Prepared for the Workshop on Early Nutritional Influences on Obesity, Diabetes and Cardiovascular Disease Risk in Later Life – The Evidence, Policy Implications and Research Priorities, Montreal, 7–9 June 2004.
Programme and policy issues related to promoting positive early nutritional influences to prevent obesity, diabetes and cardiovascular disease in later life: a developing countries view1
Article first published online: 28 JUN 2005
Maternal & Child Nutrition
Volume 1, Issue 3, pages 204–215, July 2005
How to Cite
Solomons, N. W. (2005), Programme and policy issues related to promoting positive early nutritional influences to prevent obesity, diabetes and cardiovascular disease in later life: a developing countries view. Maternal & Child Nutrition, 1: 204–215. doi: 10.1111/j.1740-8709.2005.00030.x
- Issue published online: 28 JUN 2005
- Article first published online: 28 JUN 2005
- Barker hypothesis;
- food guidelines;
- chronic diseases;
- developing countries;
Public health policy differs from programme insofar as the former is the expression of goals at a higher decision-making level (international, regional, national or provincial) and the latter involves the execution of intervention measures at the community or individual level. It has recently become fashionable to speak of ‘evidence-based’ policy. There is now ample evidence to suggest that early nutritional influences on chronic disease risk in later life are contributing to the acceleration of the overall worldwide epidemic of obesity and non-transmissible diseases. In developing countries, in which 80% of the world's population resides, the opportunities for preventive policy must be balanced against needs, cost and effectiveness considerations and the intrinsic limitations of policy execution. Not everyone in the population is at risk of suffering from any given negative condition of interest, nor will everyone at risk benefit from any given intervention. Hence, decisions must be made between universal or targeted policies, seeking maximal cost-efficiency, but without sowing the seeds of either discrimination or stigmatization with a non-universal application of benefits. Moreover, although large segments of the covered population may benefit from a public health measure, it may produce adverse and harmful effects on another segment. It is ethically incumbent on policy makers to minimize unintended consequences of public health measures. With respect to the particular case of mothers, fetuses and infants and long-term health, only a limited number of processes are amenable to intervention measures that could be codified in policy and executed as programmes.