The preferred public health approach to control non- communicable diseases is -

"It is now felt that the principles of prevention of CHD can be applied also to other major NCDs because of common risk factors. A broader concept is emerging, that is , to develop an overall integrated programme for the Prevention and control of NCDs as part of primary health care systems, simultaneously attacking several risk factors known to be implicated in the development of NCDs. Such concerted preventive actions should reduce not only cardiovascular diseases but also other major NCDs." Prevention and control of non-communicable diseases (NCDs) : 1. Population strategy : Focus on control of underlying causes (risk factors) in whole populations, 'not merely by individuals' Principle: Small changes in risk factor levels in total populations can achieve the biggest reduction in mortality, thus aim should be 'to shift the whole curve or risk factors towards biological normality' Specific interventions: 1. Dietary changes: Dietary modification is the principal preventive strategy in the prevention of CHD; WHO recommended changes (Prudent diet-dietary goals): i. Reduction of fat intake to < 20 — 30 % of total energy intake ii. Consumption of saturated fats < 10 % of total energy intake iii. Reduction in dietary cholesterol to < 100 mg/1000 kcal/day iv Increase in complex carbohydrate consumption v. Reduction of salt intake to ≤ 5 gms per day vi. Avoidance of alcohol consumption vii. Primordial prevention 2. High risk strategy : Identifying risk: by using simple tests for blood pressure, serum cholesterol measurement El Specific advice: to those identified at high risk 3. Secondary prevention : Aim: to prevent reoccurrence and progression of NCDs Most promising results have come from beta-blockers Following information has been added in 22nd /e of Park Recently, the WHO has developed a survey methodology know as "the STEPS Non-communicable Disease Risk Factors Survey" to help countries establish NCD surveillance system. The methodology prescribes three steps - questionnaire, physical measurements and biochemical measurements.