Action on obesity29/08/17Health
PEN outlines the issue of obesity in Europe and the thoughts of European Health Commissioner Vytenis Andriukaitis on the subject.
The World Health Organization (WHO) has called obesity ‘one of the greatest public health challenges of the 21st Century’. Indeed, the prevalence of obesity has tripled in many countries of the WHO European Region since the 1980s, and the numbers of those affected continue to rise at an alarming rate. In addition to causing various physical disabilities and psychological problems, excess weight drastically increases a person’s risk of developing a number of non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes.
In Europe, according to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008, with country estimates for 2008 demonstrating that over 50% of both men and women in the WHO European Region were overweight, and roughly 23% of women and 20% of men were obese. The WHO website adds that ‘based on the latest estimates in European Union countries, overweight affects 30-70% and obesity affects 10-30% of adults’, and that ‘estimates of the number of overweight infants and children in the WHO European Region rose steadily from 1990 to 2008. Over 60% of children who are overweight before puberty will be overweight in early adulthood. Childhood obesity is strongly associated with risk factors for cardiovascular disease, Type 2 diabetes, orthopaedic problems, mental disorders, underachievement in school and lower self-esteem.’
Perhaps not surprisingly, a more active lifestyle is widely held as being the most significant benefit to both preventing and treating obesity. Indeed, the WHO reveals that estimates in Europe suggest that over one-third of adults are insufficiently active, but that ‘participation in 150 minutes of moderate-intensive aerobic physical activity each week (or equivalent) is estimated to reduce the risk of ischaemic heart disease by approximately 30%, the risk of diabetes by 27%, and the risk of breast and colon cancer by 21-25%. In addition, it has positive effects on mental health by reducing stress reactions, anxiety and depression and by possibly delaying the effects of Alzheimer’s disease and other forms of dementia.’
Of course, diet also plays a fundamental role. In 2007, the European Commission established a coherent and comprehensive ‘community strategy’ to address the issues of overweight and obesity, by adopting the White Paper Strategy on nutrition, overweight, and obesity-related health issues, focusing on action that can be taken at local, regional, national and European levels to reduce the risks associated with poor nutrition and limited physical exercise, while addressing the issue of inequalities across member states.
Encompassing a range of policies that can be, and are being, marshalled towards the purpose of improving nutrition and preventing overweight and obesity, the European Commission says that this strategy ‘encourages more action-oriented partnerships across the EU, involving key stakeholders working in the field of nutrition: the private sector, member states, the European Commission and the WHO.’ The commission also argues that it ‘sets out a series of challenges to relevant stakeholders at all levels, notably the food industry, civil society and the media, by calling for widespread food reformulation schemes and responsible advertising’ and ‘sets out the commission’s plans to strengthen monitoring and reporting of the situation, in collaboration with the WHO, through initiatives such as the Nutrition Policy Database or the International inventory of documents on physical activity promotion.’
Nutrition has been the subject of a recent speech by the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, when he spoke at the 22nd meeting of the European Association of Dental Public Health, which was entitled ‘Challenges in oral epidemiology’ at Vilnius University, Lithuania. Here Andriukaitis discussed ‘sugar consumption and public health’ and, although the event was geared towards dentistry issues and oral hygiene, used the opportunity to highlight how obesity – for which unhealthy food consumption is a large contributory factor (including high sugar consumption), he said – has an important social gradient.
He explained: “As an illustration, on average, people with a lower level of education are more often obese than people with medium or higher-level education. Overweight and obesity continue to rise in Europe, affecting not only individuals and their families, but also societies and economies.
“Obesity is not only a disease but also a risk factor for other chronic diseases such as diabetes, cancer, or cardiovascular diseases which – in addition to the health impact on individuals – have a negative impact on employment and increase the pressure on health services. Perhaps most worrying of all are the increasing rates of obesity amongst children across the European Union.”
The commissioner also drew on statistics to bolster his argument: “Currently, more than one in three European schoolchildren are overweight or obese, putting them at greater risk of Type 2 diabetes or cardiovascular diseases later in life.
“It is important, of course, for everyone, especially children, to have a balanced diet to help prevent non-communicable diseases, including tooth decay, and to avoid negative impacts on individuals, on our health systems and on our economies,” he said.
In order to encourage reductions of sugar, salt and fats in processed foods, the EU is working to address food reformulation, Andriukaitis explained. The broad aim here “is to create conditions that make healthy food easily available and affordable to all – so that people can reduce their intake of salt, fat and sugars – which can help to prevent diseases.
“In short, we need to make greater and more rapid progress to make ‘the healthy food choice, the easy food choice’.”
Action at the member state level has already begun, and the health commissioner used the sugar tax on certain soft drinks as an example. However, for Andriukaitis, this is not enough. He said: “For me it is clear that if we want to curb the growing trend of overweight and obesity in children, we have to change current trends in the market using protection, prevention and promotion instruments,” and he held up reformulation, taxation, marketing, advertising, reducing accessibility to unhealthy food, early stage education, awareness-raising and increasing physical activity as tools which can be used to achieve this.
Indeed, as Andriukaitis’s speech highlighted, the tools are there. Moreover, they are being used in the EU Action Plan on Childhood Obesity, for example, or in the Joint Action on Nutrition and Physical Activity, as well as in the commitments of the EU Platform for Action on Diet, Physical Activity and Health. Perhaps, then, the foundations are now in place to tackle this serious public health challenge.
This article will appear in Pan European Networks: Science & Technology issue 24, which will be published in September, 2017.