Pineda Elisa, Atanasova Petya, Wellappuli Nalinda Tharanga, Kusuma Dian, Herath Himali, Segal Alexa Blair, Vandevijvere Stefanie, Anjana Ranjit Mohan, Shamim Abu Ahmed, Afzal Saira, Akter Fahmida, Aziz Faiza, Gupta Ananya, Hanif Abu Abdullah, Hasan Mehedi, Jayatissa Renuka, Jha Sujeet, Jha Vinitaa, Katulanda Prasad, Khawaja Khadija Irfan, Kumarendran Balachandran, Loomba Menka, Mahmood Sara, Mridha Malay Kanthi, Pradeepa Rajendra, Aarthi Garudam Raveendiran, Tyagi Akansha, Kasturiratne Anuradhani, Sassi Franco, Miraldo Marisa
Centre for Health Economics and Policy Innovation, Imperial College Business School, London, United Kingdom.
The George Institute for Global Health UK, School of Public Health, Imperial College London, London, United Kingdom.
Lancet Reg Health Southeast Asia. 2024 Jun 26;26:100428. doi: 10.1016/j.lansea.2024.100428. eCollection 2024 Jul.
The increasing prevalence of diet-related non-communicable diseases (NCDs) in South Asia is concerning, with type 2 diabetes projected to rise to 68%, compared to the global increase of 44%. Encouraging healthy diets requires stronger policies for healthier food environments.
This study reviewed and assessed food environment policies in Bangladesh, India, Pakistan, and Sri Lanka from 2020 to 2022 using the Healthy Food Environment Policy Index (Food-EPI) and compared them with global best practices. Seven policy domains and six infrastructure support domains were considered, employing 47 good practice indicators to prevent NCDs. Stakeholders from government and non-governmental sectors in South Asia (n = 148) were invited to assess policy and infrastructure support implementation using the Delphi method.
Implementation of food environment policies and infrastructure support in these countries was predominantly weak. Labelling, monitoring, and leadership policies received a moderate rating, with a focus on food safety, hygiene, and quality rather than obesity prevention. Key policy gaps prioritized for attention included front-of-pack labelling, healthy food subsidies, unhealthy food taxation, restrictions on unhealthy food promotion, and improvements in school nutrition standards to combat NCDs.
Urgent action is required to expand food policies beyond hygiene and food security measures. Comprehensive strategies targeting NCD prevention are crucial to combat the escalating burden of NCDs in the region.
This research was funded by the NIHR (16/136/68 and 132960) with aid from the UK Government for global health research. Petya Atanasova also acknowledges funding from the Economic and Social Research Council (ESRC) (ES/P000703/1). The views expressed are those of the authors and not necessarily of the NIHR, the UK government or the ESRC.
南亚地区与饮食相关的非传染性疾病（NCDs）患病率不断上升，令人担忧。预计2型糖尿病患病率将升至68%，而全球增幅为44%。鼓励健康饮食需要更强有力的政策来营造更健康的食品环境。
本研究使用健康食品环境政策指数（Food-EPI）对2020年至2022年期间孟加拉国、印度、巴基斯坦和斯里兰卡的食品环境政策进行了审查和评估，并将其与全球最佳实践进行了比较。研究考虑了七个政策领域和六个基础设施支持领域，采用47项预防非传染性疾病的良好实践指标。邀请了南亚政府和非政府部门的利益相关者（n = 148）使用德尔菲法评估政策和基础设施支持的实施情况。
这些国家的食品环境政策和基础设施支持实施情况普遍薄弱。标签、监测和领导政策得到了中等评分，重点是食品安全、卫生和质量，而非预防肥胖。需要优先关注的关键政策差距包括包装正面标签、健康食品补贴、不健康食品征税、限制不健康食品促销以及改善学校营养标准以对抗非传染性疾病。
需要采取紧急行动，将食品政策从卫生和食品安全措施扩展到其他方面。针对预防非传染性疾病的综合战略对于应对该地区不断升级的非传染性疾病负担至关重要。
本研究由英国国家卫生研究院（NIHR）（16/136/68和132960）资助，并得到英国政府对全球卫生研究的援助。佩蒂娅·阿塔纳索娃也感谢经济和社会研究委员会（ESRC）（ES/P000703/1）的资助。所表达的观点是作者的观点，不一定代表NIHR、英国政府或ESRC的观点。
