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EU action on obesity Obesity Prevention through European Network Closing event Amsterdam 25 November 2016 Attila Balogh Health determinants and inequalities European Commission Directorate-General Food Safety 2
Obesity and overweight - a human, social and economic burden 50% adults and 33% of children not a problem at the margins Overweight/obesity directly affect quality and life expectancy associated with diabetes, cancer and cardiovascular disease Lost productivity and premature death 2.8 million deaths/year associated with overweight and obesity Pressure on health care systems Up to 7% of EU health budgets on diseases linked to obesity equity as fundamental values Important regional, gender and socio-economic inequalities 3
Health inequalities There is a strong gradient in child overweight and obesity by socioeconomic status Socioeconomic inequalities in obesity are widening and the gradient is becoming steeper Women and children in low socioeconomic groups are most vulnerable Data break down by social group is needed Appropriate policies should be tailored to different needs and abilities in a range of settings 4
Children and adolescents One in three children are overweight. Children are not in a position to decide on their diets or physical activity and are more vulnerable to peer pressure and aggressive advertising and marketing. Obese children are more likely to suffer from selfconfidence issues, depression and underachievement in school. This makes action on education and exercise at schools particularly important. Only 1 in 5 European children take part in regular moderate-to-vigorous exercise. In most Member States, physical activity drops during early teenage years (especially for girls). 5
Obesity and inequalities "Guidance for addressing inequities in overweight and obesity" WHO/EC 2014 http://ec.europa.eu/health/ social_determinants/docs/ policybrief_obesity_en.pdf 6
Policy actions 7
European context for action Directorate C - Public Health Unit C4 deals with heath determinants and inequalities Improve the health of European citizens and reduce health inequalities through actions to address health determinants. In particular to promote health and reduce health inequalities, through measures addressing factors such as: nutrition and physical activity, addictions (alcohol, drugs), socio-economic conditions and environmental factors. 8
EU Strategy on Nutrition, Overweight and Obesity-related Health Issues Priority areas better informed consumers making healthier options available priority groups and settings encouraging physical activity developing the knowledge base developing monitoring systems 9
EU Strategy on Nutrition, Overweight and Obesity-related Health Issues 2007 EU Strategy on Nutrition, Overweight and encourage Obesity-related action-orientated Health Issues partnership - 2 EUROPEAN COMMISSION Member States Civil society HIGH LEVEL GROUP on Nutrition and Physical Activity EU PLATFORM for Action on Diet, Physical Activity and Health
High Level Group on Nutrition and Physical Activity http://ec.europa.eu/health/nutrition_physical_activity/high_level_group/index_en.htm 11
High Level Group 28 Member States + Norway, Switzerland + WHO sharing policy ideas, best practice and solutions Deliverables: Salt: a 2008 reformulation framework to reduce salt in food by 16% in 4 years Saturated fat: under the 2011 'EU Framework for National Initiatives of Selected Nutrients', an Annex on Saturated Fat was agreed with the objective to reducing saturated fat by 5% until 2016 and by an additional 5% by 2020. 2014: Council Conclusions on Nutrition and Physical Activity promote further action as a way of reducing the burden of chronic disease. 2014: Action Plan on Childhood Obesity (25 MS + Norway) HLG voluntary initiative; involvement of WHO in monitoring. 2015: Joint Action on Nutrition and Physical Activity to support to implementation of Action Plan. Sugar: a 2015 Annex to reduce added sugars with 10% by 2020 2016: Council Conclusions on food product improvement 12
Food reformulation /product improvement Cross-border dimension EU added value Effective protection of citizens health Level playing field for companies Challenges but also possibilities for innovation and business opportunities
Food reformulation /product improvement EU Framework for National Salt Initiatives 2008, ongoing 2010 Council conclusions on action to reduce population salt intake for better health reinforcement of work 2012 Report - Implementation of the EU Salt Reduction Framework
Food reformulation /product improvement EU Framework for National Initiatives on Selected Nutrients: energy, total fat, saturated fat, trans fat, added sugars, portion sizes, consumption frequency February 2011, ongoing Annex I: Saturated fat February 2012, ongoing Annex II: Added sugars December 2015, ongoing Currently: two working groups on reformulation lead by the MS: on monitoring and on benchmarks
Action Plan on Childhood Obesity Aim: to halt the rise in childhood obesity by 2020. 8 areas of action Support a healthy start in life Promote healthier environments, especially in schools and pre-schools Make the healthy option the easier option Restrict marketing and advertising to children Inform and empower families Encourage physical activity Monitor and evaluate Increase research Midterm evaluation in 2017 during Maltese EU Presidency http://ec.europa.eu/health/nutrition_physical_activity/docs/ childhoodobesity_actionplan_2014_2020_en.pdf 16
Action Plan on Childhood Obesity implementation so far The Commission supports the members of the High Level Group in the implementation of the Action Plan on Childhood Obesity The Commission, the High Level Group and the WHO prepared a monitoring mechanism for the implementation of the Action Plan. A baseline of 18 indicators was populated for 2014 and updated in 2015 and 2016. A lot of progress was achieved, namely in the areas of nutritional guidance for pregnancy, marketing criteria and reformulation. A mid-term evaluation is planned for 2017 and a report will be discussed during the Maltese Presidency. The Commission has commissioned a call for tender for the mid-term evaluation and the work by the contractor has started. 17
Joint Action on Nutrition and Physical Activity ('JANPA') Aim: contribute to halting the rise in overweight and obesity in children and adolescents JANPA supports the Member States in the implementation of the Action Plan on Childhood Obesity 2.5 years action, 25 Member States, 1,5 million Main Work Packages: Evidence ('Economic rationale for action on childhood obesity') Nutritional information monitoring and food reformulation Healthy environments by integrated approaches Early interventions Launched on 28 September 2015 in Luxembourg. http://www.janpa.eu/ 18
EU Platform for Action on Diet, Physical Activity and Health http://ec.europa.eu/health/nutrition_physical_activity/platform/index_en.htm 19
EU Platform A forum for European-level organisations: food industry, health NGOs, consumer organisations, research organisations and health professionals. Since 2005-10 th anniversary 34 members Support to High Level Group Voluntary approach Around 300 voluntary commitments in Platform database http://ec.europa.eu/health/ph_determinants/life_style/nutrition/platform/database/ dsp_search.cfm 20
EU Platform: Commitments in 6 areas Consumer information, including labelling In line with 2007 Strategy Advocacy and information exchange Education, including lifestyle change COMPOSITION OF FOODS (REFORMULATION) Physical activity promotion Marketing and advertising
Pilot projects 22
Pilot projects Four pilot projects supported by European Parliament - Increase consumption of fresh fruit and vegetables in Romania, Bulgaria and Slovakia (completed) - Increase consumption of fresh fruit and vegetables in Poland and Hungary (ongoing) - Promote healthy diets among children, pregnant women and elderly (ongoing) - Promote healthy diets among pregnant and lactating women of vulnerable groups (ongoing)
Taste Booster Aim: increasing consumption of fresh fruit and vegetables in local communities where the household income is below 50% of the EU average 2012-2014 Romania, Bulgaria, Slovakia q An estimated 5,000 participants were reached through almost 1,000 cooking sessions and events q 92% of participants declared to have eaten more fruit and vegetables since participating in the cooking sessions q 97% of participants said they feel more informed about nutrition q 98 tons of fruit and vegetables were consumed on location and distributed for further cooking at home 24
My healthy family Aim: increasing consumption of fresh fruit and vegetables in local communities where the household income is below 50% of the EU average 2013-2015 Poland and Hungary q specific websites have been created for both countries q 7008 households have been signed up in total, ca. 25,000 persons, all have been invited to participate in the zero measurement q participation is to determine the beneficiaries of fruit and vegetables 25
We love eating Aim: promoting healthy diets among children, pregnant women and elderly 2013-2015 7 cities of 7 Member States Spain, France, Romania, Poland, the Netherlands, Slovakia, the United Kingdom q defined, designed, produced educational material for promoting healthy lifestyle (healthy diets) q testing the educational material and communication strategy for reuse and extension in other countries q website www.we-love-eating.eu including survey for adults and children, card game and app 26
Together Aim: promoting healthy diets among pregnant and lactating women of vulnerable groups 2014-2016 5 cities of 5 Member States Bulgaria, Czech Republic, Denmark, Spain, United Kingdom q 2,500 women from each country q collaborate with doctors, health experts and NGOs to design and test the best communication and educational approaches for different settings q identified good ideas will be replicated in other European cities and regions "Healthy for you, Healthy for two"! 27
The way forward. 28
q National plans for reformulation? q Continue / strengthen salt, sat fat, sugar? categories, benchmarks, monitoring? q Develop Annexes (categories, benchmarks) for more selected nutrients (e.g. fibers)? q Increase cooperation with stakeholders on awareness raising and increased promotion of low fat/sugars/salt options? Revision of the Platform working methods (relevance, political/scientific guidance, core-business) & marketing related issues (WHO nutrient profile model to restrict marketing to children) q Integrate work on reformulation more with the Action Plan on Childhood Obesity (school meal standards, education of parents)? q Public procurement guidelines (schools, student hostels, nursing homes, hospitals, public offices, prisons) q Full use of the EU Health Policy Platform for sharing experiences on new initiatives and actions, as well as best practices, aimed at promoting food product improvement. q Promoting public health within a holistic approach q WHO, OECD, Health Program ( 450 million 2014-2020), HiAP
Thank you! 30
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