The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

Swinburn, Boyd; Kraak, Vivica; Allender, Steven; Atkins, Vincent; Baker, Phillip; Bogard, Jessica R.; Brinsden, Hannah; Calvillo, Alejandro; Schutter, Olivier De; Devarajan, Raji; Ezzati, Majid; Friel, Sharon; Goenka, Shifalika; Hammond, Ross A.; Hastings, Gerard; Hawkes, Corinna; Herrero, Mario; Hovmand, Peter S.; Howden, Mark; Jaacks, Lindsay M.; Kapetanaki, Ariadne Beatrice; Kasman, Matt; Kuhnlein, Harriet V.; Kumanyika, Shiriki; Larijani, Bagher; Lobstein, Tim; Long, Michael W.; Matsudo, Victor; Mills, Susanna; Morgan, Gareth J.; Morshed, Alexandra B.; Nece, Patricia M.; Pan, An; Patterson, David; Sacks, Gary; Shekar, Meera; Simmons, Geoff L; Smit, Warren; Tootee, Ali; Vandevijvere, Stefanie; Waterlander, Wilma; Wolfenden, Luke; Dietz, William H.

doi:10.1016/s0140-6736(18)32822-8

Cited by 2,058 publications

(2,041 citation statements)

References 173 publications

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“…Private funders, including The Gates and Clinton Foundations and Bloomberg Philanthropies, could fund independent external evaluations to evaluate IFBA firms' marketing commitments and practices, and their compliance with UN Codes of Conduct to restrict HFSS food and beverage marketing to children. The Lancet Commission on the Global Syndemic of Obesity, Undernutrition, and Climate Change further urged all actors to fully implement human rights obligations to create healthy and active environments for children that support the integrated concept of their “right to well‐being.” The Gates Foundation and UNICEF recently announced a new Lancet Commission that prioritized accountability to optimize children's health and well‐being to thrive worldwide, and there are opportunities to incorporate actions to improve marketing practices targeted to children as part of their work …”

Section: Discussionmentioning

confidence: 99%

An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy

2019

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Summary United Nations (UN) organizations have urged governments to restrict the marketing of unhealthy food and nonalcoholic beverage products to children. This study conducted an accountability evaluation for the International Food & Beverage Alliance's (IFBA's) Global Policy on Marketing Communications to Children (Global Policy) compared with UN and other best‐practice recommendations. We used the National Academy of Medicine's LEAD (ie, locate, evaluate, assemble evidence to inform decisions) framework to identify evidence (January 2004 to October 2018). We assigned a progress score (ie, none, limited, some, extensive) for five accountability steps. No progress was made to appoint an empowered body to evaluate IFBA's Global Policy. IFBA and the Access to Nutrition Foundation made some progress to take and share the account. Diverse actors made no progress to hold IFBA to account for nonadherence or to strengthen accountability structures for future compliance. IFBA could strengthen its Global Policy to align with best practices. UN organizations and other stakeholders should encourage IFBA firms to restrict the marketing of unhealthy foods and beverages to reduce children's obesity risk. This evaluation is relevant to all firms and industry associations that market products to children that undermine their diet and health.

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Section: Discussionmentioning

confidence: 99%

An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy

2019

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“…The food system drivers of unhealthy diets—especially the production, intensive marketing, and consumption of resource‐intensive foods (eg, animal‐sourced and ultra‐processed)—are also key drivers of diet‐related inequities, ecosystems degradation, and climate change . Recognition of the need to address the common drivers of undernutrition, obesity, and climate change is a core focus of the Lancet Commission on Obesity …”

Section: Introductionmentioning

confidence: 99%

Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks

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Summary Generating political commitment for ending all forms of malnutrition represents a key challenge for the global nutrition community. Without commitment, the policies, programs, and resources needed to improve nutrition are unlikely to be adopted, effectively implemented, nor sustained. One essential driver of commitment is nutrition actor network (NAN) effectiveness, the web of individuals and organizations operating within a given country who share a common interest in improving nutrition and who act collectively to do so. To inform new thinking and action towards strengthening NAN effectiveness, we use a systems dynamics theoretical approach and literature review to build initial causal loop diagrams (CLDs) of political commitment and NAN effectiveness and a qualitative group model building (GMB) method involving an expert workshop to strengthen model validity. First, a “nutrition commitment system” CLD demonstrates how five interrelated forms of commitment—rhetorical, institutional, operational, embedded, and system‐wide—can dynamically reinforce or diminish one another over time. Second, we present CLDs demonstrating factors shaping NAN effectiveness organized into three categories: actor features, resources, and capacities; framing strategies, evidence, and norms; and institutional, political, and societal contexts. Together, these models generate hypotheses on how political commitment and NAN effectiveness could be strengthened in future and may provide potential starting points for country‐specific conversations for doing so.

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“…While the impact of obesity is already stretching health resources, the determinants of obesity and opportunities to address it extend far beyond the health system. Obesity is characterised as one element of a syndemic, shaped by large scale socio‐ecological factors and biological, psychological, and socioeconomic interactions of its related comorbidities . Health professionals and health organisations, therefore, should support broader multisectoral actions designs to address the other system drivers of the syndemic, as a means to improve health.…”

Section: Broader Advocacy and Action Of Health Servicesmentioning

confidence: 99%

The challenge for global health systems in preventing and managing obesity

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Summary Few health crises have been as predictable as the unfolding obesity pandemic. Clinical and public health services remain the front line of efforts to reduce the burden of obesity. While a range of clinical practice guidelines exist, the need for clinical interventions exceeds the capacity of health systems to provide care for those affected with obesity, and routine clinical practices fall far short of guidelines recommendations even in high‐income countries. In this manuscript, we discuss current recommendations regarding obesity interventions and key challenges facing global health systems in managing the health needs of people with obesity. Improving the provision of obesity‐related health care is a considerable challenge and will require changing existing perceptions of obesity as a matter of personal failure to its recognition as a disease, innovative approaches to health system reform, clinician capacity building and implementation support, a focus on prevention, and wise resource allocation. Leadership from governments, the medical profession, and patient and community groups to address the issues raised in this manuscript is urgently needed to address the growing health concern.

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The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

Cited by 2,058 publications

References 173 publications

An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy

An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy

Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks

The challenge for global health systems in preventing and managing obesity

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