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      Policy coherence of price controls on food and noncommunicable disease prevention, WHO South-East Asia and Western Pacific regions Translated title: Cohérence des politiques de contrôle des prix des denrées alimentaires et prévention des maladies non transmissibles, régions d'Asie du Sud-Est et du Pacifique occidental de l'OMS Translated title: Coherencia de las políticas de control de precios de los alimentos y prevención de enfermedades no transmisibles en las regiones de Asia Sudoriental y el Pacífico Occidental de la OMS Translated title: الالتزام بسياسة ضوابط الأسعار فيما يتصل بالغذاء والوقاية من الأمراض غير المعدية، مناطق منظمة الصحة العالمية في جنوب شرق آسيا وغرب المحيط الهادئ Translated title: 世界卫生组织在东南亚和西太平洋地区就食品价格管制和非传染性疾病预防问题实施一致的政策 Translated title: Согласованность политики контроля цен на продукты питания и профилактики неинфекционных заболеваний, регионы ВОЗ Юго-Восточной Азии и Западной части Тихого океана

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          Abstract

          Noncommunicable diseases are the leading cause of death and disability globally, with suboptimal diet being a significant risk factor. Fiscal policies that promote nutritious foods have been identified as part of a best-practice package of interventions and are a focus for governments in the current context of rising food prices. Price controls are a strategy that governments commonly apply to limit mark-up on prices of specific foods, with the aim of protecting consumers and promoting food security. To date, which specific foods are being placed under price controls is unclear. This paper aimed to provide an overview of the use of food price controls in 10 Member States of the World Health Organization South-East Asia and Western Pacific regions, which have price controls on specific food commodities. The types of foods and beverages under price controls differed considerably. Many of these foods and beverages (for example, sugar-sweetened beverages and instant noodles) were not aligned with global recommendations for healthy diets and the prevention of noncommunicable diseases. Price controls are being implemented by government agencies for finance or commerce, which are generally separate from the agencies overseeing the prevention of noncommunicable diseases. Therefore, an opportunity exists for policy-makers to strengthen policy coherence of price controls on food and the prevention of diet-related noncommunicable diseases.

          Résumé

          Les maladies non transmissibles représentent la principale cause de décès et d'incapacité dans le monde, un régime alimentaire inadéquat constituant un facteur de risque important. Les politiques fiscales visant à promouvoir les aliments nutritifs ont été identifiées comme élément constitutif d'un ensemble de bonnes pratiques et intéressent les gouvernements dans le contexte actuel, marqué par la hausse des prix des denrées alimentaires. Exercer un contrôle sur les prix est une stratégie que les gouvernements appliquent fréquemment afin de limiter la marge sur les prix de certaines catégories d'aliments, dans le but de protéger les consommateurs et d'améliorer la sécurité alimentaire. À ce jour, les catégories d'aliments faisant l'objet d'un contrôle des prix ne sont pas clairement définies. L'objectif du présent document est d'offrir un aperçu de l'utilisation de ces contrôles dans 10 États Membres des régions d'Asie du Sud-Est et du Pacifique occidental de l'Organisation mondiale de la Santé, qui appliquent ce type de mécanisme sur des denrées alimentaires spécifiques. Nous avons constaté de grandes différences au niveau des catégories de boissons et aliments concernées. Nombre de ces boissons et aliments (par exemple les boissons sucrées et les nouilles instantanées) ne respectaient pas les recommandations mondiales relatives à une alimentation saine et à la prévention des maladies non transmissibles. Le contrôle des prix est mis en place par des agences gouvernementales dont les compétences relèvent de la finance ou du commerce, qui sont généralement séparées des agences chargées de la prévention des maladies non transmissibles. Les responsables politiques ont donc la possibilité de renforcer la cohérence des politiques de contrôle des prix sur les denrées alimentaires, ainsi que la prévention des maladies non transmissibles liées à l'alimentation.

          Resumen

          Las enfermedades no transmisibles son la principal causa de muerte y discapacidad en todo el mundo, y la dieta inadecuada es un factor de riesgo importante. Las políticas fiscales que promueven los alimentos nutritivos se han identificado como parte de un paquete de buenas prácticas de intervención y son un foco de atención para los gobiernos en el contexto actual de aumento de los precios de los alimentos. Los controles de precios son una estrategia que los gobiernos suelen aplicar para limitar los márgenes sobre los precios de determinados alimentos, con el objetivo de proteger a los consumidores y promover la seguridad alimentaria. Hasta la fecha, no está claro qué alimentos específicos están sometidos a control de precios. El objetivo de este documento es ofrecer una visión general del uso de los controles de precios de los alimentos en 10 Estados Miembros de las regiones de la Organización Mundial de la Salud para Asia Sudoriental y el Pacífico Occidental, que tienen controles de precios sobre productos alimenticios específicos. Los tipos de alimentos y bebidas sometidos a controles de precios diferían considerablemente. Muchos de estos alimentos y bebidas (por ejemplo, las bebidas azucaradas y los fideos instantáneos) no se ajustaban a las recomendaciones mundiales sobre dietas saludables y prevención de enfermedades no transmisibles. Los organismos gubernamentales de finanzas o comercio, que suelen ser independientes de los organismos que supervisan la prevención de las enfermedades no transmisibles, son los encargados de aplicar los controles de precios. Por lo tanto, los responsables políticos tienen la oportunidad de reforzar la coherencia política de los controles de precios de los alimentos y la prevención de las enfermedades no transmisibles relacionadas con la alimentación.

          ملخص

          تعتبر الأمراض غير المعدية هي السبب الرئيسي للوفاة والإعاقة على مستوى العالم، حيث يُشكل النظام الغذائي دون المستوى الأمثل عاملاً ملموسًا للخطر. وقد تم تحديد السياسات المالية التي تروّج للأطعمة المغذية كجزء من حزمة أفضل الممارسات الخاصة بالتدخلات، وهي محور تركيز الحكومات في السياق الحالي لأسعار المواد الغذائية المرتفعة. ضوابط الأسعار هي استراتيجية تطبقها الحكومات بشكل شائع للحد من زيادة أسعار أغذية معينة، بهدف حماية المستهلكين وتعزيز الأمن الغذائي. وحتى اليوم، لا تزال الأغذية المحددة التي تخضع لضوابط الأسعار غير واضحة. تهدف هذه الورقة إلى تقديم نظرة عامة على استخدام ضوابط أسعار المواد الغذائية في 10 دول أعضاء في منظمة الصحة العالمية، في مناطق جنوب شرق آسيا وغرب المحيط الهادئ، والتي لديها ضوابط للأسعار على سلع غذائية محددة. وقد اختلفت أنواع الأطعمة والمشروبات الخاضعة لضوابط الأسعار بشكل كبير. إن العديد من هذه الأطعمة والمشروبات (على سبيل المثال، المشروبات المحلاة بالسكر، والنودلز سريعة التحضير)، لا تتوافق مع التوصيات العالمية بشأن الأنظمة الغذائية الصحية، والوقاية من الأمراض غير المعدية. يتم تنفيذ ضوابط الأسعار بواسطة الهيئات الحكومية الخاصة بالتمويل أو التجارة، وهي منفصلة بشكل عام عن الهيئات المشرفة على الوقاية من الأمراض غير المعدية. وبالتالي، فإن هناك فرصة مهيأة لواضعي السياسات لتعزيز الالتزام بالسياسات فيما يتصل بضوابط الأسعار على الأغذية، والوقاية من الأمراض غير المعدية المرتبطة بالنظام الغذائي.

          摘要

          非传染性疾病是全球死亡和致残的主要原因,而次优饮食是一个重要的风险因素。以促进营养饮食为目标的财政政策已被纳入一揽子干预措施最佳做法,这些政策也是当前食品价格上涨背景下政府关注的重点。价格管制是各国政府通常用于限制特定食品价格上涨的一种策略,其目的在于保护消费者和促进食品安全。截至目前为止,尚不清楚哪些特定食品受到了价格管制。本文旨在概述世界卫生组织在东南亚和西太平洋地区的 10 个会员国通过实施食品价格管制政策,对特定食品进行价格管制的情况。受价格管制的食品和饮料类型差异很大。其中许多食品和饮料(例如含糖饮料和方便面)不符合全球健康饮食和非传染性疾病预防相关建议。政府金融或商业机构正在实施价格管制政策,而这些机构的职能通常与非传染性疾病预防监管机构是分开的。因此,政策制定者可利用此机会来增强食品价格管制和饮食相关非传染性疾病预防相关政策之间的一致性。

          Резюме

          Неинфекционные заболевания являются основной причиной смертности и инвалидности во всем мире, а нерациональное питание является значительным фактором риска. Фискальная политика, направленная на поощрение потребления полезных продуктов питания, была определена как часть комплекса мер, основанных на передовом опыте, и в нынешних условиях роста цен на продовольствие она является одним из приоритетов для правительств. Контроль цен – это стратегия, которую обычно применяют правительства для ограничения наценки на конкретные продукты питания с целью защиты потребителей и обеспечения продовольственной безопасности. Какие именно продукты питания попадают под контроль цен, пока неясно. Цель данного документа – представить обзор использования системы контроля цен на продовольствие в 10 государствах-членах Всемирной организации здравоохранения, входящих в регионы Юго-Восточной Азии и Западной части Тихого океана, в которых действует контроль цен на конкретные продовольственные товары. Виды продуктов питания и напитков, на которые распространяется ценовой контроль, существенно различаются. Многие из этих продуктов питания и напитков (например, подслащенные сахаром напитки и лапша быстрого приготовления) не соответствовали глобальным рекомендациям по здоровому питанию и профилактике неинфекционных заболеваний. Контроль за ценами осуществляется государственными финансовыми или торговыми ведомствами, которые, как правило, не связаны с ведомствами, контролирующими профилактику неинфекционных заболеваний. Таким образом, у ответственных лиц есть возможность усилить согласованность политики контроля цен на продукты питания и профилактики неинфекционных заболеваний, связанных с питанием.

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          Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

          Summary Background Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. Methods By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. Findings In 2017, 11 million (95% uncertainty interval [UI] 10–12) deaths and 255 million (234–274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1–5] deaths and 70 million [34–118] DALYs), low intake of whole grains (3 million [2–4] deaths and 82 million [59–109] DALYs), and low intake of fruits (2 million [1–4] deaths and 65 million [41–92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. Interpretation This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. Funding Bill & Melinda Gates Foundation.
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            Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

            Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Funding The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
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              A Global Review of Food-Based Dietary Guidelines

              ABSTRACT The objective of this review is to provide a concise, descriptive global review of current food-based dietary guidelines (FBDG), and to assess similarities and differences in key elements of a healthy diet articulated across countries. Information was sourced from the FBDG repository of the FAO, which catalogs FBDG for all countries where they are available, including a description of the food guide (the graphic representation of the dietary guidelines), a set of key messages, and downloadable documents provided by the countries. FBDG are currently available for 90 countries globally: 7 in Africa, 17 in Asia and the Pacific, 33 in Europe, 27 in Latin America and the Caribbean, 4 in the Near East, and 2 in North America. The year of publication of current versions ranges from 1986 to 2017 (mean 2009). This review provides summaries of the key messages and food guides that are used to communicate national dietary guidance, organized by food group, and evaluates the extent to which each set of FBDG includes existing recommendations articulated by the WHO. Some guidance appears nearly universally across countries: to consume a variety of foods; to consume some foods in higher proportion than others; to consume fruits and vegetables, legumes, and animal-source foods; and to limit sugar, fat, and salt. Guidelines on dairy, red meat, fats and oils, and nuts are more variable. Although WHO global guidance encourages consumption of nuts, whole grains, and healthy fats, these messages are not universally echoed across countries. Future frontiers in FBDG development include the incorporation of environmental sustainability and increased attention to sociocultural factors including rapidly changing dietary trends. Steps toward regional and global dietary recommendations could be helpful for refinement of country-level FBDG, and for clear communication and measurement of diet quality both nationally and globally.
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                Author and article information

                Journal
                Bull World Health Organ
                Bull World Health Organ
                BLT
                Bulletin of the World Health Organization
                World Health Organization
                0042-9686
                1564-0604
                01 January 2025
                06 November 2024
                : 103
                : 1
                : 43-50
                Affiliations
                [a ]The George Institute for Global Health , Level 18, International Towers 3, 300 Barangaroo Avenue, Sydney, , New South Wales, 2000 , Australia.
                [b ]deptMenzies Centre for Health Policy and Economics , The University of Sydney , Sydney, , Australia.
                [c ]Institute for Health Transformation, Deakin University, Barwon Heads , Australia.
                Author notes
                Correspondence to Bella Sträuli (email: bstraeuli@ 123456georgeinstitute.org.au ).
                Article
                BLT.24.291812
                10.2471/BLT.24.291812
                11704635
                355a0b05-d5d2-40c6-ba7c-130a96ece555
                (c) 2025 The authors; licensee World Health Organization.

                This is an open access article distributed under the terms of the Creative Commons Attribution IGO License ( http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

                History
                : 15 April 2024
                : 08 October 2024
                : 10 October 2024
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                Policy & Practice

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