BK FOUNDATION HEALTH AWARENESS - CHRONIC DISEASES

JOSEPH ANACHAIRMAN BOARD OF TRUSTEES

BK EDUCATION FOUNDATION

OBJECTIVE

PARTICIPANTS TO HAVE AN INCREASED AWARENESS OF CHRONIC DISEASES AND THEIR PREVENTION AND AVOIDANCE

WHAT IS KILLING PEOPLE IN THE WORLD

Global Causes of Death (2006)CHRONIC DISEASES:

- Heart disease 30.2%

- Cancer 15.7%

- Diabetes mellitus 1.9%

- Others 15.7%

The total number of people dying from chronic (58 MILLION) is double

that of all infectious diseases including HIV/AIDS, tuberculosis and malaria (Nature, 2007).

INFECTIOUS DISEASES:

-HIV/AIDS 4.9%

-TB 2.4%

-Malaria 1.5%

-Other inf. Dses 20.9%

-Injuries 9.3%

DOUBLE WHAMMY OF KILLER- DISEASES IN NIGERIA

• Infections

• Chronic disease

IN NIGERIA 2012

CHRONIC DISEASES

ADD

MENTAL ILLNESS!

Did you know??

35 000 000people died fromchronic diseases

in 2005

COMMON DENOMINATORS

• smoking• Lack of exercise• Food abuse• Alcohol abuse

10 widespread misunderstandings about chronic disease - and the

reality

• Chronic disease epidemic is rapidly evolving• Global recognition and response has not kept

pace• Misunderstandings can be dispelled by the

strongest evidence

Reality: 80% of chronic disease deaths occur in low & middle income countries

Reality: double burden = double response

Reality: chronic diseases are concentrated among the poor and chronic disease is one of the main reasons that families are pitched

into poverty

Facing illness and deepening

poverty

Reality: poor and children have limited

choice

The nextgeneration

Reality: 80% of premature heart disease, stroke and type 2 diabetes

is preventable, 40% of cancer is preventable

Heart disease Stroke Type 2 diabetes Cancer

80%

20%

80% 80%40

%

20% 20%60%

preventable

not preventable

Reality: inexpensive and cost-effective interventions

exist

Reality: these people are the rare exceptions

Reality: death is inevitable but it does not need to be slow,

painful or premature

Dying slowly, painfully and prematurely

Three risk factors

• Three risk factors cause four chronic diseases that cause over half of deaths worldwide.

• The risk factors are:

Tobacco use

Lack of physical activity

Unhealthy diet

ADDITIONALS

• ALCOHOL ABUSE – complex

• OBESITY - complex

Old and new agendas for global health

acute childhood infections maternal deaths

Simple technologiesRapid impactControlled by health

services

Within the remit of the health campus and the health department

chronic, life long infectious and non-infectious diseases

Complex interventionsDecades before impactsMain levers outside health

service controlTakes a whole university

and all government!

What works?

Comprehensive and integrated action is the means to prevent and control chronic diseases

Multiple interventions are effective

Cigarette smoking is influenced by• Fiscal measures – high taxation• Advertising bans• Prohibiting smoking in public places• No vending machines available• Health campaigns to stop smoking• Transport smoking bans• Campaign groups• Health warnings on packets• Medical advice repeatedly

Diet – changing what we eat

Source: UN FAO, 2004

Nutrition transition• Worldwide, there is an accelerating move

towards a diet high in saturated fats, sugar and refined foods, but low in fibre.

• Average food consumption per person is likely to increase from 2,680 kcal in 1997–1999 to almost 3,000 kcal by 2030.

Diet – changing what we eat

Source: The Guardian, 25 April 2006

What is driving the nutrition transition?• The cost of industrial fat has fallen by 50% in

the last 50 years, whereas the cost of a healthy ingredient such as fruit has increased by one third.

• Salt provides flavour to cheap food at around $150 (£84) a tonne. Real spices cost up to $2,000 a tonne.

Diet

From this…

8oz 12oz 16oz 20oz 34oz

Diet

… to this!

16oz 32oz 44oz 52oz 64oz

50 tsp (200g) of sugar (Coca-Cola)

Source: Brownell, 2005

• There are 1,144 kcal in a McDonald’s quarter-pounder with cheese, small fries and a small chocolate milkshake

• This is approximately 70% of the recommended daily calorie intake of a 10-year-old girl

• To work off 1,144 kcal, a child weighing 87 lbs would have to walk at 3 mph for about six hours

Source:McDonalds; AAFP; The fitness calculator

A rough example

Physical activity transition

A transition in physical activity is occurring – we lead increasingly sedentary lives:

• desk jobs replace manual work• labour-saving devices make housework easier and

less time consuming• transportation options remove the need to walk or

cycle• safety fears keep children – and older people –

indoors.

Gender

Age

Beliefs

AbilitiesSelf-image

Knowledge/ education

Motivation

Motivating people/orgs

Motivating factors

Personal characteristics

Work/school

Home Environmental

Media

Employer

Media

Family

Community

Government

ColleaguesGovernment

Architects

Industry

Town planners

Health insurers

Health professionals

PE / lunchbreaks

Playing fields

Distance to work/school

Work gym

Stair access

Shop location

Safe streets

Bike paths

Pavements

Access to gym

Green space

Stairs

Housework

Active games

Sports equipment

Influences on physical activity

Changing facilities

Income

TimeMobility

Street layout

Pollution

Friends

Teachers

School governors

NGOs

Lack of physical activity

Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004 and CDC 2002

• As a result of these trends…– UK: 69% of adults and 35% of children– US: 55% of adults and 31% of adolescents – - ? Data for Nigeria

• … do not reach the recommended levels of physical activity.

Recommended levels of physical activity

• For adults – – At least 30 minutes a day of moderate-intensity

physical activity on five or more days of the week. – The 30 minutes can be made up of bouts of

activity of 10 minutes or more.

• For children and young people – – At least 60 minutes of moderate-intensity physical

activity every day.

Benefits

Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004

• Compared with people who do not reach the recommended levels of physical activity, active people have:– almost half the risk of dying from coronary heart disease– a 27% lower risk of stroke– a 33–50% lower risk of developing type 2 diabetes– 40–50% lower risk of colon cancer, and reduced risk of

other cancers, e.g. breast cancer.• Plus, benefits for musculoskeletal health and

mental health.

Increasing physical activity

• No magic bullet• Many interventions will be necessary• Redesigning the environment will be more

important than exhortation, doctors prescribing exercise, or gyms

TAKE THE STAIRS!

THANK YOU FOR LISTENING

A: BP<135 – reassess every 3 years 85 B: BP 135 -139 – high normal

values 85 – 89 - reassess yearlyC: 145 – 159 – Hypertension 90 – 99 (after at least three

readings) ↓Target organ damage No target organ damageCVD complications No CVD complicationsDiabetes No DiabetesTen year CHD risk > 15% Ten year CHD risk < 15% ↓ ↓ TREAT OBSERVE

(reassess yearly)

HYPERTENSION - MANAGEMENT- Non pharmacological therapy (for all)- Weight reduction\salt reduction/limit alcohol- Regular exercise- increase fruit & vegetable intake- Pharmacological therapy- Diuretic- Diuretic & B-blocker- Diuretic & ACE Inhibitors (except verapramil)- Calcium antagonist & B-blocker- Calcium antagonist & ACE In hibitor- A-blocker & B-blocker