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Table 1 Definition used for the modifiable NCD risk factors for this study

From: Alarming prevalence and clustering of modifiable noncommunicable disease risk factors among adults in Bhutan: a nationwide cross-sectional community survey

a Modifiable Behavioral NCD Risk Factor

S.no

NCD risk factor

Definition

1

Tobacco use

Smoker: Currently smokes any tobacco products, such as cigarettes, cigars, or pipes, etc.

Smokeless: Currently use any smokeless tobacco such as snuff, chewing tobacco, betel, etc.

A detailed study using NCD STEPS data for tobacco use has already been done and it is currently under review for publication. Therefore this study will not focus on tobacco use; any information required will be used from that study. However, this variable will be used during the analysis of clustering of NCD risk factors.

2

High alcohol consumption

Current alcohol drinker (intermediate or high)

Those who are current alcohol drinker and drinks pure alcohol above 40 g for men and above 20 g for women on average per occasion.

3

Low consumption of fruit and vegetable

Less than five serving of fruit and/or vegetable on an average day

In a typical week, number of days the respondent ate fruit and/or vegetable, and number of servings of vegetables they ate on one of those days.

4

Low physical activity

Percentage of respondents not meeting WHO recommendations on physical activity for health (respondents doing less than 150 min of moderate-intensity physical activity per week, or equivalent).

5

Salt intake

Levels of sodium and creatinine in spot urine samples are used to estimate population 24 h salt intake, using the INTERSALT equation:

Males: 23.51 + 0.45*spot Na concentration (mmol/L) -3.09*spot creatinine concentration (mmol/L) + 4.16*BMI + 0.22*Age

Females: 3.74 + 0.33* spot Na concentration (mmol/L)-2.44* spot creatinine concentration (mmol/L) + 2.42* BMI +2.34* Age − 0.03* Age ^2

The 24 h sodium values in mmol are divided by 17.1 in order to get grams of salt.

b Modifiable Biological NCD Risk Factor

1

Overweight

Overweight is defined as Body Mass Index ≥25 kg/m2

2

Raised blood pressure

Raised blood pressure individuals are those with SBP ≥140 and/or DBP ≥ 90 mmHg or currently on medication for raised blood pressure. This study took BP 3 measurements and for the purpose of this study, the average reading of these three measurements will be used.

3

Impaired fasting glycaemia

Impaired fasting glycaemia is defined as those with capillary whole blood value: ≥5.6 mmol/L (100 mg/dl) and <6.1 mmol/L (110 mg/dl)

4

Raised fasting cholesterol level

Raised fasting cholesterol level is defined as total cholesterol level ≥ 5.0 mmol/L or ≥190 mg/dl or currently on medication for raised cholesterol