Downs Shauna M, Thow Anne-Marie, Ghosh-Jerath Suparna, Leeder Stephen R
Menzies Centre for Health Policy, University of Sydney, Sydney NSW 2006, Australia and Indian Institute of Public Health (Delhi) Public Health Foundation of India, Gurgaon 122002, India
Menzies Centre for Health Policy, University of Sydney, Sydney NSW 2006, Australia and Indian Institute of Public Health (Delhi) Public Health Foundation of India, Gurgaon 122002, India.
Health Policy Plan. 2015 May;30(4):474-84. doi: 10.1093/heapol/czu031. Epub 2014 May 14.
The World Health Organization recommends replacement of trans fat with polyunsaturated fat to reduce cardiovascular disease risk. Although several high-income countries have been successful in reducing trans fat in the food supply, low- and middle-income countries such as India may face additional contextual challenges such as the large informal sector, lack of consumer awareness, less enforcement capacity and low availability and affordability of healthier unsaturated fats. The objective of this study was to examine the feasibility and acceptability of multisectoral policy options aimed at supporting trans fat reduction and its replacement with polyunsaturated fats in India.
Multisectoral policy options examined in this study were identified using food supply chain analysis. Semi-structured interviews (n = 17) were conducted with key informants from agriculture, trade, finance, retail, industry, food standards, non-governmental organizations and the health professions to gain their views on the feasibility and acceptability of the policy options. Purposive sampling was used to identify key informants. Data were coded and organized based on key themes.
There was support for policies aimed at improving the quality of seeds, supporting farmer co-operatives and developing affordable farming equipment suited to smallholders to improve the production of healthier oils. Increasing the role of the private sector to improve links among producers, processors and retailers may help to streamline the fats supply chain in India. Blending healthier oils with oils high in saturated fat, which are currently readily available, could help to improve the quality of fat in the short term. Improving consumer awareness through mass media campaigns and improved labelling may help increase consumer demand for healthier products.
Reorienting agricultural policies to support production of healthier oils will help increase their uptake by industry. Policy coherence across sectors will be critical to reduce trans fat intakes and could be improved by increasing engagement among researchers, the private sector and government.
世界卫生组织建议用多不饱和脂肪替代反式脂肪以降低心血管疾病风险。尽管一些高收入国家已成功减少了食品供应中的反式脂肪,但印度等低收入和中等收入国家可能面临其他背景挑战,如庞大的非正规部门、消费者意识淡薄、执法能力不足以及更健康的不饱和脂肪供应不足和价格高昂。本研究的目的是检验旨在支持印度减少反式脂肪并以多不饱和脂肪替代的多部门政策选项的可行性和可接受性。
本研究中所检验的多部门政策选项是通过食品供应链分析确定的。与来自农业、贸易、金融、零售、工业、食品标准、非政府组织和卫生专业领域的关键信息提供者进行了17次半结构化访谈,以了解他们对这些政策选项的可行性和可接受性的看法。采用目的抽样法确定关键信息提供者。数据根据关键主题进行编码和整理。
大家支持旨在提高种子质量、支持农民合作社以及开发适合小农户的经济适用型农业设备以提高更健康油脂产量的政策。增强私营部门的作用以改善生产者、加工者和零售商之间的联系,可能有助于简化印度的油脂供应链。将更健康的油脂与目前 readily available(此处原文有误,推测可能是“容易获得的”)的高饱和脂肪油脂混合,有助于在短期内提高脂肪质量。通过大众媒体宣传活动和改进标签提高消费者意识,可能有助于增加消费者对更健康产品的需求。
调整农业政策以支持生产更健康的油脂,将有助于提高行业对其的采用率。各部门之间的政策一致性对于减少反式脂肪摄入量至关重要,可通过加强研究人员、私营部门和政府之间的合作来加以改善。