Diet related NCDs: Time for action

Abstract

Noncommunicable diseases (NCDs) are the leading cause of mortality and morbidity, and posing significant challenges both in developed and developing countries including Bangladesh. In 2016, of the total 56.9 million global deaths, 71.0%, were due to NCDs. Some 85.0% of premature deaths from NCDs, are in low and middle income countries, where greater burden of undernutrition and infectious diseases exist.^1-3 Evidence suggests a higher age specific mortality for NCDs among Bangladeshi population compared to Western populations, which putting burden on healthcare systems. ⁴ Bangladesh NCD Risk Factors Survey, 2018 showed that among the adult population, the mean salt intake was 16.5 gram per day and the prevalence of dislipidaemia was 28.4 %.⁵ Sugar consumption also continues to rise, driven by increased intake of beverages, biscuits, sweets and confectionary items. Industrially produced transfat in some food items is also an important issue in the country.

Malnutrition is a key risk factor for NCDs. Globally, nearly one in three people has at least one form of malnutrition, and this will reach one in two by 2025, based on current trends.^6-8 All forms of malnutrition are caused by unhealthy, poor quality diets. Unhealthy diets that include high sugar, salt and fat intake, malnutrition, and NCDs are closely linked. Not only on the health, malnutrition and diet related NCDs pose a substantial burden on the economy and development.

Food systems worldwide face major challenges, such as population growth, globalisation, urbanisation, and climate change. Today’s food systems are broken and do not deliver nutritious, safe, affordable, and sustainable diets; they undermine nutrition in several ways, particularly for vulnerable and marginalised populations. Billions of dollars are spent annually marketing foods high in calories, fats, sugars, and salt, and intake has increased globally, including in low income countries.⁸

United Nations (UN) is well committed to prevent and control noncommunicable diseases through adopting series of resolutions in its General Assembly.  In 2013, Member States of the World Health Organization (WHO) resolved to develop and implement national action plans, in line with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020).⁹ NCDs are also embedded in sustainable development goal (SDG) target 3.4, that is, to reduce by one-third the premature mortality from noncommunicable diseases by 2030. NCDs are also linked to other SDGs, notably SDG 1 to end poverty. In 2017, the WHO Global Conference on Noncommunicable Diseases reaffirmed noncommunicable diseases as a sustainable development priority in the Montevideo roadmap 2018–2030.¹⁰

Bangladesh has also developed the Multisectoral Action Plan for Prevention and Control                             of Noncommunicable Diseases 2018-2025, with a three-year operational plan.¹¹ Earlier the country has developed National Nutrition Policy, 2015, Second National Plan of Action for Nutrition, 2016-2025, Dietary Guidelines and other policies, strategies and action plan. The country is putting efforts for the prevention and control of malnutrition and NCDs.

Furthermore,  to prevent and control the diet related noncommunicable diseases across the life cycle nutrition labelling, re-formulation of food standards with limiting high sugar, salt and fat, and banning industrial transfats; restriction of food advertising particularly marketing of unhealthy foods to children, imposing tax on sugar sweetened drinks, junk food etc. Aimed at behavior change communication, mass-media campaigns, nutritional advice and nutrition education on NCDs in general and diet related NCDs in particular are thus recommended.