Overview

Health Challenge Despite the increasing life expectancy, the state of human health in Europe is declining, marked by a growing prevalence of non-communicable diseases (NCDs) such as cancer, cardiovascular disease (CVD), type 2 diabetes (T2D), pulmonary disease, and depression. Unlike infectious diseases, NCDs cannot be transmitted from person to person like bacterial or viral infections. In the Netherlands, individuals typically experience their first NCD around the age of 45. Given that these conditions are chronic and the average life expectancy is 81 years, the majority of individuals require medical attention for NCDs for nearly half of their lives. A measure called disability-adjusted life years (DALYs) quantifies the societal impact of these diseases by accounting for years lost due to disability or premature death. In high-income countries, 85% of DALYs are attributed to NCDs, with 9 out of the top 10 causes in the Netherlands being NCDs (Figure 1). The urgency for improving societal health became even more evident with the outbreak of the coronavirus (SARS-CoV-2) in 2019, which developed into the COVID-19 pandemic in 2020. Individuals with obesity, CVD, T2D, or pulmonary disease had more severe disease progression and higher mortality rates after contracting the virus, compared to those who were in good health. This put immense strain on healthcare systems globally, leading to a reduction in non-urgent medical care and even the inability to provide timely medical attention to critically ill patients, resulting in significant medical and economic burdens for societies. One common component of many NCDs is the metabolic syndrome (MetS), which encompasses various cardiometabolic abnormalities often associated with weight gain. These include abdominal obesity, unfavorable blood lipid profile, high blood pressure, and insulin resistance. According to the International Diabetes Federation, a diagnosis of MetS requires the presence of central obesity (determined by waist circumference exceeding 94 cm for European men and 80 cm for European women, with variations for different ethnicities), as well as at least two of the following factors: elevated triglyceride levels (above 150 mg/dL or 1.7 mmol/L), reduced HDL cholesterol levels (below 40 mg/dL or 1.03 mmol/L for men and below 50 mg/dL or 1.29 mmol/L for women), increased blood pressure (systolic blood pressure above 130 mmHg or diastolic blood pressure above 85 mmHg), increased fasting plasma glucose levels (above 100 mg/dL or 5.6 mmol/L), or medical treatment for any of these factors. Early detection of MetS and addressing its underlying causes could help alleviate the prevalence of NCDs and contribute to the overall improvement of health.

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