Food as prevention – leading to nutritional challenges

Naples, Italy – The risk factors contributing to the dramatic increase in non-communicable diseases (NCDs) in recent decades have long been known, but the Covid-19 pandemic has cruelly exposed our collective failure to deal with it.

The Lancet reports on the findings of the latest Global Burden of Disease Study and warns of a ‘perfect storm’ caused by the interaction between the highly contagious Covid-19 virus and the continuing increase in chronic diseases and associated risk factors , such as obesity and high blood sugar.

The growing dangers posed by NCDs are highlighted in Good Health and Well-Being, the third of the 17 interconnected Sustainable Development Goals, which target the reduction of premature mortality by NCDs through prevention and treatment by 2030.

Yet NCDs are expected to account for 52 million deaths in 2030, representing approximately 75% of all deaths, up from 63% in 2013 and 71% in 2016. The global life expectancy increase could reach a turning point.

Cardiovascular disease is responsible for most deaths due to NCDs, followed by cancer. Diabetes is also a major killer. Deaths from Alzheimer’s disease and dementia are also increasing dramatically – partly because people in richer countries are living longer, but also because of better diagnosis and reporting of death certificates, as seen in the UK, where it is now the leading cause of death. according to the Office for National Statistics.

Many – but not all – of the risk factors leading to these NCDs are preventable and treatable through changes in unhealthy behaviors. Addressing it will have enormous social and economic benefits.

Good nutrition is the general key to reducing the risk of NCDs, even for Alzheimer’s, for which there is no cure. Recent studies cited by the World Health Organization suggest that people can reduce the risk of dementia by eating a healthy diet, as well as by exercising regularly, not smoking and avoiding harmful alcohol use.

Obesity has become a global epidemic, not just in richer countries. It is increasing in low- and middle-income countries, along with malnutrition and dwarfism. One in nine people worldwide is hungry or malnourished. One in three people is overweight or obese, according to the Global Nutrition Report 2020.

More than 650 million people around the world were classified as obese in 2016, exposing themselves to a major risk factor for cardiovascular disease, hypertension, stroke, diabetes and at least 12 types of cancer.

But as noted by Agnes Kalibata, Special Envoy for the UN 2021 Food Systems Summit, addressing the challenges of nutrition is more complex than those of hunger or food security, as it goes beyond food to cover issues of quality, access and affordability.

And so it is with obesity, a very complex aspect of malnutrition. Policies and best practices range from the development of eating guidelines and new educational programs to the introduction of taxes that discourage unhealthy consumption patterns.

Studies have shown that taxes increase prices, reduce purchases and reduce the consumption of unhealthy foods and beverages. Tax policies can also influence positive changes by reformulating the products to remove sugar, salt, fat or calories. Norway has had a tax on added sugar since 1922.

Research on NCDs should touch many bases. The Food Sustainability Index, developed by the Barilla Center for Food & Nutrition (BCFN) in partnership with the Economist Intelligence Unit, ranks 67 countries into three categories. The US ranks 34th out of 35 high-income countries in the pillar of nutritional challenges, characterized by diets high in sugar, meat, saturated fat and sodium. Japan tops the nutrition rankings, while Greece and India perform best in their income categories for the quality of their policy responses to dietary patterns.

In the European Union, around 550,000 people of working age die prematurely due to NCDs. As the leading cause of death, it costs the EU economies an estimated 115 billion euros a year, or 0.8% of GDP. More than 20% of people are obese, while about 10% of those aged 25 and older have diabetes.

Inequalities in food systems, from production to consumption, must be confronted to deal with the increase in diet-related NCDs. The vast majority of people do not have access to or afford a healthy diet. Sales of cheap but highly processed foods are rising in rich countries, but are also growing rapidly in the developing world.

The importance of nutrition and the role of food as prevention are the main themes of Reset the Food System from Farm to Fork, a conference hosted on December 1 by BCFN in partnership with Food Tank to formulate recommendations for the 2021 Food Systems Summit.

Just as there is no single silver bullet to prevent or treat obesity, we need to address a range of social inequalities – including poverty, race and housing – that deal with NCDs to increase the risk of serious illness and the death of Covid . -19.

NCDs have been critical in promoting the death toll from the virus, which has so far killed more than 1.2 million people. And in a vicious circle, the closures of Covid-19 are exacerbating poverty, forcing more people to take refuge in food banks and help deliveries to feed their families. The need to address nutritional challenges through food systems has never been so critical.

Gabriele Riccardi is Professor of Endocrinology and Metabolic Diseases, Federico II of the University of Naples; former president, Italian Association for Diabetology – SID; member of the Board of the Barilla Center for Food and Nutrition Advice, Italy

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