NCD Prevention Flashcards
Primary prevention
Reduce incidence
Pre-pathogenesis
Health promotion and specific protection
Health promotion (general level)
Env modifications
Nutritional interventions
Lifestyle and Behavioural changes
Health education
Specific protection
Targets type or group of diseases
Immunisation
Specific nutrients or supplementations
Protection against occupational hazards
Control of env hazards
High risk approach
Focuses on Indivs at greatest risk of disease
But they may contribute little to overall burden of disease in popn
Adv: Subject and Physician motivation , interventions appropriate to indiv , cost effective use of resources , favourable benefit to risk ratio
Disadv: temporary (does not alter underlying causes), Behaviorally inappropriate (inconvenient, against social norms) , power to predict future disease weak —> indiv with risk factor can remain well while unexpected illness can happen to someone with clear screening
Population approach
Reduce average risk in popn
Adv: radical (attempt to remove underlying causes), small reduction can lead to significant reduction , behaviourally appropriate (social norm changes)
Disadv: bring much benefit to community but offer little to each indiv , poor subject and physician motivation
Secondary prevention
Reduce prevalence by shortening duration
Detect disease sooner and make treatment more effective
Target indivs who are free or asymptomatic
Screening —> important health problem, high prevalence , natural history understood, long latency period , early detection improves prognosis
Tertiary prevention
Reduce complications/progression of disease
Target: patients
Treatment and rehabilitation
Life course approach
Understanding processes that operate across lifespan or generations
NCDs can be prevented and controlled at multiple stages of life
Critical period
Limited time window in which exposure can have adverse or protective effects on outcome
Outside this window, no excess disease risk
Sensitive period
Not temporarily fixed
Exposure can have greater impact than at another time
Increases risk but does not necessarily result in irreversible damage
Foetal origins hypothesis
Barker hypothesis
Adaptation for survival made by foetus raise risk of chronic disease risk in later life
Preconception, foetal development
Micronutrient deficiencies
Exposure to potentially harmful substances
Gestational diabetes, congenital anomalies
Infant development
Breastfeeding
Reduction in adolescent and adult obesity rates
Reduction in risk for asthma, leukemia and other NCDs
Reduction in incidence of diabetes
Screen time
Interactive — video games, communicating via Skype
Not interactive — sitting and watching movies
Educational — doing math hw online
Recreational — games or watching videos
Childhood and adolescence
Development of habits that will carry over into adulthood
Healthy behaviours initiated in childhood shd be maintained during adolescence
Adults, Elderly
Adult: maintaining highest possible level of function
Older age: maintaining independence and preventing disability
How well you started determines how well you end
Acceleration in decline can be reversible at any age and influenced thru env, indiv, policy level measures
Early life preventive measures require long term investment but can lead to large reductions in disease risk
Diet quality
Prevent heart disease, diabetes and other NCDs
Prevention weight gain
Appropriate intake of micronutrients and macronutrients
Micronutrient
Needed only in minuscule amounts
Enable body to produce enzymes, hormones
Folic acid
Green leafy veg, legumes (peas)
Folate deficient: cells unable to divide —> macrocyte , megaloblastic ; neural tube defects
Vitamin A
Liver, milk, cheese, eggs
Deficiency: Xerophthalmia (night blindness) , infections , anaemia (low iron status)
Macronutrients
Carbohydrate: glycaemic index —> how slowly/fast food causes increase in sugar level
Fruits and veg: vitamins, minerals, dietary fiber and antioxidants
Proteins: Lean/white meats , plant oils
No saturated and trans fat: increase risk of heart disease and stroke
No high sodium/salt: increase BP, CVD, stroke
No high sugars: increase risk of overweight/obesity, tooth decay, NCDs
Physical inactivity
6 to 10% of major NCDs worldwide attributable
Alcohol use
Heart disease, stroke, pancreatic, liver damage, poor judgement, slower reaction time (depressant), impaired speech and motor skills, loss of balance, depression, anxiety
Drink in moderation: per day not more than 1 drink (women) , 2 drinks (men)
Tobacco smoking
Kills up to half of users — direct use , exposed to secondhand smoke
Sensation short lived —> smoke a no of cigarettes thru the day to maintain stimulation (addiction)
