Food for thought: unpacking the global burden of non-communicable diseases

A rapidly expanding field of research suggests that the food we eat plays an integral role in either preventing or accelerating some of the world’s most prevalent and life-threatening diseases.

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In particular, diets high in processed foods, refined sugars and trans fats are known to promote cardiovascular disease, diabetes, some cancers, chronic lung disease and even mental illness. These illnesses are collectively referred to as non-communicable diseases (NCDs) as they are not transmissible between individuals, but rather arise due to a number of predisposing factors.

Worldwide, NCDs are the leading cause of morbidity and mortality, and an unhealthy diet remains the number one risk factor for the global burden of disease.

Whilst progress has been made in reducing world hunger over recent decades, obesity has become increasingly prevalent. Today, overconsumption of nutrient-poor and calorie-dense foods sees almost 2 billion adults overweight or obese. For the first time in history, the number of overweight or obese individuals worldwide dramatically exceeds the number of those who are dangerously underweight.

Obesity, a disease in and of itself, is further associated with increased blood pressure, cholesterol, insulin resistance and inflammation, and is therefore a major risk factor for NCDs and associated morbidity and mortality.

The causal link between various foods and NCDs is well documented, and it is well established that diets consisting of predominantly plant-based, non-processed foods are protective against these illnesses. However, a number of misconceptions persist, and a striking lack of effective food policies means that it remains remarkably difficult for people to eat healthily.

Contrary to popular belief, NCDs are not diseases of the rich and lazy, nor are they inevitable features of the aging process. These diseases result from and perpetuate poverty, and the age of onset is becoming alarmingly younger.

Rhetoric surrounding the interplay between food, obesity and NCDs too often fails to recognise the impact of upstream determinants, instead shifting blame onto individuals.

Strong evidence shows that NCDs are correlated with the social gradient of health: the epidemiological and clinical phenomenon whereby inequalities in population health are correlated with inequalities in social status.

Globally, consumption of calorie-dense and nutrition-poor processed foods continues to rise, and disadvantaged populations are increasingly exposed to diets that predispose to chronic disease.

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Dramatic changes in global food systems over recent decades have seen a decrease in nutritional quality, food security and environmental sustainability. This has had vast and unfavourable implications for the availability and affordability of nutritious foods in relation to their processed alternatives.

No longer confined the West, mass-produced processed foods are now abundant across the world, and so too are their associated diseases.

Low- and middle-income countries are disproportionally affected by NCDs, and despite a continued high burden on communicable illnesses such as HIV, hepatitis and malaria, these nations now account for 80% of global NCD-related deaths.

Even in the OECD, factors such as impaired early childhood development, unemployment, and social or geographic isolation are associated with increased susceptibility to NCDs, as well as accelerated disease progression.

This demonstrates a stark correlation between socioeconomic status and NCDs, and highlights driving factors that extend far beyond individual behaviour and choice.

NCDs can no longer be dismissed as lifestyle diseases; they are products of a deeply flawed global food system and economic model.

In a world where advertising campaigns, supermarket aisles and even school canteens continually promote unhealthy foods, it is frankly unrealistic to blame individuals for becoming overweight and sick.

Junk food and chronic disease have become the social norm, and this is a tough paradigm to break. Now more than ever, we need to tackle the structural drivers that are currently pushing us towards an ill future, so that health becomes the path of least resistance.

The views and opinions expressed in this article are those of the author and do not necessarily represent those of the Doctus Project.