Objectives and implications of A Decade of Action on Food and Nutrition policies in Iran

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1 Objectives and implications of A Decade of Action on Food and Nutrition policies in Iran Amirhossein Takian, MD PhD FHEA Professor of Health Policy & Global Health- TUMS Deputy for International Organizations, MOHME- Iran

2 Leading Dietary Risk Factors for Mortality in the Middle East Afshin et al Institute for Health Metrics and Evaluation (IHME)

3 National Intakes of Protective Dietary Factors in MENA Region Vivamus elit ipsum, accumsan non quam vitae, scelerisque blandit ipsum. Integer eget ex nisl. Vivamus dignissim lorem eu lobortis faucibus. Redline represents the optimal level Afshin A, et al. BMJ Open 2015;5:e006385

4 Comparison of Usual Dietary Intakes with DASH in Iran DASH index Usual Intake in Iranian Population Dietary Approaches to Stop Hypertension (DASH) Haghighatdoost F, et al. Nutrition Azadbakht L, Haghighatdoost F, Feizi A. Nutrition. 2013

5 Comparison of Usual Oil Intakes with DASH in Iran DASH index Usual Intake in Iranian Population 2 Dietary Approaches to Stop Hypertension (DASH) 0 Saturated fat (%) Azadbakht L, Esmailzadeh A. J Nutr, 2009 Paige E Miller, Amanda J Cross, Amy F Subar, et al. Am J Clin Nutr. 2013

6 Daily per capita consumption of salt: WHO recommended: less than 5 grams per day for adults. Iran: 12 grams per day

7 Dietary energy supply, top 20 countries-2000 to 2015 In 1961 the average global calorie availability was as low as 2196 kcal/cap/day; by 2011, it had reached 2870 kcal/cap/day. In IRAN, Dietary energy supply was increased in recent decade FAO, World Food & Agriculture, 2015

8 Distribution of Governments Nutrition for Growth Policies and Program Commitments within the ICN2 Framework for Action Categories GLOBAL NUTRITION REPORT 2016 International Food Policy Research Institute (IFPRI)

9 Supreme Council for Health & Food Security (SCHFS) in Iran SCHFS Holding meetings in the cabinet Secretariat of SCHFS at MOHME Food Security & Nutrition Task group Health threats reduction task group Technical committees Technical committees Provincial Committee for Health and Food Security In 2014, the SCHFS revised the standards of trans fatty acids to less than 2% and saturated fatty acid to less than 25%. Reducing the amount of imported palm oil (from 70 % to 30%) and charging additional tariffs (Up to 40%) for imported palm.

10 Intra-sectoral Structure of INCDC at the Ministry of Health & Medical Education (MOHME)- Iran MOHME Supreme Council for Health and Food Security Deputy for Public Health Deputy for Treatment FDO Deputy for Social Affairs Deputy for Education Deputy for Research Deputy for Development Main Goal: To make integration in policy-making, planning, and monitoring (not implementation) on all activities in the field of non-communicable diseases and related risk factors in the Islamic Republic of Iran

11 Nutrition/Food Targets in National Action Plan for NCDs Target1. 25% reduction in the risk of premature death from NCDs Target 2. At least 10% relative reduction in alcohol consumption Target 4. 30% relative reduction in the average salt intake in the population Target 7. Halt the rates of diabetes and obesity Target 8. At least 70% (50%) of eligible people receive drug therapy and counselling to prevent heart attacks and strokes Target 9. An 80% availability of the affordable basic technologies and essential medicines, including generics in private and public sectors Target 10 (Iran : Zero trans fatty acid in food & oily products

12 National Nutrition and Food Security Policy (NFSPS) ( ), in implementation Decreasing the amounts of salt, sugar and fats in food and beverages, at least by 30% Reduction in mean family edible oils and frying oil trans fatty acid to lower than 2% and industrial oil (confectionary and etc.) to lower than 5% by 2025) Increasing consumption of fruits and vegetables and pulses by 15% Increasing the nutritional awareness of the target groups, by at least 50% Establishing nutrition consultation visit for obese children, adolescents, adults, pregnant and elderly, in PHC Educational Campaigns on salt/fat and sugar reduction and increasing consumption of vegetables, fruits, whole grains Revising and developing the Iranian Food Based Dietary Guideline to Integrate overweight and obesity prevention and control program into PHC system Encouraging bakeries to produce high fiber and low salt bread (from 2.3% to 1.8%) Developing educational materials on healthy diet for Community Health Centers

13 Trans Fatty acid content (%) Some early achievements aily Sugar Intake from Beverages (gram) Daily salt intake from bread (g) Salt Content (%) Trans fatty acids content of Edible fat and oil changes in National regulations (before and after implementation) 10 Food Salt content changes in national regulations (After and before plan) Frying oil Edible Vegetable oil (Semi solid) Before plan Table Margarine Spreadable Margarine After plan Margarine and Shortening for food industry uses 5 2 Minarin Before plan Cheese After plan Traditional bread 0.8 Doogh (Persian Yogurt Drink) Daily Sugar Intake from Beverages ( ) Daily Sugar Intake from Beverages ( 2015) 8.9 Daily Sugar Intake from Beverages ( 2016) Daily salt Intake from bread ( ) Daily salt Intake from bread (Before 2014) Daily salt Intake from bread (2015) 3.2 Daily salt Intake from bread (2016)

14 Food Labelling, Traffic Light & health promotion campaigns Calorie Sugar Fat Salt Trans Fatty Acids Protein High Medium Low Up to 90% of food products have been labeled by Traffic Light of Diet by OCT 2017

15 Questions/comments E: Naghshe-Jahan Square, Isfahan-Iran