New perspectives on the therapeutic potential of quercetin in non-communicable diseases:Targeting Nrf2 to counteract oxidative stress and inflammation

Non-communicable diseases(NCDs),including cardiovascular diseases,cancer,metabolic diseases,and skeletal diseases,pose significant challenges to public health worldwide.The complex pathogenesis of these diseases is closely linked to oxidative stress and inflammatory damage.Nuclear factor erythroid 2-related factor 2(Nrf2),a critical transcription factor,plays an important role in regulating antioxidant and anti-inflammatory responses to protect the cells from oxidative damage and inflammation-mediated injury.Therefore,Nrf2-targeting therapies hold promise for preventing and treating NCDs.Quercetin(Que)is a widely available flavonoid that has significant antioxidant and anti-inflammatory properties.It modulates the Nrf2 signaling pathway to ameliorate oxidative stress and inflammation.Que modulates mitochondrial function,apoptosis,autophagy,and cell damage biomarkers to regulate oxidative stress and inflammation,highlighting its efficacy as a therapeutic agent against NCDs.Here,we discussed,for the first time,the close association between NCD pathogenesis and the Nrf2 signaling pathway,involved in neurodegenerative diseases(NDDs),cardiovascular disease,cancers,organ damage,and bone damage.Furthermore,we reviewed the availability,pharmacokinetics,pharmaceutics,and therapeutic applications of Que in treating NCDs.In addition,we focused on the challenges and prospects for its clinical use.Que represents a promising candidate for the treatment of NCDs due to its Nrf2-targeting properties.

Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

Surveillance Report of the Prevalence and Risk Factors of Chronic Non-Communicable Diseases in Tinghu District,Yancheng City,2021

Objective:To comprehensively understand the changes and prevalence of major chronic diseases among residents of Tinghu District,Yancheng City,in 2021,and to analyze the trends of the major risk factors for the onset of chronic diseases in the region.Methods:Chronic diseases and their risk factors in Tinghu District in 2021 were monitored among the resident population who had lived in the district for five years or more and were aged 18 years or older.The survey was conducted using random cluster sampling,with 7,130 questionnaires collected.After data processing,7,012 valid questionnaires were obtained,resulting in a qualification rate of 98.35%.Results:Among the chronic diseases reported in the survey population,hypertension had the highest prevalence at 37.61%,followed by dyslipidemia at 37.19%.Other chronic diseases were ranked in order of prevalence from highest to lowest.Regardless of gender,the top three chronic diseases were hypertension,diabetes,and hyperlipidemia.Multifactorial regression analysis identified both non-preventable risk factors(such as family history,gender,and age)and preventable risk factors(such as smoking,sedentary behavior,overweight,and obesity)as significant contributors to the major chronic diseases in Tinghu District.Conclusion:Analyzing the trends in the main risk factors for chronic disease incidence in Tinghu District,Yancheng City,provides a basis for developing a new comprehensive chronic disease prevention and control plan to address chronic disease prevention and management.

Investigating College Students’ Diet and Physical Activity Behaviors Regarding Non-Communicable Diseases Prevention in China

We aimed to investigate if college students’ dietary and physical activity adhered to the Chinese Dietary Guidelines, the Composing Editorial Board of Physical Activity Guidelines, and WHO recommendation for NCDs prevention. Methods: A 3-day (2 weekdays and 1 weekend day) 24-hour (24-HRs) dietary recall was conducted to record details of participants’ food consumption. One-way analysis of variance (ANOVA) was applied to examine the influence of the identified demographic variables (including BMI, gender, major, family monthly income, and place of household registration) on the 8 food groups’ consumption. We analyzed the effect of the various demographic variables on sodium intake by the student’s t-test. The questionnaire, International Physical Activity Questionnaire (IPAQ)-Short Form, was utilized to assess participants’ physical activity (PA) level. The Wilcoxon-Mann-Whitney was applied to analyze participants’ physical activity. Results: Our research indicated participants consumed much fewer fruits and vegetables and excessive meats on average for both males and females regarding NCDs prevention. Conclusion: Participants’ dietary intake did not comply with the Chinese Dietary Guide-lines recommendation for chronic diseases prevention. Nutrition knowledge and health education are needed for college students. .

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.

Sustaining Increase in Life Expectancy in Africa Requires Active Preventive Measures against Non-Communicable Diseases

It is projected that aged population (≥60 years) will continue to increase globally, including in Africa. This is due to reduced population growth, decreased fecundity and improved medical interventions;factors which increase life expectancy. While this is typical for developed countries, it is not the same for Africa and similar developing regions. In these regions, a significant proportion of death is due to non-communicable diseases (NCD’s) such as hypertension, cerebrovascular accident, coronary heart disease, diabetes mellitus, chronic renal disease and cancer, among others. Rising prevalence of NCD’s due mainly to western style diets and sedentary living is made worse by inadequate nutrition education, high prevalence of low birth weight, poor health services, lack of efficient tobacco control and deficient planning of built environment. In order to halt the possible reduction in life expectancy occasioned by NCD’s, efforts by the community, health planners and governments in Africa to address relevant NCD’s, must be put in place. Suggested measures are: nutrition education, regular community directed physical exercise, improved environmental planning and development. Others are review of present health service model, early detection, prevention and treatment of NCD’s, including improved antenatal care to reduce low birth weights, and establishment of policies and measures that decreased access to tobacco especially by women of childbearing age. Africa and similar developing regions cannot fund the health bill due to NCD’s and their complications;hence it is important that this scourge is attended to with all seriousness.

Burden of Non-Communicable Diseases at a Tertiary Care Hospital of Central Uttar-Pradesh: A Retrospective Study

Introduction: Non Communicable Diseases (NCD) has emerged as leading threat to mankind. It approximates to around 70% mortality burden worldwide. Its mortality burden is more in low & middle income countries. Most of the premature deaths from NCDs are attributed to modifiable risk factors. In Uttar Pradesh there has been a raise in prevalence of non-communicable diseases in the last two decades. Methodology: Mortality and morbidity data from 1st Jan 2014 to Dec 2016 was obtained from Medical Records Department, UPUMS, Saifai Etawah. The data, thus collected was analyzed by using SPSS 24. Results: Morbidity pattern in UPUMS Saifai reported Blindness and cardiovascular disease (CVD) was leading cause of admission and was increasing year after year. Road traffic acid (RTA), Stroke and CVD were the leading causes of mortality in last 3 years among the patients admitted in tertiary care hospital UPUMS, Saifai, Etawah, U.P., India. Conclusion: Even in rural area prevalence of NCD is at raising trend. RTA, CVD and Stroke were leading causes of death even in rural area.

The challenge of combatting non-communicable diseases in Trinidad: Access to hospital care

Chronic illnesses, or non-communicable diseases (NCDs), account for a growing number of deaths worldwide. The English-speaking Caribbean has the highest per capita burden of NCDs in the region of the Americas [1]. This paper presents an overview of hospital availability on the island of Trinidad in the West Indies and examines rates of NCDs as reported in hospital discharge summaries. The project integrates a Geographic Information System (GIS) with epidemiologic and bio-statistical data to provide essential spatial analysis not otherwise possible. It examines the island’s ability to effectively deliver treatment to residents with NCDs by providing a geographic perspective to public data published on the internet by the Trinidad-Tobago Ministry of Health and the Central Statistical Office. The study reveals a significant variability in several dimensions of access to health care.

Associated Risk Factors of Non-Communicable Disease in Three Sites across Ivory Coast: An Urban (Cocody), Peri-Urban (Abobo) and Rural (Yocoboué) Area

Introduction: The prevalence of Non-communicable diseases (NCDs) has increased so it’s becoming a global public health problem. This problem is also threatening in Sub-Sahara Africa (SSA) country including Ivory Coast. Ivory Coast is a country of 22.6 million people experiencing rapid economic development and social change. All development is typically associated with an increase in non-communicable disease (NCD) risk factors. Our study aimed to determine the prevalence and associated factors of the major risk factors of NCDs among the population of Cocody, Abobo and Yocoboué in the Ivory Coast. Methods: A descriptive and analytical cross-sectional study was conducted and involved 1146 adults of 19 to 60 years from general population in Cocody (urban), Abob (peri-urban) and Yocoboué (rural). The WHO STEPS risk factor survey has been changed a bit and was administered. it contains anthropometric and biochemical measures. Results: The prevalence of NCD risk factors was markedly different across the three sites particularly between urban (Cocody) and rural (Yocoboué) areas. The overall prevalence estimates of the risk factors were 15.2% for current smoking, 57.71% for harmful use of alcohol, 58.84% for low physical activity, 24.71% for sedentariness (sitting at least 7 h), 69.45% for skipping breakfast, 61% for having late dinner and 36% for snacking. Concerning biological risk factor we noticed 40.95% for Overweight/obesity, 52.96% for abdominal obesity, 14.61% for raised blood pressure, 23.37% for raised blood sugar and 18.51 low HDL-C. Being female has an important associated with an increased risk for having abdominal obesity (OR: 25.7) and being overweight or obese (OR: 11.3), suffering from hypertension increased with age, 30 - 39 years (OR 8.45), 40 - 49 years (OR 13.4) and 50 years and above (OR 24.6). Conclusion: Adult residents in the two (Urban and peri-urban) of three different areas are developing high-risk NCDs, particularly Cocody’s population. At the end, we observed among participants that the female gender, living in urban areas and clustering are the most concerned by non-communicable disease risk factors. To reach the goal, preventive and therapeutic interventions are needed among the targeted population.

Ayurveda daily regimen practices (Dinacharya): a scientific system model approach suitable as a quaternary prevention strategy for non-communicable diseases

Background:Non-communicable or lifestyle diseases replaced infectious diseases at the end of the 20th century as the primary burden of disease worldwide,marking the epidemiological transition.The industrial revolution and technological advancements,as well as packaged processed foods,have greatly affected lifestyle,causing adverse health effects through chronic,low-level,and systemic inflammation known as“metaflammation”.The main contributors to lifestyle-related diseases are poor eating habits,physical inactivity,poor posture,and a disturbed biological clock.The study on lifestyle changes indicates that comprehensive lifestyle changes can prevent disease and reverse the progression of diseases like diabetes,heart disease,stroke,prostatic cancer and breast cancer.The concept of disease prevention is getting wider acceptability owing credit to early disease detection,better treatment modalities and reduced financial implications.However,the possible harms of over-testing and over-medicalization have led to the propagation of Quaternary prevention strategies.Ayurveda,too propagates the principle of health preservation,promotion,and disease prevention,along with early diagnosis and holistic disease management strategies,incorporating dietary and lifestyle components such as Dinacharya(daily regimen practices),Ritucharya(seasonal regimen practice).This paper critically explores the scientific relevance behind these ascribed daily regimen practices(Dinacharya)and their suitability as a quaternary prevention strategy and presents it for dialogue and research to the scientific community.Method:The classical texts of Ayurveda and the internet search engines were explored with keywords of relevant terms such as“research”“benefit”and“role in health”combined with the Ayurveda daily regimen terms and their English equivalents as provided in brackets and their different combinations and permutations,along with net surfing and hand search.The relevant articles were stored and screened for relevance and the matter is presented systematically for scientific deliberation principal findings–Ayurveda recognized the temporal effects of chronobiological cycles on human health and accordingly devised the daily regimen schedule,delineating the principles for healthy living and harmonization.The daily regimen practices of Ayurveda like timely sleeping,waking up early in the morning,proper defecation,massage,exercise,occupation,social bonding,appropriate dietary practices,etc.adopt a system biology approach with synchronization of chronobiological cycles,mind-body integration,system performance,and epigenetics,apart from other possible approaches and have considerable scientific evidence for the effectiveness as a quaternary prevention strategy.Conclusion:The adoption of these practices in the daily routine may play a crucial role in health preservation and disease prevention at all levels of preventive domains.However,prospective large scale,long-duration randomized controlled trials are yet needed to scientifically further establish the validity of the same.

Prevalence of Risk Factors for Chronic Non-Communicable Diseases to the National Teaching Hospital “HKM” of Cotonou

Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.

Life’s Essential 8 and risk of non-communicable chronic diseases:Outcome-wide analyses

Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

Opportunity and challenge of big data in improving chronic non-communicable diseases： by health system engineering approaches

Chronic non-communicable diseases （NCDs） is a sick- state in the complex system of human body. Healthsystems engineering approach can be used to recover health state by many different ways of system adjustments, including physical exercises, nutrition and psychological intervention, and drug therapies. To evaluate and assess the effects of these adjustments, many parameters of the system states have to be monitored （such as molecular high- throughput technologies, physiological, image, etc.）, and estimated at the different levels （such as molecular, cellular, tissue, organ, and system levels） and on the different dimensions （such as metabolic, immune, neural, etc.） for human system. Huge data have been produced during the whole process, and health systems engineering approach will model health and sick state in the human system by detecting and analyzing these multi-dimension and multi- level big-data in order to find personal suitable adjustment method.

Construction of the Chinese Veteran Clinical Research （CVCR） Platform for the assessment of non-communicable diseases

Background Based on the excellent medical care and management system for Chinese veterans,as well as the detailed medical documentation available,we aim to construct a Chinese Veteran Clinical Research （CVCR） platform on noncommunicable diseases （NCDs） and carry out studies of the primary disabling NCDs.Methods The Geriatric Neurology Department of Chinese People＇s Liberation Army General Hospital and veterans＇ hospitals serve as the leading and participating units in the platform construction.The fundamental constituents of the platform are veteran communities.Stratified typical cluster sampling is adopted to recruit veteran communities.A cross-sectional study of mental,neurological,and substance use （MNS） disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment,followed by systematic neuropsychological assessments to make clinical diagnoses,evaluated disease awareness and care situation.Results A total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform,yielding a response rate of 83.86％.8 812 subjects complete the MNS subproject screening and total response rate is 91.70％.The average participant age is （82.01±4.61） years,69.47％ of veterans are 80 years or older.Most participants are male （94.01％）,83.36％ of subjects have at least a junior high school degree.The overall health status of veterans is good and stable.The most common NCD are cardiovascular disorders （86.44％）,urinary and genital diseases （73.14％）,eye and ear problems （66.25％）,endocrine （56.56％） and neuro-psychiatric disturbances （50.78％）.Conclusion We first construct a veterans＇ comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans.The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

China’s biggest, most neglected health challenge: non-communicable diseases

Background:Over the past two decades,international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),tuberculosis(TB),malaria,and those diseases that address maternal and child health problems,among others,have skewed disease control priorities in China and other Asian countries.Although these are important health problems,an epidemic of chronic,non-communicable diseases(NCDs)in China has accounted for a much greater burden of disease due to the ongoing rapid socioeconomic and demographic transition.Discussion:Although NCDs currently account for more than 80%of the overall disease burden in China,they remain very low on the nation’s disease control priorities,attracting marginal investment from central and local governments.This leaves the majority of patients with chronic conditions without effective treatment.International organizations and national governments have recognized the devastating social and economic consequences caused by NCDs in low-and middle-income countries,including China.Yet,few donor-funded projects that address NCDs have been implemented in these countries over the past decade.Due to a lack of strong support from international organizations and national governments for fighting against NCDs,affected persons in China,especially the poor and those who live in rural and less developed regions,continue to have limited access to the needed care.Costs associated with frequent health facility visits and regular treatment have become a major factor in medical impoverishment in China.This article argues that although China's ongoing health system reform would provide a unique opportunity to tackle current public health problems,it may not be sufficient to address the emerging threat of NCDs unless targeted steps are taken to assure that adequate financial and human resources are mapped for effective control and management of NCDs in the country.Summary:The Chinese government needs to develop a domestically-driven and evidence-based disease control policy and funding priorities that respond appropriately to the country’s current epidemiological transition,and rapid sociodemographic and lifestyle changes.

Targeting Ageing to Decrease Complex Non-Communicable Human Diseases

During the last two centuries, there have been many spectacular advances in medical science, the main consequence of which has been the dramatically reduced burden of infectious diseases. While in the 1800s many people died before reaching adult- hood, nowadays most people survive. Hence average life ex- pectancy in 1800s was around 30-40, which was barely higher than it had been in Greek and Roman times （Finch, 2010）, but nowadays life expectancy in most modernised economies is around 75 - 80. This demographic shift, which has happened in only 200 years, has created a dramatic change in the causes of mortality. The major killers in the modern world are non- communicable diseases （NCDs）： principally cardiovascular disease, cancer and neurodegenerative disorders such as Alz- heimer＇s disease. A major factor that influences susceptibility to all these diseases is age. As we get older, our risk of developing these NCDs increases enormously. For example, the rate of breast cancer in females at age 15-19 is less than 10 per 100,000 population, but this increases to 100 at age 40-44, 275 at age 55--59 and 450 at age 85 ＋ （http：//www.cancerresearchuk.org/ cancer-info/cancerstats/types/breast/incidence/#age）. Ageing has consequently become a major medical, social and economic burden to many countries.

Dose-response associations,physical activity intensity and mortality risk:A narrative review

Physical activity is consistently associated with reduced mortality,decreased risk for non-communicable diseases,and improved mental health in observational studies.Randomized controlled trials and observational Mendelian randomization studies support causal links between physical activity and health outcomes.However,the scarcity of evidence from randomized controlled trials,along with their inherent challenges like exposure contrasts,healthy volunteer biases,loss to follow-up,and limited real-world dose-response data,warrants a comprehensive approach.This review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity,mortality risk,and other health outcomes.Additionally,it summarizes recent research since the publication of current physical activity recommendations.Novel observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits,with vigorous-intensity potentially requiring lower volumes for substantial benefits.Future guidelines,informed by device-measured physical activity studies,may offer refined age-specific recommendations,emphasize vigorous-intensity physical activity,and include daily step counts as a simple,easily assessable metric using commercial wearables.

The Effect of Macronutrient Restrictions on Gut Microbiome and Biochemical Parameters of Wistar Albino Rats

Macronutrients serve as a source of energy for both gut microbiota and its host. An increase or decrease in macronutrients can either increase or decrease the composition of gut microbiota, leading to gut dysbiosis which has been implicated in many diseases state including non-communicable diseases. To achieve this, seven diets were formulated by restricting 60% of each macronutrient. These diets were fed on 42 albino rats (Wistar), divided into 7 groups of 6 rats each. Group 1 was fed on a normal laboratory chow diet (ND), group 2 received a fat-restricted diet (FRD), group 3 received a protein-restricted diet, (PFD), group 4 received a carbohydrate-restricted diet (CRD), group 5 received a protein and fat-restricted diet (PFRD), group 6 re-ceived a carbohydrate and fat-restricted diet (CFRD) and group 7 received a carbohydrate and protein-restricted diet (CPRD). Feed and water intake were given ad libitum and daily weight and food intake were recorded. The experiment went on for 4 weeks after which animals were sacrificed and intestinal content and blood were collected for analysis (gut microbial composition, glucose, insulin levels, serum lipid, and enzyme). Compared to the control group results showed a decrease in Bacteroides (40.50 - 14.00 CFU), HDL (68.20 - 40.40 mg/dl), and AST (66.62 - 64.74 U/L) in FRD. An increase in AST (66.6 - 69.43 U/L), Bifidobacterial (59.50 - 92.00 CFU) and decreased Bacteroides (40.5 - 19.5 CFU) for PRD was also recorded. CRD reduced Lactobacillus (73 - 33.5 CFU), total bacterial count (129 - 48 CFU), HDL (68.2 - 30.8 mg/dl), and cholesterol (121.44 - 88.65 mg/dl) whereas intestinal composition of E. coli (30.5 - 51.5 CFU) increased. PFRD increased Lactobacillus (73.00 - 102.5 CFU), Bifidobacterial (59.5 - 100 CFU), HDL (68.2 - 74.7 mg/dl), and Triglyceride (111.67 - 146.67 mg/dl) concentration. Meanwhile, a reduction in Bifidobacterial (59.5 - 41.5 CFU), and an increasing of AST (66.62 - 70.30 U/l) were recorded for CFRD. However, Bacteroides (40.5 69.5 CFU), LDL (30.95 - 41.98 mg/dl) increased and Bifidobacterial (59.5 - 38.00 CFU) and HDL (68.2 - 53.5 mg/dl) decreased for CPRD. This work, therefore, concludes that macronutrient restriction causes significant changes in serum marker and enzyme profile, and gut microbial composition which can cause gut dysbiosis and later on could expose the host to inflammatory diseases in the long run.