Implementation of WHO Recommended Policies and Interventions on Healthy Diet in the Countries of the Eastern Mediterranean Region: From Policy to Action

Abstract

Non-communicable diseases (NCDs) are responsible for almost two-thirds of the deaths in the 22 countries and territories of the WHO Eastern Mediterranean Region and unhealthy diets are a major contributor. Prevalence of overweight and obesity has increased among adults, adolescents and older children in recent decades. Among countries with the highest prevalence there are signs that the increase is slowing down or even that prevalence is declining. There has been no increase in the prevalence rate in younger children, although the absolute number of children under five years affected by overweight has increased. This review summarizes prevalence data and examines current implementation of regulatory, fiscal and voluntary measures to promote healthy diet across the Region. The last decade has seen a step up in such action. Ten of the Region's countries have policies relating to trans-fatty acids and they are increasingly implementing specific regulatory measures. Thirteen countries had fully or partially implemented national salt reduction policies by 2019. Only four countries had adopted policies relating to aspects of marketing food to children by 2019, and concrete action in this area is still lacking. Eight countries have introduced taxes-sometimes at a rate of 50%-on carbonated or sugar-sweetened beverages. In order to meet the agreed global and regional goals relating to nutrition and diet-related NCDs, countries will need to build on this progress and scale up action across the Region while intensifying efforts in areas where concrete action is lacking.

Keywords: healthy diet; legislation; nutrition; obesity; overweight; policy; unhealthy diet: noncommunicable diseases.

Figure 1

Prevalence of overweight among children under five years of age in the Eastern Mediterranean Region, 1990 to 2019. Source: Data from Unicef, WHO and World Bank 2020 Joint Malnutrition Estimates [13].

Figure 2

Age-standardized prevalence of overweight and obesity among children and adolescents aged 5 to 19 years in the Eastern Mediterranean Region, 1975 to 2016, both sexes. Data from the NCD Risk Factor Collaboration (http://ncdrisc.org/index.html) [17].

Figure 3

Age-standardized prevalence of overweight and obesity among children and adolescents aged 5 to 19 years in the countries of the Eastern Mediterranean Region, 1975 to 2016, both sexes. Data from the NCD Risk Factor Collaboration (http://ncdrisc.org/index.html) [17].

Figure 4

Age-standardized prevalence of overweight and obesity among adults 18 years or older in the Eastern Mediterranean Region, 1975 to 2016, both sexes. Data from the NCD Risk Factor Collaboration (http://ncdrisc.org/index.html) [17].

Figure 5

Age-standardized prevalence of overweight and obesity among adults 18 years or older in the countries of the Eastern Mediterranean Region, 1975 to 2016, both sexes. Data from the NCD Risk Factor Collaboration (http://ncdrisc.org/index.html) [17].