), diabetes, cancers and chronic respiratory diseases were few decades ago, as popular believe presumes, typically found in developed countries due to the predominantly sedentary lifestyle (WHO, 2010a, WHO, 2010b).

However, the greatest increase is expected to be seen in highly populated low- and middle-income regions. Nearly 80% of NCD deaths occur in low- and middle-income countries and NCDs are the most frequent causes of death in most countries in the Americas, the Eastern Mediterranean, Europe, South-East Asia, and the Western Pacific, except in Africa. Even in African nations, NCDs are rising rapidly and are projected to exceed communicable, maternal, perinatal, and nutritional diseases as the most common causes of death by 2030 (WHO, 2008, WHO, 2010a, WHO, 2010b).

NCDs also lead to death at a younger age in low- and middle-income countries, where 29% of NCD deaths occur among people under the age of 60, compared to 13% in high-income countries. For cancer incidence, the estimated percentage increase by 2030, compared with 2008, will be greater in low- (82%) and lower-middle-income countries (70%) compared with the upper-middle- (58%) and high-income countries (40%) (Farmer et al., 2010, Ferlay et al., 2010, WHO, 2010a, WHO, 2010b). The same tendency is true for CVD and type 2 diabetes.