Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin university of Medical Sciences, Qazvin, Iran.
Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
PLoS One. 2023 Jan 26;18(1):e0278280. doi: 10.1371/journal.pone.0278280. eCollection 2023.
Decreasing calories, salt, sugar and fat intake is considered the golden solution to reduce obesity and cardiovascular diseases (CVDs) related to unhealthy diet. This study aimed to investigate the health system induced barriers to a healthy diet in Iran.
This is a qualitative health policy analysis. We collected data through 30 semi-structured, face-to-face interviews with purposefully identified experts, including policy-makers, top-level managers and related stakeholders. All interviews were transcribed verbatim, and analyzed with qualitative content analysis, facilitated by MAXQDA 11 software.
We identified six categories of barriers: structural problems within the Ministry of Health and Medical Education (MoHME), i.e. Supreme Council of Health and Food Security (SCHFS); the MoHME's inadequate stewardship of public health, the short life of the deputy of social affairs within the MoHME and its possible impact on the National Health Assembly; inefficient traffic lights labelling for foods; lack of adequate policies and guidelines for monitoring restaurants and fast foods and insufficient incentive policies for the food industry.
In line with the World Health Organization (WHO) Global Action Plan, in 2015, Iran defined its roadmap for prevention and control of NCDs, i.e. some nutritional interventions. However, different stakeholders including MoHME and other sectors need to provide series of interventions to change people's approach about food choice so that they might reduce the consumption of foods with excessive salt, fat and sugar.
减少热量、盐、糖和脂肪的摄入被认为是减少肥胖和与不健康饮食相关的心血管疾病（CVDs）的黄金解决方案。本研究旨在探讨伊朗健康系统在促进健康饮食方面面临的障碍。
这是一项定性的卫生政策分析。我们通过 30 次半结构化的、面对面的访谈收集了数据，访谈对象是有目的确定的专家，包括政策制定者、高层管理人员和相关利益相关者。所有访谈都逐字记录下来，并使用 MAXQDA 11 软件进行定性内容分析。
我们确定了六个类别的障碍：卫生部和医疗教育部（MoHME）内部的结构性问题，即最高卫生和食品安全委员会（SCHFS）；MoHME 对公共卫生的管理不善、MoHME 内部社会事务副部长的任期短及其对国家健康大会的可能影响；食品标签信号灯效率低下；缺乏对餐厅和快餐店进行监测的充分政策和准则以及对食品工业的激励政策不足。
根据世界卫生组织（WHO）全球行动计划，伊朗在 2015 年为预防和控制非传染性疾病制定了路线图，即一些营养干预措施。然而，包括 MoHME 和其他部门在内的不同利益相关者需要提供一系列干预措施，以改变人们对食物选择的态度，从而减少对高盐、高脂肪和高糖食物的消费。
