A look back on the WHO Global Strategy on Diet, Physical Activity and Health
We are about to celebrate the 10th anniversary of the World Health Organization (WHO) Global Strategy on Diet, Physical Activity and Health, which was adopted by the World Health Assembly in 2004. During the period since that was adopted, I wonder if world health has improved or gone backwards?
The Global Strategy on Diet, Physical Activity and Health describes the actions needed to support healthy diets and regular physical activity, and calls upon all stakeholders to take action at global, regional and local levels to improve diets and physical activity patterns at the population level.
WHO also developed the 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non-Communicable Diseases (NCDs) to help the millions who are already affected cope with these lifelong illnesses and prevent secondary complications. This action plan aimed to build on the WHO Framework Convention on Tobacco Control and Global Strategy on Diet, Physical Activity and Health. The plan apparently provided a roadmap to establish and strengthen initiatives for the surveillance, prevention and management of NCDs.
Additionally, the political declaration of the high-level meeting of the United Nations General Assembly on the prevention and control of non-communicable Diseases of September 2011 recognized the critical importance of reducing the level of exposure of individuals and populations to unhealthy diets and physical inactivity. The political declaration committed to advance the implementation of the WHO Global Strategy on Diet, Physical Activity and Health in the entire population.
We live in strange times. While we know we must increase the global food supply to feed the billions of people who are and will be suffering under-nutrition on our planet in the future, we also have to deal with the problems of a rapid upsurge in non-communicable disease risk factors such as obesity and overweight, particularly in urban settings.
It is not uncommon to find under-nutrition and obesity existing side by side within the same household. Many children in low- and middle-income countries are exposed to inadequate prenatal, infant and young child nutrition. At the same time, they are vulnerable to high-fat, high-sugar, high-salt, energy-dense, micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality.
These dietary patterns, in conjunction with lower levels of physical activity, result in sharp increases in childhood obesity, while under-nutrition issues remain unsolved. Despite the political declarations, lack of action has allowed such conditions to continue to rise.
The anniversary of the WHO strategy on diet and health comes at a time when the World Health Organisation is highlighting that diabetes alone affects over 220 million people globally, and the consequences of high blood sugar kill 3.4 million every year. If such statistics weren’t scary enough, the WHO is predicting deaths to double between now and 2030.
The total annual costs associated with diabetes in the U.S. alone are thought to be as high as $174 billion, with $116 billion in direct costs for medication, according to 2005-2007 American Diabetes Association figures.
The WHO website outlines that chronic diseases have led to about 63 percent of all deaths in the world. Of the 36 million people who died from chronic disease in 2008, 9 million were under 60, and 90 percent of these premature deaths occurred in low- and middle-income countries.
An estimated 17.3 million people died from cardiovascular diseases (CVDs) in 2008, representing 30 percent of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease, and 6.2 million were due to stroke. The number of people who die from CVDs, mainly heart disease and stroke, is expected to increase to 23.3 million by 2030.
Experts like Professor Michael Crawford and Dr. Dariush Mozaffarian will all tell you that most of these chronic deaths can be prevented.
Crawford will tell you that brain/mental issues are on the rise and will soon, if they have not already, supersede CVDs as the most costly of issues in both deaths and medical costs. Again, this situation can be prevented if governments actually listen to people like these eminent specialists and follow up on actions to which they agreed in 2004.
“If you eat a modest amount of fish, you dramatically decrease your risk of dying from a heart attack,” said the Harvard School of Public Health’s Mozaffarian. Findings from 30 large studies conducted around the world showed that people who consume just one or two servings of fish per week lower their risk of a fatal heart attack by an average of 36 percent, Mozaffarian said.
Not just your heart benefits when you regularly consume seafood. Research indicates that people who regularly consume fish oil are less apt to be depressed. That may be because omega-3 fatty acids raise levels of serotonin and dopamine, two brain chemicals that are thought to play a role in depression, according to Joseph Hibbeln, M.D., who studies the health benefits of fish at the U.S. National Institutes of Health. Omega-3s also seem to lower levels of brain chemicals that make you feel anxious and stressed out, Hibbeln says.
Your brain improves, too. Fish lovers suffer fewer strokes, cutting their risk by 40 percent in some studies. Mounting evidence suggests that omega-3 fatty acids help the brain with its normal, day-to-day functions. In a 2007 study of nearly 12,000 pregnant women, Hibbeln found that children born to mothers who ate more than 340 g of seafood weekly during pregnancy scored six points higher on tests of verbal intelligence than kids born to mothers who had other foods on the menu.
As for adults, a recent Swedish study found that young men who ate fish more than once a week scored nearly 11 percent higher on intelligence quotient tests than males who rarely ate seafood. In later years, fish eaters appear to be less likely to develop dementia. More advantages may be reported in years to come. Scientists are studying whether eating seafood helps prevent or treat disorders from asthma to infertility.
There is no better nutritional food than seafood, and with increased global seafood consumption, a good proportion of needless nutrition-related deaths can be avoided.
Governments around the world should see this and be aware they need to be food secure in the seafood department. Yet governments in the European Union, the United States and Australia fail this test with massive deficits in their trade balances. Pro-conservation policies at times counter efforts to grow seafood production.
What to do?
So what should we be doing if we are really serious about needless deaths, massive increasing health care costs and adding to the issues of many low- and middle-income countries that are now facing a “double burden” of disease?
Here are some thoughts that would not be hard to organize and could be measured:
• Young girls and women should be educated regarding nutrition so that as they grow and have children, the education platform can naturally expand to include seafood nutrition and health.
• Doctors and general practitioners can also use further education. Some in the medical profession still advise pregnant mothers to limit their intakes of seafood. Despite the evidence on the health benefits of regular seafood consumption, a limited number of resources are available to doctors for use in addressing the specific medical conditions of their clients.
• There is a need for a global analysis of the health consequences of limited seafood consumption in countries at different levels of development using local exposure data. This would assist in creating priority schedules, as well as give more precise numbers and costs.
• Aquaculture is the future for seafood growth. All governments need to be challenged to explain their current and future strategies for this industry based on sound science and a sensible, sustainable development platform. Additionally, all governments need to explain how they are meeting the recommendations detailed in the Joint FAO/WHO Expert Consultation on the Risks and Benefits of Fish Consumption, which outlines steps to assess and manage the risks and benefits of fish consumption, and more effectively communicate with citizens.
• The aquaculture industry needs to further adopt strict standards to ensure a disciplined approach to food safety, traceability, environmental stewardship, social and animal welfare, and ideally, quality. This then creates confidence within governments and the public and lessens the influence of overzealous critics.
(Editor’s Note: This article was originally published in the September/October 2013 print edition of the Global Aquaculture Advocate.)
Roy D. Palmer, FAICD
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Southbank VIC 3006 Australia
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