Plenary2 m chauliac

284 views

Published on

Published in: Education, Technology, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
284
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Réseaux habituels, + présentoir professionnels + gde distribution Partenariat media de diffusion des fiches
  • Plenary2 m chauliac

    1. 1. The French National Nutritional Health Programme (PNNS) 2001-2010 - 2015 Strategies – some actions Dr Michel Chauliac, Ministry of health (France)
    2. 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. 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. 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. 5. A main requirement COHERENCE
    6. 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. 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. 8. Different media campaigns, posters
    9. 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. 10. Many leaflets on « how to do » to go towards the consumption references for the population
    11. 11. Documents produced by NGO’s and validated by PNNS For food aid A Carribbean school programme Cosumption of FV at school canteen
    12. 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. 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. 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. 15. Reformulation <ul><li>Charters of commitments </li></ul><ul><li>to nutritional improvements </li></ul>
    16. 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. 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. 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. 19. Quantitative assessment (may 2011)
    20. 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. 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. 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. 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
    25. 26. Evolutions 2002-2008 selon le baromètre nutrition INPES
    26. 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
    27. 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%
    28. 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
    29. 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%
    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…

    ×