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Influencing food environments for healthy diets








More and more people are becoming overweight and obese, with increasing diet-related non-communicable diseases (NCDs). Behind the global shifts in malnutrition and NCDs are unhealthy diets and a sedentary lifestyle. Our food systems and the food environments are not delivering on the diets needed to promote and sustain optimum health. This publication focuses on Influencing food environments for healthy diets and offers suggestions on suitable interventions to address that environment. Countr ies will find the information useful as they develop policies and programmes to make healthy diets an easier choice for their citizens.

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    Obesity and its associated non-communicable diseases (NCDs) have become a major contributor to adult disease and death. More and more people are becoming overweight and obese and growing numbers are dying from illnesses such as diabetes, heart disease and certain types of cancer. Driving this global shift in malnutrition and NCDs are unhealthy diets, physical inactivity and sedentary behaviour. Our food systems and food environments are not delivering the diets needed to promote and sustain optimum health. FAO is working with the public and private sectors to reform them – advising on and transforming the way food is produced, collected, stored, transported, processed and distributed – to improve diets and health and to address the impact on natural resources.
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    According to the World Health Organization (WHO), of the 57 million global deaths in 2008, 36 million, or 63%, were due to non-communicable diseases (NCDs), principally ca rdiovascular diseases, diabetes, cancers and chronic respiratory diseases (WHO, 2011a). Nearly 80% of these deaths occur in low-and middle-income countries. Deaths from NCDs are projected to continue to rise worldwide, with the greatest increases expected in low- and middle-income regions. An unhealthy diet i s one of the key risk factors for NCDs. For example, inadequate consumption of fruit and vegetables increases the risk for cardiovascular diseases and several cancers; high salt consumption is an important determinant of high blood pressure and cardiovascular risk and increases the risk of stomach cancer; high consumption of saturated fats and trans-fatty acids is linked to heart disease; a range of dietary factors have been linked with diabetes; red and processed meat consumption is linked with some cancers (WHO, 2003; Steyn et al., 2004; WCRF, 2007). In addition, excessive energy intake leads to overweight and obesity, which is linked with a range of health problems, including NCDs (WHO, 2000). Diabetes has particularly strong associations with obesity (Steyn et al., 2004), and evidence shows associations between body fatness and some leading cancers (WCRF, 2007). The WHO estimates that 2.8 million people die each year as a result of being overweight or obese (WHO, 2011a). The prevalence of overweight is highest in upper-middle-income countries but very high levels are also reported from some lower-middle income countries in Europe, the Middle East and the Americas, and it is reported to be rising throughout low- and middle-income countries.Since the FAO/WHO International Conference of Nutrition in 1992, unhealthy eating patterns have been increasing around the world. For example, fat intake has been rising rapidly in lower -middle-income countries since the 1980s (WHO, 2011a). Between 1992 and 2007, a disproportionate amount of the per capita increase in calorie availability1 came from sugar and meat (Mazzocchi et al., 2012). Patterns of eating have also changed, with an increase in snacking, skipping meals, eating meals out of a family setting, and eating out of the home.
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    Nutrition policy increasingly aims to incentivise a healthy food supply – in particular, reductions in salt, fat and sugar content of food – and promote food environments that support healthy diets. However, conflicts of interest have been identified for many food industry actors regarding policy for addressing diet-related non-communicable diseases (NCDs), as such policy aims to reduce consumption of unhealthy (often highly profitable) foods. The member states of the World Health Organization (WHO), including Fiji, have recognised the importance of ensuring that food and nutrition policy making is protected from undue influence of commercial and other vested interests, in the Global Action Plan for the Prevention and Control of NCDs, 2013-2020. This briefing note summarises current best practice for identifying and managing conflicts of interest for nutrition policy making.

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