Global Strategy on Diet Physical activity
and Health:
Adaptation at local and national levels
to the Americas
Dr Godfrey Xuereb
Team Leader
Population-based Prevention
Department of Chronic Diseases and Health Promotion
xuerebg@who.int
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Noncommunicable disease and risk factors
Tobacco use
Unhealthy diets
Physical inactivity
Harmful use of
alcohol
Heart disease and
stroke




Diabetes




Cancer




Chronic lung
disease

60% of global deaths due to NCDs
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High blood pressure continues to go up
% of population
40%
High-income countries
30%
Upper Middle-income countries
Lower middle-income countries
20%
Low-income countries
10%
0
3|
1980
2008
Raised blood pressure (2008)
Source: WHO NCD Country Profiles (2010)
Overweight continues to increase
% of population
70%
60%
50%
High-income countries
40%
Upper Middle-income countries
30%
Low-income countries
Lower middle-income countries
20%
10%
0%
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1980
2008
Overweight (2008)
Source: WHO NCD Country Profiles (2010)
WHO Mandates to date
2000
2003
2004
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
2008
Global Strategy to Reduce the Harmful Use
of Alcohol
2009
WHO Global Status
Report on NCDs
2010
2011
Political Declaration on NCDs
2012+
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Realizing the commitments made in the Political Declaration
"Best buys" interventions to address NCDs
PopulationTobacco use
based
interventions
addressing NCD
risk factors
Harmful use of alcohol
Individualbased
interventions
addressing
NCDs in
primary care
-
Excise tax increases
Smoke-free indoor workplaces and public places
Health information and warnings about tobacco
Bans on advertising and promotion
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
Cancer
-
Prevention of liver cancer through hepatitis B immunization
Prevention of cervical cancer through screening (visual
inspection with acetic acid [VIA]) and treatment of precancerous 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 & PA
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What does the Political Declaration say on Diet & PA
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Physical Inactivity
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Source: WHO's report on "Global health risks"
Physical inactivity - 4th leading risk factor for global mortality
1.5 billion adults
are insufficiently active
11 |
Percentage of insufficient physical activity
comparable country estimates, 2008
Age standardized; by WHO Region and World Bank income group, men and women
Source: Global Status Report on NCDs, WHO, 2001
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Prevalence of insufficient physical activity*, ages 15+
age standardized Males, 2008
Source: Global Status Report on NCDs, WHO, 2001
13 |
Prevalence 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 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 Say
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Global 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 Say
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National strategies on diet and physical activity
Conduct a situation analysis - GSHS
Mexico
Cuba
Dominican Republic
Belize
Honduras
Nicaragua
Guatemala
El Salvador
Costa Rica
Panama
Venezuela
Guyana
Suriname
Columbia
Ecuador
Anguilla
Antigua and Barbuda
Bahamas
Barbados
British Virgin Islands
Cayman Islands
Dominica
Grenada
Guyana
Jamaica
Montserrat
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Trinidad and Tobago
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Peru
Brazil
Bolivia
Paraguay
Chile
Uruguay
Completed Survey
Implementation Workshop
Argentina*
Data collection underway
Data collection complete
National 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 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 Say
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School Policies and programs
CARICOM supports Physical Education Standards for all
Caribbean States – Feb 2011, Port of Spain.
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Recommended actions for Member States
 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;
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Recommended actions for Member States
 Improve sports, recreation and leisure facilities
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Recommended actions for Member States
 Increase the number of safe spaces available for active play
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Recommended actions for Member States
Urban
Planning
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The Floor is Yours !
http://www.who.int/dietphysicalactivity/en/
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