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Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
Plenary2 m chauliac
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Plenary2 m chauliac

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  • Réseaux habituels, + présentoir professionnels + gde distribution Partenariat media de diffusion des fiches
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    • 1. The French National Nutritional Health Programme (PNNS) 2001-2010 - 2015 Strategies – some actions Dr Michel Chauliac, Ministry of health (France)
    • 2. Some indicators linked to nutrition (source :various national studies on representative samples) <ul><li>Adults : </li></ul><ul><ul><ul><li>High Blood Pressure : 31% </li></ul></ul></ul><ul><ul><ul><li>Hyperglycemia : 4,8% </li></ul></ul></ul><ul><ul><ul><li>Dyslipidemia : 44% </li></ul></ul></ul><ul><ul><ul><li>Obesity : 17% </li></ul></ul></ul><ul><ul><ul><li>Overweight and obesity : 49% </li></ul></ul></ul><ul><ul><ul><li>Undernutrition among elderlies in institutions : 45% </li></ul></ul></ul><ul><ul><ul><li>Daily salt intake : 8,5g </li></ul></ul></ul><ul><li>>= 5 Fruit and vegetable per day : 43% </li></ul><ul><li>Less than 12,5% of energy from free sugars : 74% </li></ul><ul><li>Children : </li></ul><ul><ul><li>Obesity : 3,5% </li></ul></ul><ul><ul><li>Overweight and obesity : 17,8% </li></ul></ul>
    • 3. National Nutrition and Health Programme   « PNNS » (2001-2006-2010) www.sante.gouv.fr (thème: Nutrition) General objective To improve the state of health of the whole population by acting on one of the main determinants, namely, nutrition
    • 4. A main difficulty CACOPHONY Incentives / injunctions to consume and to stay inactive versus Health messages Social pressure valuing thinness versus obesity as risk factor and disease
    • 5. A main requirement COHERENCE
    • 6. Main strategic options <ul><li>To allow an informed consumer choice (individual freedom) </li></ul><ul><ul><ul><li>Information, education, communication TV campaigns, leaflets, pedagogical tools, labelling </li></ul></ul></ul><ul><li>To improve the nutritional environment (social responsability of all stakeholders) </li></ul><ul><ul><ul><li>Through the improvement of the food and physical environment : make the healthy choice the easiest . </li></ul></ul></ul><ul><li>Many combined ways to act : </li></ul><ul><ul><li>Reglementation, law </li></ul></ul><ul><ul><li>Public local, regional and national initiatives </li></ul></ul><ul><ul><li>Private self regulation and initiatives </li></ul></ul><ul><li>Early detection and treatment of nutritional diseases </li></ul><ul><ul><ul><li>Through the health system </li></ul></ul></ul>
    • 7. In 2005/2006 a TV campaign on the limitation of fatty and sugary food products «  Through eating less fatty and sugary products you protect your health »  PNNS Media campaign Other campaigns on physical activity , fruits and vegetables, « hidden » sugar salt and fat in manufactured foods, starchy foods…
    • 8. Different media campaigns, posters
    • 9. The nutrition guides of the PNNS Pour tous Pour tous Parents enfants 0-18 ans Adolescents Septembre 2003 And their specific issues for professionals
    • 10. Many leaflets on « how to do » to go towards the consumption references for the population
    • 11. Documents produced by NGO’s and validated by PNNS For food aid A Carribbean school programme Cosumption of FV at school canteen
    • 12. Incentives for actors <ul><li>Elected officials : </li></ul><ul><ul><ul><li>Mayors </li></ul></ul></ul><ul><ul><ul><li>« Conseillers généraux » </li></ul></ul></ul><ul><li>NGO’s </li></ul><ul><li>Food economic sector </li></ul><ul><li>Companies </li></ul>
    • 13. What is done? Some actions to change at school <ul><li>At school : </li></ul><ul><ul><li>Pedagogical tools : only with the “PNNS logo” </li></ul></ul><ul><ul><li>An official ministerial document to avoid commercial brands in schools- </li></ul></ul><ul><ul><li>The total ban of vending machines since september 2005 (by law) </li></ul></ul><ul><ul><li>A decree is prepared on the nutritional quality of school meals </li></ul></ul><ul><ul><li>A recommandation to avoid snacks at school (kindergarden and primary) ; to improve the nut quality of the foods sold at secondary school </li></ul></ul><ul><ul><li>The fruit school initiative (UE) </li></ul></ul><ul><ul><li>Actions to improve the school space to invite pupils to move </li></ul></ul><ul><ul><li>After school physical activities </li></ul></ul><ul><ul><li>Pedibus initiatives </li></ul></ul><ul><ul><li>School health : BMI surveillance </li></ul></ul>Compulsory Voluntary
    • 14. Incentives for actors <ul><li>Elected officials : </li></ul><ul><ul><ul><li>Mayors </li></ul></ul></ul><ul><ul><ul><li>« Conseillers généraux » </li></ul></ul></ul><ul><li>NGO’s </li></ul><ul><li>Food economic sector </li></ul><ul><li>Companies </li></ul>
    • 15. Reformulation <ul><li>Charters of commitments </li></ul><ul><li>to nutritional improvements </li></ul>
    • 16. Standard reference document for voluntary charters of commitments to nutritional improvement ( www.sante.gouv.fr thème nutrition PNNS, point 4.8) For who? : Producers, food-industries, retailers, caterers Based on the objectives, the food guidelines and principles of the PNNS To give a frame for voluntary commitments proposal made by food sector operators. These commitments have to be validated by public authorities They have to include clear, precise, dated, quantified and controlable objectives
    • 17. Main points of the Standard Reference Document ( www.sante.gouv.fr thème nutrition PNNS, point 4.8) <ul><li>On What ? </li></ul><ul><li>Nutritional characteristics of existing products : reduction of salt, added sugars, total fat, saturated fatty acids, increase of complex carbohydrate, fibre content ; other (with a reference in official reports from the public authorities) ; menus (in public or private catering). </li></ul><ul><li>- Consumption aspects : size of portions, accessibility of fruits and vegetables, organisation of the points of sale; improvement of the promotion on the sale spot or outside (logo PNNS) ; marketing and advertsements </li></ul>Additional areas which are not enough : internal actions in the Firm ; external actions (research, promotion of physical activity ; actions with a « logo PNNS ») General terms and conditions for approving charters Quantitative aspect : At least 2/3 of the turn over/volume produced of the company must be involved
    • 18. The committee validating the Commitments <ul><li>Four « unities » with public experts in </li></ul><ul><ul><ul><li>- Nutrition (6) </li></ul></ul></ul><ul><ul><ul><li>- Food Technology (6) </li></ul></ul></ul><ul><ul><ul><li>- Food Marketing (6) </li></ul></ul></ul><ul><ul><ul><li>- Food Economy (6) </li></ul></ul></ul>Collégial Décision for the State Created by the Ministries of Health, Economy and Agriculture
    • 19. Quantitative assessment (may 2011)
    • 20. <ul><li>Sectors followed </li></ul><ul><li>Cookie cakes, delicatessens, juices and nectars, artisanal breads, canned processed products, breakfast cereals, dairy products ultra-fresh, processed fruits, pizzas, sodas….(more than 21000 products entered in the data base in 2011) </li></ul>Observatory for the nutritional quality of the food Objective : To monitor the nutritional quality of the food supply (nutritional composition, portion size ...) and cross the data with socio-economic data (price, market segments ...) <ul><li>Impact of first 15 charters signed. Each year </li></ul><ul><ul><li>Sugars : - 11700 à -13000 t </li></ul></ul><ul><ul><li>Fats : - 3500 à - 4200t </li></ul></ul><ul><ul><li>Saturated fatty acids : - 2150t </li></ul></ul><ul><ul><li>Salt : - 223 à – 240t </li></ul></ul><ul><ul><li>Fibres : + 12t </li></ul></ul>
    • 21. Pork processed foods : description of the data <ul><li>1166 references available : a coverage of 66% of the total market </li></ul><ul><li>41 families divided in two main categories : </li></ul><ul><li>Cooked products (28 families) : cooked hams, fine paste sausages, rillettes, </li></ul><ul><li>Dry products (13 families) : hams, bacon, salamis, sausages, .. </li></ul><ul><li>70% of references are MDD (retailer brand), 20% are HD, 10% are MN (national brands) </li></ul><ul><li>Data sources: </li></ul><ul><li>52% store photos </li></ul><ul><li>37% Purchases </li></ul><ul><li>8% sending packages or computer files by retailers </li></ul><ul><li>3% manufacturers' websites </li></ul>
    • 22. Within category variability for canned processed foods 15 categories have variation coefficients above 30% for lipides 4 categories have variation coefficients above 30% for sodium VC of 67% for fat of cooked vegetables and tabbouleh   Lipides g/100g Sodium (Na) g/100g   Nb obs q1 q3 écart (q3-q1)/q1 q2 CV Nb obs q1 q3 écart (q3-q1)/q1 q2 CV Blanquettes 23 2,7 3,9 44% 3,3 29% 18 0,30 0,40 31% 0,37 21% Bœufs bourguignons 14 1,4 2,5 87% 1,8 49% 11 0,35 0,41 19% 0,35 16% Cassoulets 62 5,0 7,5 50% 6,3 28% 29 0,34 0,44 29% 0,40 16% Chili con carne 16 2,8 3,6 32% 3,3 24% 7 0,30 0,46 54% 0,35 32% Choucroutes 29 6,0 8,4 40% 7,4 30% 10 0,40 0,55 36% 0,50 25% Couscous 37 2,3 4,3 87% 2,9 38% 28 0,26 0,37 42% 0,31 24% Féculents cuisinés 4 3,6 10,3 189% 7,3 74%             Gratins/Tartiflettes 31 1,8 3,6 100% 2,5 36% 20 0,32 0,36 14% 0,33 12% Hachis Parmentier 10 3,5 5,7 66% 4,7 35% 9 0,30 0,39 30% 0,37 16% Légumes cuisinés 35 1,7 5,1 200% 3,6 67% 21 0,37 0,40 8% 0,40 17% Paëllas 27 3,2 5,0 55% 4,0 28% 20 0,28 0,40 45% 0,35 39% Plats exotiques 36 1,7 3,3 94% 2,3 51% 27 0,24 0,39 63% 0,30 30% Poissons - féculents 43 2,6 5,7 117% 4,2 48% 38 0,30 0,36 20% 0,33 20% Poissons - légumes 4 2,3 2,6 13% 2,3 22% 4 0,20 0,32 59% 0,25 31% Pâtes cuisinées 117 2,0 3,9 95% 3,0 47% 81 0,31 0,40 30% 0,35 23% Quenelles 38 7,0 10,2 46% 9,4 22% 27 0,37 0,50 35% 0,43 21% Taboulés 22 2,6 4,5 72% 2,8 67% 12 0,33 0,41 23% 0,38 15% Viandes - féculents 86 2,5 3,9 56% 3,1 48% 66 0,29 0,40 37% 0,34 22% Viandes - lentilles 48 3,7 5,0 35% 4,5 34% 28 0,33 0,40 22% 0,38 18% Viandes - légumes 12 2,7 4,3 60% 3,4 51% 10 0,31 0,35 14% 0,33 14% Viandes cuisinées 12 8,2 23,5 188% 16,6 48% 5 0,54 0,61 13% 0,60 25% VC > 30%
    • 23. Conclusion <ul><li>Some positive results after 10 years </li></ul><ul><li>The maintenance of social inequalities </li></ul><ul><li>Since 2010, the PNNS is in the Public Health Code as a quinquennial Public Health programme </li></ul><ul><li>Nutrition as a determinant of Health (Food and physical activity) </li></ul><ul><li>A social movement (from politicians to grass root level professionals) </li></ul><ul><li>Synergy between the various strategies and actions </li></ul><ul><ul><li>Supply and demand sides – with a cultural background </li></ul></ul><ul><ul><li>Compulsory and voluntary actions (but a-priori validated by public authorities) </li></ul></ul>
    • 24.  
    • 25. Source : comité des salines de France déc 2008 Y compris importations
    • 26. Evolutions 2002-2008 selon le baromètre nutrition INPES
    • 27.  
    • 28. For local governments Municipalities and districts A political commitment signed by the Mayor with the Minister of Health to act on nutrition within the PNNS frame 250 Towns (from Paris to Noailles) 12M inhabitants covered
    • 29. Nombre de produits dans la base Oqali <ul><li>26% d’augmentation depuis mai 2010 </li></ul><ul><li>18 secteurs couverts </li></ul>+26%
    • 30. Sectors analysed by OQALI : coverage of the market Données par catégorie sur % selon type d’étiquetage, présence d’allégation nutritionnelle, de santé, repère consommation, recommandation de portion
    • 31. Variabilité intra-famille pour les charcuteries : produits cuits 8 familles avec des CV supérieurs à 30% pour les lipides CV le plus élevé : jambons de volaille standard (79%) Les familles avec un nombre d’observations inférieur à 3 n’ont pas été considérées Les familles pour lesquelles les teneurs sont faibles n’ont pas été prises en compte (seuils considérés : moyenne < 1 g/100g pour lipides et sucres; moyenne < 0,1 g/100g pour sodium) Cv= Ecart-type/moyenne   Lipides g/100g Sodium (Na) g/100g   Nb obs q1 q3 écart (q3-q1)/q1 q2 CV Nb obs q1 q3 écart (q3-q1)/q1 q2 CV Cervelas 8 23,8 26,0 9% 25,5 8% 4 0,74 0,76 3% 0,75 4% Epaules cuites choix 6 4,2 5,0 20% 4,9 13% 4 0,80 0,95 19% 0,85 16% Epaules cuites standard 5 4,7 7,0 49% 5,7 24%             Jambons cuits choix 35 3,0 4,3 42% 4,0 30% 25 0,70 0,87 24% 0,80 19% Jambons cuits standard 6 2,4 4,5 88% 2,9 53% 6 0,76 1,05 38% 0,90 19% Jambons cuits supérieurs 159 3,0 4,4 47% 4,0 44% 122 0,62 0,79 27% 0,75 14% Jambons de volaille choix 16 1,0 2,0 105% 1,2 39% 12 0,85 0,93 9% 0,90 15% Jambons de volaille standard 16 2,0 4,0 100% 3,0 79% 8 0,72 1,00 38% 0,80 19% Jambons de volaille supérieurs 50 1,1 2,0 78% 1,5 54% 43 0,70 0,80 14% 0,71 21% Mortadelles 8 26,1 28,9 11% 26,9 9% 7 0,74 0,93 26% 0,77 14% Mousses de canard 20 32,8 40,0 22% 35,0 18% 15 0,59 0,64 8% 0,62 16% Pâtés/terrines de campagne 7 20,5 26,1 27% 25,4 25% 4 0,77 0,99 27% 0,85 25% Pâtés/terrines de campagne supérieurs 17 24,0 26,8 12% 25,0 10% 14 0,67 0,78 17% 0,69 10% Pâtés/mousses de foie de porc 23 23,0 28,8 25% 27,0 18% 18 0,62 0,72 17% 0,66 26% Préparations à base de jambon cuit 4 4,4 5,8 31% 4,8 33% 3 0,60 0,63 4% 0,60 5% Préparations à base de volaille 17 5,0 9,0 80% 6,4 36% 16 0,60 0,77 28% 0,64 23% Rillettes de porc 20 31,1 42,0 35% 40,3 20% 9 0,41 0,52 27% 0,50 15% Rillettes de volaille 13 29,0 34,3 18% 30,0 16% 5 0,47 0,52 11% 0,48 19% Rôtis de volaille 8 1,6 2,0 27% 1,8 19% 7 0,70 0,89 26% 0,80 17% Saucisses à pâte fine de porc  50 24,5 27,5 12% 25,7 16% 27 0,76 0,90 19% 0,84 16% Saucisses à pate fine de volaille 16 19,5 25,0 28% 23,2 19% 9 0,79 0,98 24% 0,80 15% Autres saucisses  4 23,1 29,0 25% 27,0 22% 4 0,70 0,85 21% 0,74 21% Saucissons cuits à l'ail 15 20,5 26,5 29% 23,0 19% 11 0,75 0,79 6% 0,75 13% Terrines forestières 4 29,0 30,9 6% 30,5 11% 3 0,71 0,81 15% 0,81 16% CV > 30%
    • 32. The quest for slimness is not a health objective Prevention and treatment of nutritional diseases are a health objectives Slimness = diet – restrictive diet This is antinomian of a culture where food and conviviality are so important among the earthly delights restrictive diet = punishment for a fault Social pressure for slimness Diet is within the health environment On the other side, consumption of high energy density foods is linked to youth, pleasure…

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