23 April 2003, Rome -- FAO and the World Health Organization (WHO) today launched an independent expert report on diet, which will serve as the basis for developing a global strategy to combat the growing burden of chronic diseases.

Diet, Nutrition and the Prevention of Chronic Diseases, the report on a two-year-long Joint FAO/WHO Expert Consultation, was formally issued by the heads of the two agencies, who called for close cooperation to help meet the challenge.

The expert report contains the best currently available scientific evidence on the relationship of diet, nutrition and physical activity to chronic diseases. The report examines cardiovascular diseases, several forms of cancer, diabetes, obesity, osteoporosis and dental disease.

The burden of chronic diseases is rapidly increasing; in 2001, they contributed approximately 59 percent of the 56.5 million total reported deaths in the world and 46 percent of the global burden of disease. The report concludes that a diet low in saturated fats, sugars and salt, and high in vegetables and fruits, together with regular physical activity, will have a major impact on combatting this high toll of death and disease.

All countries must act more decisively to prevent chronic diseases by supporting healthier diet and physical activity behaviours. Most developing countries simply do not have the resources in their health systems, and cannot afford to manage the growing burden of chronic disease in addition to their existing health problems, the agencies said.

"No longer rich country problems"

"Cardiovascular disease, diabetes, cancers, obesity - these are no longer rich country problems," said Dr Gro Harlem Brundtland, MD, Director-General of WHO. "The majority of chronic disease cases are occurring in the developing world. Our experience shows us that even modest, but population-wide interventions on diet and physical activity, can produce significant changes in the overall chronic disease burden in a surprisingly short time. The report is significant because we will be using it as the critical science-based foundation for the WHO Global Strategy on Diet, Physical Activity and Health, which we are preparing to address this growing chronic disease burden."

The agencies stressed that solutions to the global surge in chronic diseases would require stronger linkages between those involved in health and agriculture, at global, regional and national levels.

"This report will help both FAO and WHO devise strategies to promote nutritious diets and healthier eating habits," said FAO Director-General Dr Jacques Diouf. "Today, only a minority of people in the world are eating the amounts of fruit and vegetables recommended by this report. Our organizations are facing a strong challenge on how to increase supplies of fruits and vegetables in a way that will allow all people everywhere in the world to have access to them."

The report is based on the collective judgement of a group of 30 independent experts with a global perspective, who worked with around 30 of their peers to review the best currently available evidence on diet, nutrition and its effects on chronic diseases.

The recommendations

The report's specific recommendations on diet include limiting fat to between 15 and 30 percent of total daily energy intake, and saturated fats to less than 10 percent. The report suggests that carbohydrates should provide the bulk of energy requirements - between 55 and 75 percent of daily intake, but that free (i.e. added) sugars should remain beneath 10 percent.

Daily intake of salt, which should be iodized, should be restricted to less than 5 grams a day, while the intake of fruit and vegetables should be at least 400 grams. The recommended protein intake is 10 to 15 percent. It also notes that physical activity is a key factor in determining the amount of energy spent each day and is fundamental to energy balance and weight control. One hour per day of moderate-intensity activity, such as walking, on most days of the week, is needed to maintain a healthy body weight.

"We have known for a long time that foods high in saturated fats, sugars, and salt, are bad for you; that we are, globally, increasing our intake of energy-dense, nutritionally poor food as our lives become increasingly sedentary," said Dr Brundtland. "And that these factors - together with tobacco use - are the leading causes of the great surge we have seen in the incidence of chronic diseases. What is new, is that we are laying down the foundation for a global policy response."

WHO Member States see this as a priority health issue, she said. Member States specifically asked WHO to develop the Global Strategy in consultation and collaboration with all of the major stakeholders involved in food, diet, physical activity and chronic disease.

Food and related companies are a critical element in developing a long-term solution, said Dr Brundtland, noting that she will be meeting next month with senior executives from a number of major food and beverage companies, and also with representatives of the key professional and consumer NGOs. All of this input will be considered in developing the Global Strategy, to be finalized for the WHO Executive Board in January 2004.

"The combined energy, resources and expertise of all the relevant UN agencies, health and nutrition professionals, the private sector and civil society, will be essential to sustained progress. We have made this process as transparent and inclusive as possible, while remaining committed to our constitutional mandate to improve global public health," said Dr Brundtland. "Our primary responsibility remains to our Member States and their people. Our consultations with them so far have reaffirmed both the importance of what we are doing, and the range of different problems developing countries in particular face."

A healthy choice

The two agencies note that creating an environment in which the healthy choice is the easy choice has significant implications for consumer information and labelling and for education and recreation. It also has important consequences for agricultural production and processing methods as well as trade. It is for this reason that the two agencies have committed to working closely on diet and chronic disease prevention.

According to Dr Diouf, "This report by independent experts contains a number of very interesting recommendations. They require FAO to examine trends in consumption patterns to assess how these dietary trends would need to be altered in response to the recommendations and how the food and agricultural sectors worldwide can adjust to these needs. We will also need to assess what implications that this will have for production and trade."

Dr Diouf said that the report would be presented, together with FAO's response to its findings, to the Organization's governing bodies as soon as possible. This would include an analysis of the impact of the recommendations on consumers and farmers in developing countries, many of whom are poor and undernourished.

Dr Brundtland concluded: "Long-term progress will take time. We need to look decades ahead; and make a commitment now, to the health of our current and future generations throughout the globe. The work we are embarked upon could lead to one of the largest positive shifts in population health ever undertaken."

Erwin Northoff
Information Officer, FAO
(+39) 06 5705 3105

David Porter
Media Officer, WHO
(+41) 22-791-3774
(+41) 79-477-1740