2002年-世界发展银行全球_Food_Policy_Options___Preventing_and_Controlling_Nutrition_Related_Non-Communicable_Diseases_98页_557kb

Summary of Food Policy Options: Preventing and Controlling Nutrition Related Non-Communicable Diseases

Core Content

This document is a report from a consultation held by the World Health Organization (WHO) and the World Bank in November 2002, focusing on food policy options to prevent and control nutrition-related non-communicable diseases (NR-NCDs) in the developing world. It outlines the concept of the nutrition transition, its implications, and the role of food policy in addressing the associated health and economic challenges.

Main Points

1. The Nutrition Transition

• Definition: The nutrition transition refers to the shift in diet and activity patterns as incomes rise and populations become more urbanized.

• Stages:

  • Pattern 1: Hunter-gatherer diet with high carbohydrates and low fat.
  • Pattern 2: Periodic famine and social stratification influence diet.
  • Pattern 3: Famine recedes, diet is low in fat but high in fiber.
  • Pattern 4: Shift to sedentary lifestyles and high-fat diets, leading to increased NR-NCDs.
  • Pattern 5: Awareness of healthy nutrition and exercise grows, with a thriving economy.

• Health Implications:

  • Obesity, diabetes, hypertension, and cardiovascular diseases (CVD) are rising, particularly among the poor.
  • In some countries, obesity rates among low socio-economic status (SES) individuals are higher than among high SES individuals.
  • CVD is making inroads in Asia, North Africa, China, and India.

2. Animal Source Foods (ASF)

• Definition: ASF include meat, fish, dairy, and eggs.

• Global Trends:

  • Demand and production of ASF are increasing in developing countries.
  • Developing countries account for over half the world's meat production and 72% of food fish.
  • By 2020, developing countries are projected to produce 63% of the world's meat and 50% of its milk.

• Drivers of ASF Growth:

  • Rising incomes and urbanization.
  • Changing preferences toward more convenient and processed foods.
  • Trade liberalization reducing food prices.
  • Intra-uterine growth retardation (IUGR) due to maternal undernutrition may program individuals for future obesity.

• Challenges:

  • ASF revolution may lead to increased saturated fat intake and associated health risks.
  • Nutritional benefits may not be immediate for the poor.
  • Environmental and animal welfare concerns are growing globally.

3. Policy Levers

• Traditional Policy Levers:

  • Recognizing the limitations of conventional food policies.
  • Demanding truth in advertising.
  • Leveraging the influence of supermarkets and multinational corporations.
  • Shifting demand through realistic options.
  • Addressing internal infrastructure.
  • Using schools for targeted interventions.

• Research Needs:

  • Longitudinal studies to track diet, prices, and health outcomes.
  • The China Health and Nutrition Survey is cited as a model for such research.
  • Need for understanding how changes in food systems affect health in diverse settings.

4. Policy Challenges and Opportunities

• Health and Economic Consequences:

  • NR-NCDs are now a major health burden in developing countries, especially among the poor.
  • These diseases compromise quality of life and increase healthcare costs.

• Policy Actions:

  • Focus on both demand and supply interventions.
  • Encourage healthier diets through pricing mechanisms, such as taxes on unhealthy foods.
  • Promote food safety and sustainable practices in production.
  • Support small producers and ensure they are not excluded from new markets due to high standards.

• Long-Term Strategy:

  • WHO is developing a Global Strategy on Diet, Physical Activity and Health for the 2004 World Health Assembly.
  • The consultation’s findings will inform these discussions.

Key Information

• Nutrition Transition: A major shift in diet and lifestyle, driven by economic growth, urbanization, and technological changes.
• Obesity and NCDs: Obesity is a precursor to many NCDs and is increasing rapidly, even among the poor.
• ASF Revolution: The growing demand and production of animal source foods in developing countries has significant implications for health, trade, and poverty.
• Policy Recommendations:
  • Use school-based programs to promote healthy eating.
  • Address the role of advertising and corporate influence.
  • Conduct more research to understand dietary trends and their health impacts.
  • Develop policies that support both public health and economic development.

Conclusion

The consultation highlights the need for a multifaceted approach to address the nutrition transition and its associated health challenges. It emphasizes the importance of both immediate policy interventions and long-term research to guide effective strategies in the prevention and control of NR-NCDs in developing countries.