Background and targets: In 2016, 40.5 million (71%) of the 56.9 million deaths worldwide were due to NCDs . In the Caribbean, NCDs in 2010 outpaced those in North and South America . Male death rate from NCDs is higher than female death rate [1, 2]. This fact served as the basis for comparative studies on nutritional risk factors for NCDs in men in the Caribbean (CC) and Mediterranean (MC) countries. MC are a globally recognized reference for good nutrition and low incidence of NCDs . The impact of nutritional patterns on the burden of melanoma, multiple sclerosis, hypertensive heart disease and diabetes mellitus in men in the Mediterranean (MC) and Caribbean (CC) countries was researched.
Methods: Data on the NCD (DALY) burden in men in MC and CC were obtained from [GBD 2004]. Information on food consumption levels in countries was obtained from FAO [FAO-HQfao.org] for 2003-05. U-Manna- Whitney and multiple linear regression analysis were used to analyze differences in nutrition structure and NCD burden in MC and CC. Using the U-Manna- Whitney Criterion, we evaluated the incidence of the most important NCDs in MC and CC. Regression analysis evaluated the impact of risk factors (independent variables) on DALY for 4 types of NCDs (dependent variables). The independent variables in the first stage of the analysis were 4 food structure fractions: animal products (AP); vegetables (CV); fruits (FS); and alcoholic beverages (AB). Dependent variables were the burden of melanoma, multiple sclerosis, hypertensive heart disease, and diabetes mellitus as the diseases with the highest frequency of 63 NCDs in MC and CC. In the second stage of regression analysis, predictions of the effect of increase on the of risk factors (independent variables) on DALY for 4 types of NCDs (dependent variables) were evaluated.
Results: The total NCD burden in MC was 1.3 times lower than in CC (p = 0.006). Total daily food consumption (TDC) as well as animal products fraction (AP) in MC was 1.5 times higher than in CC (p = 0.0002). The share of CV (vegetables) in MC was 1.9 times higher than in CC (p = 0.001). The share of FS (fruits) in MC was 1.2 times higher than in CC (p = 0.3). The share of AB (alcohol) in MC was 2.5 times higher than in CC (p = 0.009). The burden of melanoma and multiple sclerosis in MC was 2 times higher than in CC (p = 0.002). In CC the burden of diabetes and hypertensive heart disease was 2.5 times higher (p = 0.001). In MC, there were 1.5-2 times higher than in CC: BMI (p = 0.03), blood cholesterol (p = 0.0002), and blood pressure (p = 0.002). As a result of multiple regression analysis, it was found that the nutrition structure fractions AP and AB, as well as GDP have the largest influence on the dependent variable (DALY). The coefficients R1 were 0.812, 0.723 and 0.819 respectively (p = 0.001). This meant that the independent variables AP, AB and GDP could determine up to 70% of the volatility of the dependent variable R2: 0.66, 0.52, 0.67 respectively. Per unit increase in AP, CV, AB, GDP and UV independent variables affected 4 types of DALY. Thus, an increase in AP by 1 g was accompanied by an increase in DALY for multiple sclerosis by 0.1% (p = 0.000) (± 95% CL). An increase in AB by 1 g reduced DALY for hypertonic disease by 0.3%, but increased DALY for melanoma by 0.5% (p = 0.001) (± 95% CL). An increase in CV by 1 g reduced DALY for diabetes by 0.1% (p = 0.001) (± 95% CL). An increase per unit of independent variable GDP ($1) was accompanied by 0.01% increase in DALY for multiple sclerosis and 0.3% decrease in DALY for hypertension (p = 0.001) (± 95% CL). An increase per unit of independent variable UV (1J/m2) reduced DALY for melanoma by 0.5% and increased DALY for diabetes by 0.3% (p = 0.001) (± 95% CL).
Conclusion: It was found that the NCD burden in MC is 1.3 times lower than in CC. However, food consumption levels, both overall and fractionally, in MC are higher than in CC. It was shown that the same risk factors (nutrition structure fractions AP, CV, AB) as well as economic and geographic factors (GDP and UV) could in some cases increase DALY NCD, in other cases had a downward effect on DALY. We assume that in NCD risk factor targets, some vectors of crosscountry DALY gradients (40-50%) out of 63 NCD types are associated with unmodifiable factor UV (or latitude), or with modifiable factor GDP either positively or negatively. This manifest itself in positive or negative correlation between DALY and risk factors in multiple regression analysis. Thus, melanoma and multiple sclerosis are positively associated with AP, AB and GDP. However, DALY for diabetes and hypertension are negatively associated with AB and GDP. Further research is required to investigate in detail the vector structure of cross-country gradients of NCDs and their correlation with risk factors.
Citation: Radkevich LA and Radkevich DA. 2020. C Comparative Analysis of Economic, Geographic, Social and Nutritional Risk Factors 4 Types of Non-Communicable Chronic Diseases (Melanoma, Multiple Sclerosis, Diabetes Mellitus and Hypertensive Heart Disease) in the Mediterranean and Caribbean Countries (Population Study). J Obes Chronic Dis 4(2): 51-58.