Preventing disease Promoting and protecting health

Preventing disease Promoting and protecting health

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Christine Bocage Sr. Technical Officer, Food Security and Nutrition Caribbean Public Health Agency (CARPHA) Presented at the 12 th Meeting of Caribbean National Epidemiologists and Laboratory Directors Hyatt Regency, POS Trinidad, September 17-19, 2014

Overview of Presentation Background/Rationale Objectives of the Proposal Expected Results Methodology Proposed Activities Next Steps

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Background NCDs are the main cause of disability and premature deaths inlatin America and the Caribbean. In addition, cardiovascular diseases (CVDs) are the number one cause of morbidity and mortality worldwide. In the English and Dutch-speaking Caribbean, Ischaemic Heart Disease, Cerebrovascular Disease and Diabetes Mellitus are the leading causes of death.

LEADING CAUSES OF DEATH IN THE ENGLISH- AND DUTCH-SPEAKING CARIBBEAN

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean The risk of CVDs and stroke has been associated with excessive salt intake and hypertension. According to WHO (2012), by 2025, 29% of adults in the world will be expected to have elevated blood pressures if appropriate interventions are not implemented. The recommended intake of salt is <5g/day, however, the average intake in most countries range from 9g to 12 g per day.

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Background Fats and oils form part of a healthy diet but too much saturated fatty acids and trans fatty acids can be harmful. High trans fatty acids intake affects choesterol levels; metabolism of omega-3 fatty acids; and has a highly damaging effect in development and growth of the infant during pregnancy Obesity is the major risk factor for the NCDs. Major contributors are: too much fats and sugars.

Energy Availability in the Caribbean 1961-2003 2900 Calories/caput/day 2700 2500 2300 2100 1900 1700 Average Energy supply RDA 1500 19961-63 1971-73 1981-83 1991-93 2001-2003 Source: CFNI

120 Trends in Sugar Availability in 10 Selected Caribbean Countries, 2000-2009 (Grams Sugar/Caput/Day) gms sugar/caput/day 110 100 90 80 70 60 50 40 30 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Sugar Population Food Goal Source: FAO Statistics 2009: www.fao.org

90 Trends in Fat Availability in 10 Selected Caribbean Countries, 2000-2009 (grams/caput per day) 85 80 77.9 78.4 79.6 80.1 80.8 81 84 83.7 81.2 82.7 Gms Fat per Caput per day 75 70 65 60 55 50 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Population Food Goals Source: FAO Statistics 2009: www.fao.org

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Background Product reformulation, offering increased access to healthier alternatives and in some cases incentives for healthier choices have had their genesis in Social Marketing Principles. Social Marketing will help in the integration of individual and population-based initiatives (PAHO/WHO 2013).

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Objectives of the Proposal To develop National Policies on Trans Fatty Acids, Dietary Salt and Sugar Intake To provide information for designing and implementing interventions to reduce population levels of dietary salt consumption. To apply a social marketing framework to the design of salt and sugar reduction initiatives To determine the fatty acid profile (saturated, cis- and trans unsaturated fatty acid content) of selected typically consumed commercially processed foods To engage Industry (manufacturers, distributors etc) and other key stakeholders in discussions about initiating product reformulation to salt and fat and to eliminate Preventing disease, trans promoting fats and protecting health

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Expected Results Countries with a better understanding of the processes involved in population-wide salt, sugar and fat reduction initiatives Social Communication initiatives developed. Comprehensive documentation of the trans fatty acids in commonly eaten foods in the región MOU with industry to reformulate products with reduced salts, fats, and sugars National Evidence based policies and programmes developed.

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Methodology Phase I: This will focus sensitizing industry and sharing experiences from Latin America and the Caribbean Phase II: Trans fats surveys to will be conducted to determine the fatty acid profile of populations; and the fatty acid content of commercially processed foods typically consumed Phase III: Policy and Programme Development; and Reformulation of foods

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Proposed Activities Review available data on salt consumption in Lating America and the Caribbean. Organize a regional meeting for NCD Focal Points and other key stakeholders (including industry) to address concerns and share experiences re salt, fats and sugars. Conduct sessions for industry and other key stakeholders re product reformulation for salt, transfats and sugars. Conduct research to determine the transfatty acid content of processed foods; and plasma fatty acid profiles in populations of the CMSs Convene meetings of multisectoral groups to develop national policies on salt, transfats and sugars Design Information, Preventing Communication disease, promoting and and protecting Education health (IEC) programmes to facilitate behaviour change with respect to salts, fats and sugar consumption

Reducing Trans Fats, Salts and Sugars for the Prevention and Control of NCDs in the Caribbean Next Steps Receive feedback from collaborators (CARICOM, PAHO, Ministry of Health Argentina; Ministries of Health Member States) to finalize the proposal. Discussed at the Officials Meeting before the COHSOD on September 26 th 2014. Get feedback from COHSOD Meeting on September 27 th and 28 th, 2014. Finalized with collaborators and signed off.