Nutritional impact on health

Peter Sousa HoejskovT h i l Offi F d S f t & NCDTechnical Officer – Food Safety & NCD

WHO Division of Pacific Technical Support (DPS) Suva, Fiji

Nutrition and its challenges – Briefing on the Second International Conference on Nutrition (ICN2), FAORAP, 29 October 2014

Asia and the Pacific is challenged by a double burden of malnutritionby a double burden of malnutrition

Nutrition is the key to good health and prosperityprosperity

• Malnutrition increases risk for morbidity and mortality throughout the life-course

• Malnutrition has economic, social and d l t l t ddevelopmental consequences at macro and micro levelsLo and middle income co ntries are orse• Low and middle income countries are worse affected

• Individuals and families with low levels of• Individuals and families with low levels of education are relative worse off

Diet related NCD risk factors contribute to death in low middle and high income countrieslow, middle and high income countries

Source: WHO (2009)

Prevalence of underweight children under age 5 by education level of mother (%)education level of mother (%)

17.418 0

20.0

11 7

15.1

14.0

16.0

18.0

11.7

6.9

10.7

8.9

8.0

10.0

12.0

6.2

3.6

5.1

3.12.8 2.52 0

4.0

6.0

0.0

2.0

2000 2005 2010

10

Nutrition impacts health throughout the life-course

St t d hild 20%

the life course

Undernutrition is the cause of 3 1 million

Stunted children earn 20% less than non-stunted children when they are adults (Grantham-McGregor et al, 2007)

cause of 3.1 million childhood deaths per year (Black et al, 2013)

15 million people are blind as a result of diabetes (WHO, 2009

People with diabetes are 3 times more likely to develop tuberculosis and

Poor nutrition can reduce a nation’s economic advancement by at least 8% due to losses in develop tuberculosis and

more likely to die from it (IDF, 2010)

productivity, schooling and poorer cognition (Horton & Steckel, 2013; Bhutta et al, 2008)

Primary indicators of an unhealthy diet

• Oversupply of calories (kilojoules)• Too much food, leading to high total energy intakes

• Imbalance in macronutrientsT h f t d/ d i ffi i t di t• Too much fat and/or sugar and insufficient dietary fibre

• Excessive intake of salt • Low intake of micronutrient

• Low intake of fresh fruits and vegetables

Nutrition transition in Asia and the PacificPacific

• Changing diets• Changing food supply structures

and policy environment– Globalization– Urbanization

N t h l i i i lt• New technologies in agriculture, food processing and distribution H k ti f ‘ h lth• Heavy marketing for ‘unhealthy foods’

Anaemia prevalence in high risk population groupsgroups

Source: WHO, 1993-2005

Percentage of all NCD deaths under age 70 (2008)age 70 (2008)

Age-standardized prevalence of obesity in age 20+ years (2008)age 20+ years (2008)

Age-standardized prevalence of diabetes in adults aged 25+ years (2008)adults aged 25+ years (2008)

Global and regional commitments

2010 2011 2012 2013 2014

WHO Western Pacific Regional Committee Resolution on‘Scaling up Nutrition’

Global nutrition targets by 2025g y

40% reduction in the number of children under 5 who are stuntedstunted

50% reduction of anaemia in women of reproductive age

30% reduction in low birth weight

N i hildh d i hNo increase on childhood overweight

Increase the rate of exclusive breastfeeding in the first 6 months t t l t 50%up to at least 50%

Reduce and maintain childhood wasting to less than 5%

Global voluntary targets for NCD prevention and control by 2025prevention and control by 2025

What determines food consumption?

Food availability Food access

Food awareness

Personal Preferencesy

• locally grown or imported?

• Food

• Access to shops

• $$ to buy the

• Nutrition education & promotion

• Cultural beliefs and values

available in stores

• Tools, equipment,

$$ yfood

• Time and ability to buy the food

• Food shopping and preparation skills

• Family structures & household food q p ,

seeds for home gardening

• Availability of

• Clean kitchen to ensure safe & hygienic preparation of

• Food labelling, advertising, marketing

distribution• Health status• Likes and

dislikesa ab y oland, labour, seeds, water

p epa a o ohealthy foods

g• Breastfeeding

support

d s es• Acceptability

What needs to happen?pp• Nutrition must be on national development agendas• Protect, promote and support optimal breastfeeding and

complementary feeding practices• Strengthen and enforce legal frameworks that protectStrengthen and enforce legal frameworks that protect,

promote and support healthy diets• Improve accessibility, quality and implementation of

nutrition services across public health programmes and settings

• Use financing mechanisms to reinforce healthy diets and• Use financing mechanisms to reinforce healthy diets and ensure delivery and use of nutrition services

Guiding principles and approaches for actionfor action

Human rights-based approach

Life-course approach

E id i f d li i d tiEvidence-informed policies and practice

Health in all policy (multisectoral action)

Participatory approach

E l i l hEcological approach

Key messagesKey messages

Nutrition is a key to good health and prosperityNutrition is a key to good health and prosperityAsia and the Pacific is threatened by a double burden of malnutritionLow income people and countries suffer the mostHigh level regional and internationalHigh level regional and international commitments are in placeWe know what to do – but strategies, plans and g , ppolicies need to turn into action

Thank youThank you

hoejskovp@wpro.who.int