Food marketing for children and adolescents: From evidence to the actions

Transcription

1 Food marketing for children and adolescents: From evidence to the actions Fabián Fiestas, M.D. Instituto de Evaluación de Tecnologías en Salud e Investigación, Seguro Social de Salud-ESSALUD Lima, marzo 2015

2 decision making context Traditional process: Policy-making process based on expert opinion, little accountability, little interest to monitor and evaluate initiatives Decision-making process closer to the garbage can theory than to the other theories of policy making

3 Context: Burden of disease in Peru Velasquez, 2009 Velasquez, 2009 Velasquez, 2009

4 Specific of causes of burden of disease in Peru Velasquez, 2009

5 Estimation of economic losses due to diseases, 2012 GNI per capita $ (2012) DALYs (2004) US dollars En soles al cambio groups of the leading diseases* 10, $ 31,347,445, S/. 84,638,103, Neuropsychiatric 10, $ 8,460,830, S/. 22,844,242, Cardiovascular 10, $ 3,994,839, S/. 10,786,065, Road accidents 10, $ 2,560,000, S/. 6,912,000, Alcohol abuse and dependence 10, $ 2,355,200, S/. 6,359,040, Adiction 10, $ 460,800, S/. 1,244,160, Depression 10, $ 1,945,600, S/. 5,253,120, Diabetes 10, $ 1,536,000, S/. 4,147,200, * Neuropsychiatric, cardiovascular, and bone and joint diseases, accidental injuries, perinatal problems, cancer

6 Diabetes is a large public health problem in Peru Something needs to be done

7 Politicians in the Peruvian Congress proposed the bill to regulate publicity that encourages consumption of junk food and promotes healthy food among children and adolescents Dr. Jaime Delgado (Congressman) Dr. Fernando Leanes (PAHO representative) Dr. Percy Minaya (Vice-minister of Health)

8 Vice minister of Health asked Instituto Nacional de Salud (INS) to develop reports showing the evidence for three of the key aspects contemplated in the bill proposal: Publicity Labels Kioskos, vending machines

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11 Evidence Pyramid Adaptación de Dr. Alfonso Gutierrez

12 Haynes pyramid Adaptación de Dr. Alfonso Gutierrez

13 Research helps to Quantify Localize Find causes Find mechanisms Find treatments and control measures

14 7 principles Scientifically robust Transparent Relialibly Independent Disscused Timely Applicable Report of the Center for Global Development s Priority-Setting Institutions for Global Health Working Group Adaptación: Dr. Victor Suarez

15 Secondary research Notas rápidas Revisiones sistemáticas Y Meta-análisis Sinopsis de revisiones sistemáticas Resúmenes de política (policy brief)

16 Work Having in mind the users of the information Congressman Media General population Elaboration of the questions to be addressed PICO format Publicity and reduction of fast food consumption among children Labeling and reduction of fast food consumption among school children, as well as increasing of consumption of healthy food Kiosks and vending machines with health food will reduce fast food consumtion among school children

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18 Question 1: Publicity Conclusion: There is evidence that government regulation reduces the consumption of junk food among children and adolescents, as well as the body mass index. The evidence does not support the use of selfregulation by the fast-food regulation as the only measure to reduce consumption of this type of food by children and adolescents.

19 Question 2: Kiosks and vending machines Conclusion: There is a scarce evidence that supports policies that regulate the sell of fast food in schools by kiosks or vending machines as a measure to reduce this type of food among school children and adolescents. However, it should be part of a broad arrange of measures implemented in schools.

20 Question 3: Labelling Conclusion: The effectivenessof labelling food packages to reduce the consumption of junk food among children and adolescent is limited However, there is a right of the public to know what they are consuming

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22 The policy entrepeneur role The INS team met with: Vice-minister and his technical team Congressman PAHO and other non-government institutions Institutions that represent the industry: Sociedad Nacional de Industrias The Minister of Heath and his board of directors

23 La iniciativa ahora señala que los anuncios no deben incentivar el consumo inmoderado de alimentos y bebidas no alcohólicas, con grasas trans, alto contenido de azúcar, sodio y grasas saturadas.

24 17 de mayo 2013

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26 Publicado: 18/05/2013

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28 Recognition that evidence is only a component in the decision-making process Evidence Environment and context Resources Values and preferences of the target population

29 Work ongoing Almost two years after: Regimentation is still being developed Critics still ongoing that are being addressed in this final phase

30 Parallel between junk food publicity and alcohol publicity

31 Challenges for public health informed in evidence Ámbito inmanejable y demandas urgentes Capacidades insuficientes Roles y responsabilidades no claras en contextos fragmentados Governanza débil y corrupción Insuficientes datos Vínculos débiles con la toma de decisiones

32 Evidence helps to make better decisions, but it takes a long and exciting journey that needs a lot of effort of several actors to get to the final goal to benefit the population