What Are NCDs?
NCDs (Non-Communicable Diseases) are chronic conditions that are not passed from person to person. They develop slowly over time and last for years or a lifetime.
Main NCDs in Kenya:
- Diabetes
- Hypertension (high blood pressure)
- Heart disease
- Obesity
- Cancer
- Chronic respiratory diseases
The truth: Most NCDs can be prevented with simple lifestyle choices.
Why NCDs Are Rising in Kenya
Lifestyle Changes
- More desk jobs, less physical work
- Eating more processed foods
- Using cars and matatus instead of walking
- Increased stress
Urban Living
- Fast food readily available
- Less home-cooked meals
- Sedentary lifestyle
- Long commutes
Cultural Shifts
- Associating wealth with large body size
- Celebrations centered on unhealthy food
- Less traditional physical activities
The challenge: As Kenya develops, NCDs are increasing rapidly.
Understanding Diabetes
What Is Diabetes?
A condition where your body can’t properly use sugar (glucose) from food. Sugar builds up in your blood instead of giving you energy.
Types of Diabetes
Type 1: Body doesn’t make insulin (usually starts in childhood) Type 2: Body doesn’t use insulin well (90% of cases, develops in adults) Gestational: Happens during pregnancy
We’re focusing on Type 2—the preventable kind.
Symptoms of Diabetes
- Frequent urination (especially at night)
- Always thirsty
- Always hungry
- Unexplained weight loss
- Blurred vision
- Slow-healing wounds
- Tingling or numbness in hands/feet
- Frequent infections
Many people have NO symptoms until complications develop.
Complications if Untreated
- Blindness
- Kidney failure
- Amputation (foot/leg)
- Heart attack
- Stroke
- Nerve damage
Risk Factors
- Overweight or obese
- Family history of diabetes
- Age over 40
- Sedentary lifestyle
- High blood pressure
- History of gestational diabetes
- Poor diet (too much sugar, refined carbs)
Understanding Hypertension (High Blood Pressure)
What Is Hypertension?
Blood pressure that’s consistently too high. Your heart works harder to pump blood, damaging your arteries and organs over time.
Normal: Below 120/80 High: 140/90 or higher
Symptoms
Usually NO symptoms (that’s why it’s called the “silent killer”)
When very high:
- Severe headache
- Nosebleeds
- Shortness of breath
- Chest pain
Complications
- Heart attack
- Stroke
- Kidney disease
- Vision loss
- Heart failure
Risk Factors
- Too much salt in diet
- Being overweight
- Lack of exercise
- Excessive alcohol
- Smoking
- Stress
- Family history
- Age (increases after 40)
Understanding Obesity
What Is Obesity?
Having too much body fat, which increases health risks.
Measured by BMI (Body Mass Index):
- Normal: 18.5-24.9
- Overweight: 25-29.9
- Obese: 30 and above
Why Obesity Is Dangerous
It increases your risk of:
- Type 2 diabetes
- High blood pressure
- Heart disease
- Stroke
- Certain cancers
- Joint problems
- Sleep apnea
- Infertility
Causes
- Eating more calories than you burn
- Sedentary lifestyle
- Poor food choices (processed foods, sugary drinks)
- Large portion sizes
- Stress eating
- Lack of sleep
- Some medications
How NCDs Are Connected
The dangerous cycle:
Obesity → High Blood Pressure + Diabetes → Heart Disease → Stroke or Heart Attack
One NCD often leads to others. That’s why prevention is so important.
NCD Prevention: Diet
What to Eat MORE
1. Vegetables (at least half your plate)
- Sukuma wiki, spinach, cabbage
- Tomatoes, carrots, onions
- Pumpkin leaves
- All green leafy vegetables
2. Fruits (2-3 servings daily)
- Bananas, oranges, papaya
- Watermelon, pineapples
- Passion fruit
- Local seasonal fruits
3. Whole Grains
- Brown ugali (whole maize flour)
- Brown rice
- Oats
- Millet, sorghum
- Whole wheat bread
4. Proteins
- Beans, lentils, ndengu
- Fish (omena, tilapia)
- Lean chicken (without skin)
- Eggs (in moderation)
- Groundnuts (unsalted)
5. Water (at least 8 glasses daily)
What to Eat LESS or AVOID
1. Sugar and Sugary Drinks
- Soda, sweetened juices
- Too much sugar in tea/coffee
- Sweets, cakes, biscuits
- Biggest culprit in diabetes and obesity
2. Salt
- Added salt in cooking
- Processed foods (high in hidden salt)
- Canned foods
- Target: Less than 1 teaspoon (5g) per day
3. Refined Carbohydrates
- White ugali, white rice
- White bread
- Excess chapati, mandazi
- Better choice: Whole grains
4. Fried Foods
- Fried chips, samosas, fried chicken
- Deep-fried foods
- Better choice: Boiled, steamed, grilled, baked
5. Fatty Meats
- Fatty cuts of meat
- Processed meats (sausages, bacon)
- Too much red meat
- Better choice: Fish, lean chicken, beans
6. Processed and Fast Foods
- Burgers, pizza (when eaten often)
- Packaged snacks (crisps, biscuits)
- Instant noodles
- Better choice: Home-cooked meals
Portion Control
The problem: We often eat too much, even of healthy foods.
The plate method:
- 1/2 plate: Vegetables
- 1/4 plate: Protein (meat, fish, beans)
- 1/4 plate: Starch (ugali, rice, potato)
Tips:
- Use smaller plates
- Eat slowly
- Stop when 80% full
- Don’t go for seconds immediately
- Pack away leftovers before eating
Healthy Swaps
Instead of white ugali → Brown ugali Instead of soda → Water, unsweetened tea Instead of frying → Boiling, grilling, steaming Instead of adding salt → Use herbs, spices, lemon Instead of sugar in tea → Reduce gradually or eliminate Instead of chips → Boiled potatoes or sweet potatoes Instead of processed juice → Whole fruit
NCD Prevention: Physical Activity
Why Exercise Matters
- Helps control weight
- Lowers blood pressure
- Improves blood sugar control
- Reduces stress
- Strengthens heart and bones
- Boosts mood
How Much Exercise?
Goal: 150 minutes per week (30 minutes, 5 days a week)
Can’t do 30 minutes? Break it up: 10 minutes, 3 times a day
Something is better than nothing: Even 10 minutes daily helps
Types of Exercise
1. Walking (easiest and free!)
- Walk to work or market
- Take stairs instead of lift
- Walk during lunch break
- Evening walks around your estate
2. Household Activities
- Sweeping, mopping vigorously
- Gardening
- Washing clothes by hand
- Carrying groceries
3. Sports and Recreation
- Football, volleyball, basketball
- Dancing
- Swimming
- Cycling
- Skipping rope
4. Structured Exercise
- Jogging or running
- Gym workouts
- Aerobics classes
- Home exercises (squats, push-ups, etc.)
Getting Started
If you’re not active:
- Start with 10 minutes of walking
- Gradually increase time and intensity
- Find activities you enjoy
- Exercise with friends or family
- Schedule it like any important appointment
If you have NCDs: Talk to your doctor before starting intense exercise.
Other NCD Prevention Strategies
1. Maintain Healthy Weight
Check your BMI:
- Measure your weight (kg) and height (m)
- BMI = weight ÷ (height × height)
- Or use online BMI calculator
If overweight (BMI > 25):
- Reduce portion sizes
- Increase vegetables and fruits
- Exercise more
- Cut sugary drinks completely
- Aim to lose 5-10% of body weight (it makes a big difference)
2. Don’t Smoke
Smoking increases risk of:
- Heart disease
- Stroke
- Lung disease
- Cancer
- Diabetes complications
If you smoke: Quit. It’s the best thing you can do for your health.
Need help? Talk to your doctor or call a quitline.
3. Limit Alcohol
Excessive drinking:
- Raises blood pressure
- Adds empty calories (weight gain)
- Damages liver
- Increases diabetes risk
Safe limits: No more than 1-2 drinks per day, or avoid completely.
4. Manage Stress
Chronic stress:
- Raises blood pressure
- Leads to emotional eating
- Disrupts sleep
- Weakens immune system
Stress management:
- Exercise regularly
- Get enough sleep
- Talk to friends, family, or counselor
- Prayer or meditation
- Hobbies you enjoy
- Take breaks from work
5. Get Enough Sleep
Poor sleep linked to:
- Weight gain
- High blood pressure
- Diabetes
- Heart disease
Goal: 7-8 hours of good sleep each night
Tips: Regular sleep schedule, avoid screens before bed, dark and quiet room
6. Regular Check-Ups
Prevention includes early detection.
Get screened:
- Blood pressure: Yearly (more often if high risk)
- Blood sugar: Every 3 years starting at age 40 (sooner if overweight)
- Cholesterol: Every 5 years starting at age 20
- Weight and BMI: Monitor regularly
Where: County health facilities (affordable), workplace wellness programs, or private clinics
Living with NCDs
If You’re Diagnosed with Diabetes, Hypertension, or Both
Don’t panic. They can be managed.
Key Management Steps
1. Take Medications as Prescribed
- Every day, even when you feel fine
- Don’t skip doses
- Don’t stop without talking to your doctor
- Attend regular follow-ups to adjust doses
2. Monitor Your Numbers
- Check blood pressure regularly
- Check blood sugar as directed
- Keep a record
- Share with your doctor
3. Lifestyle Changes Are Still Crucial
- Medication + lifestyle = best control
- Diet and exercise can reduce medication needs
- Some people can eventually reduce or stop meds with lifestyle changes (under doctor supervision)
4. Know Your Target Numbers
For diabetes:
- Fasting blood sugar: 80-130 mg/dL
- HbA1c: Below 7%
For hypertension:
- Blood pressure: Below 140/90 (or lower if doctor advises)
5. Watch for Complications
- Regular eye exams (diabetes can cause blindness)
- Foot care (check daily for sores, wear proper shoes)
- Kidney function tests
- Heart health monitoring
Where to Get Care in Kenya
County Health Facilities:
- Chronic disease clinics (usually once a week)
- Free or very affordable
- Medication often provided
Private Facilities:
- Faster service
- More expensive
- Good if county facilities are overwhelmed
Non-Governmental Organizations:
- Some NGOs offer free/subsidized diabetes and hypertension care
- Ask at your local health facility
Special Considerations
For Pregnant Women
Gestational diabetes and pregnancy-induced hypertension are serious.
Prevention:
- Eat healthy during pregnancy
- Stay active (gentle exercise approved by doctor)
- Attend all antenatal appointments
- Get screened for gestational diabetes
If diagnosed: Follow doctor’s advice carefully to protect you and baby.
For Children and Youth
NCDs are affecting younger Kenyans now.
Parents:
- Limit soda and junk food
- Encourage active play (not just screens)
- Cook healthy meals at home
- Model healthy behaviors
- Limit TV and video game time
Schools should:
- Provide healthy school meals
- Encourage physical activity
- Teach nutrition and health
For Elderly
NCDs are more common as we age.
Challenges: Multiple conditions, many medications, limited mobility
Tips:
- Simplify medication schedule (use pill organizers)
- Light exercise (walking, gentle stretching)
- Social connections (reduces stress and depression)
- Regular medical check-ups
- Family support
Myths About NCDs
Myth 1: “Only rich people get diabetes and hypertension”
False: NCDs affect all economic classes. In fact, poorer communities are hit harder due to limited access to healthy food and healthcare.
Myth 2: “If I feel fine, I don’t have NCDs”
False: Most people with high BP and early diabetes have NO symptoms. That’s why screening is important.
Myth 3: “NCDs are genetic—I can’t prevent them”
Partly true: Family history increases risk, BUT lifestyle changes can prevent or delay NCDs even with genetic risk.
Myth 4: “Once I start medication, I’ll be on it forever”
Partly true: Many people need lifelong medication, BUT significant lifestyle changes can reduce or eliminate need for some medications (under doctor supervision).
Myth 5: “Traditional herbs can cure diabetes”
False: No herb can cure diabetes. Some may help manage symptoms, but medication and lifestyle changes are proven treatments. Don’t stop prescribed medication for unproven remedies.
Take Action Today
Prevention Steps
1. Know Your Risk
- Family history of NCDs?
- Overweight?
- Sedentary lifestyle?
- Poor diet?
- Over 40?
If yes to any, you’re at higher risk. Start prevention now.
2. Get Screened
- Check your blood pressure this month
- If over 40 or at risk, get blood sugar tested
- Calculate your BMI
3. Make One Change This Week
- Swap soda for water
- Add vegetables to every meal
- Walk 10 minutes daily
- Reduce sugar in your tea
- Take stairs instead of lift
4. Make a Plan
- Set specific, achievable goals
- Start small
- Track your progress
- Get family support
- Don’t give up if you slip—just start again
Resources in Kenya
- County NCD clinics: Ask at your local health facility
- Kenya Diabetes Management and Information Centre: Nairobi
- Kenya Cardiac Society: Resources on heart health
- NCD Alliance Kenya: Advocacy and information
NCDs are preventable. The choices you make today—what you eat, how much you move, whether you smoke—determine your health tomorrow. Start with small changes. Your future self will thank you.