Noncommunicable diseases (NCDs) – such as cardiovascular diseases, diabetes, cancer and chronic respiratory diseases – are the biggest health threat in the WHO European Region and globally, according to the World Health Organization (WHO).
NCDs are responsible for more than 80% of all deaths in the WHO European Region. These diseases are closely linked to unhealthy diets and excess body weight.
In most Member States, salt intake is above the WHO-recommended maximum level of 5 g per day. High salt consumption raises blood pressure and increases the risk of cardiovascular diseases, such as heart attack, heart disease and stroke, the World Health Organization (WHO) highlights.
Cardiovascular diseases are the predominant cause of disability and premature death in the European Region, causing over 42.5% of all deaths annually, which translates to 10 000 deaths per day.
Twenty-five per cent of children and 60% of adults live with overweight or obesity. This threatens the achievement of Sustainable Development Goal target 3.4 – reducing premature NCD mortality – as well as the attainment of other goals, including those related to economic growth and education.
Overweight and obesity are the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco use. A major risk factor is the excessive intake of free sugars, which threatens the nutrient quality of the diet by providing significant energy with few other nutritional benefits.
One in every 11 deaths in the WHO European Region is due to alcohol consumption. Every year, about 800 000 deaths in the Region result from alcohol use, which represents almost a third of the global total of 2.6 million deaths.
Children and adolescents are regularly exposed to the digital marketing of many unhealthy products, including foods high in saturated fat, salt and free sugars, as well as alcoholic beverages. As time spent online shifts increasingly to social media and mobile devices, where personalised and targeted advertising predominates, the situation is likely to deteriorate.
Importance of a healthy, balanced diet
Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of NCDs and conditions.
The exact make-up of a diversified, balanced and healthy diet will vary depending on individual characteristics (such as age, gender, lifestyle and degree of physical activity), cultural context, locally available foods and dietary customs.
However, the basic principles of what constitutes a healthy diet remain the same.
General guiding principles for a healthy diet
The following list of principles for a healthy diet was compiled on the basis of WHO recommendations.
- Eat a variety of foods daily: vegetables, fruits, legumes, nuts and whole grains.
- Eat at least 400 g (5 portions) of fruits and vegetables every day.
- Limit free sugar intake to <10% of daily energy (ideally <5%). This is the equivalent of 50 g or 12 teaspoons of sugar (5% is 25 g or 6 teaspoons). Free sugar is any sugar added to a food or beverage, including sugar that is already in honey, syrup and fruit juice.
- Limit total fat intake to <30% of daily energy. Limit saturated fats to <10% and trans fats to <1%. Saturated fats are found in meat, butter, palm and coconut oil, and are usually solid at room temperature. Trans fats are industrially produced fats often found in baked goods and deep-fried foods in places without policies to restrict them as an unnecessary and potentially harmful chemical.
- Replace saturated and trans fats in the diet. This can be done with polyunsaturated fats found in fish, avocado, nuts and most plant-based oils.
- Limit salt intake to <5 g/day; use iodised salt.
Body mass index (BMI)
BMI is a measure for indicating nutritional status in adults. It is defined as a person’s weight in kilograms divided by the square of the person’s height in metres (kg/m2). For example, an adult who weighs 70 kg and whose height is 1.75 m will have a BMI of 22.9.
70 (kg) / 1.752 (m) = 22.9 (BMI)
For adults over 20 years old, BMI falls into one of the following ranges:
| BMI | Nutritional status |
| Below 18.5 | Underweight |
| 18.5–24.9 | Normal weight |
| 25.0–29.9 | Pre-obesity |
| 30.0–34.9 | Obesity class I |
| 35.0–39.9 | Obesity class II |
| Above 40 | Obesity class III |
BMI ranges are based on the effect that excessive body fat has on disease and death, and are reasonably well related to adiposity. BMI was developed as a risk indicator of disease.
As BMI increases, so does the risk for certain diseases. Common conditions related to overweight and obesity include cardiovascular diseases, high blood pressure, osteoarthritis, certain types of cancer and diabetes.
BMI is also recommended for use in children and adolescents. In children, BMI is calculated as for adults and then compared to z-scores or percentiles. During childhood and adolescence, the ratio between weight and height varies with sex and age, so the cut-off values that determine the nutritional status of those aged 0–19 years are gender- and age-specific.
The cut-off points of the 2006 BMI-for-age reference for children aged 0–5 years for the diagnosis of overweight and obesity were set as the 97th and the 99th percentile, respectively.
For those aged 5–19 years, overweight is defined as a BMI-for-age value over +1 standard deviation (SD) and obesity – as a BMI-for-age value over +2 SD.
