Obesity in Finland activity to prevent adverse trends Marjaana Lahti-Koski development manager, health promotion Adjunct prof, PhD, MSc (nutrition), Finnish Heart Association marjaana.lahti-koski@sydanliitto.fi 16.3.2011 Prevalence of obesity (BMI>30 kg/m 2 ) in Finland (aged 25-64 years) 25 20 15 10 Men Women 5 0 1967-72* 1978-80** 1982 1987 1992 1997 2000** 2002 2007 */** ikäryhmä >15-v/>30-v Rissanen et al. IJO 1988;FINRISK-Surveys 1982-2007, Lahti-Koski et al. IJO 2000, EJCPR 2007, Obes Rev 2009 1
Changes in obesity stage in 20 years aged 30-64 years* BMI>35 1978-80 2000-01 BMI>40 1978-80 2000-01 Men 1.1 (0.9-1.3) 4.1 (3.7-4.5) 0.1 (0.1-0.1) 0.9 (0.7-1.1) Women 3.7 (3.3-4.1) 6.3 (5.8-6.8) 0.6 (0.5-0.7) 2.0 (1.7-2.3) * Prevalence (95CI) Lahti-Koski et al. Obes Rev 2010;11:171-6 Prevalence of obesity, BMI>30 Lahti-Koski et al. Eur J Public Health 2008 2
BMI by age, women 29 28 27 26 25 24 55-64 45-54 35-44 25-34 23 22 1982 1987 1992 1997 2002 2007 * Männistö et al SLL 2004, Peltonen et al. KTL B34/2008 Obesity in men by age - change in 20 years 35 30 25 20 15 10 5 0 1978-80 2000-2001 mean 1978-80 mean 2000-01 30-44 45-54 55-64 65-74 75+ Lahti-Koski et al. Obes Rev 2010;11:171-6 3
35 30 25 20 15 10 5 0 Obesity in women by age - change in 20 years 1978-80 2000-2001 mean 1978-80 mean 2000-01 30-44 45-54 55-64 65-74 75+ Lahti-Koski et al. Obes Rev 2010;11:171-6 Prevalence of overweight () boys aged 12 18-years Source: The Adolescent Health and Lifestyle Susanna Kautiainen 2008 4
Prevalence of overweight () girls aged 12 18-years Source: The Adolescent Health and Lifestyle Susanna Kautiainen 2008 Prevalence of obesity (BMI>30 kg/m 2 ) by education 1987-2002, women lowest middle 2002 1997 1992 1987 highest 0 5 10 15 20 25 30 Lahti-Koski et al. EJCPR 2007;14:398-404 5
How about waistline? photo: www.hyvis.net Abdominal obesity () (waist;,men>100 cm, women>90 cm) 6
Waist >100 cm by age, 1987-2002, men 55-64-v. 45-54-v. 35-44-v. 2002 1997 1992 1987 25-34-v. 0 10 20 30 40 50 Lahti-Koski et al. EJCPR 2007;14:398-404 Waist >90 cm by age, 1987-2002, women 55-64-v. 45-54-v. 35-44-v. 2002 1997 1992 1987 25-34-v. 0 10 20 30 40 50 Lahti-Koski ym. EJCPR 2007;14:398-404 7
BMI vs. waist men Men Men 25 25 20 15 10 1987 2002 20 15 10 1987 2002 5 0 18 20 22 24 26 28 30 32 34 36 38 40 BMI (kg/m2) 5 0 67,5 72,5 77,5 82,5 87,5 92,5 97,5 102,5 cm 107,5 112,5 117,5 122,5 127,5 132,5 137,5 Lahti-Koski ym. EJCPR 2007;14:398-404 BMI vs. waist women Women Women 25 25 20 15 1987 2002 20 15 1987 2002 10 5 10 5 0 16 18 20 22 24 26 28 30 32 34 36 38 40 BMI (kg/m2) 0 5 7,5 6 2,5 6 7,5 7 2,5 7 7,5 8 2,5 8 7,5 9 2,5 9 7,5 1 0 3 1 0 8 1 1 3 1 1 8 1 2 3 1 2 8 1 3 3 1 3 8 cm Lahti-Koski ym. EJCPR 2007;14:398-404 8
Obesity prevention in national action plans and programmes Government Resolution on development guidelines for health-enhancing physical activity and nutrition 2008 URL: http://www.stm.fi/julkaisut/nayta/_julkaisu/1069549 Obesity integrated in several action plans and programmes, e.g: Health promotion - Government policy programme (2008) Action programme for implementing national nutrition recommendations (2003) Programme for the prevention of type 2 diabetes in Finland (2003) Action Plan for Promoting Finnish Heart Health for the years 2005-2011 (2005) Government Resolution on development guidelines for health-enhancing physical activity and nutrition 2008 9
TOPI was published in June 2005 gives guidelines and strategies for actions to prevent CVD nutrition and physical activity key elements implementation: Finnish Heart Plan population strategy Finnish Heart Plan - Population strategy Healthy lifestyle from the very Beginning - SMART FAMILY Population strategy Small decision a day Healthy meal services Walking programme 10
The Smart Family exercise and nutrition guidance method Provides support, tools and knowledge for personnel at primary health care to promote good dietary and physical activity habits at the level of the entire family. Based on STRIP (Special Turku coronary Risk factor Intervention Project for children) project; evidence for early prevention of CHD 1st phase: Maternity and well-baby clinics 2nd phase: Schools (and day care) The Smart Family working tools for public health nurses Card: exercise and nutrition habits mother + father + child Information pack Image pack Education 11
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Communication campaign - The little one follows the big one s example Background: The aim - healthy lifestyle from the very beginning Key messages: It is up to adults You have the responsibility You are the example/hero For parents, professionals working with children, policy makers In the eyes of a child you are a hero 13
The child follows the example of the adult. In everything. Photo: Finnish Heart Association Photo: Finnish Heart Association 14
Heart Symbol on market since 2000 Labelling system for foods Helps consumers to make better choices at groceries Currently >750 products with the symbol on the Finnish market Well recognised by consumers 15
Product groups Milk and milk (dairy) products and other similar products Fats and oils Processed meat Bread and cereals Convenience food, semi-processed food, meal components Spices and seasoning sauces Vegetables, fruit and berries (since Aug 2007) Meat and fish (since Dec 2009) Awareness THL: Health behavior of Finnish adults 32 16
Heart symbol expanded to the plate Meals can be labelled with the symbol The symbol helps: customers: to make tasty and healthy choices when eating out caterers: to inform customers of healthy choices on offer and to improve their service related to the nutritional quality of the meals Goals To increase the know how of food service employees about improving the nutritional quality of the food they prepare To increase the demand for healthier meals To help consumers to make better choices when eating out 17
Meals with the Heart symbol Components for better meals Main dish: energy, fat (quantity and quality), salt Other meal components to be available: Non-fat milk/sour milk Low-salt bread + spread (fat quality) Fresh vegetable + salad dressing (fat quality) Customer information Heart Symbol helps the customer to put together a healthy meal step by step Main dish and meal components marked with symbol on buffet Model meal to be on view Wednesday Karelian beef stew Baltic herring steaks Meatballs Mushroom soup 18
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