NUD 212 CONCEPT OF HEALTHY DIETS

A healthy diet includes eating a variety of foods from all food groups, in balance, and
with portion control. It also involves limiting processed and high-fat foods.
Principles of a healthy diet
 Variety: Eat a variety of foods from all food groups to ensure you get enough of all
essential nutrients.
 Balance: Don't consume one nutrient at the expense of another.
 Portion control: Understand which foods should be eaten in limited quantities.
 Fruits and vegetables: Eat lots of fruits and vegetables, which are full of vitamins,
minerals, fiber, and antioxidants.
 Protein: Get enough protein to stay strong and healthy.
 Processed foods: Limit processed foods, which are often high in fat and sugar.
 Fluids: Drink enough fluids, including water, tea, and clear soups.
 Meals: Eat regular meals at regular times.
 Exercise: Get plenty of exercise.
 Rest: Get enough rest.
A diet rich in fruits and vegetables can help lower the risk of developing disease.
FOOD AND NUTRITION SECURITY
Food security and nutrition security are related but distinct concepts that both involve
having access to nutritious food. Food security is about having enough food, while
nutrition security is about having access to the right foods

What is food security?

Food security is one of the most commonly used terms in food policy and advocacy.
According to the USDA, food security occurs for a household when “all members, at all
times, can access enough food for an active, healthy life.”
Food security focuses on whether households can reliably access enough food for all
members of the household. Furthermore, food security exists on a sliding scale where
families may experience high food security to very low food security.

 High food security and marginal food security are terms used to describe food
security.
 In contrast, low food security and very low food security are terms used to
describe food insecurity
The four main dimensions of food security:

 Physical availability of food: Food availability addresses the “supply side” of food
security and is determined by the level of food production, stock levels and net
trade.

 Economic and physical access to food: An adequate supply of food at the

national or international level does not in itself guarantee household level food
security. Concerns about insufficient food access have resulted in a greater
policy focus on incomes, expenditure, markets and prices in achieving food
security objectives.

 Food utilization: Utilization is commonly understood as the way the body makes
the most of various nutrients in the food. Sufficient energy and nutrient intake by
individuals are the result of good care and feeding practices, food preparation,
diversity of the diet and intra-household distribution of food. Combined with good
biological utilization of food consumed, this determines the nutritional status of
individuals.

 Stability of the other three dimensions over time: Even if your food intake is
adequate today, you are still considered to be food insecure if you have
inadequate access to food on a periodic basis, risking a deterioration of your
nutritional status. Adverse weather conditions, political instability, or economic
factors (unemployment, rising food prices) may have an impact on your food
security status.

For food security objectives to be realized, all four dimensions must be fulfilled
simultaneously.

What is nutrition security?

While food security is about access to a certain quantity of food, nutrition security
considers food quality. Nutrition is defined a situation where “all persons have
consistent and equitable access to healthy, safe, affordable foods essential to optimal
health and well-being.
” Nutrition security looks at the nutritional value, affordability, accessibility, and safety of
foods that promote well-being. Nutrition security also incorporates a focus on equity in
all of these areas.

Food and Nutrition Security

Food and nutrition security is one of the biggest global challenges of all. The 2030 goal
is for all people to have sufficient food available and be able to eat a healthy and
sustainable diet.

Since 2017, more people have again been suffering from hunger and food and nutrition
insecurity. The main drivers of this increase are global economic shocks, such as those
created by the COVID-19 pandemic and the war in Ukraine, as well as local conflicts in
partner countries and extreme weather conditions due to the advancing climate crisis.
Three billion people are currently unable to afford a healthy and sustainable diet and are
mainly reliant instead on staple foods such as wheat, maize and rice to meet their
calorie needs. At the same time, changing dietary patterns have led to an increase in
overweight and obesity worldwide.

Nevertheless, it is possible to provide the future population of ten billion people in 2050
with a healthy, sustainable diet while respecting planetary boundaries. This will require
a transformation of our agricultural and food systems, with a reduction in food loss and
waste, improved, more sustainable food production systems and changes in our eating
habits.

Strategy to actualize Food and Nutrition Security and sustainable Development

A. Production and supply of healthy food: Support is provided to actors along

agricultural value chains in order to increase the availability of safe and healthy food.

B. Climate-smart management of natural resources and disaster risk

management: Focus should be on the efficient use of existing resources and the
development and application of agricultural practices that preserve agro-biodiversity and
contribute to soil protection and rehabilitation.

C. Nutritional and hygiene knowledge, behaviours and practices: In order to

promote healthy eating and the correct storage, processing and preparation of food, it is
important to use gender-sensitive, participatory approaches to address people directly.
The aim is to change behaviours and create a supportive environment, for example
through gender equality measures.

Basic health, welfare, water and sanitation: Hygiene and health are prerequisites for
improved nutrient utilisation. Therefore promote access to clean drinking water and
sanitary facilities and to high-quality health services. It is also important to support
appropriate nutritional and care practices.

Social security and higher incomes: We can improve access to nutritious food and
promote social inclusion, for example through transfers and the further processing and
marketing of animal- and plant-based products. To achieve a long-term impact, these
actions should be combined with policy advice and income-generating measures.

Nutrition governance: We advise national, regional and local government partners and
institutions on the implementation of food security policies and programmes and support
multi-sectoral planning, coordination and monitoring processes.

Stabilisation, peace building and social cohesion: In the event of crises, conflicts
and natural disasters, we address the immediate need for food, protect livelihoods and
strengthen the resilience of the affected population. We act in a conflict-sensitive and
peace building manner, for example by establishing local dispute resolution
mechanisms. In terms of transitional aid, we combine short-term, medium-term and
long-term measures such as temporary social transfers and nutritional interventions with
support for the commencement or resumption of agricultural activities.

SUSTAINABLE DIETS

Sustainable diets are "dietary patterns that promote all dimensions of individuals’
health and wellbeing; have low environmental pressure and impact; are accessible,
affordable, safe and equitable; and are culturally acceptable". These diets are
nutritious, eco-friendly, economically sustainable, and accessible to people of various
socioeconomic backgrounds.[1] Sustainable diets attempt to address nutrient
deficiencies (e.g., undernourishment) and excesses (e.g., obesity), while accounting for
ecological phenomena such as climate change, loss of biodiversity and land
degradation.[3] These diets are comparable to the climatarian diet, with the added
domains of economic sustainability and accessibility.

In order to create a sustainable diet, emphasis is placed on reducing the environmental

cost incurred by food systems, including everything from production practices and
distribution to the mitigation of food waste. At an individual level, most sustainable diets
promote reduced consumption of meat and dairy products due to the particularly
adverse environmental impact of these industries. Data on the intersection between
food and sustainability has been prioritized by a variety of international bodies such as
the United Nations Food and Agriculture Organization (FAO) and the World Health
Organization (WHO)

COMPONENTS OF SUSTAINABLE DIETS

The FAO and WHO have outlined the components of a sustainable, healthy diet. The
outline divides these components into sections regarding health, environmental, and
sociocultural aspects. Each component is also in line with current United Nations
Sustainable Development Goals (SDG)

As a whole, sustainable diets emphasize:

 Starting early in life with breastfeeding and appropriate complementary feeding

 A great variety of unprocessed or minimally processed foods and drinks
 Emphasis on a plant-based diet: whole grains, legumes, nuts, fruits, and
vegetables
 Including moderate amounts of eggs, dairy, poultry, fish, and especially limiting
red meat
 Consuming primarily drinking water
 Providing adequate energy and nutrients, rather than not reaching or exceeding
needs
 Staying consistent with WHO guidelines to reduce risk of diet-related NCDs
  Consuming minimal amounts of pathogens, toxins, and other disease agents
through food
 Maintaining greenhouse gas emissions, land use, and chemical pollution targets
 Preserving biodiversity of crop, livestock, forest-derived foods, genetic resources,
and more by avoiding over farming, over hunting, and over fishing
 Minimizing the use of antibiotics and hormones in food
 Minimizing the use of plastics and plastic derivatives in food packaging
 Reducing food loss and waste
 Respecting local culture, culinary practices, and consumption patterns
 Being accessible and desirable
 Avoiding adverse gender-related impacts, especially related to time allocation for
buying or preparing food

Health

Building a sustainable diet can be analyzed throughout the human lifecycle. According
to the United Nations this starts with infant breast feeding. With age, the diet becomes
increasingly expanded. For children and adults, it includes a wide variety of minimally
processed foods that are balanced across food groups. The most sustainable approach
is a primarily plant-based diet, relying heavily on whole grains, legumes, fruits, and
vegetables. This is also supplemented by moderate amounts of eggs, dairy, poultry,
fish, and minimal red meat. Proportions are meant to be moderate, with all dietary
needs satisfied but not heavily exceeded. Finally, a healthy sustainable diet includes
safe and clean drinking water.

Environmental impact

In order to qualify as a sustainable diet using UN guidelines, a diet must keep

greenhouse gas emissions, use of fertilizers, and pollution within established targets.
The diet must also reduce the risk of non-communicable diseases and promote general
wellbeing. Additionally, foods produced in line with a sustainable diet should minimize
antibiotic and plastic use.

Sociocultural impact

An ideal sustainable diet takes into account local culture and culinary practices,
including emphasis on locally sourced food products and regional food knowledge. The
diet must also be accessible and affordable to all without disproportionately burdening
one gender over another. This is a crucial part of claiming a sustainable diet. Many
consumers do not realize the impacts of certain product production on surrounding
communities. Sustainability includes ethical sourcing. A key aspect of sociocultural
sustainability is managing and identifying product impacts on cultures, businesses, and
employees.
Diets described as sustainable

Sustainable diets are typically associated with low-carbon diets, which are structured to
combat global warming. The most important example of this is the Plant-based diet.
Other approaches focus on broader environmental factors as well as social and
economic challenges. For example, one strategy tied to region is the Mediterranean
diet, a plant-based diet that is rich in fruits, vegetables, whole-grains, legumes, and fish.

Choosing plant-based proteins promotes health, reduces greenhouse gas emissions,

and helps slow the rate of climate change. Examples of plant-based proteins include
vegetables, fruits, whole grains, legumes, nuts, and seeds. Research shows these
protein sources are low in saturated fats and high in antioxidants, which may help to
prevent cancer and cardiovascular diseases. Additionally, the high content of fiber in
plant-based proteins may help to regulate blood sugars. Therefore, choosing meat
alternatives has the potential to support health for our bodies and the environment.

One common anecdote is that location-oriented sourcing is an important component for

lowering the environmental footprint of food purchases. However, a very comprehensive
study that gathered data across more than 38k farms recently showed that this is not
the case. The carbon and net pollution footprints due to food transportation are almost
always negligible compared with other pollutant sources during production. The only
exception to this rule are avio-transported food items, which are niche products (e.g.,
most tropical fruits and nuts do not fly)

United Nations: 17 Sustainable Development Goals

In September 2015, the General Assembly of the United Nations adopted the 2030
Agenda for Sustainable Development. This includes 17 Sustainable Development Goals
(SDGs). The goals build on the vital principle of “leaving no one behind”, and
emphasizes a holistic approach to achieving sustainable development for all.

GOAL 1: No Poverty
End poverty in all its forms everywhere (eradicate extreme poverty currently measured
as people living on less than $1.25 a day.)
GOAL 2: Zero Hunger
End hunger, achieve food security and improved nutrition and promote sustainable
agriculture
GOAL 3: Good Health and Well-being
Ensure healthy lives and promote well-being for all at all ages
GOAL 4: Quality Education
Ensure inclusive and equitable quality education and promote lifelong learning
opportunities for all
GOAL 5: Gender Equality
Achieve gender equality and empower all women and girls
GOAL 6: Clean Water and Sanitation
Ensure availability and sustainable management of water and sanitation for all
GOAL 7: Affordable and Clean Energy
Ensure access to affordable, reliable, sustainable and modern energy for all
GOAL 8: Decent Work and Economic Growth
Promote sustained, inclusive and sustainable economic growth, full and productive
employment and decent work for all
GOAL 9: Industry, Innovation and Infrastructure
Build resilient infrastructure, promote inclusive and sustainable industrialization and
foster innovation
GOAL 10: Reduced Inequality
Reduce inequality within and among countries
GOAL 11: Sustainable Cities and Communities
Make cities and human settlements inclusive, safe, resilient and sustainable
GOAL 12: Responsible Consumption and Production
Ensure sustainable consumption and production patterns
GOAL 13: Climate Action
Take urgent action to combat climate change and its impacts
GOAL 14: Life Below Water
Conserve and sustainably use the oceans, seas and marine resources for sustainable
development
GOAL 15: Life on Land
Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably
manage forests, combat desertification, and halt and reverse land degradation and halt
biodiversity loss
GOAL 16: Peace and Justice Strong Institutions
Promote peaceful and inclusive societies for sustainable development, provide access
to justice for all and build effective, accountable and inclusive institutions at all levels
GOAL 17: Partnerships to achieve the Goal
Strengthen the means of implementation and revitalize the global partnership for
sustainable development.

CHALLENGES TO FOOD AND NUTRITION SECURITY

10 Key Factors Affecting Food Security

The 10 key factors affecting food security include population growth, poverty, global climate
change, political instability, food waste, natural disasters, food production, food distribution
networks, gender inequality, and malnutrition. Each of these factors has a significant impact on
the availability of food and the overall food security of a country.

Population Growth

Population growth has had a major impact on food security. A larger population puts increased
strain on the resources of a country, which makes food production and distribution more
difficult. Additionally, population growth can lead to increased poverty and inequality among
communities, as well as more pressure on water and land resources. To address this issue,
governments must invest in family planning programs and contraception to reduce the pressure
on resources.

Poverty

Poverty has a very direct and lasting impact on food security; very low food security occurs
when individuals have limited or uncertain access to adequate food, resulting in health
implications such as chronic undernutrition and other issues. Unfortunately, this is very common
in lower-income households, who cannot afford sufficient amounts of nutritious food, nor may
they be able to purchase higher-quality items that are essential for living a healthy lifestyle.

To help alleviate poverty-related issues, investments should be made into programs that increase
access to adequate food as well as those that promote employment and economic growth, both of
which are crucial components to lifting individuals out of poverty.

Global Climate Change

Global climate change is taking a devastating toll on food security as weather patterns, harvests,
and access to water and fertile land are all being affected. As temperatures continue to rise, more
extreme weather patterns become increasingly likely with profound implications for food
production.

To mitigate the harmful effects of climate change on our food security we need to act now by
investing in methods of adaptation, such as improved irrigation systems, active management of
the landscape to reduce erosion, and promoting active and healthy life with access to food and
nutrition security. We also need to take measures that directly tackle the causes of global climate
change before it is too late.

Political Instability

Political instability can have a profound impact on food security, threatening the food supply
chain and severely limiting food access for vulnerable populations. According to a report from
the Food and Agriculture Organization, food-insecure households are particularly at risk of food
insecurity during times of political unrest. To reduce this threat, efforts must be made to ensure
political stability in food-insecure countries.

This could include measures such as investing in effective crisis-management systems and
strengthening the government’s ability to respond rapidly to disruptions within the food supply
chain. By doing so, governments would be better able to fulfill their obligations towards their
citizens by providing much-needed food security.

Food Waste
Food waste is a major factor in determining food security, as wasted food resources are not
available for use. As the population continues to grow, so does the amount of food that is wasted,
which can have a major impact on food security. To reduce food waste, it is important to invest
in programs that reduce food waste, such as food waste education, food recovery and
redistribution, and sustainable waste management.

Natural Disasters

Food insecurity resulting from natural disasters is a global challenge, with food systems being
significantly impacted by extreme events like hurricanes, droughts, and floods. In the wake of
disasters, food availability can be drastically reduced due to crop failures and disruptions to food
production and distribution systems.

What’s more, food insecurity can rise as infrastructure relevant to food access – such as grocery
stores and markets – is damaged or destroyed. To mitigate these impacts on food security, the
investment must be directed toward sustainable development and disaster management solutions
that strengthen food systems and protect against the more extreme effects of natural disasters.

Food Production

Food production is a key factor when it comes to food security, as it is necessary to ensure there
is enough food to meet the needs of the population. Production of food is affected by a variety of
factors, including agricultural practices, technology, climate, and access to resources. To increase
food production and improve food security, it is important to invest in sustainable agriculture,
food security technology, and research and development.

Food Distribution Networks

Food distribution networks are an invaluable tool for providing physical and economic access to
food across the globe – without them, more people would be left without sustenance. Many
forces have a dramatic effect on these networks, from population growth to political unrest.
While infrastructure and technology play an important role in creating efficient distribution, an
investment in human capital is just as important.

As well as providing financial opportunities for workers, such investments can also make it
easier for communities to become food secure. Strengthening these networks must remain a
priority for governments and businesses around the world if we are to ensure equitable access to
food.

Gender Inequality

Gender inequality is a major factor when it comes to food security, as men and women have
different access to food and resources. Women are often the primary caregivers in households
and are responsible for the majority of food production. To address this issue, it is important to
invest in empowerment and education initiatives that focus on providing women with access to
resources and knowledge.

Malnutrition

Malnutrition is a major factor in food insecurity, as poor diets can lead to health issues and
decreased productivity. Malnutrition can be caused by poverty, lack of access to food, and
uneven access to resources. To address this issue, it is important to invest in initiatives that focus
on providing access to food, education, and health services.

EDUCATION particularly Nutrition Education

Nutrition education is as an essential catalyst for nutrition impact in food security, community
nutrition and health interventions. It is helps to improve dietary behaviour and nutrition
status. It has long-term effects on the independent actions of parents and through them on the
health of their children.

FOOD, NUTRITION, DIET AND NON-COMMUNICABLE DISEASES

KEY REASONS TO CONSIDER NCDS IN POLICIES TO ADDRESS MAJOR

NUTRITIONAL CHALLENGES

1. Non-communicable diseases (NCDs) affect people in every corner of the world.

Of 52.8 million deaths worldwide in 2010, 34.5 million were due to NCDs, including
cardiovascular diseases (coronary heart diseases, cerebrovascular diseases such as
strokes, and peripheral vascular diseases), diabetes, cancers and chronic respiratory
diseases.

About 80% of these deaths were in low- and middle-income countries (LMICs); 29% of
these deaths were in people under age 60. Once affected, people often live with the
consequences of NCDs for the rest of their lives; in 2010, NCDs contributed to 79% of
illness in the world’s population.

2. Foods, diets and nutritional status are important determinants of NCDs.

What we eat and our nutritional status can affect cardiovascular diseases, some types
of cancer and diabetes (Box 1). Foods, diet and nutritional status, including overweight
and obesity, are also associated with elevated blood pressure and blood cholesterol,
and resistance to the action of insulin. These conditions are not only risk factors for
NCDs, but major causes of illness themselves.
3. Populations around the world are increasingly exposed to foods and diets that
influence the risk of developing NCDs.

Globally, calories obtained from meat, sugars and oils and fats have been increasing
during recent decades, and those from fibre-rich foods such as whole grains, pulses
and roots have been declining. Consumption of processed and convenience foods
continue to rise rapidly in LMICs. This nutrition transition affects dietary patterns and
nutrient intake, which influence the risk of developing NCDs .

4. Undernutrition places people at risk of developing NCDs.

Undernutrition, and its effects on growth, development and maturation, has numerous
detrimental outcomes, including the potential to increase risk of developing an NCD
later in life.

5 Food systems present challenges to the prevention and control of NCDs as well as
undernutrition.

Food systems have undergone dramatic changes in past decades. It is well established
that this has had implications for nutrition, food security and environmental
sustainability. Global food system changes have also had dramatic implications for
NCDs by influencing the nutritional quality of foods that are available, affordable and
acceptable to consumers.

6. A more concerted response is needed for policy actions, governance and monitoring
and evaluation.

In 2011, the UN Political Declaration on NCDs called for population-based policies,

multi-sector action, cross-agency working and monitoring and evaluation. The World
Health Organization (WHO) has led the way in developing this global response to
NCDs. They have put into place a global architecture for addressing NCDs, including
recommendations on population-based actions and monitoring frameworks with targets

and indicators. Greater coordination is needed between this process and actions being
taken to address undernutrition and challenges in the food system. NCDs are also
conspicuously absent from the Millennium Development Goals (MDGs) and other
international development agendas. At the national level there has been a wide range of
responses, but still insufficient formulation and implementation of effective policies,
cross-sectoral governance, and monitoring and evaluation.
DIETARY PATTERNS

Consuming predominantly plant-based diets reduces the risk of developing obesity,

diabetes, cardiovascular diseases, and some forms of cancer. Plant-based diets are
high in vegetables and fruits, whole grains, pulses, nuts and seeds, and have only
modest amounts of meat and dairy. These diets help to achieve and maintain a healthy
weight, reduce blood pressure, and are also rich in sources of dietary fibre (which
protects against colorectal cancer).

FOOD AND NUTRIENTS

Fruits and vegetables independently contribute to preventing cardiovascular disease. It

is likely that particular vegetables and fruits, including cruciferous vegetables such as
cabbage and broccoli, and many fruits or vegetables that are rich in folate, also protect
from developing cancers of the colon and rectum, mouth, pharynx, larynx and
oesophagus.

Eating red and processed meat increases risk of developing colorectal cancer.
Saturated fat and trans fats increase blood cholesterol and cardiovascular risk. Higher
sodium/salt intake is a major risk factor for elevated blood pressure and cardiovascular
diseases, and probably stomach cancer.

Diets high in meat and dairy also increase blood pressure. Diets high in energy-dense,
highly-processed foods and refined starches and/or sugary beverages contribute to
overweight and obesity.

BODY COMPOSITION

Overweight and obesity is associated with increased total mortality and increased risk of

disease or death from cardiovascular diseases, diabetes, and several types of cancer. It
does so by increasing high blood pressure, blood cholesterol, insulin resistance and
inflammation as well as hormone levels.

LIFECOURSE

The provision of nutrients in the womb, and what we eat and how active we are from
birth onwards influences the size and shape of the human body throughout the life
course. These processes influence the rate at which we grow and mature from
conception to adult life, and our physical and mental development. There is a need to
understand these processes better, but they have already been shown to influence risk
of cardiovascular diseases and cancers.

Babies that are born large within the normal range and people who grow tall have a
lower risk of cardiovascular disease and diabetes in adulthood, but a greater risk of
some cancers. Conversely those who are born small have a greater risk of
cardiovascular diseases and diabetes later in life. These effects apply not just to people
who are seriously over- or under-nourished, but also across the full spectrum of growth
and body composition.

Breastfeeding also plays a role in the health of mothers and their children. For example,

the greater the sum of months a mother accumulates lactating over successive
pregnancies, the lower her risk of developing breast cancer. Breastfeeding also
promotes a healthy growth trajectory in the infant that is associated with lower risk of
later obesity.

The first thousand days from conception to the age of two are critical for the current
health of the child and also for later risk of disease in adulthood. By influencing health
and nutritional status of prospective mothers, early nutrition can also influence the
health of subsequent generations.

The science on the connection between nutrition and NCDs (www.wcrf.org

www.ncdalliance.org)

KEY ACTIONS FOR NATIONAL GOVERNMENTS

a. Develop and implement a comprehensive range of well- targeted policy

actions to provide an environment conducive to nutritious, healthy diets.
This should include the options set out in WHO and UN documents and
take a coordinated approach to undernutrition, obesity and NCDs.
b. Lists some of the policies needed to change food environments, food
systems, and create incentives for behaviour change.
c. Governments should ensure that agricultural and food policies are
supportive of health policies. They should set nutrition goals for policies,
programmes and interventions in agriculture and across all other relevant
sectors.
d. Where data is available, national governments should monitor the
implementation and effects of policies to address nutrition and NCDs
following the indicators set in international frameworks. They should also
assess the effects of agri-food systems and policies on nutrition and
NCDs.
e. Governments should ensure evaluation is incorporated early in the policy
development process and establish data collection systems where data is
lacking.
KEY ACTIONS FOR INTERNATIONAL HEALTH,

FOOD AND DEVELOPMENT AGENCIES

a The institutional architecture for NCDs and nutrition should be strengthened to ensure
different UN agencies and programmes work more effectively together, engage in
constructive dialogue, and agree on common objectives. Clear roles and responsibilities
are needed for each agency.

b In conjunction with other members of the UN Interagency Taskforce on NCDs, the

WHO should provide toolkits to enable countries to design and implement effective
policies. A toolkit should be available for all key policy actions, including a summary of
the best available evidence and how policies can more effectively address inequalities.

c Agencies should champion the prioritising of nutrition, including NCDs, across

international development agendas. The UN should integrate nutrition and NCDs into
the post-2015 development agenda, and explicitly add NCD risk factor measures to its

Scaling-Up Nutrition initiative.

Agencies should assist countries in monitoring and evaluation. They should provide
guidance on appropriate metrics where needed (e.g. in agriculture and food systems)
and collate the data for international use.

b Tools should be provided to governments to help them safeguard against conflicts of

interests in governance and policy-making.

KEY ACTIONS FOR RESEARCHERS

Researchers should engage proactively with the monitoring and evaluation of policy
actions in order to build the evidence base, and communicate the full range of available
evidence clearly and consistently to policy makers.

KEY ACTIONS FOR DONORS AND RESEARCH FUNDERS

a. Support capacity building for effective policy development in governments, the

development of a trained workforce of public health nutrition professionals, and
advocacy in civil society organisations. These are needed to enable effective
policies to be developed and implemented, sustain support for the prioritisation of
nutrition and NCDs, and overcome opposition from vested interests.
b. Support the development of data systems to enable countries to monitor and
evaluate in the many places where data is lacking.
c. Provide support to evaluation studies, including ‘rapid response’ funding streams
to allow for the collection of baseline data in response to the introduction of new
policies.
KEY ACTIONS FOR CIVIL SOCIETY

a. Civil society should act as advocates and watchdogs, by monitoring and

assessing policy actions being taken by government agencies and commercial
operators and their impact on nutrition and NCDs.
b. Civil society should build coalitions across organisations with a stake in nutrition
and NCDs for more effective global and national advocacy. They should likewise
work to develop a social movement to create demand for policy change, and
mobilise the mass media in support of nutrition and NCDs.

RECOMMENDATIONS FOR PRIORITY ACTIONS

While there are many lessons still to be learned, there is widespread agreement on a
number of priority actions needed to effect change.

N -Nutrition labelling that is clear and concise, such as interpretative

signals, on all packaged foods.

O-Offer healthy foods in school feeding, social safety net programmes and other
institutional settings, including the use of behavioural incentives.

U- Use financial instruments, such as health-oriented cash transfer programmes, and

well-targeted taxes and healthy food subsidies.

R- Restrict advertising and promotion of breast milk substitutes, and of unhealthy foods
especially to children.

I- Improve the nutritional quality of the food supply, such as through community food
production, biofortification and reformulation.

S- Set incentives and rules for retailers and traders to ensure a healthier community
food environment.

H- Harness the power of other sectors to improve nutrition governance and policy
coherence.

I- Inform the public and private sector about nutrition and health, the role of government
policy, and the need for responsible corporate actions.

N- Nutrition interventions, including support for breastfeeding and complementary

feeding, and dietary counseling in primary care.

G- Give training and education to increase skills, including targeted health literacy to
health workers.
 MODIFIABLE RISK FACTORS FOR NON-COMMUNICABLE DISEASESThe primary
modifiable risk factors for non-communicable diseases (NCDs) are tobacco use,
physical inactivity, unhealthy diets, and the harmful use of alcohol. These behaviors
contribute to increased risk of NCDs by leading to key metabolic and physiological
changes like raised blood pressure, overweight/obesity, raised blood glucose, and
raised cholesterol.

Elaboration:

Tobacco use:

Smoking is a major risk factor for a range of NCDs, including heart disease, stroke,
lung cancer, and diabetes. Tobacco accounts for over 7.2 million deaths every year
(including from the effects of exposure to second-hand smoke) and is projected to
increase markedly over the coming years.

Physical inactivity:

A lack of physical activity is linked to increased risk of obesity, cardiovascular disease,

type 2 diabetes, and some cancers. 1.6 million deaths annually can be attributed to
insufficient physical activity.

Unhealthy diets:

High intake of processed foods, saturated and trans fats, sugar, and salt, coupled with
low intake of fruits and vegetables, contribute to NCDs like obesity, type 2 diabetes, and
heart disease.

Harmful use of alcohol:

Excessive alcohol consumption is associated with increased risk of hypertension,

stroke, some cancers, and liver disease.

Modifiable behavioral risk factors

Modifiable behaviors, such as tobacco use, physical inactivity, unhealthy diet, and the
harmful use of alcohol, all increase the risk of NCDs. More than half of the 3.3 million
annual deaths attributable to alcohol use are from NCDs, including cancer.

4.1 million annual deaths have been attributed to excess salt/sodium intake.

Metabolic risk factors

Metabolic risk factors contribute to four key metabolic changes that increase the risk of
NCDs:
 a. raised blood pressure
b. overweight/obesity

c. hyperglycemia (high blood glucose levels) and

d. hyperlipidemia (high levels of fat in the blood).

In terms of attributable deaths, the leading metabolic risk factor globally is elevated
blood pressure (to which 19% of global deaths are attributed), followed by overweight
and obesity, and raised blood glucose.