Opinion: Reshaping the food environment to reduce NCDs

Processed foods at a convenience store. Photo by: PAHO

Ultraprocessed products are food and drink products that have gone through multiple stages of industrial processing, to the point where the end product contains very little real food at all, let alone any nutritional value. Not only are ultraprocessed foods full of sugar, fats, and sodium, but they are rich in additives designed to mimic and enhance the real flavor of food, which makes us consume even more.

In 2016, 1.9 million people in Latin America and the Caribbean died from complications of diet-related conditions such as high blood pressure, high blood glucose, and obesity, which can lead to cardiovascular disease, diabetes, and specific cancers. Increasing consumption of ultraprocessed food and sugary drinks over the past three decades has been damaging the health of populations throughout Latin America and the Caribbean, so much so that poor diet now contributes to more than half of all deaths.

Furthermore, it is estimated that the consumption of processed foods has also led to an accumulated 46 million years of healthy life lost due to premature death and illness in this region. In Chile, Ecuador, and Mexico, which account for a quarter of the region’s population, the annual health care costs due to obesity alone have reached $11.6 billion.

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Some may argue that consuming ultraprocessed food and drinks is a matter of personal choice and responsibility. However, given the relentless marketing and unchecked availability of products that are cheaply produced with unhealthy ingredients, and designed to generate maximum profit at the expense of health, it is not hard to see that, as with issues such as smoking, much more must be done by governments to protect the health of their citizens.

Some countries in Latin America and the Caribbean are already paving the way in the fight against processed foods and diet-related noncommunicable diseases to ensure that the basic human right to health is respected and prioritized.

Why rules matter

Obesity and other forms of malnutrition are determined by the environment in which people live; both the physical and the economic environment disproportionately affect vulnerable populations, particularly low-income groups. Ultraprocessed products are generally available at low-cost and require little or no preparation, and are therefore attractive to at-risk groups. It is essential that appropriate measures are taken to better support people to make healthier dietary choices.

In response to the epidemic of childhood obesity, countries are taking action by implementing regulatory measures to reduce the demand for products that promote weight gain and obesity, and related diseases. For example, Mexico was the first country in the Americas to tackle the issue of sugary drinks by increasing taxes on these products. This led to a 5.5 percent drop in consumer purchases in 2014 and then a 9.7 percent drop in 2015. While it is still too early to analyze the impact of this measure on NCDs, it is projected that a 10 percent reduction in the consumption of sugary drinks among adults in Mexico will lead to 189,300 fewer cases of diabetes, 20,400 fewer cases of stroke, and will save the lives of 18,900 people between 2013 and 2022.

“Some countries in Latin America and the Caribbean are already paving the way in the fight against processed foods and diet-related noncommunicable diseases to ensure that the basic human right to health is respected and prioritized.”

Increasing prices by means of fiscal policies that can effectively lower the affordability of unhealthy products is one way to ensure that processed foods and sugary drinks are less accessible, but the mass marketing of these products, often directly to children, also promotes consumption.

In Chile, companies are prohibited from marketing unhealthy products, including those high in calories, sugar, saturated fats, and sodium, to children under age 14. Since June 2016, the country has also enforced a law to ensure that all unhealthy processed food carry front-of-package nutritional warning labels. During the first year of implementation, it was estimated that these policies positively influenced 92 percent of the population when it came to making healthy purchasing choices. In addition, the measure also encouraged the industry to change their products, and by December 2016, industry reporting indicated that approximately 18 percent of products had been reformulated.

Improving the school environment is also important. In Brazil, the national school food policy has banned the sale of sugary drinks and restricted the purchase of ultraprocessed foods within the country’s national school meals program. This policy has succeeded in helping children make healthier choices so that students within the public school system are now respectively 78 percent, 25 percent, and 21 percent more likely to regularly consumer beans, fruit, and vegetables, than students attending private schools.

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While these measures are just the tip of the iceberg, they illustrate the huge potential programs have to address the issue of unhealthy eating on health and well-being in the region.

What can we do?

In order to promote good health and reduce the negative impact of ultraprocessed foods on health in the Americas, the Pan American Health Organization’s five-year plan to prevent obesity in children and adolescents, unanimously agreed by governments of the Americas, provides a series of recommendations to encourage the promotion of healthier eating. These include imposing:

• Taxes on sugary drinks and other ultraprocessed foods to reduce their affordability.
• Bans on marketing ultraprocessed food and drinks that increase the burden of NCDs.
• Implementing front-of-package labeling to ensure that consumers can easily identify products not recommended as part of a healthy diet.
• Reshaping food settings, including in schools, workplaces, prisons, universities, institutional facilities, so that procurement focuses on fresh, local, minimally-processed foods that promote public health, the environment, and equitable socio-economic growth.

The Pan American Health Organization works to support countries in ensuring the development of policies to tackle NCDs by reshaping the food environment, strengthening the region’s health, contributing to sustainable development, and ensuring that everyone can fully exercise his or her right to health. Only through taking clear measures to tackle ultraprocessed foods will we ensure that populations in Latin America, and the world, can live healthier lives.

For more coverage of NCDs, visit the Taking the Pulse series here.

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About the authors

  • Anselm

    Anselm Hennis

    Dr. Anselm Hennis is director of the Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, World Health Organization. He graduated in medicine from the University of the West Indies and qualified in internal medicine in the U.K. Dr. Hennis was also a Wellcome Trust Fellow to the London School of Hygiene and Tropical Medicine where he obtained an M.Sc. and Ph.D. in epidemiology.
  • Fabio

    Fabio Gomes

    Dr. Fabio Gomes is the regional advisor on nutrition and physical activity at the Pan American Health Organization, World Health Organization. He is a nutritionist with a master's in population studies and social research and a Ph.D. in public health. He worked as a senior officer at the Ministry of Health in Brazil for 10 years developing strategies to promote healthy eating practices in multiple settings; mobilizing regulatory measures to reduce the demand for unhealthy products; and protecting public policies on health, food, and nutrition from opposing commercial actors.