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1.
Lancet Oncol ; 22(9): e391-e399, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34478675

RESUMO

The number of patients with cancer in Africa has been predicted to increase from 844 279 in 2012 to more than 1·5 million in 2030. However, many countries in Africa still lack access to radiotherapy as a part of comprehensive cancer care. The objective of this analysis is to present an updated overview of radiotherapy resources in Africa and to analyse the gaps and needs of the continent for 2030 in the context of the UN Sustainable Development Goals. Data from 54 African countries on teletherapy megavoltage units and brachytherapy afterloaders were extracted from the Directory for Radiotherapy Centres, an electronic, centralised, and continuously updated database of radiotherapy centres. Cancer incidence and future predictions were taken from the GLOBOCAN 2018 database of the International Agency for Research on Cancer. Radiotherapy need was estimated using a 64% radiotherapy utilisation rate, while assuming a machine throughput of 500 patients per year. As of March, 2020, 28 (52%) of 54 countries had access to external beam radiotherapy, 21 (39%) had brachytherapy capacity, and no country had a capacity that matched the estimated treatment need. Median income was an important predictor of the availability of megavoltage machines: US$1883 (IQR 914-3269) in countries without any machines versus $4485 (3079-12480) in countries with at least one megavoltage machine (p=0·0003). If radiotherapy expansion continues at the rate observed over the past 7 years, it is unlikely that the continent will meet its radiotherapy needs. This access gap might impact the ability to achieve the Sustainable Development Goals, particularly the target to reduce preventable, premature mortality by a third, and meet the target of the cervical cancer elimination strategy of 90% with access to treatment. Urgent, novel initiatives in financing and human capacity building are needed to change the trajectory and provide comprehensive cancer care to patients in Africa in the next decade.


Assuntos
Recursos em Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Radioterapia/tendências , África/epidemiologia , Previsões , Recursos em Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Agências Internacionais , Neoplasias/epidemiologia , Neoplasias/radioterapia , Radioterapia/estatística & dados numéricos , Desenvolvimento Sustentável
2.
BMC Public Health ; 21(1): 1608, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34470632

RESUMO

BACKGROUND AND AIM: According to the United Nations' Sustainable Development Goal (SDG) target 3.4, premature mortality from four non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes mellitus, collectively referred to as NCD4) should achieve a minimum decline of 33% in 2030 relative to 2015. This remains a challenge for China. This study aimed to evaluate the current status and progress towards this target in Liaoning Province, one of the three provinces in northeast China. METHODS: We calculated the premature mortality rates (PMRs) per year and average annual percentage changes (AAPCs) from NCD4 using mortality data between 2004 and 2017. The trend was analyzed in the whole population, as well as in subpopulations of gender (male/female) and inhabiting area (urban/rural). PMRs from NCD4 for 2030 were projected by fitting a linear regression based on the current trend, which was identified by a Joinpoint model. FINDINGS: In the whole population, only chronic respiratory diseases showed a significant decline (AAPC: - 6.5%, p < 0.05), while only cancer showed a significant increase (AAPC: + 1.3%, p < 0.05); taken together, NCD4 showed a significant increase (AAPC: + 0.6%, p < 0.05). In the subpopulations, while males showed a significant increase in NCD4 (AAPC: + 1.5%, p < 0.05), cardiovascular diseases (AAPC: + 1.7%, p < 0.05), cancer (AAPC: + 1.8%, p < 0.05), and diabetes mellitus (AAPC: + 4.2%, p < 0.05), females showed a significant decline in NCD4 (AAPC: - 1.2%, p < 0.05), cardiovascular diseases (AAPC: - 1.8%, p < 0.05), diabetes mellitus (AAPC: - 2.1%, p < 0.05), but showed a mild increase in cancer (AAPC: + 0.5%, p > 0.05). A comparative analysis of the projected PMRs for 2030 with the 2015 levels revealed that only chronic respiratory diseases are expected to achieve the SDG target 3.4, apart from in the urban male subpopulation. CONCLUSION: Except for chronic respiratory diseases, NCD4 cannot be expected to achieve the SDG target 3.4 in the whole population of Liaoning Province. Under these circumstances, special attention should be paid to reducing the risks of cancer and providing preventative interventions for men.


Assuntos
Doenças não Transmissíveis , Desenvolvimento Sustentável , China/epidemiologia , Feminino , Objetivos , Humanos , Masculino , Mortalidade Prematura , Doenças não Transmissíveis/epidemiologia
3.
Health Res Policy Syst ; 19(1): 124, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503537

RESUMO

BACKGROUND: The Sustainable Development Goals (SDGs) and universal design (UD) principles call for inclusive planning. Within the transportation field, this includes the development or improvement of facilities that accommodate people with disabilities. Between 10% and 20% of the African population is affected by disabilities. A lack of understanding of the needs of people with disabilities leads to isolation. Within the transportation field, isolation manifests itself as a reduction in trip-making. METHODS: This paper investigates the availability of transport policies and guidelines in 29 different African countries, focusing on the inclusion of persons with disabilities. A desktop study was conducted creating heat maps for 29 African countries, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines, and appropriate implementation leads to a lack of accessibility, opportunities, and social isolation, measured through trip frequencies. RESULTS: The data analysed revealed that many African countries omit, or only superficially include, people with disabilities in their transport policy framework. Ghana has the most inclusive People with Disabilities Act, while South Africa is most inclusive regarding their planning and design of transport facilities and services. In South Africa, 4.5% of the population did not travel at all in the 7 days before the interview, as disability or age prevented them from doing so, or due to a lack of appropriate travel services. When comparing the trip rates per week, people with disabilities travel significantly less, between 27.2% and 65.8%, than their abled counterparts. CONCLUSIONS: The study reveals that people with disability live less integrated, more isolated lives due to the lack of acknowledgement in the transport policy framework and accommodation in infrastructure and services. The results underpin the need for disability-inclusive planning in the African context and provide recommendations for actions that mitigate the isolation challenges faced by people with disabilities. Municipalities play a crucial role in improving the quality of life for people with disabilities.


Assuntos
Pessoas com Deficiência , Qualidade de Vida , Gana , Humanos , África do Sul , Desenvolvimento Sustentável
4.
Washington, D.C.; PAHO; 2021-09-10. (PAHO/CDE/CE/21-0004).
Não convencional em Inglês | PAHO-IRIS | ID: phr-54816

RESUMO

This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAHO) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.


Assuntos
Mudança Climática , Meio Ambiente e Saúde Pública , Sistemas de Saúde , Desenvolvimento Sustentável , América
5.
Rev Sci Tech ; 40(2): 585-595, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34542093

RESUMO

Within the framework of the Sustainable Development Goals (SDGs) of the United Nations, particularly those that livestock impact most significantly (SDGs 1, 2, 3, 5, 8, 12, 13, 15 and 17), this paper provides an overview of the livestock sector's impact on food system sustainability and opportunities for building solutions through sustainable livestock options that are supported by robust animal health services. The discourse is shaped by the experiences of the Global Agenda for Sustainable Livestock, a multi-stakeholder partnership which facilitates policy dialogue and action among diverse stakeholders to make livestock systems more sustainable. The Global Agenda for Sustainable Livestock adopted the aforementioned SDGs as the reference framework for its actions, which are organised under four domains (food and nutrition security, animal health and welfare, livelihoods and economic growth, and climate and natural resources). These domains are used to highlight the complexity and diversity of the livestock sector, its positive and negative relationships to development, the integral roles of animal health systems and the opportunities for livestock sector contributions towards a sustainable future.


Assuntos
Gado , Desenvolvimento Sustentável , Animais , Saúde Global , Objetivos , Nações Unidas
6.
Rev Sci Tech ; 40(2): 483-495, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34542101

RESUMO

Animal health services play an essential role in supporting livestock production, with the potential to address the challenges of hunger, poverty, health, social justice and environmental health as part of the path towards the Sustainable Development Goal (SDG) defined in the United Nations, 2030 Agenda. However, the provision of animal health services remains chronically underfunded. Although the aspiration that â€Ëœno one will be left behind' is core to the SDG agenda, animal health service provision still fails to meet the basic needs of many of the poorest livestock owners. This review draws largely on experience from Tanzania and highlights the obstacles to equitable provision of animal health services, as well as identifying opportunities for improvement. Delivery models that rely on owners paying for services, whether through the private sector or public?private partnerships, can be effective for diseases that are of clear economic importance to animal keepers, particularly in more market-orientated production systems, but are currently constrained by issues of access, affordability, availability and quality. Substantial challenges remain when attempting to control diseases that exert a major burden on animal or human health but are less well recognised, as well as in the delivery of veterinary public health or other public good interventions. Here, the authors propose solutions that focus on: improving awareness of the potential for animal health services to address the SDGs, particularly those concerning public and environmental health; linking this more explicitly with advocacy for increased investment; ensuring that the voices of stakeholders are heard, particularly those of the rural poor; and embracing a cross-cutting and expanded vision for animal health services to support more adaptive development of livestock systems.


Assuntos
Setor Privado , Saúde Pública , Animais , Gado , Avaliação de Resultados em Cuidados de Saúde , Desenvolvimento Sustentável
7.
Nutrients ; 13(8)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34444976

RESUMO

Food provides humans with more than just energy and nutrients, addressing both vital needs and pleasure. Food habits are determined by a wide range of factors, from sensorial stimuli to beliefs and, once commanded by local and seasonal availability, are nowadays driven by marketing campaigns promoting unhealthy and non-sustainable foodstuffs. Top-down and bottom-up changes are transforming food systems, driven by policies on SDGs and by consumer's concerns about environmental and health impacts. Food quality, in terms of taste, safety, and nutritional value, is determined by its composition, described in food composition databases (FDBs). FDBs are then useful resources to agronomists, food and mechanical engineers, nutritionists, marketers, and others in their efforts to address at maximum human nutrient needs. In this work, we analyse some relevant food composition databases (viz., purpose, type of data, ease of access, regularity of updates), inspecting information on the health and environmental nexus, such as food origin, production mode as well as nutritional quality. The usefulness and limitations of food databases are discussed regarding what concerns sustainable diets, the food 'matrix effect', missing compounds, safe processing, and in guiding innovation in foods, as well as in shaping consumers' perceptions and food choices.


Assuntos
Gerenciamento de Dados , Bases de Dados Factuais , Dieta , Alimentos , Valor Nutritivo , Comportamento Alimentar , Abastecimento de Alimentos , Promoção da Saúde , Humanos , Desenvolvimento Sustentável
8.
J Environ Manage ; 298: 113361, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34375918

RESUMO

Global challenges impact upon substantial numbers of people in different locations and inform policy at multiple levels under the United Nation's Sustainable Development Goals (SDGs). An aspect of the SDGs framework is the stated inter-relationship between SDGs and local, regional and global partnerships for research and development. In response to dissatisfaction with existing approaches to addressing such complex problems the purpose of this paper is to propose a problem-language-context (PLC) model as a way of framing sustainable development challenges; and in so doing create a heuristic that allows challenges such as water security to be understood using a logically consistent framework. Such an approach builds on a growing transdisciplinary innovation literature that strives to generate knowledge that is problem-focused and inclusive of both scientific and societal stakeholders. The utility of the PLC model is then examined using a case study review carried out on a body of evidence - the United Nations World Water Development Reports (WWDRs) 2003-2019. The result of this review suggests that such problem framing can be of value in revealing the implicit (and sometimes contradictory) assumptions held by policy makers, practitioners and researchers. The main conclusion is that a transdisciplinary approach is one way of better understanding some of the conflicting viewpoints evident in discipline-based approaches to sustainable development, global water challenges and water security.


Assuntos
Desenvolvimento Sustentável , Água , Saúde Global , Humanos , Nações Unidas
9.
Am J Nurs ; 121(9): 58-63, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34438434

RESUMO

This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDG 16: "Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable, and inclusive institutions at all levels."


Assuntos
Equidade em Saúde/tendências , Liderança , Desenvolvimento Sustentável/tendências , Nações Unidas/normas , Violência/prevenção & controle , Enfermagem Baseada em Evidências , Humanos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34444583

RESUMO

The tourism sector is a driver of economic development characterised by its environmental impact. It is a prevalent part of the 2030 Agenda, given its potential to help meet the Sustainable Development Goals (SDGs). At the same time, board gender diversity is considered essential for companies to implement environmentally sustainable initiatives. However, analysis of the relationship between the role of women on boards and environmental performance has been neglected in the tourism literature. This paper adopts a novel approach to the study of this sector by analysing the relationship between gender diversity on the board of directors and companies' environmental practices. A fixed effects model is estimated using an international sample of 120 listed tourism companies for the period 2002 to 2019. The results show that boards that are more gender diverse and have a greater female presence are associated with poorer environmental performance and a weaker implementation of policies and practices to reduce resource use and emissions. However, board gender diversity aids performance in environmental innovation.


Assuntos
Desenvolvimento Econômico , Turismo , Meio Ambiente , Feminino , Humanos , Políticas , Desenvolvimento Sustentável
11.
Sci Total Environ ; 791: 148311, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34412384

RESUMO

Rapid urbanization has seriously disturbed the structure and function of ecosystems and caused many eco-environmental problems, in turn, these problems also reduce the quality of urbanization and threaten the sustainable development of urban. Currently, most studies only focus on the impact of urbanization on ecosystem components (i.e., structure, functions or services), few studies have explored the coordination and spatiotemporal heterogeneity between urbanization and ecosystem health from a systematic view. Therefore, in viewing of this, this study integrated coupling coordination degree model (CCDM) and geographically and temporally weighted regression (GTWR) to measure the interaction relationship and spatiotemporal heterogeneity between urbanization and ecosystem health (UAEH) in Chongqing at the county scale from 1997 to 2015. Results showed that: 1) the degree of coordination between UAEH in Chongqing increased gradually from 1997 to 2015, developed from the moderately unbalance stage to moderately balance stage, and experienced a transition from urbanization lag to ecosystem health lag. Moreover, the coupling coordination degree showed a decreased spatial trend from the western to the eastern of Chongqing. 2) The restriction effect between UAEH gradually weakened from 1997 to 2015, and the synergistic effect between them gradually strengthened. Additionally, the interaction between UAEH tended to converge, and the negative effects between UAEH were mainly distributed in the central and western of Chongqing. In these area, population urbanization aggravated the deterioration of the natural ecosystem, in turn, the decline of ecosystem vigor and resilience also restricted the sustainable development of urbanization. Finally, this study also puts forward some corresponding policy recommendations based on each region's coupling type.


Assuntos
Ecossistema , Urbanização , China , Cidades , Humanos , Desenvolvimento Sustentável
12.
J Environ Manage ; 298: 113465, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371220

RESUMO

Efficient environmental resource management is a serious concern for sustainable development in developing countries. This study determines the impact of institutional quality on sustainable development, based on total factor productivity improvements through the environmental regulatory process by way of abatement policies using an augmented endogenous sustainable growth model. Based on panel data covering 66 developing countries from 1984 to 2019, the employed methods involve the fixed effects and the system generalized method of moments (GMM). The main results indicate that institutional quality has a positive impact on sustainable development. Institutional quality has a more positive role in sustainable development in lower middle-income countries than low-income countries. The overall results indicate that the disaggregated performance of institutional quality variables is higher in lower middle-income countries than low-income countries. Two main policy implications are implied by our analyses: legislative backing in the form of institutional enforcement is mandatory to design efficient and productive policy relevant to environmental resource management; and various institutional forms should be considered when designing environmental resource protection policy from an environmental governance point of view.


Assuntos
Conservação dos Recursos Naturais , Política Ambiental , Países em Desenvolvimento , Renda , Desenvolvimento Sustentável
13.
J Urban Health ; 98(Suppl 1): 69-78, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34414511

RESUMO

Food is an important determinant of health, featuring prominently in the Sustainable Development Goals. The term "big data" is seldom used in relation to food, partly because food data are scattered across different sectors. The increasing availability of food-related data presents an opportunity to glean new insights on food and food systems. These insights may enhance the quality of products and services and improve decision-making on optimizing food availability, all to the end of producing better health. Yet, knowledge gaps remain about the unique opportunities and challenges linked to big data on food and their use in decision-making. This scoping review explored the available literature linking food with big data and decision-making, using the following research question: What is the current literature on data about food, and how are these data used in decision-making? We searched PubMed until 29 February 2020 and Embase, Web of Sciences, and the Cochrane Database of Systematic Reviews until 8 March 2020. We included studies written in English and conducted narrative analyses to identify relevant themes from included studies. Sixteen studies fulfilled our eligibility criteria, including big data analyses, modelling studies, and reviews. These studies described the added value of using big data and how evidence from big data had or can be used for decision-making, as well as challenges and opportunities for such use. The majority of the included studies examined the link between food and big data, while hypothesizing of how these insights could inform decision-making, including policies, interventions, programs, and financing. There were only two examples wherein big data on food informed decision-making directly. The review highlights several false dichotomies in how the subject is approached in the literature and the importance of context, both between and within countries, in shaping the availability and types of data that can be used as meaningful evidence to inform decision-making. This review shows the paucity of research around the intersection of food, big data, and decision-making, as well as the potential in using big data on food systems to the end of informing decisions to improve the health of populations. Future research and decision-making around health systems can benefit from examining the full spectrum of perspectives on the subject. Future research and decision-making around health systems can also employ the steadfast embrace of technology, which will potentially reduce disparities in big data availability, to the end of improving the health of populations.


Assuntos
Big Data , Desenvolvimento Sustentável , Análise de Dados , Humanos , Revisões Sistemáticas como Assunto
14.
BMJ Open ; 11(8): e047779, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413102

RESUMO

OBJECTIVES: Latin America and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored. SETTING: We studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indicator Cluster Survey carried out from 2011 to 2016 PARTICIPANTS: The surveys collect nationally representative data on women and children using multistage sampling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries. OUTCOME MEASURES: Five health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indicators were assessed through absolute and relative measures. RESULTS: In most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman's age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. CONCLUSIONS: Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.


Assuntos
Disparidades nos Níveis de Saúde , Desenvolvimento Sustentável , Adolescente , Idoso , Região do Caribe , Criança , Estudos Transversais , Feminino , Disparidades em Assistência à Saúde , Humanos , Recém-Nascido , América Latina/epidemiologia , Fatores Socioeconômicos
15.
Artigo em Inglês | MEDLINE | ID: mdl-34444070

RESUMO

In the past 30 years, China's industrialization level has developed rapidly, and agricultural green development (AGD) is facing severe challenges. The research on the temporal and spatial features of the coupling and coordination of industrialization and agricultural green development is a key issue to promote the sustainable development of agriculture. This paper takes China's industrialization and AGD level as the research object, and uses panel data from 31 provinces in China from 1990 to 2019 to construct an evaluation index system for industrialization and AGD. This paper uses the coupling coordination degree model and spatial autocorrelation analysis method to calculate, test and analyze the temporal and spatial features of the coupling coordination level of industrialization and AGD. The results show that: this paper compares the industrialization and AGD levels during the study period and finds that China's industrialization development level is on the rise as a whole, and the AGD level shows a downward trend first and then rises later. Through the horizontal comparison of different regions, this paper finds that there is a large regional imbalance in the level of industrialization and AGD. The coupling and coordination level of industrialization and AGD has always been primary. From the time point of view, coupling coordination degree shows a trend of first decline and then rise. From a spatial point of view, coupling coordination degree varies greatly among provinces, with the eastern, central and western regions decreasing successively. The level of coupling coordination has obvious positive autocorrelation in spatial distribution, and presents significant spatial agglomeration characteristics in space. The research results can provide a theoretical basis for regionally differentiated governance of the coordinated development of industrialization and AGD, and promote coordinated development.


Assuntos
Desenvolvimento Industrial , Desenvolvimento Sustentável , Agricultura , China , Análise Espacial
16.
Nutrients ; 13(8)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34444900

RESUMO

Sustainable food systems are often defined by greenhouse gases, land use, effects on biodiversity, and water use. However, this approach does not recognize the reason food is produced-the provision of nutrients. Recently, the relationship between diets and sustainability has been recognized. Most accepted models of 'sustainable diets' focus on four domains: public health, the environment, food affordability, and cultural relevance. Aligned with the FAO's perspective, truly sustainable diets comprise foods that are affordable, nutritious, developed with ingredients produced in an environmentally friendly manner, and consumer preferred. Identifying solutions to address all four domains simultaneously remains a challenge. Furthermore, the recent pandemic exposed the fragility of the food supply when food accessibility and affordability became primary concerns. There have been increasing calls for more nutrient-dense and sustainable foods, but scant recognition of the consumer's role in adopting and integrating these foods into their diet. Dietary recommendations promoting sustainable themes often overlook how and why people eat what they do. Taste, cost, and health motivate consumer food purchase and the food system must address those considerations. Sustainable foods are perceived to be expensive, thus marginalizing acceptance by the people, which is needed for broad adoption into diets for impactful change. Transformational change is needed in food systems and supply chains to address the complex issues related to sustainability, taste, and cost. An emerging movement called regenerative agriculture (a holistic, nature-based approach to farming) provides a pathway to delivering sustainable foods at an affordable cost to consumers. A broad coalition among academia, government, and the food industry can help to ensure that the food supply concurrently prioritizes sustainability and nutrient density in the framework of consumer-preferred foods. The coalition can also help to ensure sustainable diets are broadly adopted by consumers. This commentary will focus on the challenges and opportunities for the food industry and partners to deliver a sustainable supply of nutrient-dense foods while meeting consumer expectations.


Assuntos
Dieta Saudável/métodos , Indústria Alimentícia/métodos , Abastecimento de Alimentos/métodos , Política Nutricional , Desenvolvimento Sustentável , Custos e Análise de Custo , Promoção da Saúde , Humanos
17.
Nutrients ; 13(8)2021 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-34444855

RESUMO

The concept of sustainable nutrition considers different fields: from human health to environmental, economic and socio-cultural aspects. Currently, in Europe, the diets that reflect the assumptions of the sustainable diet are the Mediterranean Diet and the New Nordic Diet. They both encourage the consumption of vegetable, organic and minimally processed foods, as well as regional, seasonal and Fair-Trade products, reducing the ecological impact of the production chain. These eating habits could be established starting from the prenatal period and from infancy during the complementary feeding stage, aiding children to accept of a more variable diet in terms of flavor, taste and texture. In particular, the positive parental role model is an effective method for improving a child's diet and behaviors. Two healthy plates representing a sustainable diet in early infancy, at 6 and 24 months, are here proposed, in line with the "Planetary Health Diet" approved by the EAT-Lancet Commission. Our work aims to highlight how a sustainable diet is possible since infancy, since the introduction of solid foods.


Assuntos
Dieta Saudável/métodos , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Fenômenos Fisiológicos da Nutrição do Lactente , Paladar , Comportamento de Escolha , Feminino , Humanos , Lactente , Alimentos Infantis , Masculino , Desenvolvimento Sustentável
19.
Lancet ; 398(10303): 870-905, 2021 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-34416195

RESUMO

BACKGROUND: Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. METHODS: We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. FINDINGS: Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3-74·0) in 2000 to 37·1 (33·2-41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8-29·5) in 2000 to 17·9 (16·3-19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05-10·30) in 2000 and 5·05 million (4·27-6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53-4·02]) in 2000 to 48% (2·42 million; 2·06-2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71-0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27-1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35-2·58; 37% [95% UI 32-43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. INTERPRETATION: Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. FUNDING: Bill & Melinda Gates Foundation.


Assuntos
Mortalidade da Criança/tendências , Saúde Global/tendências , Mortalidade Infantil/tendências , Desenvolvimento Sustentável , COVID-19/epidemiologia , Causas de Morte/tendências , Criança , Pré-Escolar , Feminino , Saúde Global/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Tábuas de Vida , Masculino , SARS-CoV-2
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