Several barriers have been shown to reduce the availability, affordability, dissemination and efficacy of optimal management of chronic diseases. Economic and generic barriers include poverty, poor education, illiteracy, lack of sanitation and poor infrastructure (13-15). Environment barriers include tobacco smoke and other indoors pollutants, outdoors pollution, the use of solid biomass fuels, occupational exposure and nutrition. Poor nutrition is common in low and middle income countries, whereas obesity and overweight are increasing in high income countries and in urban areas of low and middle income countries (16)