Sat, Jan 08, 2005 - Page 9 News List

The consequences of excess consumption are rarely sweet

A sedentary life at home and at work is the result of urbanization and growing food markets, and it isn't healthy

By Kaare Norum

ILLUSTRATION YUSHA

The holiday season now upon us is a time for festivity, and usually overeating. But the rampant consumption of sugar that marks this time of year is nothing to celebrate.

In fact, the seasonal upsurge in sugar consumption is just part of a huge transition in world health that is now underway. Many countries, especially developing countries, are facing the consequences of huge changes in lifestyle: modifications in diet, lower levels of physical activity, and increased tobacco use.

These changes are determined to a large extent by the globalization and expansion of food markets and by ever-greater levels of urbanization. Both of these factors incite sedentary behavior at home and at work, as well as profound alterations in dietary habits.

So it should be no surprise that noncommunicable diseases (NCDs), including cardiovascular diseases (CVDs), obesity, diabetes and cancer now kill 33 million people around the world each year and cause almost 60 percent of total deaths. Indeed, they account for almost half the global burden of disease.

By 2020, that contribution is expected to rise to 73 percent of all deaths and 60 percent of the global burden of disease. Moreover, more than 60 percent of these deaths occur in the developing world, and it is here that NCDs increasingly appear in younger age groups, which can have huge implications for how productive a country's workers are.

Recent data from China reflect the extent of the problem. In China's rural areas, with more than 800 million people, NCDs account for more than 80 percent of deaths.

Many countries are now afflicted by a double burden of diseases. Countries that still struggle with malnutrition and illnesses like malaria, tuberculosis, and HIV/AIDS must now contend with an explosion of CVDs, diabetes and obesity, as well as soaring rates of high blood pressure and high blood cholesterol.

Indeed, five of the 10 leading causes of death worldwide are related to diet and physical activity: high blood pressure, high cholesterol, low intake of fruit and vegetables, high body mass index and insufficient exercise. Clearly, effective strategies to tackle the NCD burden require a critical examination of what people are eating and their levels of physical activity.

The World Health Organization (WHO), together with a group of international experts, has developed a global strategy on diet, physical activity and health over a period of 18 months through an extensive series of consultations in more than 80 countries, and with the input of UN bodies, civic groups and food producers. One of the strategy's key conclusions is that reducing the burden of NCDs requires a multi-sectoral approach. Like a toolbox, the strategy provides WHO members with a comprehensive range of policy options from which to choose.

Governments can act. Transport ministries should provide safe roads so that children can bike to school.

Finance ministers could tax unhealthy food and subsidize healthy food.

And education ministers should demand healthy school meals.

Many countries are already developing their own national strategies. Most of what WHO is recommending has been endorsed by public-health officials for many years. But we face a global problem, with many international stakeholders, and this requires an urgent and worldwide response.

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