• Save
Plenary2 m chauliac
Upcoming SlideShare
Loading in...5
×
 

Plenary2 m chauliac

on

  • 289 views

 

Statistics

Views

Total Views
289
Views on SlideShare
289
Embed Views
0

Actions

Likes
0
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • Réseaux habituels, + présentoir professionnels + gde distribution Partenariat media de diffusion des fiches

Plenary2 m chauliac Plenary2 m chauliac Presentation Transcript

  • The French National Nutritional Health Programme (PNNS) 2001-2010 - 2015 Strategies – some actions Dr Michel Chauliac, Ministry of health (France)
  • Some indicators linked to nutrition (source :various national studies on representative samples)
    • Adults :
        • High Blood Pressure : 31%
        • Hyperglycemia : 4,8%
        • Dyslipidemia : 44%
        • Obesity : 17%
        • Overweight and obesity : 49%
        • Undernutrition among elderlies in institutions : 45%
        • Daily salt intake : 8,5g
    • >= 5 Fruit and vegetable per day : 43%
    • Less than 12,5% of energy from free sugars : 74%
    • Children :
      • Obesity : 3,5%
      • Overweight and obesity : 17,8%
  • 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
  • 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
  • A main requirement COHERENCE
  • Main strategic options
    • To allow an informed consumer choice (individual freedom)
        • Information, education, communication TV campaigns, leaflets, pedagogical tools, labelling
    • To improve the nutritional environment (social responsability of all stakeholders)
        • Through the improvement of the food and physical environment : make the healthy choice the easiest .
    • Many combined ways to act :
      • Reglementation, law
      • Public local, regional and national initiatives
      • Private self regulation and initiatives
    • Early detection and treatment of nutritional diseases
        • Through the health system
  • 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…
  • Different media campaigns, posters
  • The nutrition guides of the PNNS Pour tous Pour tous Parents enfants 0-18 ans Adolescents Septembre 2003 And their specific issues for professionals
  • Many leaflets on « how to do » to go towards the consumption references for the population
  • Documents produced by NGO’s and validated by PNNS For food aid A Carribbean school programme Cosumption of FV at school canteen
  • Incentives for actors
    • Elected officials :
        • Mayors
        • « Conseillers généraux »
    • NGO’s
    • Food economic sector
    • Companies
  • What is done? Some actions to change at school
    • At school :
      • Pedagogical tools : only with the “PNNS logo”
      • An official ministerial document to avoid commercial brands in schools-
      • The total ban of vending machines since september 2005 (by law)
      • A decree is prepared on the nutritional quality of school meals
      • A recommandation to avoid snacks at school (kindergarden and primary) ; to improve the nut quality of the foods sold at secondary school
      • The fruit school initiative (UE)
      • Actions to improve the school space to invite pupils to move
      • After school physical activities
      • Pedibus initiatives
      • School health : BMI surveillance
    Compulsory Voluntary
  • Incentives for actors
    • Elected officials :
        • Mayors
        • « Conseillers généraux »
    • NGO’s
    • Food economic sector
    • Companies
  • Reformulation
    • Charters of commitments
    • to nutritional improvements
  • 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
  • Main points of the Standard Reference Document ( www.sante.gouv.fr thème nutrition PNNS, point 4.8)
    • On What ?
    • 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).
    • - 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
    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
  • The committee validating the Commitments
    • Four « unities » with public experts in
        • - Nutrition (6)
        • - Food Technology (6)
        • - Food Marketing (6)
        • - Food Economy (6)
    Collégial Décision for the State Created by the Ministries of Health, Economy and Agriculture
  • Quantitative assessment (may 2011)
    • Sectors followed
    • 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)
    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 ...)
    • Impact of first 15 charters signed. Each year
      • Sugars : - 11700 à -13000 t
      • Fats : - 3500 à - 4200t
      • Saturated fatty acids : - 2150t
      • Salt : - 223 à – 240t
      • Fibres : + 12t
  • Pork processed foods : description of the data
    • 1166 references available : a coverage of 66% of the total market
    • 41 families divided in two main categories :
    • Cooked products (28 families) : cooked hams, fine paste sausages, rillettes,
    • Dry products (13 families) : hams, bacon, salamis, sausages, ..
    • 70% of references are MDD (retailer brand), 20% are HD, 10% are MN (national brands)
    • Data sources:
    • 52% store photos
    • 37% Purchases
    • 8% sending packages or computer files by retailers
    • 3% manufacturers' websites
  • 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%
  • Conclusion
    • Some positive results after 10 years
    • The maintenance of social inequalities
    • Since 2010, the PNNS is in the Public Health Code as a quinquennial Public Health programme
    • Nutrition as a determinant of Health (Food and physical activity)
    • A social movement (from politicians to grass root level professionals)
    • Synergy between the various strategies and actions
      • Supply and demand sides – with a cultural background
      • Compulsory and voluntary actions (but a-priori validated by public authorities)
  •  
  • Source : comité des salines de France déc 2008 Y compris importations
  • Evolutions 2002-2008 selon le baromètre nutrition INPES
  •  
  • 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
  • Nombre de produits dans la base Oqali
    • 26% d’augmentation depuis mai 2010
    • 18 secteurs couverts
    +26%
  • 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
  • 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%
  • 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…