Non-communicable diseases (NCDs) are the leading cause of mortality in Brazil and accounted for 72% of all deaths in 2007.1 The burden of NCDs in Brazil reflects accelerated epidemiological, demographic, and nutritional changes in the past few decades. In 1930, 46% of all deaths in Brazilian state capitals were caused by infectious diseases, but by 2007 this figure had fallen to 10%.1During the same period, mortality from cardiovascular diseases increased from 11% to 31%.1—3 The country's demographic transition is the result of declines in premature mortality and fertility rates, alongside a rapidly ageing population.1—3 Increased income, industrialisation, urbanisation, and globalisation have led to much economic and social change in Brazil. One consequence has been a rise in unhealthy diets and physical inactivity; the prevalence of men who were overweight increased from 18·6% in 1974 to 50·1% in 2008.1, 4
NCDs and their risk factors affect people from all socioeconomic groups, but especially individuals who are most vulnerable, such as older adults and those with low educational attainment or from low-income families.1, 5 Surveys in Brazil have shown that smoking, obesity, and unhealthy diets are more frequent in individuals with low educational attainment.4, 6 Among Indian populations living in Brazil, the prevalence of obesity reached 25% in men and 41% in women in 1989, particularly due to westernised diets and reductions in physical activity.7/.../
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