The European Response The European Charter on Counteracting Obesity and the European Action Plan for

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The European Response The European Charter on
Counteracting Obesity and the European Action
Plan for Food and Nutrition Policy

• Professor Kaare Norum MD, PhD
• Department of Nutrition, University of Oslo,
  Norway

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WHY ?
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Projected overweight (incl. obesity) rates for
school age children
Wang and Lobstein, IOTF, 2006.
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Trends of overweight among school children in
the WHO European Region
Source WHO Regional Office for Europe, 2006.
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Setting the policy scene the European Charter
on counteracting obesity
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Preparatory process

• Documentation
• Partnerships European Commission, ngo network,
  European Platform
• Drafting of the European Charter (Member States)
• Member State consultations and intersectoral
  meetings
• Expert consultations on obesity policies,
  physical activity, role of local governments,
  inequalities, school policies, marketing to
  children

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The Ministerial Conference on counteracting
obesity

• Istanbul, 15-17 November 2006
• 48 Countries
• 65 Ministers, deputy Ministers and state
  secretaries
• 500 Participants (25 from non health sectors)
• European Commission, Nordic Council of Ministers,
  Council of Europe, FAO, World Bank, UNICEF, ILO
• European Platform, non governmental
  organizations, experts

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Counteracting obesity - healthy food

• Agricultural policy
• Food composition
• Food pricing
• Food distribution and marketing
• Catering
• Food in schools and kindergartens
• Food in the workplace
• Food in hospitals
• Food advertising and promotion
• Food labelling
• Information and education
• Breastfeeding and complementary feeding

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Counteracting obesity physical activity

• Active transport
• Urban design and housing environment
• Schools and kindergartens
• Workplace
• Organised recreational activities
• Sport

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Health-related recommendations of physical
activity in children and youth

• All children and youth should engage in physical
  activity with moderate intensity for at least 1
  hr/day

Norwegian Directorate for Health and Social
affairs
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Sitations from the European Charter on
counteracting obesity

• Government should ensure consistency and
  sustainability through regulatory action,
  including legislation
• Specific regulatory measures should include the
  adoption of regulations to substantially reduce
  the extent and impact of commercial promotion of
  energy-dense foods and beverages, particularly to
  children,with the development of international
  approaches, such as a code on marketing to
  children in this area

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Policy framework

• Individuals alone are not responsible - changing
  the social, economic and physical environment
• Responsibility of government across sectors
• Involvement of all stakeholders
• Portfolio of interventions designed to change the
  social, economic and physical environment
• Portfolio of policy tools (from legislation to
  public/private partnerships)
• International coordination
• Special focus on children and on disadvantaged
  socioeconomic population groups

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Goal

• 2.2 Curbing the epidemic and reversing the trend
  are the ultimate goal of action in the Region.
  Visible progress, especially relating to children
  and adolescents, should be achievable in most
  countries in the next 45 years and it should be
  possible to reverse the trend by 2015 at the
  latest.

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International policy developments referring to
the European Charter

• EU Parliament Report on Promoting healthy diets
  and physical activity (2006)
• World Health Assembly (2007)
• UN Standing Committee on Nutrition (2007)
• FAO/WHO Codex Alimentarius Commission (2007)
• EC White paper on Nutrition (2007)
• EU Council conclusions on Health promotion by
  means of nutrition and physical activity (2007)

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Policy developments in Member States

• Development or revision of policy documents
• Intersectoral process established
• Public/private partnerships
• Budget increase
• Charter translation and dissemination

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Operationalising policy the Second Action Plan
for Food and Nutrition Policy
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Why a Revised Action Plan?

• The 2000 Action Plan promoted the development of
  nutrition policies
• Nutrition policies are not fully implemented

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What is new in the Food and Nutrition Action Plan
2007 ?

• Common goals
• 25 priority actions to influence supply of food
  and consumers behaviours
• Built on good practice in Member States
• Portfolio approach some well established and
  some more advanced actions

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Common goals

• lt10 of daily energy intake from saturated fat
• lt1 of daily energy intake from trans fatty
  acids
• lt10 of daily energy intake from free sugars
• gt 400g fruits and vegetables a day
• lt5 g a day of salt
• infants should be exclusively breastfed for the
  first six months of life and breastfeeding should
  be continued until at least 12 months

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Intake of saturated fatty acids is higher than
recommended
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Challenges and action areas
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Action area 2Ensuring safe, healthy and
sustainable food supply

• Improve the availability of fruit and vegetables
• Promote the reformulation of mainstream food
  products
• Improve food supply and food safety in public
  institutions
• Explore the use of economic tools (taxes,
  subsidies)

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Action area 3Providing comprehensive information
and education to consumers

• Food-based dietary guidelines and food safety
  guidelines, complemented by physical activity
  guidelines
• Public campaigns aimed at informing consumers
• Appropriate marketing practices
• Adequate labelling of food products

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Action area 4 Increasing opportunities to
perform physical activity in daily life

• Physically active transport
• Urban environment
• Curricular and extra curricular pursuits in
  kindergartens and schools
• Working environment
• Access to indoor and outdoor recreation
  facilities
• Large scale population interventions

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Action area 5Strengthening nutrition and food
safety in the health sector

• Engage primary care staff in nutrition assessment
  and in the provision of diet, food safety and
  physical activity counselling
• Improve the standards of service delivery for the
  prevention, diagnosis and treatment of nutrition
  related diseases
• Improve the quality of nutrition services and
  food safety in hospitals

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Steps for implementation
Review of policies and action plans
Prioritising and adapting
Allocating tasks and resources
Multisectoral mechanisms
Monitoring implementation
Dialogue and partnerships
Policy implementation
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WHOs role in ensuring implementation

• Advocacy
• Building partnerships
• Guiding international action and ensuring
  critical mass in actions
• Surveillance and policy analysis
• Good practices in programmes and policies
• SMARTen and operationalise actions
• Cost effectiveness and development scenarios

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Building partnerships

• European Commission
• UN organisations
• NGO networks and alliances
• The private sector setting operational goals

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Ensuring critical mass in actions the action
networks

• Action member state network on marketing foods
  and non alcoholic beverages to children
• led by Norway (involving Belgium, Bulgaria,
  Denmark, Finland, Portugal, Slovenia, Spain and
  the United Kingdom)
• Action member state network on salt reduction
• led by UK (involving Russian Federation, Finland,
  Serbia, Ireland, Bulgaria, Belgium, Portugal,
  Spain, France, Slovenia)

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Action tools

• Policy and programme database
• Good practice evaluation tool
• Childhood obesity surveillance initiative
• Nutrition friendly school initiative
• Nutrition profiles for use in labelling,
  marketing, economic tools and food procurements
• Food procurements in public institutions
• Labelling

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Marketing of foods to children international
action is essential

• National actions alone are inadequate
• International action is essential to ensure an
  effective overall approach
• The growth of marketing activities in emerging
  economic and developing countries is of special
  concern
• It is recommended that WHO take the lead in
  developing an international code on the
  commercial promotion of food and beverages to
  children
• Marketing of food and non-alcoholic beverages to
  children. Report of a WHO Forum and Technical
  Meeting,Oslo, 2-5 May 2006

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Some recent initiatives

• The WHO EMRO Resolution on Marketing Food and
  Beverages to Children
• Consumers International / IOTF Recommendations
  for an International Code of Marketing Foods and
  Beverages to Children
• Canadian Initiative
• The Bangkok Call on Action on Marketing of Food
  to Children

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Thank you If you want to know more .

• Nutrition and Food Security http//www.euro.who.in
  t/Nutrition
• Obesity http//www.euro.who.int/obesity
• Database on nutrition policy and obesity
  http//data.euro.who.int/nutrition/
• WHO/Europe, Transport and health website http//
  www.euro.who.int/Transport
• HEPA Europe http// www.euro.who.int/hepa