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Nfhk mikael fogelholm_turku2011

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  • 1. Improving public health - does research have an influence? Mikael Fogelholm, Professor in Nutrition Department of Food and Environmental Sciences Faculty of Agriculture and Forestry Department of Food and Environmental Sciences www.helsinki.fi/yliopisto 4.10.2011 1
  • 2. Health-related grand challenges for European research: age distribution100 %80 % 80+ 65-7960 % 50-64 25-4940 % 15-24 0-1420 % 0% 1950 1975 2000 2025 2050 www.helsinki.fi/yliopisto
  • 3. Health-related grand challenges forEuropean research: dementia 40 30 Dementia 20% Stroke 10 Parkinson 0 60 70 80 90 100 Age (years) www.helsinki.fi/yliopisto
  • 4. Health-related grand challenges for European research: obesity 25 20 15% withoverweight 10 5 0 67 71 74 77 80 84 85 86 94 95 98 99 2 3 Overweight among adolescents (12-18 y) in Nordic countries between years 1967 and 2003. www.helsinki.fi/yliopisto 4.10.2011
  • 5. Health-related grand challenges for European research: type 2 diabetes Non-obese Obese 35Type 2 diabetes 30in Finland 25• 1970: 50 000 20• 2010: 200 000 %• 2030: 400 000? 15 10 5 0 46-50 36-40 26-30 46-50 36-40 26-30 Birth year (19..) The proportion (%) of type 2 diabetics among obese (BMI>30) and non-obese (BMI<30) in Päijät-Häme (Lahti region), South Finland. www.helsinki.fi/yliopisto 4.10.2011 5
  • 6. Joint programming perspectives and motivationl Harmonizing strategic research approaches within countries to tackle more efficiently societal challengesl Synergistic use of shrinking research budgets in a difficult economic climatel Grouping calls for grants at the level of several member states on a voluntary basis will reinforce the potential for scientific collaboration in Europel Accountability to stakeholders in pooling research efforts addressing common social issues in Europel Simplifying European procedures governing scientific collaboration (and its administration) www.helsinki.fi/yliopisto 4.10.2011 6
  • 7. Health-related Joint Programming topicsNeurodegenerative diseases, in particular Alzheimer’s diseaseMore Years, Better Lives - The Potential and Challenges of Demographic ChangeA healthy diet for a healthy lifeThe microbial challenge – an emerging threat to human health www.helsinki.fi/yliopisto 4.10.2011 7
  • 8. A healthy diet for a healthy lifePolicy and societal challenges• Social inequalities• Young generation & elderly• Obesity, type 2 diabetes• Determinants of choices & health• Food supply • Sustainable & reasonable price• Competitiveness of food industry www.helsinki.fi/yliopisto 4.10.2011 8
  • 9. A healthy diet for a healthy lifeHow to change?Understanding of • Individual differences • Relationships between habits-onset disease • Mechanisms • Genetic basis • Needs due to social inequalities ‒ Minority groups • Social environments www.helsinki.fi/yliopisto 4.10.2011 9
  • 10. A healthy diet for a healthy life Research needs identified• Validation of health claims• Share databases and large intervention studies• European Food Research Institute?• European network on Food-omics• Long-term European multi-centre intervention studies• Standardization of investigation procedures and designs www.helsinki.fi/yliopisto 4.10.2011 10
  • 11. Good Ageing in Lahti Region (GOAL),Finnish research project on ageing andwell-being www.helsinki.fi/yliopisto 4.10.2011 11
  • 12. The province of Paijat-Hame in thebeginning of GOAL (y. 2000)Low-tech industry characteristic for town of Lahti,agriculture for the rural areasHigh unemployment rateAgeing rapidlyRelatively poor health statusUnhealthy lifestyles, high BMIMunicipalities having great economic difficulties,pressure to organizational changesHealth care sector operating with lowest costs inthe country; and with rapidly ageing personnel www.helsinki.fi/yliopisto 4.10.2011 12
  • 13. Proportion of 65-74 –y old in Päijät-Häme, yr. 2000 (pink) and 2015 (light blue, predicted) Hollola Pukkila Lahti Nastola Orimattila IiittiHämeenkoski Artjärvi Kärkölä Heinola Asikkala Sysmä Padasjoki Hartola 0 5 10 15 20 22.6.2006 Finland, 2000 Finland, 2015
  • 14. Good Ageing in Lahti Region (GOAL),Finnish research project on ageing andwell-being Collaborators University of Helsinki, Palmenia University of Helsinki, Dept. of Social Policy University of Helsinki, Division of Nutrition National Institute for Health and Welfare Lahti Polytechnic (University of Applied Sciences) Päijat-Hame Hospital District and its 15 municipalities www.helsinki.fi/yliopisto 4.10.2011 14
  • 15. Good Ageing in Lahti Region (GOAL),Finnish research project on ageing andwell-being: goals To empower both the population and the professionals in health promotion And as a consequence To increase welfare, diminish morbidity, and improve quality of life among ageing population in Lahti Region www.helsinki.fi/yliopisto 4.10.2011 15
  • 16. Good Ageing in Lahti Region (GOAL), Finnish research project on ageing and well-being: the three parts1) 10-year cohort study (2002-2012) three birth cohorts (baseline n=2815) will be followed, those born in 1946-50, 1936-40 and 1926-30 needs assessment general program evaluation2) Community-based interventions (2002-2012) evidence-based implementation studies development of policies and practicies3) Community Diagnoses (2002) combining data from cohort study, statistical reports and policy documens from each municipality www.helsinki.fi/yliopisto 4.10.2011 16
  • 17. Self-reported health compared to 1 year earlier (GOAL cohort, 2005)100 %80 %60 % Worse Similar40 % Better20 % 0% 46-50 36-40 26-30 46-50 36-40 26-30 Year of birth (19..) Ikihyvä Päijät-Häme, interim report 2005 (Fogelholm et al. 2007) www.helsinki.fi/yliopisto 4.10.2011 17
  • 18. Self-reported difficulties in performing activities related to daily living in women, born 1926-30, 1936-40 and 1946-50. 0 10 20 30 40 50 60 70 80 90 100 % Bathing/dressing Walk 100 m Walk 500 m Stairs 1 floor up Walk 2 km 1946-50 Carrying food-bag 1936-40 1926-30Moderate exertions Kneeing/bendingStairs several floors Vigorous activities Ikihyvä Päijät-Häme, interim report 2005 (Fogelholm et al. 2007)
  • 19. Proportion of individuals with severe restrictions in walking 500 m or bending, according to local community type. Results are adjusted for age and sex. 20 18 * * * = p<0.001 16 vs. other 14% 12 Urban 10 Semi-urban 8 Rural 6 4 2 0 Walking 500 m Bending Fogelholm et al. Scand J Publ Health, 2006 www.helsinki.fi/yliopisto 4.10.2011 19
  • 20. Intervention I: Group-counselling for prevention of T2D and CVD, based on The Health Action Process Approach. 1-y results. Intervention goals GOAL, % DPS, % N=352 N=265 Total fat < 30E% 48 47Those achieving 4-5 goals had SFA < 10E% * 34 26significantly moreoften normal Fibre > 15g/1000 kcal*** 52 25glucose tolerance at1-y follow-up Exercise > 30 min / d*** 66 86(χ2 = 7.120, p < 0.05) Weight loss > 5% *** 12 43 4-5 goals achieved 20 18 Absetz et al. Diabetes Care 2007, 30, 2465-2470. www.helsinki.fi/yliopisto
  • 21. Intervention II: Identification and counselling for individuals with impaired physical functioning 3rd sector Community health-careInterventions Identification of• Social networking Health Action Process Approach individuals with• Strength and Motivation mobilitybalance training Empowerment problems• Nutrition To the intervention Back to health care for follow-up measurements www.helsinki.fi/yliopisto
  • 22. Lessons learned from GOALEmphasis shifted from individual towards social andhealth care sector and municipal administration asprimary targetsSensitivity to emerging intervention needsInterventions support each other ideologically,structurally and methodologicallyDuring its brief history, GOAL has established itselfas a developmental resource in Päijät-Häme – but ittakes time to overcome resistance! Maatalous-metsä tieteellinen tiedekunta / Henkilön nimi / Esityksen nimi www.helsinki.fi/yliopisto 4.10.2011 22

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