Non-communicable diseases (NCDs): Setting the scene in 2026

The four major groups of NCDs are:

1. Cardiovascular diseases

• Includes hypertension (high blood pressure), stroke, ischaemic heart disease

• Hypertension is a major risk factor and leading contributor to death

2. Cancers

3. Diabetes

• Diabetes is fast increasing in prevalence

• It is the second leading cause of death overall; and the leading cause of death among women

4. Chronic respiratory diseases

• Includes asthma and chronic obstructive pulmonary disease (COPD)

What are the key risk factors for NCD’s?

Evidence shows the burden is driven to a large extent by modifiable lifestyle risks:

Behavioural risks

· Unhealthy diets (high salt, sugar, processed foods)

· Physical inactivity

· Tobacco smoking

· Harmful alcohol use

Metabolic risks

· High body mass index (obesity)

· High blood glucose

· Hypertension (high blood pressure)

Structural drivers

· Poverty and inequality exacerbate the issue in South Africa

· Limited access to healthy food, urbanisation with lifestyle changes and lack of safe spaces for exercise play a role

· Low- and middle-income populations are disproportionately affected

What has the South African government done about the rise in NCDs?

South Africa has implemented several globally recognised interventions:

· Sugar-sweetened beverage tax

· Mandatory salt reduction in processed foods

· Trans-fat regulations

· The Launch of the National Strategic Plan for NCDs (2022–2027)

However, enforcement and monitoring remain challenges. In addition, the drive to exercise has been lacking in current policies.

What can we do to reduce our risk of NCD’s

1. Exercise

Cardiorespiratory fitness literally saves lives. A landmark study published in JAMA by Kodama et al. (2009), pooling data from over 102 000 individuals, found that higher cardiorespiratory fitness was associated with a 45% lower risk of deaths from heart disease and a 36% lower risk of all-cause mortality; regardless of other risk factors.

Physically active individuals also have substantially lower rates of stroke, and certain cancers. In addition, aerobic exercise helps improve the risk factors that lead to heart disease, including high blood pressure and diabetes. Exercise is the best health polypill! .

The World Health Organization recommends: - 150 +minutes of moderate-intensity aerobic activity per week (e.g. brisk walking, cycling), or - 75+ minutes of vigorous-intensity activity (e.g. running, swimming laps)

That equates to 20–30 minutes most days of the week. It is achievable, and the returns are outsized. In addition, adding strength training 2-3 times a week helps build and maintain muscle- which so important for healthy independent living and also for metabolic control.

 

2. Healthy Diet

This a big topic in itself, but a healthy, balanced diet with minimal processed foods, minimal refined sugar, plenty of fresh fruits and vegetables, sufficient proteins and plenty of fibre, supports cardiovascular and gut health, and reduces NCDs substantially.

3. Maintaining a healthy weight and working on an improved body composition, with reduced fat and increased muscle.

4. Adequate, good quality sleep: 7-9 hours a night of good sleep is just the right amount to help rest, repair and immunity for fighting diseases.

5. Regular screening for blood pressure, diabetes and cholesterol issues

6. Avoiding tobacco, nicotine and excessive alcohol.

At SSISA, we can help you to reduce NCDs by guiding exercise plans with our amazing biokineticists, guiding diet with our skilled dietitians, and helping with blood pressure, body composition, blood glucose and cholesterol screening.

Don’t delay- come and visit us- this one “move” may save your life!

REFERENCES

1. Phaahla J et al on behalf of the Department of Health, 2024. Response to tackle the burden of NCDs in South Africa. www.gov.za. Accessed 26 March 2026

2. National Department of Health of South Africa. National Strategic Plan for the Prevention and Control of Non-Communicable Diseases. 2022. Health.gov.za (accessed 27 March 2026)

3. Zhang Y, Pan X-F et al. Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. J Epidem & Comm Health 2021; 75: 92-99

4. Jackowska B, et al. Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality

from noncommunicable diseases. PLoS ONE 2024; 19: e0298696.

5. World Health Organization. Global recommendations on physical activity for health. Geneva:

WHO; 2020.

6. Kodama S, et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women: A Meta-analysis. JAMA. 2009;301: 2024-2035.

7. Lear SA, et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet. 2017;390: 2643-2654.

8. Arnett DK, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596-e646.

9. Jabbarzadeh Ganjeh B, et al. Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials. Hypertens Res. 2024;47:385-398.

10. Jayedi A, Emadi A, Shab-Bidar S. Dose-Dependent Effect of Supervised Aerobic Exercise on HbA1c in Patients with Type 2 Diabetes: A Meta-analysis of Randomized Controlled Trials. Sports Med. 2022;52:1919-1938.

11. Lloyd-Jones DM et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146:e18–e43.