The North Karelia project: Finland

The North Karelia Project was launched in Finland in 1972 in response to the local petition to get urgent and effective help to reduce the great burden of exceptionally high coronary heart disease mortality rates in the area.

A community based preventive programme has been carried out here since 1972, resulting in an annual decline in deaths from ischaemic heart disease in men on average of 2.9%, compared to 2% in the rest of Finland.

Reference: Puska, P. 2000, "Nutrition and mortality: the Finnish experience", Acta Cardiol., vol. 55, no. 4, pp. 213-220.

South Korea

The structure of South Korea's economy, along with the country's dietary and disease patterns, began an accelerated shift in the 1970s. Major dietary changes included a large increase in the consumption of animal food products and a fall in total cereal intake. Uniquely, the amount and rate of increase in fat intake have remained low in South Korea.

South Korea also has a relatively low prevalence of obesity compared with other Asian countries with similar or much lower incomes. South Korea’s government have encouraged continuing adherence to the relatively healthy traditional Korean diet that, despite a large intake in the consumption of animal products over the last 30 years, has contributed to limiting fat intake and slowed the rise in obesity.

Reference: Kim, S., Moon, S., & Popkin, B. M. 2000, "The nutrition transition in South Korea", Am.J.Clin.Nutr., vol. 71, no. 1, pp. 44-53.

England

The National Service Framework (NSF) for Coronary Heart Disease which set national standards for the prevention as well as the diagnosis and treatment of coronary heart disease in England represents an example of a government-led programme on population-based prevention and included the 5-a-day programme which aimed to increase fruit intake, a national school fruit scheme which provided a free piece of fruit each school day to over a million children aged 4 to 6 years and local healthy living centres.

Reference: Department of Health 2000, National Service Framework for coronary heart disease: modern standards and service models.

Mauritius

In 1987 the government of Mauritius changed the composition of the commonly used cooking oil from being mostly palm oil (high in saturated fatty acids) to being wholly soya bean oil (high in unsaturated fatty acids). From 1987 to 1992, there were reports that total cholesterol concentrations had fallen. A reduction in the saturated fat content of a ubiquitous cooking oil was thought to explain some of this observed decrease in serum cholesterol.

Reference: Uusitalo U, Feskens E, Tuomilehto J, Dowse G, Haw U, Fareed D, et al. Fall in total cholesterol concentration over five years in association with chnages in fatty acid composition of cooking oil in Mauritius: cross sectional survey. BMJ 1996; 313:1044–1046