Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Keeping Public Health Clean: Food Policy Barriers and Opportunities in the Era of the Industrial Epidemics

1 Department of Public Health and Policy
2 Department of Public Health and Policy, University of Liverpool

Special Issues: Health and Wealth, inequality and health status, public health nutrition: the major challenges to creating a healthier world

Poor diet accounts for a larger burden of disability and death than tobacco, alcohol and physical inactivity combined.[1] The World Health Assembly has recognized this as a priority and has challenged member countries to reduce non-communicable disease (NCD) mortality by 25% by 2025 targeting their determinants.[2] Reaching these ambitious targets is possible, but it will require decisive action on diets and tobacco smoking if we want to make a difference.[1] Certainly diet can deliver these reductions rapidly, possibly in less than a decade, and particularly by reducing cardiovascular disease burden, still one of the most important cause of death globally.[3,4]
But the impact of these diseases can be substantially lowered. Several natural experiments have shown the dramatic changes in mortality can be observed after changes of risk factors at population level, many attributable to changes in food intake [5]
  Article Metrics


1. Kontis V, Mathers CD, Rehm J, et al. (2014) Contribution of six risk factors to achieving the 25×25 non-communicable disease mortality reduction target: A modelling study. Lancet 384: 427-37.    

2. World Health Assembly. Global action plan for the prevention and control of noncommunicable diseases.Geneva, 2013. Available from: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf.

3. Capewell S, O’Flaherty M. Rapid mortality falls after risk-factor changes in populations. Lancet 378: 752-3.

4. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; published online June. DOI:10.1016/S0140-6736(15)60692-4.

5. Capewell S, O’Flaherty M. (2011) Can dietary changes rapidly decrease cardiovascular mortality rates? Eur Hear J 32: 1187-9.    

6. STROM A, JENSEN RA. (1951) Mortality from circulatory diseases in Norway 1940-1945. Lancet (London, England) 1: 126-9.

7. Notzon FC, Komarov YM, Ermakov SP, Sempos CT, Marks JS, Sempos E V. (1998) Causes of declining life expectancy in Russia. JAMA 279: 793-800.    

8. Ezzati M, Obermeyer Z, Tzoulaki I, Mayosi BM, Elliott P, Leon D a. (2015) Contributions of risk factors and medical care to cardiovascular mortality trends. Nat Rev Cardiol : 1-23.

9. Zatonski WA, McMichael AJ, Powles JW. (1998) Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991. BMJ 316: 1047-51.    

10. Bandosz P, O’Flaherty M, Drygas W, et al. (2012) Decline in mortality from coronary heart disease in Poland after socioeconomic transformation: modelling study. BMJ 344: d8136.    

11. Franco M, Bilal U, Orduñez P, et al. (2013) Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends. BMJ 346: f1515.    

12. Capewell S, Graham H. (2010) Will cardiovascular disease prevention widen health inequalities? PLoS Med 7: e1000320.    

13. McGill R, Anwar E, Orton L, et al. (2015) Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact. BMC Public Health 15: 457.

14. Collins M, Mason H, O’Flaherty M, Guzman-Castillo M, Critchley J, Capewell S. (2014) An economic evaluation of salt reduction policies to reduce coronary heart disease in England: a policy modeling study. Value Health 17: 517-24.    

15. Gillespie DOS, Allen K, Guzman-Castillo M, et al. (2015) The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast. PLoS One 10: e0127927.    

16. Allen K, Pearson-Stuttard J, Hooton W, Diggle P, Capewell S, O’Flaherty M. (2015) Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study. BMJ 351: h4583.

17. Smith R. (2012) Learning from the abolitionists, the first social movement. BMJ 345: e8301.    

18. Jahiel RI, Babor TF. (2007) Industrial epidemics, public health advocacy and the alcohol industry: lessons from other fields. Addiction 102: 1335-9.    

19. Monteiro CA. (2011) The big issue is ultra-processing. There is no such thing as a healthy ultra-processed product. World Nutr 2: 333-49.

20. Swinburn BA, Sacks G, Hall KD, et al. (2011) The global obesity pandemic: shaped by global drivers and local environments. Lancet 378: 804-14.

21. Bromley H, Lloyd-Williams F, Orton L, O’Flaherty M, Capewell S. Identifying the most effective and cost effective public health nutrition policy options for CVD prevention. Bruxelles, 2014. Available from: http://www.ehnheart.org/projects/euroheart-ii/euroheart-ii-publications/publication/786-identifying-the-most-effective-and-cost-effective-public-health-nutrition-policy-options-for-cvd-prevention.html (accessed June 15, 2015).

22. Lloyd-Williams F, Bromley H, Orton L, et al. (2014) Smorgasbord or symphony? Assessing public health nutrition policies across 30 European countries using a novel framework. BMC Public Health 14: 1195.

23. Capewell S. (2014) Personal Communication.

24. World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization, 2003. Available from: http://www.who.int/fctc/en/ (accessed April 13, 2016).

25. Action on Sugar. 2015. Available from: http://www.actiononsalt.org.uk/actiononsugar/ (accessed Nov 6, 2015).

26. Brownell KD, Warner KE. (2009) The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q 87: 259-94.

27. England PH. From evidence into action: opportunities to protect and improve the nation’s health. 2014. Available from: https://www.gov.uk/government/publications/from-evidence-into-action-opportunities-to-protect-and-improve-the-nations-health.

28. Public Health England. Sugar Reduction: The evidence for Action. 2015.

29. Instituto Nacional de Salud Publica. Reducción en el consumo de bebidas con impuesto después de la implementación del impuesto en México. 2015. Available from: http://www.insp.mx/epppo/blog/3666-reduccion-consumo-bebidas.html (accessed Nov 6, 2015).

30. Sugar Rush | Jamie Oliver. Available from: http://www.jamieoliver.com/sugar-rush/#lA8MBiMVZdyt83td.97 (accessed Nov 6, 2015).

31. Moodie R, Stuckler D, Monteiro C, et al. (2013) Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet (London, England) 381: 670-9.    

32. Bryden A, Petticrew M, Mays N, Eastmure E, Knai C. (2013) Voluntary agreements between government and business - a scoping review of the literature with specific reference to the Public Health Responsibility Deal. Health Policy 110: 186-97.    

33. McKee M, Diethelm P. (2010) How the growth of denialism undermines public health. BMJ 341: c6950.    

34. Nestle M. Food Politics » Another 5 industry-funded nutrition studies with results favorable to the sponsor. The score: 75:6. 2015. Available from: http://www.foodpolitics.com/2015/10/another-5-industry-funded-nutrition-studies-with-results-favorable-to-the-sponsor-the-score-766/ (accessed Nov 6, 2015).

35. Naci H, Dias S, Ades AE. (2014) Industry sponsorship bias in research findings: a network meta-analysis of LDL cholesterol reduction in randomised trials of statins. BMJ 349: g5741.    

36. O’Connor A. Coca-Cola Funds Scientists Who Shift Blame for Obesity Away From Bad Diets - The New York Times. New York Times. 2015. Available from: http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/?_r=0 (accessed Nov 6, 2015).

37. Beaglehole R, Bonita R, Yach D, Mackay J, Reddy KS. (2015) A tobacco-free world: a call to action to phase out the sale of tobacco products by 2040. Lancet 385: 1011-8.    

38. United Nations. United Nations Millennium Development Goals. Geneva: United Nations, 2015. Available from: http://www.un.org/millenniumgoals/ (accessed April 13, 2016).

39. Katz R, Kornblet S, Arnold G, Lief E, Fischer JE. (2011) Defining health diplomacy: changing demands in the era of globalization. Milbank Q 89: 503-23.

40. Weiss M. Trading Health? UK Faculty of Public Health Policy Report on the Transatlantic Trade and Investment Partnership. London, 2015. Available from: http://www.fph.org.uk/ttip_’threat_to_people's_health_in_uk_and_across_europe' (accessed Nov 6, 2015).

41. Bailey R, Harper DR. Reviewing Interventions for Healthy and Sustainable Diets. London, England, 2015. Available from: http://www.isags-unasur.org/uploads/biblioteca/7/bb[327]ling[3]anx[1100].pdf (accessed April 1, 2016).

Copyright Info: © 2016, Martin O’Flaherty, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved