Overweight and Obesity in Saudi Arabia

Page 153

Food Systems Approach to Nutrition Policies in Saudi Arabia

Three case studies highlight the experiences of countries with integrated and systems-based strategies (Mexico, Chile, and the United Kingdom) and the sequencing of various initiatives (annex 8A). Overall, the case studies show that engaging with industry too early in the process can be counterproductive and greatly delay efforts to make impactful change in the public’s understanding and actualization of behavior change. Additionally, when a more complete policy package is staged in its implementation or becomes fully implemented, much larger transformations of the food system can be realized. That said, integrated and vertical sequencing (using regulations that build on each other) or horizontal sequencing (with regulations that get stricter over time) of policies also make evaluations of each of the policies that make up the overall package extremely difficult to assess, so teasing out the contribution of each of the various components becomes more challenging. Similar to the countries in the three case studies, Saudi Arabia has the capacity and resources to catalyze the collective action to transform its and its region’s food system. Given the stage of the nutrition transition in Saudi Arabia and existing dietary trends, it would be best to begin with policies and actions aimed at discouraging diets that are detrimental to the country’s people and environment. Using the four priority policies actions of the Foresight Report (GLOPAN 2020), a nutrient profiling model (NPM) can be used to develop a thoughtful sequencing of policies and their implementation to reduce the availability, accessibility, affordability, and desirability of unhealthful products. This can be achieved by creating sequenced actions along two dimensions. The first is vertical sequencing, which occurs when new policies build on existing policies. The second dimension is horizontal sequencing, which allows a reasonable period of time for industry to adapt in a stepwise manner to improve its offerings, as the regulations also get stricter over time. A next stage once meaningful progress has been made on discouraging poor diets would be to encourage diets that benefit people and the environment and again can be tackled along vertical and horizontal sequenced policies using food-based dietary guidelines (FBDGs) that do not contradict the NPM as the basis (WHO EMRO 2017). The following sections first describe trends in key sources of nutrients of concern in Saudi Arabia (“Trends in Key Sources of Nutrients of Concern: Ultraprocessed Products”), then lay out considerations in developing a Saudi Arabia–specific NPM aimed at addressing these trends (“Considerations for Developing a Saudi-Specific NPM to Discourage Ultraprocessed Foods and Beverages”) and how to apply the NPM for integrated policies (“Applying a Saudi-Specific NPM for Transforming the Food System”). The chapter ends with conclusions.

TRENDS IN KEY SOURCES OF NUTRIENTS OF CONCERN: ULTRAPROCESSED PRODUCTS Saudis are consuming more processed packaged foods over time; 65–70 percent of food and beverages sold in Saudi Arabia are either processed or ultraprocessed, as shown using aggregate data from Euromonitor (figures 8.2 through 8.5). Specifically, the share of the ultraprocessed foods’ contribution to total calories sold rose steadily between 2010 (8.7 percent) and 2019 (10.4 percent). There has been a corresponding decrease in the share of fresh foods over this period. The slight reduction in total calories appear to be at least

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8A.5 Example of UK multiple traffic light front-of-package labeling

5min
pages 177-178

Annex 8A: Case studies of countries with integrated and systems-based strategies Annex 8B: Examples of applied or recommended nutrient

2min
page 172

8.7 Stage 2: Increase the intake of healthy foods in Saudi Arabia 8A.2 Complete set of black seal labels that might be applied on front-of-package

7min
pages 168-170

8A.3 Example of campaign among public health advocates in support of Mexico’s front-of-package labeling regulation 8A.4 Example of cereal before (left) and after (right) Chile’s food labeling and

1min
page 175

labeling for Mexico based on product characteristics

1min
page 174

marketing law

1min
page 176

8A.1 Example of campaign material by advocates for the sugar-sweetened beverages tax to fund drinking fountains in schools

1min
page 173

Applying a Saudi-specific NPM for transforming the food system

2min
page 166

8.6 Stage 1: Reduce the intake of unhealthy foods in Saudi Arabia

2min
page 167

approaches

4min
pages 161-162

in Saudi Arabia and Chile

5min
pages 159-160

References

22min
pages 142-150

healthy diets

2min
page 152

per capita per day), 2010–19

1min
page 154

products

2min
page 153

Conclusions

2min
page 139

reformulation in Saudi Arabia

7min
pages 134-136

7.5 Saudi Arabia’s voluntary traffic light label, 2018

4min
pages 132-133

7A.2 Examples of different tax designs and evidence on their effectiveness

2min
page 141

Key lessons learned from global experiences

2min
page 138

7.3 Trends in carbonated drink volume per capita sales (liters), 2010–18

4min
pages 127-128

Obesity-prevention policies and their effectiveness evidence

2min
page 124

References

17min
pages 114-120

of COVID-19

9min
pages 109-112

Conclusions

2min
page 113

Summary and conclusions

3min
pages 95-96

The impact of obesity on COVID-19

2min
page 102

References

5min
pages 98-100

Estimating the economic burden using the economic growth approach method

2min
page 94

Estimating the economic burden using the value-of-a-statistical-life method

5min
pages 92-93

obesity

5min
pages 90-91

method

2min
page 87

Annex 4B: Supplementary details for intervention assumptions

2min
page 78

5.2 Direct medical costs attributable to overweight

1min
page 88

Key messages

1min
page 85

Results

2min
page 60

risk factors

5min
pages 57-58

Methods

2min
page 55

References

7min
pages 50-52

and obesity

2min
page 44

References

5min
pages 37-38

Socioeconomic and cultural influences

4min
pages 47-48

Dietary behaviors contributing to overweight and obesity Physical inactivity as a risk factor in the development of overweight

8min
pages 41-43

ages 5–9 years, by sex, 1975–2016

1min
page 30

2 Engagement of men and women in sufficient physical activity in

2min
page 23
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