Interventions on diet and physical activity – what works; government policy.

From: World Health Organisation

Journal rating:
rating: 90%
Study Quality:
rating: 10%
%

Overall Reliability

Article Quality:
rating: 5%
Partcipants
rating: 0%

Participants/situation

  • The paper is a review of the existing literature.

Study

  • This report by the World Health Organisation was published in 2009 and was a review of the eligible studies investigating diet and/or physical activity.
  • 937 diet studies were chosen for inclusion and 776 physical activity studies.

Results

Effective Interventions

  1. Government regulatory policies to support a healthier balance of staple foods (e.g. replacing palm with soya oil reduces the saturated fatty acid content of the oil).

  2. Environmental interventions targeting the built environment, policies that reduce barriers to physical activity, transport policies and policies to increase space for recreational activity.

  3. Point-of-decision prompts to encourage using the stairs (e.g. information on the benefits of physical activity beside elevators and stairs).

Moderately Effective Interventions

  1. Pricing strategies and point-of-purchase prompts in grocery stores, vending machines, cafeterias and restaurants to support healthier choices.

  2. Multi-targeted approaches to encourage walking and cycling to school, healthier commuting and leisure activities

Example Interventions

  1. In 1987, the Ministry of Health of Mauritius introduced a regulatory policy to change the composition of general cooking oil, limiting the content of palm oil and replacing it with soya bean oil. Five years after the intervention, total cholesterol concentrations had fallen significantly in men and women. Consumption of saturated fatty acids had decreased by an estimated 3.5% of energy intake. This activity was part of the national NCD intervention programme and a demonstration project within WHO's “Interhealth” initiative.

  2. Ciclovia is an environmental intervention targeting the built environment and a multi-targeted approach to encourage healthier commuting. In 1995, the city of Bogota in Colombia initiated a vast transformation of the physical urban environment, providing accessible pathways for nonmotorised transport and an improved public transport system. A total of 260 km and 16 routes for bicycles have now been constructed. Ciclovia happens every Sunday when 120 km of roadways are closed to motorised vehicles. Results show that women who usually participate in Ciclovia are seven times more likely to be physically active. Another result of the cycle routes is an improvement in public transport, and the prevalence of persons travelling by car has dropped from 17% to 12% during peak times

Additional

  1. "National and local governments should frame policies and provide incentives to ensure that walking, cycling and other forms of physical activity are accessible and safe; transport policies include nonmotorised modes of transportation; ... and sport and recreation facilities embody the concept of sport for all."

Answer

  • As per the results above.

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Editors Notes

  • Noncommunicable diseases (chronic disease which are not passed from person to person) are by far the leading cause of death in the world today, and their impact is steadily growing. In 2005, 35 million people died from NCDs, which represents 60% of the total number of global deaths in that year.
  • A small set of common risk factors is responsible for most of the major noncommunicable diseases: unhealthy diet, physical inactivity and tobacco use. Elimination of these modifiable risk factors would prevent 80% of premature heart disease, 80% of premature stroke, 80% of type 2 diabetes and 40% of cancer.

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