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...... .. .... ... ... .. ...... .... ..... . .......... . ....... .. .... ... ... .. ....... . ........................ . ....... .. .... ... ... .. ....... . ........................ . ••• ••• •• ••• ••• •• ••• • •••••••••••••••••• ... ... .. .... ... ... .. ...... .... . ... ... ... . ..... . ::: ::: :s :::: ::: ::: :: ·:::::: :::: • :::.:::::::::: ::::::: ... ... .. ... ... .. ... .. . .............. . ... ... .. .... .......... ....... .. . ................... . ... ... .. .... .......... ....... .. . .................. . ... ... .. .... .......... ...... .. . ................ . Healthy eating in Europe What do Europeans eat? How do their food habits affect their health? What dietary changes wou ld be likely to protect and improve their health? There is no simple or definitive answer to any of these questions. Nevertheless. much more can be learned about this subject in future thanks to a WHO Regional Office for Europe publication entitled "Healthy nutrition - pre- venting nutrition-related diseases in Europe." Draf- ted by medical nutritionists. this work describes in detai l the evo lution of diseases and of nutrition in Europe over time. as well as the increas- ingly evident ties which con- nect them. What is now known is that throughout Europe almost half the premature deaths of men and women aged under 65 are due to diseases in which diet plays a major role. Coronary heart disease. infarctus. cancer of all sorts. diseases of the mouth. anae - mia. goitre. cirrhosis of the liver. diabetes. gal lstones. obesity. hypertension and bone diseases in elderly per- sons - the list of such ai l- Food habits of Europe Photo WHO/J Germam ments is a long one. and they place a heavy burden on the medica l services. Yet all can be considered as avoidable even if it is not yet clear exactly how dietary excesses or deficiencies provoke them. A thoroug h analysis of these 30 nutritional factors has never- theless enabled the authors to define a series of common objectives to be achieved with respect to nutrition for al l people living in Europe. The publication specifies lower and upper limits which shou ld not be exceeded; these have been deduced from recommendations for - mulated by various national committees; they can be con - sidered as the basis of an idea l diet for preventing non - communicab le diseases. lt stresses particularly the per- centages of total energy which shou ld come re- spective ly from carbo- hydrates. proteins and fats. The consumption of fibres. sa lt. cho lesterol. and even fluor in water are also the subjects of precise recom- mendations A ll the evidence suggests that certain objectives w ill not be easy to attain. for instance keeping down to 20-30 per cent the propor- tion of total energy drawn from fatty foods For this reason . less ambitious inter- mediate objectives have been set: in the case of fatty foods. initial efforts wi ll be made to reduce their proportion to 35 per cent for the popu lation as a who le and to 30 per cent among. groups with a high cardiovascular risk These intermediate objec- tives seem particularly appro - priate for people living in North and East Europe. The Mediterranean countries already have a diet which is healthier and closer to the objectives fixed by WHO, alth ough certain negative trends continue to cause concern Th e purpose of "Healthy nutrition" is to encourage governments to trust in the dietary and cu ltu - ral traditions of their own countries whi le at the same time drawing up recom- mendations which wil l lead to improvements in the nutri- tiona l status of their people A coherent food policy which emphasises preven- tion necessarily involves close col laboration between the ministries of hea lth. agri- cu lture. food education. industry and economics. so as to ensure that the health benefits do not have harmful repercussions on local food production. Moreover. edu- cation of the public assumes cap ital importance. Appro- priate information. notably through the media. can help to modify the habits of the consumer. Emphasising especia lly the important role that news- papers and the radio have to play in educating people about nutrition or other health-related factors. the authors observe that doctors and other hea lth profes - siona ls often avoid contacts with press. radio and te levi- sion for fear that their intentions might be carica- tured or distorted. Conse- quently they leave to less Mortality in developed countries Statistics compiled by WHO now make it possible to obtain a comprehensive view of the health situation in developed countries - that is. the European countries as a whole (including the USSR). Australia. Canada. Israel. Japan. New Zealand and the qualified people the task of present ing their point of view. and this may on ly result in confusing the public Those in charge of public health in Europe are invited to use this new publication to help Europe to take a decisive step towards a more bal- anced nutritional diet. a con- dition essent ial if the goa ls of Hea lth for all are to be achieved "Healthy Nutrition" (European Ser ies. No 24 ISBN 9289011157) may be purchased from major booksellers. otherwise from Distribution and Sa les Unit. WHO. 1211 Geneva27. Switzerland. price Sw.Fr.20 • United States The popu- lations of these 33 countries amount to one thousand mil- li on inhabitants. which repre- sents about a quarter of the world population Some 11 million deaths occur every year in the developed countries. 3 4 mil- Above. Heart disease kills 3. 3 mil- lion people in the industrialised world every year Photo WHO/E Mandelmann WOR LD HEALTH, May 1989 lion of them before the age of 65. The overall expectations of li fe at birth for these coun- tr ies is 73.7 yea rs. but there are w ide va riations between countries. In Japan. for instance. life expectancy at birth is 79.1 yea rs. whi le for Eastern Europe it is around 70 to 71 years There is also a clear difference between the sexes. because women have a life expectancy of 77.2 years on average compared · with only 70 1 for men . In f our count ries ( France. Japan. Sweden and Switzer- land) life expectancy for women actua lly exceeds the 80-year li mit. headed by Japan with 82.1. lt is also in Japan that men live longest. w here their life expectancy reaches 75.9 - one year more than in Ice land and two years more than in Greece. Sweden and Switzerland. Out of the 11 milli on annua l deaths 1n 14 developed countries. there are some 3.3 mil lion deaths from heart disease. 1 .9 from cancer. 1. 5 from strokes. 0 9 from resp iratory diseases and 750.000 vio lent deaths. among which 170.000 resu lt from road accidents and at least 130.000 from suicide. As regards the ri sk of dying according to the cause. it can be sa id that one newborn baby out of three w ill die of heart disease (31.6 per cent). one out of six of cancer (16.2 per cent) and one in seven from stroke (144 per cent). The.risks of succumbing to a resp iratory ailment or a vio- lent death are about the same - some five per cent One of the factors on wh ich public health has the possibi li ty of maki ng an impact is obv io usly th e "premature" deaths. whether these resu lt from road acci- dents or su icides or from unhea lthy lifestyle behaviour - in particu lar from smoking. Extrapolating the results of studies ca rri ed out in the USA a tota l of 1.5 million deaths per annum are caused by smoking th roughout the developed countries as a w hole - a little over one- third among women and almost half-a-mi ll ion among people aged under 65. a finding which invalidates the theory that smoki ng is mainly a cause of morta lity among the elderly. Detai led results of this study were published in issue No. 14 (1989) of W HO's Weekly Epidemiological Record . • W ORLD HEALTH , May 1989 Nevvsbriefs Or Marc Danzon has been appointed Director of the French Committee for Hea!Jh Education (CFES) A medical doctor. he also holds a diploma in psychiatry and is a specialist in public health. From 7 985 until 7 988 Or Danzon was in charge of public information at WHO's Regional Office for Europe in Copenhagen. The 7th International Congress on Environment. Geo- cancerology and Preventive Medicine has been convened in Brussels in M ay Sponsored by WHO. UNESCO and the Commission of the European Communities. the congress was called to deal with the various types of environmental pollution as well as the geographical distribution of cancers and the means of preventing them The fight against smoking and alcoholism also figured prominently in the agenda. In his message on the occasion of World Health Day, 7 April. devoted this year to communication for health. Or U Ko Ko. Director of WHO 's Regional Office for South-East Asia. declared that the slogan "Let's talk health" should contribute to the establishment of a dialogue between those who provide health care and those who use it He added that it should also help to spread the light of knowledge and thereby to dispel the darkness of ignorance. superstition and disease. The Zimbabwe Broadcasting Corporation this year won the Radio Red Cross first pnze for a broadcast promoting primary health care in Africa. Awarded for the fifth time since its creation ten years ago. the prize is organtzed jointly by the League of Red Cross and Red Crescent Societies. WHO. UNICEF and the Union of National Radio and Television Orgamzations of Africa (URTNA) The second and third pnzes went respectively to Chad National Broadcasting and Rural Radio of Mauritania. A special pnze offered by the Norwegian Red Cross for programmes dealing with women ·s activities was awarded to the Gambian Red Cross and Gambian Radio. Countries all over the world made plans to mark 37 May as the World's 2nd No- Tobacco Day WHO chose as slogan for the Day "The female smoker. at added risk". and invited health educators and media communicators to focus world attention on those risks. Both developing and developed countries notified WHO of their intention to mark the Day with a variety of activities. "A lcoholic drinks are carcinogenous for humans ... This is the striking conclusion of a 400-page report on alcohol consumption published by the International Agency for Research on Cancer (/ARC) in Lyon. France. Prepared by 7 9 international experts. the report concludes that the consump- tion of alcoholic drinks has a clear cause-and-effect rela- tionship with cancers of the mouth. pharynx. larynx. oesophagus and liver. The risks increase as the quantity of alcohol rises. and smokers are particularly threatened since the harmful effects of tobacco are added to those of alcohol • In the next issue Epidemio logy is the study of the d istr ibut ion and of the causes of ill - health in popu lat ion s What may seem a dry-as -dust co llection of figures can provide medical science with cruc ia l clues to the prevention of disease. Some of the ways in wh ich epidemiology is serv ing public hea lth are exam ined in the June issue of World Health. Authors of the month Or John f)AARTIN is Responsible Officer for District Health Systems. at WHO headquarters in Geneva. Mr Kausar S. KHAN is the Coordi - nator for the Social Sector and for Women's Development in the Depart- ment of Community Health Sciences. Aga Khan University, Karachi. Pakis- tan: Dr Kamal ISLAM works in the same department: Or John H . BRYANT is Professor and Chairman in the same Department. He also served as a member of the Executive· Board of WHO. Mr Gunnar BOLSTAD is a journalist on health and environmental issues and Editor of the information bureau LIV in Oslo. Norway. Or Sidney Saul NDEKI is Principal of the Centre for Educational Develop- ment in Health in Arusha. Tanzania (the WHO collaborating centre) Or Raman GRANADOS is a health consultant with the PAHO/WHO rep - resentative's office in Bolivia: Or Angel VALENCIA is Director-General for the Health Department at the Bolivian Ministry of Social Services and Health. and Or Juan Manuel SOTELO is the PAHO/WHO Repre- sentative in Bolivia. Or Sylvia MOORE was until recently a Public Information Officer with WHO 's Department of Public Information and Public Relations. Or Gebre Selassie OKUBAGZHI is Associate Professor and Head of the Ras lmru Training Centre in Addis Ababa. Ethiopia Or Edmund J. -McTERNAN is Pro - fessor and Dean at the School of Allied Health Professions at Stony Brook. New York. USA. and Or Lee J . HOLDER is also with the School of Allied Health Professions at Stony Brook. Professor Monroe T. MORGAN is Professor of Environmental Health and Special Assistant to the President for International and Regional Devel - opment at East Tennessee State Uni - versity in Johnson City, Tennessee. USA. Dr Szeming SZE was a member of the Chinese Delegation to the Conference convened to draft the Charter of the United Nations in 1945. WORlD HEALTH for readers everywhere Since the start of 1989. two-year and three-year subscriptions are no longer being offered. Readers are invited to take out one-year subscriptions at the rates given below. USS 0 Sw.fr. 0 One year 20.- 25.- WHO also offers its "Health Hori- zons" combined subscriptions to both World Health (ten issues per year) and the quarterly World Health Forum The annual price will be: US$ 0 Sw.fr. 0 52.- 65.- 0RDER FORM Please enter my one-year subscription to World Health D Health Horizons D I enclose cheque/ international postal order in the amount of: Name: ............. ... ...•..... ·~· · .. 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