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Global Strategy on Diet Physical activity and Health :

Adaptation at local and national levels to the Americas

Dr Godfrey XuerebTeam Leader

Population-based PreventionDepartment of Chronic Diseases and Health Promotion

xuerebg@who.int

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Tobacco use Unhealthy diets Physical inactivity Harmful use of alcohol

Heart disease and stroke

Diabetes

Cancer Chronic lung disease

Noncommunicable disease and risk factors

60% of global deaths due to NCDs

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High-income countries

Upper Middle-income countries

Lower middle-income countries

Low-income countries

1980 2008

% o

f pop

ulati

on

0

10%

20%

30%

40%

High blood pressure continues to go up

Raised blood pressure (2008) Source: WHO NCD Country Profiles (2010)

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0%

10%

20%

30%

40%

50%

60%

70%

High-income countries

Upper Middle-income countries

Lower middle-income countries

Low-income countries

1980 2008

% o

f pop

ulati

onOverweight continues to increase

Overweight (2008) Source: WHO NCD Country Profiles (2010)

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WHO Mandates to date

2000

2003

2004

2008

Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Diet, Physical Activity and Health

Action Plan on the Global Strategy for the Prevention and Control of NCDs

2010

2009

2011

Global Strategy to Reduce the Harmful Use of Alcohol

WHO Global Status Report on NCDs

Political Declaration on NCDs

2012+ Realizing the commitments made in the Political Declaration

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"Best buys" interventions to address NCDs

Population-based interventions addressing NCD risk factors

Tobacco use

- Excise tax increases - Smoke-free indoor workplaces and public places- Health information and warnings about tobacco - Bans on advertising and promotion

Harmful use of alcohol - Excise tax increases on alcoholic beverages - Comprehensive restrictions and bans on alcohol marketing- Restrictions on the availability of retailed alcohol

Unhealthy diet and physical inactivity

Salt reduction through mass media campaigns and reduced salt content in processed foods

Replacement of trans-fats with polyunsaturated fats Public awareness programme about diet and

physical activity

Individual-based interventionsaddressing NCDs in primary care

Cancer - Prevention of liver cancer through hepatitis B immunization- Prevention of cervical cancer through screening (visual

inspection with acetic acid [VIA]) and treatment of pre-cancerous lesions

Cardiovascular disease and diabetes - Multi-drug therapy (including glycaemic control for diabetes mellitus) for individuals who have had a heart attack or stroke, and to persons at high risk (> 30%) of a cardiovascular event within 10 years

- Providing aspirin to people having an acute heart attack

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The General Assembly adopted by consensus the resolution titled "Political Declaration of the High-level Meeting of the General Assembly on the Prevention

and Control of Non-communicable Diseases" (document A/66/L.1).

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What does the Political Declaration say on Diet & PAWhat does the Political Declaration say on Diet & PA

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What does the Political Declaration say on Diet & PAWhat does the Political Declaration say on Diet & PA

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Physical InactivityPhysical Inactivity

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Sou

rce:

W

HO

's r

epor

t on

"G

loba

l hea

lth r

isks

"

Physical inactivity - 4th leading risk factor for global mortality Physical inactivity - 4th leading risk factor for global mortality

1.5 billion adultsare insufficiently active

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Percentage of insufficient physical activity comparable country estimates, 2008Percentage of insufficient physical activity comparable country estimates, 2008

Age standardized; by WHO Region and World Bank income group, men and womenSource: Global Status Report on NCDs, WHO, 2001

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Prevalence of insufficient physical activity*, ages 15+ age standardized Males, 2008Prevalence of insufficient physical activity*, ages 15+ age standardized Males, 2008

Source: Global Status Report on NCDs, WHO, 2001

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Prevalence of insufficient physical activity*, ages 15+ age standardized Females, 2008Prevalence of insufficient physical activity*, ages 15+ age standardized Females, 2008

Source: Global Status Report on NCDs, WHO, 2001

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Being inactive costs the country and the individualBeing inactive costs the country and the individual

• New study* just released on the health care costs of physical inactivity in Canadian adults shows that the estimated direct, indirect and total health care costs in 2009 were:

Direct: 2.4 billion C$ (3.8% of overall health care costs)Indirect: 4.3 billion C$ Total Costs: 6.8 billion C$ (3.7% of overall health care costs)

• Other studies** have shown that 19% of the coronary artery disease cases in Canadian men are due to physical inactivity

* Janssen, 2012, Appl. Physiol. Nutr. Metab.** Katzmarzyk and Janssen, 2004 Can.J. Appl. Physiol.

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What does the Global Strategy SayWhat does the Global Strategy Say

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Global recommendations on PA for HealthGlobal recommendations on PA for Health

• 5-17 yrs old• At least 60 minutes of moderate to vigorous intensity PA daily.

• +18 yrs old: • At least 150 minutes of moderate-intensity aerobic PA spread

throughout the week or • At least 75 minutes of vigorous-intensity aerobic PA spread

throughout the week or an equivalent combination. • 65yrs old & above:

• Should perform PA to enhance balance and prevent falls on 3 or more days/ week.

• When they cannot do the recommended amounts of PA due to health conditions, they should be as physically active as their abilities and conditions allow.

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What does the Global Strategy SayWhat does the Global Strategy Say

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Brazil

Peru

Chile

Suriname

Guatemala

Costa Rica

Completed Survey Implementation Workshop

Data collection underway

Venezuela

Data collection complete

Ecuador

Columbia

Uruguay

Argentina*

Panama

Bolivia

Mexico

Nicaragua

Belize

Guyana

Dominican Republic

Paraguay

El Salvador

Honduras

National strategies on diet and physical activityConduct a situation analysis - GSHS

AnguillaAntigua and BarbudaBahamasBarbadosBritish Virgin IslandsCayman IslandsDominicaGrenadaGuyanaJamaicaMontserratSt. Kitts and NevisSt. LuciaSt. Vincent and the GrenadinesTrinidad and Tobago

Cuba

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National strategies on diet and physical activityNational strategies on diet and physical activity

Establish a coordinating team to develop the policy/ strategy/ programme

Review of Policies in selected Low and

Middle Income Countries

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National strategies on diet and physical activityNational strategies on diet and physical activity

Multisectoral collaboration: Coordinating mechanism headed or chaired by ministry of health. Multisectoral collaboration containing representation from all key sectors.

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What does the Global Strategy SayWhat does the Global Strategy Say

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School Policies and programsSchool Policies and programs

CARICOM supports Physical Education Standards for all Caribbean States – Feb 2011, Port of Spain.

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Introduce transport policies that promote active and safe methods of travelling to and from schools, such as walking or cycling;

Ensure that walking, cycling and other forms of physical activity are accessible to and safe for all;

Recommended actions for Member StatesRecommended actions for Member States

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Improve sports, recreation and leisure facilities

Recommended actions for Member StatesRecommended actions for Member States

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Increase the number of safe spaces available for active play

Recommended actions for Member StatesRecommended actions for Member States

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Recommended actions for Member StatesRecommended actions for Member States

UrbanPlanning

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The Floor is Yours !The Floor is Yours !

http://www.who.int/dietphysicalactivity/en/