Somasundaram Noel P, Kalupahana Nishan Sudheera
Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Department of Physiology, Faculty of Medicine, University of Peradeniya, Sri Lanka.
WHO South East Asia J Public Health. 2016 Apr;5(1):22-26. doi: 10.4103/2224-3151.206548.
As the incidence of noncommunicable diseases such as diabetes continues to rise at an alarming rate in South-East Asia, it is imperative that urgent and population-wide strategies are adopted. The most important contributors to the rise in noncommunicable disease are a rise in mean caloric intake and a decrease in physical activity. The evidence for population-based dietary approaches to counter these factors is reviewed. Several structural and cohesive interdepartmental coordination efforts are required for effective implementation of prevention strategies. Since low- and middle-income countries may lack the frameworks for effective and integrated multi-stakeholder intervention, implementation of population-based dietary and physical-activity approaches may be delayed and may be too late for effective prevention in current at-risk cohorts. Evidence-based strategies to decrease energy intake and increase physical activity are now well established and their urgent adoption by Member States of the World Health Organization South-East Asia Region is essential. In the context of Sri Lanka, for example, it is recommended that the most effective and easy-to-implement interventions would be media campaigns, restrictions on advertisement of unhealthy foods, taxation of unhealthy foods, subsidies for production of healthy foods, and laws on nutrition labelling that introduce colour coding of packaged foods.
在东南亚，糖尿病等非传染性疾病的发病率正以惊人的速度持续上升，因此必须采取紧急且覆盖全人群的策略。非传染性疾病上升的最重要因素是平均热量摄入增加和身体活动减少。本文回顾了基于人群的饮食方法以应对这些因素的相关证据。为有效实施预防策略，需要开展多项结构性且有凝聚力的跨部门协调工作。由于低收入和中等收入国家可能缺乏有效且综合的多利益相关方干预框架，基于人群的饮食和身体活动方法的实施可能会延迟，对于当前的高危人群而言，可能为时已晚而无法进行有效预防。减少能量摄入和增加身体活动的循证策略现已确立，世界卫生组织东南亚区域各成员国迫切采用这些策略至关重要。例如，在斯里兰卡的背景下，建议最有效且易于实施的干预措施包括媒体宣传活动、限制不健康食品广告、对不健康食品征税、对健康食品生产给予补贴以及实施营养标签法，对包装食品采用颜色编码。
