Towards a new
milestone in European
nutrition and physical
activity policies
by João Breda,
WHO Regional Office for Europe
GBD – attributable for 20 RF 2010 as % DALY
15 out of 20 RF linked with nutrition and PA Lim & al. 2012
Prevalence of overweight (%) among adult men
(BMI ≥25.0 kg/m2)
25
30
35
40
45
50
55
60
65
70
1994 1997 2000 2003 2006 2009...
Prevalence of overweight (%) among adult women
(BMI ≥25.0 kg/m2)
25
30
35
40
45
50
55
60
65
70
1994 1997 2000 2003 2006 20...
0
10
20
30
40
50
Prevalenceofoverweight(including
obesity)(%)
6-year-olds 7-year-olds 8-year-olds 9-year-olds
Childhood ob...
Childhood obesity prevalence in 12 countries
(trends)– COSI 2008-2010 (boys)
20.0
25.0
30.0
35.0
40.0
45.0
50.0
1 2
Czech ...
WHO COSI, round (2010):
1 in every 3 children aged 6-9
years was overweight or
obese
The prevalence of overweight
(includi...
THE SOCIOECONOMIC GRADIENT IN CHILDHOOD OVERWEIGHT AND
OBESITY: DIVERSITY ACROSS FIVE EUROPEAN COUNTRIES (WHO
COSI) – unpu...
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Percentagedistribution
2010
2030
Projected obesity for 2030
WHO Modelling obesit...
Prevalence gains per 100,000 of
the EU population in 2030 based on 2 scenarios
WHO Modelling obesity Project 2013 together...
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
TUR
HUN
HRV
MKD
CZE
BGR
SVN
PRT
ROU
SWE
EST
ESP
ITA
LUX
FRA
CHE
LTU
IRL
...
0
200
400
600
800
1000
1200
AND
M…
SMR
GEO
BGR
LVA
CZE
MDA
SVK
LTU
FIN
TJK
DEU
POL
EST
KGZ
TKM
RUS
CHE
ISL
HRV
UKR
FRA
SWE...
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
FRA
BEL
DNK
FIN
AUT
SWE
NLD
GRC
LVA
HUN
DEU
SVN
IRL
LUX
GBR
ITA
PRT
ESP
POL
MLT
RO...
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
AND
EST
FRA
MCO
RUS
SMR
GBR
GRC
BGR
ITA
IRL
LUX
SVN
BEL
BLR
AUT
SWE
GEO
TKM
ISR
AZE...
Inactivity status in European Region
• WHO estimates that in adults :
– 63% are not reaching the minimum recommended level...
Europe: mandate for action
Overview Policy Actions Implementation
53 WHO/Europe Member States – 2012/13
Policy
Actions
0% 10% 20% 30% 40% 50% 60% 70%...
Nutrition Policy 2007-2013
• 143 nutrition policies
• 39 obesity policies
• 184 physical activity policies
Nutrition Policy in 2007-2013
• For the 143 nutrition policies, 39 obesity
policies and 184 physical activity policies:
• ...
No action
reported
Partially or fully
implemented
Countries (N) 20 33
No action
reported
Partially or fully
implemented
Co...
Policy and Social Innovation:
Regulation & taxes
• 4 countries in the EU with bans on “trans” fat and several
others with ...
Culture, tradition… protective diets
Med diet & cognitive impairment
Psaltopoulou et al. Ann Neurol 2013 May 30.
doi: 10.1...
Country profiles as a result of EC/WHO collaboration and based on
NOPA information system.
Nutrition and PA policies in Europe
History of success but more is needed…..
• Monitoring and surveillance
• Evaluation
• ...
Vienna Declaration process
• Technical (comments)
• NGO interaction
• Political level
Way forward
• Environments/Governance mechanisms
• Life-course
• Health sector
• Monitoring and surveillance
• Forging all...
Towards a new milestone in European nutrition and physical activity policies
Towards a new milestone in European nutrition and physical activity policies
Towards a new milestone in European nutrition and physical activity policies
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Towards a new milestone in European nutrition and physical activity policies

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Presented by João Breda of WHO Regional Office for Europe at the WHO European Ministerial Conference on Nutrition and Noncommunicable Diseases in the Context of Health 2020, 4 July 2013, in Vienna, Austria

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  • Nice overview, work to be done in the Nutrition area.
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Towards a new milestone in European nutrition and physical activity policies

  1. 1. Towards a new milestone in European nutrition and physical activity policies by João Breda, WHO Regional Office for Europe
  2. 2. GBD – attributable for 20 RF 2010 as % DALY 15 out of 20 RF linked with nutrition and PA Lim & al. 2012
  3. 3. Prevalence of overweight (%) among adult men (BMI ≥25.0 kg/m2) 25 30 35 40 45 50 55 60 65 70 1994 1997 2000 2003 2006 2009 2012 Prevalence of overweight (%) among adult men (BMI >25.0 kg/m2) Austria, 20+ Belgium, 18+ Denmark, 16+ Estonia, 16–64 Finland, 15–64 France, 15+ Germany, 18+ Ireland, 18+ Italy, 18+ Latvia, 15–64 United Kingdom, Scotland, 16–64 Lithuania, 20–64 Luxembourg, 16+ Netherlands, 20+ Norway, 16+ Portugal, 18–64 Spain, 18+ Sweden, 16–84 Switzerland, 15+ United Kingdom, Wales, 16+ United Kingdom, England, 16+
  4. 4. Prevalence of overweight (%) among adult women (BMI ≥25.0 kg/m2) 25 30 35 40 45 50 55 60 65 70 1994 1997 2000 2003 2006 2009 2012 Prevalence of overweight (%) among adult women (BMI >25.0 kg/m2) Armenia, 15–49 Austria, 20+ Belgium, 18+ Denmark, 16+ Estonia, 16–64 Finland, 15–64 France, 15+ Germany, 18+ Ireland, 18+ Italy, 18+ Latvia, 15–64 Lithuania, 20–64 Luxembourg, 16+ Netherlands, 20+ Norway, 16+ Portugal, 18–64 Spain, 18+ Sweden, 16–84 Switzerland, 15+ Turkey, 15–49 United Kingdom, Wales, 16+ United Kingdom, England, 16+ United Kingdom, Scotland, 16–64
  5. 5. 0 10 20 30 40 50 Prevalenceofoverweight(including obesity)(%) 6-year-olds 7-year-olds 8-year-olds 9-year-olds Childhood obesity prevalence in 12 countries – COSI 2010
  6. 6. Childhood obesity prevalence in 12 countries (trends)– COSI 2008-2010 (boys) 20.0 25.0 30.0 35.0 40.0 45.0 50.0 1 2 Czech Republic, 7-year-olds Latvia, 7-year-olds Malta, 6-year-olds Norway, 8-year-olds Slovenia, 8-year-olds Italy, 9-year-olds Ireland, 7-year-olds Italy, 8-year-olds Lithuania 7-year-olds Portugal, 7-year-olds Slovenia, 6-year-olds Slovenia, 7-year-olds
  7. 7. WHO COSI, round (2010): 1 in every 3 children aged 6-9 years was overweight or obese The prevalence of overweight (including obesity) ranged from 24% to 57% among boys and from 21% to 50% among girls. Simultaneously, 9 31% of boys and 6 21% of girls were obese 1/4 in 2008 to 1/3 in 2010
  8. 8. THE SOCIOECONOMIC GRADIENT IN CHILDHOOD OVERWEIGHT AND OBESITY: DIVERSITY ACROSS FIVE EUROPEAN COUNTRIES (WHO COSI) – unpublished data
  9. 9. 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Percentagedistribution 2010 2030 Projected obesity for 2030 WHO Modelling obesity Project 2013 together with UK Health Forum – NOPA II
  10. 10. Prevalence gains per 100,000 of the EU population in 2030 based on 2 scenarios WHO Modelling obesity Project 2013 together with UK Health Forum – NOPA II 0 200 400 600 800 1000 1200 Cancer CHD+stroke Diabetes Hypertension 1% decrease in obesity 5% decrease in obesity Scenario 1 – 3 Million cases avoided Scenario 2 – 9 Million cases avoided
  11. 11. 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0 20.0 TUR HUN HRV MKD CZE BGR SVN PRT ROU SWE EST ESP ITA LUX FRA CHE LTU IRL GBR DNK NOR AUT NLD SVK FIN ISL DEU AND LVA BEL ISR POL CYP ALB ARM AZE BLR BIH GEO GRC KAZ KGZ MLT MCO MNE MDA RUS SMR SRB TJK TKM UKR UZB Grams Country Salt intake per person per day for adults in the WHO European Region from individual country-based surveys, various years WHO/FAO RECOMMENDATION - <5 grams No data
  12. 12. 0 200 400 600 800 1000 1200 AND M… SMR GEO BGR LVA CZE MDA SVK LTU FIN TJK DEU POL EST KGZ TKM RUS CHE ISL HRV UKR FRA SWE NOR NLD BLR KAZ GBR HUN BEL SVN CYP ROU AUT ESP AZE DNK SRB IRL UZB LUX MKD BIH MLT ITA ISR PRT ALB TUR GRC ARM MNE Grams Country Fruit and vegetable supply per person per day in the WHO European Region, 2009 WHO/FAO RECOMMENDATION - >600 grams
  13. 13. 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 FRA BEL DNK FIN AUT SWE NLD GRC LVA HUN DEU SVN IRL LUX GBR ITA PRT ESP POL MLT ROU EST LTU BGR ALB AND ARM AZE BLR BIH HRV CYP CZE GEO ISL ISR KAZ KGZ MCO MNE NOR MDA RUS SMR SRB SVK CHE TJK MKD TUR TKM UKR UZB Energy(%) Country Proportion of energy from saturated fatty acids among adults in the WHO European Region, 2007 FAO RECOMMENDATION - max. 10% energy No data
  14. 14. 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 AND EST FRA MCO RUS SMR GBR GRC BGR ITA IRL LUX SVN BEL BLR AUT SWE GEO TKM ISR AZE NOR CYP ROU CHE SRB FIN LVA BIH CZE NLD UKR MNE ISL POL DEU MKD TJK UZB LTU ESP SVK KAZ PRT ARM MLT HUN ALB TUR MDA HRV KGZ DNK Percentage Country Prevalence of exclusive breastfeeding under or at 6 months of age in the WHO European Region from individual country-based surveys, various years No data
  15. 15. Inactivity status in European Region • WHO estimates that in adults : – 63% are not reaching the minimum recommended level of physical activity – 20% of those are rated as “inactive” – 38% are sufficiently/highly active • 41% of adults does not engage in any moderate physical activity in a typical week • 22% of 11-year old girls and 30% of boys report at least one hour of daily MVPA • PA recommendations in EU Member States + Norway and Switzerland - 19 Member States
  16. 16. Europe: mandate for action
  17. 17. Overview Policy Actions Implementation 53 WHO/Europe Member States – 2012/13 Policy Actions 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Measures to affect food prices Labelling - signposting Reformulation - less sugar and salt Promote Active Travel for school-children Marketing HFSS foods to children - restrictions Salt reduction initiatives School Fruit Scheme (SFS) or similar Programs in schools (inc. vending machines) Baby Friendly Hospital Initiative Physical Activity Policy incl. Guidelines Breastfeeding promotion and protection policies Food Based Dietary Guidelines Labelling - nutritional information No Action Partially implemented Fully implemented
  18. 18. Nutrition Policy 2007-2013 • 143 nutrition policies • 39 obesity policies • 184 physical activity policies
  19. 19. Nutrition Policy in 2007-2013 • For the 143 nutrition policies, 39 obesity policies and 184 physical activity policies: • Only 16 clearly focus on low income groups • 8 address attention to health professionals…
  20. 20. No action reported Partially or fully implemented Countries (N) 20 33 No action reported Partially or fully implemented Countries (N) 23 30 Great progress in certain areas Salt reduction policies MKT HFSS foods policies
  21. 21. Policy and Social Innovation: Regulation & taxes • 4 countries in the EU with bans on “trans” fat and several others with effective self-regulatory approaches; • Social innovation – use of taxes for PH: several countries but Hungary and Denmark most recent prominent examples: – Estimated revenue was accomplished – No differences in social class – 6% reduction in saturated fat • Marketing food to children • Mainstream food reformulation – i.e. salt
  22. 22. Culture, tradition… protective diets Med diet & cognitive impairment Psaltopoulou et al. Ann Neurol 2013 May 30. doi: 10.1002/ana.23944. [Epub ahead of print]
  23. 23. Country profiles as a result of EC/WHO collaboration and based on NOPA information system.
  24. 24. Nutrition and PA policies in Europe History of success but more is needed….. • Monitoring and surveillance • Evaluation • Exchange/collaboration • More success where accountability and external pressure/evaluation exist • Challenge to comply with Global targets…….
  25. 25. Vienna Declaration process • Technical (comments) • NGO interaction • Political level
  26. 26. Way forward • Environments/Governance mechanisms • Life-course • Health sector • Monitoring and surveillance • Forging alliances “The current document on Nutrition and NCD’s is masterfully worded and highly consistent with the best available evidence on the critical topic” Walter Willett; 04/07/2013

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