Nutritional change is not a simple answer to non-communicable diseases

Yach, Derek

doi:10.1136/bmj.d5097

Cited by 7 publications

(9 citation statements)

References 11 publications

(11 reference statements)

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“…The case of palm oil represents a more general problem that programs focused on economic development and those focused on health are often siloed. As part of the discussion around the United Nation's High-level Meeting on Non-communicable Disease Prevention and Control in September 2011, recent calls have included the development of "healthy crops" and policies that encourage their sustainability [31] and the deeper involvement of the World Health Organization in food and agricultural production to support these efforts [32]. …”

Section: Discussionmentioning

confidence: 99%

Multi-Country analysis of palm oil consumption and cardiovascular disease mortality for countries at different stages of economic development: 1980-1997

et al. 2011

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BackgroundCardiovascular diseases represent an increasing share of the global disease burden. There is concern that increased consumption of palm oil could exacerbate mortality from ischemic heart disease (IHD) and stroke, particularly in developing countries where it represents a major nutritional source of saturated fat.MethodsThe study analyzed country-level data from 1980-1997 derived from the World Health Organization's Mortality Database, U.S. Department of Agriculture international estimates, and the World Bank (234 annual observations; 23 countries). Outcomes included mortality from IHD and stroke for adults aged 50 and older. Predictors included per-capita consumption of palm oil and cigarettes and per-capita Gross Domestic Product as well as time trends and an interaction between palm oil consumption and country economic development level. Analyses examined changes in country-level outcomes over time employing linear panel regressions with country-level fixed effects, population weighting, and robust standard errors clustered by country. Sensitivity analyses included further adjustment for other major dietary sources of saturated fat.ResultsIn developing countries, for every additional kilogram of palm oil consumed per-capita annually, IHD mortality rates increased by 68 deaths per 100,000 (95% CI [21-115]), whereas, in similar settings, stroke mortality rates increased by 19 deaths per 100,000 (95% CI [-12-49]) but were not significant. For historically high-income countries, changes in IHD and stroke mortality rates from palm oil consumption were smaller (IHD: 17 deaths per 100,000 (95% CI [5.3-29]); stroke: 5.1 deaths per 100,000 (95% CI [-1.2-11.0])). Inclusion of other major saturated fat sources including beef, pork, chicken, coconut oil, milk cheese, and butter did not substantially change the differentially higher relationship between palm oil and IHD mortality in developing countries.ConclusionsIncreased palm oil consumption is related to higher IHD mortality rates in developing countries. Palm oil consumption represents a saturated fat source relevant for policies aimed at reducing cardiovascular disease burdens.

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Section: Discussionmentioning

confidence: 99%

Multi-Country analysis of palm oil consumption and cardiovascular disease mortality for countries at different stages of economic development: 1980-1997

et al. 2011

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“…During my career, I have sought to engage the broadest possible stakeholder groups required to develop evidence‐based policies and with the aim of improving public health. My experience at PepsiCo has confirmed my view about the need for scientific exchange regardless of the existence, and persistence, of disagreements about policy .…”

Section: Labelling Mattersmentioning

confidence: 52%

“…Open discourse does not imply endorsement, but it is essential if we are to provide the world with healthy and sustainable food. Through such discourse, the public sector would learn, and benefit from the knowledge, that: The myriad efforts to transform the nutrient content of foods to meet national and international norms related to salt, sugar and saturated fats across many companies represent a massive investment that could be enhanced by better public messaging about the value of such changes to health . For example, effective public sector‐led campaigns focused on the dangers of excessive salt in the diet and on the value of increasing vegetables would boost the ability of those companies to supply such products. The cheapest commodities in our diet are those that have been heavily subsidized over decades.…”

Section: What Could Be Learned Through Dialogue?mentioning

confidence: 99%

“…The more expensive ones, particularly fruits and vegetables, have become relatively more expensive over time. Efforts to address price distortions require a strong set of private–public initiatives to overcome deep resistance to change, which is historically determined and comes mainly from agribusiness interests . Industry innovation has shown that the public responds when fruits and vegetables are priced more affordably . Michigan's Double Up Food Bucks programme incentivizes purchase of locally grown products by doubling SNAP dollars up to $20 for fruits and vegetables grown in Michigan and has now expanded to over 90 stores .…”

Section: What Could Be Learned Through Dialogue?mentioning

confidence: 99%

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Food industry: friend or foe?

Yach

2013

Obesity Reviews

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Open discourse and tolerance between the food industry and public sector is limited. As a result, the public and private sectors are reluctant to collaborate on pressing nutritional issues. Those in the public sector have never heard what they could do to encourage a food company's transition towards healthier foods and beverages, whereas many in the private sector dismissed policies and actions initiated within the public sector. During my career, I have sought to engage the broadest possible stakeholder groups required to develop evidence-based policies and with the aim of improving public health. My recent experience in industry confirmed my view about the need for scientific exchange regardless of the disagreements about policy. Open discourse and partnering is essential if we are to tackle complex food and health issues and improve the global food system. Private-public engagement can provide faster and more sustainable results than government alone without impacting profits. Moreover, a high-quality product in smaller portions will have higher profit margins than a bargain-sized product of lower quality. The food industry and private sector must come together to implement innovative strategies to address urgent nutritional needs.

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“…Perhaps the central message that must emerge from the UN meeting is that a "whole of government and whole of society" approach is needed to tackle NCD. 6 Only limited progress can be made if action is expected only from within the health system. This is an important message for low and middle income countries.…”

mentioning

confidence: 99%