International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 44 Editorial: Lifestyle Changes in the Management of Non-Communicable Diseases in Low and Middle- income Countries Mainul Haque1 Keywords : Way of life, Alteration, Management, Avert, Handle, Deal with, NCDs, Non-Communicable Diseases, Resource-Constraint, Developing, Countries. Correspondence to: Mainul Haque, Professor of the Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia. Land Line: +60 3 9051 3400 Ext 2257 (Office). +60 3 6179 5871 (Home). Cell Phone: + 60 10 926 5543. Email: runurono@gmail.com Orcid ID: https://orcid.org/0000-0002-6124-7993 International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page : 4-6 DOI: http://dx.doi.org/10.31344/ijhhs.v5i1.223 Non-communicable diseases (NCDs) embracing cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing all over the globe, but disproportionately in high frequency in low- and middle-income countries (LMICs). 1-4 Although our planet has achieved a lot in reducing deaths from infectious and contagious diseases. 5 A significant portion of patients suffering from NCDs did not get enough healthcare support in LMICs, although treatment options are available and access in high-income countries (HICs). 2, 6 The globe is observing high death rates due to NCDs, but the situation turns into a grave public health risk in LMICs. 6-8 The chronic NCDs on most occasions to date do not have much curative treatment. The current pharmacological invention possibilities clinically available are controlling and prevention strategies. Furthermore, LMICs because of resource constraint management of NCDs is quite limited to address the whole population. Additionally, research regarding NCDs management principally conducted in HICs. 2 Usually LMICs follows management strategies for NCDs developed in HICs. The need for research regarding NCDs management has been recognized to improve prevention and control strategies for specific country context; again, resource constraints remain a major issue for research. 2, 6, 9 Lifestyle is an essential component that has been identified as the primary cause of NCDs around the globe. 10 Tobacco, and alcohol consumption, unhealthy dietary practice, overweight and obesity, hypercholesterolemia, with sedentary life has been recognized as a significant cause of NCDs. 6, 11, 12 These causative factors are the part of lifestyle disorders correlated to NCDs and considered as the modifiable risk factors. 13 All these risk issues act as a leading role in producing NCDs, a group of them called as metabolic syndrome had been extreme apprehension for the last few decades. 13 NCDs appears as a significant cause of morbidity and mortality. The situation much worse in LMICs because of resource constraints. It is additionally speculated that NCDs will cause around seventy percent mortality in LMICs by 2020. 12 Metabolic syndromes are the most common metabolic disorder, which ultimately causes cardiovascular diseases and diabetes.13 Additionally, these risk factors of NCDs are correlated with cancer and chronic pulmonary disease.12 The principal preventive measures regarding NCDs are focused on the road in modifying lifestyle-related risk factors. 14, 15 One Indian study conducted in Barwala village, Delhi, India, reported that the study participants were contacted on their cell phone once a month for about 20 minutes. Researchers during discussion emphasis repeatedly the necessity of adaptation of a healthful lifestyle in promoting their overall health. Investigators additionally meet the study participant’s health-related questions and on condition that optimistic support. This research package also included weekly short message service (SMS). The SMS contained 25–30 words mentioning within brief but attractive sayings and Running Title: Lifestyle Changes in the Management of Non-Communicable Diseases 5 International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 limericks on the significance of amendment of risk factors. This finally reported that this cost-effective strategy of counseling had a positive outcome in turning-down lifestyle-related risk factors and promoting health.14 Another multicentre study from South Asia conducted among fourteen to seventeen years old population of six different schools found that more than 80% of the study- participants consume unwholesome foods, and 54% were physically inactive especially girls (OR, 4.07; 95% CI, 2.69 to 6.17). Much of the study-participants often exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and 14% were regular smokers more observed among males (OR, 2.17; 95% CI, 1.19 to 3.91). More than 33% of study-participants chewed betel nut (OR, 2.03; 95% CI, 1.34 to 3.06), and 25% used oral tobacco. This finally concluded that these lifestyle-related risk factors are preventable with the comprehensive and integrated intervention program. 15 Another research similarly reported that educational intercessions targeting to alter dietary habits, and lifestyle features, varying the environment, changing the food supply, commissioning community involvements, and instigating economic policy strategies. 16 Multiple countries around the globe implemented high- level tax for tobacco, sugar-sweetened beverages, and many other unhealthy foods and improved in maintaining a healthy lifestyle.17-19 Bangladesh and other LMICs should stringent policy measures to modify lifestyle-related risk factors of NCDs to safeguard their ordinary people. Furthermore, LMICs need to amend their health policy planning based on primary health care strategies to improve the the overall health care system.20-24 Funding This research did not obtain any financial support. Conflict of Interest The authors do not possess any conflict of interest. References: 1. World Health Organization. Noncommunicable diseases. Key Facts. 2018. Available at https:// w w w. w h o . i n t / n e w s - r o o m / f a c t - s h e e t s / d e t a i l / noncommunicable-diseases [Accessed February 13, 2020] 2. Checkley W, Ghannem H, Irazola V, et al. Management of NCD in low- and middle-income countries. Glob Heart. 2014;9(4):431–443. https:// doi.org/10.1016/j.gheart.2014.11.003 3. Lee ES, Vedanthan R, Jeemon P, et al. Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review. PLoS One. 2016;11(6): e0157036. https:// doi.org/10.1371/journal.pone.0157036 4. Gowshall M, Taylor-Robinson SD. The increasing prevalence of non-communicable diseases in low- middle income countries: the view from Malawi. Int J Gen Med. 2018; 11:255–264. https://doi. org/10.2147/IJGM.S157987 5. Holmes KK, Bertozzi S, Bloom BR, et al. Major Infectious Diseases: Key Messages from Disease Control Priorities, Third Edition. In: Holmes KK, Bertozzi S, Bloom BR, et al., editors. Major Infectious Diseases. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 3. Chapter 1. Available at: https://www.ncbi.nlm.nih. International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 6 gov/books/NBK525197/ https://doi.org/10.1596/978- 1-4648-0524-0/ch1 [Accessed February 13, 2020] 6. Islam SM, Purnat TD, Phuong NT, Mwingira U, Schacht K, Fröschl G. Non-communicable diseases (NCDs) in developing countries: a symposium report. Global Health. 2014; 10:81. https://doi.org/10.1186/ s12992-014-0081-9 7. Oni T, Unwin N. Why the communicable/non- communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition. Int Health. 2015;7(6):390–399. https://doi. org/10.1093/inthealth/ihv040 8. Boutayeb A, Boutayeb S. The burden of non- communicable diseases in developing countries. Int J Equity Health. 2005;4(1):2. https://doi. org/10.1186/1475-9276-4-2 9. Sharma A. Global research priorities for noncommunicable disease prevention, management, and control. Int J Non-Commun Dis 2017;2 (4):107- 112. https://doi.org/10.4103/jncd.jncd_57_17 10. Habib SH, Saha S. Burden of non-communicable disease: Global overview. Diabetes Metab Syndr Clin Res Rev. 2010; 4 (1): 41-47. https://doi.org/10.1016/j. dsx.2008.04.005 11. Al-Mawali A. Non-Communicable Diseases: Shining a Light on Cardiovascular Disease, Oman’s Biggest Killer. Oman Med J. 2015;30(4):227–228. https://doi. org/10.5001/omj.2015.47 12. Boutayeb A The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100(3):191-9. https://doi.org/10.1016/j.trstmh.2005.07.021 13. Esmailnasab N, Moradi G, Delaveri A. Risk factors of non-communicable diseases and metabolic syndrome. Iran J Public Health. 2012;41(7):77–85. 14. Sharma M, Banerjee B, Ingle GK, Garg S. Effect of mHealth on modifying behavioral risk-factors of non- communicable diseases in an adult, rural population in Delhi, India. Mhealth. 2017; 3:42. https://doi. org/10.21037/mhealth.2017.08.03 15. Jamison DT, Breman JG, Measham AR, et al., editors. Priorities in Health. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2006. Chapter 5, Cost-Effective Strategies for Noncommunicable Diseases, Risk Factors, and Behaviors. Available at https://www.ncbi.nlm.nih.gov/books/NBK10246/ [Accessed February 15, 2020] 16. Willett WC, Koplan JP, Nugent R, et al. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. In: Jamison DT, Breman JG, Measham AR, et al., editors. Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2006. Chapter 44. Available at https://www.ncbi.nlm.nih.gov/books/ NBK11795/ Co-published by Oxford University Press, New York. [Accessed February 15, 2020] 17. Haque M, McKimm J, Sartelli M, Samad N, Haque SZ, Bakar MA. A narrative review of the effects of sugar-sweetened beverages on human health: A key global health issue. J Popul Ther Clin Pharmacol. 2020;27(1): e76-e103. https://doi.org/10.15586/jptcp. v27i1.666 18. Nahar Q, Rokeya B, Al Mahmood AK, Rahman M. Effect of a Modified Chapati on Blood Glucose and Lipid Levels in Diabetic Patients. Diab Endocr J 2007; 35 (1): 25-28. 19. Al-Mahmood AK, Ismail AA, Rashid FA, Azwany YN, Singh R, Gill G. Effect of Therapeutic Lifestyle Changes on Insulin Sensitivity of Non-obese Hyperlipidemic Subjects: Preliminary Report. J Atheroscler Thromb, 2007; 14:122-127. 20. Haque M, Islam T, Rahman NAA, McKimm J, Abdullah A, Dhingra S. Strengthening Primary Health-Care Services to Help Prevent and Control Long-Term (Chronic) Non-Communicable Diseases in Low- and Middle-Income Countries. Risk Manag Healthc Policy. 2020; 13:409-426. https://doi. org/10.2147/RMHP.S239074 21. Bitton A, Fifield J, Ratcliffe H, et al. Primary healthcare system performance in low-income and middle-income countries: a scoping review of the evidence from 2010 to 2017. BMJ Glob Health. 2019;4(Suppl 8): e001551. https://doi.org/10.1136/ bmjgh-2019-001551 22. Fadlallah R, Bou-Karroum L, El-Jardali F, et al. Quality, safety, and performance management in primary health care: from scoping review to research priority setting and implementation plan in the Eastern Mediterranean Region. BMJ Glob Health. 2019; 4(Suppl 8): e001477. https://doi.org/10.1136/ bmjgh-2019-001477 23. Murshid ME, Haque M. Hits and misses of Bangladesh national health policy 2011. J Pharm Bioall Sci 2020; 12 (2):83-93. https://doi.org/10.4103/jpbs. JPBS_236_19 24. 24.Murshid ME, Haque M. Bangladesh National Drug Policy 1982-2016 and Recommendations in Policy Aspects. Eurasian J Emerg Med. 2019;18(2):104-109. https://doi.org/10.4274/eajem.galenos.2019.43765