By Chidinma Omereji
Modifiable risk factors can help in identifying emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCDs). Among the important risk factors for NCDs are malnutrition and unhealthy diets (Francesco et al., 2019). Non communicable diseases are diseases of long duration and slow progression. They are not transmitted from one person to another but are a result of a combination of genetic, physiological, environmental, and behavioural factors, having the most significant impact on deaths worldwide (WHO, 2018). According to the Pan American Health Organization, cardiovascular diseases, cancer, respiratory diseases, and diabetes are the four leading causes of NCD deaths (Pan American Health Organisation, 2016).
Human nutrition deals with all the effects of any component found in food on people. It comprises the physiological and biochemical processes involved in nourishment which includes how substances in food provide energy or are converted into body tissues and the diseases that result from insufficient or excess of essential nutrients (Jim & Stewart, 2017). It also refers to the study of the relationship between people and their foods (Mary, 2003).
On the other hand, malnutrition includes nutritional disorders caused by deficient intake of energy or nutrients such as stunting, wasting, and micronutrient deficiencies. It also includes excessive and imbalanced intake of nutrients leading to overweight, obesity, and diet-related NCDs. Both categories of malnutrition are caused by unhealthy, poor quality diets.
Malnutrition is a global challenge that all countries need to address. There are suggestions that the prime cause of high magnitude of NCDs is unhealthy dietary behaviour (Alam et al., 2019). Poor diet is one of the biggest contributors to NCDs burden in all six World Health Organization regions (Francesco et al., 2019). Whereas NCDs disproportionately affect vulnerable and disadvantaged groups in wealthier countries, about 85% of premature deaths from NCDs now occur in low and middle income countries, where people also bear the greater burden of poor nutrition. A descending order of the number of deaths caused by diet-related NCDs annually is shown below (WHO, 2018):
- Cardiovascular diseases — 17.9 million people
- Cancers — 9 million people
- Diabetes — 1.6 million people
Not everyone takes alcohol, smokes, nor is physically inactive all the time, but everyone eats on a daily basis and this may directly or indirectly predispose to other risk factors which eventually determine our health status in the long run. The understanding and awareness of nutrition is a basic necessity to optimally promote health maintenance, prevent diseases including NCDs, facilitate recovery from illness, and augment the treatment of diseases.
Good nutrition is fundamental to human health and could greatly reduce the risk of NCDs. Poor quality diets, malnutrition in all its forms, and NCDs are closely related. While there has been an increase in the availability of inexpensive, high-calorie foods often from staple cereal crops which has reduced hunger for many, it has, however, often been at the expense of healthier diets. Unhealthy foods with salt, sugars, saturated fats, and trans fats have become cheaper and more widely available. The global demand and supply of meat, dairy products, sugar-sweetened drinks, and processed/ultra-processed foods has increased dramatically. Unfortunately, access to diverse micronutrient rich foods such as fresh fruits, vegetables, legumes, pulses, and nuts has not improved equally for everyone (Glopan, 2016). Many factors influence consumers’ dietary behaviours, from personal such as culture, knowledge, skills, dietary preferences, and time for food preparation to economic and political such as the cost or availability of food. Information about food, whether through education or marketing, also influences choices (Francesco et al., 2019). Better nutrition is related to improved child and maternal health, stronger immune system, safer pregnancy and childbirth, lower risk of non-communicable disease, and longevity (WHO, 2017). Specific recommendations for a healthy diet include:
- Consuming predominantly plant based diet such as fruits, vegetables, legumes, nuts, and grains;
- Reducing salt, sugar, and fat intake; and
- Consuming more unsaturated fats instead of saturated ones.
In spite of these glaring challenges, pharmacists remain well placed as the most accessible health professionals globally. Effective utilisation of pharmacists’ knowledge and skills have been shown to improve the delivery of healthcare services. There is evidence of the potential need for pharmacist involvement in the delivery of dietary advice. In the UK, community pharmacists undertake public health work, and their role in managing conditions requiring dietary advice can be effective (Botomino et al., 2008). Pharmacists do have a role to play in delivering health weight management programmes, and more training is needed to equip pharmacists and their staff with appropriate knowledge and skills to deliver these services effectively (Newlands et al., 2011). The Association for Nutrition in 2012 recognised the increased role of pharmacists in the provision of dietary advice and suggested enhanced pharmacists access to evidence-based dietary materials. Pharmacists in their respective countries should also advocate for implementation of WHO measures such as restricting marketing of unhealthy foods to children, taxing sugar sweetened drinks, or banning industrial trans fats.
In conclusion, the unique role that pharmacists play as the most accessible health professionals worldwide cannot be overemphasised, and it strategically positions pharmacists to contribute immensely to the fight against NCDs burden. Hence, the more knowledge pharmacists have about NCDs prevention, as well as its management, would contribute a whole lot in reducing the global burden of NCDs. Pharmacists could play diverse roles in the prevention and treatment of NCDs via nutritional support including counselling patients on special dietary modifications, developing dietary plans, and providing dietary advice for healthy lifestyle in order to promote health and prevent disease. Empowerment of pharmacists through adequate knowledge and skill acquisition will enhance the quality of care provided to patients with NCDs and also promote the prevention of such diseases.
References
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Botomino A, Bruppacher R, Krähenbühl S, Hersberger K. (2008). Change of body weight and lifestyle of persons at risk for diabetes after screening and counselling in pharmacies. Pharmacy World and Science. https://doi.org/10.1007/s11096-007-9174-3
Francesco B, Anna L, Stineke O, Victor A, Gunhild S, Ruth R, Mario A, Ashkan A. (2019). Transforming the food system to fight non-communicable diseases. The British Medical Journal. https://doi.org/10.1136/bmj.l296
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Pan American Health Organization. (2016). Communicable diseases and health analysis/health information and analysis. Health situation in America. Core indicators http://iris.paho.org/xmlui/handle/123456789/31289?locale-attribute=en
World Health Organisation. (n.d.). Non-communicable diseases. https://www.emro.who.int/noncommunicable-diseases/causes/index.html
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