As part of the IFPRI Egypt Seminar in partnership with the National Nutrition Committee (ASRT affiliated): "100 million healthy lives: Scientific evidence on the double burden of malnutrition in Egypt"

1. 100 million healthy lives: Scientific evidence
on the double burden of malnutrition in
Egypt
Introducing a multidimensional framework for
control of obesity
Sahar Zaghloul
National Nutrition Committee
Cairo Egypt
February 2019

2. Outline of the presentation
• Role of research in management of public
health problems.
• Obesity is a complex health problem with
many factors contributing to weight gain.
• Data needed to support decision makers for
developing sound strategies and polices.
• Research agenda to fill the gap in our
knowledge.

3. Scientific
evidence
Basis for
policy and
strategy
recommendations
Action plan
(Government
bodies,
multistakeholders
bodies)
Implementation
Monitor and
evaluation
Role of research in management of public health
problems

4. Obesity is a complex health problem with many factors contributing to weight
gain.

6. Knowledge/
Attitude
Obesogenic
Environment
 Walkability
 Recreation areas
 Food outlets
 Transportation
system
Introducing a multidimensional framework for control of
obesity
Food Health
Food availability,
accessibility,
affordability
Food consumption Obesity
 Diabetes
 Hypertension
 Cardiovascular
disease
 Cancer
 Agricultural products
 Imported food
 Food Industry
 Subsidized food
 Social safety net
 School canteens
 School feeding programs
 Food prices
 Unemployment
 Poverty
 GDP
 Policies/Food security
Lack of Physical Activity
 Breastfeeding and complementary feeding
 Food consumption patterns
 High sugar and sugary beverages
 High fat diet (trans fat)
 High calories
 Low fruit and vegetables
 Low dairy products
 Unhealthy snacks
 Food habits and traditional foods
 Food eaten away from home
 Iron deficiency anemia
 Stunting
Microbiota
Sahar Zaghloul January 2019
Food advertisment

7. What do we know ?

9. “By subsidizing foods such
as bread, sugar, edible oil,
and rice that are high in
calories but poor in
vitamins and minerals, the
system has inadvertently
incentivized people to
consume too much cheap,
calorie-rich food lacking in
nutritional value”.
Ecker et al., 2017

12. What are the data needed to support
decision makers for developing sound
strategies and polices.

13. Building a multidimensional framework for
control of obesity
Good Food Good Health
1

14. Building a multidimensional framework for
control of obesity
Food availability, accessibility,
affordability
Food consumption
Obesity
DiabetesHypertension,
Cardiovascular diseases,
Cancer
2

15. Building a multidimensional framework for control
of obesity
Agricultural products
 Import Foods
Processed Foods
Subsidized food
 Distributed food aids
School canteens/ school
feeding program
Food prices
Unemployment
Poverty
GDP
Food policies/Food
security
Food availability, accessibility,
affordability
3

16. Building a multidimensional framework for control
of obesity
Food availability, accessibility,
affordability
Food consumption
Obesity
DiabetesHypertension,
Cardiovascular diseases,
Cancer

17. Building a multidimensional framework for control
of obesity
Foodconsumption Inadequate breastfeeding and poor complementary feeding
Food consumption patterns
High sugar and sweeteners beverages
High fat diet (trans fat)
High calorie diet
Low fruits and vegetables
Low dairy products
Unhealthy snacks
High caloric traditional foods
Food eaten away from home
Poor knowledge of Functional food availability
4

18. Knowledge/
Attitude/Choice
Obesogenic Environment
 Walkability
 Recreation areas
 Food outlets
 Transportation system
 Iron deficiency
anemia
 Stunting
Food
consumption
Building a multidimensional framework for control of
obesity --Non dietary factors recognized to date
Food
advertisement
Obesity
 Diabetes
 Hypertension
 Cardiovascular
disease
 Cancer
Microbiota
Food
availability,
accessibility,
affordability
Lack of Physical
Activity
5

19. Knowledge/
Attitude
Obesogenic
Environment
 Walkability
 Recreation areas
 Food outlets
 Transportation
system
Building a multidimensional framework for control of
obesity
Food Health
Food availability,
accessibility,
affordability
Food consumption Obesity
 Diabetes
 Hypertension
 Cardiovascular
disease
 Cancer
 Agricultural products
 Import Foods
 Processed Foods
 Subsidized food
 Distributed food aids
 School canteens/ school
feeding program
 Food prices
 Unemployment
 Poverty
 GDP
 Food Policies
 Food security
Lack of Physical Activity
 Inadequate Breastfeeding and poor complementary feeding
 Food consumption patterns
 High sugar and sugary beverages
 High fat diet (trans fat)
 High calories
 Low fruit and vegetables
 Low dairy products
 Unhealthy snacks
 High caloric traditional foods
 Food eaten away from home
 Iron deficiency anemia
 Stunting
Microbiota
Food advertisment

20. X

21. Key messages
 Use of Scientific evidence to achieve a healthy and sustainable food environment
for all Egyptians and fill the gap in our knowledge by developing a research agenda
to assist decision makers to formulate sound food and nutrition related policies
and legal framework.
 Raise the priority ranking of NCD prevention by comprehensive actions involving a
wide range of stakeholders in association with a research advisory committee.
 Reactivation and strengthening of inter-ministerial collaboration √
 Update dietary guidelines to reflect the change in the food intake, food habits and
practices of Egyptians.
 Increase healthy food availability/ accessibility and physical activity environment.
 Apply the healthy cities model (WHO) to link between health, nutrition and urban
planning.
 Design effective, sustainable and multifaceted interventions for obesity prevention
 Individual  Community
 Systems  Policies
 Each intervention alone may have minimal effects but synergism between multiple
interventions can halt the rate of obesity.

22. Naja et al., 2017)
Ranking of Egypt in peer reviewed publications
addressing nutrition in association with NCD (2006-2016 )

23. Word Health Organization
Guiding principles for the development of a
population-based childhood obesity prevention
strategy
• Integrated strategy
• Policy support from multiple levels of governance
• Equity and inclusivity
• Environmental support
• Monitoring and surveillance
• Engagement with multiple sectors and settings

24. Thank you

27. Example: fruit and vegetable (g) per capita/day =4*3331/100/4= 33 g
Recommendations is 300 fruits and 400 g vegetables and beans for day to protect from NCD

30. What do we know?
What
•Obesity is a world health problem and is progressive
over the last 40 years.
do
•World leaders are committed to meet World Health Assembly
recommendation to halt and reverse obesity.
we
•Several interventions have been tested.
know
•No country to date has successfully reversed its
epidemic.
•WHY?