Journal of Community Medicine & Health Education
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Non-communicable diseases are the leading causes of death globally and on the rise, both in low- and middle-income countries. International research links the rapidly changing food environment with chronic diseases, suggesting that population-level dietary changes are necessary. A literature review was done focusing on the link between the rise in dietrelated NCDs, their proximal determinants focusing on diet patterns, environmental factors, current practice and international recommendations, and the most relevant national level policies for South Africa. The rise in diet-related NCDs is associated with an observed change in diet from traditional to more western, highly processed diets consisting of more energy-dense, processed foods, foods of animal origin, and more added sugar, salt and fat. This âdietary transitionâ is also evident in South Africa and has been associated with changes in the food environment under the influence of large commercial entities (Big Food). Marketing strategies to increase the availability, affordability and acceptability of less healthy products, including the rapid expansion of supermarkets, have contributed to dietary changes and decreased dietary quality, contributing to an increased burden of obesity and NCDs. Environmental and policy interventions are needed to create population-wide improvements in food consumption. In South Africa some policy steps have been taken at national level to address unhealthy diets and NCD prevention, including reduced salt intake and the taxation of sugar-sweetened beverages is high on the political agenda. National efforts addressing diet-related NCDs, its proximal determinants and contributing factors however have to be strengthened, coordinated and sustained. The creation of a multi-stakeholder national NCDs coordinating body, the South African National Health Commission, could be a tipping point in the fight against NCDs, but this will require an intersectoral approach in need of concerted action at policy level.
Peter Delobelle is a medical doctor with 15+ years’ experience in public health research, teaching and service delivery in resource limited settings, including South Africa. His research focuses on health promotion and systems research, with a particular interest in NCDs and systems thinking. He works at the University of Cape Town Chronic Disease Initiative for Africa (CDIA) and the University of Western Cape, School of Public Health as a senior lecturer and project manager of a multicentre trial to improve type-2 diabetes prevention and care, which includes assessing the impact of the food environment on diet-related NCDs. He is a Fellow of the Royal Society for Public Health; a member of the Global Alliance for Chronic Diseases; International Union for Health Promotion & Education; and Health Systems Global; and is actively involved in the Public Health Association of South Africa Special Interest Group in Health Promotion.
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