Nutritional information is determinant to improve the quality of food and to make the “good choice” easier for the consumer. The French Observatory of Food Quality (Oqali) has shown that monitoring nutritional information does not only allow to evaluate the nutritional quality but also to promote a nutritional reformulation in the food industry. The information gathered permit to establish a mapping of products and to identify the best formulation for a family of products, creating a “virtuous circle” among the food producers. This data also allows to monitor changes in agreements or charters signed between public and private partners for the improvement of the food quality. Oqali has been proved to be a valuable decision tool to the public health authorities.
JANPA has implemented the Oqali model in Austria and in Romania for two food sectors: soft drinks and breakfast cereals. These studies have given a good overview of the food supply for these categories of products and have permitted a comparison between Austria, Romania and France. The data gathered are sufficient to represent the nutritional characteristics of these products and the variation of sugars, fat, salt and fiber for breakfast cereals. The methodology used, extended to other countries, could be used to define the baseline for a nutritional reformulation in the countries within the framework of the European High Level Group on Nutrition and Physical activity.
The nutritional labeling is also a valuable tool to inform the consumer about the nutritional composition of products. As nutritional information is often very complex, JANPA is gathering the best practices in order to facilitate the understanding by the consumers.
By its actions, JANPA will improve the monitoring of food information, produce recommendations regarding food labeling and thereby empower the public authorities and families “to make the good choice”.
Many children today are growing up in an obesogenic environment that encourages weight gain. School environment is crucial in the development of children and should be free from nutritional and other environmental risk factors. Interventions that create a more supportive environment might facilitate children to maintain healthy behaviors.
The exchange of good practices has been identified by the European Commission as one of the approaches to prevent chronic diseases. Therefore, one of the objectives of Work Package 6 (WP6) “Healthy environments” was to collect and analyse policy approaches and national good practices that fulfil the good practice criteria defined for this purpose. Various sectors influence childhood obesity including health, education, agriculture, transport and urban design. Assessing existing capacities and resources of these sectors in WP6 partner countries will help to understand the factors influencing the implementations of effective environmental measures.
In the second phase, our working group developed a protocol to gather national good practices and policy approaches. All associated WP6 partner countries sent good practices. WP6 received 37 programs or policies on childhood obesity prevention in kindergartens and schools from 15 JANPA countries. The majority of the interventions were national level programs, 40% of the initiatives contained both nutrition and physical activity elements.
The WP6 working group conducted a web-based survey and face-to-face interviews with high-level key stakeholders in the fields of nutrition, health, sport, and education sectors. These studies aimed to obtain an overview of existing capacities and resources for the prevention of childhood obesity in the WP6 partner countries. We received 187 web-based questionnaires from 13 associated partner countries between May 13th and June 16th 2016. 16 semi-structured personal interviews were carried out in five advanced countries in the above-mentioned sectors.
In Work Package 6 (WP6) “Healthy environments”, a web-based stakeholder survey was conducted to explore the perceptions of key stakeholders on enablers and barriers for childhood obesity prevention as well as the capacities available to them. Stakeholders were selected by using a sampling matrix in order to cover all relevant political sectors. In all, 187 questionnaires were completed in 12 EU Member States. Stakeholders who took part in the survey came mainly from the national level (115), and represented public institutes (47), ministries (23), universities (22) or scientific organisations (17). Stakeholders represented the following sectors: health (121), education (102), nutrition (80) and sports & physical activity (58).
The results show that most stakeholders agree that childhood obesity is a severe problem (69%) in their Nation. When asked what the biggest perceived barriers for the prevention of childhood obesity were, stakeholders named the commercial marketing of foods, followed by the lack of public funding, and the lack of parental support. To counteract childhood obesity, creating physical activity friendly environments, increasing parental support, and restricting food marketing in schools were named. Stakeholders from all political sectors named physical activity friendly environments as the biggest facilitator for preventing childhood obesity.
Organisational capacities for childhood obesity prevention were mapped by using the ADEPT-model as a theoretical framework to explain policy development (Rütten et al 2011). The results shows that stakeholders have specific goals regarding childhood obesity prevention, they feel obliged to fight childhood obesity and to see opportunities to increase their efforts. However, they state a striking lack of human and financial resources in order to do so. Such human and financial resources seem to be lacking especially at local level.
According to the data, integrated approaches, addressing multiple aspects of childhood obesity and including actors from different sectors, don’t seem to be commonly used in European countries to fight childhood obesity. Nevertheless, stakeholders agree that they have a potential to be scaled up.
More results of the stakeholder survey, about the key lessons as well as main facilitators and barriers of integrated approaches in kindergartens and schools, will be published in summer 2017 in the Guidance document.
Friedrich-Alexander-University Erlangen-Nürnberg - FAU
The “Evidence Paper & Study Protocols” contains two parts. The first, the Evidence Paper summarises the evidence about the prevalence of childhood obesity, its health & societal impacts and its healthcare & societal costs. It also deals with the experience of socially disadvantaged in the EU. The Evidence Paper was based on four systematic reviews undertaken by Irish colleagues and extra materials collected from the seven EU countries participating in JANPA WP4.
The second part the Study Protocols, describes the protocols for the modeling study that aims to estimate the lifetime costs of childhood obesity and overweight in the seven participating countries; estimate the effect of 1% and 5% reductions of childhood obesity; and asses the feasibility of generalizing the JANPA WP4 modelling methodology to other EU countries.
The good practices to prevent childhood overweight and obesity in early stages of life where collected and analyzed in the ‘’Report of case studies in Member States’’. The document describes the methodology and the data collected in order to assess examples of actions in the EU countries. Out of the 13 participating countries 11 sent programmes/interventions for a total number of 50. All participating partners provided information of the policy background concerning pregnant mothers and families with children under the age of three years. This report contributes to the overall aim of WP7, which is to identify programmes implemented in the participating countries and to gain better understanding of the conditions where good models work and where they do not work.
The JANPA characters come to life to tell us about the project. This video illustrate the aims, objectives and expected results of the Joint action.
The Polish programme aims at supporting the correct development of children and adolescents through proper nutrition; promoting physical activity; improving the quality of food served at care and educational facilities; raising the awareness of parents in terms of the nutrition of children.
The program is being carried out since 2012, in the Silesian province, in Southern Poland and so far 3 editions took place. The implementation of the program was a result of an analysis of the outcomes of controls and researches, conducted by the State Sanitary Inspection of the Silesian province between 2007 and 2011, which has shown that there were many aspects to be improved in terms of the nutrition of children and adolescents (33% of nurseries, 40% of kindergartens, 51% of schools). The most common were: poor quality of food, unbalanced menus for protein content, fat and carbohydrates, deficiency of vitamins and minerals (eg. vitamin C, potassium).
Nutritional education has been provided for children, parents (nearly 8000 persons has attended nutritional workshops carried out by employees of the State Sanitary Inspection and nourishment specialists) and workers responsible for the nourishment in nurseries, kindergarten and schools. In order to implement the program, a manual for the above mentioned workers has been developed.
Since the beginning of the program nearly 4000 menus have been evaluated and the meals in the analyzed facilities were balanced in terms of the share of protein, fat and carbohydrates. In comparison to the last research, carried out before the implementation of the program, there has been an increase in the share of animal protein and protein in general, iron, magnesium, and vitamin C. In comparison to the previous research, there has also been an increase in the share of calcium and potassium.
The implementation of an educational program involving children, parents, and the most important people responsible for nourishment in educational facilities, resulted in an improvement in the quality of nourishment in these facilities. Satisfactory changes have been observed in terms of a quantitative and qualitative composition of the menus. The necessity to continue the program is evident.
The National Nutrition and Dietetics Project in Schools - EYZHN is an ongoing intervention programme carried out by the Hellenic Ministry of Education and is selected as a good practice for childhood obesity prevention. The programme aims at raising awareness and knowledge on healthy eating and wellbeing, ensuring a healthy development of children and adolescents by adopting balanced eating habits and physical activity.
It includes various tests and activities taking place in primary and secondary schools (children aged 4-15 years), designed to offer knowledge and skills in the field of wellbeing in order to develop strategies for a lifelong healthier attitude. Moreover, every year the program records and evaluates the growth rate, diet habits, physical activity and level of fitness, through anthropometric measurements, sport tests, dietary and physical activity questionnaires. Through an annual report, parents are informed about the growth and development of their children.
The different target groups, children, parents, teachers and scientific communities, have access to the website of this program to receive specific advices and information on children development, diet and physical activities. Supporting material for teachers is also available on the website to implement health education programs in the schools..
EYZHN observed stabilization and even a trend for decrease in the prevalence of overweight and obesity in the pediatric population of Greece (from 34% in 2012 to 32% in 2015), especially in low socioeconomic districts of the country. A significant improvement of children’s dietary habits was seen as indicated by a greater proximity to the Mediterranean Diet (MD) (40% of children had a poor adherence to the MD in 2012, compared with 30% in 2015).
The changing of the organism during childhood and youth requires adequate nutrition habits. School facilities should provide suitable boarding for the health and welfare of children and adolescents. The school facilities have an important role in the nutritional education of children.
The basic key elements in the school boarding is the use of the highest quality of food products (with traceability of their origin) in the preparation of meals and beverages.
The Ministry of Health of the Slovak Republic, in cooperation with the Ministry of Education, Science, Research and Sport, annually updates recipes for the school canteens. Every recipe is based on recommended nutrition doses that are regularly updated according to the latest scientific knowledges. Food products with a lower content of salt and sugar are carefully selected for the preparation of these recipes. Products for school boarding are produced in accordance with the respective government material: “Principles for the increase of safety and quality of purchased foodstuffs for mass boarding”.
Freshness and traceability are the main requirements for the quality of food products. As for the beverages at schools, the serving of drinking water and syrups without addition of synthetic colorants, flavourings and without preserving agents are preferred. Recipes also take into account nutritional demands of children and adolescents in the framework of saving, diabetic and gluten-free diet. Schools also provide snacks. The effort is to prepare them in a correct way in the school kitchen. In this way, their nutritional value for different age groups is secured.
Public health experts regularly provide nutritional education to expert employees in the schools that participate in working meetings of school canteen workers which are organised by different authorities.
Every year in occasion of the World Food Day the event “Let’s talk about food” is organised for the pupils and teachers of the basic schools. The aim of this event is to create and promote collaboration and active participation of a school in the education of children and adolescents about good food products and good nutrition habits as part of healthy life style and about the role of food products in protection of health.
Started in the Veneto Region (Northern Italy), GenitoriPiù is a Regional and National Programme based on early childhood development, and a life course approach in the first “1000 days”, for equity, a healthy start to life and for a the family, the community and the empowerment of health workers.
Parents are the protagonists of Children’s health: from the moment they decide to conceive, day by day, during pregnancy, step by step during the first years of life. At every stage the care that only a loving and well-informed parent can give, is extremely important.
For this reason, since 2006, the Program GenitoriPiù, promotes 8 evidence based Actions for the child’s health:
1. Taking folic acid in advance (before conceiving)
2. Not drinking alcohol during pregnancy and during the breastfeeding period
3. Not smoking during pregnancy and not near to the Baby
4. Breastfeeding the Baby
5. Putting the Baby to sleep on his back
6. Protecting the Baby in the car and at home
7. Vaccinating the Baby
8. Reading to your Baby from birth
Every single action protects a baby from more than one problem. All together, these actions are a health investment for the future.
GenitoriPiù has succeeded in creating a network for promoting these 8 actions using marketing techniques and the continuous training of health workers in the Veneto region and, with the Ministry of Health, all over Italy.
The Program has carried out recurring surveys for evaluating knowledge and behaviour of parents and health workers. Together with National Institute of Health (ISS) a Surveillance System on Early Life and Early Health Inequalities will be created.
“Healthy eating from the start!” is an Austrian early childhood health promotion programme that supports women and families with young children to establish healthy nutrition habits right from the start.
It is important to provide our target groups with quality assured, consistent expert knowledge. This information should be easy to understand and available for all. Therefore, our target group-specific materials are written in comprehensible language and translated in different languages. The following information materials are available for download in English, Bosnian/Serbian/Croatian and Turkish:
The General Assembly (GA) of JANPA was held on 14 September 2016 and was attended by 30 associated partners, 3 collaborative partners, Chafea (the Consumers, Health, Agriculture and Food Executive Agency), representative from DG SANTE and 3 independent external evaluators. Technical workpackages (WP) meetings took place on 13 and 15 September. The GA and WP meetings were hosted in Berlin by the German Federal Ministry of Health and the Federal Ministry of Food and Agriculture.
The GA which took place half-way through the project was the opportunity to present and discuss the implementation of the activities and their compliance with the Grant agreement signed with the European Commission (Chafea). As an introduction, an overview of the project was given by the Technical coordinator who presented outreach work performed at European level and the collaborative efforts with relevant initiatives. The Coordinator also presented the work achieved during the first reporting period in terms of both project management and technical coordination and the procedures implemented for the upcoming reporting period. These general presentations were followed by a presentation by each WP leader of an activity report describing all major achievements including finalised Deliverables when applicable, as well as the progress towards the specific objectives of the WP.
Each WP presentation was an opportunity to present the challenges faced, the solutions implemented when appropriate and the upcoming workplan and details of activities. All along the presentations and discussions the external evaluators could intervene to both provide with feedback and ask for further details and clarifications. The specific half-day WP meetings provided an opportunity for the partners involved in a WP to go into more detailed presentations and discussions of the activities of the WP.
As a conclusive remark the JANPA Project officer from Chafea emphasised that the recommendations from the work will have a strong impact as JANPA involves Member States’ ministries and public health institutes working on nutrition and physical activity.
The content of this newsletter represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.