What On Earth Are We To Do About Lifestyle Diseases?

Story at a Glance

  • Non-communicable diseases (NCDs) are causing about 70% of deaths worldwide.
  • Focusing on bioscience, pharmaceutical treatment and public health messages have not dented the worrying rise in these conditions.
  • Whilst lifestyle choices are important, it’s more important to influence the environments that have caused the rise in NCDs; poverty, lack of education, processed food, regulation of tobacco, alcohol and unhealthy food.

Yes you’ve heard of them before, the diseases we attribute, without trying to sound pithy, to our lifestyle. Obesity. Heart disease. Diabetes. Stroke. Cancer. Chronic respiratory diseases. But they’re not called lifestyle diseases. They’re called NCDs, non-communicable diseases. Which means you can’t catch them because they’re not infectious. But they will kill you. Just as surely as Ebola will. It will just take a bit longer.

Our complacency towards these NCDs is causing about 70% of deaths worldwide. And it’s likely to completely decimate our health care systems, globally. Being in a wealthy country offers no immunity to the damage NGO’s are wrecking financially on our medical systems.

A study by Dermot Maher and Nathan from from the London School of Hygiene and Tropical Medicine and the Medecins Sans Frontieres, Geneva1, respectively, states,

“The growing global NCD crisis is now killing 36 million people each year and needs urgent and comprehensive action.”

Luke Allen, a Global Health Analyst and British physician has been working with The World Health Organisation to mount a new approach to this world wide seemingly unstoppable disaster2. He acknowledges that previously the WHO had, rationally attempted to stem this tide by focusing on bioscience, pharmaceutical treatment and public health messages. But it has been blatantly apparent that this model has not worked, he states,

“…such efforts have not dented the worrying rise in these conditions.”

Which is why the WHO are shifting their focus.

It’s clear there’s a lot of scientific understanding as to the nature of these diseases. Most of these we understand intimately on a biological and causation level. But what we’ve been failing to do is to treat the cause, instead focusing on the symptoms.

It’s a fine line to manage. When people are sick it’s important to treat the illness. Pharmaceutical drugs in that respect are still an important part of the process. Director-General Maragert Chan has described it as a difficult balancing act. But it’s prioritising prevention that needs to be focused on now.

“The global health community has long acknowledged that social, political and economic environments are much stronger drivers of disease than genetics, biology and individual choice: the conditions in which we are born, live, work and age and over which individuals have little control are more important for health,” Allen says.

But it’s time to stop leaning on the science and the drugs to solve the problem. They merely tell us what’s wrong and then act to relieve symptoms without actually changing the root issues that cause the problem to start with.

Whilst lifestyle choices are important, it’s more important to influence the environments that have caused the rise in NCDs; poverty, lack of education, processed food. And to address policies that lie beyond the health sector and require government action, tobacco and alcohol control, environmental safely and agricultural and food industry reforms1.

“We are still struggling to fathom how the outsized health impact of socioeconomic inequalities can be reduced. Even less space has been given to understanding the food environment, the health impact of regional trade agreements and the regulation of tobacco, alcohol and unhealthy foods,” says Allen.

And the way to influence these aspects is to first intimately understand them.

To that end, in 2014 the WHO set up a task force called the Global Coordination Mechanism for NCDs. Acknowledging that the task requires a coordinated effort to combat the major cause of chronic diseases rather than finding new ways of treating the diseases’ symptoms; they’ve enlisted researchers in law, economics, sociology and political science to help nut out a solution.

Allen sites China as a recent example of a country rising out of poverty and into an economic prosperity bringing with it an unprecedented rise in obesity. Field workers now working in sedentary jobs and eating processed food. Inactivity and calorific, non-nutritional food equalling all the very best criteria for the rampant increase in NCDs.

“Similar economic and nutritional transitions are occurring worldwide, spurring the rising tide of NCDs and demanding viable political, economic and societal solutions,” Allen comments.

And the outlook?

A sobering final thought from Allen,

“Encouraging more research into these – however complex they may be – will be vital for stemming the seemingly inexorable rise of non-communicable diseases.”

References

[1]  Action on noncommunicable diseases: balancing priorities for prevention and care. Dermot Maher a & Nathan Ford. Bulletin of the World Health Organization 2011;89:547-547A. doi: 10.2471/BLT.11.091967

[2] Beyond drugs: the war on lifestyle disease needs new tactics. Luke Allen New Scientist 4 Aug 2016