Ncdmännistö2014

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  • 1. 1 Obesity in Finland – activity to prevent adverse trends 11.3.2014 Satu Männistö Ph.D, Adj.Prof., Academy Research Fellow RESULTS - OBESITY www.terveydeksi.fi 11.3.2014 Satu Männistö 2 11.3.201412.3.2014 BMI in men aged 30 to 59 years in 1972-2012 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1972 1977 1982 1987 1992 1997 2002 2007 2012 kg/m2 Vuosi Miehet Pohjois-Karjala Kuopio Turku/Loimaa Helsinki Pohjois- Pohjanmaa/Kainuu Satu Männistö 3 North Karelia Northern Savo Turku/Loimaa Helsinki/Vantaa Northern Ostrobothnia 11.3.201412.3.2014 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1972 1977 1982 1987 1992 1997 2002 2007 2012 kg/m2 Vuosi Pohjois-Karjala Kuopio Turku/Loimaa Helsinki Pohjois- Pohjanmaa/Kainuu Satu Männistö 4 BMI in women aged 30 to 59 years in 1972-2012 North Karelia Northern Savo Turku/Loimaa Helsinki/Vantaa Northern Ostrobothnia BMI and proportion of obesity in Finland in 2007-2012; aged 25 to 64 years men and women FINRISK 2007 25-64 v n=4804 FINRISK 2012 25-64 v n=4399 p-value Men BMI, kg/m2 ≥25 (%) ≥30 (%) Waist, cm >100 cm (%) 27.0 65.9 18.8 96.5 31.8 27.1 66.3 20.4 96.1 31.0 0.42 0.76 0.17 0.29 0.59 Women BMI, kg/m2 ≥25 (%) ≥30 (%) Waist, cm >90 cm (%) 26.3 49.5 18.3 86.6 30.9 26.0 46.4 19.0 85.4 29.7 0,07 0,04 0,51 0.001 0.38 BMI = weight (kg) / height (m)2 Esim. 83 kg / (1,752) = 27,1 kg/m2 11.3.2014 Satu Männistö 5 Excess kilograms in overweight and obese subjects vr BMI 18.5-25 vr BMI=25 BMI 25-30 + 14,3 kg + 6,6 kg BMI≥30 + 31,2 kg + 25,4 kg BMI unit (kg/m2) = 3,1 kg for men (176 cm) and 2,7 kg for women (163 cm) 11.3.2014 Satu Männistö 6
  • 2. 2 BMI (kg/m2) by age groups in men 11.3.201412.3.2014 7 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1997 2002 2007 2012 kg/m2 25-34 35-44 45-54 55-64 Satu Männistö 11.3.201412.3.2014 8 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1997 2002 2007 2012 kg/m2 25-34 35-44 45-54 55-64 BMI (kg/m2) by age groups in women Satu Männistö BMI (kg/m2) by education groups aged 30 to 59 years in men 11.3.201412.3.2014 9 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1997 2002 2007 2012 kg/m2 low medium high Satu Männistö 11.3.201412.3.2014 10 23,0 24,0 25,0 26,0 27,0 28,0 29,0 1997 2002 2007 2012 kg/m2 Alin Keski Ylin BMI (kg/m2) by education groups aged 30 to 59 years in women high medium low Satu Männistö 11.3.2014 Satu Männistö 11 www.hivehealthmedia.com www.lowdensitylifestyle.com 11.3.2014 Satu Männistö 12 WHO 2011
  • 3. 3 11.3.2014 Satu Männistö 13 WHO 2011 Mona Lisa, Botero 1977 Why? 11.3.2014 Satu Männistö 14 12.3.2014 Satu Männistö www.bis.cov.uk 12.3.2014 0 2 4 6 8 10 12 14 1982 1992 1997 2002 2007 2012 MJ Vuosi Energy intake (MJ) in working-aged men and women; Findiet 1982-2012. Miehet Naiset Men Women Year Working-aged Finnish men and women: • 50% reach moderate or vigorous intensity aerobic activity as recommended. • 10% practice muscle-strengthening activities as recommended • 20% are physically inactive (Husu et al. 2011) 11.3.2014 Satu Männistö 17 Changes in diet and long-term weight gain in women and men Mozaffarian D et al. N Engl J Med. 2011 NHS: n=50000, 20 v NHS: n=48000, 12 v HPFS: n=22000, 20 v All weight changes were adjusted simultaneously for age, baseline body-mass index, sleep duration, and changes in smoking status, physical activity, television watching, alcohol use, and all of the dietary factors shown. 11.3.2014 Satu Männistö 18
  • 4. 4 11.3.2014 Satu Männistö Food consumption in Finland, 1950-2001 Food balance sheet 0 20 40 60 80 100 120 140 160 50-52 56-58 62-64 68-70 74-76 80-82 86-88 92-94 98-00 kg/person/year cereals potatoes fats meat fish fruit & berries vegetables 19 Daily fruit consumption by age groups Hélldan ym. 2013 0 10 20 30 40 50 60 miehet naiset % 55-64 v 45-54 v 35-44 v 25-34 v 15-24 y. Women Men Energy intake from meals and snacks, USA (n=63380) Age group 1978 1995 2-18 v meals snacks total 1600 267 1840 1549** 400** 1958** 40-59 v meals snacks total 1572 175 1747 1632** 323** 1954** 60+ v meals snacks total 1495 128 1619 1406** 228** 1633 Nielsen et al. 2002 11.3.2014 Satu Männistö 21 Hannu Hausen 14 kg 11.3.2014 Satu Männistö 22 Consumption of beverages; food balance sheet Kg/person/year 11.3.2014 Satu Männistö 23 Alcohol consumption in Finland 11.3.2014 Satu Männistö 24
  • 5. 5 Portion sizes have increased 11.3.2014 Satu Männistö 25 ”French paradox” • Fat and cholesterol levels high in meals • CVD incidence lower in France than in the USA • Proportion of obese subjects lower in France 11.3.2014 Satu Männistö 26 12.3.2014 27 What has already been done in Finland? 1/2 • Research and data collection, monitoring of obesity epidemic – Several small scale interventions at different settings • Consensus meeting on obesity in 2005 • National nutrition and physical activity recommendations • Current Care Guidelines for – Adults’ and children’s obesity – Physical activity • Physical activity prescriptions • Sugar tax on sweets, soft drinks and ice cream (2011) • Various campaigns/programs related to obesity and for different target groups – ”Wise family” - Nutrition and physical activity counseling program to child health care and school health care (The Finnish Heart Association). – ”Finnish Schools on the Move” (Likes, the Ministry of Education and Culture in Finland) to increase physical activity and decrease sedentary time among school-aged children – ”One Life (2012-2017)”. Large coalition of NGO’s (the Finnish Brain Association, the Finnish Diabetes Association and the Finnish Heart Association) to promote heart health and diabetes prevention What has already been done in Finland? 2/2 National Obesity Program 2012-2015 (1/2) Coordinated by National Institutefor Health and Welfare • Main aims – to decrease the prevalence of obesity – to improve welfare, heath, working capacity and functional capacity of Finnish population • The program includes – general aims for all – specific aims for different age groups and stakeholders – practical actions to prevent obesity and improve the obesity treatment more effectively • We need to prevent people from gaining weight throughout their life and pay attention to different socioeconomic levels. • Healthy diet and active lifestyle should be easy to choose. • We have to identify and eliminate barriers, • and at the same time we need to create novel approaches to thinking about health and obesity prevention. • Together with all stakeholders. • Our aim is to improve the health of Finnish population and to be the first country to turn the obesity trend down. National Obesity Program 2012-2015 (2/2)
  • 6. 6 All together suu-auki.blogspot.com11.3.2014 Satu Männistö 31 In order to tackle the obesity epidemic there is a need to work together European Congress on Obesity – policy team, 2013 • No one strategy will be sufficient to tackle obesity (e.g. treatment, diet, food environments, physical activity, policy), we need to integrate approaches and focus on supporting each area rather than competing for space • Political will is an important determinant of policy and we need to make sure we frame messages about obesity in a way that can help achieves this • Academics need to better communicate their work and findings to aid public health and policy development, for instance by better utilising media opportunities that exist • Public health experts need to better use the evidence that is available and let researchers know what research is important to support and achieve policy goals • The food industry has an important role in tackling the obesity crisis, at the end of the day they provide the food we eat, but we need to work out how best to manage this for the public's health and to avoid conflicts of interest 11.3.2014 Satu Männistö 32