1. Zhai, Public Health Nutrition, Feb 2002 WHAT IS CHINA DOING IN POLICY-MAKING TO PUSH BACK THE NEGATIVE ASPECTS OF THE NUTRITION TRANSITION? Fengying Zhai Professor of Nutrition Institute of Nutrition and Food Hygiene Chinese Academy of Preventive Medicine

2. Zhai, Public Health Nutrition, Feb 2002 Fig1. Trend of mortality of NCDs Respiratory diseases Heart diseases CVD Cancer Metabolic diseases Digestive disease Death rate 1/100000 Death rate of NCD in urban areas 1954-1998 Source:China Disease Surveillance data.

3. Zhai, Public Health Nutrition, Feb 2002 Fig4. Comparison of BMI Distributions of Chinese Young Adults of Different Surveys UrbanRural Source: Ge K Y, et al. The dietary and nutritional status of Chinese population. People’s Medical Publishing House.p-92. %

4. Zhai, Public Health Nutrition, Feb 2002 Direct medical costs of selected NCDs: 1998 Survey  COPD: 49.50 billion RBM  CVD: 25.89 billion RBM  Cancer: 12.8 billion RBM  Total: 88.19 billion RBM (10 billion USD) Direct medical cost only includes fees from inpatient Source: China Disease Surveillance Data

5. Zhai, Public Health Nutrition, Feb 2002 1989 10.77 14.59 1991 9.8 17.78 1993 8.87 10.07 Tab.2 The prevalence of malnutrition in children aged under 5-year in 8 provinces in China from 1989 to 1997 1997 4.58 10.38 16.94 29.85 18.92 31.37 14.50 27.09 12.88 20.38 Underweight (%) Urban Rural Stunting(%)

6. Zhai, Public Health Nutrition, Feb 2002 Actions in nutrition sector The Dietary Guidelines for Chinese Residents and Food Guide Pagoda Eat a variety of foods, with cereals as the staple. Consume plenty of vegetables, fruits, and tubers. Consume milk, beans, or dairy- or bean-products every day. Consume appropriate amounts of fish, poultry, eggs, and lean meat. Reduce fatty meat and animal fat in the diet. Balance food intake with physical activity to maintain a healthy body weight. Choose a light diet that is also low in salt. If you drink alcoholic beverages, do so in limited amounts. Avoid unsanitary and spoiled foods.

7. Zhai, Public Health Nutrition, Feb 2002 The change of meat consumption

8. Zhai, Public Health Nutrition, Feb 2002 The change of energy intake % of fat

9. Zhai, Public Health Nutrition, Feb 2002

15. Actions in nutrition sector (con’t) National Plan of Action for Nutrition Background support

16. Zhai, Public Health Nutrition, Feb 2002 The Outline on China Food and Nutrition Development from 2001  2010 The current consumption of meats in China: pork-70%, beef and mutton-15%, poultry-15% pork consumption will be adjusted to be reduced to 62% of the total meat consumption poultry consumption will be increased to 20% after adjustment at the same time

17. Zhai, Public Health Nutrition, Feb 2002 Related health sector activities The National Plan of community-based control and prevention for the NCDs The National Guideline for the Control and Prevention of Hypertension The National Plan for the Prevention and Control of Diabetes Mellitus, Malignant Tumor The National Plan for Community-Based Prevention and Control of Cardiovascular Diseases

18. Zhai, Public Health Nutrition, Feb 2002 Efforts by other sectors Promotion to develop soybean industry and to increase soybean consumption Subsidization of vegetables Smoking cessation Physical activity promotion

19. Zhai, Public Health Nutrition, Feb 2002 Fig. 2. Age-adjusted prevalence of hypertension in population aged 35-64 of demonstration sites in 1989 and 1996 Prevalence (%) Source: Tianjin non-communicable chronic disease community comprehensive prevention and control project Definition of hypertension: systolic blood pressure≥160 &/or diastolic bp ≥ 95 mm Hg

20. Zhai, Public Health Nutrition, Feb 2002 Primary School Children Secondary School Children elderly Household Intervention group A Control group A Control group B Intervention group B

21. Zhai, Public Health Nutrition, Feb 2002 Conclusions National policies attempts to prevent DR- NCD Dietary Guidelines Food supplies, productions, and consumption and utilization Through implementations of national plans for controlling and prevention of DR-NCD to change KAP and improve people’s health

22. Zhai, Public Health Nutrition, Feb 2002 Some suggestions The intersectorial collaboration should be strengthened A working group at national level should be formulated A comprehensive intervention strategy should be taken The nutrition education activities should be strengthened The dietitian law should be formulated