Diet and Physical Activity Related NonCommunicable Diseases: Challenges and Response Including the W

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Diet and Physical Activity Related
Non-Communicable Diseases Challenges and
Response Including the WHO Global Strategy on
Diet, Physical Activity and Health

• Dr. Ala Alwan,
• Assistant Director-General, World Health
  Organization, Geneva, Switzerland

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Outline

• Burden of disease and risk factors
• WHO mandates for action
• - Global Strategy for NCD prevention and Control
  and the Global Strategy on Diet, Physical
  Activity and Health

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Diet-Related Noncommunicable Diseases

• The major noncommunicable diseases
• Cardiovascular diseases
• Cancer
• Diabetes
• The main causes are 4 shared preventable risk
  factors
• Tobacco use
• Unhealthy diets
• Physical inactivity
• Harmful use of alcohol

gt Noncommunicable diseases gt
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• In 2005
• - 17.5 million people died from cardiovascular
  disease
• - 7.6 million people died of cancer
• - 1.1 million people died from diabetes

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Diet Related Noncommunicable Diseases

• 60 of deaths globally are due to Diet related
  noncommunicable diseases (NCD)
• 80 of NCDs in low middle- income countries
• - Deaths from NCDs will increase over the next 10
  yrs
• -

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Mortality due to NCDs is increasingMost deaths
occur in low-income countries
gt Noncommunicable diseases gt
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Mortality due to NCDs is increasing
gt Noncommunicable diseases gt
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Implications for economic growth

• Household level
• People living on less than US2 a day spend on
  average 10 of their budgets on tobacco products
• The cost of (long-term) care for noncommunicable
  diseases, combined with loss of income due to
  illness or care giving, can push households more
  deeply into poverty.
• There is a growing body of evidence that suggests
  that maternal food deprivation or low birth
  weight may program a child to be more prone to
  adulthood obesity and noncommunicable diseases

gt Noncommunicable diseases gt
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Reducing risk

• - Unhealthy diet causes approximately 5.3 million
  deaths a year
• - Physical inactivity causes approximately 1.9
  million deaths a year
• - Tobacco use causes 5.4 million people a year

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Saving lives
Prevention is possible
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The Need for ActionWhy?

• Cost-effective interventions exist for primary
  prevention
• Raising tobacco taxes and prices
• Improving availability and affordability of
  healthy food
• Improving transportation policies and
  environmental designs
• Raising alcohol taxes and prices
• Cost-effective interventions exist for secondary
  and tertiary prevention
• Cardiovascular disease can be prevented by
  targeting high risk people
• 75 of recurrent heart attacks and strokes can be
  prevented by 4 medicines
• Treating diabetes
• Early detection of cancer

gt Noncommunicable diseases gt
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WHO Mandates

• WHA53.17 (2000) - Global Strategy for Prevention
  and Control of Noncommunicable Diseases
• WHA 56.1 (2003) WHO Framework Convention on
  Tobacco Control
• WHA57.17 (2004) Global Strategy on Diet,
  Physical Activity and Health
• WHA60.23 (2007) Prevention and control of
  noncommunicable diseases implementation of the
  global strategy

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Relationships
Global strategy on noncommunicable diseases
Action Plan for the Global strategy on
noncommunicable diseases
2003
2004
2007
implementation
WHO Framework Convention on Tobacco Control
Global strategy on harmful use of alcohol
Global strategy on diet, physical activity and
health
Implementation of the global strategy on NCDs
gt NCD Action Plan gt
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The Global Strategy for the Prevention and
Control of Noncommunicable Diseases

• Based on a careful review of evidence and
  international experience (1989-2000)
• Endorsed by the World Health Assembly in 2000
• Addresses action required by Member States, WHO,
  and international partners

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Lessons Learned

• - NCDs are preventable through interventions
  against the common risk factors and their
  determinants
• - Strategies to reduce exposure to established
  risk factors should be combined with strategies
  to prevent the emergence of risk factors
• - To have an impact, interventions should be of
  appropriate intensity and sustained over extended
  periods of time
• - Success requires community participation,
  supportive policy decisions, legislation,
  intersectoral action and health care reforms
• - More health gains are achieved by influencing
  public policies in other sectors like trade,
  education, agriculture, food production, urban
  development and taxation than by changes in
  health policy alone.

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Key objectives of the Global Strategy

• To map the emerging epidemic of NCDs and risk
  factors and analyse determinants
• - To reduce exposure of individuals and
  populations to common risk factors (tobacco,
  unhealthy diet physical inactivity)
• - To strengthen health care to people with CVDs,
  diabetes, cancer and chronic respiratory diseases

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Key Components of the Global Strategy

• - Surveillance to quantify and track NCDs and
  their risk factors and determinants to provide
  the foundation for advocacy, national policy and
  global action
• - Promotion of health across the life course and
  prevention of risk factors are the most feasible
  approaches for many member states
• - Improving access to, and quality of, health
  care,focusing on cost-effective and equitable
  interventions for people with chronic diseases
• -

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WHO Mandates

• WHA53.17 (2000) - Global Strategy for Prevention
  and Control of Noncommunicable Diseases
• WHA 56.1 (2003) WHO Framework Convention on
  Tobacco Control
• WHA57.17 (2004) Global Strategy on Diet,
  Physical Activity and Health
• WHA60.23 (2007) Prevention and control of
  noncommunicable diseases implementation of the
  global strategy

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The Global Strategy on Diet Physical Activity and
Health (DPAS)
www.who.int/dietphysicalactivity
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Diet and Physical Activity Strategy

• Develop, strengthen, implement global, regional,
  national policies, plans to improve diets and
  increase physical activity that are sustainable,
  comprehensive and actively engage all sectors
  Improve diets and increase physical activity

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Basic Components of the Diet and Physical
Activity Strategy (DPAS)

• Public health action to reduce the risk factors
  of NCDs (at global, regional and national levels)
• Strengthening national capacity
• Supporting research and monitoring progress

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What does DPAS aim to achieve?(Basic
Recommendations)

• Achieve energy balance and a healthy weight
• Limit energy intake from total fat, and shift fat
  consumption from saturated fat to unsaturated fat
  and eliminate trans fatty acids
• Increase consumption of fruit, vegetables,
  legumes, whole grains and nuts
• Limit intake of simple sugar
• Limit intake of salt
• Engage in adequate levels of physical activity

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Pre-requisites for Effective Implementation

• Sustained political commitment
• Full engagement of other sectors
• Reliable information system
• Adopting a life-course perspective, starting with
  MCH, nutrition during pregnancy, breast feeding,
  and emphasis on school children, workers, and the
  elderly

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Why is it important to focus action in early
life ?

• - Maternal food deprivation and low birth weight
  may program a child to be more prone to adulthood
  obesity and NCDs.
• - Malnourished children are more likely to
  become obese later in life.
• - Unhealthy dietary habits and physical
  inactivity emerge and act in early life, and
  continue to have a negative impact throughout
  life course.

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DPAS

• - Multisectoral action
• - Implementation based on country needs
• - Responsibilities for action include Member
  States, WHO and international partners
• - Regional plans..

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DPAS

• WHO's role
• - Leadership
• - Technical support
• - Tools and guidelines
• - Interaction with stakeholders
• - Civil Society
• - Private sector
• - UN agencies

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Development of a set of recommendations on
marketing of foods and nonalcoholic beverages to
children
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WHO Mandates

• WHA53.17 (2000) - Global Strategy for Prevention
  and Control of Noncommunicable Diseases
• WHA 56.1 (2003) WHO Framework Convention on
  Tobacco Control
• WHA57.17 (2004) Global Strategy on Diet,
  Physical Activity and Health
• WHA60.23 (2007) Prevention and control of
  noncommunicable diseases implementation of the
  global strategy

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Objectives

• Place NCDs higher on the global and national
  development agendas and to integrate their
  prevention and control into policies across the
  whole of government
• To establish and strengthen national policies and
  plans for the prevention and control of NCDs
• Promote interventions to reduce the main shared
  modifiable risk factors for NCDs tobacco use,
  unhealthy diets, physical inactivity and harmful
  use of alcohol
• Promote research for the prevention and control
  of NCDs
• Promote partnerships for the prevention and
  control of NCDs
• Monitor NCDs and their determinants and to
  evaluate progress at the national, regional and
  global levels

gt NCD Action Plan gt
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EMRO

• WHO EMRO Plan for prevention and control of diet
  and physical activity related NCDs
• Workshop 25th March, Dubai, UAE
• Develop multisectoral approach for the prevention
  and control of NCD's