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  • The promotion of fruits and vegetables is often considered

    2019-04-15

    The promotion of fruits and vegetables is often considered the so-called low-hanging ondansetron hcl of nutrition interventions, because their intake can indicate the nutritional quality of diets. Moreover, promotion of fruits and vegetables is likely to be more palatable economically to governments and the food industry than are interventions that restrict intake of unhealthy choices. But a sole focus on increasing fruit and vegetable consumption might not be enough to improve diets. Between 1986 and 2012, remote Aboriginal communities in Australia successfully doubled fruit and vegetable intake when the relative affordability of these foods improved by 30%. However, the overall effect was a decline in total diet quality, characterised by increased supply and intake of foods high in saturated fat, added sugar, or salt, particularly sugar-sweetened beverages, convenience meals, and takeaway foods, reflecting broader concomitant changes to the Australian food supply. Australian households now spend around 58% of their food budget on these unhealthy foods; only 10–15% is spent on fruits and vegetables, compared with 29% of the food budget (around 7% of disposable household income) required to achieve recommended intakes. The International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS) is working globally to benchmark and monitor the healthiness of food environments, including diet price and affordability, using standardised methods. It is not clear from Miller and colleagues\' study whether the investigators have plans to repeat this cross-sectional survey; but if so, the methods could articulate within the INFORMAS stepwise framework. Ideally, intracountry variation should also be examined to better target strategies to improve diet and health equity.
    In , Ali Mokdad and colleagues present the interesting subject of health in times of uncertainty, which sheds light on the burden of morbidity and mortality in the eastern Mediterranean region—a major setting for violence in the past decade. The security fluctuation in these countries draws attention to the need to analyse the health situation through translation of health status to a clear sketch about disease, death, and years of potential life lost in the region.
    In their Article, Eduardo González-Pier and colleagues estimate the magnitude of Mexico\'s challenge to accomplish the committed goal on mortality reduction as a component of the Sustainable Development Goals (SDG) in 2015. According to the authors\' estimations, Mexico\'s present mortality trend will fall short of the committed goal and so there is a need to improve public policies that might result in a faster decrease in mortality. González-Pier and colleagues propose a set of potential interventions that the country should implement for this purpose. Although already reported, the magnitude of the challenge that chronic disorders and injuries represents for Mexico is still striking. As highlighted in the report from the Global Burden of Disease (GBD) study, the main causes of disability-adjusted life-years in Mexico are diabetes, chronic kidney disease, and ischaemic heart diseases. This shift to non-communicable diseases as main causes of death is a worldwide phenomenon reported by the GBD study.
    Universal vaccination programmes have greatly reduced the burden of infectious diseases in both developing and developed countries. In the 1960s and 1970s, these reductions led to optimism that a victory in the battle against infectious diseases could be within reach. Unfortunately, even though the benefits of most childhood vaccinations are scientifically unquestioned, vaccination coverage rates are far from 100% in many countries, and show substantial variation. Early detection of trends and an improved understanding of underlying mechanisms are paramount to be able to improve vaccination policies.