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Selected Category: noncommunicable diseases (NCDs)

Take charge of your health this World Diabetes Day

Categories: diabetes, noncommunicable diseases (NCDs)

world diabetes day
Diabetes is a chronic condition that continues to be a burden throughout the world. As we observe World Diabetes Day, let’s define some terms and talk about who is at risk. How does diabetes affect you or someone close to you?

Ann Albright, PhD, RD, Director, CDC Division of Diabetes Translation

Ann Albright, PhD, RD, Director, CDC Division of Diabetes Translation

Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes glucose to build up in your blood.

A person with prediabetes has a blood sugar level higher than normal, but not high enough yet for a diagnosis of diabetes. He or she is at higher risk for developing type 2 diabetes and other serious health problems, including heart disease and stroke.

You are at increased risk for developing prediabetes and type 2 diabetes if you:

  • Are 45 years of age or older.
  • Are overweight.
  • Have a parent with diabetes.
  • Have a sister or brother with diabetes.
  • Have a family background that is African-American, Hispanic/Latino, American-Indian, Asian-American, or Pacific-Islander.
  • Had diabetes while pregnant (gestational diabetes), or gave birth to a baby weighing 9 pounds or more.
  • Are physically active less than three times a week.

What can you do to prevent or delay type 2 diabetes? We know of three things that together help prevent or delay this: healthy eating, physical activity, and weight management.

Healthy eating and physical activity are great concepts, but they can seem like lofty challenges on hectic days. To prevent or delay type 2 diabetes, as well as care for yourself if you have diabetes, eating well and increasing physical activity are an important part of a routine to ward off a host of problems. And with a bit of planning and careful scheduling, healthy eating and moving more can be both achievable and fun.

You already know that healthy eating is important and the right thing to do, both for yourself and for your family. The latest diabetes numbers tell the story: 382 million are living with diabetes worldwide. In addition, 86 million Americans have prediabetes, and 9 out of 10 of them don’t know they have it. If you pay attention to your body’s cues, you know how much better you feel with a consistent approach to good nutrition. Cooking with your family can be a great way to spend time together, encouraging one another while sharing food preparation and even trying new things to eat. This can work with adults as well as children!

Healthy meals don’t have to mean more shopping trips or additional preparation time. There are many free resources with updated healthy recipes, even for those who want 30-minute or less meals, low sodium items, vegan dishes, etc. It’s easy to spark your imagination and find something new and healthy to cook. In fact, this year the American Diabetes Association’s November diabetes month theme is “Get Cooking to Stop Diabetes.” Small changes can make a big difference.

For increasing physical activity, we’re not talking about adding hours of daily physical activity. Limiting calorie intake, as well as moving more, is essential to losing weight. We know this: research shows that modest weight loss and regular physical activity can help prevent or delay type 2 diabetes by up to 58% in people with prediabetes. Modest weight loss means 5% to 7% of body weight, which is 10 to 14 pounds for a 200-pound person. Getting at least 150 minutes each week of physical activity, such as brisk walking, is important. May not be able to start at 150 minutes each week, but start with a few a few minutes each day and increase the time so you can reach this goal.

Some people like to work out first thing in the morning, which can be great if you have children and schedule after-school activities. Or, you can walk, ride a bike, jog or even go to the gym directly after work (do not go home, avoid the couch). Others like to use lunchtime to work out in a fitness center or take a brisk walk outside. Use the stairs, or have a walking meeting. If you can find just ten minutes here and there throughout the day, that’s good, too.

If you have prediabetes and want additional help making these changes, consider finding a local program of the CDC-led National Diabetes Prevention Program. This is currently offered in the United States and U.S. territories. Lifestyle coaches work with participants to identify helpful tools and techniques as well as emotions and situations that can sabotage their success, and the group process encourages participants to share strategies for dealing with challenges.

Here are more resources for delicious meals and tips for physical activity:

On this day to ponder the effects of diabetes throughout the world, take time to eat right and move more.

Two Initiatives Worth Their Salt: Reducing Sodium Intake in Philadelphia and Shandong, China

Categories: cardiovascular disease, noncommunicable diseases (NCDs)

September 29 is World Heart Day.

September 29 is World Heart Day.

Background information

Barbara Bowman, Ph.D., Director, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC

Barbara Bowman, Ph.D., Director, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC

CDC’s 2013 Vital Signs publication reported that more than 200,000 deaths among Americans younger than age 75 are preventable. These deaths from heart disease and stroke, both primary contributors to cardiovascular disease (CVD), could be prevented through better lifestyle practices and better care. Heart disease and stroke are two of our nation’s leading causes of death, responsible for nearly 1 in 3 deaths in the US each year. Globally, hypertension accounts for almost one-half of heart attacks and strokes. In China alone, CVD caused an estimated 3.5 million deaths in 2008.

Excess sodium intake is a key risk factor for hypertension, and reducing sodium intake is a global and domestic public health priority. A 2007 study found that reducing average population sodium intake by 15% in 23 low- and middle-income countries (bearing 80% of the chronic disease burden) could prevent 8.5 million deaths over 10 years, at a cost of only $0.05 / person / year (see footnote #1). In China and in the US, average sodium consumption is in excess of recommendations (see footnote #2). Primary sources of sodium vary depending on the country: the primary sources of sodium in the US are packaged and restaurants foods, while in China it is salt added during cooking. Thus, efforts to reduce sodium consumption in each country focus on their respective primary contributors to sodium intake.

Shandong Province is the third most populous province in China with 96 million residents. Rates of hypertension and salt intake in adults are higher than the national average; Shandong Province is also one of the largest salt producers in China. To reduce the burden of hypertension, in 2011China’s National Health and Family Planning Commission (formerly the Ministry of Health) and Shandong provincial government, with technical assistance provided by US CDC, launched the first comprehensive salt reduction project in China: the Shandong Province & Ministry of Health Action on Salt and Hypertension (SMASH). The goal of SMASH is to: 1) reduce daily salt intake from 12.5 grams/day to 10 grams/day by 2015; and 2) improve hypertension control within the province.

In order to reduce salt intake, food labeling, reformulating local cuisine, distribution of scaled spoons for measurement of salt use in cooking, and food industry product reformulation are being broadly adopted. The initiative works with restaurants to develop sodium standards for Shandong cuisine, including, developing and conducting chef training and contests to provide lower salt menu items and recipes track salt usage, and disseminate educational resources. Restaurants that follow the lower salt requirement are designated a “Distinguished Restaurant”.

Philadelphia, also interested in reducing salt intake as part of its Get Healthy Philly initiative, launched the Philadelphia Healthy Chinese Take-out Initiative in 2012, a joint effort of the Philadelphia Chinese Restaurant Association, the Center for Asian Health of Temple University, the Asian Community Health Coalition and the Department of Health (DOH), to improve access to healthier food options. In an effort to control and prevent high blood pressure, the initiative aims to reduce the sodium content in Chinese take-out dishes by 10-15%. BetweenJuly, 2012 and April, 2013, 206 restaurants of more than 400 agreed to participate in the initiative. Philadelphia Healthy Chinese Take-out Initiative provided a series of free cooking trainings for owners and chefs on low salt cooking techniques. These included enhancing flavor with herbs and spices, using lower sodium ingredients such as reduced sodium soy sauce, modifying recipes to use ½ the amount of prepared sauce in dishes, and limiting distribution of soy sauce packets to customers. Marketing materials for owners and consumers to promote awareness of the initiative were also developed and distributed. DOH staff collected and analyzed samples of two popular dishes from 20 restaurants to assess changes in sodium content since the program began: preliminary results show an average of a 10% reduction in sodium content over the past two years.

After learning about US sodium reduction efforts via CDC’s Salt e-Update, SMASH officials have been working with Philadelphia Healthy Chinese Take-out Initiative to share information on their respective sodium reduction initiatives. Shandong shared CDC sodium fact sheets translated to Chinese with Philly, which assisted Philly in communicating with participating restaurant operators who only speak Chinese. Philly has provided Shandong with program insights and experience on monitoring and evaluation as well as program scope. Continued discussions will allow both communities to better communicate and share enhanced recipes, cooking techniques, and chef training materials with restaurants to reduce sodium in their menus. Expanded dialogue will also allow both projects to share lessons learned and fine tune efforts around training restaurants to reduce sodium, conducting public education campaigns focused on sodium reduction, and collecting baseline survey data to help inform targeted strategies for sodium reduction.

While the US continues to make progress in achieving our national CVD goals for sodium intake, there remains great opportunity to achieve more. Active engagement with global partners not only provides the unique opportunity to share our expertise and knowledge but to also leverage existing global efforts to enhance our knowledge and improve domestic approaches. SMASH and Philly’s Healthy Chinese Take-out Initiative share similar goals and approaches and are leveraging resources and experiences to enhance their respective programs.

To learn more:

  • CDC Division for Heart Disease and Stroke Prevention
    The mission of the Division for Heart Disease and Stroke Prevention (DHDSP) is to provide public health leadership to improve cardiovascular health for all, reduce the burden, and eliminate disparities associated with heart disease and stroke.
  • Sodium
    Most of the sodium we consume is in the form of salt, and the vast majority of sodium we consume is in processed and restaurant foods. Too much sodium can increase your blood pressure and your risk for a heart attack and stroke. Heart disease and stroke is the leading cause of death in the US.
  • Sodium Reduction Toolkit: A Global Opportunity to Reduce Population-Level Sodium Intake
    The toolkit is designed to provide international and national government agencies and public health organizations with a brief overview, tools, and information for developing and implementing sodium reduction programs, policies, and initiatives aimed at lowering sodium intake. The toolkit offers seven self-guided modules, each about 30 minutes to complete. (Chinese modules are currently hosted on a Chinese site through US CDC China office.)
  • High Blood Pressure
    High blood pressure is a common and dangerous condition. Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be. But you can take steps to control your blood pressure and lower your risk of heart disease and stroke.
  • The Shandong Province and Ministry of Health Action on Salt and Hypertension (SMASH)
  • Healthy Chinese Takeout Initiative

A Call for Action: Responding to the Tobacco Epidemic and the Price of Cigarettes

Categories: cancer, cardiovascular disease, noncommunicable diseases (NCDs), tobacco

Woman smoking tobacco

“Raising taxes to increase the price of tobacco products is the most effective means to reduce tobacco use and encourage smokers to quit.” – WHO Report on the Global Tobacco Epidemic, 2013

Samira Asma, DDS, MPH - Chief, CDC Global Tobacco Control Branch

Samira Asma, DDS, MPH - Chief, CDC Global Tobacco Control Branch

Real People, Real Stories

Mehmet Nuhoğlu started smoking when he was in middle school at the age of 12 after hearing that real men smoke. Little did he know that 45 years later his two pack a day addiction would lead to a heart attack and then cancer. “I never thought it would happen to me. I still can’t believe it,” he says.

Featured in national ads similar to the US Tips campaign, Mehmet was one of the real-life people featured in Turkey’s anti-tobacco mass media campaign that was launched in the later part of 2011. He tells of his experience with cigarettes and what daily smoking ended up costing him- his voice and his health. Now speaking with the help of an electrolarynx (a device that helps users who have lost their voice box produce clearer speech), he confesses that he regrets smoking.

March 10-16 Is World Salt Awareness Week

Categories: cardiovascular disease, noncommunicable diseases (NCDs)


This blog was originally posted on on January 23, 2014.


Grocery store

Almost two years ago, Philadelphia launched its Healthy Chinese Take-out Initiative with the goal of reducing sodium content by 10% to 15%.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

The city’s Public Health Department worked with 206 restaurants, first evaluating their menus for sodium content and then helping them choose ingredients and develop recipes with less sodium. One way found to reduce sodium was for restaurants to cut the use of commercially prepared sauces and instead make their own.

After nine months, the initiative analyzed two popular dishes from 20 participating restaurants to see what changed. The result? A 20% reduction in sodium, more than the project’s goal.

It’s one thing to choose how much salt to add to your food when you eat. It’s another to live with decisions made by those who prepare your food before it makes it to the table.

Global Burden of Mental Illness

Categories: mental health, noncommunicable diseases (NCDs)

Barbara Lopes Cardozo, MD, MPH, CDC Division of Global Health Protection

Barbara Lopes Cardozo, MD, MPH, CDC Division of Global Health Protection

“Total health” includes both physical and mental health. The Surgeon General’s landmark report on mental health in 1999 raised awareness about the inter-connectedness of mind and body, of physical and mental health. That reality has been validated ever since. However, mental health and addressing mental health-related problems are often under-emphasized.

CDC recognizes that the mental health of individuals in the community is a vital component of public health and that public health cannot be adequately addressed without also addressing mental health. Therefore, CDC is working on the public health issues related to mental health.

Improving Disease Surveillance and Outbreak Response in the Latin American and Caribbean Region through the Field Epidemiology Training Program

Categories: global health security, health systems strengthening, infectious disease, noncommunicable diseases (NCDs)


FETP residents taking water sample to test for cholera (2013)

FETP residents taking water sample to test for cholera (2013)

Dr. Victor Caceres, CDC Field Epidemiology Training Program Branch

Dr. Victor Caceres, CDC Field Epidemiology Training Program Branch

With increased global travel, everyone is more vulnerable to emerging and reemerging public health threats. This vulnerability is why every country needs a team of highly trained epidemiologists that can detect and rapidly respond to outbreaks and is why CDC is committed to working with countries to establish and support Field Epidemiology Training Programs (FETPs) all over the world including the Latin American and Caribbean (LAC) region.

For the last three years, CDC has been working with the Dominican Republic’s Ministry of Health (MoH), in collaboration with the University of Puerto Rico, to strengthen basic and intermediate-level training capacity for epidemiologists and laboratory personnel as part of the three-tiered “pyramid” training model developed and implemented by countries in Central America. 

Increasing Community and Stakeholder Knowledge, Awareness, and Acceptability of Cervical Cancer in Kenya

Categories: cancer, noncommunicable diseases (NCDs), women's/maternal health

Children in Kibera, Nairobi, Kenya

Children in Kibera, Nairobi, Kenya (Photo courtesy of Natasha Buchanan, CDC)

This year, in recognition of World Cancer Day, CDC’s Division of Cancer Prevention and Control (DCPC) is raising awareness about the impact of cancer around the world and CDC’s efforts to reduce the global burden. DCPC’s global activities include cancer prevention and control projects in Colombia, Brazil, Bolivia, Trinidad and Tobago, Tanzania, Kenya, Zambia, Botswana, India, Thailand, and Vietnam.

Natasha Buchanan, PhD, CDC Division of Cancer Prevention and Control

Natasha Buchanan, PhD, CDC Division of Cancer Prevention and Control

Many of these global projects are focused on helping to reduce the burden of cancer in developing regions, where more than half of the annual 14 million new cancer cases and 8 million cancer deaths occur. Among women worldwide, cervical cancer is the fourth most common cancer and the fourth leading cause of cancer-related death, but in less developed regions, the burden is much higher.

Eighty-five percent of cervical cancer deaths occur in developing countries where cervical cancer screening programs are incomplete or nonexistent. Because most women with cervical cancer in developing countries are 50 years old or younger, cervical cancer is the largest cause of years of life lost due to cancer in the developing world.

Working together to help strengthen Kenya’s capacity for birth defects prevention: A great collaborative start

Categories: child health, noncommunicable diseases (NCDs)


Working together to help strengthen Kenya’s capacity for birth defects prevention


Alejandro Azofeifa and Diana Valencia work to expand birth defects surveillance worldwide through Birth Defects COUNT, a CDC global initiative.

A Call for Assistance

Diana Valencia

Diana Valencia

Alejandro Azofeifa

Alejandro Azofeifa

In early 2012, Dr. Leland Albright, a pediatric neurosurgeon at Kijabe Hospital in Kijabe, Kenya, alerted CDC to what appeared to be a rising number of patients with some serious birth defects of the brain and spine called neural tube defects. He asked CDC to help pinpoint whether the prevalence was actually increasing or if there was simply an increased number of referrals to the hospital from throughout Kenya. Dr. Albright also questioned whether genetic, nutritional or social factors could be causing the increase.

The Value of CDC’s Work in Thailand

Categories: global disease detection, global health security, health systems strengthening, HIV/AIDS, infectious disease, noncommunicable diseases (NCDs), refugee health, tuberculosis (TB), violence and injury


Thai monk


When I became country director in 2013 the relationships between Thailand’s public health officials and CDC were already strong and well established.

Mitch Wolfe, MD MPH, Director, CDC-Thailand

Mitch Wolfe, MD MPH, Director, CDC-Thailand

That wasn’t surprising. CDC’s collaboration with the Ministry of Public Health, after all, began 30 years ago and the partnership has been prospering  – and expanding – ever since. And there is a strong history between the two countries – this year Thailand and the US are celebrating 180 years of Friendship.

The reasons are well established too. And numerous.

Last summer, while visiting family, I was asked by a U.S. border guard, “Why is America working abroad for public health?” I was happy to get this question, as it was an opportunity to deepen understanding for why CDC works abroad – to protect Americans from health threats, to build important relationships with strategic partners, and to learn lessons that can be expanded to other parts of the world.

CDC Launches New Noncommunicable Disease Training for Field Epidemiologists

Categories: noncommunicable diseases (NCDs)

Sharmily Roy, CDC Field Epidemiology Training Program (FETP)

Sharmily Roy, CDC Field Epidemiology Training Program (FETP)

Noncommunicable diseases (NCDs) are responsible for nearly 40 million deaths each year which represents almost three quarters of all deaths worldwide. These include deaths caused by injuries, such as motor vehicle injuries, and chronic diseases, such as cardiovascular disease, cancer, diabetes, and chronic respiratory diseases. Deaths due to NCDs are becoming more common in low- and middle-income countries, where the majority of NCD deaths occur and health systems are often not equipped to respond. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

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