The document discusses the rising prevalence of childhood obesity in Europe, highlighting its implications for future health and the food industry. It addresses the role of genetic, social, and environmental factors in contributing to obesity, emphasizing the impact of marketing and the food environment on children's health. The need for policy changes in nutrition, food marketing, and urban planning is proposed to combat the obesity epidemic.

1. PHILIP JAMES Chairman, International Obesity Task Force CHILDHOOD OBESITY IN EUROPE: IMPLICATIONS FOR THE FUTURE FOOD CHAIN

2. 10 17 18 31 36 22 19 18 27 15 16 18 33 27 35 34 26 12 17 33 34 9 21 20 17 17 22 23 25 8 9 17 13 12 12 18 11 Overweight (%) Equivalent to BMI>25 14-17 years 7-11 years

3. European national prevalences (%) of overweight and obesity in children aged 7-11yrs using IOTF cut-off points Norway Poland† Netherlands Slovakia Bulgaria Slovenia Sweden* Spain Italy Czech Rep Ireland (Rep) Denmark France Switzerland Germany England Cyprus Greece* Portugal† † 7-9yrs * 6-11yrs © International Association for the Study of Obesity Sept 2010 5 10 15 20 25 30 35 Obese Overweight

4. Children’s Overweight + Obesity Lobstein T. OECD. Sept 25th2010

5. Genetics influence susceptibility to prevailing dietary and activity environment

6. Rachel Leach, IOTF, April 28 th 2008

7. The natural history of childhood overweight/obesity using IOTF cut-offs in Australia over the last century and regional global increases Wang and Lobstein, IOTF, Int J Ped Ob 2006. 2000 1980 1960 1940 1920 1900 1900 0 10 20 30 40 Year % overweight + obese Raw data All data e.g. Japan e.g. India % e.g. US e.g. S.Arabia e.g. UK Global total now: obese 74 mil. +overwt. 287 mil. Norton K et al, Int J Ped Ob 2006 Australia

11. Sarah Hinde: The car-reliant environment. In: The 7 deadly sins of obesity. Univ. of NSW, Australia. 2007. CAR-RELIANCE limits child development Increase in traffic Parent concern for child safety Sedentary replaces active transport Parents chauffeur children Organised sport replaces play for children PHYSICAL INACTIVITY

13. The Traditional Mediterranean Diet Compiled by Anna Ferro-Luzzi Institute of Nutrition Rome

19. The keys to success in the food business and in obesity and chronic disease prevention Marketing Availability Price

20. A quarter-pound cheeseburger, large fries and a 16 oz. soda provide: 1,166 calories 51 g fat 95 mg cholesterol 1,450 mg sodium “ Obesity is a commercial success. Promotional budgets and advertising markets for energy-dense nutrient-poor (junk) food and drinks hugely outweigh those for healthy food. Similarly, the budgets for inactive transport and entertainment (video games, internet, TV) morbidly outweigh those for active transport and active entertainment” Australian Prev.HlthTaskforce,Oct,2008

21. Car washes Book stores Hardware stores (Home Depot) Gas stations Office buildings (vending machines) Health clubs/gyms Video stores Car repair shops Snack Foods Are Everywhere

22. CHIPS ARE IN SEASON! Doubling shelf space increases sales by 40%

24. Marketing : celebrities and sports Gary Lineker = potato crisps David Beckham = soft drinks

26. Who controls the food chain ? Corinna Hawkes, 2006 PUB L I C Local markets, roadside stalls and farm shops Supermarkets: the "food consuming industry" Small food outlets Global Feed Companies Global Food Companies Fa rme r s Family and other small food companies

27. The current obesity dilemma UK Government report Oct. 2007 Obesity is a normal "passive" biological response to our changed physical and food environment Some children/adults are more susceptible for genetic, social and economic reasons Overwhelming environmental impact reflects outcome of normal industrial development Obesity reflects failure of the free market

28. Sept.25 th 2010

29. Why the obesity pandemic? An OECD 2010 perspective “ The mass production of food over time has changed both the quality and availability of food Falling relative food prices contributed up to 40% of the increase in BMI in the US 1976-1994…. Convenience also played a major role, in combination with falling prices, with the spread and concentration of fast food restaurants….. The use of increasingly sophisticated marketing techniques is naturally associated with an increase in the supply of food…. These effects are consistent with the patterns observed in the distribution of obesity among population groups, with more vulnerable individuals and families and those whose time available for meal preparation and cooking has become more limited being more exposed to the influence of supply-side changes.”

30. e.g. Any focus on Health Education selectively helps upper socio-economic groups. But need understandable food labelling; Drs have major role in identifying susceptible adults to avoid diabetes Individual responsibility Changes to the "toxic" environment Adapted from Puska P, 2001 Progressively adapt all towns/cities to favour pedestrian/cycling as norm with car restrictions Nutritional standards for food in all government facilities/schools; eliminate trans fats; catering on Finnish scale: fruit + veg. within meal costs Limit/abolish all marketing to children Selectively increase costs of high fat/sugary products; soft drinks Social/employment/medical policies for breast feeding as the norm/new nursery standards Complementary approaches to obesity & chronic disease prevention

31. US Adults Global Children De Onis et al.Amer J Clin Nut.2010;92:: 1257-1264 Ogden et al .CDC posters 2010

32. Fiscal Phys/Dietician counselling Mass media Work site School Food labelling Regulation Food advertising Self Regulation Physcn.Cnslng OECD/WHO modelling

33. Major initiatives in France are reversing the obesity epidemic in children 64 Regions Children aged 7-9yrs IOTF cut-off points Prevalence s 2000: 18.1% O/W 3.8% Obese 82007: 15.5% O/W 2.% Obese Data presented by the Ministry of health at the International Congress of Nutrition ,Bangkok. October 2009

35. The interest and influences of different stakeholders 5 0 - - 10 0 5 10 INFLUENCE -10 - - 5 0 5 10 INTEREST Children Health professionals Advocacy orgs . Scientists Parents Ministry of Health Parliament Farmers Media Church Ministries of Transport & Agriculture Retailers Treasury President Advertising industry Food/drink industry Food inspectors Ministry of Education Teachers 0 5 10 Ministry of Trade Lobstein T : Analyses based on The Food Commission's experience and new EU policy work. ?