Feasting and fasting

‘Keep the metabolic syndrome away!’ This was the mission of the government of Japan when in 2006 two deputy ministers for health announced that they would cut their backs. Undoubtedly buoyed by the intense scrutiny of his progress by the media, he duly did so, reducing Keizo Takemi’s girth from 100.5 to 95cm in six months.

As was evident from a comprehensive survey of nutrition issues at last month’s Pacific Health Summit in Seattle, Washington, behavior change is a key element in tackling the twin scourges of under-nutrition and obesity, which are easily forgotten in the competition. Is. for the attention of the world.

What is inadequately recognized is the dual nature of the challenge. The combination of “feasting and fasting,” as Margaret Chan, director-general of the World Health Organization (WHO), describes it in Seattle, increases rapidly as countries develop. For example, China and Mexico are showing both aspects of the ‘nutritional transition’ – from overnutrition to obesity caused by inadequate exercise and excess of an unhealthy diet, and the subsequent diabetes and cancer.

Researchers have tracked the effects of undernutrition on mothers before becoming pregnant and on their babies in the first two years of life.

Not only does this cause immediate health problems for the offspring, but it affects their health, educational and work prospects for the rest of their lives. (For an impressive overview, see the series published online by The Lancet in January 2008, http://www.thelancet.com/online/focus/undernutrition.) Those long-term consequences, including an increase in type 2 diabetes, are serious. take form. Health problems that arise from obesity as countries progress in their development.

Action priorities to encourage behavior change include education, mandatory labeling of the calorie content of restaurant menus, and regulation of the food industry. Healthy eating in both developed and developing countries also requires changes in farming and retailing practices.

But science also matters. And, above all, science that spans the full range—the study of diet and exercise habits, physiology, and molecular mechanisms and genetics of populations—and includes the social sciences of behavior as well as the natural sciences of nutrients.

For example, cohort studies that examine women’s dietary intake – often it is women who play an important role in public health and who need empowerment – ​​may be related to physiological studies of the effects of dietary components, Which in turn may be related to the effect of a particular micronutrient on human or model-organism gene expression. Such a holistic approach has the potential to have an immediate impact on policies.

Some funding agencies say they don’t get strong offers in nutrition. But the researchers reasonably claim that for many years the undermining of biology in favor of cell and molecular studies is only to blame itself. A plausible exception to this is France, which has for many decades built and sustained nutrition science in a strategic and multidisciplinary manner.

What can best motivate more researchers to tackle these challenges? For starters, awareness of the wide-ranging effects of poor nutrition: 35 percent of child deaths under five and 11% of the global disease burden are due to malnutrition, poor breastfeeding, and zinc and vitamin A deficiencies. Huh.

Meanwhile a poor energy balance in individuals is at the heart of an epidemic in obesity, which the WHO estimates has caused up to 7% of global health care costs in developed countries, including a rising tide of diabetes. Cancer.

But ultimately governments need to take the lead. In April, Japan announced a follow-up to its ministers’ personal regime of eating less and moving more, with a national program of health checks. Next month it hosts the G8 summit, where the cause of improving nutrition will have an opportunity as participants focus on the food crisis. Science is a critical element that needs the attention of the G8 to tackle the huge and global burden of poor nutrition.

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