Diet and Non-Communicable Diseases

NCDs & Diet - The Basic Bind

• Diet: Key modifiable risk factor for Non-Communicable Diseases (NCDs).
• Impact via:
  • Caloric imbalance (→ Obesity).
  • Nutrient quality (unhealthy fats, sugars, salt, low fiber).
• Major Diet-Related NCDs:
  • Obesity: ↑Energy intake, ↓expenditure.
  • Type 2 Diabetes (T2DM): Linked to obesity, high glycemic index foods.
  • Hypertension (HTN): ↑Sodium, ↓Potassium.
  • Cardiovascular Disease (CVD): Saturated/trans fats, ↓fruits/vegetables.
  • Cancers (e.g., colorectal): ↓Fiber, ↑red/processed meat.
• 

⭐ Globally, dietary risk factors are estimated to account for 11 million deaths and 255 million disability-adjusted life years (DALYs) annually (GBD 2017).

Dietary Villains - Bad Bites

• Saturated Fats:
  • Sources: Ghee, butter, red meat, palm/coconut oil.
  • Impact: ↑ LDL cholesterol → Atherosclerosis.
  • WHO: < 10% total energy.
• Trans Fats (TFAs):
  • Sources: Vanaspati, bakery items, fried foods.
  • Impact: ↑ LDL, ↓ HDL → Highest CVD risk.
  • WHO: < 1% total energy; aim for elimination.
• Excess Free Sugars:
  • Sources: Sweets, sugary drinks (SSBs), processed foods.
  • Impact: Obesity, dental caries, insulin resistance, T2DM.
  • WHO: < 10% total energy (ideally < 5%).
• High Salt (Sodium):
  • Sources: Pickles, papads, processed foods, table salt.
  • Impact: ↑ Blood pressure → Hypertension, CVD, stroke.

  ⭐ WHO: Daily salt intake < 5g (< 2g sodium/day) to ↓ BP & CVD risk.

• Processed Foods:
  • Often high in unhealthy fats, sugar, salt; low in fiber.
  • Contribute to overall NCD risk. 📌 Villains: Sour Sweets Taste Salty & Processed.

Dietary Heroes - Good Grub

• Fiber Power: WHO recommends ≥25g/day.
  • Soluble (oats, legumes, fruits): ↓LDL cholesterol, improves glycemic control.
  • Insoluble (whole grains, vegetables): Promotes gut health, ↑satiety.
• Fruits & Veggies Rainbow: ≥5 servings (≥400g) daily. Rich in vitamins, minerals, antioxidants, fiber. 📌 "Eat 5 A Day"
• Healthy Fats Focus:
  • MUFA (olive oil, avocados, nuts): ↓LDL, anti-inflammatory.
  • PUFA (Omega-3: fatty fish, flaxseeds, walnuts; Omega-6: sunflower oil): Essential for heart & brain health.
• Antioxidant Arsenal: Vitamins A, C, E; Selenium; Phytochemicals (flavonoids, carotenoids). Neutralize free radicals.
• Star Dietary Patterns:
  • DASH Diet: ↑Fruits, vegetables, whole grains, lean protein, low-fat dairy; ↓Sodium, saturated/trans fats.
  • Mediterranean Diet: ↑Fruits, vegetables, nuts, legumes, whole grains, fish, olive oil; moderate wine.

⭐ The Mediterranean diet is associated with a ~30% reduction in cardiovascular events (e.g., PREDIMED trial).

India's NCD Fight - Nutrition Notes

• ICMR/NIN Dietary Guidelines (NCD Prevention):
  • Salt: Limit to < 5 g/day.
  • Added Sugar: < 25 g/day (or < 10% of total daily energy).
  • Total Fat: 20-30% of total energy.
    • Saturated Fats (SFA): < 10%.
    • Trans Fats (TFA): < 1%.
    • Prioritize MUFA & PUFA.
  • Fruits & Vegetables: ≥ 400 g/day (at least 5 servings).
  • Emphasize whole grains, millets, pulses.
• FSSAI - Eat Right India Initiative:
  • Promotes safe, healthy, sustainable food.
  • Key messages: "Aaj se thoda kam" (Salt, Sugar, Fat).
  • Advocates for food fortification (+F logo).
• NPCDCS (National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke):
  • Focuses on health promotion, including dietary interventions for NCD control.

⭐ ICMR recommends daily salt intake < 5 g/day (equivalent to Sodium < 2000 mg/day) for NCD prevention.

High‑Yield Points - ⚡ Biggest Takeaways

• High salt intake (>5g/day) is a key risk for hypertension & CVD.
• Trans fats & saturated fats ↑ CVD risk; PUFA/MUFA are protective.
• Low fiber diet linked to colon cancer, diabetes, & obesity.
• Excess sugar contributes to obesity, Type 2 Diabetes, & dental caries.
• DASH diet effectively controls hypertension; Mediterranean diet is cardioprotective.
• High processed/red meat intake ↑ colorectal cancer risk.