부산대학교 도서관

Non-communicable diseases (NCDs) are a global public health problem, causing 74% of all deaths worldwide. High systolic blood pressure and an unhealthy diet are the first and second most important contributors to the burden of cardiovascular diseases.In this dissertation, I analyze policies implemented in micro-and macro-environments aiming to modify the food environment to address the burden of diet-related non-communicable diseases (DR-NCDs). I follow Hawke's framework that highlights the food environment as a mediator between preference learning and actual food consumption. Thus, policies that address the food environment are more likely to succeed because they address the main barriers to healthy eating.The first paper provides evidence of the food industry's tactics in weakening and preventing the national and international diffusion of the sugar-sweetened beverages (SSB) tax's policy effectiveness, implemented in Mexico in 2014. The food industry paid scientists to produce evidence aligned with their interests, showing that the tax was ineffective in improving health and harming the economy. The second paper examines how a workplace SSB sales ban at the University of California, San Francisco (UCSF) reduced SSB consumption at work and outside work. Heavy SSB drinkers reduced their consumption by half at work and outside workplaces. Finally, the third paper evaluates the impact of a Food Pharmacy Program (FPP) at clinics in the San Francisco Health Network. The FPP is associated with significant systolic and diastolic blood pressure reduction in low-income adults with hypertension, with greater effects among those with poor blood pressure control, and those that attended the FPP at least five times.I conclude that to reduce the burden of DR-NCDs, a package of interventions and policies at different levels that modify the food environment may be effective in reducing the access to health-harming products and increase the availability and access to healthy food. In addition, governments and policymakers should be free of conflict of interest and implement policies based on independent peer-reviewed evidence.