Diet, Nutrition and the Prevention of Chronic Diseases


WHO Technical Report Series
916

Report of a Joint WHO/FAO Expert Consultation

WORLD HEALTH ORGANIZATION

FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS




Table of Contents


Shifting dietary patterns, a decline in energy expenditure associated with a sedentary lifestyle, an ageing population - together with tobacco use and alcohol consumption - are major risk factors for noncommunicable diseases and pose an increasing challenge to public health.

This report of a Joint WHO/FAO Expert Consultation reviews the evidence on the effects of diet and nutrition on chronic diseases and makes recommendations for public health policies and strategies that encompass societal, behavioural and ecological dimensions. Although the primary aim of the Consultation was to set targets related to diet and nutrition, the importance of physical activity was also emphasized.

The Consultation considered diet in the context of the macroeconomic implications of public health recommendations on agriculture and the global supply and demand for fresh and processed foodstuffs. In setting out ways to decrease the burden of chronic diseases such as obesity, type 2 diabetes, cardiovascular diseases (including hypertension and stroke), cancer, dental diseases and osteoporosis, this report proposes that nutrition should be placed at the forefront of public health policies and programmes.

This report will be of interest to policy-makers and public health professionals alike, in a wide range of disciplines including nutrition, general medicine and gerontology. It shows how, at the population level, diet and exercise throughout the life course can reduce the threat of a global epidemic of chronic diseases.




Table of Contents


Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases

Abbreviations

1. Introduction

Reference

2. Background

2.1 The global burden of chronic diseases
2.2 The double burden of diseases in the developing world
2.3 An integrated approach to diet-related and nutrition-related diseases
References

3. Global and regional food consumption patterns and trends

3.1 Introduction
3.2 Developments in the availability of dietary energy
3.3 Availability and changes in consumption of dietary fat
3.4 Availability and changes in consumption of animal products
3.5 Availability and consumption of fish
3.6 Availability and consumption of fruits and vegetables
3.7 Future trends in demand, food availability and consumption
3.8 Conclusions
References

4. Diet, nutrition and chronic diseases in context

4.1 Introduction
4.2 Diet, nutrition and the prevention of chronic diseases through the life course

4.2.1 Fetal development and the maternal environment
4.2.2 Infancy
4.2.3 Childhood and adolescence
4.2.4 Adulthood
4.2.5 Ageing and older people

4.3 Interactions between early and later factors throughout the life course

4.3.1 Clustering of risk factors
4.3.2 Intergenerational effects

4.4 Gene-nutrient interactions and genetic susceptibility
4.5 Intervening throughout life
References

5. Population nutrient intake goals for preventing diet-related chronic diseases

5.1 Overall goals

5.1.1 Background
5.1.2 Strength of evidence
5.1.3 A summary of population nutrient intake goals
References

5.2 Recommendations for preventing excess weight gain and obesity

5.2.1 Background
5.2.2 Trends
5.2.3 Diet, physical activity and excess weight gain and obesity
5.2.4 Strength of evidence
5.2.5 General strategies for obesity prevention
5.2.6 Disease-specific recommendations
References

5.3 Recommendations for preventing diabetes

5.3.1 Background
5.3.2 Trends
5.3.3 Diet, physical activity and diabetes
5.3.4 Strength of evidence
5.3.5 Disease-specific recommendations
References

5.4 Recommendations for preventing cardiovascular diseases

5.4.1 Background
5.4.2 Trends
5.4.3 Diet, physical activity and cardiovascular disease
5.4.4 Strength of evidence
5.4.5 Disease-specific recommendations
References

5.5 Recommendations for preventing cancer

5.5.1 Background
5.5.2 Trends
5.5.3 Diet, physical activity and cancer
5.5.4 Strength of evidence
5.5.5 Disease-specific recommendations
References

5.6 Recommendations for preventing dental diseases

5.6.1 Background
5.6.2 Trends
5.6.3 Diet and dental disease
5.6.4 Strength of evidence
5.6.5 Disease-specific recommendations
References

5.7 Recommendations for preventing osteoporosis

5.7.1 Background
5.7.2 Trends
5.7.3 Diet, physical activity and osteoporosis
5.7.4 Strength of evidence
5.7.5 Disease-specific recommendations
References

6. Strategic directions and recommendations for policy and research

6.1 Introduction
6.2 Policy principles for the promotion of healthy diets and physical activity
6.3 Prerequisites for effective strategies

6.3.1 Leadership for effective action
6.3.2 Effective communication
6.3.3 Functioning al liances and partnerships
6.3.4 Enabling environments

6.4 Strategic actions for promoting healthy diets and physical activity

6.4.1 Surveillance of people’s diets, physical activity and related disease burden
6.4.2 Enabling people to make informed choices and take effective action
6.4.3 Making the best use of standards and legislation
6.4.4 Ensuring that “healthy diet” components are available to all
6.4.5 Achieving success through intersectoral initiatives
6.4.6 Making the best of health services and the professionals who provide them

6.5 Call to action
Reference

Acknowledgements

Annex. Summary of the strength of evidence for obesity, type 2 diabetes, cardiovascular disease (CVD), cancer, dental disease and osteoporosis

Selected WHO publications of related interest

Back cover


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World Health Organization

Geneva 2003

WHO Library Cataloguing-in-Publication Data

Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases (2002: Geneva, Switzerland)
Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation, Geneva, 28 January - 1 February 2002.

(WHO technical report series; 916)

1. Chronic disease - epidemiology 2. Diet - standards
3. Feeding behavior 4. Energy metabolism 5. Motor activity
6. Cost of illness I. Title II. Series.

ISBN 92 4 120916 X

(NLM classification: QU 145)

ISSN 0512-3054


© World Health Organization 2003

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