Workshop2 e martos


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Workshop2 e martos

  1. 1. INTERVENTIONS AGAINST CHILDHOOD OBESITY Éva Martos MD PhD, National Institute for Food and Nutrition Science Budapest , HUNGARY Action for Prevention Conference , WORKSHOP 2, 30 May 2011
  2. 2. <ul><li>PRESENTATION OUTLINE </li></ul><ul><li>Backgrund- Problem of childhood obesity </li></ul><ul><li>Planning Phase </li></ul><ul><li>Evidence </li></ul><ul><li>Evaluation </li></ul><ul><li>Identify needs and action areas </li></ul><ul><li>Intervention-Pilot Phase, Results </li></ul><ul><li>National Disseminatin </li></ul><ul><li>Conclusions </li></ul>
  3. 3. THE PROBLEM - Tendency of childhood obesity 1996-2006
  4. 4. THE PROBLEM - Prevalence of overweight and obesity in 7 year old schoolchildren Source: WHO C hildhood O besity S urveillance I nitiative, 2010 In 2010 – 20% of 7-year-old boys and 25% of 7-year-old girls OW / OB Overweight Obese Overweight + Obese Boy (n=562) 12.1% 7.8% 19.9% Girl (n=707) 16.8% 7.9% 24.7%
  5. 5. PLANNING – EVIDENCE Nutritional factors associated with overweight in children Source: American Dietetic Association Evidence Library, 2009 Food / Nutrition / Food behavior Effect Evidence Sugar-sweetened beverages ↑ I High fat intake ↑ II High energy intake ↑ II Adequate fruit and vegetable consumption ↓ II 100% fruit juice -> II Low calcium intake ↑ III Low dairy product consumption ↑ III Portion size ↑ III Number of meals ↓ III Eating out (specially fast food) ↑ III Snacking ↑ III Breakfast skipping ↑ III
  6. 6. PLANNING – EVIDENCE Most important factors in prevention of childhood obesity Source : Eurobarometer, 2006 School has a central role as a setting for prevention
  7. 7. PLANNING - EVALUATION Nutritional surveys by NIFNS <ul><li>DIETARY HABITS </li></ul><ul><li>R epresentative survey in metropolitan primary and secondary schools , 2005-2006 </li></ul><ul><li>Cross-sectional survey in all primary schools from Óbuda, Budapest , 2008 </li></ul><ul><li>WHO Childhood Obesity Surveillance Initiative, 2010 </li></ul><ul><li>NUTRITIONAL ENVIRONMENT </li></ul><ul><li>National survey in school canteens, 2006 </li></ul><ul><li>National representative survey in schools, 2008 </li></ul><ul><li>National representative survey in pre-schools, 2009 </li></ul>
  8. 8. PLANNING – IDENTIFY NEEDS AND ACTION AREAS Amount of daily soft drink intake (dl / day) Supply of school canteens 64% of schools offer free drinking water ONLY in restrooms
  9. 9. AIM To ensure free availability of water in schools, which will significantly decrease soft drinks consumption and increase water intake . S UBJECTS 397 children (7-10 yrs); 6 primary schools of Budapest I NTERVENTION – 2 months long Education AND f ree availability of mineral water in school – full control and support 2 QUESTIONNAIRES AND 1-YEAR FOLLOW-UP – knowledge and behaviors H ungarian A qua P romoting P rogram in Y oung 2007 – PILOT PHASE THE INTERVENTION
  11. 11. NATIONAL DISSEMINATION - HAPPY Week 2010 <ul><li>Support from the Ministry of Health </li></ul><ul><li>To ensure sustainability </li></ul><ul><li>Less support and control from NIFNS </li></ul><ul><li>To make water consumption cool and trendy </li></ul><ul><ul><li>- Water Bar </li></ul></ul><ul><ul><li>- Drawing competition </li></ul></ul><ul><ul><li>- Water Police Service </li></ul></ul><ul><ul><li>- Sports competition </li></ul></ul><ul><ul><li>- Flash mob </li></ul></ul><ul><ul><li>- Restriction of soft drinks in vending machines and buffets </li></ul></ul>NEW TOOLS
  12. 12. HAPPY Week
  13. 13. <ul><li>PARTICIPANTS </li></ul><ul><li>1 7 counties + capital ( Budapest ) </li></ul><ul><li>77 schools and 1 school dentist </li></ul><ul><li>24 300 students / 20 080 received water </li></ul><ul><li>6 MONTHS FOLLOW-UP </li></ul><ul><li>Education seems to be sustainable, but schools n eed financial support for free water </li></ul><ul><li>HAPPY Week i nduced long-term changes in </li></ul><ul><ul><li>- choice of healthy fluids </li></ul></ul><ul><ul><li>- restriction of soft drinks in vending machines </li></ul></ul><ul><ul><li>- c ontinue s use of educational materials </li></ul></ul>RESULTS OF HAPPY Week 2010
  14. 14. NATIONAL DISSEMINATION - HAPPY Week 2011 <ul><li>NO Support from the Ministry of Health </li></ul><ul><li>To ensure free water in schools – collaboration with industry </li></ul><ul><li>Key points for partnership </li></ul><ul><ul><li>Clear rules – signed agreements </li></ul></ul><ul><ul><li>Branding / advertisement – ONLY confirmed materials </li></ul></ul><ul><ul><li>Publications / media – ONLY approved versions </li></ul></ul><ul><ul><li>Local school – local company </li></ul></ul>
  15. 15. LESSONS LEARNT <ul><li>Pilot projects are important to prove the concept </li></ul><ul><li>Education AND Environmental changes </li></ul><ul><li>Involvement of relevant stakeholders </li></ul><ul><li>Provide relevant data to decision-makers -> they might provide funding </li></ul><ul><li>PPP carries risks – set clear rules </li></ul><ul><li>Need more access to parents – could ensure sustainable provision of water without company involvement </li></ul><ul><li>To find appropriate marketing techniques for making healthy choice ‘ cool’ and trendy </li></ul>
  16. 16. Thank you for your attention! Eva MARTOS, MD PhD [email_address]