801
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Chokshi DA, Farley TA. Health. Changing behaviors to prevent noncommunicable diseases. Science 2014; 345:1243-4. [PMID: 25214590 DOI: 10.1126/science.1259809] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Dave A Chokshi
- Departments of Population Health and Medicine, New York University Langone Medical Center, New York, NY 10016, USA.
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802
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Abstract
Various indices and scores based on admittedly healthy dietary patterns or food guides for the general population, or aiming at the prevention of diet-related diseases have been developed to assess diet quality. The four indices preferred by most studies are: the Diet Quality Index; the Healthy Eating Index; the Mediterranean Diet Score; and the Overall Nutritional Quality Index. Other instruments based on these indices have been developed and the words 'adapted', 'revised', or 'new version I, II or III' added to their names. Even validated indices usually find only modest associations between diet and risk of disease or death, raising questions about their limitations and the complexity associated with measuring the causal relationship between diet and health parameters. The objective of this review is to describe the main instruments used for assessing diet quality, and the applications and limitations related to their use and interpretation.
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803
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Huffman SL, Piwoz EG, Vosti SA, Dewey KG. Babies, soft drinks and snacks: a concern in low- and middle-income countries? MATERNAL & CHILD NUTRITION 2014; 10:562-74. [PMID: 24847768 PMCID: PMC4299489 DOI: 10.1111/mcn.12126] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Undernutrition in infants and young children is a global health priority while overweight is an emerging issue. Small-scale studies in low- and middle-income countries have demonstrated consumption of sugary and savoury snack foods and soft drinks by young children. We assessed the proportion of children 6-23 months of age consuming sugary snack foods in 18 countries in Asia and Africa using data from selected Demographic and Health Surveys and household expenditures on soft drinks and biscuits using data from four Living Standards Measurement Studies (LSMS). Consumption of sugary snack foods increased with the child's age and household wealth, and was generally higher in urban vs. rural areas. In one-third of countries, >20% of infants 6-8 months consumed sugary snacks. Up to 75% of Asian children and 46% of African children consumed these foods in the second year of life. The proportion of children consuming sugary snack foods was generally higher than the proportion consuming fortified infant cereals, eggs or fruit. Household per capita daily expenditures on soft drinks ranged from $0.03 to $0.11 in three countries for which LSMS data were available, and from $0.01 to $0.04 on biscuits in two LSMS. Future surveys should include quantitative data on the purchase and consumption of snack foods by infants and young children, using consistent definitions and methods for identifying and categorising snack foods across surveys. Researchers should assess associations between snack food consumption and stunting and overweight, and characterise household, maternal and child characteristics associated with snack food consumption.
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Affiliation(s)
- Sandra L. Huffman
- Department of Nutrition and Program in International and Community NutritionUniversity of CaliforniaDavisCaliforniaUSA
| | | | - Stephen A. Vosti
- Department of Agricultural and Resource EconomicsUniversity of CaliforniaDavisCaliforniaUSA
| | - Kathryn G. Dewey
- Department of Nutrition and Program in International and Community NutritionUniversity of CaliforniaDavisCaliforniaUSA
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804
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Smith L, Haddad L. Reducing Child Undernutrition: Past Drivers and Priorities for the Post-MDG Era. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/j.2040-0209.2014.00441.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lisa Smith
- Senior economist at TANGO, International in Tucson, Arizona
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805
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Ferro CJ, Ritz E, Townend JN. Phosphate: are we squandering a scarce commodity? Nephrol Dial Transplant 2014; 30:163-8. [PMID: 25230707 DOI: 10.1093/ndt/gfu295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Phosphorus is an essential element for life but is a rare element in the universe. On Earth, it occurs mostly in the form of phosphates that are widespread but predominantly at very low concentration. This relative rarity has resulted in a survival advantage, in evolutionary terms, to organisms that conserve phosphate. When phosphate is made available in excess it becomes a cause for disease, perhaps best recognized as a potential cardiovascular and renal risk factor. As a reaction to the emerging public health issue caused by phosphate additives to food items, there have been calls for a public education programme and regulation to bring about a reduction of phosphate additives to food. During the Paleoproterzoic era, an increase in the bioavailability of phosphate is thought to have contributed significantly to the oxygenation of our atmosphere and a dramatic increase in the evolution of new species. Currently, phosphate is used poorly and often wasted with phosphate fertilizers washing this scarce commodity into water bodies causing eutrophication and algal blooms. Ironically, this is leading to the extinction of hundreds of species. The unchecked exploitation of phosphate rock, which is an increasingly rare natural resource, and our dependence on it for agriculture may lead to a strange situation in which phosphate might become a commodity to be fought over whilst at the same time, health and environmental experts are likely to recommend reductions in its use.
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Affiliation(s)
- Charles J Ferro
- Department of Nephrology, Queen Elizabeth Hospital and University of Birmingham, Birmingham, UK
| | - Eberhard Ritz
- Division of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Jonathan N Townend
- Department of Cardiology, Queen Elizabeth Hospital and University of Birmingham, Birmingham, UK
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806
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Charlton K, Webster J, Kowal P. To legislate or not to legislate? A comparison of the UK and South African approaches to the development and implementation of salt reduction programs. Nutrients 2014; 6:3672-95. [PMID: 25230210 PMCID: PMC4179182 DOI: 10.3390/nu6093672] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 08/19/2014] [Accepted: 08/25/2014] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization promotes salt reduction as a best-buy strategy to reduce chronic diseases, and Member States have agreed to a 30% reduction target in mean population salt intake by 2025. Whilst the UK has made the most progress on salt reduction, South Africa was the first country to pass legislation for salt levels in a range of processed foods. This paper compares the process of developing salt reduction strategies in both countries and highlights lessons for other countries. Like the UK, the benefits of salt reduction were being debated in South Africa long before it became a policy priority. Whilst salt reduction was gaining a higher profile internationally, undoubtedly, local research to produce context-specific, domestic costs and outcome indicators for South Africa was crucial in influencing the decision to legislate. In the UK, strong government leadership and extensive advocacy activities initiated in the early 2000s have helped drive the voluntary uptake of salt targets by the food industry. It is too early to say which strategy will be most effective regarding reductions in population-level blood pressure. Robust monitoring and transparent mechanisms for holding the industry accountable will be key to continued progress in each of the countries.
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Affiliation(s)
- Karen Charlton
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Jacqui Webster
- The George Institute for Global Health, Sydney, NSW 2050, Australia.
| | - Paul Kowal
- WHO Study on global AGEing and adult health, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
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807
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Baker P, Kay A, Walls H. Trade and investment liberalization and Asia's noncommunicable disease epidemic: a synthesis of data and existing literature. Global Health 2014; 10:66. [PMID: 25213212 PMCID: PMC4180923 DOI: 10.1186/s12992-014-0066-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/25/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Trade and investment liberalization (trade liberalization) can promote or harm health. Undoubtedly it has contributed, although unevenly, to Asia's social and economic development over recent decades with resultant gains in life expectancy and living standards. In the absence of public health protections, however, it is also a significant upstream driver of non-communicable diseases (NCDs) including cardiovascular disease, cancer and diabetes through facilitating increased consumption of the 'risk commodities' tobacco, alcohol and ultra-processed foods, and by constraining access to NCD medicines. In this paper we describe the NCD burden in Asian countries, trends in risk commodity consumption and the processes by which trade liberalization has occurred in the region and contributed to these trends. We further establish pressing questions for future research on strengthening regulatory capacity to address trade liberalization impacts on risk commodity consumption and health. METHODS A semi-structured search of scholarly databases, institutional websites and internet sources for academic and grey literature. Data for descriptive statistics were sourced from Euromonitor International, the World Bank, the World Health Organization, and the World Trade Organization. RESULTS Consumption of tobacco, alcohol and ultra-processed foods was prevalent in the region and increasing in many countries. We find that trade liberalization can facilitate increased trade in goods, services and investments in ways that can promote risk commodity consumption, as well as constrain the available resources and capacities of governments to enact policies and programmes to mitigate such consumption. Intellectual property provisions of trade agreements may also constrain access to NCD medicines. Successive layers of the evolving global and regional trade regimes including structural adjustment, multilateral trade agreements, and preferential trade agreements have enabled transnational corporations that manufacture, market and distribute risk commodities to increasingly penetrate and promote consumption in Asian markets. CONCLUSIONS Trade liberalization is a significant driver of the NCD epidemic in Asia. Increased participation in trade agreements requires countries to strengthen regulatory capacity to ensure adequate protections for public health. How best to achieve this through multilateral, regional and unilateral actions is a pressing question for ongoing research.
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Affiliation(s)
- Phillip Baker
- />Regulatory Institutions Network, College of Asia & the Pacific, Australian National University, Canberra, Australia
| | - Adrian Kay
- />Crawford School of Public Policy, College of Asia & the Pacific, Australian National University, Canberra, Australia
| | - Helen Walls
- />Regulatory Institutions Network, College of Asia & the Pacific, Australian National University, Canberra, Australia
- />National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University; Leverhulme Centre for Integrated Research on Agriculture and Health, and Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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808
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Cameron AJ, Zimmet PZ. What will it take to curb the rise in obesity? Med J Aust 2014; 201:25-6. [PMID: 24999882 DOI: 10.5694/mja14.00553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/29/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Adrian J Cameron
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, VIC, Australia.
| | - Paul Z Zimmet
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
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809
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810
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Affiliation(s)
- Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, GA 30303, USA.
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811
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812
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Herrick C. Alcohol, ideological schisms and a science of corporate behaviours on health. CRITICAL PUBLIC HEALTH 2014. [DOI: 10.1080/09581596.2014.951313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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813
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Miller HE, Thomas SL, Robinson P, Daube M. How the causes, consequences and solutions for problem gambling are reported in Australian newspapers: a qualitative content analysis. Aust N Z J Public Health 2014; 38:529-35. [PMID: 25169775 DOI: 10.1111/1753-6405.12251] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/01/2013] [Accepted: 03/01/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the 'actors' and sources who influence media coverage. METHODS A qualitative content analysis guided by framing theory analysed coverage of problem gambling in Australian newspapers in the period 1 July 2011 to 30 June 2012. RESULTS Solutions to problem gambling were more frequently discussed than causes and consequences. A focus on the responsibility of individuals was preferred to reporting that focused on broader social, ecological, and industry determinants of problem gambling. Reporting was highly politicised, with politicians frequently quoted and political issues frequently discussed. In contrast, the community sector, health professionals and problem gamblers were rarely quoted. CONCLUSIONS AND IMPLICATIONS This analysis has revealed the need for a more proactive, coordinated approach to the media by both public health researchers and health groups. The establishment of a gambling-specific coalition to push for evidence-based reform is recommended.
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Affiliation(s)
- Helen E Miller
- School of Health and Society, Faculty of Social Sciences and Australian Health Services Research Unit, Faculty of Business, University of Wollongong, New South Wales
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814
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Dubé L, Addy NA, Blouin C, Drager N. From policy coherence to 21st century convergence: a whole-of-society paradigm of human and economic development. Ann N Y Acad Sci 2014; 1331:201-215. [PMID: 25146105 DOI: 10.1111/nyas.12511] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The 20th century saw accelerated human and economic development, with increased convergence in income, wealth, and living standards around the world. For a large part, owing to the well-entrenched Western-centric linear and siloed industrialization pattern, this positive transformation has also been associated with complex societal challenges at the nexus of agricultural, industrial, and health sectors. Efforts at cross-sectoral policy coherence have been deployed with limited success. To go beyond what has been possible thus far, the whole-of-society (WoS) paradigm for human and economic development proposes a 21st century convergence where, instead of the rest (of the world) converging with the West, sectoral and cross-sectoral efforts converge in their single and collective policy and action on a common target of human and economic development. In this paper, we first review and discuss contributions and limitations of policy coherence approaches. We then elaborate the institutional foundation of the WoS paradigm, taking as an anchor the well-established model of polycentric governance that views individuals, and state, market, and community, forming society as part of the same complex adaptive system. Actors within such systems self-organize into nested hierarchies that operate at multiple scales and move toward 21st century convergence of human and economic development.
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Affiliation(s)
- Laurette Dubé
- McGill Center for the Convergence in Health and Economics (MCCHE) and Desautels Faculty of Management, Montreal, Quebec, Canada
| | - Nii A Addy
- McGill Center for the Convergence in Health and Economics (MCCHE) and Desautels Faculty of Management, Montreal, Quebec, Canada
| | - Chantal Blouin
- McGill Center for the Convergence in Health and Economics (MCCHE) and Desautels Faculty of Management, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Quebec City, Quebec, Canada
| | - Nick Drager
- McGill Center for the Convergence in Health and Economics (MCCHE) and Desautels Faculty of Management, Montreal, Quebec, Canada.,London School of Hygiene and Tropical Medicine, London, England
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815
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Sacks G, Mialon M, Vandevijvere S, Trevena H, Snowdon W, Crino M, Swinburn B. Comparison of food industry policies and commitments on marketing to children and product (re)formulation in Australia, New Zealand and Fiji. CRITICAL PUBLIC HEALTH 2014. [DOI: 10.1080/09581596.2014.946888] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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816
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Ng SH, Kelly B, Se CH, Chinna K, Sameeha MJ, Krishnasamy S, Ismail MN, Karupaiah T. Obesogenic television food advertising to children in Malaysia: sociocultural variations. Glob Health Action 2014; 7:25169. [PMID: 25141835 PMCID: PMC4139933 DOI: 10.3402/gha.v7.25169] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/11/2014] [Accepted: 07/28/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Food advertising on television (TV) is well known to influence children's purchasing requests and models negative food habits in Western countries. Advertising of unhealthy foods is a contributor to the obesogenic environment that is a key driver of rising rates of childhood obesity. Children in developing countries are more at risk of being targeted by such advertising, as there is a huge potential for market growth of unhealthy foods concomitant with poor regulatory infrastructure. Further, in developing countries with multi-ethnic societies, information is scarce on the nature of TV advertising targeting children. OBJECTIVES To measure exposure and power of TV food marketing to children on popular multi-ethnic TV stations in Malaysia. DESIGN Ethnic-specific popular TV channels were identified using industry data. TV transmissions were recorded for each channel from November 2012 to August 2013 (16 hr/day) for randomly selected weekdays and weekend days during normal days and repeated during school holidays (n=88 days). Coded food/beverage advertisements were grouped into core (healthy), non-core (non-healthy), or miscellaneous (unclassified) food categories. Peak viewing time (PVT) and persuasive marketing techniques were identified. RESULTS Non-core foods were predominant in TV food advertising, and rates were greater during school holidays compared to normal days (3.51 vs 1.93 food ads/hr/channel, p<0.001). During normal days' PVT, the ratio of non-core to core food advertising was higher (3.25 food ads/hr/channel), and this more than trebled during school holidays to 10.25 food ads/hr/channel. Popular channels for Indian children had the lowest rate of food advertising relative to other ethnic groups. However, sugary drinks remained a popular non-core product advertised across all broadcast periods and channels. Notably, promotional characters doubled for non-core foods during school holidays compared to normal days (1.91 vs 0.93 food ads/hr/channel, p<0.001). CONCLUSIONS This study highlights non-core food advertising, and predominantly sugary drinks are commonly screened on Malaysian TV channels. The majority of these sugary drinks were advertised by multinational companies, and this observation warrants regulatory attention.
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Affiliation(s)
- See H Ng
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Bridget Kelly
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Chee H Se
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Epidemiology and Biostatistics Unit, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Jamil Sameeha
- Nutrition Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shanthi Krishnasamy
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - M N Ismail
- Nutrition & Dietetics Department, Faculty of Health Sciences, UiTM, Puncak Alam, Malaysia
| | - Tilakavati Karupaiah
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia;
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817
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Pettigrew S, Chapman K, Miller C, Thomas S. A conceptual classification of parents’ attributions of the role of food advertising in children’s diets. BMC OBESITY 2014. [DOI: 10.1186/s40608-014-0017-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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818
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Browne J, Hayes R, Gleeson D. Aboriginal health policy: is nutrition the ‘gap’ in ‘Closing the Gap’? Aust N Z J Public Health 2014; 38:362-9. [DOI: 10.1111/1753-6405.12223] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/01/2013] [Accepted: 01/01/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Jennifer Browne
- School of Public Health and Human Biosciences, La Trobe University, Victoria
- Victorian Aboriginal Community Controlled Health Organisation, Victoria
| | - Rick Hayes
- School of Public Health and Human Biosciences, La Trobe University, Victoria
| | - Deborah Gleeson
- School of Public Health and Human Biosciences, La Trobe University, Victoria
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819
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Lobstein T, Brinsden H. Symposium report: the prevention of obesity and NCDs: challenges and opportunities for governments. Obes Rev 2014; 15:630-9. [PMID: 24888259 DOI: 10.1111/obr.12193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/08/2014] [Accepted: 04/23/2014] [Indexed: 11/29/2022]
Abstract
This paper is written as a briefing document with the aim of providing support to policy-makers and government officials tackling obesity and related non-communicable diseases. It is based on a symposium Obesity and non-communicable diseases: Learning from international experiences convened by the International Association for the Study of Obesity (now the World Obesity Federation) and its policy section, the International Obesity TaskForce (now World Obesity - Policy and Prevention). The symposium discussed a wide range of proposals to tackle the consumption of unhealthy food products, including interventions in the market through fiscal policies and marketing restrictions, measures to strengthen public health legislation and measures to limit agri-food company lobbying activities. It recognized the need for government leadership and action in order to reduce preventable deaths while improving economic performance and identified a need for governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress.
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Affiliation(s)
- Tim Lobstein
- World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK
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820
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Vineis P, Stringhini S, Porta M. The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization. ENVIRONMENTAL RESEARCH 2014; 133:424-430. [PMID: 24593864 DOI: 10.1016/j.envres.2014.02.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/24/2013] [Accepted: 02/05/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Non-communicable diseases (NCDs) are increasing worldwide. We hypothesize that environmental factors (including social adversity, diet, lack of physical activity and pollution) can become "embedded" in the biology of humans. We also hypothesize that the "embedding" partly occurs because of epigenetic changes, i.e., durable changes in gene expression patterns. Our concern is that once such factors have a foundation in human biology, they can affect human health (including NCDs) over a long period of time and across generations. OBJECTIVES To analyze how worldwide changes in movements of goods, persons and lifestyles (globalization) may affect the "epigenetic landscape" of populations and through this have an impact on NCDs. We provide examples of such changes and effects by discussing the potential epigenetic impact of socio-economic status, migration, and diet, as well as the impact of environmental factors influencing trends in age at puberty. DISCUSSION The study of durable changes in epigenetic patterns has the potential to influence policy and practice; for example, by enabling stratification of populations into those who could particularly benefit from early interventions to prevent NCDs, or by demonstrating mechanisms through which environmental factors influence disease risk, thus providing compelling evidence for policy makers, companies and the civil society at large. The current debate on the '25 × 25 strategy', a goal of 25% reduction in relative mortality from NCDs by 2025, makes the proposed approach even more timely. CONCLUSIONS Epigenetic modifications related to globalization may crucially contribute to explain current and future patterns of NCDs, and thus deserve attention from environmental researchers, public health experts, policy makers, and concerned citizens.
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Affiliation(s)
- Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, St. Mary׳s Campus Norfolk Place, W2 1PG London, United Kingdom; Human Genetics Foundation, Torino (HuGeF), Italy.
| | - Silvia Stringhini
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, 1010 Lausanne, Switzerland
| | - Miquel Porta
- Hospital del Mar Institute of Medical Research (IMIM), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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821
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Pettigrew S, Borys JM, du Plessis HR, Walter L, Huang TTK, Levi J, Vinck J. Process evaluation outcomes from a global child obesity prevention intervention. BMC Public Health 2014; 14:757. [PMID: 25065414 PMCID: PMC4122757 DOI: 10.1186/1471-2458-14-757] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 07/22/2014] [Indexed: 12/22/2022] Open
Abstract
Background While it is acknowledged that child obesity interventions should cover multiple ecological levels (downstream, midstream and upstream) to maximize their effectiveness, there is a lack of evaluation data to guide the development and implementation of such efforts. To commence addressing this knowledge gap, the present study provides process evaluation data relating to the experiences of groups implementing the EPODE approach to child obesity prevention in various locations around the world. The aim of this exploratory study was to investigate the barriers and facilitators to program implementation in program sites around the world to assist in developing strategies to enhance program outcomes. Methods An online survey that included open-ended questions was distributed to the 25 EPODE programs in operation at the time of the survey (May 2012). The survey items asked respondents to comment on those aspects of program implementation that they found challenging and to suggest areas for future improvement. Eighteen programs representing 14 countries responded to the request to participate in the survey, yielding a 72% response rate. The responses were analyzed via the constant comparative method using NVivo qualitative data analysis software. Results The main concerns of the various EPODE programs were their ability to secure ongoing funding and their access to evidence-based intervention methods and policy advice relating to relationships with third parties. These issues were in turn impacted by other factors, including (i) access to user-friendly information relating to the range of intervention strategies available and appropriate evaluation measures; (ii) assistance with building and maintaining stakeholder relationships; and (iii) assurance of the quality, independence, and transparency of policies and practices. Conclusions The findings are facilitating the ongoing refinement of the EPODE approach. In particular, standardized and tailored information packages are being made available to advise program members of (i) the various evaluation methods and tools at their disposal and (ii) methods of acquiring private partner support. Overall, the study results relating to the types of issues encountered by program members are likely to be useful in guiding the future design and implementation of multi-level initiatives seeking to address other complex and intractable health-related problems.
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Affiliation(s)
- Simone Pettigrew
- School of Psychology and Speech Pathology, CurtinUniversity, Kent St, Bentley, WA 6102, Australia.
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822
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Watson WL, Johnston A, Hughes C, Chapman K. Determining the ‘healthiness’ of foods marketed to children on television using the Food Standards Australia New Zealand nutrient profiling criteria. Nutr Diet 2014. [DOI: 10.1111/1747-0080.12127] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Wendy L. Watson
- Health Strategies Division; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Aimee Johnston
- Health Strategies Division; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Clare Hughes
- Health Strategies Division; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Kathy Chapman
- Health Strategies Division; Cancer Council NSW; Woolloomooloo New South Wales Australia
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823
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Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One 2014; 9:e100652. [PMID: 25007189 PMCID: PMC4090010 DOI: 10.1371/journal.pone.0100652] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/29/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Some popular weight loss diets restricting carbohydrates (CHO) claim to be more effective, and have additional health benefits in preventing cardiovascular disease compared to balanced weight loss diets. METHODS AND FINDINGS We compared the effects of low CHO and isoenergetic balanced weight loss diets in overweight and obese adults assessed in randomised controlled trials (minimum follow-up of 12 weeks), and summarised the effects on weight, as well as cardiovascular and diabetes risk. Dietary criteria were derived from existing macronutrient recommendations. We searched Medline, EMBASE and CENTRAL (19 March 2014). Analysis was stratified by outcomes at 3-6 months and 1-2 years, and participants with diabetes were analysed separately. We evaluated dietary adherence and used GRADE to assess the quality of evidence. We calculated mean differences (MD) and performed random-effects meta-analysis. Nineteen trials were included (n = 3209); 3 had adequate allocation concealment. In non-diabetic participants, our analysis showed little or no difference in mean weight loss in the two groups at 3-6 months (MD 0.74 kg, 95%CI -1.49 to 0.01 kg; I2 = 53%; n = 1745, 14 trials; moderate quality evidence) and 1-2 years (MD 0.48 kg, 95%CI -1.44 kg to 0.49 kg; I2 = 12%; n = 1025; 7 trials, moderate quality evidence). Furthermore, little or no difference was detected at 3-6 months and 1-2 years for blood pressure, LDL, HDL and total cholesterol, triglycerides and fasting blood glucose (>914 participants). In diabetic participants, findings showed a similar pattern. CONCLUSIONS Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.
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Affiliation(s)
- Celeste E. Naude
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anel Schoonees
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marjanne Senekal
- Division of Human Nutrition, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
| | - Paul Garner
- Effective Health Care Research Consortium, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jimmy Volmink
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
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824
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Johnston JL, Fanzo JC, Cogill B. Understanding sustainable diets: a descriptive analysis of the determinants and processes that influence diets and their impact on health, food security, and environmental sustainability. Adv Nutr 2014; 5:418-29. [PMID: 25022991 PMCID: PMC4085190 DOI: 10.3945/an.113.005553] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a "better" way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of "sustainability" of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system.
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Affiliation(s)
- Jessica L. Johnston
- Office of the UN Special Envoy for Financing of the Health Millennium Development Goals and Malaria, MDG Health Alliance, New York, NY,To whom correspondence should be addressed. E-mail:
| | - Jessica C. Fanzo
- Columbia University, Institute for Human Nutrition, New York, NY; and
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825
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Trevena H, Dunford E, Neal B, Webster J. The Australian Food and Health Dialogue - the implications of the sodium recommendation for pasta sauces. Public Health Nutr 2014; 17:1647-53. [PMID: 23830096 PMCID: PMC10282366 DOI: 10.1017/s1368980013001791] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 05/12/2013] [Accepted: 05/29/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the change in Na content of Australian pasta sauces between 2008 and 2011. A secondary objective was to project the mean Na content of these same products in 2014 using the Australian Food and Health Dialogue Na commitment and compare projections with the 2012 UK Na target for pasta sauce. DESIGN Na data were collected from the product labels of pasta sauce products. Mean Na content was calculated for 2008 and 2011 and change assessed. Projected mean values for 2014 were derived by applying a 15 % reduction to the 2011 products above the 'action point' of 420 mg Na/100 g, consistent with the Food and Health Dialogue commitment (scenario 1). A 15 % reduction was applied to products already below the 'action point' (scenario 2). Projections were compared with the 2012 UK target. SETTING Na data for pasta sauce products in Australian supermarkets (July-September) in 2008 and 2011. SUBJECTS Not applicable. RESULTS Data were available for 124 (2008) and 187 (2011) products, and mean Na levels were not significantly different (451 mg/100 g v. 423 mg/100 g; P = 0·16). The projected means (381 mg Na/100 g in scenario 1; 375 mg Na/100 g in scenario 2) exceeded the 2012 UK target (330 mg Na/100 g) and to attain this would require a 22 % reduction from 2011 levels. CONCLUSIONS There is little evidence that all Australian manufacturers of pasta sauces systematically reduced the Na content of their products between 2008 and 2011. Even if all manufacturers achieve the current voluntary commitment by 2014, average salt levels in Australian products would still be above the 2012 UK target.
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Affiliation(s)
- Helen Trevena
- The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Elizabeth Dunford
- The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
| | - Jacqueline Webster
- The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
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826
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Kypri K, Connor J, Maclennan B, Sellman D. What became of New Zealand's golden opportunity for liquor law reform? Drug Alcohol Rev 2014; 32:557-60. [PMID: 24219658 DOI: 10.1111/dar.12075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Australia; Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, New Zealand
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827
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Towards comprehensive global monitoring of food environments and policies to reduce diet-related non-communicable diseases. Public Health Nutr 2014; 16:2101-4. [PMID: 24182451 DOI: 10.1017/s1368980013002887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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828
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Affiliation(s)
- Thiago Hérick de Sá
- University of São Paulo, School of Public Health, Nutrition, São Paulo, SP 01246-904, Brazil.
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829
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Hawkins B, McCambridge J. Industry actors, think tanks, and alcohol policy in the United kingdom. Am J Public Health 2014; 104:1363-9. [PMID: 24922137 DOI: 10.2105/ajph.2013.301858] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Corporate actors seek to influence alcohol policies through various means, including attempts to shape the evidential content of policy debates. In this case study, we examined how SABMiller engaged the think tank Demos to produce reports on binge drinking, which were heavily promoted among policymakers at crucial stages in the development of the UK government's 2012 alcohol strategy. One key report coincided with other SABMiller-funded publications, advocating measures to enhance parenting as an alternative to minimum unit pricing. In this instance, the perceived independence of an influential think tank was used to promote industry interests in tactics similar to those of transnational tobacco corporations. This approach is in keeping with other alcohol industry efforts to marginalize the peer-reviewed literature.
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Affiliation(s)
- Benjamin Hawkins
- Benjamin Hawkins and Jim McCambridge are with the London School of Hygiene and Tropical Medicine, London, England
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830
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Magnusson RS, Patterson D. The role of law and governance reform in the global response to non-communicable diseases. Global Health 2014; 10:44. [PMID: 24903332 PMCID: PMC4077679 DOI: 10.1186/1744-8603-10-44] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 03/24/2014] [Indexed: 11/10/2022] Open
Abstract
Addressing non-communicable diseases ("NCDs") and their risk-factors is one of the most powerful ways of improving longevity and healthy life expectancy for the foreseeable future - especially in low- and middle-income countries. This paper reviews the role of law and governance reform in that process. We highlight the need for a comprehensive approach that is grounded in the right to health and addresses three aspects: preventing NCDs and their risk factors, improving access to NCD treatments, and addressing the social impacts of illness. We highlight some of the major impediments to the passage and implementation of laws for the prevention and control of NCDs, and identify important practical steps that governments can take as they consider legal and governance reforms at country level.We review the emerging global architecture for NCDs, and emphasise the need for governance structures to harness the energy of civil society organisations and to create a global movement that influences the policy agenda at the country level. We also argue that the global monitoring framework would be more effective if it included key legal and policy indicators. The paper identifies priorities for technical legal assistance in implementing the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020. These include high-quality legal resources to assist countries to evaluate reform options, investment in legal capacity building, and global leadership to respond to the likely increase in requests by countries for technical legal assistance. We urge development agencies and other funders to recognise the need for development assistance in these areas. Throughout the paper, we point to global experience in dealing with HIV and draw out some relevant lessons for NCDs.
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Affiliation(s)
- Roger S Magnusson
- Sydney Law School, F10, The University of Sydney, Sydney NSW 2006 Australia
| | - David Patterson
- Department of Strategy and Innovation, International Development Law Organization (IDLO), Viale Vaticano, Rome, Italy
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831
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Moubarac JC, Parra DC, Cannon G, Monteiro CA. Food Classification Systems Based on Food Processing: Significance and Implications for Policies and Actions: A Systematic Literature Review and Assessment. Curr Obes Rep 2014; 3:256-72. [PMID: 26626606 DOI: 10.1007/s13679-014-0092-0] [Citation(s) in RCA: 265] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper is the first to make a systematic review and assessment of the literature that attempts methodically to incorporate food processing into classification of diets. The review identified 1276 papers, of which 110 were screened and 21 studied, derived from five classification systems. This paper analyses and assesses the five systems, one of which has been devised and developed by a research team that includes co-authors of this paper. The quality of the five systems is assessed and scored according to how specific, coherent, clear, comprehensive and workable they are. Their relevance to food, nutrition and health, and their use in various settings, is described. The paper shows that the significance of industrial food processing in shaping global food systems and supplies and thus dietary patterns worldwide, and its role in the pandemic of overweight and obesity, remains overlooked and underestimated. Once food processing is systematically incorporated into food classifications, they will be more useful in assessing and monitoring dietary patterns. Food classification systems that emphasize industrial food processing, and that define and distinguish relevant different types of processing, will improve understanding of how to prevent and control overweight, obesity and related chronic non-communicable diseases, and also malnutrition. They will also be a firmer basis for rational policies and effective actions designed to protect and improve public health at all levels from global to local.
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Affiliation(s)
- Jean-Claude Moubarac
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907.
| | - Diana C Parra
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey Cannon
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
| | - Carlos A Monteiro
- Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, Brazil, 01246-907
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
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832
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Durkin S, Wakefield M. Commentary on Sims et al. (2014) and Langley et al. (2014): mass media campaigns require adequate and sustained funding to change population health behaviours. Addiction 2014; 109:1003-4. [PMID: 24796401 DOI: 10.1111/add.12564] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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833
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Stern D, Piernas C, Barquera S, Rivera JA, Popkin BM. Caloric beverages were major sources of energy among children and adults in Mexico, 1999-2012. J Nutr 2014; 144:949-56. [PMID: 24744311 PMCID: PMC4083240 DOI: 10.3945/jn.114.190652] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/05/2014] [Accepted: 03/21/2014] [Indexed: 11/14/2022] Open
Abstract
Mexico, with 1 of the highest obesity prevalences in the world, instituted a 10% excise tax for any sugar-sweetened beverage (SSB) starting on 1 January 2014. Understanding the recent patterns and trends in beverage intake and sales in Mexico provides both background and baseline data for the importance of SSBs and other beverages in the Mexican diet. We analyzed a single 24-h dietary recall from 2 nationally representative surveys: the Mexican Nutrition Survey 1999 (n = 6049) and the National Health and Nutrition Survey 2012 (n = 10,343). To describe trends and patterns in beverages, we calculated the volume and energy intake per capita and per consumer and the proportion of consumers of each beverage group in each survey. A commercial sales dataset was used to describe beverage sales trends from 1999 to 2012. From 1999 to 2012, total daily energy from beverages increased among children aged 5-11 y (+45.3 kcal), females aged 12-19 y (+57.3 kcal), and adult females aged 20-49 y (+96.4 kcal) (P < 0.05). Over the same period, intake of beverages with added sugars increased, specifically flavored milk, agua fresca (fruit water made in stalls or at home, usually with added sugars), and fruit drinks among children aged 5-11 y and females aged 12-19 y and caloric coffee/tea, soda, and agua fresca among adult females aged 20-49 y. In 2012, beverages represented 17.5% (325 kcal) and 19.0% (382 kcal) of the total daily energy intake per capita in children aged 1-19 y and adults aged ≥20 y, respectively. In 2012, flavored milk beverages, caloric soda, and high-fat milk were the top 3 major contributors to total daily energy intake per capita in all children aged 1-19 y. Caloric soda, caloric coffee/tea, and agua fresca were the top 3 major energy contributors in adults aged ≥20 y. From 1999 to 2012, sales of soda, fruit-flavored drinks, and flavored waters increased. In conclusion, consumption of several beverages with added sugars increased among children and adult females in Mexico. Because caloric soda is currently 1 of the top beverages consumed, a 10% tax on SSBs might help to significantly reduce added sugars intake in Mexico.
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Affiliation(s)
- Dalia Stern
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Carmen Piernas
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Simon Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Juan A Rivera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
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834
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Promoting cardiovascular health worldwide: strategies, challenges, and opportunities. ACTA ACUST UNITED AC 2014; 67:724-30. [PMID: 25172068 DOI: 10.1016/j.rec.2014.01.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/22/2014] [Indexed: 11/23/2022]
Abstract
Cardiovascular disease is the leading cause of death in the world, affecting not only industrialized but, above all, low- and middle-income countries, where it has overtaken infectious diseases as the first cause of death and its impact threatens social and economic development. The increased prevalence of cardiovascular disease in recent years together with projected mortality for the coming decades constitute an irrefutable argument for the urgent implementation of well-planned interventions to control the pandemic of cardiovascular diseases, especially in the more economically deprived countries. The combination of behavioral, social, environmental, and biological factors, and others related to health care systems, that contribute to the development of cardiovascular diseases requires a multi-sector strategy that promotes a healthy lifestyle, reduces cardiovascular risk factors, and cuts mortality and morbidity through quality health care services. These proposals should be guided by leaders in the scientific community, government, civil society, private sector, and local communities.
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835
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Downs SM, Thow AM, Ghosh-Jerath S, Leeder SR. Developing Interventions to Reduce Consumption of Unhealthy Fat in the Food Retail Environment: A Case Study of India. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2014. [DOI: 10.1080/19320248.2014.908452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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836
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Clark J. Medicalization of global health 3: the medicalization of the non-communicable diseases agenda. Glob Health Action 2014; 7:24002. [PMID: 24848661 PMCID: PMC4029219 DOI: 10.3402/gha.v7.24002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/17/2014] [Accepted: 04/21/2014] [Indexed: 01/08/2023] Open
Abstract
There is growing recognition of the massive global burden of non-communicable diseases (NCDs) due to their prevalence, projected social and economic costs, and traditional neglect compared to infectious disease. The 2011 UN Summit, WHO 25×25 targets, and support of major medical and advocacy organisations have propelled prominence of NCDs on the global health agenda. NCDs are by definition 'diseases' so already medicalized. But their social drivers and impacts are acknowledged, which demand a broad, whole-of-society approach. However, while both individual- and population-level targets are identified in the current NCD action plans, most recommended strategies tend towards the individualistic approach and do not address root causes of the NCD problem. These so-called population strategies risk being reduced to expectations of individual and behavioural change, which may have limited success and impact and deflect attention away from government policies or regulation of industry. Industry involvement in NCD agenda-setting props up a medicalized approach to NCDs: food and drink companies favour focus on individual choice and responsibility, and pharmaceutical and device companies favour calls for expanded access to medicines and treatment coverage. Current NCD framing creates expanded roles for physicians, healthcare workers, medicines and medical monitoring. The professional rather than the patient view dominates the NCD agenda and there is a lack of a broad, engaged, and independent NGO community. The challenge and opportunity lie in defining priorities and developing strategies that go beyond a narrow medicalized framing of the NCD problem and its solutions.
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Affiliation(s)
- Jocalyn Clark
- icddr,b, Dhaka, Bangladesh; Department of Medicine, University of Toronto, Toronto, Canada; ;
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837
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Vandevijvere S, Swinburn B. Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases: design and methods for nation-wide surveys. BMJ Open 2014; 4:e005339. [PMID: 24833697 PMCID: PMC4025455 DOI: 10.1136/bmjopen-2014-005339] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Unhealthy diets are heavily driven by unhealthy food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has been established to reduce obesity, NCDs and their related inequalities globally. This paper describes the design and methods of the first-ever, comprehensive national survey on the healthiness of food environments and the public and private sector policies influencing them, as a first step towards global monitoring of food environments and policies. METHODS AND ANALYSIS A package of 11 substudies has been identified: (1) food composition, labelling and promotion on food packages; (2) food prices, shelf space and placement of foods in different outlets (mainly supermarkets); (3) food provision in schools/early childhood education (ECE) services and outdoor food promotion around schools/ECE services; (4) density of and proximity to food outlets in communities; food promotion to children via (5) television, (6) magazines, (7) sport club sponsorships, and (8) internet and social media; (9) analysis of the impact of trade and investment agreements on food environments; (10) government policies and actions; and (11) private sector actions and practices. For the substudies on food prices, provision, promotion and retail, 'environmental equity' indicators have been developed to check progress towards reducing diet-related health inequalities. Indicators for these modules will be assessed by tertiles of area deprivation index or school deciles. International 'best practice benchmarks' will be identified, against which to compare progress of countries on improving the healthiness of their food environments and policies. DISSEMINATION This research is highly original due to the very 'upstream' approach being taken and its direct policy relevance. The detailed protocols will be offered to and adapted for countries of varying size and income in order to establish INFORMAS globally as a new monitoring initiative to reduce obesity and diet-related NCDs.
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Affiliation(s)
| | - Boyd Swinburn
- University of Auckland, School of Population Health, Auckland, New Zealand
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838
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Affiliation(s)
- Young-Ho Khang
- Department of Preventive Medicine, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil Songpa-Gu, Seoul, 138-736 Korea.
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839
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Bellis MA, Hughes K, Leckenby N, Perkins C, Lowey H. National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England. BMC Med 2014; 12:72. [PMID: 24886026 PMCID: PMC4234527 DOI: 10.1186/1741-7015-12-72] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 03/21/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Epidemiological and biomedical evidence link adverse childhood experiences (ACEs) with health-harming behaviors and the development of non-communicable disease in adults. Investment in interventions to improve early life experiences requires empirical evidence on levels of childhood adversity and the proportion of HHBs potentially avoided should such adversity be addressed. METHODS A nationally representative survey of English residents aged 18 to 69 (n = 3,885) was undertaken during the period April to July 2013. Individuals were categorized according to the number of ACEs experienced. Modeling identified the proportions of HHBs (early sexual initiation, unintended teenage pregnancy, smoking, binge drinking, drug use, violence victimization, violence perpetration, incarceration, poor diet, low levels of physical exercise) independently associated with ACEs at national population levels. RESULTS Almost half (47%) of individuals experienced at least one of the nine ACEs. Prevalence of childhood sexual, physical, and verbal abuse was 6.3%, 14.8%, and 18.2% respectively (population-adjusted). After correcting for sociodemographics, ACE counts predicted all HHBs, e.g. (0 versus 4+ ACEs, adjusted odds ratios (95% confidence intervals)): smoking 3.29 (2.54 to 4.27); violence perpetration 7.71 (4.90 to 12.14); unintended teenage pregnancy 5.86 (3.93 to 8.74). Modeling suggested that 11.9% of binge drinking, 13.6% of poor diet, 22.7% of smoking, 52.0% of violence perpetration, 58.7% of heroin/crack cocaine use, and 37.6% of unintended teenage pregnancy prevalence nationally could be attributed to ACEs. CONCLUSIONS Stable and protective childhoods are critical factors in the development of resilience to health-harming behaviors in England. Interventions to reduce ACEs are available and sustainable, with nurturing childhoods supporting the adoption of health-benefiting behaviors and ultimately the provision of positive childhood environments for future generations.
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Affiliation(s)
- Mark A Bellis
- Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
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840
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Neal B. Dietary Salt Is a Public Health Hazard That Requires Vigorous Attack. Can J Cardiol 2014; 30:502-6. [DOI: 10.1016/j.cjca.2014.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 02/13/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022] Open
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841
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Esposito K, Ciardiello F, Giugliano D. Unhealthy diets: a common soil for the association of metabolic syndrome and cancer. Endocrine 2014; 46:39-42. [PMID: 24408049 DOI: 10.1007/s12020-013-0151-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 12/16/2013] [Indexed: 01/03/2023]
Abstract
The association between metabolic syndrome and cancer continues to be acknowledged. Metabolic syndrome is a common long-term complication in cancer survivors; on the other hand, findings from several recent meta-analyses suggest that the presence of metabolic syndrome is associated with increased risk of future cancer at specific sites. Approximately one-third of cancer deaths occurring in the USA each year may be caused by unhealthy lifestyle habits, including poor nutrition. Worldwide, diets low in fruits rank third for deaths attributable to individual risk factors. Metabolic syndrome may be a surrogate marker for dietary risk factors for cancer, a sentinel for the deleterious effect of unhealthy diet in susceptible individuals, who may first manifest metabolic consequences (visceral obesity, dysglycemia, hypertension, and dyslipidemia), and then an increased risk of cancer. From the standpoint of preventive oncology, people with the metabolic syndrome should be encouraged, more than sex- and age-matched counterparts, to undergo appropriate cancer screenings.
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Affiliation(s)
- Katherine Esposito
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
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842
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Campbell N, Pipe A, Duhaney T. Calls for Restricting the Marketing of Unhealthy Food to Children: Canadian Cardiovascular Health Care and Scientific Community Get Ignored by Policy Makers. What Can They Do? Can J Cardiol 2014; 30:479-81. [DOI: 10.1016/j.cjca.2013.11.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 11/25/2022] Open
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843
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844
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Abstract
During the last 20 years, India has emerged as a fast growing economy with changes in lifestyle-related behavior partially responsible for the increasing cancer burden. While cancer incidence rates are lower than many western countries some changes over recent decades have emerged. This paper examines the time trends in cancer-specific incidence from six population-based cancer registries in India and review articles published on cancer trends in the country. The results are examined in light of their implications to cancer prevention and cancer control.
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Affiliation(s)
- Rajendra A Badwe
- *Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai 400012, India.
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845
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Affiliation(s)
- Jim McCambridge
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9HS.
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846
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Egilman D, Bird T, Lee C. Dust diseases and the legacy of corporate manipulation of science and law. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2014; 20:115-25. [PMID: 24999846 PMCID: PMC4090870 DOI: 10.1179/1077352514z.000000000104] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The dust diseases silicosis and asbestosis were the first occupational diseases to have widespread impact on workers. Knowledge that asbestos and silica were hazardous to health became public several decades after the industry knew of the health concerns. This delay was largely influenced by the interests of Metropolitan Life Insurance Company (MetLife) and other asbestos mining and product manufacturing companies. OBJECTIVES To understand the ongoing corporate influence on the science and politics of asbestos and silica exposure, including litigation defense strategies related to historical manipulation of science. METHODS We examined previously secret corporate documents, depositions and trial testimony produced in litigation; as well as published literature. RESULTS Our analysis indicates that companies that used and produced asbestos have continued and intensified their efforts to alter the asbestos-cancer literature and utilize dust-exposure standards to avoid liability and regulation. Organizations of asbestos product manufacturers delayed the reduction of permissible asbestos exposures by covering up the link between asbestos and cancer. Once the decline of the asbestos industry in the US became inevitable, the companies and their lawyers designed the state of the art (SOA) defense to protect themselves in litigation and to maintain sales to developing countries. CONCLUSIONS Asbestos product companies would like the public to believe that there was a legitimate debate surrounding the dangers of asbestos during the twentieth century, particularly regarding the link to cancer, which delayed adequate regulation. The asbestos-cancer link was not a legitimate contestation of science; rather the companies directly manipulated the scientific literature. There is evidence that industry manipulation of scientific literature remains a continuing problem today, resulting in inadequate regulation and compensation and perpetuating otherwise preventable worker and consumer injuries and deaths.
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Affiliation(s)
- David Egilman
- Department of Community Health, Brown University, Attleboro, MA, USA
| | - Tess Bird
- Never Again Consulting, Attleboro, MA, USA
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847
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Affiliation(s)
- A Rob Moodie
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic., 3010, Australia.
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848
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Elliott T, Trevena H, Sacks G, Dunford E, Martin J, Webster J, Swinburn B, Moodie AR, Neal BC. A systematic interim assessment of the Australian Government's Food and Health Dialogue. Med J Aust 2014; 200:92-5. [PMID: 24484111 DOI: 10.5694/mja13.11240] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 12/20/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate whether the Food and Health Dialogue (the Dialogue), established by the Australian Government in 2009, is having an impact on reducing premature death and disability caused by poor diet in Australia. DESIGN AND SETTING We used information derived from the Dialogue website, media releases, communiqués and e-newsletters to evaluate the Dialogue's achievements from October 2009 to September 2013, using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. Data describing the processed foods marketed in Australia were extracted from an existing food composition database. MAIN OUTCOME MEASURES Achievements of the Dialogue (goals, targets, actions and health outcomes). RESULTS The primary goal of the Dialogue was identified as "raising the nutritional profile of foods" to be achieved "through reformulation, consumer education and portion standardisation". Employing a public-private partnership model, the Dialogue has established a framework for collaboration between government, public health groups and industry. In the first 4 years, targets were set for 11 (8.9%) of a total of 124 possible action areas for food reformulation and portion standardisation. None were yet due to have been achieved. There was no evidence that any education programs had been implemented by the Dialogue. There are no indicators of the extent to which population exposure to target nutrients has changed or whether any positive or negative health impacts have ensued. CONCLUSIONS The Dialogue has highly creditable goals but the mechanism for delivering on them has proved inadequate. Explicit processes and the outcomes to be delivered within defined timelines are required, along with a clear plan for remediation if they are not achieved.
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Affiliation(s)
- Tamara Elliott
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.
| | - Helen Trevena
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, VIC, Australia
| | - Elizabeth Dunford
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - Jane Martin
- Obesity Policy Coalition, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Jacqui Webster
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - Boyd Swinburn
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, VIC, Australia
| | - A Rob Moodie
- University of Melbourne, Melbourne, VIC, Australia
| | - Bruce C Neal
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
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849
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Kearney FM, Fagan XJ, Al-Qureshi S. Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease. Clin Exp Ophthalmol 2014; 42:564-73. [PMID: 24373051 DOI: 10.1111/ceo.12290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 12/16/2013] [Indexed: 01/08/2023]
Abstract
This review examines the current evidence of the relationship between sugar consumption and the development of retinal and other eye diseases including diabetic retinopathy, hypertensive retinopathy, age-related macular degeneration, non-arteritic anterior ischaemic optic neuropathy and cataract. Sucrose is comprised of fructose and glucose. Sugar consumption has increased five-fold over the last century, with high quantities of sucrose and high-fructose corn syrup found in processed food and soft drinks. This increased consumption is increasingly recognized as a central factor in the rapidly rising rates of obesity and type 2 diabetes. The body metabolizes fructose and glucose differently, with fructose appearing to have the greater propensity to contribute to the metabolic syndrome. This review examines the effect of high rates of dietary consumption of refined carbohydrates on the eye, including the effect of chronic hyperglycaemia on microvascular disease in diabetic retinopathy, and the pathophysiological changes in the retinal circulation in hypertensive retinopathy.
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Affiliation(s)
- Frances M Kearney
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria; Vision Centre Gold Coast, Southport, Queensland, Australia
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850
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Casswell S, Huckle T, Wall M, Yeh LC. International alcohol control study: pricing data and hours of purchase predict heavier drinking. Alcohol Clin Exp Res 2014; 38:1425-31. [PMID: 24588859 DOI: 10.1111/acer.12359] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 01/02/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study reports findings from the International Alcohol Control (IAC) study that assesses the impact of alcohol control policy on consumption and policy-related behaviors. Modeled on the International Tobacco Control study that uses longitudinal surveys with comparison between countries, the baseline survey was carried out in New Zealand. This study reports analysis of the purchasing behavior respondents report separately for on- and off-premise outlets, providing validation data for both alcohol consumption and reported prices. METHODS New Zealand is a high-income country with an adult per capita alcohol consumption (as of 2011) of 9.5 l. The survey was carried out among a nationally representative sample of drinkers. Interview data on place and time of purchase, amounts purchased, price paid, and consumption (beverage and location specific) was collected. Relationships between policy relevant variables and consumption were modeled taking into account demographic variables. Validation was provided by government data on alcohol available for consumption, aggregate expenditure and prices from the Consumer Price Index. RESULTS Drinkers paying low prices at on- or off-licensed premises had higher odds of consuming 6+ drinks on a typical occasion, as did drinkers purchasing alcohol at later times. Regarding frequency, drinkers purchasing at later times were more likely to be daily drinkers. Lower price in off licenses but not on licenses predicted daily drinking. The data collected accounted for approximately 96% of alcohol available for consumption and the prices accounted for 98% of aggregate expenditure. CONCLUSIONS Valid survey data were collected to give an accurate picture of alcohol consumption and prices paid by drinkers. Heavy drinkers were more likely to buy cheaper alcohol and purchase at later times; 2 policy issues under discussion in many settings. This analysis suggests the IAC study that has the potential to provide data to contribute to the debate on appropriate policy responses to reduce alcohol-related harm.
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Affiliation(s)
- Sally Casswell
- SHORE and Whariki Research Centre, School of Public Health, Massey University, Auckland, New Zealand
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