#ISBNPA2019, Keynote, Barry Popkin: The Nutrition Transition, Dynamics in low- and middle-income countries, and Current Policy and Regulatory Activities to address nutrition-related health issues.

Presented at #ISBNPA2019, June 7

Chair: Annie Anderson The world has entered a stage of the nutrition transition dominated by increasingly unhealthy diets and activity patterns. Body composition distribution and NCDs related to diet and activity are increasing, especially in low and middle-income countries(LMICs). LMICs face an accelerating shift as global food systems and technology have dramatically changed food supplies and physical activity patterns. Food processors, food services, retailers, and agribusinesses have assumed the major role in food provision, and their voluntary efforts have failed to improve global diets. The shifts in diet and activity patterns are discussed. Most major policy initiatives by LMICs have been utilizing large-scale regulatory strategies to improve diets with limited focus on physical activity. Two approaches are foremost. First is a combination of taxation and price subsidies that make unhealthy foods and beverages, especially sugar-sweetened beverages, expensive and healthy traditional foods and beverages, such as fresh produce and legumes, more affordable. Second is prohibition of marketing that does not promote healthy behaviors. In addition to controls on media aimed at children, which have limited value, some countries are implementing full controls on all media, sometimes in combination with front-of-the-package profiling and positive or negative logos on products that encourage consumers to make healthier food purchases. Another initiative is placing controls on foods and beverages in schools and other public institutions. Few countries have introduced national programs to promote physical activity, yet that lifestyle component cannot be ignored. Important evidence regarding the impacts of large-scale actions is emerging. We are entering for the first time an era where many large-scale regulatory approaches are being evaluated and we will finally begin to test and then refine approaches that are more likely to prevent obesity and improve our diets in a way that will reduce the risk of many noncommunicable diseases and intermediate cardiometabolic risk factors.