By: Prof. Dr. Mohammad Tariqur Rahman
NONCOMMUNICABLE diseases such as obesity, diabetes, cardiovascular diseases (CVD), and cancer are leading causes of death globally. These four diseases are also linked to one another.
Obesity is one of the major risk factors for the development of diabetes. In turn, both obesity and diabetes are major modifiable risk factors that can lead to CVD. Again, diabetes is associated with increased cancer risk.
All these four conditions are caused largely because of dietary and other lifestyle factors. In 1998 the WHO warned that the war against ill-health in the twenty-first century will have to be fought simultaneously on two main fronts, one of which is to fight against noncommunicable diseases such as heart disease, cancer, diabetes, and other “lifestyle” conditions.
The increasing trend of these lifestyle diseases is well evident in the published reports from the WHO and independent research.
According to a report published in the Lancet, the prevalence of obesity almost doubled from 1980 to 2008. The number of obese men increased from 4.8% to 9.8% and that of women increased from 7.9% to 13.8%.
Almost 10 years later the same journal published research showing a growing trend of overweight and obesity continue in adults and children. From 1975 to 2016, the prevalence of overweight or obese children and adolescents aged 5–19 years increased more than four-fold from 4% to 18% globally.
Scientific reports also showed that the proportion of global overweight or obese adults increased between 1980 and 2013 from 28·8% to 36·9% in men, and from 29·8% to 38·0% in women. Prevalence of overweight or obesity in 2013 in children and adolescents in developed countries was also recorded at 23·8% for boys and 22·6% for girls – significantly higher than the previous years.
The prevalence of diabetes has been steadily increasing over the past few decades similar to that of obesity and overweight. Noticeably, the majority of the patients having diabetes are living in low-and middle-income countries.
According to the WHO, as of today, there are more than 420 million people worldwide who have diabetes, the disease that causes 1.5 million deaths each year. This number is far more than the WHO prediction in 1998. The estimated number of diabetes cases in adults was predicted to be 300 million in 2025 from 143 million in 1997.
The earlier prediction and the current prevalence did not help to prevent the prevalence of diabetes. On the contrary, the predicted prevalence in the future sounds rather more alarming. From the year 2025 to 2060, the prevalence of diabetes mellitus in the USA is predicted to increase by 39.3%.
A similar possibility is predicted for obesity to increase by 8.3%. Concurrently, the projected prevalence of ischemic heart disease, heart failure, and myocardial infarction will similarly increase by 31.1%, 33.0%, and 30.1% respectively from the year 2025 to 2060.
The prevalence and deaths due to cancer are no different than any of the other non-communicable diseases.
According to the WHO report of 1998, cancer would remain one of the leading causes of death worldwide. This has also been proven true. According to the journal BMJ Oncology, global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% between 1990 and 2019. Globally, 18,094,716 million cases of cancer were diagnosed in 2020.
It is rather more alarming to hear the prediction of cancer risk by Professor Shuji Ogino, at Harvard Chan School and Harvard Medical School. Prof Shuji noted that the risk of having cancer is increasing with each generation. For instance, people born in 1960 experienced higher cancer risk before they turned 50 than people born in 1950. He predicts that the risk level will continue to climb in successive generations.
Focusing on Malaysia, the increasing trends of non-communicable lifestyle diseases give a grieving scenario. The percentage of adult males living with overweight and obesity has increased from about 30% to above 50% from 1993 to 2019.
The WHO has estimated that in 2030, Malaysia will have a total number of 2.48 million diabetics compared to 0.94 million in 2000 – a 164% increase.
On World Cancer Day (4 February 2023) cancer researchers estimated approximately 1 in 10 individuals in Malaysia to be diagnosed with cancer in their lifetime. In the year 2020 the number of reported cancer cases in Malaysia was below fifty thousand and deaths due to cancer were below thirty thousand out of over 32 million people at that time.
Taken together, these reports not only show the prevalence but also the predicted rise of those lifestyle-related diseases over the years. This gives rise to two pertinent questions: why have we failed to prevent the predicted rise of those diseases? And, will we be able to prevent the prediction from coming true?
This question needs attention as our future generations are at risk of deadly conditions that are often irreversible.
Needless to say, we have proven our ability in medical biotechnology where we are now able to produce new vaccines in a couple of months and administer the vaccine to the global population in an unprecedented shorter period than has happened ever before. Here I am referring to our success story in combating COVID-19.
Indeed, developing and administering vaccines to the global population is not the same as preventing lifestyle diseases that need utmost individual awareness. But at the policy level, there is a lot more that could be done to tame the rising trend of lifestyle diseases.
The author is the Associate Dean (Continuing Education), Faculty of Dentistry, and Associate Member, UM LEAD, Universiti Malaya.
