As part of the IFPRI Egypt Seminar in partnership with the National Nutrition Committee (ASRT affiliated): "100 million healthy lives: Scientific evidence on the double burden of malnutrition in Egypt"
1. 100 million healthy lives: Scientific evidence
on the double burden of malnutrition in
Egypt
Introducing a multidimensional framework for
control of obesity
Sahar Zaghloul
National Nutrition Committee
Cairo Egypt
February 2019
2. Outline of the presentation
• Role of research in management of public
health problems.
• Obesity is a complex health problem with
many factors contributing to weight gain.
• Data needed to support decision makers for
developing sound strategies and polices.
• Research agenda to fill the gap in our
knowledge.
9. “By subsidizing foods such
as bread, sugar, edible oil,
and rice that are high in
calories but poor in
vitamins and minerals, the
system has inadvertently
incentivized people to
consume too much cheap,
calorie-rich food lacking in
nutritional value”.
Ecker et al., 2017
12. What are the data needed to support
decision makers for developing sound
strategies and polices.
14. Building a multidimensional framework for
control of obesity
Food availability, accessibility,
affordability
Food consumption
Obesity
DiabetesHypertension,
Cardiovascular diseases,
Cancer
2
15. Building a multidimensional framework for control
of obesity
Agricultural products
Import Foods
Processed Foods
Subsidized food
Distributed food aids
School canteens/ school
feeding program
Food prices
Unemployment
Poverty
GDP
Food policies/Food
security
Food availability, accessibility,
affordability
3
16. Building a multidimensional framework for control
of obesity
Food availability, accessibility,
affordability
Food consumption
Obesity
DiabetesHypertension,
Cardiovascular diseases,
Cancer
17. Building a multidimensional framework for control
of obesity
Foodconsumption Inadequate breastfeeding and poor complementary feeding
Food consumption patterns
High sugar and sweeteners beverages
High fat diet (trans fat)
High calorie diet
Low fruits and vegetables
Low dairy products
Unhealthy snacks
High caloric traditional foods
Food eaten away from home
Poor knowledge of Functional food availability
4
18. Knowledge/
Attitude/Choice
Obesogenic Environment
Walkability
Recreation areas
Food outlets
Transportation system
Iron deficiency
anemia
Stunting
Food
consumption
Building a multidimensional framework for control of
obesity --Non dietary factors recognized to date
Food
advertisement
Obesity
Diabetes
Hypertension
Cardiovascular
disease
Cancer
Microbiota
Food
availability,
accessibility,
affordability
Lack of Physical
Activity
5
19. Knowledge/
Attitude
Obesogenic
Environment
Walkability
Recreation areas
Food outlets
Transportation
system
Building a multidimensional framework for control of
obesity
Food Health
Food availability,
accessibility,
affordability
Food consumption Obesity
Diabetes
Hypertension
Cardiovascular
disease
Cancer
Agricultural products
Import Foods
Processed Foods
Subsidized food
Distributed food aids
School canteens/ school
feeding program
Food prices
Unemployment
Poverty
GDP
Food Policies
Food security
Lack of Physical Activity
Inadequate Breastfeeding and poor complementary feeding
Food consumption patterns
High sugar and sugary beverages
High fat diet (trans fat)
High calories
Low fruit and vegetables
Low dairy products
Unhealthy snacks
High caloric traditional foods
Food eaten away from home
Iron deficiency anemia
Stunting
Microbiota
Food advertisment
21. Key messages
Use of Scientific evidence to achieve a healthy and sustainable food environment
for all Egyptians and fill the gap in our knowledge by developing a research agenda
to assist decision makers to formulate sound food and nutrition related policies
and legal framework.
Raise the priority ranking of NCD prevention by comprehensive actions involving a
wide range of stakeholders in association with a research advisory committee.
Reactivation and strengthening of inter-ministerial collaboration √
Update dietary guidelines to reflect the change in the food intake, food habits and
practices of Egyptians.
Increase healthy food availability/ accessibility and physical activity environment.
Apply the healthy cities model (WHO) to link between health, nutrition and urban
planning.
Design effective, sustainable and multifaceted interventions for obesity prevention
Individual Community
Systems Policies
Each intervention alone may have minimal effects but synergism between multiple
interventions can halt the rate of obesity.
22. Naja et al., 2017)
Ranking of Egypt in peer reviewed publications
addressing nutrition in association with NCD (2006-2016 )
23. Word Health Organization
Guiding principles for the development of a
population-based childhood obesity prevention
strategy
• Integrated strategy
• Policy support from multiple levels of governance
• Equity and inclusivity
• Environmental support
• Monitoring and surveillance
• Engagement with multiple sectors and settings
27. Example: fruit and vegetable (g) per capita/day =4*3331/100/4= 33 g
Recommendations is 300 fruits and 400 g vegetables and beans for day to protect from NCD
30. What do we know?
What
•Obesity is a world health problem and is progressive
over the last 40 years.
do
•World leaders are committed to meet World Health Assembly
recommendation to halt and reverse obesity.
we
•Several interventions have been tested.
know
•No country to date has successfully reversed its
epidemic.
•WHY?
Hinweis der Redaktion
The determinants of obesity are complex and varied and it is important to recognise that no single intervention is likely to prevent childhood obesity
Environmental interventions targeting the built environment, policies that reduce barriers to physical activity, transport policies and policies to increase space for recreational activity have been demonstrated to be effective (18).
It is a trend that it is continuing as is shown in the following slides
Freedom of choice
Environmental interventions targeting the built environment, policies that reduce barriers to physical activity, transport policies and policies to increase space for recreational activity have been demonstrated to be effective (18).
Environmental interventions targeting the built environment, policies that reduce barriers to physical activity, transport policies and policies to increase space for recreational activity have been demonstrated to be effective (18).
Role of the Nutrition Committee is to help the nutrition research community in Egypt to raise the ranking of Egypt to the top of the list.
What is making it worth is 75% of the publications were investigating one nutrient / food rather than dietary pattern
the underlying determinants of health and social equity in society
Per capita protein from milk, eggs, poultry and pulses revealed a marked shortage compared to recommendations for 2-5 year old children.