1. Document 2004/03 18th Session of COAG
COAG 18th Session – 9-10 Feb 2004
Document 2004/ th Session of COAG
9 -10 February 2004

2. Joint FAO/WHO Expert Consultations
COAG 18th Session – 9-10 Feb 2004
Joint FAO/WHO Expert Consultations
Fats and Oils in Human Nutrition, 1993
Carbohydrates in Human Nutrition, 1997
Vitamin & Mineral Requirements, 1998
Human Energy Requirements, 2001
Protein and Amino Acid Requirements, 2002
Diet, Nutrition and the Prevention of Chronic Diseases, 2003
FAO is mandated to work with WHO on a whole range of issues related to food and nutrition since the 1950s. This includes joint work on nutritional requirements, nutritional indicators and the assessment of undernourishment, nutrition education, etc.
It works jointly with WHO on food safety and Codex and codex related activities including provision of scientific advice to Codex and other bodies.
The list here is but a sample of joint activities since the 1990s.

3. Deaths by regions, 2000 % 75 50 25 COAG 18th Session – 9-10 Feb 2004
Non communicable diseases include premature heart disease, stroke, diabetes, and cancers. Overweight and Obesity are serious underlying problems that increase risk of NCDs.
If one looks ate the mortality from diseases it is already evident in the year 2000 that NCDs have overtaken infectious diseases in most regions of the world apart from Africa.
High cholesterol accounts for 4 million premature deaths while high blood pressure is responsible for 7 million premature deaths.
It has been projected that in 2020:
71% of deaths due to heart disease, 75% due to stroke and 70% due to diabetes, will be in developing countries.
Premature death and disability from NCDs are the result of unhealthy diets and lack of physical activity.
They are largely preventable by healthy diets and lifestyles.
AFRICA
Eastern
Mediterranean
SE-ASIA
W.PACIFIC
AMERICAS
EUROPE
Accidents
Communicable diseases
Non-communicable Diseases
Source: WHO, World Health Report 2001

4. Global burden of disease in developing countries
COAG 18th Session – 9-10 Feb 2004
Global burden of disease in developing countries
1990
2020
27%
43%
22%
49% 9%
21%
The burden of disease is no only due to premature death but also due to disability associated with the illness. These have both economic and health care costs and are hence a burden to the economy of countries.
Of the 672 million affected with NCDs in 2000, nearly 370 million are from developing countries.
Diabetes alone accounts 84 million in 1995 in developing countries and this is expected to increase to 228 million in 2020
Overweight and obesity are serious problems. WHO has estimated that in 2000 more than 1 billion adults worldwide were overweight while 300 million were clinically obese. Among these half a million were expected to die in North America and Europe alone from obesity related NCDs.
15%
14%
Infectious diseases
Non Communicable Diseases
Mental Illness
Injuries

5. Developing countries face double burden of under and over nutrition
COAG 18th Session – 9-10 Feb 2004
Developing countries face double burden of under and over nutrition
Poor maternal nutrition and low birth weight increases risk of obesity and NCDs later in life
Poverty, hunger and undernutrition are
linked to chronic diseases
Almost 24% of infants born in developing countries have Low birth weight (below 2.5Kg).
The main cause is poor maternal nutrition.
The Barker hypothesis has clearly demonstrated that low birth weight increases risk of NCDs in adult hood and that these individuals are more at risk from the usual risk factors such as diet and physical activity in adulthood which increases their risk of Obesity and NCDs.
These will further contribute to the double burden in developing societies.

6. Main recommendations of Expert Report
COAG 18th Session – 9-10 Feb 2004
Main recommendations of Expert Report
Dietary factor Goal (% of total energy)
Total fat %
Saturated fatty acids <10%
Total carbohydrate %
Free sugars <10%
Sodium chloride <5 g per day
Fruits and vegetables >400 g per day
Physical activity minutes of walking/day
These are some of the main recommendations

7. Recommendations of Expert Report
COAG 18th Session – 9-10 Feb 2004
Recommendations of Expert Report
Goals are recommendations on population averages
Goals are not intended as regulatory targets
Recommendations in keeping with recent advice provided by national and international reports

8. The COAG Document 2004/03
COAG 18th Session – 9-10 Feb 2004
Provides preliminary assessment of possible implications for agriculture, food processing and marketing
Edible oils and fats
Sugar
Cereals
Fruits and vegetables
Milk and meat
Fish and fish products
Food processing technologies and marketing
Proposes follow-up actions
Requests guidance from COAG
Reviews the Expert Consultation Report

9. COAG 18th Session – 9-10 Feb 2004
The COAG Document 2004/03
Follow-up in the context of on-going work ...
Incorporate emerging scientific evidence on the double burden of hunger and over-nutrition
Inform and protect consumers
Promote the livelihoods of farmers and food processors given changing consumption patterns

10. The COAG Document 2004/03
COAG 18th Session – 9-10 Feb 2004
Follow-up in the context of evolving areas ...
Take stock of dietary patterns and their health implications
Interpret dietary goals in country-specific situations
Supporting innovation in food products
Examine food and agricultural policy options and actions

11. The COAG Document 2004/03 COAG’s approval is sought for FAO to ...
COAG 18th Session – 9-10 Feb 2004
COAG’s approval is sought for FAO to ...
Strengthen work with WHO in nutrition and promotion of healthy diets
Provide Members with advice and assistance in raising awareness of nutrition and healthy diets
Assist Members in formulating and implementing policies and programmes for diversification of agricultural production

12. Briefing for COAG 18th Session
Changes in nutrient intake: Outlook to If business as usual continues ...
This slides presents the rapid nutrition transition the world has been experiencing over the last 40 years. It will also give an outlook into the next 30 years
On the x-axis you see the so-called DES, i.e. the dietary energy supply in calories per person and day
On the y-axis is the daily protein availability in g/day
Also note that the time will be changing (it’s in the subtitle over the next 60 seconds or so, starting with the year 1960 going to the year 2030
There are a number of lines in the chart to denote whether a diet is rich in energy and/or protein: A diet that provides more than 3000 kcal and more than 75g protein per day is generally considered a very rich diet and is also a potential contributor to obesity
We start in 1961 and first go through the past 40 years:
As you see, many countries moves into the center at a growing speed.
We witness a rapid nutrition transition owing
To the achievements of the Green Revolution
Falling real prices for food (60% lower than in the 1960s)
Rapid income growth, declining population growth (population growth has rapidly declined in developing countries; over the next 30 years (1.1%), it will only be about half of what it was over the last 30 years (2%)
[stop the slide at the end of the 1990s]
By the end of the 1990s, many developing countries, particularly in Asia and Latin America have moved out of the lower-left quadrant, i.e. out of the area where energy and protein deficiencies are highly prevalent.
Outlook to 2030: speed accelerates and the picture of the 1960s reverses: all countries except for those in SSAF are moving towards the upper right corner.
This suggests that the burden on obesity and NCDs coming from the diet may quickly accelerate,
The projections of the dietary changing alone may even understate the problem: We also expect that growing urbanization, mechanization, etc will reduce calorie expenditure so that excess consumption may even increase faster than this chart suggest
But also note that there will be still hunger in the world. As you know, more than we all want (443 million by 2030). In most cases, hunger will be limited to Sub-Saharan African countries, but also a few countries in the Near East North African region and South Asia will still be affected.
As a result, we will see a nutritional dichotomy where hunger and overnutrition exist in tandem, often even in the same country. In other words, the double burden of hunger and obesity is poised to further increase over the next 30 years!
The world is therefore sitting on a nutritional time bomb, many developing countries can still avoid the obesity and NCD problems of developed countries, but they need to act soon. We thought that the expert recommendations could provide an overall frame for the right nutritional guidance!

13. Green Room 9 February 2004 13:30 – 14:30
Briefing for COAG 18th Session
COAG Side Event
Implications of dietary recommendations for the undernourished and developing countries
Chair: Hartwig de Haen
Implications of recommendations for developing countries
Prof. Ricardo Uauy, INTA, Chile (Chair of Expert Consultation)
Implications for the undernourished and links with chronic disease
Prof. Alan Jackson, Univ Southampton, UK (Chair of Scientific Committee on Nutrition, UK)
Implications for producers in developing countries
Dr Don Mitchell, World Bank, Washington
Green Room
9 February :30 – 14:30