The National recommendations are comprehensive, and will involve buy-in from a range of Government agencies, and stakeholders including food and drink manufacturers and caterers.
As a large proportion of CVD can be modified through lifestyle changes, the recommendations are quite specific, and are included below. For full information, please refer to Cardiovascular disease prevention | recommendations | Guidance and guidelines | NICE
High intake of salt from food, particularly from the high levels within processed foods is linked with high blood pressure, which can lead to stroke and impact on coronary heart disease. Although there has been progress, through working with the Food Standards Agency, on reducing salt in processed foods, the rate of consumption in children continues to be a cause for concern. Policy within the UK is more stringent than in the EU, and strengthening of EU policy is considered to be a priority. Additionally promotion of low salt products through competitive pricing , and a recognition of low salt intake levels for children is proposed.
Through joint work with the Food Standards Agency, industry and consumers, the population intake of saturated fats is being reduced, with the aim of attaining intake of saturated fats at below 11% of food energy, with the current rate being 13.3%. A cautious note is that if the consumption was still more dramatically reduced, to approximately 6-7% of total energy consumption, it might prevent not only 30,000CVD deaths annually, but would also prevent the same number of new cases developing each year.
This is a potential enormous health benefit. National initiatives to reduce consumption target food manufacturers, and promoting semi-skimmed milk for children over 2 years.
Industrially-produced trans fatty acids (IPTFAs) which are found mainly in fried fast foods constitute a significant health hazard. Although some countries have banned IPTFAs, an EU ban has not yet been established. Through more accurate recording of who within the population is most impacted, more targeted interventions may be feasible. At a local level, it may be possible for Local Authorities to monitor their use in food outlets, and continue to encourage the use of vegetable oils high in poly and monounsaturated fatty acids to replace IPTFAs.
- Marketing and promotions aimed at children and young people
There are currently restrictions on advertisements for food products which are high in fats, sugars and salt being shown when under 16year olds are watching television. Information from other countries where the ban on such advertising is until 9pm have demonstrated considerable reduction in advertising exposure. Additionally, moves to restrict advertising aimed at young people particularly using other technologies may need to be considered.
Informed choice by consumers, including parents, is supported by clarity of labelling, which is understandable, clear and easy to interpret. There is evidence that a simple visual system, based on the traffic light system, and including information on the product’s percentage contribution to daily guideline amounts for salt, sugar and fat is effective.
Any initiative which encourages physical activity as a regular inclusion in everyday a life is positive. However, the promotion of walking and cycling as active transport modes is patchy, and inclusion of this in overall strategy for CVD reduction, including weight management and children’s obesity and inactivity issues is positive.
- Public sector catering guidelines
It is estimated that, overall, public service organisations provide around one in three meals eaten outside of the home. Therefore, ensuring good nutritional quality contributes to a well-balanced and healthy diet assists with prevention of CVD. All publically funded catering should comply with Foods Standards Agency approved guidelines.
- Take-away and other food outlets
Fast food outlets can be controlled through local planning authorities, and thereby assist in both prevention and reduction of CVD. This is particularly pertinent to location of outlets near schools.
As CVD accounts for about a third of the observed gap in life expectancy for those living in the areas of deprivation, when compared with other areas, it is important that data and interventions are both monitored and directed towards those with the largest health inequalities. This monitoring could include using population surveys (including the 'National diet and nutrition survey' [NDNS] and the 'Low income diet and nutrition survey' [LIDNS]) and data from all relevant sources to monitor intake of nutrients for all population groups. (Sources include: the Food Standards Agency, Department of Health, Department for Environment, Food and Rural Affairs, Office for National Statistics, the Public Health Observatories, academic and other researchers.)