Hello fellow med-hivers and readers 😍! After the success of week 1 prompt my confidence level is way up, therefore I'm gonna take this opportunity to continue to participate and hopefully be able to contribute with some knowledge to the community 😊.

Although this is not my area of expertise, that is dealing with chronic diseases, I think I can still contribute with some general recommendations, especially in the physical activity area. For that reason, I believe today's post will be more practical and maybe less exhaustive than the last one (note to self - I can hear your sigh of relief 😆).

I hope today's post can help fellow hivers who suffer from non-communicable disease (NDC's) with information in order to help them make informed decisions about their lifestyle and habits. I also hope to help some doctors with some practical advice they can give to patients who suffer from NDC's.

First of all, I think it's important for for non-medical readers to understand what NDC's are. As the name indicates, non-communicable diseases are illnesses that don't transmit from person to person. According to the World Health Organization (WHO),

The main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

We can also include hypertension, osteoarthritis, osteoporosis and many others.

Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.

Behavioural and environmental factors are not the only ones that matter, that much is true. But they are the ones that we can change and have some degree of control. We cannot change our genetics or physiology, they are what they are.

Dear reader, how many times do we blame our genetics for some of these diseases, like diabetes or hypertension? Are you focusing on what you can actually change or are you running away from taking responsibility for your health? No judgement here dear reader! I too struggle sometimes to keep up with my physical activity goals 😅.

Now, let's go over some harsh facts... According to WHO,

Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally.

Yes, numbers like this can be scary dear reader, but these are the facts.

77% of all NCD deaths are in low- and middle-income countries.

This is an important thing to talk about. Poverty and NDC's are linked and its impact is astonishing. Because of the limited access to health care facilities, poor diet and other factors, people who live in low and middle-income countries are more likely to die. In fact,

The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries, particularly by increasing household costs associated with health care.

In a way we can say that by reducing NDC's we can also reduce poverty and the good news here is that low-cost solutions do exist and they can be implemented even in low-income countries!

Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from a NCD.

This shows again that behaviour factors do have a major impact. And now, the statistic I wanted to focus on for the purpose of this post is... What are the main consequences of physical inactivity regarding NDC's?

1.6 million deaths annually can be attributed to insufficient physical activity

So this means that we could prevent 1.6 million deaths annually if we did sufficient physical activity. It seems simple, but as we know, and maybe have experienced, life habits are hard to change. Another study gives us some important statistics 👇

Globally, 7.2% and 7.6% of all-cause and cardiovascular disease deaths, respectively, are attributable to physical inactivity. The proportions of non-communicable diseases attributable to physical inactivity range from 1.6% for hypertension to 8.1% for dementia.

Physical inactivity is an established risk factor for premature mortality and several non-communicable diseases. It has been estimated that in 2008, physical inactivity caused 6%–10% of the cases of premature mortality, coronary heart disease, type 2 diabetes, breast cancer and colon cancer globally.

If we see at the financial burden NDC's are it's quite significative 👇

the physical inactivity-related healthcare costs associated with these non-communicable diseases was estimated to be INT$53.8 billion worldwide in 2013

However, I believe that knowing and perceiving the risks as well as the benefits of meeting those physical activity goals are the most important in order for meaningful and long lasting changes to occur. Maybe some of you are asking what is considered a sufficient physical activity in order for us to be healthy?

Let's go over to the next section.

The following statements and recommendations are specific for people living with chronic conditions and are based on the WHO guidelines on physical activity, updated in 2020.

Evidence was reviewed for the following chronic conditions: cancer, hypertension, type 2 diabetes

First, let's see what the evidence says about the benefits of physical activity in these conditions.

Type 2 Diabetes

Among adults with type 2 diabetes, there is high-certainty evidence that physical activity is associated with decreased risk of cardiovascular disease (CVD) mortality and decreased levels of haemoglobin A1c, blood pressure, body mass index and lipids.

Hypertension

Among adults with hypertension, there is high-certainty evidence that physical activity decreases risk of progression of cardiovascular disease and reduces blood pressure, while there is moderate-certainty evidence that physical activity reduces the risk of CVD mortality.

Cancer

High-certainty evidence shows that physical activity performed postcancer diagnosis is related to lower risks of mortality from all causes and mortality from cancer in female breast cancer survivors and colorectal cancer survivors.

For achieving this benefits, first we need to start to change our sedentary behaviours as we know, keeping that behaviour will increase,

all-cause mortality, cardiovascular disease mortality and cancer mortality and incidence of cardiovascular disease, type 2 diabetes and cancer.

So, in order to avoid all of these risks it is recommended that adults with chronic conditions:

1. Limit the amount of time spent being sedentary (lying or sitting). Replace it with physical activity (PA). Even light intensity PA, like slow walking, is associated with health benefits.
2. Perform weekly, at least 150 - 300 minutes of moderate-intensity aerobic PA, like swimming, bicycle (anything that gets your heart pumping a little faster) OR 75 - 150 minutes of vigorous-intensity aerobic PA, like running, hiking uphill (anything that keeps you from talking while catching your breath)
3. Perform at least 2x/week, muscle-strengthening activities at moderate or greater intensity, involving all major muscle groups.

If this seems a lot already dear reader, the truth is the more the merrier!

Adults may increase moderate-intensity aerobic physical activity to >300 min, or do >150 min of vigorous-intensity aerobic physical activity throughout the week for additional health benefits (when not contraindicated for those with chronic conditions).

Before you go, there's a few notes that are important. If you have identified you have sedentary behaviours, or you are in a low physical fitness level, you shouldn't start doing the 75 min. of vigorous activity and going to the gym curling 5kg on your biceps!

It is imperative that you start slowly and progress from there! The key is to start! For example, start with 10 minutes (even light intensity PA) and add 5 more minutes each week. Do it at your own pace and if possible go to your doctor/physiotherapist for advice before you start.

In some cases of chronic conditions, exercise may be contra-indicated, depending on the level of incapacity/disability. For that reason, always check with your doctor if you're clear to slowly start your physical activity. However, even if you're not able to do vigorous activity due to your physical limitations that doesn't keep you from doing maybe some light PA! We have already seen that even light PA comes with health benefits.

Also, always listen to what your body is trying to say. There is no reason to overdue and hurting yourself will keep you from having the full benefits of physical activity.