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Non-communicable disease risk factors: a call for primary care clinicians to act and to refer. Brief intervention, not silent abdication.
  1. Anna L Beale1,
  2. Alessandro R Demaio2
  1. 1 Department of Medicine, Monash University, Melbourne, Australia
  2. 2 Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
  1. Correspondence to Dr Alessandro R Demaio, Nutrition for Health and Development, World Health Organization, Geneva,Switzerland; demaioa{at}

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In a single century, preventable chronic disease has gone from marginal killer to major cause of global mortality.

Non-communicable diseases (NCDs), including cardiovascular disease, cancers, chronic respiratory diseases and diabetes, are the leading causes of death and morbidity globally.1 Ischaemic heart disease and stroke alone accounted for 15 of the 56.4 million deaths worldwide in 2015, and together NCDs represented 70% of total mortality.2 The main drivers across all four NCDs are shared and include tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol;1 risk factors that are uniformly preventable and for which there are clear policy and clinical practice solutions.

A modest 10% reduction in physical inactivity worldwide could lead to 533 000 fewer deaths annually.3 There is strong evidence for the role of physical inactivity in driving at least 9% of premature mortality attributable among NCDs. Similarly, obesity and poor diet are each responsible for approximately 4% of the global burden of disease, accounting for more than …

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  • Competing interests ARD is a staff member of the World Health Organization in Geneva.

  • Provenance and peer review Not commissioned; internally peer reviewed.