Burden of disease and mortality
Non-communicable diseases (also known as non-communicable chronic diseases) are diseases that begin in childhood, accumulate, progress over a long period of time, and require systematic and long-term treatment, even lifelong. These diseases are not caused by infections and are not transmitted between people, but are caused by unhealthy habits and lifestyles that occur over a long period of time.
Currently, Vietnam's non-communicable disease (NCD) prevention activities are focusing on four main disease groups: hypertension (HTN), cardiovascular diseases (stroke, heart failure, coronary artery disease, etc.), diabetes (DM), cancers and chronic obstructive pulmonary disease (COPD).
Non-communicable diseases are the leading cause of death globally and are one of the major health challenges of the 21st century. According to statistics from the World Health Organization (WHO) in 2016, NCDs caused 71% (41 million people) of the total 57 million deaths worldwide. In Vietnam, NCDs are also the leading cause of death. Out of 10 deaths, nearly 8 people die from NCDs, mainly from cardiovascular diseases, diabetes, cancer and COPD. In 2016, Vietnam had 548,800 deaths, of which deaths from NCDs accounted for 77% and 44% of deaths from NCDs were before the age of 70.
It is estimated that each year, on average, our country has about 12.5 million people with hypertension; 3.5 million people with diabetes, 2 million people with heart disease, COPD and nearly 126,000 new cases of cancer. Each year, in our country, about 115,000 people die from cancer (315 people/day). WHO ranks Vietnam in the top 50 countries in the top 2 of the cancer map, at 78/172 countries and territories surveyed with a mortality rate of 110/100,000 people. In addition, NCDs also cause severe disability and seriously affect the quality of life of patients if not detected early and treated, monitored and cared for long term.
The role of nutrition in non-communicable diseases
According to WHO, 80% of early-stage cardiovascular disease, stroke and type 2 diabetes and over 40% of cancer can be prevented through proper diet, regular physical activity and not smoking.
Both undernutrition and overnutrition have negative effects on disease development, and the combination of both is even worse. Therefore, ensuring a healthy, reasonable and safe diet throughout the life cycle, from preparation for pregnancy, to the stage of fetal development in the womb, to the next stages of life is important for the prevention of chronic non-communicable diseases. In addition, nutrition also affects gene expression and genome formation, thereby determining opportunities for health and susceptibility to disease. Early malnutrition in the first 1000 golden days of life can also increase the risk of chronic diseases in later stages of life through the mechanism of gene and nutrition interactions.
Improper nutrition linked to chronic disease
- Eating less vegetables and fruits: Causes 1.7 million deaths, accounting for 2.8% of total deaths worldwide, including 19% of gastrointestinal cancers, 31% of ischemic heart disease and 11% of strokes. Currently, more than half of the adult population in Vietnam does not eat enough vegetables and fruits.
- Eat more energy-dense foods: Scientific evidence shows that processed foods high in fat and sugar increase the risk of obesity and have the same harmful effects as eating less vegetables and ripe fruit.
- Eating foods high in saturated fat (found in animal fat) and trans fatty acids (often found in processed foods) increases the risk of cardiovascular disease and diabetes.
- Eating too much salt: Daily salt intake increases the risk of high blood pressure, stroke, stomach cancer, kidney failure, osteoporosis and some other cardiovascular diseases. Currently, Vietnamese adults are eating (9.4g/day) almost twice the recommended amount.
Healthy nutrition prevents non-communicable diseases
According to WHO and the World Food Organization, nutritional care to prevent non-communicable diseases needs to implement the following contents:
- It is necessary to start early in each person's life with good fetal nutrition, exclusive breastfeeding for the first 6 months and continued breastfeeding up to two years of age or beyond along with appropriate complementary feeding. Comprehensive nutritional care in the first 1000 days of a child's life to prevent early malnutrition that alters metabolic processes and increases the risk of chronic disease in later stages of life.
- The diet should be based on natural foods, combining a variety of foods, balancing food groups, limiting processed foods and sweet drinks, alcohol and beer.
- Increase intake of whole grains, beans, and nuts.
- Increase intake of vegetables and fruits: You should eat at least 400g of vegetables and fruits and eat a variety of vegetables and fruits of different colors because they contain different types of nutrients and phytonutrients.
- Eat foods like eggs and dairy in moderation, eat small amounts of red meat and increase your intake of fish and lean poultry.
- Eat just enough energy and nutrients to grow, develop, meet the needs for an active and healthy life throughout the life cycle, not to be overweight, obese or have a belly fat. Choose foods with low energy density and low glycemic index.
Ensure that energy from fat is less than 30% of total energy consumption. Switch from consuming saturated fats to unsaturated fats and aim to eliminate industrial trans fats. Unsaturated fats (found in fish, avocados and sunflower seeds, soybeans, olives) are better than saturated fats (found in meat of large livestock, from dairy products of cows, goats and sheep such as butter, palm oil, coconut oil, fresh cream, cheese, animal fat) and trans fats of all kinds, including fats created in industrial production (baked, fried foods and pre-packaged processed foods and snacks).
Limit free sugars to less than 10% (preferably less than 5%) of total energy intake: Less than 50g/day (preferably less than 25g/day). Free sugars (such as sucrose, maltose, glucose, fructose) are sugars added by manufacturers to foods and beverages, during the preparation and processing of foods/drinks, and sugars naturally found in honey, syrups, fresh fruit juices and fruit juice concentrates.
Limit total salt intake to less than 5g/day by reducing salt intake, dipping lightly and reducing salty foods. Use iodized salt.
Minimize pathogens, toxins or other factors that can cause disease from food (such as aflatoxin in moldy peanuts, antibiotic residues in vegetables, fruits or meat from livestock, poultry, seafood, etc.).
Weight control to maintain weight should be at a level equivalent to BMI = 21 in people under 50 years old and BMI = 22 in people 55 years old and over and not have abdominal obesity (waist circumference < 90 cm in men and < 80 cm in women).
Maintain an active lifestyle with regular moderate or vigorous physical activity for at least 30 minutes a day; limit alcohol and do not smoke. Get vaccinated against high-risk infectious diseases such as cancer, hepatitis B, C, Herpes, etc.
Dr. Do Thi Phuong Ha - Institute of Nutrition