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Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 2153

Editors

Dr. Daniele Piovani

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
2. IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
Interests: epidemiology; biostatistics; evidence based medicine; systematic reviews; meta-analysis; umbrella review; research methodology; GRADE
Special Issues, Collections and Topics in MDPI journals
Dr. Gisella Figlioli

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
2. IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
Interests: biostatistics; epidemiology; cancer genetics; systematic review; meta-analysis

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of “Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases” (https://www.mdpi.com/journal/jcm/special_issues/SWVY3375T7).

Non-communicable diseases (NCDs) represent the leading cause of mortality and morbidity worldwide, accounting for more than 70% of global deaths each year. These conditions, including cardiovascular diseases, cancers, chronic respiratory diseases, diabetes mellitus, and mental health disorders, are caused by a multifactorial interplay of genetic, metabolic, environmental, and behavioural factors.

The global burden of NCDs has increased steadily over recent decades, largely driven by ageing populations, urbanization, and lifestyle changes. Without effective preventive strategies, this trend is expected to continue, imposing substantial social, economic, and healthcare challenges across all countries, particularly in low- and middle-income regions.

Reducing exposure to modifiable risk factors such as tobacco use, physical inactivity, unhealthy diet, obesity, and harmful alcohol consumption represents a cornerstone of global efforts to prevent and control NCDs. Evidence-based public health interventions targeting these determinants can significantly decrease premature mortality and improve quality of life at the population level.

This Special Issue aims to provide a comprehensive and updated overview of advances in the prevention and management of non-communicable diseases through the reduction of modifiable risk factors. Building on the success of the first edition, this second edition specifically encourages submissions that leverage novel methodologies, including digital health tools, real-world data analytics, and implementation science frameworks, to evaluate the effectiveness and scalability of risk factor interventions. We welcome contributions from clinicians, clinical researchers, epidemiologists, and public health professionals working at the intersection of NCD prevention and clinical practice. Submissions may include original research articles, systematic reviews and meta-analyses, clinical studies, observational studies, intervention trials, and narrative reviews that provide evidence-based insights into risk factor modification and NCD control strategies. We look forward to receiving high-quality submissions that will contribute to strengthening the scientific basis for reducing the global burden of NCDs.

Dr. Daniele Piovani
Dr. Gisella Figlioli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • non-communicable disease
  • chronic disease
  • cardiovascular disease
  • cancer
  • chronic respiratory disease
  • diabetes
  • mental health
  • tobacco use
  • physical inactivity
  • unhealthy diet
  • alcohol use
  • disease prevention

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Related Special Issue

Published Papers (4 papers)

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Research

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12 pages, 2189 KB  
Article
Changing Trends in Cardiovascular Disease Burden in North Africa and the Middle East, 1990–2023: A Joinpoint Analysis of GBD 2023 Data
by Hanane Ouddoud, Judah Israel Ong Lescano, Keith Pardillada Belangoy, Yoshito Nishimura, Ko Harada, Hideharu Hagiya, Quynh Thi Vu, Naohiro Iwata, Tatsuaki Takeda, Yoshito Zamami and Toshihiro Koyama
J. Clin. Med. 2026, 15(13), 4866; https://doi.org/10.3390/jcm15134866 (registering DOI) - 23 Jun 2026
Abstract
Background/Objectives: Cardiovascular disease (CVD) burden decreased in the North Africa and Middle East (NAME) region between 1990 and 2019. This study used Global Burden of Disease (GBD) 2023 data to examine whether trends in mortality, disability-adjusted life years (DALYs), incidence, and prevalence [...] Read more.
Background/Objectives: Cardiovascular disease (CVD) burden decreased in the North Africa and Middle East (NAME) region between 1990 and 2019. This study used Global Burden of Disease (GBD) 2023 data to examine whether trends in mortality, disability-adjusted life years (DALYs), incidence, and prevalence continued through 2023 across all 21 NAME countries. Methods: We analysed age-standardised CVD mortality, incidence, prevalence, and DALY rates from 1990 to 2023. Joinpoint regression identified changes in temporal trends and calculated the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: Age-standardised CVD mortality decreased from 579.6 per 100,000 in 1990 to 358.2 in 2023 (AAPC: −1.42%; 95% CI: −1.48 to −1.35). However, no significant reduction occurred between 2019 and 2023 (APC: −0.33%; 95% CI: −1.37 to 1.75). DALY, incidence, and prevalence rates followed similar patterns, with no significant decline in the final years of this study. Egypt was the only country with a long-term increase in CVD mortality, which accelerated after 2020 (APC: +5.20%; 95% CI: 1.20 to 12.87). High systolic blood pressure, dietary risks, lead exposure, and air pollution were the leading modifiable risk factors. Conclusions: The earlier decline in CVD burden in the NAME region did not clearly continue after 2019. The region is currently off track to meet Sustainable Development Goal 3.4 by 2030. Future progress may depend on improved blood pressure control, lipid management, dietary habits, and environmental risk reduction. Full article
(This article belongs to the Special Issue Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases: 2nd Edition)
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13 pages, 316 KB  
Article
Post-Diagnosis Decline in Moderate-to-Vigorous Physical Activity Is Associated with Higher Triglyceride and Fasting Glucose Levels in Newly Diagnosed Diabetes: A National Cohort Study
by Byeongsu Kim, Dong Ok Kim, Seogsong Jeong and Hwamin Lee
J. Clin. Med. 2026, 15(9), 3201; https://doi.org/10.3390/jcm15093201 - 22 Apr 2026
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Abstract
Background/Objectives: Evidence remains limited on how post-diagnosis changes in moderate-to-vigorous physical activity (MVPA) are associated with triglyceride and fasting glucose levels in newly diagnosed diabetes. We examined this association in a Korean national cohort. Methods: Using the National Health Insurance Service National Sample [...] Read more.
Background/Objectives: Evidence remains limited on how post-diagnosis changes in moderate-to-vigorous physical activity (MVPA) are associated with triglyceride and fasting glucose levels in newly diagnosed diabetes. We examined this association in a Korean national cohort. Methods: Using the National Health Insurance Service National Sample Cohort, we identified adults with newly diagnosed diabetes in 2009–2010 who completed health screenings in both 2010–2011 (period I) and 2012–2013 (period II). Period II MVPA frequency was examined within strata defined by period I MVPA category. Adjusted least-squares means for five metabolic indicators were estimated using multivariable linear regression. Results: Among 3719 participants, the clearest associations were observed among those performing MVPA five or more times per week during period I, in whom lower period II MVPA frequency was associated with higher triglyceride (P for trend = 0.036) and fasting glucose (P for trend = 0.015) levels. Increases in MVPA among initially inactive participants were not consistently associated with favorable metabolic profiles. Conclusions: A post-diagnosis decline in MVPA was associated with higher triglyceride and fasting glucose levels, particularly among initially active individuals. Preventing declines in MVPA after diabetes diagnosis may be clinically relevant. Full article
(This article belongs to the Special Issue Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases: 2nd Edition)
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22 pages, 337 KB  
Article
Cardiometabolic Mortality and Health System Expansion in Kuwait (2010–2022): A National Time-Series Analysis
by Ahmad Salman
J. Clin. Med. 2026, 15(7), 2697; https://doi.org/10.3390/jcm15072697 - 2 Apr 2026
Viewed by 515
Abstract
Background: Cardiometabolic diseases are a leading cause of premature mortality globally, yet longitudinal national mortality patterns remain insufficiently characterised in Gulf Cooperation Council settings. This study examines national trends in cardiometabolic mortality alongside health system financing, capacity, and utilization in Kuwait between [...] Read more.
Background: Cardiometabolic diseases are a leading cause of premature mortality globally, yet longitudinal national mortality patterns remain insufficiently characterised in Gulf Cooperation Council settings. This study examines national trends in cardiometabolic mortality alongside health system financing, capacity, and utilization in Kuwait between 2010 and 2022. Methods: A national ecological time-series analysis used Ministry of Health administrative data covering mortality, cardiac care unit (CCU) capacity and discharges, cardiovascular procedural volumes, and MOH expenditure. Cause-specific outcomes included circulatory disease, ischaemic heart disease (IHD), cerebrovascular disease, hypertensive disease, and diabetes mellitus. Ordinary least squares regression estimated annual trends; pre-COVID restricted models (2010–2019) separated secular from pandemic-period effects. Results: All-cause deaths rose significantly from 5448 (2010) to 8041 (2022; β = +373.5/year; p = 0.001), peaking at 10,938 in 2021. Circulatory disease mortality rates increased over the full series but not pre-COVID, indicating pandemic-era acceleration. IHD death counts rose significantly in both models (β = +68.4 and +67.0/year; p < 0.01); IHD rates showed no significant trend, implicating demographic growth. Diabetes demonstrated the strongest signal: significant increases in death counts (β = +36.5/year; p < 0.001) and mortality rates (β = +0.689/100,000/year; p = 0.002), rising progressively across all time blocks. Hypertensive mortality declined significantly (β = −0.113/year; p = 0.002). MOH expenditure, CCU capacity, and CCU discharges increased significantly, demonstrating sustained structural expansion of cardiovascular services. Conclusions: Rising cardiometabolic mortality—driven prominently by diabetes—occurred alongside sustained health system expansion in Kuwait, indicating that tertiary capacity growth alone is insufficient to offset underlying epidemiological pressures. These findings underscore the urgency of strengthening upstream cardiometabolic prevention, integrated diabetes surveillance, and long-term metabolic risk control as central pillars of sustainable NCD policy. Full article
(This article belongs to the Special Issue Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases: 2nd Edition)

Other

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14 pages, 412 KB  
Study Protocol
Randomized, Double-Blind, Crossover Trial Comparing Low-Glycemic Index Functional and Conventional Wholegrain Carbohydrates on Glycolipid Metabolism and Vascular Stress Markers in Adults with Suboptimal Triglyceridemia: The GLOW Study
by Marina Giovannini, Federica Fogacci, Cristina Scollo, Valentina Di Micoli, Elisa Grandi and Arrigo F. G. Cicero
J. Clin. Med. 2026, 15(5), 1745; https://doi.org/10.3390/jcm15051745 - 25 Feb 2026
Viewed by 791
Abstract
Mild fasting hypertriglyceridemia is often accompanied by early insulin resistance and atherogenic dyslipidemia, making it an attractive target for pragmatic dietary prevention. This trial aims to determine whether substituting common cereal-based staples with functional low-glycemic index (low-GI) products improves the triglyceride–glucose (TyG) index [...] Read more.
Mild fasting hypertriglyceridemia is often accompanied by early insulin resistance and atherogenic dyslipidemia, making it an attractive target for pragmatic dietary prevention. This trial aims to determine whether substituting common cereal-based staples with functional low-glycemic index (low-GI) products improves the triglyceride–glucose (TyG) index in adults with fasting triglycerides >150 mg/dL. The GLOW study is an exploratory, randomized, double-blind, single-center crossover trial. Adults aged ≥18 years with fasting triglycerides >150 mg/dL and body mass index ≤30 kg/m2 will be enrolled. Participants will follow a stabilized Mediterranean-style diet and will complete two 28-day intervention periods in random sequence: (i) functional low-GI Altograno® pasta, pizza base and flatbread; and (ii) conventional standard wholegrain products. Intervention periods will be separated by a 28-day washout. Study foods will be consumed as fixed daily substitutions of usual staple servings (one bread portion and one pasta or pizza portion). The primary endpoint is the between-intervention difference in TyG response over each period, defined as the period-specific change from the corresponding period baseline to the end-of-period assessment. The primary analysis will compare end-of-period TyG between interventions while adjusting for the period-specific baseline value. Secondary endpoints include fasting triglycerides and glucose, atherogenic lipoproteins (non–high-density lipoprotein cholesterol and apolipoprotein B), inflammation (high-sensitivity C-reactive protein), endothelial reactivity assessed with the Endocheck®/Vicorder® system, and food acceptability. Safety endpoints include adverse event recording. Treatment effects will be estimated using linear mixed-effects models accounting for treatment, period and sequence, with prespecified carryover sensitivity analyses. A total of 40 participants will be recruited to generate feasibility data and effect size estimates. This protocol will provide crossover evidence on whether pragmatic, product-level low-GI staple substitution improves TyG and related cardiometabolic and vascular biomarkers in adults with suboptimal triglyceridemia, informing larger trials. Trial registration: ClinicalTrials.gov NCT07198789. Full article
(This article belongs to the Special Issue Reducing Modifiable Risk Factors to Prevent and Control Non-Communicable Diseases: 2nd Edition)
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