Non-Communicable Diseases and Lifestyle-Related Diseases among Filipinos

1. NON-COMMUNICABLE DISEASES
– LIFESTYLE RELATED DISEASES
IEC
WILMA N. BERALDE, RM, RN, MAN
NDP – Balatan
Non – Communicable Disease Coordinator

3. 4 MAJOR NCDs IN THE
PHILIPPINES
• CARDIOVASCULAR DISEASES
• CANCERS
• CHRONIC OBSTRUCTIVE PULMONARY
DISEASES
• DIABETES MELLITUS

4.  The Philippines is one of the 23 selected
countries contributing to around 80% of the total
mortality burden attributable to chronic diseases
in developing countries, and 50% of the total
disease burden caused by NCDs worldwide
(Lancet, 2007)
Epidemiology of the Major NCDs

5. Common Risk Factors Leading to Major NCDs
Risk Factors
Cardiovascular
Diseases
Diabetes
Mellitus
Cancers
Chronic
Respiratory
Diseases
Smoking    
Diet/Nutrition    
Physical inactivity    
Obesity    
Alcohol   
Raised blood
pressure
  
Raised blood sugar   
Abnormal blood
lipids
  
* coronary artery disease, hypertension, stroke
**chronic obstructive pulmonary disease, asthma
Source: WHO STEPwise Approach to Surveillance of NCD Risk, 2003

7. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES
Coronary Artery Disease
Myocardial Infarction
Congenital Heart Disease
Congestive Heart Failure
Hypertension
Cardiovascular Disease
• describes a range of diseases that affect the heart and blood vessels and includes:
Stroke
Arrhythmias
others.

8. Description of Major NCDs
– Coronary artery diseases
– Hypertension
– Cerebrovascular diseases
(stroke)
• increased total cholesterol, high LDL,
low HDL, smoking,
obesity/overweight, physical
inactivity, diabetes
• Family history, age, high salt intake,
obesity, excess alcohol intake
• Age, sex, heredity, hypertension,
smoking, diabetes, heart disease, high
RBC, excessive alcohol intake, drug
abuse
Cardiovascular diseases and their risk factors

9. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES

10. HYPERTENSION
An increase in blood pressure ≥ 140/90 mmHg in two (2) or
more separate occasions.
One of the leading causes of disability among Filipinos due to
stroke.
Classification of blood pressure for adults
BLOOD PRESSURE
CLASSIFICATION
SYSTOLIC BP DIASTOLIC BP
NORMAL LESS THAN 120 mmHg
LESS THAN 80
mmHg
PRE HYPERTENSION 120 - 139 mmHg 80 – 89 mmHg
Stage 1
Hypertension
140 – 159 mmHg 90 – 99 mmHg
Stage 2
Hypertension
160 mmHg or Higher
100 mmHg or
higher

11. HYPERTENSION
RISKFACTORS
 Smoking
 Excessive alcohol consumption
 Overweight
 Family history of hypertension, heart disease, diabetes and
kidney disease
 Sedentary lifestyle
 Chronic stress
 Advancing age
PREVENTION
 Regular exercise and eating”heart healthy” diet
 Excessive alcohol consumption and cigarette smoking
also increases the likelihood of hypertension

12. HYPERTENSION
USUAL SIGN AND SYMPTOMS
NOT ALL HYPERTENSIVE PATIENTS HAVE SYMPTOMS….
 Headache
 Dizziness
 Blurring of visions
 Nape/ neck discomfort
EARLY DETECTION IS AN IMPORTANT FACTOR FOR PREVENTING
FURTHER COMPLICATIONS……
POSSIBLECOMPLICATIONS
Chronic, undiagnosed and untreated hypertension may
result to:
Heart attack stroke kidney failure loss of vision

13. Lifestyle modification to prevent and manage
hypertension
LIFESTYLE
MODIFICATION
RECOMMENDATION APPROXIMATE SYSTOLIC
BP REDUCTION
Weight reduction Maintain normal body weight 5-20 mmHg
Adopt DASH eating
plan (dietary
Approach to stop
hypertension)
Consume a diet rich in fruits,
vegetables, and low fat dairy
products
8-14 mmHg
Dietary sodium (salt)
restriction
Reduce dietary sodium intake 2 – 8 mmHg
Physical activity Engage in regular aerobic physical
activity such as brisk walking (at
least 30 min per day, most days of
the week)
4 -9 mmHg
Moderation of
alcohol consumption
Limit consumption to no more than
2 drinks per day in most men and
not more than 1 drink per day in
women and lighter weight persons
2 -4 mmHg

15. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES
Type 1 Type 2
Body’s failure to
produce insulin
and usually sets
in among the
young
population
groups
Secondary to
decreased
activity of the
insulin produced
which results in
increased blood
sugar level and
usually sets in
among the older
age groups

16. – Diabetes • Family history, overweight, lack of
physical activity, hypertension,
HDL < 35mg/dl, triglyceride
>250mg/dl, history of gestational
diabetes, with impaired glucose
tolerance
Diabetes and its risk factors
Description of Major NCDs

17. DIABETES
group of metabolic disorders
characterized by high blood sugar level
on 2 separate occasions
results when the body cannot properly
regulate the amount of sugar (e.g.
glucose in the blood)

18. DIABETES
4 clinical types of diabetes
Type 1 : INSULINDEPENDENTDIABETES
Type 2 : NON-INSULINDEPENDENTDIABETES
whocan be managed throughoral anti-diabetic
medications but mayeventuallyalso require insulin
treatment to attaingood blood glucose control
Type 3 : GESTATIONALDIABETES
whowere first diagnosedto have diabetesduring pregnancy
Type 4 :SECONDARY DIABETES
acquired diabetesthat may be drugor chemical-inducedsuchas those whoare being
treatedfor AIDSor from other endocrine diseases suchas hyperthyroidism.

19. Values for the diagnosis of diabetes and other categories of
hyperglycemia
Type of Testing FBS Values Classification
Criteria for
Diagnoses of
Diabetes Mellitus
Fasting blood sugar
(FBS) - no caloric intake
for at least 8 hours
which means no food,
juices, milk, but water is
allowed
2-hour blood sugar test:
performed after using
75 g glucose dissolved in
water or after a good
meal
109 mg% Normal Any of the following:
Symptoms of diabetes
plus RBS> 200 mg/dL
(11.1 mmol/L)
FBS> 126 mg/ dL (7.0
mmol)
2-hr blood sugar >
200 mg/dL (11.1
mmol/L) during an
oral glucose tolerance
test (OGTT)*
110- 125 mg% Impaired
glucose
tolerance
126 mg% Possible
diabetes
mellitus
* FPG estimation is the biochemical test of choice for screening in all age groups. In adults,
FPG measurement has been found to be more reproducible than the 2-hour plasma glucose
level following an OGTT.
**OGTT is the gold standard for diagnosing diabetes and can be used as a screening test.

20. DIABETES
RISK FACTORS FOR DIABETES
 High blood pressure
 High triglyceride levels
 Giving birth to an 8 lb baby
 Sedentary lifestyle
 Obesity
 Family history of type 2 diabetes mellitus among 1st
degree relatives
USUAL S/S OF DIABETES
 Fatigue excessive urination
 Unexplained weight loss poor wound healing
 Excessive thirst Excessive hunger

21. DIABETES
PREVENTION
Diabetes , a lifestyle –related disease which can
be prevented through regular exercise (at least
30 min every other day) and eating a “heart
healthy” diet (i.e. low -salt ,low-fat diet)
Excessive alcohol consumption and cigarette
smoking also increases the likelihood of
diabetes

23. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES

24. Cancer warning signs
Guidelines for Common Screening
Procedures for Major NCDs
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in warts or moles
Nagging cough or hoarseness in voice
Unexplained anemia
Sudden weight loss

25. – Oral cancer
– Breast cancer
– Lung cancer
– Cervical cancer
• Smoking, excessive alcohol
use, chronic irritation, Vitamin
A deficiency
• Early menarche/late
menopause, high fat diet,
obesity, physical inactivity,
alcohol, family history
• Smoking, radiation exposure
• Smoking, HPV infection,
chlamydia infection, low
intake of fruits and vegetables,
family history
Some cancers and their risk factors
Description of Major NCDs

26. Screening guidelines for breast cancer
(targets 15-60 years old and above)
• Monthly breast self-examination
• Breast examination by health worker (annually) for all child-bearing
woman
• Annual mammography for women over 50 years old and above
• For certain high risk women, baseline mammography at age 35 with
repeat upon recommendation of attending physician
• Genetic screening and counseling for high risk patients or if
appropriate
• Referral to hospital for further management if found positive (+) for
mass or any abnormalities
Guidelines for Common Screening
Procedures for Major NCDs

27. Breast Self- Examination
Guidelines for Common Screening
Procedures for Major NCDs
Stand in front of a
mirror. Check each
breast for anything
unusual (dimpling,
discharge).
Clasp your hands
behind your head and
press hands forward.
Check contour of
breast.

28. Breast Self- Examination
Guidelines for Common Screening
Procedures for Major NCDs
Gently squeeze each nipple
and look for discharge
While standing, raise one arm. Use
finger pads to check the breast and
surrounding area – firmly, carefully and
thoroughly.

29. Breast Self- Examination
Guidelines for Common Screening
Procedures for Major NCDs
Lines
CirclesWedges

30. Breast Self- Examination
Guidelines for Common Screening
Procedures for Major NCDs
Lie flat on your back, with one arm over your head and a
pillow or folded towel under the shoulder. This position
flattens the breast and makes it easier to check.

31. Changes in the breast that should be noted and reported to a
physician
• Any lump or hard knot
found in the breast or
armpit
• Any lump or thickening
of the tissue that does
not shrink or lessen aftr
her next period
• Any change in the size,
shape, or symmetry of
her breast
• A thickening or swelling
of the breast
• Any dimpling, puckering,
or indention in the
breast
• Dimpling, skin irritation,
or other change in the
breast skin or nipple
• Redness or scaliness of
the nipple or breast skin
• Discharge from the
nipple (fluid coming from
the nipples other than
breast milk), particularly
if the discharge is clear
and sticky, dark or occurs
without squeezing the
nipple
• Nipple tenderness or
pain
Guidelines for Common Screening
Procedures for Major NCDs

33. – COPD
– Asthma
• Smoking
• Genetic predisposition,
allergens, smoking, air
pollution, respiratory
infections
COPD and Asthma and their risk factors
Description of Major NCDs

34. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES
Chronic Respiratory Disease
• The most common morbid conditions suffered by Filipinos are respiratory diseases.
Major causes of death
due to Respiratory
causes
• Chronic Respiratory
Diseases (Asthma,
COPDs)
• Pneumonia
Top leading
Respiratory causes of
Morbidity
• Acute Respiratory
Infection
• Acute Lower
Respiratory Tract
Infection
• Pneumonia
• Bronchitis

35. NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES

37.  Accidents are unintentional, unexpected and undesirable
events while injuries are either intentional or
unintentional events that result in damage or harm to a
person (DOH, 2005).
 Most accidents and injuries can be avoided.
 Their effects can be reduced through measures like road safety
education, installation of adequate walkways, streetlights,
signages, and home safety management.
 In high-income countries, road traffic injuries, self-inflicted
injuries and interpersonal violence are the three leading
causes of death among those aged 15 to 44 years.
 In the same age group, there are twice as many suicides and
three times as many traffic-related deaths as homicides.
NON-COMMUNICABLE DISEASES – LIFESTYLE RELATED DISEASES
CANCER HEART DISEASE LUNG DISEASE DIABETES
ACCIDENTS &
INJURIES

42. Key Areas for the Primary Prevention of the
Major NCDs
 Promote Proper Nutrition
 Encourage more physical activity and exercise
 Promote smoke-free individuals and environment
 Discourage excessive alcohol drinking
 Manage stress effectively
 Maintain regular health check-up

43. • Smoking cessation for active smokers to reduce risk
• Prohibit smoking inside living areas, houses and closed areas
• Avoid smoke-filled places
• Advocate for implementation of policies that support smoke-
free environment
• Support policies/ordinances/laws that limit access of cigarettes
to children and youth
PROMOTE SMOKE-FREE INDIVIDUALS
AND ENVIRONMENT
Key Areas for the Primary Prevention of the
Major NCDs

45. • Discourage excessive alcohol drinking
• Regular health check-up for early diagnosis and prompt
treatment
PROMOTE ALCOHOL-FREE ENVIRONMENT
Key Areas for the Primary Prevention of the
Major NCDs

47. • Limit intake of fatty, salty and preserved foods
• Increase intake of vegetables and fruits
• Avoid high caloric low-nutrient value food like junk food, instant
noodles, soft drinks
• Start developing healthy habits in children
PROMOTE PROPER NUTRITION
Key Areas for the Primary Prevention of the
Major NCDs

49. • Moderate physical activity of at least 30 minutes for most days
• Integrate physical activity and exercise into regular day-to-
day activities
• Promote walking as one form of exercise that is possible for all
including older persons and persons with cardiovascular
disease
ENCOURAGE MORE PHYSICAL ACTIVITY
Key Areas for the Primary Prevention of the
Major NCDs

51. • Manage stress effectively
• Regular health check-up for early diagnosis and prompt
treatment
PROMOTE A STRESS-FREE ENVIRONMENT
Key Areas for the Primary Prevention of the
Major NCDs

53. wilmarmrnman