Intended for healthcare professionals

Analysis Personal Paper

Nutritional change is not a simple answer to non-communicable diseases

BMJ 2011; 343 doi: (Published 11 August 2011) Cite this as: BMJ 2011;343:d5097
  1. Derek Yach, senior vice president of global health and agriculture policy
  1. 1PepsiCo, 700 Anderson Hill Road, Purchase, New York, United States
  1. derek.yach{at}
  • Accepted 3 August 2011

The United Nations high level meeting on non-communicable diseases is expected to include nutritional interventions among the suggested actions. Derek Yach warns that we should not underestimate the challenge of implementation, especially in developing countries, or ignore the vital role of agriculture

The United Nations high level meeting on non-communicable diseases in September is a once in a generation chance to chart a way forward to tackle these major threats to health. Among the many proposals being considered in the lead up to the UN meeting are nutrition based interventions such as reducing use of saturated fats and oils and salt consumption.1 The success of these interventions in developed countries has been closely related to the presence of sophisticated government agencies, behaviour change within populations, and the actions of food companies. However, the proposals underestimate the complexity and societal costs of efforts needed to shift people, particularly in developing countries, towards healthier food options. Without this recognition, the suggested actions might not lead to the desired improvement in public health.

After years of working to promote public health in South Africa and prevent and control non-communicable diseases at the World Health Organization, the Rockefeller Foundation, and most recently at PepsiCo, I believe that the prevention of chronic diseases requires new ways of working across the development sectors and between players from government, industry, academia, and non-governmental organisations.

Salty problem

Salt reduction is a good example. WHO and the US Institute of Medicine have highlighted its importance, and it has been cited as a “best buy” second only to tobacco control in terms of its potential to prevent non-communicable diseases.2 3 4 The Lancet reports that up to 8.5 million deaths could be averted in 23 high burden countries over 10 years if population-wide salt consumption is reduced by 15%.5 …

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