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. 2023 Feb 6;18(2):e0281355.
doi: 10.1371/journal.pone.0281355. eCollection 2023.

Dietary practices, physical activity and social determinants of non-communicable diseases in Nepal: A systemic analysis

Sudesh Sharma  1   2 , Anna Matheson  3 , Danielle Lambrick  4 , James Faulkner  5 , David W Lounsbury  6 , Abhinav Vaidya  7 , Rachel Page  2
Affiliations

Dietary practices, physical activity and social determinants of non-communicable diseases in Nepal: A systemic analysis

Sudesh Sharma et al. PLoS One. .

Abstract

Unhealthy dietary habits and physical inactivity are major risk factors of non-communicable diseases (NCDs) globally. The objective of this paper was to describe the role of dietary practices and physical activity in the interaction of the social determinants of NCDs in Nepal, a developing economy. The study was a qualitative study design involving two districts in Nepal, whereby data was collected via key informant interviews (n = 63) and focus group discussions (n = 12). Thematic analysis of the qualitative data was performed, and a causal loop diagram was built to illustrate the dynamic interactions of the social determinants of NCDs based on the themes. The study also involved sense-making sessions with policy level and local stakeholders. Four key interacting themes emerged from the study describing current dietary and physical activity practices, influence of junk food, role of health system and socio-economic factors as root causes. While the current dietary and physical activity-related practices within communities were unhealthy, the broader determinants such as socio-economic circumstances and gender further fuelled such practices. The health system has potential to play a more effective role in the prevention of the behavioural and social determinants of NCDs.

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Conflict of interest statement

The authors declare that no competing interests exist.

Figures

Fig 1
Fig 1. Systemic intervention study design to study social determinants of NCDs in Nepal (image republished from authors’ open access article [27]).
Fig 2
Fig 2. Adapted Social determinants of health framework for the study of the social determinants of NCDs in Nepal (image republished from authors’ open access article [27]).
Fig 3
Fig 3. Prevention delay sub-system showing the interaction of governmental response to promote healthy diet and physical activity, other sub-systems and NCDs.
Fig 4
Fig 4. Demand-supply sub-system showing the interaction of availability and sales of junk food, other sub-systems and NCDs.
Fig 5
Fig 5. Socio-economic influence sub-system showing the interaction of socio-economic status, other sub-systems for dietary and physical activity practices and NCDs.
Fig 6
Fig 6. System archetypes showing different mechanisms of influence of dietary and physical activity practices on NCDs.
See this image and copyright information in PMC

References

    1. World Health Organization. Global Status Report on noncommunicable diseases 2014. World Health Organization, 2014.
    1. Lachat C, Otchere S, Roberfroid D, Abdulai A, Seret FMA, Milesevic J, et al. Diet and Physical Activity for the Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Policy Review. PLOS Medicine. 2013;10(6):e1001465. doi: 10.1371/journal.pmed.1001465 - DOI - PMC - PubMed
    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Impact of Physical Inactivity on the World’s Major Non-Communicable Diseases. Lancet. 2012;380(9838):219–29. doi: 10.1016/S0140-6736(12)61031-9 - DOI - PMC - PubMed
    1. Aryal KK, Mehata S, Neupane S, Vaidya A, Dhimal M, Dhakal P, et al. The Burden and Determinants of Non Communicable Diseases Risk Factors in Nepal: Findings from a Nationwide STEPS Survey. PloS one. 2015;10(8):e0134834. doi: 10.1371/journal.pone.0134834 - DOI - PMC - PubMed
    1. Dhungana RR, Bista B, Pandey AR, de Courten M. Prevalence, clustering and sociodemographic distributions of non-communicable disease risk factors in Nepalese adolescents: secondary analysis of a nationwide school survey. BMJ open. 2019;9(5):e028263. doi: 10.1136/bmjopen-2018-028263 - DOI - PMC - PubMed

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