Holistic Evaluation of Lifestyle and Performance Diagnostics (HELP-D): A Theoretical Framework for Screening and Managing Non-Communicable Diseases

Abstract

Non-communicable diseases (NCDs) are a cluster of chronic conditions represented by slow health-to-disease transitions and convoluted disturbances in biological networks that underpin human pathologies. The collective burden of NCDs accumulates into an annual death toll of approximately 41 million individuals. Research has identified several modifiable NCD risk factors, which may serve as the behavioral precursors to disruptions in these biological networks. Furthermore, lifestyle-based interventions indicate efficacy in managing or reversing NCDs. Consequently, our objective was to design a theoretical framework for screening and managing NCDs in local gymnasiums, presenting the facilities as the nexus between healthcare and lifestyle medicine. We utilized a quasi-structured narrative review using predefined search terms combined with Boolean operators across three databases (Google Scholar, PubMed, and ProQuest) from December 1, 2024, to June 12, 2025. The literature search consisted of three phases, starting with preliminary search strings and evolving to 14 distinct keywords. Henceforth, snowballing and forward citation search strategies were applied to correspond with the broad scope of the review. Additionally, we employed a prioritization method to assess the relevance of inclusion and utilized a modified feasibility assessment framework to compare screening modalities. Our quasi-structured narrative review evolved into the Holistic Evaluation of Lifestyle and Performance Diagnostics (HELP-D) framework. The theoretical framework comprises a sociodemographic analysis, a prescreening tool, a lifestyle questionnaire, anthropometric measurements, an overhead squat assessment, handgrip strength testing, and a maximal oxygen uptake evaluation, alongside assessments of potential confounding factors (e.g., caffeine intake). To illustrate its potential diagnostic and inferential significance, the model is applied to the population of the State of Kuwait. Although the embedded screening tools are grounded in empirical research, the model has contemporary limitations that necessitate a pilot study. Contingent upon validation, the theoretical HELP-D framework holds promise for widespread adoption.