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Aims India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey. Methods A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters. Results Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3–9.4%) whereas prevalence of prediabetes was 6.3% (5.4–7.3%). Age group (45–69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status. Conclusions The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.

Background The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India. Methods A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire. Results No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6–97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males ( p  < 0.001). Conclusions Poor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non communicable disease control strategy need to address these issues with a gender equity lens. Rapid urbanization of rural India might be responsible for the absence of a significant urban rural difference.

Hypertension is a major public health concern and a leading risk factor for cardiovascular diseases in Rwanda. While previous national surveys have documented its burden, updated analysis of current prevalence patterns and determinants is needed to inform contemporary prevention strategies. This study aimed to assess hypertension prevalence and key determinants using data from the 2022 Rwanda WHO STEPS Survey to inform targeted prevention and intervention strategies. This secondary data analysis utilized nationally representative data from the 2022 Rwanda WHO STEPS Survey. Bivariate analysis was conducted using weighted chi-square tests to examine associations between hypertension and sociodemographic, behavioral, and clinical variables. Variables with p  < 0.05 in bivariate analysis were included in a weighted multivariable logistic regression model to identify independent factors associated with hypertension. Data analysis was performed using STATA version 17, accounting for the complex survey design. Bivariate analysis was conducted using the chi-square test to assess associations between hypertension and independent variables. Significant variables were included in a multivariable logistic regression model to identify independent factors associated with hypertension. The overall prevalence of hypertension was 16.8%, with higher rates observed among older individuals and those with obesity. In multivariable logistic regression analysis, compared with younger adults, respondents aged 60–69 years were 5.7 times more likely to have hypertension (AOR = 5.7, 95% CI [3.76–8.65], p  < 0.001). Overweight and obese individuals were 1.6 times more likely to have hypertension (AOR = 1.6, 95% CI [1.20–2.00], p  = 0.001). Alcohol consumption in the past 12 months was associated with increased hypertension risk (AOR = 1.4, 95% CI [1.11–1.87], p  = 0.006). Geographic disparities were noted, with individuals in the Northern (AOR = 1.5, 95% CI [1.05–2.09], p  = 0.025), Western (AOR = 1.6, 95% CI [1.21–2.24], p  = 0.002) and Southern (AOR = 1.7, 95% CI [1.26–2.27], p  < 0.001) provinces at greater risk compared to the Eastern province. Hypertension is prevalent in Rwanda, with age, obesity, alcohol consumption, and regional disparities emerging as key risk factors. These findings underscore the urgent need for targeted public health interventions, including hypertension screening, weight management programs, and lifestyle modifications. Strengthening community-based prevention initiatives and policy-driven strategies can improve cardiovascular health outcomes in Rwanda.

Background The burden of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa, but data available for intervention planning are inadequate. We determined the prevalence of selected NCDs and HIV infection, and NCD risk factors in northwestern Tanzania and southern Uganda. Methods A population-based cross-sectional survey was conducted, enrolling households using multistage sampling with five strata per country (one municipality, two towns, two rural areas). Consenting adults (≥18 years) were interviewed using the WHO STEPS survey instrument, examined, and tested for HIV and diabetes mellitus (DM). Adjusting for survey design, we estimated population prevalences of hypertension, DM, obstructive pulmonary disease, cardiac failure, epilepsy and HIV, and investigated factors associated with hypertension using logistic regression. Results Across strata, hypertension prevalence ranged from 16 % (95 % confidence interval (CI): 12 % to 22 %) to 17 % (CI: 14 % to 22 %) in Tanzania, and from 19 % (CI: 14 % to 26 %) to 26 % (CI: 23 % to 30 %) in Uganda. It was high in both urban and rural areas, affecting many young participants. The prevalence of DM (1 % to 4 %) and other NCDs was generally low. HIV prevalence ranged from 6 % to 10 % in Tanzania, and 6 % to 12 % in Uganda. Current smoking was reported by 12 % to 23 % of men in different strata, and 1 % to 3 % of women. Problem drinking (defined by Alcohol Use Disorder Identification Test criteria) affected 6 % to 15 % men and 1 % to 6 % women. Up to 46 % of participants were overweight, affecting women more than men and urban more than rural areas. Most patients with hypertension and other NCDs were unaware of their condition, and hypertension in treated patients was mostly uncontrolled. Hypertension was associated with older age, male sex, being divorced/widowed, lower education, higher BMI and, inversely, with smoking. Conclusions The high prevalence of NCD risk factors and unrecognized and untreated hypertension represent major problems. The low prevalence of DM and other preventable NCDs provides an opportunity for prevention. HIV prevalence was in line with national data. In Tanzania, Uganda and probably elsewhere in Africa, major efforts are needed to strengthen health services for the PREVENTION, early detection and treatment of chronic diseases.

Background The promotion of a physically active lifestyle might help address the increasing burden of non-communicable diseases in Nepal. However, there is a lack of nationally representative estimates of physical activity (PA) prevalence in Nepal. The aim of this nationwide cross-sectional study was to determine domain-specific PA levels and the association of socio-demographic and lifestyle characteristics with total PA among Nepalese adults aged 15–69 years. Methods The data were collected using self-administered questionnaires in a nationally representative sample of 4143 adults (66.5% females), comprised of both rural and urban populations in Nepal. PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). Results Based on self-reported estimates, around 97% (95% confidence interval [CI]: 96–98%) of men and 98% (95% CI: 98–99%) of women were found to meet the recommended levels of PA. Both men and women reported high occupational PA, whilst most participants of both sexes did not report engaging in any leisure-time PA. A multiple regression analysis showed that less self-reported total PA was associated with older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes and with overweight and obesity in males ( p  < 0.05 for all). Conclusion According to self-reported estimates, majority of Nepalese men and women are meeting the recommended levels of PA. The total self-reported PA in Nepalese adults is high, because many of them have labour intensive jobs. Although older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes, as well as overweight and obesity in males were inversely associated with self-reported PA, the overall level of PA in all these groups was very high. Given the high overall self-reported PA found in the current study, promoting more PA in Nepal may not be as important as in some other countries; not even in the population groups for which we found a negative association with PA. Nevertheless, future studies should examine whether a more balanced distribution of occupational and leisure-time PA would promote better health among Nepalese adults.

Background Obesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN. Method Data from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN. Results The results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia. Conclusion Obesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN.

To examine trends in the intake of key food groups among Iranian adults between 2005 and 2016, overall, and according to sociodemographic characteristics. Repeat cross-sectional data from the Iran-STEPwise approach to risk factor surveillance (Iran-WHO STEPS) 2005-2016 were analysed. Regression analyses were used to evaluate trends in the frequency of fruits, vegetables and fish intake and type of oil used over time. Interactions by sex, age and area of residence were examined. Iran. 225 221 Iranian adults. The frequency of vegetables ( : -0·03; 95 % CI (-0·06, -0·00); -trend = 0·030) and fish ( : -0·09; 95 % CI (-0·10, -0·08); -trend < 0·001) intake and use of solid fat (OR: 0·70; 95 % CI (0·70, 0·72); -trend < 0·001) declined, whilst the frequency of fruit intake ( -Coeff: 0·03, 95 % CI (0·01, 0·05); -trend = 0·014) and liquid oil use (OR: 1·40; 95 % CI (1·3, 1·4); -trend<0·001) rose. Rising trends in fruit intake were larger in mid-aged (40-60 years) and older (>60 years) adults ( -interaction < 0·001), whilst declines in vegetable ( -interaction < 0·001) and fish intake ( -interaction = 0·001) were larger in older adults. The declining use of solid fat was strongest in middle-aged and older adults ( -interaction = 0·035), while the increasing use of liquid oil was strongest in rural areas ( -interaction = 0·011). During the nutrition transition, liquid oil use and the frequency of fruit intake rose, while the frequency of vegetables and fish intake declined. Nonetheless, the fatty acid composition and cooking methods are important considerations. The changes observed are concerning from a public health perspective and demonstrate the need for interventions and possible targets for tailored strategies.

Background The coexistence of obesity and hypertension (HTN) is a global health concern due to its association with various health abnormalities. This study targeted the association between uncontrolled HTN—defined according to the JNC8 guidelines— and different obesity patterns (general and abdominal) among adult hypertensive individuals. Methods Data for the present investigation were obtained from the 2021 STEPwise Approach to NCD Risk Factor Surveillance (STEPS) national survey in Iran. Participants were classified based on general obesity (BMI) and different abdominal obesity patterns (waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]). Data were weighted by sex, age, and residence (rural and urban). Multivariate logistic regression models were performed to determine the association between different obesity patterns and uncontrolled HTN, adjusting for confounders including demographic variables, lifestyle factors, and history of metabolic abnormalities. Results A total of 8,692 hypertensive adult subjects ≥ 18 years were recruited from all provinces in Iran. The overall mean age of participants was 55.8 ± 0.15, and 55.6% being women. The prevalence of general obesity among controlled and uncontrolled hypertensive patients was 30.3% and 69.8%, respectively. Regarding abdominal obesity, the prevalence among controlled and uncontrolled hypertensive patients was 29.8% and 70.2% based on WC, 28.4% and 71.6% based on WHR, and 28.8% and 71.2% based on WHtR, respectively. Compared to normal weight, underweight (adjusted odds ratio [AOR] = 0.94, 95% CI: 0.57–1.56), overweight (1.37 [1.16–1.61]), and general obesity (1.47 [1.24–1.75]) were associated to uncontrolled HTN compared to normal weight. Abdominal obesity according to WC (1.30 [1.13–1.51]), WHR (1.31 [1.10–1.53]), and WHtR (1.39 [1.11–1.74]) was also associated with uncontrolled HTN. Conclusion Both general and abdominal obesity are more prevalent and strongly associated with uncontrolled HTN in hypertensive patients. These findings underscore the need for healthcare providers to implement targeted interventions promoting healthy lifestyle changes to mitigate these risk factors and improve HTN management.

Background Non-communicable diseases (NCDs) are an important problem in South Africa; they account for 60% of all deaths. Early screening could help lower NCD incidences and long-term consequences. Objective The study aimed to profile NCD risk factors among insourced support staff at the University of Pretoria in 2018. Design A cross-sectional, descriptive study was conducted at the University of Pretoria, Hatfield Campus. The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) questionnaire was administered to collect data in three steps. The participants’ behavioural risk profiles were gathered using the face-to-face interview technique (STEP I), followed by their physical risk profile using anthropometric and blood pressure measurements (STEP II). Last was the biochemical risk profile, including finger-prick blood glucose and cholesterol measurement (STEP III). Data were analysed using Epi-Info, version 3.54. Subjects A convenient sample of participants aged 18–64 years from the Departments of Industrial Hygiene and Building Services, Landscape Services, Sports Fields Management, and Security Services (n = 146, 60% were females) took part in the study. Results Most participants (97.8%) had low daily fruit and vegetable intake. Some 80% of the study population always or often added salt to their food when cooking. Daily alcohol consumption was reported by a quarter of the sample. More than two-thirds of all the participants were overweight or obese and 61% had central obesity. Conclusion The study identified a high prevalence of several NCD risk factors. Tailored nutrition education and monitoring are needed to lower the elevated risk.

Background and Objectives: Physical inactivity contributes to high rates of cardiovascular disease, diabetes, and obesity in Kazakhstan, yet national data remain scarce. The primary objective of this study was to assess the level of physical activity among the adult population of Kazakhstan. The secondary objectives were to identify demographic, socioeconomic, and regional factors associated with physical activity, to determine risk groups, and to develop recommendations aimed at increasing physical activity and improving public health. Materials and Methods: We conducted a cross-sectional nationwide survey (December 2021–May 2022) including 6720 adults aged 18–69 years from all 17 regions. Data were collected using the WHO STEPS questionnaire and the Global Physical Activity Questionnaire. Results: Overall, 19.7% of adults did not meet WHO recommendations. Average weekly activity was 7108 min, mainly from transport (42.1%) and work (28.9%). Men and young adults were more likely to be sufficiently active. Lower levels were observed among women, individuals over 35, married respondents, civil servants, students, and the unemployed. Significant regional and ethnic disparities were identified. Conclusions: One in five adults in Kazakhstan has insufficient physical activity. Targeted, multisectoral interventions are needed, with special focus on women, older adults, and urban populations.