Non – Communicable Diseases – The Co-Killer

The COVID19 pandemic as today has infected about 400,000 and has killed more than 20,000 people, with the numbers rapidly increasing with new cases being reported from different territories. According to the World Heart Federation, “non-communicable diseases (NCD), specifically chronic obstructive pulmonary disease, heart disease, hypertension and diabetes are major risk factors for developing severe symptoms of COVID-19.” This is corroborated by a recent study from China, which reports higher prevalence in patients with hypertension (30%), diabetes (19%), and coronary heart disease (8%).

To begin with, NCDs are today the world’s biggest killers, leading to 71% of all deaths in 2018 a total of 42 million deaths per year globally. NCD is a habitual/behavioural disease stemming from unhealthy lifestyle whereby physical inactivity is one of the biggest threat. Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including the world’s major non-communicable diseases (NCDs) of coronary heart disease (CHD), type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world’s population is inactive, this presents a major public health problem.

Physical activity (PA) is defined as any bodily movement produced by skeletal muscles that results in energy expenditure. According to the WHO guidelines (2010), an adult aged 18 to 64 years should perform at least 150 minutes/week of moderate-intensity aerobic PA, or 75 min/week of vigorous-intensity aerobic PA, or an equivalent combination of moderate- and vigorous-intensity PA. In Malaysia there are 36.9% physically inactive adults. The level of inactivity was higher in females compared to males (50.0% vs 24.7%).

One of our regulars at MS New Symphony Exercise Clinic

COVID-19 is highly infectious, unlike the seasonal flu (which some are prone to compare it to). The virus affects persons with a compromised/weakened immune system. An unhealthy lifestyle has been a risk factor to the development of NCDs and associated comorbidities, and calorie deficits are known to weaken the immune system. A viral disease like COVID- 19 can spread fast, undetected and kill already immunocompromised populations – like the elderly, and those with chronic non-communicable disease.

Another important factor to note is that coronavirus does not affect all ages equally. A study by the Chinese Center for Disease Control and Prevention concludes that older people with pre-existing health conditions are more prone to getting affected by coronavirus. In Malaysia, more than 70% of the overall deaths by COVID19 has co-morbidities of NCDs. The risk to COVID-19 is higher in people with weak immune defences and can further be compromised in chronic conditions like heart disease, lung disease and diabetes. Adding to the burden can be emotional stress, lack of sleep and physical exhaustion, which can further make one prone to diseases by weakening immunity.

Public exercise session before the MCO

Maintaining a healthy diet with food that boost immunity can help fight infections. Physical activity and nutrition have known to boost the immune system. Foods rich in Vitamin C, D, and E improve the immune system by increasing the infection-fighting cells. The antioxidant in Vitamin C & E plays an important role in controlling infections and functioning of the immune system. Increasing the consumption of citrus fruits, bell peppers, garlic, ginger, spinach, yogurt, almond, turmeric, papaya in one’s daily diet can help strengthen immunity to fight infections. Also keeping the body hydrated and adequate sleep to increase protein associated with infection and inflammation can help in curtailing the disease.

Source: Chinese Center for Disease Control and Prevention, February 2020

It is important to keep in mind, however, that what works in combating COVID-19 itself is yet unknown. “Your immune system is (the) best weapon against coronavirus,” as said by a Turkish scholar. Strengthening the immune system with healthy nutrition and exercising with a low to moderate intensity may help equip people with a defense mechanism against viruses.

新冠肺炎已感染了约40万人,并杀死了2万多人,而且这一数字正在迅速增加,不同地区每天几乎都有新病例报告。

根据世界心脏联合会(World Heart Federation)的说法,非传染性疾病(NCD),特别是慢性阻塞性肺疾病,心脏病,高血压和糖尿病是产生COVID-19严重症状的主要危险因素。

中国最近的一项研究证实了这一点,该研究指出,高血压(30%)、糖尿病(19%)和冠心病(8%)患者感染新冠肺炎的机率较高。首先,非传染性疾病是当今世界上最大的杀手,在2018年占所有死亡率的71%,全球每年共有4200万人死于非传染性疾病。

非传染性疾病是一种不健康的生活方式引起的习惯性/行为性疾病,因此缺乏运动是最大的威胁之一。已经有很多的研究表明,缺乏运动会增加许多不利于健康状况的风险,包括冠心病(CHD)、2型糖尿病、乳腺癌以及结肠癌等世界几项主要的非传染性疾病,并且还会缩短人类的寿命。由于世界上依然有许多人不注重运动,因此这是一个重大的公共卫生议题。

体力活动(Physical Activity,PA)定义为骨骼肌产生的任何导致能量消耗的身体运动。根据世界卫生组织的(WHO)于2010发表的指南显示,年龄在18至64岁之间的成年人应每周至少进行150分钟的中等强度有氧运动,或每周进行75分钟的剧烈强度有氧PA,或同等的组合和高强度PA。在马来西亚,有36.9%的成年人处于不活跃的状,而与男性相比,女性的不活跃水平更高(50.0%对24.7%)。

 新冠肺炎具有高度传染性,与季节性流感不同(有些人很容易将其与之相比),该病毒会感染免疫系统受损或虚弱的人。

 而不健康的生活方式一直是非传染性疾病和相关合并症发展的危险因素,已知热量不足会削弱免疫系统。像新冠肺炎这样的病毒性疾病可以迅速传播,在还未变检测出来时已经能杀死免疫受损的人群,例如老年人和患有慢性非传染性疾病的人群。

要注意的另一个重要因素是冠状病毒并不会公平的影响各个年龄段,中国疾病预防控制中心的一项研究得出了结论,患有健康状况的老年人更容易受到冠状病毒的感染。

在马来西亚,新冠肺炎死亡总数的70%以上是非传染性疾病的合并症。免疫防御能力较弱的人患新冠肺炎的风险更高,在心脏病、肺病和糖尿病等慢性疾病中可能会进一步受到危害。精神压力、睡眠不足和身体疲惫可能会加重负担,这可能会通过削弱免疫力使人更容易患上疾病。

用能增强免疫力的食物维持健康的饮食可以帮助抵抗感染。 众所周知,运动和营养可以增强免疫系统。 富含维生素C、D和E的食物可通过增加抵抗感染的细胞来改善免疫系统 

 维生素C和E中的抗氧化剂在控制感染和免疫系统功能中起着重要作用, 在日常饮食中增加柑橘类水果、甜椒、大蒜、生姜、菠菜、酸奶、杏仁、姜黄和木瓜的摄入量可以帮助增强抵抗感染的免疫力。 同样,保持身体水分充足、充足的睡眠可以增加蛋白质,以帮助减少疾病。

资料来源:中国疾病预防控制中心,2020年2月