1. Nutrition – actions at the European level Dr. João Breda PhD, MPH, MBA Programme Manager Nutrition, Physical Activity and Obesity World Health Organization - Regional Office for Europe
2. Overweight and obesity among adults in the WHO European Region
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5. WHO European Childhood Obesity Surveillance Initiative
6. Prevalence of overweight, incl. obesity Based on the 2007 WHO growth reference for children and adolescents 5-19 years. Source: WHO, 2010. 50 40 30 20 10 0 Prevalence (%) Countries 9-year-olds 8-year-olds 7-year-olds 6-year-olds Belgium Bulgaria Ireland Italy Latvia Lithuania Norway Portugal Slovenia Sweden
24. Overview Policy Actions Implementation 27 EU MS EC/WHO Joint Monitoring Project on Nutrition, Physical Activity and prev of obesity Food Based Dietary Guidelines Guidelines Physical Activity Subsidized School Fruit Scheme School Vending Machines Promote Active Travel Initiatives to reduce Salt Increase healthier processed foods Measures to affect food prices Legislation labelling energy Signposting Food Products Regulation Marketing Baby Friendly Hospital Promotion Breastfeeding EU Member States Policy Actions No Action Partly Implemented Fully Implemented
Ladies and Gentlemen, Diet and physical activity related diseases are the main killers in the WHO European Region. Region-wide, cardiovascular diseases are by far the leading killer with over five million deaths estimated to take place annually from the causes alone. Today’s meeting goes beyond a discussion of the impact and the negative effects. Today we are analysing and evaluating the efforts that we have been doing in the promotion of healthy eating, health enhancing physical activity and the prevention of obesity.
Compared with the data available at the Istanbul Conference, new data was identified for 36 countries since then, two/third of the countries in our Region. Of these, 23 countries reported on data that was collected as of 2007 and beyond, so after the Istanbul Conference. Only 16 countries, however, measured body weight and height to estimate the prevalence among adult women and even less, 11 countries collected measured data to estimate the prevalence among adult men.
These figures show that overweight affects between one quarter to 7 out of ten individuals depending on the country and obesity affects 5 to 30% of adults in the countries of the WHO European Region. The highest overweight for men was found in Malta and in the UK we found the highest prevalence for women.
To show the developments after the Istanbul Conference, these trend figures are based on comparable data within a country and the latest survey was carried out in 2007 or later. In most countries an upward trend is visible. Exceptions are Finnish men, Irish women, Swiss women and both men and women from England, United Kingdom. The overweight range seemed to be narrower in men than in women.
The WHO Regional Office for Europe has established a European Childhood Obesity Surveillance System (COSI) in fifteen countries in the Region. The system aims to routinely measure trends in overweight and obesity in primary school children (6-9 years), in order to understand the progress of the epidemic in this population group and to allow for comparisons between countries within the European Region.
Preliminary results of the first round, which took place during the school year 2007-2008, indicate that on average one in every four children (24%) aged 6-9 years old are overweight or obese (based on the 2007 WHO growth reference for children and adolescents). These preliminary results show a range of 18-45% among 6 to 9 year-old children.
With protective behaviours like breastfeeding a lot is still to be done. Europe is in the worse situation
We are working in: Monitoring and surveillance of the Nutritional status, physical activity levels, dietary habits and policy developments Implementation of the European Charter on Counteracting Obesity commitments and the FNAP priority actions Development of tools and programmes for the promotion of PA at MS level
Priorities are: Coordinate regional and national action: Implementation of salt reduction strategies Tools and programmes for the promotion of PA Elimination of “trans” fat Promoting active transport policies Monitoring progress on improving nutrition, PA and prevention of obesity Support to MS on the development, implementation and evaluation of FNAP with focus on inequalities Implement obesity prevention and control mechanisms based on the European Charter to Counteract Obesity Principles
Mr. President, Regional Director Honourable Ministers Distinguished delegates Ladies and Gentlemen It is my pleasure to introduce to you the background, rationale and main features of the 2 nd WHO European Action Plan for Food and Nutrition Policy
A process of selection the data you need Available online http://10.16.131.240/nopa/RegionCompare.aspx
The results are displayed by country and by policy type. By moving a mouse pointer over checkmarks, you can see a list of references
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The Provision of Free or Subsidized School Fruit and Vegetable schemes was mentioned by a large majority of countries followed by the implementation the food based dietary guidelines. Measures that affect food prices were the least referred as fully implemented.
When tackling obesity we have to be more sensitive to its links with inequalities as I said before…. In fact, Most European countries have developed National Action Plans against Poverty and Social Exclusion; Many countries also developed national policies and/or action plans against overweight and obesity; Few countries, however, interlink these policies. National policies against overweight and obesity seldom contain policies against social exclusion, and likewise policies against social exclusion mostly do not consider obesity as a social problem.
The WHO Country Reporting Template monitored all the policy actions indicated as priority within the WHO Second Action Plan for Food and Nutrition Policy 2007-2012. These charts are an overview of selected policy actions that indicate a level of commitment to fight the epidemic of obesity in the WHO European Region. The first chart is on overview of the actions for the 27 EU MS, the second chart is an overview of the 26 non-EU MS for the same selected Policy Actions (please note, the level 0 is included as not all the data reported by the Member States has been validated by the WHO Office so 0 indicates if the country did not report any action for this field of activity) and the last chart is an overview of all the WHO European Region MS. The selected Policy Actions that are visible in these charts are: References for the 13 selected Policy Actions for the X-as FBDG Food Based Dietary Guidelines GPA Guidelines Physical Activity PFSFV Provision of Free or Subsidized School Fruit and Vegetable schemes REDNF Removing Energy Dense Nutrient poor Foods and beverages in school vending machines PAT Promote Active Travel for school-children IRS Initiatives to Reduce Salt content of processed foods IIA Initiatives to Increase the Availability of processed foods with reduced content of total fat and/or added sugars MAF Measures to Affect Food prices (taxes on soft drinks, chocolates and confectionary and/or incentives on fruit and vegetables) LRL Legislation Requiring Labelling of foods with nutritional information such as ingredients and the corresponding energy intake SFP Signposting on Food Products RM Regulations on Marketing of unhealthy foods and non-alcoholic beverages to children BHF Baby Friendly Hospital Initiative PB Promote Breastfeeding
Adolescents are at serious risk of obesity. This is the age when they develop consumers habit and eating behaviour ( Brownell et al, 2009 ). To reach out this age group, advertisers now are employing multi-channel strategy that accommodates various media and various devices. Adolescents are the most active users of new digital communication gadgets and social media tools. They are constantly connected to technology, even when they are asleep. Computers, SmartPhones, laptops, MP3 players…. Through the technology teenagers learn about new products, evaluate them, provide a feedback to the companies from anywhere at any time. Engagement strategies are becoming increasingly game-like and interactive. Marketers have being trying to create a more personal and authentic relationship with your customers. They have become part of the conversation Now they convince customers to buy their products by using experts and customers reviews. Consumers tend to trust the Internet much more than they trust magazines or TV. They consider the internet as less intrusive and shopping is less impulsive and value the fact that they can take their time choosing a product and buying it. They also think that digital shopping is more fun as they can share their opinion or get someone’s instantly. Also, finding new deals online mark shoppers not as thrifty and cost- conscious, but paint them as tech-savvy and smart shoppers. Shoppers used to hide that they use discounts, but now the deals are discussed and get sent to friends and colleagues.
Food companies’ marketing nature has changed dramatically for the last 5 years. Interactive marketing has been replacing monologue marketing communication. Before, major brands were pouring their messages to children and teens only in a passive way as a monologue that was coming mostly from TV, radio, magazines or billboards. However, now the monologue has turned into a dialogue that happened through emails, banner ad, blogging, cost per click, instant messaging, spam, opt-in list, social media, YouTube, Facebook, twitter, mobile barcodes, you name it. Now, customers are actively involved in brand building. From passive viewers, children and young people turned into ad producers and distributers, when companies ask users to send feedbacks. With digital marketing, the companies can create, test and adjust their marketing messages real time. Online behavioural tracking tools allow companies to track users’ personal preferences, interests and their philosophical profile and market products that might interest users. By analyzing people’s social network and social graphs, the companies can influence not only individual kids, but also a group of kids, a community. Source - http://www.yadvertisingblog.com/blog/2011/04/05/infographic-of-the-week-rising-online-video-ad-spend/
Even though, a traditional media like TV, is still consuming $129 billion, there is a steady upward trend for companies’ spending on online video ad. This spending increased by 41% in 2009 alone and by 2014 it will reach $5.2 billion US$ (ref – eMarketer). From 2008 to 2009, McDonald's increased it spending on online display advertising by 47%, PepsiCo by 69%, General Mills by 106%, Coca-cola by 163%, Kellogg by 225%, Wendy's by 336%, Dr. Pepper by 428%
This impressive information doesn’t speaks about levels of implementation however it provides baseline evidence to indicate that the European Region is willing to fight against the epidemic of obesity and follow up on the action points mentioned in the Charter. This conclusion can be drawn by just looking at when these policies have been developed and approximately 65% of them have been developed after 2004.
