World Health Day: We Need Healthier People To Live On A Healthier Planet

World Health Day: We Need Healthier People To Live On A Healthier Planet

Celebrated on April 7th each year, World Health Day is an initiative by the World Health Organization (WHO) and other organizations to raise awareness of people’s overall health and well-being around the world. This year’s theme is “Our Planet, Our Health” therefore, to be able to inhabit a healthy planet, healthier people are needed and vice versa.

Globally, 70% of deaths are due to chronic diseases caused by poor diets, unhealthy lifestyles, polluted environments, and poor living conditions. The epidemic of non-communicable diseases (NCDs) is already overwhelming our health system, economy, and well-being. The risk of NCDs is strongly associated with exposure to environmental stressors such as air pollutants, noise pollution, night artificial lighting, extreme heat, desert storms, and climate change such as wildfires. Food systems that produce highly processed, unhealthy foods and beverages are causing a wave of obesity, increasing cancer and heart disease, and causing one-third of the world’s greenhouse gas emissions.

Exposure to almost all environmental risk factors triggers several specific pathophysiological mechanisms focused on stress hormone signalling, oxidative stress, and inflammation. As a result, researchers face the problem of identifying specific biochemical features of various environmental risk factors. In addition, oxidative stress and inflammation are also critical pathological mechanisms of cardiovascular, neurodegenerative, and metabolic disorders, further complicating research. Therefore, environmental stress factors, unhealthy behaviour, and metabolic health risk factors (e.g., hypertension, diabetes, obesity) all-cause similar pathological mechanisms; thus, they can be additive. Synergistic effects should exist, leading to more pronounced development and faster progression of NCDs.

The main types of NCDs are cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. High blood pressure increases the risk of various CVDs, including stroke, coronary artery disease, heart failure, atrial fibrillation, and peripheral vascular disease. Over the last few decades, low- and middle-income countries (LMICs) have seen significant changes in hypertension. However, in LMICs, only one in three people are aware of the condition of high blood pressure, and about 8% have it controlled. This increasing burden widens the inequality gap, contributes to the tremendous financial difficulties of patients and caregivers, and increases the cost to the health systems, facing challenges such as low physician-to-patient ratios and lack of access to treatment.

Hypertension is linked to obesity and diabetes; this synergistic disease state is known as metabolic syndrome (MetS) – which has caused more severe COVID-19 infections. In patients with COVID-19, untreated hypertension is associated with an approximately two-fold increase in mortality compared to treated hypertension. The pathophysiology of obesity, diabetes and CVDs is complex. However, they share common metabolic conditions, including insulin resistance, systemic inflammation, and abdominal obesity. High blood pressure and heart disease have been commonly liked to high salt intake. However, compelling evidence implicates that sugars, particularly the monosaccharide fructose, play a significant role in developing hypertension. Added sugars include white and brown sugar, corn syrup, honey, glucose, fructose, dextrose, lactose, malt syrup, maltose, brown rice syrup, and molasses. These added sweeteners are not limited to desserts and soda. Sugar is also found in processed savoury foods like condiments, bread, soup, peanut butter, spaghetti sauce, crackers, etc.

Coincidently, processed foods are high in sodium and added sugars. Indeed, reducing processed-food consumption would be consistent with existing guidelines that have misguidedly focused on less-consequential salt intake. Added sugars have already been shown to negatively affect cholesterol, may be linked to inflammation and oxidative stress markers, and may increase the risk of being overweight or obese. Consequently, all these conditions decrease heart health and increase the risk for CVDs.

Unhealthy diets also tend to be bad for the planet since less nutritious foods and drinks account for nearly a quarter of diet-related greenhouse gas emissions. Hence, the combined effects of heat, air pollution, individual age, socioeconomic and health status are the causes of preventable acute cardiovascular disease events. Inexcusably, to create the future we want — all people can live in healthy, equitable and just societies — we need to play an active role.

References

• Cicero AFG, Veronesi M, Fogacci F. Dietary Intervention to Improve Blood Pressure Control: Beyond Salt Restriction. High Blood Pressure & Cardiovascular Prevention. 2021; 28:547–553
• DiNicolantonio JJ, Lucan SC. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 2014;1:e000167. doi: 10.1136/openhrt-2014-000167
• Hannah R, Roser Environmental Impacts of Food Production. Our World in Data. 2020. Available at: https://ourworldindata.org/environmental-impacts-of-food
• Schutte AE, Venkateshmurthy NS, Mohan S, Prabhakaran D. Hypertension in Low- and Middle-Income Countries. Circulation Research. 2021;128:808–826. DOI: 10.1161/CIRCRESAHA.120.318729
• World Health Organization (WHO). COVID-19 significantly impacts health services for noncommunicable 2020:1–3. Available from: https://www.who.int/news- room/detail/01-06-2020-covid-19-significantly-impacts-health-services-for- noncommunicable-diseases
• World Health Organization (WHO). World health day 2022. Available from: https://www.who.int/campaigns/world-health-day/2022
• Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 2014;174(4):516–524. doi:10.1001/jamainternmed.2013.13563

About The Author

Georgina Pujol-Busquets Guillén

Georgina holds a BSc in Pharmacy from the University of Barcelona, Spain and an MSc in Nutrition and Public Health and an MSc in Global Health. After working in community pharmacies and public hospitals in Spain, USA, and Peru, she realized the need for a nutritional approach to chronic disease. She worked as an intern for The Noakes Foundation in 2017 and she has finalized her PhD in Physiology at the University of Cape Town. She is part of Eat Better South Africa’s research team and her study was a mixed-method project to evaluate the effectiveness of Eat Better South Africa nutrition education program on components of metabolic health and well-being in women from South African under-resourced communities.

She is also teaching Qualitative Methods at the Master of Nutrition and Public Health at the Open University of Catalonia. In 2021 she was the recipient of the Tim & Marilyn Noakes Grant fellowship and she will start a Postdoctoral position at MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) at the University of the Witwatersrand. Georgina is passionate about inequality, women’s rights, nutrition, public health, and diet-related diseases. Her research career is focused on understanding the social determinants that affect women’s health in low-income communities and how to bring low carbohydrate diets into those areas to treat metabolic diseases. She believes that through Eat Better South Africa programs women are empowered and consequently, the wider community is influenced by virtue of their position in their household.