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 and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Poursina Ave, Tehran, Iran.
J Health Popul Nutr. 2023 Jan 30;42(1):8. doi: 10.1186/s41043-023-00348-8.
Non-communicable diseases (NCDs), also known as chronic diseases, specifically cardiovascular diseases (CVD), cancers, respiratory diseases, and diabetes are the main reason for more than two-thirds of global deaths, in which the unhealthy diet is one of the primary risk factors. The golden solution to reducing obesity and CVD linked to an unhealthy diet is to reduce calories, salt, sugar, and fat intake. Besides, activities highlighting lifestyles that contain healthy diets usually focus on reducing salt, sugar, and saturated fat consumption. As a result, the researchers aimed to study the gaps and economic barriers to recommended consumption of salt, sugar, and fat in Iran, based on WHO recommendations.
This is a qualitative study. We conducted semi-structured and in-depth interviews with 30 stakeholders, including academics, experts, and key informants in different sectors from December 2018 until August 2019 in Tehran, Iran. We used a purposeful and snowball sampling method to select participants. All interviews were transcribed verbatim and thematically analyzed using MAXQDA 11.
Economic problems and inflation in Iran caused people to eat more unhealthy foods, while a healthy diet consumption was reduced due to higher prices. Unfair political sanctions imposed on the country caused economic pressure and adversely affected family nutrition. Worse still, despite legal bans, advertising unhealthy foods via media, mainly to generate revenue, encouraged more consumption of unhealthy food. The lack of targeted subsidies and failure in tax legislation and implementation related to the unhealthy products deteriorated the conditions.
Some economic barriers have hampered plans to reduce salt, fat, and sugar consumption in Iran. Fundamental reforms in the tax and subsidy system are required to improve people's eating habits. In particular, citizens' income that has been continuously shrinking due to economic conditions, imposed sanctions, and the inevitably high inflation needs to be addressed urgently. Unless the government of Iran deals with the economic barriers to healthy nutrition, the pathway for implementing the national action plan for prevention and control of NCDs toward a 30% mortality reduction due to NCDs by 2030 looks unlikely to reach.
非传染性疾病（NCDs），又称慢性病，具体包括心血管疾病（CVD）、癌症、呼吸疾病和糖尿病，是全球三分之二以上死亡的主要原因，其中不健康饮食是主要危险因素之一。减少与不健康饮食相关的肥胖和 CVD 的黄金解决方案是减少卡路里、盐、糖和脂肪的摄入。此外，强调健康饮食生活方式的活动通常侧重于减少盐、糖和饱和脂肪的摄入。因此，研究人员旨在根据世界卫生组织（WHO）的建议，研究伊朗减少盐、糖和脂肪推荐摄入量方面的差距和经济障碍。
这是一项定性研究。我们于 2018 年 12 月至 2019 年 8 月在伊朗德黑兰对 30 名利益相关者（包括学术界人士、专家和不同部门的主要信息提供者）进行了半结构式和深入访谈。我们使用有目的和滚雪球抽样方法选择参与者。所有访谈均逐字记录并使用 MAXQDA 11 进行主题分析。
伊朗的经济问题和通货膨胀导致人们食用更多不健康的食物，而由于价格上涨，健康饮食的消费减少。对该国实施的不公平政治制裁造成了经济压力，并对家庭营养产生了不利影响。更糟糕的是，尽管有法律禁令，但媒体宣传不健康食品主要是为了创收，这鼓励了更多人消费不健康食品。缺乏有针对性的补贴以及与不健康产品相关的税收立法和执行不力，使情况恶化。
一些经济障碍阻碍了伊朗减少盐、脂肪和糖摄入的计划。需要对税收和补贴制度进行根本改革，以改善人们的饮食习惯。特别是，由于经济条件、制裁和不可避免的高通胀，伊朗公民的收入不断缩水，这需要紧急解决。除非伊朗政府应对健康营养方面的经济障碍，否则实施国家行动计划以实现到 2030 年减少 30%因非传染性疾病导致的死亡率的目标，看起来不太可能实现。
