Abstract
Diet-related noncommunicable diseases (NCDs) are increasing rapidly in low- and middle-income countries (LMICs) and constitute a leading cause of mortality. Although a call for global action has been resonating for years, the progress in national policy development in LMICs has not been assessed. This review of strategies to prevent NCDs in LMICs provides a benchmark against which policy response can be tracked over time. We reviewed how government policies in LMICs outline actions that address salt consumption, fat consumption, fruit and vegetable intake, or physical activity. A structured content analysis of national nutrition, NCDs, and health policies published between 1 January 2004 and 1 January 2013 by 140 LMIC members of the World Health Organization (WHO) was carried out. We assessed availability of policies in 83% (116/140) of the countries. NCD strategies were found in 47% (54/116) of LMICs reviewed, but only a minority proposed actions to promote healthier diets and physical activity. The coverage of policies that specifically targeted at least one of the risk factors reviewed was lower in Africa, Europe, the Americas, and the Eastern Mediterranean compared to the other two World Health Organization regions, South-East Asia and Western Pacific. Of the countries reviewed, only 12% (14/116) proposed a policy that addressed all four risk factors, and 25% (29/116) addressed only one of the risk factors reviewed. Strategies targeting the private sector were less frequently encountered than strategies targeting the general public or policy makers. This review indicates the disconnection between the burden of NCDs and national policy responses in LMICs. Policy makers urgently need to develop comprehensive and multi-stakeholder policies to improve dietary quality and physical activity.
Highlights
Noncommunicable diseases (NCDs) are the leading cause of death globally
AND [‘‘Policy’’ OR ‘‘Strategies’’ OR ‘‘Actions’’]) for all publicly available national policies related to diet, nutrition, NCDs, and health in the countries classified as low- and middle-income countries (LMICs) by the World Bank in 2011 [25]
Of the 140 LMICs found in the six World Health Organization (WHO) regions (Africa, Europe, the Americas, South-East Asia, the Eastern Mediterranean, and the Western Pacific), we found information on the availability of policies for 83% (116/140) countries (Figure 2; Table S1)
Summary
Noncommunicable diseases (NCDs) are the leading cause of death globally. Of the 57 million global deaths in 2008, 36 million (63%) were due to NCDs, principally cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases [1]. Diet-related noncommunicable diseases (NCDs) are increasing rapidly in low- and middle-income countries (LMICs) and constitute a leading cause of mortality. In 2004, the World Health Organization (WHO) adopted the Global Strategy on Diet, Physical Activity and Health It recommended that individuals achieve energy balance and a healthy weight; limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats and towards the elimination of trans-fatty acids; increase consumption of fruits, vegetables, legumes, whole grains, and nuts; limit the intake of free sugars; and limit salt consumption from all sources and ensure that salt is iodized. It recommended at least 30 minutes of regular, moderate-intensity physical activity on most days throughout a person’s life
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