WHO calls for ‘stronger focus’ on nutrition but do recommendations go far enough?

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Global health services need to integrate a ‘stronger focus’ on optimum nutrition at different life stages, according to a new report from the World Health Organisation.

A change in approach could save 3.7m lives by 2025, WHO estimated. It could also bring countries closer to the goal of achieving universal health coverage – one of the United Nations Sustainable Development Goals (SDGs).

The WHO’s Essential Nutrition Actions​ publication is a compilation of nutrition actions to provide a tool for countries to integrate nutrition interventions into their national health and development policies.

By bringing nutrition to the fore, WHO believes progress can be made to stem rising levels of obesity. The prevalence of children considered overweight rose from 4.8% to 5.9% between 1990 and 2018, an increase of over 9 million children. Adult overweight and obesity are also rising in nearly every region and country, with 1.3 billion people overweight in 2016, of which 650 million (13% of the world’s population) are obese.

Obesity is linked to higher risk of non-communicable diseases such as diabetes, cardiovascular disease and some cancers.

WHO stressed that improving nutrition at a population level brings economic benefits. Every dollar spent on basic nutrition programmes returning US$16 to the local economy, the organisation claimed.

Investment in nutrition actions will help countries get closer to their goal of achieving universal health coverage and the Sustainable Development Goals. It can also help the economy, with every US$1 spent by donors on basic nutrition programmes returning US$16 to the local economy

“Nutrition should be positioned as one of the cornerstones of essential health packages,”​ said Dr Naoko Yamamoto, Assistant Director-General at WHO. “We also need better food environments which allow all people to consume healthy diets.”

‘Robust nutrition components’ needed: WHO

WHO said that essential health packages need to contain ‘robust nutrition components’.

However, the intragovernmental organisation stopped short of calling on national governments to take specific actions stating: “Countries will need to decide which interventions best support their national health policies, strategies and plans.”

WHO flagged some ‘key interventions’, such as iron and folic acid supplements as part of antenatal care; promoting, protecting and supporting breastfeeding; and providing advice on diet such as limiting the intake of free sugars in adults and children and limiting salt intake to reduce the risk of heart disease and stroke.

Do recommendations go far enough?

While WHO called on national governments to increase education efforts, it did not advocate more controversial measures such as marketing restrictions or so-called ‘sin taxes’ on junk food.

According to Marion Nestle, Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University, WHO should take a stronger leadership role in advocating more radical policy interventions that are shown to be effective.

“Like any other UN agency, WHO has no real power beyond leadership. Although it cannot force its member states to act, WHO can and should exert strong leadership. It should be strongly encouraging member states to enact policies to tackle obesity and its consequences,”​ she told FoodNavigator.

“We know that some policies are effective in improving food choices: taxes on sugary beverages, warning labels on ultra-processed foods, restrictions on food industry marketing of junk foods (especially to kids), controls on portion sizes, keeping junk foods out of schools, keeping food companies out of policy decisions.”

A new study, published this week in The BMJ​, served to underline the effectiveness of fiscal measures such as taxes on unhealthy foods. Through economic modelling, UK researchers found a tax on high sugar snacks such as biscuits, cakes and confectionery, would be even more effective at combatting obesity than the tax on sugary drinks, which is already in force in the UK.

The research concluded that increasing the price of biscuits, cakes, chocolates, and sweets by 20% would reduce annual average energy intake by around 8,900 calories, leading to an average weight loss of 1.3 kg over one year. A similar price increase on sugary drinks would result in an average weight loss of just 203 g over one year.

The model predicts the impact of a 20% tax would be greatest in low income households, with the highest obesity rates. “The results also suggest that price increases in high sugar snacks could also make an important contribution to reducing health inequalities driven by diet related disease​,” they concluded.