Healthy food procurement policy: an important intervention to aid the reduction in chronic noncommunicable diseases.

In 2010, unhealthy diets were estimated to be the leading risk for death and disability in Canada and globally. Although important, policies aimed at improving individual's skills in selecting and eating healthy foods has had a limited effect. Policies that create healthy eating environments are strongly recommended but have not yet been effectively and/or broadly implemented in Canada. Widespread adoption of healthy food procurement policies are strongly recommended in this policy statement from the Hypertension Advisory Committee with support from 15 major national health organizations. The policy statement calls on governments to take a leadership role, but also outlines key roles for the commercial and noncommercial sectors including health and scientific organizations and the Canadian public. The policy statement is based on a systematic review of healthy food procurement interventions that found them to be almost uniformly effective at improving sales and purchases of healthy foods. Successful food procurement policies are nearly always accompanied by supporting education programs and some by pricing policies. Ensuring access and availability to affordable healthy foods and beverages in public and private sector settings could play a substantive role in the prevention of noncommunicable diseases and health risks such as obesity, hypertension, and ultimately improve cardiovascular health.

Stroke prevention and cognitive reserve: emerging approaches to modifying risk and delaying onset of dementia.

Demographic changes and improvements in health care are projected to result in dramatic increases in the prevalence of dementia. Alzheimer's disease is widely considered to be the primary cause of dementia - a disease for which there is currently no cure nor effective treatment, and for which it is thought that little can be done to mitigate risk. However, an increasing understanding of the role and extent of vascular contributions to the development of dementia, and appreciation of the interactions between stroke and Alzheimer's disease, suggest that targeting vascular risk factors may be very beneficial in reducing the impact of dementia. We also describe how active stimulation of the brain throughout the life course builds cognitive reserve that can offset or compensate for cognitive decline in later life. Finally, we discuss the implications of these emerging approaches for dementia prevention and advocate for the urgent implementation of more extensive public health strategies to improve vascular health.

Canadian initiatives to prevent hypertension by reducing dietary sodium.

Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada's dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of the Sodium Work Group and report back to them.