Story Mary T, Duffy Emily
Duke Global Health Institute, Duke University, Durham, North Carolina, USA,
Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
Nestle Nutr Inst Workshop Ser. 2019;92:69-82. doi: 10.1159/000499549. Epub 2019 Nov 28.
A healthy diet is central to health and well-being throughout life. The United States and many other countries are undergoing an obesity epidemic and experiencing serious diet-related health problems. There exists a misalignment and wide gap between national dietary recommendations and dietary patterns of Americans, and thus, a need to find new ways to improve diet and nutrition. This article posits that nutrition education combined with policy, systems, and environmental (PSE) change approaches is more effective than either strategy in isolation and both are needed to reduce the global burden of diet-related chronic diseases. This article presents a conceptual framework for understanding the multiple influences on what people eat; discusses the need for PSE strategies to augment direct nutrition education approaches; and highlights examples of synergistic and promising linkages between nutrition education and PSE strategies in 3 areas: federal nutrition assistance programs, food retail settings, and nutrition and calorie labeling. In addition, future directions where this synergistic approach holds promise for improving population health and reducing health inequities are discussed. Nutrition education combined with PSE changes at governmental and community levels, as well as strategic public-private alliances have the potential to change the way people eat and improve health and well-being.
健康饮食是一生健康和幸福的核心。美国和许多其他国家正面临肥胖流行，并经历着与饮食相关的严重健康问题。美国的国家饮食建议与美国人的饮食模式之间存在偏差和巨大差距，因此，需要找到改善饮食和营养的新方法。本文认为，营养教育与政策、系统和环境（PSE）变革方法相结合比单独采用任何一种策略都更有效，并且两者都是减轻与饮食相关的慢性病全球负担所必需的。本文提出了一个概念框架，用于理解对人们饮食的多种影响；讨论了PSE策略增强直接营养教育方法的必要性；并强调了营养教育与PSE策略在三个领域协同且有前景的联系示例：联邦营养援助计划、食品零售场所以及营养和卡路里标签。此外，还讨论了这种协同方法有望改善人群健康和减少健康不平等的未来方向。政府和社区层面的营养教育与PSE变革相结合，以及战略性公私联盟有可能改变人们的饮食方式，改善健康和幸福。
