Dr Nithiya Sinarajoo / Professor Dr Noran Naqiah Hairi / Professor Dr Moy Foong Ming

An aging population is one of the public health greatest success story. However, the rising number of non-communicable disease (NCD's) such as diabetes, cardiovascular disease and cancer among older people reduces their quality of life.

Evidence shows that more than 15 million of all deaths attributed to NCDs occur between the ages of 30 and 69 years. Healthy aging must start much earlier, before one becomes an older adult.

The million-dollar question is on how to reduce the rising burden of NCDs among older adults in a holistic manner?

Where and when do we start? The answers to all these questions would be the life course approach where the prevention of NCDs begins from the mother's womb itself. These are some of the examples on how personalized womb to tomb care can help to reduce NCDs among older adults.

Firstly, during pregnancy: mothers should go for regular antenatal check up. Studies show that impaired fetal growth (due to maternal underweight and nutritional deficiency and preterm babies) is associated with the maternal risks of heart attack, diabetes and hypertension at the later stage of life.

Children born of diabetic mothers are more likely to develop diabetes. Regular screening during antenatal follow up can detect and prevent early complications such hypertension or diabetes during pregnancy.

A pregnant mother's diet need to be modified to accommodate the nutritional needs of the baby.

During antenatal appointments, baby's growth will be monitored, and any growth retardation can be detected earlier, and action can be taken.

Secondly, during the infant period through school-going stage: breastfeeding is encouraged for the babies. Formula milk consumption is related to higher cardiovascular risks.

Growth retardation during childhood also appears to be a risk factor for chronic disease during adulthood. Childhood obesity is a risk factor for NCDs during later stage of life.

Many unhealthy behaviors that underlie NCDs start during childhood and adolescence. School children should be educated to consume healthy diet. Physical activity, taking proper nutrition, avoidance of substance abuse should be practiced during school life.

Curriculum on healthy lifestyle needs to be enforced in the school syllabus. Effective self-management behaviors should be encouraged since childhood.

Thirdly, during midlife and adulthood: unhealthy diets, physical inactivity, obesity, smoking and excessive use of alcohol are common risk factors of NCDs. During this stage, NCDs tend to manifest.

Maintaining healthy weight, reducing dietary salt, unhealthy fats, sugars, and increasing fresh fruits and vegetables in daily diet is essential at this stage.

One has to avoid excessive use of alcohol and stop smoking. We can start to be physically active just by brisk walking. Even though we may be too busy, carrying out at least 15-20 minutes of brisk walking every day is very beneficial to our health.

In the end, it's the quality and not the quantity of life that matters. Changes in physical as well as cognitive function are common in normal aging.

Therefore, it is important to find activities that interest you and could enhance your well-being. Keep interested and stay involved in social activities. Enjoy the company of others, this helps to maintain cognitive capabilities.

In conclusion, life course approach can reduce NCDs' burden and promise healthy aging in our community. Let's maximize healthy lives from womb to tomb for a better future.

References

Darnton-Hill, I., Nishida, C., & James, W. (2017). A life course approach to diet, nutrition and the prevention of chronic diseases. 

Gyasi, R. M., & Phillips, D. R. (2020). Aging and the Rising Burden of Non-communicable Diseases in Sub-Saharan Africa and other Low- and Middle-Income Countries: A Call for Holistic Action. The Gerontologist, 60(5), 806–811. 

Rudnicka, E., Napierała, P., Podfigurna, A., Męczekalski, B., Smolarczyk, R., & Grymowicz, M. (2020). The World Health Organization (WHO) approach to healthy ageing. Maturitas, 139, 6–11. 

Ruthsatz, M., & Candeias, V. (2020). Non-communicable disease prevention, nutrition and aging. Acta Biomed, 91(2), 379–388.

(Dr Nithiya Sinarajoo, Professor Dr Noran Naqiah Hairi and Professor Dr Moy Foong Ming, Center of Epidemiology & Evidence Based Practice, Department of Social & Preventive Medicine, Faculty of Medicine, Universiti Malaya.)