Obesity, hypertension, carbohydrate disorders and the risk of chronic diseases. Is there any epidemiological evidence for integrated prevention programmes?

The major cause of coronary heart disease, hypertension, non-insulin-dependent diabetes and obesity in adults in developed countries appears to be the result of risk factors that are introduced by way of their life-styles. Many developing countries are also noting increases in morbidity and mortality from these diseases. There is increasing evidence of common risk factors in the aetiology of these chronic disorders and two or more of these diseases may coexist in the same subjects. This evidence provides a strong rationale for a community-based, integrated approach to the primary prevention of such non-communicable diseases by the reduction of the level of risk factors. This may be achieved by community-based programmes which stress the importance of a healthy life-style, such as the practice of good nutrition, weight reduction in the obese, increased physical activity, the avoidance of stress and a reduction in alcohol and cigarette consumption.