In my country, obesity and diabetes has reached great heights. The minister of health and the deputy Prime minister show great concern. The link shows a list of running, walking and swimming events. But I continue with my own fitness program using the gym and track in college. My students who are on the track with me are the ones who have been running for their schools and states.

http://www.mrxevents.com/race_calender.html

Its the same in Brunei. In 2011, Diabetes is the third: http://www.bt.com.bn/news-national/2011/11/25/diabetes-third-leading-cause-death-brunei.

In every school, physical education must be included as one of the curriculum subjects. Students are required to have fitness test at least once or twice a year as well as written exams.

I haven't got much details on the NCD Dr. Yeoh, but attached is some documents I've got from the net for 2010.

Thanks Fatimah. Actually Brunei is a rich nation!

Actually, I'm from a poor family; and my dad was so generous so many cousins came to stay with us, and he took care of us all. We got used to having 2 meals a day. I stick to that, so being from a poor family can be a blessing in disguise.

I do think Fatimh's comment is a good approach to tackle this issue.

Yes, thanks Samer. We have Physical education in the school time table and for college too. It's compulsory, 2 hours a week. Each game like hockey is usually after school, also 2 hours a week. I just got some extra info, when I surfed this morning on this matter...

'DASH eating plan, known to reduce blood pressure and bad cholesterol, also reduces the 10-year risk of heart attack, especially among African-Americans, according to research reported in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. The DASH eating plan emphasizes fruits, vegetables and low-fat dairy products as well as whole grains, poultry, fish and nuts.'

http://www.sciencedaily.com/releases/2010/08/100831164939.htm

It is spreading widely now. Changing the life style is the key for reducing its threat.

@Hashem and @Mario, thanks. Any details? any stats to add? Any links to share? Let's make this a useful thread.

This is the effect of fast food.

'Fast food and junk food are usually high in cholesterol, salt, calories and sugar. Some very bad fats called trans fats are usually found in fast food. Trans fats are by-products of hydrogenated oil. They behave like saturated fats when they get in the body. They clog up the human arteries and cause plaque to build up contributing to heart disease and stroke symptoms.'

http://www.healthy-eating-and-nutrition.com/high-cholesterol-foods.html

Dr. Yeoh, we are neighbouring countries, what's in yours can be seen in us... But the difference is we have smaller population. A rich nation doesn't mean the community is rich. We face the same universal problems i.e. poverty, but being a smaller country, the number is smaller.

God bless we have a generous ruler. And a fit ruler! He was the one who suggests to have compulsory physical education time in schools. He made visits to schools and met and talked to a number of obese primary school children. That's when it started.

I do agree with the negative effects of fast food and junk food. Easy to get them, easy to get the 'big' diseases too. ;)

@Fatimah, thanks. Yes, I agree that among rulers and leaders, your king is fit. I see that many leaders are on the way to being overweight, but he isn't so!

About the diseases related to consumption of fast food, once I surfed and found a link to something interesting on the amount of atherosclerosis in the arteries of dead soldiers (after 2 different wars), it was interesting; but I wasn't careful then to book mark it...sorry, I couldn't find it now.

I just got this news:

'Posted: 28 May 2014 05:42 PM PDT

Worldwide, there has been a startling increase in rates of obesity and overweight in both adults (28% increase) and children (up by 47%) in the past 33 years, with the number of overweight and obese people rising from 857 million in 1980 to 2.1 billion in 2013, according to a major new analysis. However, the rates vary widely throughout the world with more than half of the world’s 671 million obese individuals living in just ten countries—the USA, China and India, Russia, Brazil, Mexico, Egypt, Germany , Pakistan, and Indonesia.'

Thanks @Mario, I agree that obesity is growing exponentially. I managed to get this data on obesity in various countries. Sad, because the quality of life is affected. Many of us agree that quality of life is as important as quantity of years.

I got some info related to this thread, on the significance of walking as exercise:

'Posted: 17 Jun 2014 10:08 AM PDT

People who live in neighborhoods that are conducive to walking experienced a substantially lower rate of obesity, overweight and diabetes than those who lived in more auto-dependent neighborhoods, according to a pair of studies. Specifically, the studies found that people living in neighborhoods with greater walkability saw on average a 13 percent lower development of diabetes incidence over 10 years than those that were less walkable.'

To me, I think the whole world is gradually seating on a "Gun Powder" called NCDs. Most especially in many developing countries where the fight against communicable disease are still on-going. Whereas NCDs have overtaken this problems. Well, not much has been done to combat NCDs in my country, even in the developed nations not to talk of developing ones. This calls for a massive approach, research and funding with a quality base or center/branch which will be under one umbrella as an head-quarter in each country of the world to combat the problems. Serious intervention programs are required to achieve this.

Dear Prof Kamal, Sunday et al., do you know that in my community, people will attend a feast or home party to eat, but if we ask them to join us on the jogging track, we are considered as unusual creatures? Is this so in your countries? Since no one likes to exercise with me, I just go alone. And I have grown quite independent in a way...

But it's sad that people have wrong priorities.

People respond to the environment they live in. The only way to reduce smoking rates at the population level is through law and policy, including tax; the same is likely true for NCDs. We need to make healthy foods widely available, and make unhealthy foods more unattractive (ban ads) and expensive (tax, remove subsidies). And make it easier for people to incorporate physical activity into their daily lives through walking and cycling as transport, rather than expecting them to set aside time for exercise. I've uploaded on my profile a resource I co-wrote on NCD prevention that you may find useful.

The strategies to prevent NCDs are strongly based on health promotion strategies, implementing healthy public policies, examples show that smoking rates and smoking initiation have dropped since the smoke free spaces were implemented, as well as increase in taxes to increase price, and also with bigger warning on packages, finally with limiting publicity on TV and movies. Similarly, healthy spaces have increased the number of people that exercise, and who eat healthier foods, municipalities and cities everywhere have implemented walking and bike trails, farmers markets have increased access to vegetables and fruits. Community participation has increased awareness of the importance of healthy spaces, in school and workplaces. Social communication and social medial have increased the number of people receiving messages about

prevention of NCDs, and school programs have increased life skills to improve healthy behaviors. All in all countries and communities are implementing many strategies, policies and programs to prevent NCDs and promote healthy living.

I see impressive reply from @Maria Teresa Cerqueira. The best aspect of the reply is that it covers policies & strategies and their implementation, the need to create awareness and effective use of electronic media. perfect.

Dear Debra, Maria, Asmat, thanks for your answers. I'm happy to read about:

'healthy spaces have increased the number of people that exercise, and who eat healthier foods, municipalities and cities everywhere have implemented walking and bike trails, farmers markets have increased access to vegetables and fruits. Community participation has increased awareness of the importance of healthy spaces, in school and workplaces. Social communication and social medial have increased the number of people receiving messages about prevention of NCDs, and school programs have increased life skills to improve healthy behaviors'.

It is a wonder that all the effort put into promoting healthy living...we still live in a paradox. I come from the Pacific Island which is one of the highest growing rate for obesity and chronic diseases. Certainly public policies, government and community based preventative strategies will make such a difference as Maria indicated. However, we have generations of behavioral and cultural attitudes that needs to be shifted........

@Heena and friends, thanks.

Yes Heena, it's true. At times when I'm very busy with extra classes for students, I have to buy food from the cafetaria. It's so salty, I regret it each time. But sometimes, it seems unavoidable, especially when there are no more fruits left in the fridge. So I just drink lots of water to eliminate as much of the salt as possible.

Preventing Non-communicable Disease can be a pain in the ass in my society for example, Papua New Guinea is a developing nation still trying to crawl up from the rubbles left by colonizations and trying to develope on its own, but the effects on the population by the government is a issue that reduces preventions of NCD's in all areas of live because everyone is trying to be what they are not meant to be. Talking about prevention is better than curre is just a theory in P.N.G cultures and traditions because after all, after being infected the cause is greater than the the cure itself thus reducing the tendency of promoting quality and preventable measures in combating NCD's. Fighting for a beter enhancement in quality of life by preventing NCD's would never happen because of the people's mindset in their cultures and traditions that is greatly affecting the societies and communities of P.N.G's today. P.N.G's majority on population decreases is due to the facts and findings of people dying or being affected directly from NCD's death related. By looking up into the history of Papua New Guinea you could find articles all leading to NCD's issues and problems related.

For more informaion, visiti his webstes:

Thank you all for the in-depth review of the policies and strategies to prevent NCDs, especially also the barriers.  I am not sure that culture is such a barrier, it seems rather that the industri's push for empty calorie foods has made a mess of traditional cultures, which were rather healthy with many vegetables and less meats, certainly less fried foods and sweetened beverages.  Perhaps a review of what we understand as cultural food habits may be useful to untangle the web.  I will share with you this adapted version of Your Heart Your Life by NIH/NHLBi, which has been translated into many languages and is available, download, free. This is the spanish version adapted for Mexico.

Camino a la Salud. Su corazón, su vida. Manual para promotoras y promotores.

http://iris.paho.org/xmlui/handle/123456789/4313

Camino a la Salud. Su corazón, su vida. Cuaderno de trabajo del participante.

http://iris.paho.org/xmlui/handle/123456789/4314

Dear Miranda and Maria

It is nice conversation and comment. I still believe that we should concentrate on the prophylactic measures more than other things.  Doing regular exercise,  selecting a proper food, sleeping sufficient hours on regular early bases, and keeping stressful life away from our daily routine will be the best strategy to improve our life style and fight NCDs.  This goal is what we as exercise scientists working to achieve in our community. 

Dear Maria, do you have the articles in English as well?

@Hashem, thanks.  The stress that we all need to avoid is toxic stress.  'When stress hormones remain elevated over long periods of time, they produce “wear and tear” on the brain and certain biological systems. This effect is called allostatic load and it is associated with vulnerability to health problems later in life. The development of supportive environments for children is key to both reduce their exposure to toxic stress and create buffers of support to make stressful life events more tolerable.'

http://www.albertafamilywellness.org/brain-development-addiction/positive-tolerable-toxic-stress

Dear Miranda

Agree with you so we need to learn how to relax in a daily basis. Stretching exercise is one of the techniques used for relaxation. 

Dear friends, I find that exercise is very beneficial, especially when I can get good fresh air.  Exercise increases the endorphins.   Here are 2 places where I enjoy jogging and brisk walking, one is near home, and the other is my college track.

@Miranda and friends, something about Mediterranean diet, an excellent method of prevention for NCDs with important international awards.

The Mediterranean diet is a nutritional model inspired by the traditional dietary patterns of three European and one African basin of the Mediterranean: Italy, Greece, Spain and Morocco. In 2007, Italy, Spain, Morocco and Greece asked UNESCO to include the Mediterranean diet in the list of intangible cultural heritage of humanity. As a result of the negotiations coordinated by Spain, UNESCO vetoed the request. In May 2008, Italy renominated, under the coordination of UNESCO Task Force of the Ministry of Agriculture, Food and Forestry directed by Professor Pier Luigi Petrillo, Legal Adviser of UNESCO, supported by Spain, Morocco and Greece. On November 16, 2010 in Nairobi, Kenya, as a result of a long and delicate international, UNESCO has inscribed the Mediterranean Diet in the Representative List of the Intangible Cultural Heritage of Humanity, recognizing these assets belong to Italy, Morocco, Greece and Spain. In November 2013, the award was extended to Croatia, Cyprus, and Portugal.

This nutritional model was abandoned during the economic boom of the sixties and seventies because it was considered too poor and unattractive compared to other dietary patterns rich in particular from America, but now the Mediterranean diet is surely regaining between nutritional patterns, the 'consumer interest and is experiencing a large spread, especially after the nineties, in some American countries including Argentina, Uruguay, some areas of the United States of America and in Australia.

Dear Enzo and friends, thanks.  I add a bit more concerning health benefits of olives and their oil.

'Olives are unusual in their fat quality, because they provide almost three-quarters of their fat as oleic acid, a monounsaturated fatty acid. (In addition they provide a small amount of the essential fatty acid called linoleic acid, and a very small amount of alpha-linolenic acid, an omega-3 fatty acid.) The high monounsaturated fat content of olives has been associated with reduced risk of cardiovascular disease. When diets low in monounsaturated fat are altered to increase the monounsaturated fat content (without becoming too high in total fat), research study participants typically experience a decrease in their blood cholesterol, LDL cholesterol, and LDL:HDL ratio. All of these changes lower our risk of heart disease.

Recent research studies have also shown that the monounsaturated fat found in olives (and olive oil) can help to decrease blood pressure. The oleic acid found in olives—once absorbed up into the body and transported to our cells—can change signaling patterns at a cell membrane level (specifically, altering G-protein associated cascades). These changes at a cell membrane level result in decreased blood pressure.

In terms of their phytonutrient content, olives are nothing short of astounding. Few high-fat foods offer such a diverse range of antioxidant and anti-inflammatory nutrients—some of which are unique to olives themselves.'

@Miranda, olive oil is an essential component of Mediterranean diet.

Dear Miranda,

excuse my short answer. Olive oil is a wonderful taste. I love it, and this oil knows it´s obligation.

Dear Hanno, Enzo and dear friends, I like eating olives, whatever the color.  And among the fast foods, Subway provides black olive slices and olive oil as a dressing.

Dear Miranda,

hmmm!!

Dear friends, are the statistics brighter in your community?  Just look at this:

Spreading awareness of non-communicable diseases (NCDs) is the focus of this year’s Nutrition Month Malaysia.  Recognising a significant increase in non-communicable diseases (NCDs) such as obesity, diabetes, heart disease and cancer amongst Malaysians, Dr Tee E Siong, chairman of the NMM National Steering Committee, highlighted that the focus this year is to promote greater awareness on the importance of healthy eating and active living in order to reduce the prevalence of diet-related chronic diseases.

'*The incidence of obesity has increased about three-fold, from 4.4% in 1996 to 15.1% in 2011, and this puts the number of obese Malaysians at about 2.5 million people.

*Diabetes numbers in Malaysia has also increased, from 11.6% in 2006 to 15.2% in 2011, and this accounts for about 2.6 million adults.

*The incidence of hypertension remains high at 35.1%, which represents about 5.8 million Malaysians, and an estimated 32.7%, or 6.2 million Malaysians, have been diagnosed with hypercholesterolaemia.'

http://www.thestar.com.my/story/?sec=lifearts&file=%2f2013%2f5%2f22%2fhealth%2f13135662

Dear all, just to chime in and to share what I found for Austria (WHO 2014): http://www.who.int/nmh/countries/aut_en.pdf

The probability of dying between ages 30 and 70 years from the 4 main NCDs is 12%.

Total deaths: 78,000, NCDs are estimated to account for 92% of total deaths.

cf: FOR ALL COUNTRIES (WHO):  http://www.who.int/nmh/countries/en/

cf. http://www.ehfg.org/intranet/app/webroot/uploads/presentations//files/uploads/71b546f14c7f00dd5682c922cfa064.pdf

BTW:  How you make it possible to include those small images after a set http:// address (yes I imagine this only is possible if one saves either the http:// link  or the file underlying there as an attachment, right??) 

Best wishes and regards, Wolfgang

Dear @Wolfgang, thanks for the interesting facts about Austria.  The population is just around 8.464 million, but here, it's 30 million.  And I see there are 2 'Yes', among several 'No's.  (The little pic came with the link; I didn't do anything.)

'Has an operational policy, strategy or action plan to reduce unhealthy diet and/or promote healthy diets Yes

Has evidence-based national guidelines/protocols/standards for the management of major NCDs through a primary care approach No

Has an NCD surveillance and monitoring system in place to enable reporting against the nine global NCD targets No

Has a national, population-based cancer registry Yes'

http://www.thestar.com.my/News/Nation/2014/02/26/Malaysia-30-mil-population/

Dear Miranda,

as of my knowledge our ministeries are going to evaluate possibilities to establish National guidelines/standards for the management of major NCDs through a primary care approach) but thsi will take its time (imagine the delay of data transfer to WHO and publishing them). Most of these guidelines every practitioner will have in his files and will forward to his/her patients (recommendations of Austrian, European as well as International societies will be followed). SInce Austria is reported to be one of European countries having medical support (practitioners as well as specialized physicians) above average and legislation will not be that intervening (into "rights" of people") as this might be in other countries or for other targets (addituionally I remember e. g. following EUROPEAN /E.C.-Legislation (for) against smoking and other kind of hazards to human health and sanity and others) it to set national standards. Also as to my knowledge, we do have statistical evaluation of all these cases (+/- by self-governed organisations) but NO surveillance AUTHORITY(-ies). Our social as well as health system differs much from most countries in the world, I guess (but it has been said also that we in Austria have implemented a good one (which should be reformed-restructured in some way....but this really isn't easy bcause of the interests of medics as well as their professional associations and the social&health self-governmental associations. Regards, Wolfgang

Dear Wolfgang and friends, thanks.  I'm happy about this '...establish National guidelines/standards for the management of major NCDs through a primary care approach.'

Concerning smoking here, it's about as bad as Austria, although few women smoke.  'About 10,000 people in Malaysia lose their lives due to tobacco smoking each year, said Dr Amer Siddiq Amer Nordin, a coordinator of the Nicotine Addiction Research & Collaborating Centre (NARCC), the nicotine addiction research group of the University Malaya Centre of Addiction Sciences (UMCAS).

Describing it as alarming, he said the figure might only be the tip of the iceberg.  

“When we talk about the effects of tobacco smoking, we think of cancer. But, bear in mind tobacco smoking is also a major or contributing factor to various heart and lung diseases as well as various types of cancers. '

http://www.freemalaysiatoday.com/category/nation/2013/10/07/nearly-10000-die-yearly-due-to-smoking/

NCDs prevalence are souring Diabetes, Hypertension cancers and even arthritis are at epidemic levels. Actions to manage or control these??? I am not sure!!!