Search Results (648)

Non-communicable diseases (NCDs) remain a major contributor to global morbidity and mortality, with India bearing a substantial share of this burden. The COVID-19 pandemic disrupted routine clinical care and accelerated the transition to telemedicine for chronic disease management. This study explores healthcare providers’ perspectives on the use of telemedicine for NCD care during and after the pandemic, including its perceived benefits, limitations, and future relevance within the broader digital health landscape. Semi-structured interviews were conducted with 33 purposively selected healthcare providers with experience in telemedicine for NCD care between February and June 2025, audio-recorded, transcribed verbatim, and thematically analyzed using NVivo 15. Providers reported that telemedicine supported continuity of care, reduced the need for in-person visits, facilitated medication adherence, and offered reassurance for patients during periods of restricted mobility. However, limitations were identified, including the inability to conduct physical examinations, connectivity challenges, and low digital literacy, particularly among older adults. While overall satisfaction with telemedicine was positive, participants emphasized the need for strengthened digital infrastructure, greater patient awareness, and simplified platforms to improve usability. The findings underscore telemedicine’s continued relevance for NCD management beyond the pandemic, contingent on improved accessibility and system integration. Full article

Maqui (Aristotelia chilensis) is a berry native to southern Chile, recognized for its high content of phenolic compounds, particularly delphinidin-type anthocyanins, which confer strong antioxidant and anti-inflammatory properties and have generated growing interest as a functional food. Its scientific relevance has increased due to advances in understanding its biological mechanisms, including the Nrf2 signaling pathway, modulation of systemic inflammation, improvement in mitochondrial function, and potential applications in cardiometabolic, renal, and vascular health. Objective: The objective of this study is to analyze the available evidence on maqui in relation to its nutritional composition, bioactive profile, antioxidant and anti-inflammatory mechanisms, bioavailability, and emerging clinical applications in the prevention and/or treatment of chronic non-communicable diseases. Main findings: Maqui is rich in delphinidins, dietary fiber, and antioxidant micronutrients and modulates key oxidative stress and inflammatory pathways, including Nrf2-HO-1 and NF-κB. Preclinical and early clinical evidence supports its cardiometabolic and nephroprotective effects, with improvements in glycemic control, lipid metabolism, oxidative stress, and endothelial function. Conclusions: Maqui shows considerable potential as a Chilean functional food with antioxidant and anti-inflammatory effects relevant to human health. However, robust clinical trials and formulations with enhanced bioavailability are required to consolidate its therapeutic application. Full article

Objective: To evaluate the prevalence of systemic chronic diseases among patients undergoing endodontic therapy in a University Department of Endodontology and to assess their potential implications for treatment planning and prognosis. Methods: A retrospective cross-sectional study analysis was performed on clinical records of patients aged > 18 years treated at the Department of Endodontics, University of Bologna. Data collected included demographic information, presence of chronic systemic diseases, endodontic disease and medication history. Descriptive statistics were used to estimate prevalence rates. Results: More than one third of patients (35%) presented with at least one systemic chronic disease or multiple comorbidities. Cardiovascular diseases (19.8%) were the most prevalent. Polypharmacy was observed in 32% of patients. Patients aged 40 years and older showed a significantly higher prevalence of systemic conditions compared to younger individuals. Conclusions: The study supports the finding that a high percentage of patients undergoing endodontic therapies present systemic chronic diseases, multiple comorbid conditions and polypharmacy. It is important to assess these factors and to customize endodontic treatment and decision-making. These realities are likely to become even more pronounced in the coming years, as global population aging continues apace. Full article

Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article

Kidney aging is receiving growing attention in middle- to high-income societies due to increasing longevity in general population. Chronic Kidney Disease (CKD) has been widely accepted as a major non-communicable human disease affecting over 10% of the adult population in industrialized countries. CKD is mainly caused by metabolic and cardiovascular disorders such as diabetes mellitus and hypertension, disproportionally affecting older people, whereas natural kidney aging is driven by age-dependent systemic and renal low-grade inflammation. Interleukin-6 (IL-6) is the key cytokine mediating age-related inflammation. At the same time, IL-6 has been implicated in the pathophysiology of cardiovascular and renal disorders as a major pro-inflammatory cytokine. Thereby, IL-6 is placed at the intersection between natural and pathophysiological kidney aging, and the latter accelerates systemic aging and substantially limits life quality and expectancy. Growing clinical availability of IL-6 inhibitors for treatment of autoimmune and autoinflammatory disorders demands clarification of potential renal consequences as well. Available data suggests that IL-6 inhibition may be renoprotective in some kidney disorders, but the setting of kidney aging has received only minor attention. The present review focuses on the known effects of IL-6 associated with natural or pathophysiological renal aging. Full article

Berries are an excellent source of bioactive compounds, particularly polyphenols, and have been widely used in folk medicine by the Mapuche people of southern Chile. In this study, a hydroalcoholic extract of Berberis congestiflora Gay (BE) was analyzed to determine its phytochemical composition and to evaluate its antioxidant capacity, vasorelaxant effects in rat aortas, and inhibitory activity on enzymes related to chronic non-communicable diseases, including exploration of a possible vasodilatory mechanism in isolated rat aortas. Antioxidant activity was assessed using Oxygen Radical Absorbance Capacity (ORAC), DPPH (2,2-diphenyl-1-picrylhydrazyl), and ABTS (2,2-azinobis-(3-ethylbenzothiazolin-6-sulfonic acid)) radical scavenging assays, as well as ferric reducing antioxidant power (FRAP). Vascular responses to the Berberis extract were studied using isometric tension recordings in an ex vivo rat thoracic aortic ring model, and the chemical constituents of BE were identified for the first time by HPLC-DAD-MS. The extract itself produced a dose-dependent contraction at 100 and 1000 µg/mL and induced relaxation in phenylephrine-precontracted aortas at the same concentrations, with a maximum contraction of 71% and maximum relaxation of 70% at 1000 µg/mL. Mechanistically, the extract triggered calcium-mediated contraction primarily through calcium release from the sarcoplasmic reticulum and, to a lesser degree, via extracellular Ca²⁺ influx, while its relaxant effect depended on an intact endothelium and activation of the NO/cGMP pathway. In addition, the extract showed inhibitory activity against cholinesterase, glucosidase, and amylase, with IC₅₀ values of 7.33 ± 0.32, 243.23 ± 0.3, and 27.21 ± 0.03 µg/mL, respectively, and docking studies were carried out for selected berry compounds. Overall, these findings indicate that these berries are a rich source of bioactive constituents with antioxidant properties and endothelium-dependent vasodilator effects, supporting their traditional use and highlighting their potential as enzyme inhibitors and as promising candidates for the development of phytotherapeutic products, particularly as supplements for chronic disease management. Full article

Cardiovascular diseases, malignancy, and diabetes mellitus are the most common chronic non-communicable diseases affecting the population in Serbia. According to The Cancer Registry of the Republic of Serbia, breast cancer is the most common cancer affecting women in Serbia. Every year, 4600 women get diagnosed with BC, and 1600 women die from this disease. Every eighth woman in Serbia is diagnosed with BC. This review aims to summarize clinical and theoretical information about breast cancer, metabolic syndrome and cardiovascular risk connection. The literature search was conducted through PubMed, Google Scholar and cross-references in January 2024. We concluded that although there is a well-established connection between cardiovascular risk, metabolic syndrome, inflammation, dyslipidemia, obesity, diabetes mellitus and breast cancer, more multicenter prospective clinical studies are needed to establish the precise association and pathophysiological mechanisms. Full article

Background: Ultra-processed foods (UPFs) have emerged as a critical component of diet quality, yet data on the associations between UPF and nutrient intakes remain limited. This study aimed to evaluate nutrient consumption in relation to UPF intake and adherence to international dietary guidelines for non-communicable disease (NCD) prevention. Methods: Data from 469 individuals aged 2–18 years enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were analyzed. Intakes were assessed using two 24 h recalls, and foods were classified according to the NOVA system. Participants were categorized by UPF energy intake tertiles. Nutrient adequacy was assessed using Nordic Nutrition Recommendations, European Society of Cardiology guidelines for macronutrients, and the Institute of Medicine’s Estimated Average Requirements and Adequate Intake values for micronutrients. Results: Children in the highest UPF tertile had significantly higher intakes of energy, carbohydrates, added sugars, saturated fats, polyunsaturated fats, and cholesterol, but lower intakes of protein compared to those in the lowest tertile. Fiber intake remained inadequate across all tertiles, with no significant differences. Regarding adherence to NCD prevention guidelines, children in the 3rd UPF tertile had a 2.3 times higher prevalence ratio for exceeding added sugar recommendations, while their protein intake prevalence ratio was 0.8 times lower. For micronutrients, the highest UPF tertile showed significantly elevated intakes of vitamins E, B₁, folate, calcium, iron, copper, and sodium, but lower potassium intake compared to the lowest tertile. Conclusions: Our results underscore the need for effective public health strategies to improve diet quality in children and adolescents and prevent diet-related NCDs. Full article

Obesity is among the top contributing factors for non-communicable chronic disease development and has attained menacing global proportions, affecting approximately one of eight adults. Phytochemicals that support energy metabolism and prevent obesity development have been the subject of intense research endeavors over the past several decades. Cycloastragenol is a natural triterpenoid compound and aglycon of astragaloside IV, known for activating telomerase and mitigating cellular aging. Here, we aim to characterize the effect of cycloastragenol on lipid metabolism in a glucose-induced obesity model in Caenorhabditis elegans. We assessed the changes in the body length, width, and area in C. elegans maintained under elevated glucose through automated WormLab system. Lipid accumulation in the presence of either cycloastragenol (100 μM) or orlistat (12 μM), used as a positive anti-obesity control drug, was quantified through Nile Red fluorescent staining. Furthermore, we evaluated the changes in key energy metabolism molecular players in GFP-reporter transgenic strains. Our results revealed that cycloastragenol treatment decreased mean body area and reduced lipid accumulation in the C. elegans glucose-induced model. The mechanistic data indicated that cycloastragenol suppresses the nuclear hormone receptor family member NHR-49 and the delta(9)-fatty-acid desaturase 7 (FAT-7) enzyme, and activates the 5′-AMP-activated protein kinase catalytic subunit alpha-2 (AAK-2) and the protein skinhead 1 (SKN-1) signaling. Collectively, our findings highlight that cycloastragenol reprograms lipid metabolism by down-regulating the insulin-like receptor (daf-2)/phosphatidylinositol 3-kinase (age-1)/NHR-49 signaling while simultaneously enhancing the activity of the AAK-2/NAD-dependent protein deacetylase (SIR-2.1) pathway. The anti-obesogenic potential of cycloastragenol rationalizes further validation in the context of metabolic diseases and obesity management. Full article

Periodontitis is a chronic non-communicable inflammatory disease in which oxidative stress plays an important role in tissue destruction and alveolar bone loss. Excessive production of reactive oxygen species disrupts redox homeostasis, activates inflammatory signaling pathways, and promotes regulated cell death processes such as pyroptosis and ferroptosis. The Nrf2/Keap1 pathway is a key regulator of antioxidant defense and cellular adaptation to redox imbalance. Impaired Nrf2 signaling has been associated with enhanced oxidative injury, NF-κB and NLRP3 inflammasome activation, osteoclast-driven bone resorption, and reduced regenerative capacity in periodontal tissues. Experimental studies suggest that Nrf2 activation can restore the redox balance and attenuate inflammation and bone destructive responses in a periodontal model. Moreover, therapeutic approaches involving phytochemicals, microbial-derived metabolites, and redox-responsive biomaterials have been reported to influence Nrf2-related signaling in experimental settings. However, the majority of the available evidence is derived from in vitro or animal studies, and the relevance of these findings to clinical periodontitis remains to be established. This review summarizes the current advances linking oxidative stress, redox signaling, cell death pathways, and bone remodeling with Nrf2 dysfunction in periodontitis and outlines the key mechanistic insights while highlighting the existing knowledge gaps. Full article

Rivers and groundwater supply 88% of Europe’s freshwater and are critical for public health. We examined whether cross-country differences in arsenic, lead, mercury, and nickel concentrations in groundwater and rivers are associated with disease burden. In an ecological cross-sectional study of 24 European countries, nationally aggregated concentrations from the European Environment Agency’s Waterbase Water Quality (2016–2019) were linked to cause-specific disability-adjusted life years (DALYs) from the Global Burden of Disease 2021 for six disease groups. Variables were z-standardized. Associations were assessed using Pearson correlations and linear regression with Benjamini–Hochberg correction. Missing concentrations were addressed via multiple imputation by chained equations using 1980–2025 monitoring records, and models were sequentially adjusted for health system, demographic, and economic indices. In groundwater, lead was positively associated with diabetes and kidney disease DALYs and remained significant after imputation and adjustment (β = 0.60, p = 0.011). In rivers, arsenic was positively associated with all-cause, cardiovascular, and neoplasm DALYs in unadjusted analyses but attenuated after adjustment and/or imputation. No consistent associations were observed for mercury or nickel. These continent-wide, non-causal findings can help prioritize monitoring and risk management and support progress toward Sustainable Development Goal 6. Full article

Type 2 diabetes mellitus (T2DM) is a growing public health challenge worldwide, disproportionately affecting populations in low- and middle-income countries (LMICs). Poor glycemic control contributes significantly to the global burden of non-communicable diseases (NCDs), increasing morbidity, mortality, and healthcare costs. Understanding behavioral and lifestyle determinants is critical for designing effective public health strategies, particularly in resource-limited settings such as Lesotho. A cross-sectional population-based study was conducted among 184 adults with T2DM attending the out-patient department of Maluti Adventist Hospital, Lesotho. Data was collected using a structured questionnaire and analyzed descriptively with SPSS 26 Variables assessed included sociodemographic, dietary practices, physical activity, behavioral risk factors and self-care knowledge. Participants were predominantly aged 45–69 years (65.2%), with an equal sex distribution. Hypertension was the most prevalent comorbidity (65.2%). Risk factor exposure was widespread, 100% consumed fewer than five daily servings of fruits/vegetables, 95.1% reported insufficient physical activity, and 88.0% had elevated blood pressure. Overall, 86.4% had three or more NCD risk factors. Knowledge levels were intermediate, with 33.2% scoring poor, 52.7% moderate, and only 14.1% good. Glycemic control was suboptimal, with 40.8% uncontrolled. This study highlights the urgent public health need to address lifestyle and behavioral determinants of poor glycemic control in Lesotho. Tailored interventions focusing on dietary education, physical activity promotion, and routine monitoring are essential to reduce NCD risks and improve outcomes. The findings have broader implications for achieving Sustainable Development Goal 3.4 on reducing premature NCD mortality in LMICs. Strengthening culturally sensitive health promotion, community-based interventions, and integrated chronic disease care models could significantly advance diabetes prevention and control in low-resource settings. Full article

Physical exercise is a potent non-pharmacological strategy for the prevention and management of chronic non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular diseases, obesity, and certain cancers. Growing evidence demonstrates that the benefits of exercise extend beyond its physiological effects and are largely mediated by coordinated molecular and cellular adaptations. This review synthesizes current knowledge on the key mechanisms through which exercise modulates metabolic health, emphasizing intracellular signaling pathways, epigenetic regulation, and myokine-driven inter-organ communication. Exercise induces acute and chronic activation of pathways such as AMPK, PGC-1α, mTOR, MAPKs, and NF-κB, leading to enhanced mitochondrial biogenesis, improved oxidative capacity, refined energy sensing, and reduced inflammation. Additionally, repeated muscle contraction stimulates the release of myokines—including IL-6, irisin, BDNF, FGF21, apelin, and others—that act through endocrine and paracrine routes to regulate glucose and lipid metabolism, insulin secretion, adipose tissue remodeling, neuroplasticity, and systemic inflammatory tone. Epigenetic modifications and exercise-responsive microRNAs further contribute to long-term metabolic reprogramming. Collectively, these molecular adaptations establish exercise as a systemic biological stimulus capable of restoring metabolic homeostasis and counteracting the pathophysiological processes underlying NCDs. Understanding these mechanisms provides a foundation for developing targeted, personalized exercise-based interventions in preventive and therapeutic medicine. Full article

The global population is aging rapidly and the prevalence of age-related noncommunicable diseases is increasing. Favorable dietary patterns have the power to reduce the risk or progression of various age-related chronic diseases, including obesity, hypertension, cardiovascular disease, type 2 diabetes, several types of cancer, and some neurodegenerative diseases. In contrast, adverse dietary patterns may contribute to the onset or progression of many chronic diseases or their risk factors. A diet rich in wholesome, nutrient-dense, minimally processed foods, such as a Mediterranean-style diet, may promote health and prevent disease through its abundance of antioxidants, fiber, omega-3 fatty acids, and micronutrients. Conversely, a diet high in nutrient-poor and ultra-processed foods may accelerate disease onset and progression by promoting inflammation and affecting metabolic pathways adversely. This narrative review summarizes the literature from clinical trials and large population-based studies on protective dietary patterns and adverse dietary patterns that influence risk of cardiovascular disease and related risk factors, cancer, Alzheimer’s disease and related dementias, type 2 diabetes, frailty, and liver disease. Full article

Background: Dietary patterns influence systemic inflammation, which is involved in the pathogenesis of non-communicable diseases. The dietary inflammatory index (DII) quantifies the inflammatory potential of the diet and varies across populations due to cultural and regional eating habits. Limited data exist on the inflammatory potential of diets in Saudi Arabia. This study aimed to assess the inflammatory potential of the diet and its association with sociodemographic and lifestyle factors among adults in Saudi Arabia. Methods: A cross-sectional study included 256 adults aged 18–50 years residing in Saudi Arabia. Participants were recruited using convenience sampling via social media platforms. Data were collected between November 2024 and August 2025 using a validated Saudi food frequency questionnaire and sociodemographic survey. Energy-adjusted DII (E-DII) scores were calculated using 42 food parameters. Non-parametric tests (Mann–Whitney U and Kruskal–Wallis) were applied to examine associations between E-DII and sociodemographic variables. Results: Significant differences in E-DII were observed by sex (p < 0.001). Males had higher E-DII scores than females, suggesting more pro-inflammatory diets. Participants with postgraduate education tended to have lower E-DII than participants with only a high school degree, reflecting more anti-inflammatory dietary patterns. However, this trend was not statistically significant (p = 0.06). The mean E-DII was 4.8 ± 1.3, indicating a predominantly pro-inflammatory dietary pattern. No significant differences were found across age, education, income, BMI, marital status, employment, or smoking status. Conclusions: Sex was a key determinant of dietary inflammatory potential. Adults demonstrated overall pro-inflammatory dietary patterns in Saudi Arabia. Public health interventions should target higher risk groups, such as males with a higher risk of non-communicable diseases, to promote anti-inflammatory dietary habits and reduce chronic disease risk in this population. Full article