The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report – Table of Contents

Reproduced from: https://www.thelancet.com/commissions/global-syndemic

Table of Contents

1. A Policy Brief for national and municipal governments, civil society, funders, businesses, and international agencies
   • Background
   • Societal Costs of The Global Syndemic
   • Policy Inertia
   • The Global Syndemic Narrative
   • Double-duty and Triple-duty Actions
   • Examples of triple-duty actions
   • The Path Forward
     • Actions for All
     • Actions for Nations and Municipalities
     • Actions for Civil Society
     • Actions for Funders
     • Actions for International Agencies
   • Lancet Commission on Obesity: Commissioners and Fellows
2. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report
   • Executive summary
     • The Global Syndemic
     • Syndemic drivers
       • • • Key messages
     • Double-duty or triple-duty actions
     • Changing trends in obesity, undernutrition, and climate change
     • The economic burden of The Global Syndemic
     • Actions to address The Global Syndemic
   • Introduction
     • • • • Panel 1: The Lancet Commission on Obesity
           • Panel 2: Definitions
   • The obesity pandemic
     • • People’s experiences
         • • Panel 3: People’s experience — a patient’s experience
           • Panel 4: People’s experience — the bus driver mum’s tale
       • The obesity context
         • Malnutrition in all its forms
           • Figure 1: The burden of malnutrition in all its forms
         • The four major global outcomes
           • Figure 2: The Systems Outcomes Framework
   • Re-thinking obesity: The Global Syndemic and complex adaptive systems
     • The Global Syndemic
       • Obesity, undernutrition, and climate change cluster in time and place
       • Obesity, undernutrition, and climate change interact with each other
       • Obesity, undernutrition, and climate change have common systems drivers
     • Complex adaptive systems
       • Five sets of feedback loops
       • Levers to convert policy inertia into policy traction
       • The role of individuals
       • The nature of double-duty or triple-duty actions
     • Food systems as syndemic drivers
       • • • Panel 5: Red meat as a syndemic driver
           • Panel 6: Ultra-processed foods as syndemic drivers
       • Growing consensus on the need for healthy, sustainable food systems
       • Double-duty or triple-duty actions for food systems
         • • Table 1: Nutrition recommendations, drawn from High Level Panel of Experts Nutrition and Food Systems Report, scored for potential effects on climate change mitigation and adaptation
           • Table 2: Abbreviated recommendations for physical activity and indicative potential for effect on climate change
       • Investment needed to improve nutrition
         • • Panel 7: Civil society support drove commitment for Mexico’s sugary drinks tax
       • Voluntary, quasi-regulatory, and regulatory approaches to improving food systems
         • • Panel 8: People’s experience — the Chilean Senator’s battle for food policies
     • Transportation, urban design, and land use as syndemic drivers
       • Urban design and food systems
         • • Panel 9: Food deserts and swamps
       • Planning, development, and retrofitting
       • City leadership
       • Effects of physical activity recommendations on climate change
     • Country contexts for action
       • • • Figure 3: Key Global Outcome indicators by region 
       • Economic prosperity
       • Natural ecosystem health and wellbeing
         • • Table 3: Descriptions of complementary factors of current or past public health actions related to tobacco, alcohol, gun control, traffic safety, and infant nutrition and implications for making progress on obesity
       • Human health and wellbeing
       • Social equity
   • Strengthening public sector governance
     • Governance challenges
       • Governance challenge 1: driving coherent action
       • Governance challenge 2: generating and sustaining commitment
       • Governance challenge 3: mobilising capacities and resources for impact
         • • Panel 10: Challenges of collaborative local governance — urban food systems in Kenya
       • Governance challenge 4: addressing power asymmetries in food systems
       • Next steps for strengthening governance
     • Right to wellbeing
       • • • Figure 4: Intersection of human rights that comprise the overarching right to wellbeing framework
       • The right to health
       • The right to food
       • Cultural rights
       • The Rights of the Child
       • The right to healthy environments
       • Implications of the right to wellbeing framework
     • A Framework Convention on Food Systems
     • Global to local implementation
   • Private-sector challenges
     • Reducing power imbalances and conflicts of interest
     • Business models for the 21^st century
       • Drivers of corporate performance
       • Measures of corporate performance
       • Business-driven mechanisms to re-orient markets and corporations
       • Government-driven mechanisms to re-orient markets and corporations
       • Investor-driven mechanisms to re-orient markets and corporations
         • • Panel 11: Towards a sustainable economic model: a global summit
       • Small and medium enterprises
         • • Panel 12: People’s experience — an Indian shop owner’s challenge in selling healthier foods
       • Civil society-driven mechanisms to re-orient markets and corporations
   • Mobilising civil society
     • Learning from previous social change
       • Social change and public health
       • Strategic considerations
       • Mobilising demand for change
       • Political movements
       • Implications
         • • Panel 13: People’s experience — making local change happen
     • Cultural influences and indigenous approaches
       • Sociocultural determinants of obesity
       • Indigenous and traditional peoples and The Global Syndemic
       • Learning from traditional peoples’ approaches for systemic action
         • • Panel 14: People’s experience — a Māori approach to holistic health and wellbeing
     • Community-based actions
       • • • Table 4: Characteristics of the three broad types of interventions for prevention of childhood obesity 
       • Examples of systems activation approaches from Victoria, Australia
         • • Panel 15: People’s experience — community-based health promoter
   • Accountability systems
     • Outcomes and risk factor monitoring
     • Upstream monitoring
       • • • Figure 5: Benchmarking the level of implementation of recommended food environment policies by national governments
     • WHO-level and UN-level monitoring
     • Sustainability of monitoring efforts
     • Engagement processes
   • Strategic funding
   • Strategic research
   • Recommendations
     • Six underlying principles
     • Actions to maximise impact on The Global Syndemic
       • Think in Global Syndemic terms
       • Join up the silos of thinking and action
       • Strengthen national and international agency governance levers
       • Strengthen municipal governance levers
       • Strengthen civil society engagement
       • Reduce the influence of large commercial interests on public policy development
       • Strengthen accountability systems
       • Sustainable and health-promoting business models for the 21^st century
       • Focus research on The Global Syndemic determinants and actions
     • Future monitoring
       • • • Panel 16: Accounting monitoring for propositions
     • Contributors
     • Declaration of interests
     • Acknowledgments
   • References
3. Supplementary Material
   • Appendix 1: The Lancet Commission on Obesity and the Sustainable Development Goals
   • Appendix 2: Complex pathways from climate/weather variability to undernutrition in poor rural farming households
   • Appendix 3: Indicators by region and country of obesity, underweight, greenhouse gas emissions, gross domestic product, and income inequalities (GINI coefficient)
   • Appendix 4: Potential activities, partners and double- or triple-duty actions according to program or policy interventions
   • Appendix 5: Identifying double- or triple-duty policy actions
   • Appendix 6: Nutrition recommendations, drawn from High Level Panel of Experts Nutrition and Food Systems Report, scored for potential impact on Climate Change mitigation and adaptation
   • Appendix 7: Public Health Responsibility Deal
   • Appendix 8: UK structured approach to reducing sugar in the food supply
   • Appendix 9: Urban agriculture in Havana
   • Appendix 10: Physical activity recommendations, drawn from the WHO Global Action Plan on Physical Activity (2017), scored for potential impact on climate change mitigation and adaptation
   • Appendix 11: Analysis of the global governance for nutrition
   • Appendix 12: Criteria for new global health treaties and counter-arguments
   • Appendix 13: Examples of influential frames used in various countries
   • Appendix 14: Policy frameworks to address obesity
   • Appendix 15: Cultural preferences and perceptions of body size.
   • Appendix 16: State-led case study – Healthy Together Victoria
   • Appendix 17: Community-led case study – South-West Victoria
   • Appendix 18: Proposed country scorecard for comparing upstream indicators on food policies and environments
   • Appendix 19: Indicators of policies to support active environments
   • Appendix 20: Upstream monitoring – lessons from HIV/AIDS and tobacco prevention monitoring
   • Appendix 21: Role of development agencies and the flows of global aid for health
   • References