6. Strategic directions and recommendations for policy and research:
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The rapid increase in the consumption of animal-based foods, many of which are produced by intensive methods is likely to have a number of profound consequences. On the health side, increased consumption of animal products has led to higher intakes of saturated fats, which in conjunction with tobacco use, threatens to undermine the health gains made by reducing infectious diseases, in particular in the countries undergoing rapid economic and nutrition transition. Intensive cattle production also threatens the world’s ability to feed its poorest people, who typically have very limited access to even basic foods. Environmental concerns abound too; intensive methods of animal rearing exert greater environmental pressures than traditional animal husbandry, largely because of the low efficiency in feed conversion and high water needs of cattle.
Intensive methods of livestock production may well provide much needed income opportunities, but this is often at the expense of the farmers’ capacity to produce their own food. In contrast, the production of more diverse foods, in particular fruits, vegetables and legumes, may have a dual benefit in not only improving access to healthy foods but also in providing an alternative source of income for the farmer. This is further promoted if farmers can market their products directly to consumers, and thereby receive a greater proportion of final price. This model of food production can yield potent health benefits to both producers and consumers, and simultaneously reduce environmental pressures on water and land resources.
Agricultural policies in several countries often respond primarily to short-term commercial farming concerns rather than be guided by health and environmental considerations. For example, farm subsidies for beef and dairy production had good justification in the past - they provided improved access to high quality proteins but today contribute to human consumption patterns that may aggravate the burden of nutrition related chronic disease. This apparent disregard for the health consequences and environmental sustainability of present agricultural production, limits the potential for change in agricultural policies and food production, and at some point may lead to a conflict between meeting population nutrient intake goals and sustaining the demand for beef associated with the existing patterns of consumption. For example, if we project the consumption of beef in industrialized countries to the population of developing countries, the supply of grains for human consumption may be limited, specially for low-income groups.
Changes in agricultural policies which give producers an opportunity to adapt to new demands, increase awareness and empower communites to better address health and environmental consequences of present consumption patterns will be needed in the future. Integrated strategies aimed at increasing the responsiveness of governments to health and environmental concerns of the community will also be required. The question of how the world’s food supply can be managed so as to sustain the demands made by population-size adjustments in diet is a topic for continued dialogue by multiple stake-holders that has major consequences for agricultural and environmental policies, as well as for world food trade.
A large proportion of the world’s population currently takes an inadequate amount of physical activity to sustain physical and mental health. The heavy reliance on the motor car and other forms of laboursaving machinery has had much to do with this. Cities throughout the world have dedicated space for motor cars but little space for recreation. Changes in the nature of employment have meant that more time is spent travelling to and from work, thereby limiting the time available for the purchase and preparation of food. Cars are also contributors to growing urban problems, such as traffic congestion and air pollution.
Urban and workplace planners need to be more aware of the potential consequences of the progressive decline in occupational energy expenditure, and should be encouraged to develop transport and recreation policies that promote, support and protect physical activity. For example, urban planning, transportation and building design should give priority to the safety and transit of pedestrians and safe bicycle use.
Modern marketing practices commonly displace local or ethnic dietary patterns. Global marketing, in particular, has wide-ranging effects on both consumer appetite for goods and perceptions of their value. While some traditional diets could benefit from thoughtful modification, research has shown that many are protective of health, and clearly environmentally sustainable. Much can be learned from these.
6.4 Strategic actions for promoting healthy diets and physical activity
The strategies for promoting healthy diets and physical activity need to reflect local and national realities as well as global determinants of diet and physical activity. They must be based on scientific evidence on the ways in which people’s dietary and physical activity patterns have positive or adverse effects on health. In practice, strategies are likely to include at least some of the following practical actions.
6.4.1 Surveillance of people’s diets, physical activity and related disease burden
A surveillance system for monitoring diet, physical activity and related health problems is essential to enable all interested stakeholders to track progress towards each country’s diet-related health targets, and to guide the choice, intensity and timing of measures to accelerate achievement. The data required for implementing effective policies need to be specific for age, sex and social group, and indicate changing trends over time.
Information about fat quality, salt and sugars content, and energy density should be incorporated into nutrition and health promotion messages, and as required in food labelling tailored to different population groups - including disadvantaged population groups - through the wide reach of modern media. The ultimate goal of information and communication strategies is to assure availability and choice of better quality food, access to physical activity and a better-informed global community.
6.4.3 Making the best use of standards and legislation
The Codex Alimentarius - the intergovernmental standard-setting body through which nations agree on standards for food - is currently being reviewed. Its work in the area of nutrition and labelling could be further strengthened to cover diet-related aspects of health. The feasibility of codes of practice in food advertising should also be explored.
6.4.4 Ensuring that “healthy diet” components are available to all
As consumers increase their preference for healthy diets, producers and suppliers will wish to orient their products and marketing to respond to this emerging demand. Governments could make it easier for consumers to exercise healthier choices, in accordance with the population nutrient intake goals given in this report by, for example, promoting the wider availability of food which is less processed and low in trans fatty acids, encouraging the use of vegetable oil for domestic consumers, and ensuring an adequate and sustainable supply of fish, fruits, vegetables and nuts in domestic markets.
In the case of meals prepared outside the home (i.e. in restaurants and fast-food outlets), information about their nutritional quality should be made available to consumers in a simple manner so that they can select healthier choices. For example, consumers should be able to ascertain not only the amount of fat or oil in the meals they have chosen, but also whether they are high in saturated fat or trans fatty acids.
6. Strategic directions and recommendations for policy and research:
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