Fat Intake Reduction Strategies among Children and Adults to Eliminate Obesity and Non-Communicable Diseases in the Eastern Mediterranean Region

Abstract

Non-communicable diseases (NCDs) are the leading cause of mortality globally with an estimated 39.5 million deaths per year (72% of total death) in 2016, due to the four major NCDs: cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. In the Eastern Mediterranean Region (EMR), almost 68% of all deaths are attributed to NCDs commonly known as chronic or lifestyle-related diseases. Two-thirds of NCD premature deaths are linked to 4 shared modifiable behavioral risk factors: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. These unhealthy behaviours lead to 4 key metabolic/biological changes; raised blood pressure, overweight/obesity, high blood glucose levels/diabetes, and hyperlipidemia (high levels of fat in the blood), that increase the risk of NCDs. Globally, countries are already working towards agreed global goals on maternal and infant nutrition and on the prevention of NCDs. In both fields the goals include halting the increase in overweight and obesity and reducing NCD diet-related risk factors including reducing saturated fatty acids (SFAs) and trans fatty acids (TFAs) intake. The objective of this review is to present an up-to-date overview of the current fat (SFAs and TFAs) intake reduction initiatives in countries of the Eastern Mediterranean Region (EMR) by highlighting national and regional programs, strategies and activities aiming at decreasing the intakes of dietary fat (SFA and TFA). The literature review shows that the average intake of SFA is estimated to be 10.3% of the total energy intake (EI), exceeding the WHO (World Health Organization) upper limit of 10%. The average TFA intake is estimated at 1.9% EI, which also exceeds the WHO upper limit of 1% EI. The highest SFAs intake was reported from Djibouti, Kuwait, Saudi-Arabia, Lebanon and Yemen, while the highest TFAs intakes were reported from Egypt and Pakistan. If countries of the EMR receive immediate public health attention, that toll of NCD-related morbidity and mortality would be considerably decreased through the implantation of evidence-based preventive interventions. In this context, reductions in SFAs and TFAs intakes have been highlighted as cost-effectives strategies that may hamper the growth of the NCD epidemic.

Prevalence of Risk Factors of Non-Communicable Diseases in the Sultanate of Oman: STEPS Survey 2017

“…The national prevalence rate of raised total cholesterol was reported as 36% in the survey, which was in line with the global prevalence of raised total cholesterol (27). Our results are lower than a majority of Gulf countries where the prevalence was 50% or higher (28). The prevalence among women was higher than men, which also seemed to be the trend globally (27).…”

Understanding the complexities of prevalence of trans fat and its control in food supply in Pakistan

“…Thus, elimination of industrially produced TFA is achievable through two policy options recommended by WHO, that is, ban on partially hydrogenated fat or limit of TFA <2% of total fat in all fats and food products. During the past decade, several countries have virtually eliminated industrially produced TFA from the food supply through implementation of systematic policy actions and monitoring programs 9 . The REPLACE package issued by WHO in May 2018 serves as a roadmap for countries to implement actions to reduce and eliminate industrially produced TFA, and outlines six strategic action areas to support the prompt, complete, and sustained elimination of industrially produced TFA from the food supply 10 …”

The association of fat preference with eating behavior and sex: Turkish version of the Fat Preference Questionnaire©

“…Thus, it is also considered that its textural and olfactory characteristics are effective on preference (Besnard, 2016). However, excessive amounts and unhealthy types may play a role in the increased risk of developing chronic diseases including cardiovascular diseases and obesity, which is related to increased morbidity and mortality (Freeland‐Graves & Nitzke, 2013; Jawaldeh & Al‐Jawaldeh, 2018; Macronutrients, 2005). It has been shown that increased fat intake contributes to increased calorie intake resulting in increased body weight regardless of the types consumed (Vannice & Rasmussen, 2014).…”