6. Strategic directions and recommendations for policy and research: Previous page | 1,2,3,4

6.3.2 Effective communication

Change can only be initiated through effective communication. The core role of health communication is to bridge the gap between technical experts, policy-makers and the general public. The proof of effective communications is its capacity to create awareness, improve knowledge and induce long-term changes in individual and social behaviours - in this case consumption of healthy diets and incorporating physical activity for health.

An effective health communication plan seeks to act on the opportunities at all stages of policy formulation and implementation, in order to positively influence public health. Sustained and well targeted communication will enable consumers to be better informed and make healthier choices. Informed consumers are better able to influence policy-makers; this was learned from work to limit the damage to health from tobacco use. Consumers can serve as advocates or may go on to lobby and influence their societies to bring about changes in supply and access to goods and services that support physical activity and nutritional goals.

The cost to the world of the current and projected epidemic of chronic disease related to diet and physical inactivity dwarfs all other health costs. If society can be mobilized to recognize those costs, policy-makers will eventually start confronting the issue and themselves become advocates of change. Experience shows that politicians can also be influenced by the positions taken by the United Nations agencies, and the messages that they promote. Medical networks have also been found to be effective advocates of change in the presence of a government that is responsive to the health needs of society. Consumer nongovernmental organizations and a wide variety of civil society organizations will also be critical in raising consumer consciousness and supporting the climate for constructive collaboration with the food industry and the private sector.

6.3.3 Functioning al liances and partnerships

Change can be accelerated if all groups in favour establish alliances to reach the common objective. Ideally, the effort should include a range of different parties whose actions influence people’s options and choices about diet and physical activity. Alliances for action are likely to extend from communities to national and regional levels, involving formal focal points for nutrition within different public, private and voluntary bodies. The involvement of consumers associations is also important to facilitate health and nutrition education. International organizations with nutrition-related mandates, such as FAO and WHO, are expected to encourage the routing of reliable information through these networks. Alliances with other members of the United Nations family are also important - for example, with the United Nations Children’s Fund on maternal - child nutrition and life-course approaches to health. Private sector industry with interests in food production, packaging, logistics, retailing and marketing, and other private entities concerned with lifestyles, sports, tourism, recreation, and health and life insurance, have a key role to play. Sometimes it is best to work with groups of industries rather than with individual industries that may wish to capitalize on change for their own benefit. All should be invited; those who share the health promotion objective will usually opt to participate in joint activities.

6.3.4 Enabling environments

Individual change is more likely to be facilitated and sustained if the macroenvironment and microenvironment within which choices are made support options perceived to be both healthy and rewarding. Food systems, marketing patterns and personal lifestyles should evolve in ways that make it easier for people to live healthier lives, and to choose the kinds of food that bring them the greatest health benefits. An enabling environment encompasses a wide frame of reference, from the environment at school, in the workplace and in the community, to transport policies, urban design policies, and the availability of a healthy diet. Furthermore, it requires supportive legislative, regulatory and fiscal policies to be in place. Unless there is an enabling context, the potential for change will be minimal. The ideal is an environment that not only promotes but also supports and protects healthy living, making it possible, for example, to bicycle or walk to work or school, to buy fresh fruits and vegetables, and eat and work in smoke-free rooms.

Specific actions to create enabling environments are outlined in greater detail below.

Supporting the availability and selection of nutrient-dense foods (fruits, vegetables, legumes, whole grains, lean meats and low-fat dairy products)

Within this overall concept, the issue of nutrient-dense foods versus energy-dense/nutrient-poor foods is critical as it concerns the balance between providing essential nourishment and maintaining a healthy weight. The quality of the fat and carbohydrate supplied also plays a key role. The following are all important: increasing access - especially of low-income communities - to a supply of nutrient-dense fresh foods; regulations that support this; facilitating access to high-quality diets through food pricing policies; nutrition labels to inform consumers, in particular about the appropriate use of health/nutrition claims. The provision of safe and nutritious food is now recognized not only as a human need but also as a basic right.

Assessing trends in changing consumption patterns and their implications for the food (agriculture, livestock, fisheries and horticulture) economy

Recommendations, which result in changes in dietary patterns, will have implications for all components of the food economy. Hence it is appropriate to examine trends in consumption patterns worldwide and deliberate on the potential of the food and agriculture sector to meet the demands and challenges posed by this report. All sectors in the food chain, from farm to the table, will have to be involved if the food economy is to respond to the need for changes in diets that will be necessary to cope with the burgeoning epidemic of noncommunicable diseases.

Hitherto most of the information on food consumption has been obtained from national Food Balance data. In order to understand better the relationship between food consumption patterns, diets and the emergence of noncommunicable diseases, it is crucial to obtain more reliable information on actual food consumption patterns and changing trends based on representative consumption surveys.

There is a need to monitor whether the guidelines developed in this report, and strategies based on them, will influence the behaviour of consumers and to what extent consumers will change their diets (and lifestyles) towards more healthy patterns.

The next step will be to assess the implications that these guidelines will have for agriculture, livestock, fisheries and horticulture. To meet the specified levels and patterns of consumption, new strategies may need to be developed. This assessment will need to include all stages in the food chain - from production and processing to marketing and consumption. The effects that these changes in the food economy could have on the sustainability of natural resource use would also need to be taken into account.

Likewise, international trade issues would need to be considered in the context of improving diets. Trade has an important role to play in improving food and nutrition security. Factors to consider include the impact of lower trade barriers on the purchasing power of consumers and variety of products available, while on the export side, questions of market access, competitiveness and income opportunities for domestic farmers and processors would merit attention. The impact that agricultural policy, particularly subsidies, has on the structure of production, processing and marketing systems and, ultimately, on the availability of foods that support healthy food consumption patterns will need to be examined.

Finally, assessments of the above issues, and more, will certainly have policy implications at both the national and international levels. These implications would need to be taken up in the appropriate forum and considered by the stakeholders concerned.

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