Challenges and Opportunities in Scaling-Up Nutrition in Healthcare
Abstract
:1. Introduction
2. Background
3. Global Shifts
Risk Factor | Country/Ethnicity | Gender | |
---|---|---|---|
Male | Female | ||
Waist circumference (cm) | Europids; Sub-Saharan Africans; Eastern Mediterranean and Arab populations | ≥94 | ≥80 |
South Asians; Chinese; Japanese; South and Central Americans | ≥90 | ≥80 | |
Plasma triglycerides mmol/L | ≥1.7 | ≥1.7 | |
Plasma high density lipoprotein cholesterol mmol/L | ≤1.03 | ≤1.29 | |
Blood pressure mm Hg | ≥130 (systolic), ≥85 (diastolic) | ≥130 (systolic), ≥85 (diastolic) | |
Fasting plasma glucose mmol/L | ≥5.6 | ≥5.6 |
4. Barriers to Healthcare
4.1. Immediate Barriers
4.1.1. Individual
4.1.2. Biological: Epigenetic Effects of Poor Nutrition
4.1.3. Measurement: Increasing the Evidence Base for Effectiveness
4.1.4. Structural
4.2. Longer Term Barriers
4.2.1. International Trade
4.2.2. Staffing Shortages Where Most Needed
4.2.3. Environmental Impacts on Global Health
5. Opportunities
5.1. Improved Science and Technology to Increase Access to Healthcare
5.2. Strengthening the Nutrition Component of Healthcare and Medical Training
5.3. Structural Interventions to Increase Access
6. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- World Health Organization (WHO). Life Expectancy. In Global Health Observatory; WHO: Geneva, Switzerland, 2012. [Google Scholar]
- World Health Organization (WHO). Social determinants of health. What are social determinants of health? Available online: http://www.who.int/social_determinants/sdh_definition/en/ (accessed on 30 October 2014).
- Food and Agriculture Organization of the United Nations. The State of Food Insecurity in the World 2014. Available online: http://www.fao.org/publications/sofi/2014/en/ (accessed on 30 October 2014).
- Marmot, M. Social determinants of health inequalities. Lancet 2005, 365, 9464–1104. [Google Scholar] [CrossRef]
- World Health Organization (WHO). Preventing Chronic Disease: A Vital Investment; WHO: Geneva, Switzerland, 2005. Available online: http://who.int/chp/chronic_disease_report/en/index.html (accessed on 30 October 2014).
- Bhutta, Z.A.; Das, J.K.; Rizvi, A.; Gaffey, M.F.; Walker, N.; Horton, S.; Webb, P.; Lartey, A.; Black, R.E.; The Lancet Nutrition Interventions Review Group; et al. Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? Lancet 2013, 382, 452–477. [Google Scholar] [CrossRef] [PubMed]
- Victora, C.G.; Adair, L.; Fall, C.; Hallal, P.C.; Martorell, R.; Richter, L.; Sachdev, H.S.; The Maternal and Child Undernutrition Group. Maternal and child undernutrition: Consequences for adult health and human capital. Lancet 2013, 371, 340–357. [Google Scholar] [CrossRef]
- Black, R.E.; Victora, C.G.; Walker, S.P.; Bhutta, Z.A.; Christian, P.; de Onis, M.; Ezzati, M.; Grantham-McGregor, S.; Katz, J.; Martorell, R.; et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013, 382, 427–451. [Google Scholar] [CrossRef] [PubMed]
- UNICWEF/WHO/The World Bank. The UNICEF-WHO-The World Bank: Joint Child Malnutrition Estimates; World Health Organization: Geneva, Switzerland, 2012. Available online: http://www.who.int/nutgrowthdb/estimates/en/ (accessed on 20 December 2014).
- UNS Standing Committee on Nutrition. Scaling up Nutrition (SUN), 2009. Available online: http://www.unscn.org/en/sun-scaling-up/ (accessed on 30 October 2014).
- Bloom, D.E.; Cafiero, E.T.; Jané-Llopis, E.; Abrahams-Gessel, S.; Bloom, L.R.; Fathima, S.; Feigl, A.B.; Gaziano, T.; Mowafi, M.; Pandya, A.; et al. The Global Economic Burden of Noncommunicable Diseases; World Economic Forum: Geneva, Switzerland, 2011. [Google Scholar]
- World Health Organization (WHO). World Health Statistics 2014; WHO: Geneva, Switzerland, 2014. Available online: www.who.int/gho/publications/world_health_statistics/2014/en (accessed on 30 October 2014).
- The NCD Alliance. Putting Non-Communicable Diseases on the Global Agenda. The Globle Epidemic. Available online: http://www.ncdalliance.org/globalepidemic (accessed on 30 October 2014).
- Pitsavos, C.; Panagiotakos, D.; Weinem, M.; Stefanadis, C. Diet, exercise and the metabolic syndrome. Rev. Diabet Stud. 2006, 3, 118–126. [Google Scholar] [CrossRef] [PubMed]
- Alberti, G.; Zimmet, P.; Shaw, J.; Grundy, S.M. The International Diabetes Federation Consensus Worldwide Definition of the Metabolic Syndrome; IDF Communications: Brussels, Belgium, 2006. Available online: http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf (accessed on 20 December 2014).
- Nichols, G.A.; Moler, E.J. Metabolic Syndrome components are associated with future medical costs independent of cardiovascular hospitalization and incident diabetes. Metab. Syndr. Relat. Disord. 2011, 9, 127–133. [Google Scholar] [CrossRef] [PubMed]
- Gregg, E.W.; Zhuo, X.; Cheng, Y.J.; Albright, A.L.; Narayan, K.M.V.; Thompson, T.J. Trends in lifetime risk and years of life lost due to diabetes in the USA, 1985–2011: A modelling study. Lancet Diabet. Endocrinol. 2014. [Google Scholar] [CrossRef]
- Whiting, D.R.; Guariguataa, L.; Weila, C.; Shaw, J. IDF diabetes atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabet. Res. Clin. Pract. 2011, 94, 311–321. [Google Scholar] [CrossRef]
- Australian Institute of Health and Welfare. Diabetes expenditure in Australia 2008–2009; AIHW: Canberra, Australia, 2013. Available online: http://www.aihw.gov.au/publication-detail/?id=6442472450 (accessed on 20 December 2014).
- Man, C.; Lee, Y.; Colagiuri, R.; Magliano, D.J.; Cameron, A.J.; Shaw, J.; Zimmet, P.; Colagiuri, S. The cost of diabetes in adults in Australia. In Diabetes Expenditure in Australia 2008–2009; Australian Institute of Health and Welfare: Canberra, Australia, 2013. [Google Scholar]
- Png, M.E.; Yoong, J.S.-Y. Evaluating the cost-effectiveness of lifestyle modification versus metformin therapy for the prevention of diabetes in Singapore. PLoS One 2014, 9, e107225. [Google Scholar] [CrossRef] [PubMed]
- Swinburn, B.; Egger, G.; Raza, F. Dissecting obesogenic environments: The development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev. Med. 1999, 29, 563–570. [Google Scholar] [CrossRef] [PubMed]
- Reedy, J.; Krebs-Smith, S.M.; Miller, P.E.; Liese, A.D.; Kahle, L.L.; Park, Y.; Subar, A.F. Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults. J. Nutr. 2014, 144, 881–889. [Google Scholar] [CrossRef] [PubMed]
- Eskelinen, M. The effects of midlife diet on late-life cognition: An epidemiological approach. Dissertations in Health Sciences, no. 220. Publications of the University of Eastern Finland. Available online: http://epublications.uef.fi/pub/urn_isbn_978-952-61-1394-4/urn_isbn_978-952-61-1394-4.pdf (accessed on 22 April 2014).
- Kraschnewski, J.L.; Boan, J.; Esposito, J.; Sherwood, N.E.; Lehman, E.B.; Kephart, D.K.; Sciamanna, C.N. Long-term weight loss maintenance in the United States. Int. J. Obes. 2010, 34, 1644–1654. [Google Scholar] [CrossRef]
- Swinburn, B.A.; Sacks, G.; Hall, K.D.; McPherson, K.; Finegood, F.T.; Moodie, M.L.; Gortmaker, S.L. The global obesity pandemic: Shaped by global drivers and local environments. Lancet 2011, 378, 804–814. [Google Scholar] [CrossRef] [PubMed]
- Dombrowski, S.U.; Knittle, K.; Avenell, A.; Araújo-Soares, V.; Sniehotta, F.F. Long term maintenance of weight loss with non-surgical interventions in obese adults: Systematic review and meta-analyses of randomised controlled trials. Br. Med. J. 2014, 348, g2646. [Google Scholar] [CrossRef]
- Bhaumik, S. The public health threat from sugary drinks in India. Br. Med. J. 2014, 349, g6216. [Google Scholar] [CrossRef]
- Larsson, S.C.; Åkesson, A.; Wolk, A. Sweetened beverage consumption is associated with increased risk of stroke in women and men. J. Nutr. 2014, 144, 856–860. [Google Scholar] [CrossRef] [PubMed]
- Ludwig, D.S.; Peterson, K.E.; Gortmaker, S.L. Relation between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis. Lancet 2001, 357, 505–508. [Google Scholar] [CrossRef] [PubMed]
- Chopra, M.; Darnton-Hill, I. Tobacco and obesity epidemics: Not so different after all? Br. Med. J. 2004, 328, 1558–1560. [Google Scholar] [CrossRef]
- Barker, D.J.P. Developmental origins of chronic disease. Publ. Health 2012, 126, 185–189. [Google Scholar] [CrossRef]
- Sim, K.A. Developmental origins of health and disease. In Presented at The Boden Seminar Series, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia, 1 May 2014.
- Ripatti, S.; Tikkanen, E.; Orho-Melander, M.; Havulinna, A.S.; Silander, K.; Sharma, A.; Guiducci, C.; Perola, M.; Jula, A.; Sinisalo, J.; et al. A multilocus genetic risk score for coronary heart disease: Case-control and prospective cohort analyses. Lancet 2010, 376, 1393–1400. [Google Scholar] [CrossRef] [PubMed]
- Reynolds, M.R.; Allan, K.M.; Raja, E.A.; Bhattacharya, S.; McNeill, G.; Hannaford, P.C.; Sarwar, N.; Lee, A.J.; Bhattacharya, S.; Norman, J.E. Materanl obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: Follow-up of 1,323,275 person years. Br. Med. J. 2013, 347, f4539. [Google Scholar]
- Labayen, I.; Ruiz, J.R.; Ortega, F.B.; Loit, H.-M.; Harro, J.; Veideman, T.; Sjöström, M. Intergenerational cardiovascular disease risk factors involve both maternal and paternal BMI. Diabetes Care 2010, 33, 894–900. [Google Scholar] [CrossRef] [PubMed]
- Darnton-Hill, I.; Caterson, I.; Colagiuri, S. Nutrition and the benefits of early interventions in diabetes, cardiovascular and noncommunicable diseases. In Nutrients, Dietary Supplements, and Nutriceuticals: Cost Analysis Versus Clinical Benefits; Gerald, J.K., Watson, R.R., Preedy, V.R., Eds.; Humana Press: New York, NY, USA, 2011; pp. 365–390. [Google Scholar]
- Raiten, D.J.; Namasté, S.; Brabin, B.; Combs, G., Jr.; L’Abbé, M.R.; Wasantwisut, E.; Darnton-Hill, I. Executive summary: Biomarkers of nutrition for development (BOND): Building a consensus. Am. J. Clin. Nutr. 2011, 94, 633S–650S. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization (WHO). E-Library of Evidence for Nutrition Actions (eLENA). WHO: Geneva, Switzerland. Available online: http://www.who.int/elena/en/ (accessed on 30 October 2014).
- US Department of Health and Human Services, National Institutes of Health. Biomarkers of Nutrition for Development: Query-based System Tool 2014. Available online: https://www.nichd.nih.gov/global_nutrition/programs/bond/Pages/tool.aspx (accessed on 30 October 2014).
- Samman, S.; O’Connor, H.T.; Bell-Anderson, K.S.; Foster, M. Trace elements and inflammation. In Nutrition & Physical Activity in Inflammatory Diseases; Garg, M.L., Wood, L.G., Eds.; CABI Press: Wallingford, UK, 2013; pp. 128–144. [Google Scholar]
- OECD. Health at a glance 2013: OECD Indicators. Available online: http://dx.doi.org/10.1787/health_glance-2013-en (accessed on 30 October 2014).
- Osei-Assibey, G.; Dick, S.; Macdiarmid, J.; Semple, S.; Reilly, J.J.; Ellaway, A.; Cowie, H.; McNeill, G. The influence of the food environment on overweight and obesity in young children: A systematic review. Br. Med. J. Open 2012, 2, e001538. [Google Scholar]
- Malik, V.S.; Popkin, B.M.; Bray, G.A.; Després, J.-P.; Willet, W.C.; Hu, F.B. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes. Diabetes Care 2010, 33, 2477–2483. [Google Scholar] [CrossRef] [PubMed]
- Hawkes, C.; Buse, K. Public health sector and food industry interaction: It’s time to clarify the term ‘partnership’ and be honest about underlying interests. Eur. J. Publ. Health 2011, 21, 400–401. [Google Scholar] [CrossRef]
- The Migration of Health Care Workers: Creative Solutions to Manage Health Workforce Migration. Available online: http://www.hrhresourcecenter.org/node/2685 (accessed on 10 December 2014).
- Algazy, J.; Gipstein, S.; Riahi, F.; Tryon, K. Why governments must lead the fight against obesity. Healthcare payor and provider practice series. Available online: http://www.animate-eu.com/public/news/active/375/McKinsey%20quarterly_Why%20governments%20must%20lead%20the%20fight%20against%20obesity%20plus%20posts.pdf (accessed on 10 December 2014).
- Silvestri, D.M.; Blevins, M.; Afzal, A.R.; Andrews, B.; Derbew, B.; Kaur, S.; Mipando, M.; Mkony, C.A.; Mwachaka, P.M.; Ranjit, N.; et al. Medical and nursing students’ intention to work abroad or in rural areas: A cross-sectional survey in Asia and Africa. Bull. World Health Org. 2014, 92, 750–759. [Google Scholar] [CrossRef] [PubMed]
- Darnton-Hill, I.; Cogill, B. Maternal and young child nutrition adversely affected by external shocks such as increasing global food prices. J. Nutr. 2010, 140, 162S–169S. [Google Scholar] [CrossRef] [PubMed]
- McMichael, A.; Montgomery, H.; Costello, A. Health risks, present and future, from global climate change. Br. Med. J. 2012, 344, e1359. [Google Scholar] [CrossRef]
- Godlee, F. Climate change. Br. Med. J. 2014, 349, g5945. [Google Scholar] [CrossRef]
- Tirado, M.C.; Crahay, P.; Mahy, L.; Zanev, C.; Msangi, S.; Brown, R.; Scaramella, C.; Coitinho, D.; Costa, A. Climate change and nutrition: Creating a climate for nutrition security. Food Nutr. Bull. 2013, 34, 533–547. [Google Scholar] [PubMed]
- Bryce, J.; Coitinho, D.; Darnton-Hill, I.; Pelletier, D.; Pinstrup-Andersen, P.; The Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: Effective action at national level. Lancet 2008, 371, 510–526. [Google Scholar] [CrossRef] [PubMed]
- Lele, U. Lancet’s micro-focussed recommendations for reducing malnutrition are too narrow for the real world complexity of food and nutrition outcomes. SCN News 2014, 40, 95–98. [Google Scholar]
- World Health Organization (WHO). Global action plan for the prevention and control of noncommunicable diseases 2013–2020; WHO: Geneva, Switzerland, 2013. Available online: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf (accessed on 30 October 2014).
- Capewell, S.; Graham, H. Will cardiovascular disease prevention widen health inequalities? PLoS Med. 2010, 7, e1000320. [Google Scholar] [CrossRef] [PubMed]
- Touraine, M.; Gröhe, H.; Coffie, G.R.; Sathasivam, S.; Juan, M.; Louardi, E.H.; Call Seck, A. Universal health coverage and the post-2015 agenda. Lancet 2014, 384, 1161–1162. [Google Scholar] [CrossRef] [PubMed]
- Capewell, S. Sugar sweetened drinks should carry obesity warnings. Br. Med. J. 2014, 348, g3428. [Google Scholar] [CrossRef]
- Caraher, M.; Coveney, J. Public health nutrition and food policy. Publ. Health Nutr. 2003, 7, 591–598. [Google Scholar]
- Gostin, L.O. A framework convention on Global Health. Health for all, justice for all. JAMA 2012, 307, 2087–2092. [Google Scholar] [PubMed]
- Word Cancer Research Fund International. Food Policy Highlights from around the World. Available online: http://www.wcrf.org/ (accessed on 30 October 2014).
- Chan, M. Investing in health: Progress but hard choices remain. Lancet 2013, 382, e34–e35. [Google Scholar] [CrossRef] [PubMed]
© 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Darnton-Hill, I.; Samman, S. Challenges and Opportunities in Scaling-Up Nutrition in Healthcare. Healthcare 2015, 3, 3-19. https://doi.org/10.3390/healthcare3010003
Darnton-Hill I, Samman S. Challenges and Opportunities in Scaling-Up Nutrition in Healthcare. Healthcare. 2015; 3(1):3-19. https://doi.org/10.3390/healthcare3010003
Chicago/Turabian StyleDarnton-Hill, Ian, and Samir Samman. 2015. "Challenges and Opportunities in Scaling-Up Nutrition in Healthcare" Healthcare 3, no. 1: 3-19. https://doi.org/10.3390/healthcare3010003