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An Overview of Non-Communicable Diseases

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Diseases and health conditions are classified to create an understandable system to monitor, control, prevent and treat them – the biggest distinction between illnesses from a public health standpoint is their status as a communicable or non-communicable disease. For the purpose of this article, we will not focus on communicable diseases, which are caused by a specific pathogen and transmissible between infected to uninfected hosts – physical, social, and economic factors play a strong role in the epidemiology of these diseases. Non-communicable diseases (NCD), also known as chronic diseases, are mainly a byproduct of societal conditions and lifestyle habits such as poor nutrition, excess alcohol intake, a sedentary lifestyle, and smoking. Health Trumps Wealth was drafted up to focus on non-communicable diseases and their prevention. Given that most of the readers live in nations with a reduced prevalence of infectious diseases (except for the recent COVID-19 pandemic), it’s only logical to focus on what could have more impact.

The World Health Organization estimated that in 2010, around 150 million people were affected with some flavor of NCD, with a greater concentration in low to middle income countries. 4 primary NCD categories that you are probably aware of are cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, with these 4 categories accounting for over 80% of NCD deaths. NCDs are the leading cause of global death, making up ~71% of the yearly total death rate. If we note that NCDs alone killed 41 million people in 2018, these 4 categories accounted for around 32 million deaths – this truly a staggering number that could be reduced. One other noteworthy point is that the global economic cost of NCDs is expected to exceed $51 trillion USD by 2025, if health management continues as it is now. This paves way for strong economic benefit in the healthcare/medical/pharma sector, or can be seen as a strong opportunity for preventative and grassroots community health efforts to take a stand. Both paths have their own pros and cons.

Analysis and identification of particular risk factors and early detection methods yield an increased opportunity for reducing the instances of NCDs, and lower their prevalence and associated complications in modern society. A big factor in driving change, and ultimately improvements in global health, is a broader scope of public health measures – this includes prioritizing issues to sanitation, food safety, and infectious disease controls, as these categories all lay the foundation upon which a functional and healthy society grows. Once these are handled, prevention efforts can grow as a social movement, by means of individual education, and population interventions at the primary, secondary, and tertiary levels. An ounce of prevention is worth a pound £ of cure, if not significantly more (in this case, an amount surpassing tens of trillions of dollars ;).

Below, we have a cool graphic from the WHO that depicts some interventions that are economically feasible for most nations to implement. These interventions are aptly named “Best Buys”, and should have no affiliation with the known American electronic retailer. You may notice that a good portion of the listed measures are common warnings and bits of advice a well meaning companion or doctor may tell you….

Taken directly from https://www.who.int/nmh/publications/best_buys_summary.pdf?ua=1

With all of that being said, what can we directly do to prevent and reduce instances of NCDs as time passes? A HUGE impact can be made through educating the younger population in school (maybe in Physical Education, or Health classes?) about NCDs and associated risk factors. It may be shocking to hear that over 80% of adolescents don’t get adequate physical activity, and that 41 million children under the age of 5 are overweight or obese. These poor lifestyle choices and behaviors lead to cemented habits and sub optimal environments that ensure the progression of NCDs in future generations.

Given the widespread use of the internet and the access to information that youth now have, the opportunity for these young people to learn and utilize the available knowledge to improve their lives and prevent NCDs is up for the taking. Social media, digital journalism, and community programs are just some of the ways that the youth population can raise awareness of NCDs and promote behavioral change that would translate into healthy habits. The long term hope is that these efforts can drive change at the policy level, and have a longer lasting effect at a far greater scale.

Any comments, concerns, or questions? Drop a message in the comments box below. As always, thanks for reading.

Sources:

  1. http://www.acphd.org/communicable-disease.aspx
  2. https://en.wikipedia.org/wiki/Non-communicable_disease
  3. https://www.who.int/nmh/publications/ncd_report_full_en.pdf
  4. https://www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases
  5. https://www.un.org/youthenvoy/wp-content/uploads/2015/06/YouthStatsHealthpdf2.pdf
  6. https://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf;jsessionid=DBD694F29005B1696AAD941D327CC2DC?sequence=1
  7. https://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf;jsessionid=DBD694F29005B1696AAD941D327CC2DC?sequence=1

https://www.amazon.com/Intelligent-Peephole-Security-Doorbell-KAMANQI/dp/B07DKJ25ZR

Sitting is the New Smoking: What does this mean for your body?

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Modern jobs and careers require many of us to be seated at a desk for over 10 to 12 hours every single day. This is usually followed by more sitting, after work, at home (hunched over a PC, watching TV, eating dinner…) which adds up to a considerable amount of time on a daily basis. Sitting itself is not bad for your body, and neither is slouching. However, the real problem begins when your body is stuck in the same position throughout the day. Your joints and muscles acclimate to the poor form you are seated in, and this leads to serious problems down the line. Most people do this for years, even decades, at a time, and do not realize that there is a problem until the pain gets too severe and requires medical attention. This can be especially harmful to people with certain genetic predispositions to musculoskeletal diseases.

To initially learn about how muscles weaken when constrained to one position, it’s useful to develop a visual analogy. Muscles always cross some joint while connecting to a minimum of 2 bones. They can be lengthened or tightened through stretching and exercising, respectively. For example, by exercising the biceps, you will over time, shorten the muscle and increase the resting muscle tone. It may help to thing of the muscle like a piece of rope, with the end goal being to get the piece of rope to its ideal length, through lengthening and tightening (with the means being exercise and stretching). With neglect and sedentary lifestyle habits, these “ropes” lose their length and tightness, requiring effort (in the form of exercise and stretching) to bring them back to their ideal state.

The graphic above shows some common postures when sitting at a desk. As mentioned earlier, the muscles and tendons adapt to the conditions to which they are placed in – in the case of incorrect postures, the muscles and tendons begin to support the resulting musculoskeletal imbalances, leading to a variety of health problems down the line that could even comprise mental health and digestive issues. If we take the second incorrect posture, with the individual hunched over the desk, the thoracic (abdominal) region of the erector spinae muscles will hyperextend (over lengthen) and weaken. This is because A) The muscles are being stretched constantly, without any compression and B) They are not being exercised to shorten them to their ideal length. Remember that rope analogy from earlier? You can use it to visualize what’s happening here. Another issue is that the ligaments covering the spine will loosen on the posterior (back) side of the spine from being over-stretched. This could result in disc-related issues down the line, not a pretty sight to think about, let alone experience.

When you sit at a compute for prolonged periods of time, the following things are going on in your body:

  1. There is extensive posterior pelvic tilt. This is seen in the image below, and can be described as the end range-of-motion if you performed a hip thrust, or tried to hump something while standing.
  2. Your lower and upper back muscles are in flexion, where the spine is curved backwards at a great angle and looks like the left parenthesis -> (
  3. Your shoulders are positioned vertically over your thighs, and not over the pelvis, where they should be
  4. Your head is extended far over your thighs, instead of being in line with your shoulders, placing excessive stress on your neck
  5. Your forearms are pronated (rotated internally) to an excessive degree, applying unnecessary stress to your joints and tendons
  6. Your iliacus and psoas (muscles comprising the hip flexors) are in a hyperextended position

This means that your body will adapt to the posture and muscular positions noted above. Below, a picture presents the effects of posterior and anterior tilt on the pelvic complex:

Posterior and anterior pelvic tilt. taken from Essentials of Kinesiology for the Physical Therapist Assistant (Third Edition)
Posterior vs Anterior Pelvic tilt – shown while seated

What does all of this mean for you?

  1. The posterior pelvic tilt has been shown to contribute to chronically tight hamstrings, due to the shortened position they are subjected to
  2. The natural inward curvature of your spine is reduced, and results in a more “flat” lower back. This causes thoracic stiffness, and forces your pelvis into posterior tilt when standing
  3. The flexion in the upper back muscles translates into excessive kyphosis while standing – have you seen Quasimodo? Yeah, that’s not a very attractive outcome. In addition to the slightly unattractive posture, excessive kyphosis has been known to cause shoulder impingement, chronic headaches, and additional issues that would seriously detract from the quality of your life.
  4. The shoulders are positioned over the thighs, instead of over the pelvis, which contributes to a kyphotic posture in combination with the upper back flexion. This means A) your upper trapezius muscles are very shortened, and overactive to the point of being engaged with any arm movement and B) your levator scapulae is overstretched, which could result in migraines and neck pain down the line. The quick fix would be to massage these areas, but that’s not as sustainable as fixing the root cause altogether.
  5. Your psoas and iliacus muscles, are going to become weak from constantly being in a relaxed position. This means that your your knees and pelvis are not positioned directly over your ankles, but rather in front of them. Your upper body compensates for this forward position by leaning backwards, putting your hip flexors into an elongated position, similar to what happens when sitting down.

Having read this, how do you fix all of this?

To be fair, this post makes strong generalizations about how the average human’s body responds to a sedentary lifestyle. You may not be the average human. You could play sports, be old, be fat, have joint disease…anything other than typical to be honest. It’s entirely possible that some individuals’ bodies will react in the exact opposite way to what is expected from doing corrective exercises. That situation is far from ideal. I don’t wan’t you to injure yourself when the purpose of this blog is to live a healthier, higher quality life.

For now, the best thing to possibly do is to massage your back, using a foam roller, the efforts of a close friend or family member, or by getting a deep tissue massage. Another test can be done by lying on your back, on a hardwood floor. Have a friend try to fit their fingers underneath your lower back, when you are relaxed. If the fingers don’t fit, you may have a slight degree of lordosis. If they are able to get a tennis ball under there, that’s a very big issue…That being said, this sitting issue applies to everybody, athlete or not. We all sit, meaning our body has gotten used to and good at sitting. You need to have this fact in mind before coming up with a corrective/rehab plan to get the best results.

Shown below is a picture of stretches that help you deal with lower back pain and tightness in the lower back muscles:

Sources:

  1. https://exrx.net/Kinesiology/Posture
  2. https://www.t-nation.com/training/neanderthal-no-more-1 (Parts 1-4)

Chronic Pain Overview

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Do you find yourself dealing with pain on a weekly, or even daily basis? The focus here isn’t on mental pain, although that’s something we can discuss at a later time and place. The focus here is on physical pain, that makes it hard for you to do things on a daily basis.

I’ve been through a good amount of physical pain, back and hip injuries resulting from poor posture, and have had to scour the internet for knowledge from doctors, therapists, and academics to make my life a bit better. Fortunately, there is hope to increase the quality of life significantly and eliminate pain. Physical therapy and rehabilitation is not rocket science.

How do you know if you have pain in a certain area? You simply know the affected area hurts…it’s not that complicated and you don’t need a medical professional telling you that something is wrong with your lower back if it hurts all the time. Ibuprofen and acetaminophen are not the cure to your problem. Many people, including some of the HTW readers, have been suffering mild pain in, say, their knee, for a decade or two. The pain wasn’t “too bad” after their first medical visit, which could not find a remedy, they just put up with it and took painkillers/NSAIDs on a regular or occasional basis. Those people should be able to get the most out of a rehab program, and should read these relevant articles.

These posts are not targeted towards those affected by chronic joint diseases such as osteoporosis and arthritis- these diseases have more of a molecular component that may be slightly relieved through exercise, stretching, and massage, BUT requires more of a medical approach involving diet and therapeutic remedies. I don’t have any experience with these conditions and am not qualified to pontificate on the subject.

Take ownership of your problem, educate yourself, and increase the quality of your life. Just put in the work. The articles on HealthTrumpsWealth will point you to the right path.

Minerals and Why They Matter

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This post aims to give an overview of what minerals are, and how the human body utilizes them when we (ideally) consume them in the required quantities. This post is Part 2 of the Diet and Nutrition overview, and the next in line after the Vitamins post, which you can access by clicking HERE.

To start off this post, the video below highlights the differences between vitamins and minerals. Quite often, people get the two confused, and although they are both equally important for the human body to function at its best state, there are some key differences.

Major Minerals Required By The Human Body

Calcium: Needed for muscle, heart and digestive system health, builds bone, supports synthesis and function of blood cells
Sources: Dairy products, eggs, canned fish with bones (salmon, sardines), green leafy vegetables, nuts, seeds, tofu, thyme, oregano, dill, cinnamon

Calcium unter Argon Schutzgasatmosphäre.jpg
This is pure calcium

Phosphorous: A component of bones (see apatite), cells, in energy processing, in DNA and ATP (as phosphate) and many other functions
Sources: Red meat, dairy foods, fish, poultry, bread, rice, oats

PhosphComby.jpg
This image shows some forms of phosphorous. The human body primarily utilizes apatite

Potassium: A systemic electrolyte and is essential in co-regulating ATP with sodium
Sources: Sweet potato, tomato, potato, beans, lentils, dairy products, seafood, bananas, prune, carrot, orange

File:Potassium-2.jpg
Pearls of potassium are shown above

Sodium: A systemic electrolyte and is essential in co-regulating ATP with potassium
Sources: Table salt (sodium chloride), sea vegetables (seaweed, kelp, algae), milk, and spinach

Na (Sodium).jpg
Sodium in its pure form is a very reactive element

Magnesium: Required for processing ATP and for bones
Sources: Spinach, legumes, nuts, seeds, whole grains, peanut butter, avocado

File:CSIRO ScienceImage 2893 Crystalised magnesium.jpg
Magnesium is the ninth most abundant element in the world

The following list of minerals needed for the human body’s optimal function are considered “trace elements.” The concentration of these trace elements in human tissue is far less than the concentration of the essential major minerals. According to Dr. Osamu Wada’s 2004 paper (Source 4 for further inquiry, definitely recommend checking this out) in the Japan Medical Association Journal, various epidemiological studies have suggested the possibility that trace element deficiencies are associated with a reduced anti-oxidant potential in organisms (which is believed to possibly underlie the onset of cancer and atherosclerosis), accelerated aging, developmental retardation in children, and an increased incidence of abnormal pregnancies, immunological abnormalities, and lifestyle-related diseases. Now what does this mean for you as the reader? Having an adequate intake of trace minerals in your diet, and supplementing them if not, is crucial to maintaining health as one ages and to reduce the risk of developing debilitating diseases down the line! Imagine being unable to care for your loved ones because of some neglected minerals in an earlier portion of your life….that’s pretty scary to me.

Sulfur: Essential component of all living cells.
Sources: Garlic, onions, eggs, and protein-rich foods

File:Sulfur-sample.jpg
This is pure sulfur. You may be familiar with its rather repulsive smell

Iron: Required for proper functioning of proteins and enzymes, hemoglobin being a notable one
Sources: Meat, seafood, nuts, beans, dark chocolate

File:Cellular iron homeostasis.png
This chart shows the general overview of iron metabolism in humans. Iron, although a trace mineral, is essential for energy production. Without it, you’d be dead

Chlorine: Needed for production of stomach acid, and for cellular transport mechanisms
Sources: Iodized salt

A glass container filled with chlorine gas
This is chlorine in gaseous form. It’s also found in swimming pools, and is a very reactive element…

Cobalt: Necessary component of vitamin B12 and plays a very important role in forming amino acids, some proteins in nerve cells, and in creating crucial neurotransmitters
Sources: Fish, nuts, leafy green vegetables, cereals, and oats

File:Kobalt electrolytic and 1cm3 cube.jpg
Cobalt is a key molecule in Vitamin B12. Deficiencies cause harmful metabolic issues

Copper: Key component of proteins involved in electron transport and redox reactions, and in oxygen transport (within blood for example)
Sources: Liver, seafood, oysters, nuts, seeds, whole grains, legumes

File:ARS copper rich foods.jpg
This image shows a selection of copper-rich foods

Zinc: Second most abundant trace mineral, after iron, and appears in almost all enzymes. Critical for RNA and DNA metabolism, and testosterone production
Sources: Oysters, red meat, poultry, nuts, whole grains, dairy products

Zinc: An underappreciated modulatory factor of brain function ...
This image shows the effects of zinc excess and zinc deficiency

Manganese: Key component of various enzyme systems involved in macronutrient metabolism, bone formation, and free radical defense systems
Sources: Grains, legumes, seeds, nuts, leafy vegetables, tea, coffee

File:Mangan 1-crop.jpg
Excessive manganese intake leads to a neurodegenerative disease called manganism, with symptoms like those of Parkinson’s disease

Molybdenum: Crucial component of enzymes that metabolize sulfur-containing amino acids, drugs and various toxins
Sources: Legumes, whole grains, nuts

File:Molybdenum crystaline fragment and 1cm3 cube.jpg
An interesting fact is that molybdenum does not occur naturally as a free metal on Earth. Mo is also commonly found in bacteria, where it’s used to break down Nitrogen

Iodine: Critical to proper functioning of the endocrine, digestive, and reproductive systems
Sources: Seaweed (kelp or kombu), grains, eggs, iodized salt

File:Thyroid system.svg
Iodine is essential to proper functioning of the the thyroid system. Consumption issues lead to hormone imbalances, which are harsh to deal with

Selenium: Crucial to proteins involved in thyroid hormone metabolism, reproduction, DNA synthesis, and protection from oxidative damage and infection
Sources: Brazil nuts, seafoods, organ meats, meats, grains, dairy products, eggs

SeBlackRed.jpg
This picture shows selenium in amorphous forms

This cool infographic below shows reference ranges for mineral concentrations in the human body. Are your levels proper?

Blood concentrations of minerals in men and women, required for functioning at healthy levels

Sources:

  1. https://www.youtube.com/watch?v=g-Sd8847sO8
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872358/
  3. https://en.wikipedia.org/wiki/Mineral_(nutrient)
  4. http://www.med.or.jp/english/pdf/2004_08/351_358.pdf
  5. https://www.ncbi.nlm.nih.gov/pubmed/26557039
  6. https://fullscript.com/blog/sulfur-rich-foods
  7. https://www.sciencedirect.com/science/article/abs/pii/S0006295214004572
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2198910/
  9. https://ods.od.nih.gov/factsheets/Molybdenum-HealthProfessional/
  10. https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/
  11. All mineral pictures were taken from their respective wikipedia pages

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Vitamins and Why They Matter

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This post aims to give an overview of what vitamins the human body utilizes when we (ideally) consume them in the required quantities. And the particular biochemical pathways and organ systems they’re used in. Part 2 will be a similar post focusing on minerals.

An easy way to get started is to view the 5 minute video below, for a simple medical-grade explanation of vitamins and their function in the human body.

Sufficient intake of these useful molecules will keep your body primed to fight off pathogens (I.e bacterial and viral infections…looking at you, coronavirus), and keep your mental and physical well being at a high baseline level.

Let’s start with a list of the basics

Vitamin A : Useful for healthy vision, skin, bones, teeth, and reproduction
Sources: Liver, Eggs, Fish, Milk, Sweet Potato, Pumpkin, Spinach

File:Vitamin-A-Synthese.png
Some well-known forms of Vitamin A are Retinol and Beta Carotene

Vitamin B1 (Thiamin): Used to convert food into energy, and is critical for nervous system function
Sources: Pork, Soy, Watermelon, Tomato, Spinach

File:Thiamin.svg
Grain processing removes most of the thiamine content, so enrichment is common

Vitamin B2 (Riboflavin): Used to convert food into energy and supports healthy skin, hair, blood, and nervous system
Sources: Dairy, Meat, Green Leafy Vegetables, Enriched Wheat, Oysters

File:Riboflavin.svg
As a supplement, Riboflavin is used to treat migraines

Vitamin B3 (Niacin): Used to convert food into energy and is essential for healthy nervous system
Sources: Beef, Chicken, Shrimp, Avocado, Peanuts, Tomato, Spinach

File:Niacin structure.svg
Niacin deficiency results in a disease called Pellagra

Vitamin B6 (Pyridoxine): Helps develop red blood cells and improves sleep, appetite, and mood
Sources: Chicken, Tofu, Banana, Watermelon, Fish, Legumes

File:Pyridoxal-phosphate.svg
B6 deficiency leads to impairment of proprioception and nerve damage

Vitamin B7 (Biotin): Used to metabolize and utilize amino acids, carbohydrates, and fats into energy molecules
Sources: Whole Grains, Eggs, Almonds, Soybeans, Fish

File:Biotin structure.svg
Biotin deficiency, although rare, causes metabolic and dermatological issues

Vitamin B9 (Folate): Essential for creation of new cells, and DNA + RNA synthesis
Sources: Legumes, Spinach, Leafy Greens, Chickpeas, Tomato, Asparagus

File:Folic acid.svg
Folate deficiency results in loss of weight, appetite, and anemia

Vitamin B12: Breaks down fatty acids and amino acids, helps in the synthesis of red blood cells, and is very important for normal neural function
Sources: Dairy, Beef, Pork, Poultry, Fish, Eggs

File:Cobalamin.png
This picture depicts cyanocobalamin, a form of B12. Because there are few non-animal sources, vegans are advised to supplement with vitamins

It’s worthwhile to note that all B vitamins have a crucial role in cellular metabolism, and that that low levels of these compounds lead to adverse conditions such as lethargy, acne, anemia, mental weakness, and more.

Vitamin C: Serves as an antioxidant, helps in cellular synthesis, and important in immune system function
Sources: Almost all Fruit and Vegetable Juices, Pepper, Broccoli, Tomato, Spinach

File:L-Ascorbic acid.svg
Vitamin C is an essential nutrient, with deficiencies causing scurvy and collagen synthesis problems

Vitamin D: Strengthens and helps with bone and teeth formation, by helping them absorb calcium. It’s also used in other organ systems (GI/digestive for one), and a key driver of testosterone production in males
Sources: Egg Yolk, Fatty Fish, Liver, Sunlight

Note double bond at top center.
Vitamin D2 is shown. Deficiencies are common and could lead to rickets, osteoporosis, and skin pigmentation

Vitamin E: Serves as an antioxidant, and helps to stabilize cell membranes
Sources: Nuts, Avocado, Tofu, Whole Grains, Seeds

File:RRR alpha-tocopherol.png
One of Vitamin E forms (RRR alpha tocopherol) is shown. Deficiencies, although rare, could point to an underlying fat digesting issue

Vitamin K: Crucial for blood clotting and regulation of blood calcium levels
Sources: Broccoli, Brussels Sprouts, Liver, Leafy Greens

File:Vitamin K structures.jpg
Shown are some subtypes of Vitamin K. Deficiencies could lead to uncontrolled bleeding and osteoporosis

As noted above (but not only limited to!!), there are a wide variety of vitamins and minerals that the human body requires for optimal function and performance, not just on a daily but lifetime basis. A deficiency or shortage of any of these is going to hinder you from peak performance, and hold you back from living your best life

Sources:

  1. https://ods.od.nih.gov/factsheets
  2. https://en.wikipedia.org/wiki/Vitamin
  3. https://www.youtube.com/watch?v=FmafhSMv0e0 (special thx to McMaster University)
  4. All skeletal formulas were taken from their respective wikipedia pages

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