The increasing prevalence of overweight and obesity especially in children is a major public health issue in most developed countries, including in Europe. Currently, no other chronic disease reaches such a high rate in the school-aged population.
Childhood and adolescence is a critical period to intervene as eating habits, lifestyle and behavior patterns are developed that may persist throughout adulthood. Pre-schools and schools are in the front line and represent obvious intervention settings as they can reach the vast majority of children and they are the places where children spend most of their time in contact with qualified professionals. Also, what is learnt by the students may have a multiple effect by being taken home to influence behaviors in the family.
As pre-schools and schools are in a key position to form children’s behavior, also on a longer term, a health promoting environment has to be created via eliminating unhealthy foods and providing easy access to the healthy options and facilitating physical activity. School-wide messages must be consistent and mutually reinforcing.
One interesting way is to combine, within the curriculum, practice – for instance through the establishment of food gardens and/or food preparing kitchens- and nutrition and health education, that include economic and ecological food preparation and cooking skills, sustainable food systems and understanding food labels. This is to ensure that pre-schools and schools do not only teach children about healthy lifestyles but also give them the skills to implement the recommendations. Educational resources must be evaluated and validated before dissemination by national experts from both scientific and ethical points of view, especially materials sponsored by various stakeholders. Besides, setting up standards for meals provided and foods sold could reinforce what children have learned. School meals play a key role in increasing the availability of healthy diets as well as in nutrition education and in the promotion of health and well-being of the whole school community. A well-balanced school meal can also add joy and improve academic results. The impacts of healthy school meals follow children throughout their lives as food memories and experiences about learning to eat, the widening of taste preferences and modelling good eating habits. Along these lines, establishing nutritional criteria in food service procurement would support the process. Also, mandatory nutritional education to school kitchen staff should be introduced to maximize the impact of these measures. To facilitate physical activity, quality physical education should be introduced with appropriately trained staffs and facilities, preferable on every day. Infrastructure for active breaks using new or existing places and equipment should also be provided. Finally, pre-schools and schools need to be free from marketing of less healthy food and drink options.
In summary, creating healthy pre-school and school environment is not only relevant for defining healthy lifestyles for the entire lifespan of the children but also for reaching out to the whole family. A close link with the parents to discuss this global education might be useful particularly for low socio-economic level families.
For its final conference, JANPA organise a one-day event which took place in Paris on the 24th of November.
The conference focus on the key findings and recommendations and address the contribution of JANPA’s output into the EU Action Plan on Childhood Obesity 2014-2020.
The presence of the Health and Food Safety Commissioner and of the French Minister for Solidarity and Health is expected. Speakers and panellists from EU and international institutions, as well as various stakeholders, will discuss with the JANPA partners and the audience practical and political implications of the JANPA key results and the follow-up of JANPA’s actions at country and European level.
The event is free but registration is required. For further information and registration, visit the dedicated website.
The Workpackage 5 (WP5) dedicated to food information and reformulation have conducted a literature search in the 9 countries (Austria, Belgium, Bulgaria, France, Lithuania, Norway, Romania, Slovak republic and Slovenia) in order to identify the best practices on food monitoring, nutrition policies and consumer information and to enhance food reformulation. The results are described in the document “Best practices inventory and guidelines for improving the collection and use of nutritional food information” with the objective of sharing the best practices on how the nutritional information on food and diet is gathered and used for nutritional policies by the different stakeholders, in the 9 volunteering countries in the WP.
Results of the review demonstrate that some studies have shown that information campaigns are important to increase the consumers’ awareness regarding nutrition; however they do not affect the populations with a lower socio-economic status and have a low impact on consumers’ behavior, and therefore are unable to reduce social inequalities. Their implementation is nevertheless relatively easy and such campaigns are widely deployed in European countries.
Reformulation of food products can be quite efficient to improve the quality of the products but its impact is often limited as it is applied only to some families of products and/or brands/nutrients. Even if it has the advantage of touching the whole population, its global impact is too restricted to improve the quality of the whole diet as its spread is insufficient. Some studies showed nonetheless that a significant improvement gap could be obtained through reformulation and that it is more efficient than food labelling as it has a more direct impact on the consumers.
Actions on food environment may also have a positive impact, like the reduction of portion size in the case of individually wrapped food consumed in one eating occasion (like snacks or cans of beverages).
Finally, food labelling is an important tool for the consumer and it has been demonstrated that a simplified system can help the consumer in a situation of purchase. However, no system meets all criteria of efficiency and several studies have shown that even if the simplified labelling system increases the understanding of the consumers, purchases are also influenced by many other factors. Food labelling has therefore a limited impact on the food basket. Logos may however encourage food reformulation in some cases. In conclusion, several types of nutrition policies are efficient but none of them is sufficient to win the fight against obesity; a combination of several kinds of actions is necessary.
JANPA has clearly shown that there is no brand-specific monitoring tool of the food composition in most of the European countries while monitoring at brand level is a valuable tool for governments in order to assess the quality of the food offer in their country. It appears then that it is necessary to combine various actions like information, promotion of food reformulation and actions on food environment to improve the quality of the whole diet but also to develop monitoring tools in order to assess the consequences of these actions on food composition.
Impact of Different Front-of-Pack Nutrition Labels on Consumer Purchasing Intentions: A Randomized Controlled Trial. Ducrot and al, 2016
Following the literature search conducted in the Workpackage 5 (WP5), on food information and reformulation, the present document is dealing with the pilot studies on monitoring the food composition that have been implemented in Austria and Romania during the project, based on the French experience and the establishment of a network of monitoring systems at EU level.
The pilot studies had two main objectives. The first objective was to test a possible implementation of a monitoring tool at brand level as the one implemented in France since 2008 (Oqali) in order to assess the nutritional quality of the food products. The second objective was to describe the food offer and to conduct a comparison of the nutritional content of two sectors: soft drinks and breakfast cereals in the 3 participating countries (Austria, Romania and France).
The results of the pilot studies demonstrated that the methodology used in Oqali was adaptable to other European countries with minor modifications. It demonstrated that a study carried out with limited resources (time and budget) allowed nevertheless to produce an accurate picture of the market (nutritional content and food offer).
The comparison of the nutrient content (sugar, fat, saturated fat, salt and fibres) of two sectors, soft drinks and breakfast cereals, has also shown that differences exist between the 3 countries. The high variability observed in several families of products among soft drinks and breakfast cereals also suggested a potential for reformulation.
The pilot studies highlighted that it is necessary to have a monitoring tool for each country, at the product family level, in order to qualify the nutritional quality of the food offer: the offer is different between European countries, there are few common products, and the composition of these products can vary from one country to another. A European harmonized tool would enable comparisons, competition between companies’ products from a nutritional point of view, and monitoring of global progresses through reformulation. All these reasons explain why the development of a monitoring network constitutes an important step for the success of JANPA and its follow-up: Austria, France and Romania now constitute the “hard core” of this newly constituted monitoring network.
For further information read the document.
The Work Package 6 (WP6) ‘Healthy environment by integrated approaches’ aims to provide guidance on policy options and initiatives at different levels for facilitating more effective measures in pre-schools and schools. In this regard, WP6 collected and analysed existing good practices (GPs) from the 16 EU countries. Across Europe many actions have been taken on the area of promoting healthier school food environments. The “Compendium of Good Practices in Creating Healthier Environments in Pre-Schools and Schools” brought together 39 diverse practices which were collected and analysed in a standardized way.
Education alone or in combination with other methods was the most frequently used approach within the collected good practices. Education measures most often targeted children, teachers and/or parents, but in some cases training was delivered to special target groups (e.g. policy food manufacturers, caterers, health professionals). The second most used approach was awareness raising alone or in combination with other measures. In particular, 8 initiatives provided the healthy option (e.g. water or fruit and vegetables), 4 used legislative measures (e.g. to regulate the supply of school canteens or set up standards for school meals), 3 changed the built environment and 1 encouraged active transport. Three GPs had monitoring components and 2 dealt with obesity care and management. Only 4 initiatives had physical activity elements either in the form of active breaks or additional physical education classes. The compendium has also highlighted some examples on how countries or programs approached inequalities. On the other hand, just a few initiatives considered equity dimensions during planning and there was only a limited number of equity-focused process evaluation or impact assessment. The practices included in the compendium also reveal that more attention to marketing of unhealthy food and to obesity management as components of school-based interventions is required.
For further information read the document.
IIn June 2016, a convention was signed in Belgium between the Minister of Health, the food industry and the retailers, with the aim reducing the energy intake by 5% in a five-year period. This initiative is in line with the “EU framework for national initiatives on selected nutrients” focusing on Saturated Fatty Acids (SFA) and added sugars. The goal will be reached by modifying the nutritional composition of food products, with a reduction of sugar and lipids content of the processed food. In the framework of this agreement, it is also planned to increase the proportion of fibers and to decrease the portion size.
In the long run (2020) plans are to further decrease SFA’s and added sugar. In the same convention, the partners also took the engagement to set up a monitoring system in order to follow up the energy/sugar/lipid content of the processed food products. In order to do so it is necessary to collect the information on the composition of food products that can be found on the Belgian market and to make sure that the information is continuously updated for all the new products.
For this purpose and in line with inter-sectoral collaborations, Belgium is assessing the GS1 database which elaborates supermarket barcodes. The information available on each barcode will be verified to confirm whether they are valid as far as the food composition is concerned. On a weekly basis, this information will be imported for each new food product in the food composition database and classified by the FoodEx2 classification. Based on the levels of this food classification hierarchy, it will become possible to set up an automatic monitoring system of the food composition.
A week to "make Europe active", through sport and physical activity: this
is the purpose of the European week of the sport promoted by the European
Commission in order to encourage an active lifestyle through the citizen.
The initiative, which runs from 23 to 30 September, involves 32 countries of
the European Union with over 10 million participants and 33 thousand events.
The official hashtag of the event is #beactive, which is to document
activities and participate in the Beactive Challenge.
For more information, consult the Commission website and the list of the initiatives per Country.
No country has reached all the recommended standards for breastfeeding: this is what emerges from a new joint report by UNICEF and WHO, carried out in collaboration with the Global Breastfeeding collective. In particular, the Global Breastfeeding Scorecard which evaluated 194 countries found that only 40% of children under six months of age are breast-fed only, and that only 23 Member States have exclusive breastfeeding rates above 60%. Breastfeeding brings benefits to both mothers (e.g. reducing the risk of developing ovarian and breast cancer) and children, protecting the latter from diarrhea and pneumonia, two of the greatest causes of death in childhood at world level. The scorecard was published at the beginning of the World Breastfeeding Week (1-7 August). Breastfeeding is one of the most effective public health interventions and it is estimated that an investment of US $4.7 per newborn would suffice to increase the exclusive breastfeeding rate by 50% by 2025, which would allow saving the life of approximately 520.000 children under five years of age and generate 300 billion dollars in economic gains by 2025, as a result of the reduction of illness and health care and the increase in productivity.
For more information visit the WHO website and download the document "Tracking Progress for Breastfeeding policies and programmes".
Despite the great socio-economic progress achieved over the last few decades particularly in the 41 countries with high economic development of the Organization for Economic Co-operation and Development (OECD), for a large part of children and adolescents, the United Nations goals for sustainable development are not met (Sustainable Development Goals - SDG): this is what emerges from a UNICEF report released in June 2017.
The report "Building the Future: Children and the SDGs in Rich Countries", which also uses some indicators of the Hbsc study (Health Behaviour in School-aged Children), recalls the importance of focusing on long-term national development plans on the needs of the younger population. Numerous data were reported, among them: on average, 1 out of 5 children lives in poverty (ranging from 1/10 in Denmark to 1/3 in Israel and Romania) and an average of 1 in 8 faces food insecurity.
Based on these results, UNICEF calls for high-income countries to take action in five key areas:
For more information download the report "Building the Future: Children and the SDGs in Rich Countries”.
4 - 6 October 2017 Bad Hofgastein, Austria
5 - 7 October 2017 Bratislava, Slovak Republik
1 - 4 November 2017
Stockholmsmässan, Stockholm, Sweden
15 - 17 November 2017
Collaborated to this newsletter:
-*Viktoria Anna Kovacs (National Institute of Pharmacy and Nutrition) and the team from Hungary.
-**Jean Tafforeau (OD Public health and Surveillance) and the team from Belgium.
Editorial committee: Eva Appelgren, Pierfrancesco Barbariol, Chiara Cattaneo, Barbara De Mei, Lorenzo Fantozzi, Carla Faralli, Susanna Lana, Antonella Lattanzi, Paola Luzi, Sabrina Sipone, Angela Spinelli.
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.