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Supporting the WHO Global Strategy on Diet Physical Activity and Health

  • Date: Dec 14 2005
  • Policy Number: 20058

Key Words: Education, Health Education, Infant Feeding, Physical Fitness

The World Health Organization (WHO) Global Strategy on Diet, Physical Activity and Health1 was ratified by the World Health Assembly2 in May of 2004 in response to the high prevalence and alarming increases in overweight and obesity throughout the world3-12

The four main objectives of the Global Strategy 1are: (1) to reduce the risk factors for non-communicable diseases that stem from unhealthy diets and physical inactivity by means of essential public health action and health-promoting and disease preventing measures; (2) to increase the overall awareness and understanding of the influences of diet and physical activity on health and of the positive impact of preventive interventions; (3) to encourage the development, strengthening and implementation of global, regional, national and community policies and action plans to improve diets and increase physical activity that are sustainable, comprehensive, and actively engage all sectors, including civil society, the private sector and the media; (4) to monitor scientific data and key influences on diet and physical activity; to support research in a broad spectrum of relevant areas, including evaluation of interventions; and to strengthen the human resources needed in this domain to enhance and sustain health.

The Global Strategy urges that member states develop:

  • leadership from all levels of government as stewards of the strategy. 
  • support for action plans, including national strategies on diet and activity, dietary guidelines and physical activity guidelines. 
  • consumer information that increases public awareness and understanding of the multiple benefits of healthy eating and physical activity by the population, as well as product labeling, advertising and marketing that is consistent with that understanding. 
  • agricultural policies consistent with protection and promotion of public health including promotion of under-consumed nutritious foods consistent with public health, fiscal policies that encourage consumption of nutritious foods and high quality foods delivered through food programs. 
  • Multisectoral policies that encourage community involvement and encourage partnerships with government agencies and with private interests.

Recognizing the importance of the WHO global strategy on diet, physical activity and health;1,2 Supporting the many partners cited in the Responsibilities for Action: Recognizing the high severity of the problems of overweight and obesity for developed countries such as the US for adults13-17 as well as children,18-21 the high burden of disease, 22-25 and high cost of this burden;26-30 Anticipating the dire consequences of overweight and obesity for developing countries;3,4,7,8 and Acknowledging the influence of the United States throughout the world in agricultural practices, food processing, and marketing and advertising of foods.31

APHA therefore

  1. Encourages the U.S. government to support other countries implementation of this WHO Global Strategy. 
  2. Encourages the government to development nutritional guidelines for its citizens to be conducted with the sole purpose of protecting the health of the public through dissemination of evidence-based guidance in dietary intake and physical activity; 
  3. Encourages development of aggressive plans to implement the 2005 Dietary Guidelines for Americans including a vigorous initiative to achieve the goals therein, especially for fruits and vegetables, low-fat milk, whole grains, and physical activity; 
  4. Encourages local, state, federal and tribal governments of the United States to provide leadership to Americans, and to the world by example, in developing strategies, insuring implementation, evaluation and monitoring the impact of actions on overweight and obesity; 
  5. Encourages local, state, federal and tribal governments of the United States to maintain the surveillance data collection processes currently conducted, and augment the collection of health and nutrition data at the local and state level including rigorous program evaluation for new and existing strategies;> 
  6. Encourages public and private funding sources to increase the availability of funds for applied research to identify and disseminate effective approaches, policies, and resources (media literacy tools), communications economics and technology transfer to be used throughout American society to encourage physical activity, consumption of health foods, and understanding of messages from private corporations aimed at purchasing and consuming increased amounts of less nutritious foods; 
  7. Urges the development of new policies and enforcement of current laws banning advertising messages that provide misinformation, and those that increase the consumption and purchase of foods of poor nutritional value by children;
  8. Encourages organizations at all levels of American society including schools, work places, and religious organizations to support nutritious food choices and physical activity through the provision and promotion of nutritious food choices and opportunities to be physically active;> 
  9. Urges the federal government to set the policies of the Department of Agriculture to be consistent with the protection and promotion of public health, and decrease and ultimately eliminate subsidy of production of foods or ingredients of minimal nutritional value; 
  10. Encourages the local, state, federal and tribal governments to develop policy for pricing strategies to decrease the price of and increase the availability of high quality fresh fruits, vegetables, low and non-fat milk, whole grains and drinking water; 
  11. Encourages the local, state, federal and tribal governments to develop policy for a variety of funding strategies to support the progress in alignment with the guidelines including increasing the price of and decreasing the availability of foods of low nutritional quality; 
  12. Encourages the federal government to continue to increase the quality of the food delivery programs through the implementation of the dietary guidelines offering more under-consumed nutritious foods (e.g. fruits and vegetables) and encouraging physical activity, as well as monitoring plans for programs such as school lunches, WIC, and food stamps; 
  13. Encourages the U.S. local, state, federal and tribal governments to promote physical activity by reviewing existing and developing new policies that encourage people powered transportation including safe walking and bike routes, and encourages public participation in developing strategies for increasing physical activity in every day life; 
  14. Promote a healthy environment at schools and work sites that includes nutritious food choices and opportunity for physical activity, providing accurate and frequent messages regarding choosing nutritious foods and encouraging activity, eliminating marketing of low nutritional quality foods and beverages, eliminating or reducing sales of low nutritional quality foods and beverages, and conducting work site wellness programs; 
  15. Encourage participation by the public in development of policies in their local, and state governments, and providing opinions and support to federal congressional delegation; 
  16. Encourage support by the public, as well as federal, state and tribal governments for strengthening of the local community built environmental through land use and zoning laws, lot preservation, community support agencies, redevelopment, and support for food outlets that provide access to nutritious foods such as supermarkets, grocery stores and restaurants; 
  17. Encourages support by government and non-government granting organizations of research to identify community and clinical strategies to identify, prevent and treat overweight and obesity at all ages including coordinated weighing, measuring, and documentation of weight during clinical visits; 
  18. Support the implementation of clinical education strategies where found to be effective, including dissemination of guidelines and delivery of educational messages through counseling, group classes, effective written, video and computer educational channels, and community programs in partnership with governmental, healthcare and business stakeholders; and> 
  19. Urges the U.S. federal and state governments to mandate the implementation and reimbursement of the documented cost effective clinical strategies by third party payers; 

References

  1. Global Strategy on Diet, Physical Activity and Health, Geneva, World Health Organization, 2004. 
  2. Fifty-Seventh World Health Assembly, Agenda Item 12.6, WHA 57.17. 
  3. The World Health Report 2002, Reducing risks, promoting healthy life. Geneva, World Health Organization, 2002. 
  4. Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H, Tuomilehto J; WHO MONICA Project. Trends in obesity and energy supply in the WHO MONICA Project. Int J Obes Relat Metab Disord. 2004 May;28(5):710-8. 
  5. Abelson P, Kennedy D. The obesity epidemic. Science. 2004 Jun 4;304(5676):1413. 
  6. Chopra M, Galbraith S, Darnton-Hill I. A global response to a global problem: the epidemic of overnutrition. Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. 
  7. Caballero B. Introduction. Symposium: Obesity in developing countries: biological and ecological factors. J Nutr. 2001 Mar;131(3):866S-870S. 
  8. Darnton-Hill I, Coyne ET. Feast and famine: socioeconomic disparities in global nutrition and health. Public Health Nutr. 1998 Mar;1(1):23-31. 
  9. Seidell JC. Obesity: a growing problem. Acta Paediatr Suppl. 1999 Feb;88(428):46-50. 
  10. Popkin BM, Doak CM. The obesity epidemic is a worldwide phenomenon. Nutr Rev. 1998 Apr;56(4 Pt 1):106-14. 
  11. Saw SM, Rajan U. The epidemiology of obesity: a review. Ann Acad Med Singapore. 1997 Jul;26(4):489-93. 
  12. de Onis M, Blossner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr. 2000 Oct;72(4):1032-9. 
  13. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994 Jul 20;272(3):205-11. 
  14. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med. 1995 Oct;149(10):1085-91. 
  15. Galuska DA, Serdula M, Pamuk E, Siegel PZ, Byers T. Trends in overweight among US adults from 1987 to 1993: a multistate telephone survey. Am J Public Health. 1996 Dec;86(12):1729-35. 
  16. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998 Jan;22(1):39-47. 
  17. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002 Oct 9;288(14):1723-7. 
  18. Ogden CL, Troiano RP, Briefel RR, Kuczmarski RJ, Flegal KM, Johnson CL. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics. 1997 Apr;99(4):E1. 
  19. Gordon-Larsen P, Adair LS, Popkin BM. The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obes Res. 2003 Jan;11(1):121-9. Erratum in: Obes Res. 2003 Apr;11(4):597. 
  20. Jolliffe D. Extent of overweight among US children and adolescents from 1971 to 2000. Int J Obes Relat Metab Disord. 2004 Jan;28(1):4-9. 
  21. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004 Jun 16;291(23):2847-50. 
  22. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991-1998. JAMA. 1999 Oct 27;282(16):1519-22.
  23. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999 Oct 27;282(16):1523-9. 
  24. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003 Jan 1;289(1):76-9. 
  25. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001 Sep 12;286(10):1195-200. 
  26. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998 Mar;6(2):97-106. 
  27. Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc. 1999 Nov;31(11 Suppl):S663-7. 
  28. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003 Jan 8;289(2):187-93. 
  29. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who's paying? Health Aff (Millwood). 2003 Jan-Jun;Suppl:W3-219-26. 31) Nestle M. Food Politics: How the Food Industry Influences Nutrition and Health (California Studies in Food and Culture). University of California Press, Berkeley and Los Angeles, CA. Copyright 2002.

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