Food system overhaul: WHO Nutrition Director highlights role of diet in slashing NCDs

12 Dec 2019 --- A food system overhaul is necessary to curb climbing rates of deadly noncommunicable diseases (NCDs), including hypertension, heart issues and many types of cancer. This is according to Francesco Branca, Director of the Department of Nutrition for Health and Development (NHD) at the World Health Organization (WHO). He speaks to NutritionInsight from Oman, where world leaders and health experts are gathering to give WHO eight new recommendations that may potentially save millions of lives.

The WHO Independent High-level Commission highlights that NCDs – many of which are nutrition-related – still account for over 70 percent of deaths. The organization also notes that many countries face challenges and need more support to implement solutions. 

“An unhealthy diet is a key risk factor for the obesity burden. The way we eat is a major cause of death and NCDs. The unbalanced diets that are widely consumed are often the result of the marketing and sales of processed foods that are high in fat, sugar and salt. This is part of the wider food environment, which has to do with what is sold in stores, as well as the availability and price of raw materials,” Branca explains.

The report was received by Dr. Tedros Adhanom Ghebreyesus, WHO’s Director-General, and includes recommendations such as:

• Support countries in efforts to empower individuals to make healthy choices, including by ensuring that the environment is conducive to living a healthy life, and that people receive the information they need to make healthy choices.
• Encourage countries to invest in the prevention and control of NCDs as a key opportunity to enhance human capital and accelerate economic growth.
• Advise countries to include services to prevent and treat NCDs as essential components of Universal Health Coverage.
• Increase engagement with businesses and provide technical support to Member States so they can mount effective national responses to NCDs.

A positive food environment will be key to fighting nutrition-related issues.Creating a healthy food environment
A positive food environment will be key to fighting many NCDs. However, Branca continues that the demand for unhealthy food is driven by both marketing and individual food choice. “Additionally, the proportion of processed foods is increasing. In certain parts of the world, over 60 percent of the food we eat is ready-made or processed. We have lost the habit of eating and preparing fresh food,” he warns.

Public policy is also a crucial element of shaping the food system. Branca points to labeling regulation and taxation as effective ways for limiting unhealthy nutrients. Earlier this year it was revealed that the UK’s Soft Drink Industry Levy (SDIL), which came into effect in April 2018, has led to a sugar reduction in beverages of nearly a third, thoroughly beating the initial 20 percent target.

Other ways of encouraging healthy eating are restricting the marketing of processed foods, mass media campaigns and local-level zoning to regulate the number and nature of food outlets in a specific geography. “Public procurement also has a lot of potential. Vast numbers of meals are purchased daily. If these meals are in line with health guidelines, then the people eating the meal will have a better diet, helping shift demand toward healthier options,” explains Branca.  

He also highlights the importance of accessible price-points. “There are different ways of shaping the food environment so people have easier access to healthy foods. By changing these price dynamics, more people are likely to afford healthy food, which tends to be more expensive.”

Updating nutrient intake goalsMany countries face challenges and need more support to implement solutions.
In another move to prevent NCDs, the WHO’s NHD is also updating the population nutrient intake goals. This is through the work of the Nutrition Guidance Expert Advisory Group (NUGAG) Subgroup on Diet and Health, and follows a 2012 update on sodium and potassium intake and a 2015 update on sugars. 

Next week, the board will convene in Qingdao, China, to update guidance on the intake of total fat, saturated fatty acids, trans-fatty acids, polyunsaturated fatty acids, non-sugar sweeteners and carbohydrates, including dietary fiber. Branca anticipates that the guidance will be released toward the end of next year or in early 2021. “Once our guidelines are updated, there is generally a very rapid uptake at a national level,” he adds.

“These recommendations are important because they are based on the latest scientific evidence. We take a systematic look at whatever has been published, before grading the quality of the evidence. This is to ensure that we are using the best scientific understanding,” concludes Branca. 

However, experts at the European Nutrition Conference in Ireland recently argued that societal themes such as sustainability and technology should also be taken into account when developing food-based dietary guidelines. 

By Katherine Durrell