NUTRITION AND PHYSICAL ACTIVITY...2016/11/30 · showcase successful projects in the areas of...
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Consumers, Health, Agriculture and Food Executive Agency INVESTING IN HEALTH PROMOTION TO KEEP PEOPLE ACTIVE FOR LONGER IS INVESTING IN A BETTER FUTURE. The Cluster Meeting organized by the Executive Agency of the European Commission (Chafea) aims to showcase successful projects in the areas of nutrition and physical activity that can be carried out by policy makers, schools and the community. NUTRITION AND PHYSICAL ACTIVITY How European Union contributes to public health priorities including Obesity. Budapest, Hungary 30 November to 2 December 2016 Presentation Summaries
Transcript of NUTRITION AND PHYSICAL ACTIVITY...2016/11/30 · showcase successful projects in the areas of...
Consumers, Health, Agriculture and Food Executive Agency
INVESTING IN HEALTH PROMOTION TO KEEPPEOPLE ACTIVE FOR LONGER IS INVESTING
IN A BETTER FUTURE.
The Cluster Meeting organized by the Executive Agencyof the European Commission (Chafea) aims to
showcase successful projects in the areas of nutrition and physical activity that can be carried out
by policy makers, schools and the community.
NUTRITION AND PHYSICAL ACTIVITY
How European Union contributes to public
health prioritiesincluding Obesity.
Budapest, Hungary30 November
to 2 December 2016
Presentation Summaries
Contents Contents 1________________________________________________________________
Infographics and factsheets 3________________________________________________Factsheet “5 Keys to a healthy nutrition” 4....................................................................................................................................Factsheet “Breasfeeding, the goal for 2025” 6..............................................................................................................................Factsheet “Physical activity in adolescents” 8...............................................................................................................................Factsheet “Physical activity pie”, UKK Institute, Finland 12..........................................................................................................Factsheet “Food and nutrition” 14.................................................................................................................................................Factsheet “Physical activity - Global recommendations on physical activity for health” 18..........................................................
Fact Sheet “EU Health Programme 2014-2020” 22________________________________
Selected Presentations 25___________________________________________________
Opening Session 26________________________________________________________Keynote Speaker: Attila Balogh 27
From European Projects to Hungarian National Policies 28.........................................................................................................Eva Martos 29
26 European Member States working together to halt the rise of overweight and obesity in children and adolescents – the Joint Action on Nutrition and Physical Activity (JANPA) 30.............................................................................................................
Michel Chauliac 31
Session 01: Nutrition, physical activity and obesity in media communication – The importance of a public health perspective 32_____________________________________
Chair: Viktória Anna Kovács 33
International perspectives on Breastfeeding and the role of media and advertisement 34...........................................................Maryse Arendt 35
Giving a clear picture on the obesity problem - Training and Information Services to public and health professionals in Europe (OBTAINS_E). 36...................................................................................................................................................................
Mohamad Qutub 37
Hunting misconceptions and myth about the value of physical activity on health – The core facts on Physical Activity and Health38...........................................................................................................................................................................................
Pekka Oja 39
Research into Policy to enhance Physical Activity (REPOPA) 40................................................................................................Arja R Aro 41
Raising awareness for the public health perspective in journalism - Health Reporting Training for Journalists (HeaRT) 42........Afroditi Veloudaki 43
Session 02: Enabling a healthy start in life and counteracting childhood obesity 44_______How young people campaign to promote healthy eating and physical activity to peers vulnerable to obesity - European Youth
Tackling Obesity (EYTO) 46...................................................................................................................................................Magaly Aceves-Martins 47
Promoting life-long healthy eating - from pregnant & breast feeding women and early years through to seniors 48...................Begoña García Campos 49
Health promoting schools – The evidence for different types of interventions and activities and ideas for implementation (SHE Network). 50...........................................................................................................................................................................
Jesper von Seelen Hansen 51
Promoting milk consumption through a food aid and healthy nutrition program in schools of underprivileged areas in Greece – participation in the European School Milk Scheme 52...........................................................................................................
Afroditi Veloudaki 53
The transformative power of sports – improving physical fitness, health and wellbeing of people with intellectual disabilities through year around sport and health programs (Special Olympics) 54................................................................................
Bjoern Koehler, 55
Arpad SZABO and Orsolya Kárpáti 55
Session 03: Providing policy options for communities 56___________________________Local health ambassadors promoting health among children, young people and their families (Healthy Children). 58...............
Henriette Hansen 59
Promotion of physical activity as a mean to tackle inequities - (MOVE). 60.................................................................................Jacob Schouenborg 61
Disclaimer:
The content of this conference abstract represents the views of the respective authors only and is his/her sole responsibility; it can not 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.
Helping local authorities to improve their planning and implementation practices within the field of health promotion towards children, young people and their families (PoHeFa). 62.........................................................................................................
Anette Schulz 63
Strengthening the methodology of Community Based Programmes through EPODE methodology - Reducing socio-economic inequalities as a mean of tackling obesity (OPEN and EPHE) 64..........................................................................................
Julie Mayer 65
Supporting successful community-activities - Web based learning platform (HEPCOM). 66.......................................................Henriette Hansen 67
Session 04: Encourage Physical Activity – health benefits diet-independent and healthy aging. 68________________________________________________________________
Building policy capacities for promotion of physical activity among elders - theory to practice (PASEO and EUNAAPA). 70......Peter Gelius 71
Healthy ageing through empowerment of elders (HASIC). 72.....................................................................................................Katariina Felixson 73
Harnessing football passion towards adoption of healthy lifestyles (EuroFIT) 74.........................................................................Eivind Andersen 75
Cycling – a key approach to a more active lifestyle (LIFE CYCLE) 76........................................................................................Karl Reiter 77
How people empowerment contributes to their health and wellbeing - The Credits System (C4H) 78........................................Maria Luisa Brandi 79
Session 05: Research and Monitoring 80________________________________________Toolbox for development, evaluation and implementation of interventions aiming at improving lifestyle behaviours. (DEDIPAC).
82...........................................................................................................................................................................................Jeroen Lakerveld 83
Measuring the economic impact of policies/interventions – importance of the harmonisation of methods (EConDA) 84............Laura Webber 85
Connecting transport and health – Promoting active mobility as a mean to improve health (PASTA) 86.....................................Mailin Gaupp-Berghausen 87
Effective integrated intervention approaches – factors associated with success and failure of interventions (SPOTLIGHT) 88..Jeroen Lakerveld 89
Session 06: Promoting supportive environments – to make the healthiest choice the easiest choice, supportive commuting systems and addressing disadvantaged groups' particularities. 90__________________________________________________________
Chair: Susanna Kugelberg 91
Providing tools to promote leisure-time physical activity - Planning, financing, building, and managing of local infrastructures for physical activity (IMPALA) 92.................................................................................................................................................
Peter Gelius 93
Improving eating choices of employees during their working day (FOOD) 94..............................................................................Nolwenn Bertrand 95
Giuseppe Masanotti 95
Coaching toolkit – enhancement of the young's health while addressing socially determined health inequalities (Health25) 96Sylvia Schanner 97
Closing Session: Promotion of healthy diets and physical activity - The future ahead 98___Chair: Belina Rodrigues 99
Keynote speech: From the past research to the future ahead 100..............................................................................................Antonia Trichopoulou 101
Keynote speech: Childhood obesity in Europe – upstream prevention and the role of the information systems. 102..................Michael Rigby 103
2
Infographics and factsheets
3
Factsheet “5 Keys to a healthy nutrition”
4
Source: http://www.who.int/nutrition/5keyshealthydiet_banner.pdf?ua=1
Why? On its own, breast milk provides all
the nutrients and fluids that babies need for
their first 6 months of healthy growth and
development. Exclusively breastfed babies
have better resistance against common
childhood illnesses such as diarrhoea,
respiratory infections and ear infections. In
later life, those who were breastfed as infants
are less likely to become overweight or obese,
or to suffer from noncommunicable diseases,
such as diabetes, heart disease and stroke.
EAT A VARIETY OF FOODS
• Eat a combination of different foods, including
staple foods (e.g. cereals such as wheat, barley,
rye, maize and rice; or starchy tubers or roots
such as potato, yam, taro and cassava), legumes
(e.g. lentils and beans), vegetables, fruit and
foods from animal sources (e.g. meat, fish, eggs
and milk)
Why? Eating a variety of whole (i.e.
unprocessed) and fresh foods every day helps
children and adults to obtain the right
amounts of essential nutrients. It also helps
them to avoid a diet that is high in sugars, fats
and salt, which can lead to unhealthy weight
gain (i.e. overweight and obesity) and
noncommunicable diseases. Eating a healthy,
balanced diet is especially important for young
children's growth and development; it also
helps older people to have healthier and more
active lives.
BREASTFEED BABIES AND YOUNG CHILDREN
• From birth to 6 months of age, feed babies
exclusively with breast milk (i.e. give them no
other food or drink), and feed them “on demand”
(i.e. as often as they want, day and night)
• At 6 months of age, introduce a variety of safe
and nutritious foods to complement
breastfeeding, and continue to breastfeed until
babies are 2 years of age or beyond
• Do not add salt or sugars to foods for babies
and young children
EAT PLENTY OF VEGETABLES AND FRUIT
• Eat a wide variety of vegetables and fruit
• For snacks, choose raw vegetables and fresh fruit,
rather than foods that are high in sugars, fats or salt
• Avoid overcooking vegetables and fruit because
this can lead to the loss of important vitamins
• When using canned or dried vegetables and fruit,
choose varieties without added salt and sugars
Why? Vegetables and fruit are important
sources of vitamins, minerals, dietary fibre,
plant protein and antioxidants. People
whose diets are rich in vegetables and fruit
have a significantly lower risk of obesity,
heart disease, stroke, diabetes and certain
types of cancer.
EAT MODERATE AMOUNTS OF FATS AND OILS
• Use unsaturated vegetable oils (e.g. olive, soy, sunflower
or corn oil) rather than animal fats or oils high in
saturated fats (e.g. butter, ghee, lard, coconut and palm oil)
• Choose white meat (e.g. poultry) and fish, which are
generally low in fats, in preference to red meat
• Eat only limited amounts of processed meats because
these are high in fat and salt
• Where possible, opt for low-fat or reduced-fat versions
of milk and dairy products
• Avoid processed, baked and fried foods that contain
industrially produced trans-fat
Why?Fats and oils are concentrated
sources of energy, and eating too much fat,
particularly the wrong kinds of fat, can be
harmful to health. For example, people who
eat too much saturated fat and trans-fat are
at higher risk of heart disease and stroke.
Trans-fat may occur naturally in certain meat
and milk products, but the industrially
produced trans-fat (e.g. partially
hydrogenated oils) present in various
processed foods is the main source.
EAT LESS SALT AND SUGARS
• When cooking and preparing foods, limit the amount
of salt and high-sodium condiments (e.g. soy sauce
and fish sauce)
• Avoid foods (e.g. snacks), that are high in salt and
sugars
• Limit intake of soft drinks or soda and other drinks
that are high in sugars (e.g. fruit juices, cordials and
syrups, flavoured milks and yogurt drinks)
• Choose fresh fruits instead of sweet snacks such as
cookies, cakes and chocolate
Why? People whose diets are high in
sodium (including salt) have a greater risk of
high blood pressure, which can increase their
risk of heart disease and stroke. Similarly,
those whose diets are high in sugars have a
greater risk of becoming overweight or
obese, and an increased risk of tooth decay.
People who reduce the amount of sugars in
their diet may also reduce their risk of
noncommunicable diseases such as heart
disease and stroke.
Factsheet “Breas feeding, the goal for 2025”
6
Source: http://www.who.int/nutrition/global-target-2025/infographic_breastfeeding.pdf?ua=1
WHAT?
Exclusive breastfeeding provides babies:
& everything they
Significantly limit the marketing of breastmilk substitutes
Provide hospital and health facilities-based capacity to support exclusive breastfeeding
Provide community-based strategies to support exclusive breastfeeding counselling for pregnant and lactating women
Peer-to-peer and group counselling to improve exclusive breastfeeding rates, including the implementation of communication campaigns tailored to the local context
Expand and institutionalize the baby-friendly hospital initiative in health systems
Empower women to exclusively breastfeed
38% 800,000Globally, only Suboptimal breastfeeding contributes to
infant deaths
of infants are exclusively breastfed
BENEFITS OF BREASTFEEDING
LIMIT FORMULA MARKETING
STRENGTHEN HEALTH SYSTEMS
SUPPORT MOTHERS
SUPPORT PAID LEAVE
WHY IT MATTERS RECOMMENDED ACTIONS
SCOPE OF THE PROBLEM
5 BREASTFEEDING |
Folasin
Niacin
B6
E A
D
K
C
B1B2
B12
the
nutrition
from respiratory infections, diarrhoeal disease, and other
life-threatening ailments
Protection
obesity & Protection against
such as asthma and diabetes
FORMULA
WHAT?
WHAT?
WHAT?
HOW?
HOW?
HOW?
HOW? Strengthen the monitoring, enforcement and legislation related to the International Code of Marketing of Breastmilk Substitutesbreastmilk
nothing but
best start
Babies who are fed
from birth through their first 6 months of life get the
Enact six-months mandatory paid maternity leave and policies that encourage women to breastfeed in the workplace and in public
By 2025, increase to at least 50%
the rate of exclusive breastfeeding
in the first six months
THE
GOAL
1 2
3 4
5 6
perfect
need for healthy growth and brain development
non-communicable diseases
To improve maternal, infant and young child nutrition
Factsheet “Physical activity in adolescents”
8
Source: http://www.euro.who.int/__data/assets/pdf_file/0018/303480/HBSC-No.7_factsheet_Physical.pdf?ua=1
© WHO 2016
PHYSICAL ACTIVITY IN ADOLESCENTS
KEY FACTS AND FIGURES
FACT SHEET, 15 March 2016
This fact sheet presents highlights from the international report of the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey. HBSC, a WHO collaborative cross-national study, asks boys and girls aged 11, 13 and 15 years about their health and well-being, social environments and health behaviours every four years. The 2013/2014 survey was conducted in 42 countries and regions across the WHO European Region and North America.
BACKGROUNDPhysical activity is essential for short- and long- term well-being, including physical and mental health, and may improve academic and cognitive performance. It is associated with increased self-esteem, musculoskeletal and cardiovascular health, and reduced anxiety and depression among adolescents. It also has societal benefits by increasing social interaction and community engagement.
Physical activity habits established during childhood and adolescence are likely to be carried through into adulthood. Sedentary behaviour and lower levels of physical activity (that is, those not reaching WHO recommendations) are associated with overweight, obesity and chronic conditions including diabetes, hypertension, cardiovascular diseases and various forms of cancer. Low levels can also impair concentration and productivity at school and contribute to social exclusion and loneliness.
WHO guidelines and recommendations on health-enhancing physical activity have been adopted and translated by many governments in Europe. They establish that children need to undertake at least 60 minutes of moderate-to-vigorous physical activity (MVPA) a day. The evidence suggests, however, that a significant proportion of young people – more than 80% of adolescents in the vast majority of Member States of the WHO European Region – do not meet this minimum standard. Evidence also shows, however, that any level of physical activity is better than none.
Research has suggested that people should reduce extended periods of sedentary behaviour, such as sitting at school or watching television, as these may constitute an independent risk factor for ill health regardless of other activity levels. Even highly active individuals are susceptible to the negative health effects of sedentary behaviour.
Adolescence is a critical stage in the life course in which to intervene and promote active lifestyles before long-term patterns of behaviour become established. This may be particularly important for adolescent girls, in whom a sharp downturn in
Age differencesTime spent being physically active declines through adolescence.
Cross-national and gender differencesPhysical activity levels are generally very low, with under 50% of young people meeting the current guideline of 60 minutes MVPA per day in all countries and regions.
Levels of physical activity are lower among girls.
Family affluenceBoys and girls from high-affluence households are more likely to achieve the recommended 60 minutes of MVPA daily in more than half of the countries and regions surveyed.
Difference between 2010 and 2014Levels of daily activity have increased slightly for boys and girls in all age groups since the previous HBSC survey in 2009/2010.
© WHO 2016
FACT SHEET TOBACCO USE IN ADOLESCENCEFACT SHEET PHYSICAL ACTIVITY IN ADOLESCENTS
levels of physical activity has previously been identified. Promoting physical activity in early life is of the greatest importance to the healthy development of children and young people. Physical inactivity is a leading risk factor for ill health, going well beyond issues related to weight control and influencing physical and mental well-being.
Age differencesTime spent being physically active declines through adolescence, with 25% of 11-year-olds meeting the recommended level compared to just 16% of 15-year-olds. The decrease between 11- and 15-year-olds is significant in most countries for both genders and is up to 22 percentage points for girls (Ireland) and 25 for boys (Finland). These findings demonstrate that adolescence is a critical period for intervention.
Cross-national and gender differencesPhysical activity levels are generally very low, with under 50% of young people meeting the current guideline of 60 minutes MVPA per day in all countries and regions. Prevalence varies between countries, which suggests that national policies and guidelines may influence behaviours. Finland, for example, which shows the highest prevalence of participation in physical activity among 11-year-olds (boys 47%; girls 34%), has recommendations for physical activity that exceed the WHO guidelines.
Levels of physical activity are lower among girls, with clear gender differences for 11-, 13- and 15-year olds in nearly all countries and regions. The largest gender gaps are found among 13-year-olds in Ireland, Luxembourg, Portugal and Spain. The only instance in which girls report higher activity levels is among 13-year-olds in the Republic of Moldova (boys 20%; girls 25%).
Family affluenceBoys and girls from high-affluence households are more likely to achieve the recommended 60 minutes of MVPA daily in more than half of the countries and regions surveyed. The difference between higher- and lower-affluence households is generally less than 10%, which replicates the pattern identified in the previous HBSC survey.
a Top and bottom 3, and average across all countries in the HBSC report
10% 20%0% 40%30% 50%
4734
45
3021
2011
1911
31
4230
178
Finland
Ireland
Bulgaria
HBSC average
Greece
Denmark
Italy
GIRLSBOYS11-year-olds who report at least
60 minutes of MVPA daily a
a Average across all countries in the HBSC report
0%
10%
20%
30%30
2125
15
21
11
GIRLSBOYS
11-year-olds 13-year-olds 15-year-olds
Adolescents who report at least 60 minutes of MVPA daily a
© WHO 2016
FACT SHEET TOBACCO USE IN ADOLESCENCEFACT SHEET PHYSICAL ACTIVITY IN ADOLESCENTS
Difference from the previous HBSC surveyLevels of daily activity have increased slightly for boys and girls in all age groups since the previous HBSC survey in 2009/2010. The gender gap has changed little over time, however, and the proportion of young people meeting recommended activity levels remains very low.
HOW CAN POLICY HELP?The WHO European physical activity strategy for 2016–2025 identifies ways in which governments and public policies, with stakeholder support and engagement, can make physical activity part of everyday life for adolescents.
Priority policies in the strategy are to:
• adopt national guidelines tailored to the promotion of physical activity among adolescents; • improve urban planning and transport infrastructure to promote active transport, such as walking and
cycling to school; • create environments to support physical activity for adolescents (such as free outdoor sport and leisure
infrastructures, safe walking- and cycling-friendly routes, and clean beaches, parks and forest areas);• ensure school curricula for adolescents include a strong physical education component; • provide adolescents with opportunities for physical activity before, during and after the formal school day; and • ensure adolescents with lower affluence or disabilities and those from minority ethnic groups have easy access
to physical activity opportunities.
Investing in children: the European child and adolescent health strategy 2015–2020 calls for an intersectoral approach to promoting physical activity throughout the life-course. WHO guidance on promoting physical activity places major emphasis on the evaluation of actions, which will contribute further to the development of an evidence base for effective and cost-effective interventions
Further information
Child and Adolescent Health WHO Regional Office for Europe Email: [email protected] Website: www.euro.who.int/cah
Health Behaviour in School-aged Children study Email: [email protected] Website: www.hbsc.org
a Average across all countries in the HBSC report
0%
10%
20%
30% 28
19
30
21
2009/2010 2013/2014
11-year-olds
19
10
21
11
2009/2010 2013/2014
15-year-olds
GIRLSBOYSYoung people who report at least 60 minutes of MVPA daily a
Factsheet “Physical activity pie”, UKK Institute, Finland
12
Source: http://www.ukkinstituutti.fi/en/products/physical_activity_pie
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Factsheet “Food and nutrition”
14
Source: http://www.euro.who.int/__data/assets/pdf_file/0006/257919/Fact-sheet-2014-Food-and-Nutrition-Eng.pdf?ua=1
What can policy makers do?
In order to respond to this situation, policy-makers may consider certain actions that:
Create healthy food and drink environments restrict the marketing of food and non-
alcoholic beverages to childrenpromote easy-to-understand front of pack labelling
improve nutritional content of food products, such as through salt, saturated fat and sugar reduction
ban the use of trans fat in all foods and processes
Promote healthy diets throughout life promote, protect and support exclusive
breastfeeding in the first 6 months introduce healthy school meals and school
fruit schemes as standard
Reinforce health systems to promote healthy diets
nutrition counselling and obesity management should be freely available through health systems
Engage everyone in making changeensure affordability and availability of healthy foods by engaging government departments outside of the health sector and identifying joint goals and actions
Fact Sheet Food and Nutrition
Unhealthy diets are the leading
factor affecting health and well-
being in every European country
Excessive consumption of saturated fats, trans fatty acids, sugar and salt increase the risk of overweight and obesity, cardiovascular diseases, diabetes and several types of cancer. These conditions are the main cause of illness and disability across the Region. Of the six WHO regions, the European Region is the most severely affected by noncommunicable diseases (NCDs). The four major NCDs – cardiovascular disease, diabetes, cancer and respiratory diseases – account for 77% of death and disability and almost 86% of premature deaths in the Region.
Why are NCDs so common in the European Region?
5 g per day) in every European country where data are available. Many countries show double digit consumption.
within recommended limits.
among children and adolescents is very high, and in many countries they are the single biggest source of free sugars for young people. Many sodas contain 20–30 g of sugar, which can be as much as 9 teaspoons in a standard serving (330 ml). WHO currently recommends that free sugars contribute no more than 10% of total energy, but has issued draft guidelines suggesting a further reduction to below 5% of total energy. For many children, one serving of soda could contribute over half of this.
trans fatty acids has declined in some countries, it remains a concern in many parts of the Region where no policy or ban is in place. Some food categories, such as bakery products, margarines and spreads, contain large amounts of trans fatty acids, and specific population groups, particularly poorer communities, can consume very high levels.
Overweight and obesity rates are extremely high in many countries in the Region:
countries in the Region.
obese.1
disadvantaged groups in the vast majority of countries and, in some, the gap is widening.
over 50% of people are overweight or obese
over 20% of people are obese
In the WHO European Region
1 In countries participating in the WHO Europe Childhood Obesity Surveillance Initiative (COSI)
For further information, visit our website: www.euro.who.int/nutritionWHO Regional Office for Europe | UN City, Marmorvej 51 | DK-2100 Copenhagen Ø | Tel: +45 4533 7000
WHO response WHO has highlighted the need to promote healthy diets, increase physical activity and prevent obesity both at global and European levels for more than a decade. Highlights of this ongoing work at Regional level include:
Initiative (COSI), which collects nationally-represented, measured and internationally comparable data on overweight and obesity among primary schoolchildren;
notably in the areas of food marketing to children and salt reduction; and
range of policy areas, including recent work on nutrient profile models for the purposes of restrictions on food marketing to children.
in many countries making it hard to meet the recommended availability of more than 600 g per capita per day.
the first 6 months.
What is driving this trend towards more unhealthy
diets?Changes to how food is processed and delivered and our eating habits have had a huge effect.
oils and fats have increased and have become relatively more affordable, while calories from foods that should form the largest part of the diet such as whole grains, pulses and root vegetables have been declining. There are many reasons for this shift, but changes to trade and agricultural policies are key factors.
Modern processing, distribution and retail mean that highly-processed convenience foods, often high in saturated fats, trans fats, sugar or salt, are increasingly available and affordable in many countries. In many cases, consumers struggle to identify healthy options.
marketing and promotion of food on television and billboards, online and via social media tend to be for foods high in saturated fats, trans fats, sugar or salt, and often target children.
snacking, and consuming sugar-sweetened beverages instead of water have changed the way we consume food.
Key landmarks for food and nutrition policy
nutrition (2012), focusing on promoting exclusive breastfeeding in the first 6 months, and halting the increase in overweight among children under the age of 5
Vienna Declaration on Nutrition and NCD in the Context of Health 2020 (2013) from the WHO European Ministerial Conference on Nutrition and NCDs in the Context of Health 2020
NCDs 2013–2020 (2013)
Set of 9 voluntary global NCD targets for 2025, part
including a 0% increase in obesity among adults by 2025.
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4
56
Useful links:Draft European Food and Nutrition Action Plan 2015–2020 – http://www.euro.who.int/food-and-nutrition-action-plan
WHO/Europe website on nutrition – http://www.euro.who.int/nutrition
WHO/Europe country profiles on nutrition, physical activity and obesity
http://www.euro.who.int/en/country-profiles-on-nutrition,-physical-activity-and-obesity
Nutrition, obesity and physical activity (NOPA) database – http://data.euro.who.int/nopa/
Methodology and summary Country profiles on
nutrition, physical activity and obesity in the53 WHO European Region Member States
Factsheet “Physical activity - Global recommendations on physical activity for health”
18
Source: http://www.euro.who.int/__data/assets/pdf_file/0005/288041/WHO-Fact-Sheet-PA-2015.pdf
Fact Sheet Physical Activity
Global recommendations on physical activity for health
* Unless specific medical conditions indicate the contrary
Consequences of
physical inactivity
Physical inactivity is one of the leading risk factors for overweight, obesity and noncommunicable diseases and chronic conditions, including diabetes, hypertension, cardiovascular diseases, various forms of cancer, stress, depression and anxiety. Of the six WHO regions, the European Region is the most severely affected by noncommunicable diseases.
Physical inactivity can also impair concentration and productivity at school and work, and contribute to social exclusion and loneliness.
Physical inactivity has direct costs (health care) and indirect costs (loss of economic output due to illness, disease-related work disability or premature death). It is estimated that, for a population of 10 million people of whom 50% are insufficiently physically active, the cost is EUR 910 million per year.
FACTSHEETS ON HEALTH-ENHANCING PHYSICAL ACTIVITY IN
THE 28 EUROPEAN UNION MEMBER STATES OF THE WHO EUROPEAN
REGION
At least 60 minutes of moderate-
to vigorous-intensity PA daily.
Most of the daily PA should be aerobic.
At least 150 minutes of
moderate-intensity aerobic PA
weekly or at least 75 minutes of vigorous-intensity aerobic PA weekly or an equivalent combination of moderate- and vigorous-intensity activity.Muscle-strengthening activities should be done for major muscle groups on 2 or more days a week.
At least 150 minutes of moderate-intensity
aerobic PA weekly or at least 75 minutes of vigorous-intensity aerobic PA weekly or an equivalent combination of moderate- and vigorous-intensity activity.Older adults with poor mobility should perform PA to enhance balance and prevent falls on 3 or more days per week.Muscle-strengthening activities for major muscle groups should be done on 2 or more days a week.When older adults cannot do the recommended amounts of PA because of health conditions, they should be as physically active as their abilities and conditions allow.
Children aged 5–17 years*
Adults aged 18–64 years*
Adults 65 years of age and above*
Definition of physical activity: Physical activity (PA) is any bodily movement produced by skeletal muscles that requires energy expenditure; it is a fundamental means of improving people’s physical and mental health.
WHO has made recommendations to provide guidance for national and regional policy-makers on the relations between the frequency, duration, intensity, type and total amount of PA required for the prevention of noncommunicable diseases.
The recommendations address three age groups:
Inequality in physical activity There are large socioeconomic inequalities in levels of PA across different social groups.
environments that do not support PA.
for promoting PA than others.
What can Member States do to increase physical activity?PA can and should be part of people’s everyday lives. Countries in the WHO European Region have a number of policy options. In order to make a sizeable impact and create the necessary conditions for PA to become a part of everybody’s daily life, governments will have to act on a large scale, in a consistent and coherent way and across various levels of government and sectors, including urban planning, transport, education, health and sports.
Countries may base their actions on the following key principles:
designing policies and interventions.
For further information, visit our website: www.euro.who.int/physical-activityWHO Regional Office for Europe | UN City, Marmorvej 51 | DK-2100 Copenhagen Ø | Tel: +45 4533 7000
Priority policy options might include:
coordination;
acceptability and safety of, and supportive infrastructure for, forms of active transport such as walking and cycling;
safe walking- and cycling-friendly routes);
to tertiary level), including opportunities for PA before, during and after the formal school day, including school sports;
disabilities or from minority ethnic groups, including community schemes to improve access to appropriate local options for PA;
innovative Information and Communication Technologies, such as social media (when appropriate), to inform the population about the benefits of PA and to encourage the adoption of healthy behaviour; and
effective and cost–effective actions.
What can I do to improve my physical activity level?The benefits of PA are not restricted to competitive sports or exercise in a gym. One of the easiest ways to increase levels of PA might be to integrate it into everyday activities:
the rest of the route.
TV.
and avoiding sharp furniture can encourage children to be active.
your daily life, with walking and other forms of PA.
Key facts about physical
inactivity in the
European Region
Each year, 1 million people dies from causes related in some way to physical inactivity.
Each year, 8.3 million disability-adjusted life years are lost due to physical inactivity.
It is estimated that more than one third of adults are not sufficiently active.
It is estimated that more
than 70% of adolescents do not meet the PA recommendations.
The general trend in
the Region is towards decreasing levels of PA.
Girls are less active than boys, and women are less active than men.
1
2
3
4
5
6
Useful links, references and policy documents
Global action plan for the prevention and control of noncommunicable diseases 2013–2020
www.who.int/nmh/events/ncd_action_plan/en/ Global recommendations on physical activity for health
www.who.int/dietphysicalactivity/publications/9789241599979/en/Global strategy on diet, physical activity and health
www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdfWHO/Europe website on physical activity
www.euro.who.int/physical-activity Physical activity strategy 2016–2025
www.euro.who.int/en/physical-activity-strategy-europe
European Physical Activity Strategy 2016–2025
The Strategy, presented to the 53 Member States in the WHO European Region at the 65th session of the WHO Regional Committee for Europe, is a
exclusive focus on promoting PA for all age groups.
The goal of the strategy is to increase PA levels by:
sedentary behaviour;
are available for PA by providing attractive, safe built environments, accessible public spaces and infrastructure;
for PA regardless of gender, age, income, education, ethnicity or disability; and
facilitating PA.
One of the 9
global NCD targets
is a reduction by 10%
of the prevalence of
insufficient PA by
2025.
Fact Sheet “EU Health Programme 2014-2020”
22
Health andConsumers
THE THIRD HEALTH PROGRAMME 2014�2020FUNDING HEALTH INITIATIVES
ChallengesAn increasingly challenging demographic context, threatening the sustainability of health systemsA fragile economic recovery, limiting the availability of resources to invest in healthcare An increase of health inequalities between and within Member States
An Increase in the prevalence of chronic disease
General objectivesImprove the health of EU citizens and reduce health inequalitiesEncourage innovation in health and increase sustainability of health systemsFocus on themes that address current health issues across Member States
Support and encourage cooperation between Member States
Specific objectivesPromote health, prevent diseases, and foster supportive environments for healthy lifestylesProtect citizens from serious cross-border health threatsContribute to innovative, efficient and sustainable health systems.
Facilitate access to better and safer healthcare for Union citizens
Operational objectivesIdentify, disseminate and promote the up-take of evidence-based and good practices for cost-effective disease prevention and health promotion activities
Identify and develop coherent approaches and implement for better preparedness and coordination in health emergencies
Identify and develop tools and mechanisms at Union level to address shortages of resources, both human and financial, and facilitate the voluntary up-take of innovation in public health intervention and prevention strategies
Increase access to cross-border medical expertise and information for medical conditions of low prevalence, high specialisation or rare diseases
Facilitate the application of research results and developing tools towards quality healthcare and patient safety
Examples of expected resultsIncreased use of evidence-based practices in Member StatesIntegrated coherent approaches in Member States preparedness plan, improved surveillance and response to cross-border health threats Increased sustainability of health systemsCreation of European Reference Networks, for example on rare diseases
PROGRAMMING AND IMPLEMENTATION
on the basis of Annual Work Programmes through calls for grants and tenders*
MONITORING AND REPORTING
Annual implementation reports to European Parliament & Council; mid-term review in 2017
BUDGET:
€449.4 million (2014-2020) to support
Cooperation projects at EU levelActions jointly undertaken by Member State health authoritiesThe functioning of non-governmental bodiesCooperation with international organisations
Thematic Priorities*
1. Promote health, prevent diseases and foster supportive environments for healthy lifestyles
3. Contribute to innovative, efficient and sustainable health systems
4. Facilitate access to better and safer healthcare for Union citizens
2. Protect Union citizens from serious cross-border health threats
Risk factors such as use of tobacco and passive smoking, harmful use of alcohol, unhealthy dietary habits and physical inactivityDrugs-related health damage, including information and preventionHIV/AIDS, tuberculosis and hepatitis Chronic diseases including cancer, age-related diseases and neurodegenerative diseases Tobacco legislation Health information and knowledge system to contribute to evidence-based decision-making
1.1
1.21.31.41.51.6
3.13.23.33.4
3.63.5
3.7
2.12.2
2.3
2.4
4.14.24.34.44.54.6
European Reference Networks Rare diseases Patient safety and quality of healthcare Measures to prevent antimicrobial resistance and control healthcare-associated infections Implementation of Union legislation in the fields of tissues and cells, blood, organs Health information and knowledge system to contribute to evidence-based decision-making
Health Technology Assessment Innovation and e-health Health workforce forecasting and planning Setting up a mechanism for pooling expertise at Union level European Innovation Partnership on Active and Healthy Ageing Implementation of Union legislation in the field of medical devices, medicinal products and cross-border healthcare Health information and knowledge system including support to the Scientific Committees set up in accordance with Commission Decision 2008/721/EC
Additional capacities of scientific expertise for risk assessment Capacity-building against health threats in Member States, including, where appropriate, cooperation with neighbouring countries Implementation of Union legislation on communicable diseases and other health threats, including those caused by biological and chemical incidents, environment and climate change Health information and knowledge system to contribute to evidence-based decision-making
* Full text of the Regulation and further information at: http://ec.europa.eu/health/programme/policy/index_en.htm
EN N
D-04-14-369-EN
-N ISBN
978-92-79-37243-8 DO
I 10.2772/14552
Selected Presentations
25
Opening Session
26
Keynote Speaker: Attila Balogh European Commission, DG SANTE, Luxembourg
27
After his medical studies and his specialisation in neurosurgery in Hungary, Dr. Balogh worked and
carried out research as a clinical neurosurgeon in Hungary and Germany between 1992 and
2003. He then joined the Office of the Chief Medical Officer in Hungary, where as deputy head
of department he was responsible for chemical safety, occupational safety and health, food
safety, and environmental safety. In 2006, Dr. Balogh completed his specialisation in public
health and preventive medicine. He began his career at the European Commission (DG ENTR) in
Brussels in 2006-2007, by notably contributing to the establishment of the European Chemicals
Agency (ECHA). After the Agency became operational in Helsinki in 2007, he joined it as one of
its first staff members, and worked in the Member State Committee as a scientific policy officer
from 2008 to 2013.
In 2013, Dr. Balogh moved to Luxembourg to join the European Commission (DG SANTE). His main
area of responsibility concerned addictions (particularly alcohol related harm) until 2015. Since
2016, he has been heading the sector dealing with nutrition, physical activity and addictions.
on in neurosurgery in Hungary, Dr. Balogh worked and
eon in Hungary and Germany between 1992 and
From European Projects to Hungarian National Policies Hungarian public health data are very unfavourable. Overall, Hungary usually ranks one of the
worst places among the EU countries. The case is the same also with obesity where the prevalence
in adults reaches 30%. The reason behind is an unhealthy nutrition together with physical inactivity
which affects a significant proportion of the population. National public health policies, therefore,
are focusing on measures that promote a healthy diet and physical activity. Recently, fulfilment of
these aims was a high priority on the political agenda. In the last 5 years, diverse governmental
regulatory actions have been initiated to prevent diet-related non communicable diseases. As a
fiscal measure, the public health product tax act on non-staple foods has been introduced (2011).
Besides, the regulation on mandatory daily physical activity classes in schools has been developed
(2011). Also, the restriction of trans fatty acids in foods (2013) and legislation on healthy public
catering were established (2015).
In the preparation process of the legislations monitoring activity, including objectively measured
data, had a substantial role. For instance, the unexpectedly high salt content in meals provided for
pre-school children (6.7 grams on average which is well above the WHO recommendation) served
as a facilitator to pave the way towards the mandatory standards in public catering.
Besides the monitoring activities, another important experience was for us the continuous
participation in different EU-funded projects, such as the InForm, ENHR II or PREVACT, that provided
the possibility of cooperation and exchange of knowledge. The common added value of these
collaborations under the umbrella of the EU Health Programmes were coming from the share of
good practices among countries with different public health systems, the international and multi-
sectorial cooperation as well as the network of high level experts with different backgrounds (NGO,
academia, civil servants etc.). Either the innovative tools and solutions of different projects or the
age-specific messages or the use of social media or the know-how for engagement of different
stakeholders were all well used during the different phases of the preparation of legislations.
Moreover, the effective participation in the projects together with the continuous robust monitoring
activities resulted in the opportunity to lead a work package in the ongoing Joint Action on
Nutrition and Physical Activity. The strong collaboration of 25 participating countries in order to
facilitate the implementation of EU Action Plan on Childhood Obesity provides a step forward in
tackling the EU wide problem of childhood obesity.
28
Eva Martos President of the Hungarian Society of Sports Medicine
29
Professor Eva Martos M.D.PhD, the president of the Hungarian Society of Sports Medicine worked
as the general director of the National Institute for Food and Nutrition Science over the past ten
years. Under her supervision the institute worked in different international collaborative research
projects (e.g. HECTOR, InForm, IDLE, and as WP leader in ENHR II and EU Joint Action on Nutrition
and Physical Activity), participated in the WHO Childhood Obesity Surveillance Initiative (COSI),
and conducted two national representative population survey about nutritional status and
dietary habits of adults. Her main research interests are dietary habits and nutritional status of the
population with a special focus on childhood obesity.
She has participated in the preparation of many relevant national legislations addressing food
taxation, limitation of trans fatty acids in food or standards for public caterers. At EU level, she is a
member of the High Level Group on Diet and Physical Activity and she is the WHO Nutrition
Counterpart for Hungary. Besides, she has contributed to the planning, implementation and
evaluation of the EU Salt Reduction Framework.
She is regularly representing Hungary on high level events such as FAO Second International
Conference on Nutrition (2014) or WHO European Ministerial Conference on Nutrition and
Noncommunicable Diseases (2013). She was selected as a member of the WHO working group
on Global Coordination Mechanism on the Prevention and Control of Noncommunicable
Diseases (2016).
dent of the Hungarian Society of Sports Medicine worked
nstitute for Food and Nutrition Science over the past ten
26 European Member States working together to halt the rise of overweight and obesity in children and adolescents – the Joint Action on Nutrition and Physical Activity (JANPA) Despite a largely shared awareness of the problem for more than 15 years, prevalence of adult
and child overweight and obesity continues to increase in Europe, with large socio-economic
inequalities. The consequences of this situation on the majority of the main non-communicable
diseases (diabetes, cardiovascular diseases, cancers…) are well known. There is a consensus that
prevention strategies, starting during early childhood, are necessary to improve the situation with
regards to overweight and obesity.
In order to start some coordinated and concrete initiatives in different countries based on the EU
Action Plan, a “Joint Action” was initiated. Joint Actions are one funding instrument under the third
EU Health Programme 2014-2020, which are co-financed with Member State authorities.
The Joint Action on Nutrition and Physical Activity (JANPA) was launched in September 2015 and
will last till November 2017, with the overarching objective of contributing to halting the rise of child
obesity in Europe. Thirty-nine institutions from 26 countries (as well as additional collaborating
stakeholders including WHO-Europe and the EU Joint Research Centre) take an active part in the
work packages. A diversity of complementary issues are addressed:
• Produce an economic estimate and understanding of the foreseen cost of childhood obesity
for social budgets. This will allow a stronger advocacy at government level on the need to
invest in childhood obesity prevention.
• Allow a sharing of knowledge and experiences on the way nutritional information on food is
used at individual, population, government level in the different countries, and start to
harmonize the monitoring of the nutritional value of food which is sold in different countries.
These objective data should contribute to the aim of fixing realistic and ambitious objectives for
food reformulation.
• Share the best practices (selected using sound criteria), which in the various countries have
proved to be successful for improving, from early infancy to the end of school age, children’s
food consumption, physical activity, and prevalence of overweight and obesity.
JANPA’s outputs and conclusions will be shared during the final conference to be held in Paris in
November 2017.
30
Michel Chauliac French Ministry of Health, Paris, France
31
Dr Michel Chauliac, public health physician, worked from 1983 to 1999 on international nutrition
mainly on children malnutrition at the International Chlidren Center in many third world countries
with many links with UNICEF, WHO, FAO.
Since 2000 he is responsible for the French National Nutrition and Health Programme at the
French Ministry of social affairs and health. He is the French representative at the High level group
on nutrition and physical activity at EU level.
Session 01: Nutrition, physical activity and obesity in media communication –
The importance of a public health perspective
32
Chair: Viktória Anna Kovács National Institute of Pharmacy and Nutrition, Budapest, Hungary
33
Viktória Anna Kovács is a medical doctor working for the National Institute of Pharmacy and
Nutrition. She received her PhD on the prevention and treatment of childhood obesity. Her work
and publications have focussed on childhood obesity and its risk factors, and exercise training as
a possible solution. Currently, her main focus is to support the implementation of the EU Joint
Action on Nutrition and Physical Activity as WP6 leader. Also, she is the Principle Investigator for
WHO Childhood Obesity Surveillance Initiative in Hungary.
Dr Kovács has broad experience with European projects. She was a member of the expert group
assisting DG AGRI and the Member States on the evaluation and implementation of EU School
Fruit Scheme. She was also part of a group assigned to assess the impact of EU-funded public
health research from FP5 to FP7 and draw down conclusions for Horizon2020. She supported the
implementation of several international projects like ENHR II or InForm. Also, she was the main
contributor for CHAFEA’s publication on EU funded actions to support the EU Public Health
priorities - Nutrition and Physical Activity Actions addressing Obesity 2008-2013.
International perspectives on Breastfeeding and the role of media and advertisement Breastfeeding is the natural way to feed infants and young children. Exclusive breastfeeding for the
first six months of life ensures optimal growth, development and health. After that breastfeeding,
with appropriate complementary foods contributes to optimum nutrition of infants and young
children, development and health, including prevention of infection, overweight, obesity, cancer
and chronic diseases. This recommendation of WHO is endorsed by many health ministers in the EU,
who have issued similar national public health recommendations. Ample scientific evidence exists
that breastfed infants are healthier or (if you turn it around to analyze it from the biological norm)
that bottle fed infants have higher risk of infections and chronic diseases.
Breastfeeding is a complex healthy behavior; it involves two persons and is influenced by a
multitude of determinants. Those determinants have been analyzed and numerous
recommendations have been adopted. International and European documents recommend best
evidence based practices to protect, promote and support breastfeeding. (1-5)
Breastfeeding is a topic of child and women’s right. The states are the duty bearers to protect those
rights. They got clear messages in article 35, 44, 52 of the general observations to article 24 from the
Committee on the Rights of the Child under the UN Convention on the Rights of the Child in 2013.
(6) Breastfeeding is a right of the mother that needs to be protected but it is not a duty to her.
Actually breastfeeding rates are very different in EU member states and are far from reaching the
public health goals adopted by leading public health agencies. Breastfeeding rates in Europe are
even not comparable, as common agreed indicators are not in place, not followed or not
measured. Additionally surveys on breastfeeding shed a light on the fact that breastfeeding
mothers give up breastfeeding earlier than planned due to lack of information, support or due to
constraints outside of their influence. It is not about forcing women to breastfed but about support
to those who have chosen to do it, for as long as they need it, by support and protection in the
health service, at the workplace and in society.
Media reports may by highlighting controversies and by biased information undermine the
confidence in breastmilk and breastfeeding and impede an informed choice by the mother. By
publishing advertisements for breastmilk substitutes in breach of the International Code of
Marketing of breastmilk substitutes, mothers fear might be exploited commercially. Media can also
be part of the solution by playing an important role in fulfilling their duty to inform the public and
the mothers and helping to create an enabling, supportive environment.
1. Protection promotion and support of breastfeeding in Europe: A blueprint for action (revised 2008) http://ec.europa.eu/health/ph_projects/2002/promotion/fp_promotion_2002_frep_18_en.pdf http://www.aeped.es/sites/default/files/6-newblueprintprinter.pdf
2. Global strategy for infant and young child feeding http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/
3. Innocenti declaration https://www.unicef-irc.org/publications/435/
4. ILO Convention on maternity protection http://www.ilo.org/dyn/normlex/fr/f?p=1000:12100:0::NO::P12100_INSTRUMENT_ID,P12100_LANG_CODE:312328,en:NO
5. ILO recommendation 191 http://www.ilo.org/dyn/normlex/fr/f?p=1000:12100:0::NO::P12100_INSTRUMENT_ID,P12100_LANG_CODE:312529,en:NO
6. General comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health (art.24) http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRC%2fC%2fGC%2f15&Lang=en
34
Maryse Arendt International Baby Food Action Network – IBFAN
35
Maryse Arendt, a lactation consultant IBCLC, is currently the Executive Director of the
organisation “Initiativ Liewensufank” (www.liewensufank.lu) (loosely translated as “initiative
beginning of life”), which aims to improve the conditions around birth and breastfeeding and
supports women and men for a good start into parenthood. This is achieved by providing
expecting and new parents with information, course offers, support and advocacy on national,
European and international level.
Mrs. Arendt is also the coordinator of the Baby-Friendly Hospital Initiative (BFHI) in Luxembourg, a
combined effort by UNICEF and the World Health Organization to improve the care of pregnant
women, mothers and newborn babies at health facilities (http://www.who.int/nutrition/topics/
bfhi/en/). To protect, promote and support breastfeeding, in accordance with the International
Code of Marketing of Breast milk Substitutes, she is the European co-coordinator of IBFAN
(www.ibfan.org). She has been elected to the Steering committee of WABA, the World Alliance
of Breastfeeding Action as the European representative (www.waba.org.my). She has ample
experience in attending World Health Assemblies and Codex Alimentarius meeting as an NGO
delegate.
Mrs. Arendt interests include child and human rights in general, social cohesion as well as the
protection of the environment.
Giving a clear picture on the obesity problem - Training and Information Services to public and health professionals in Europe (OBTAINS_E). Promoting best practice in weight management with training for healthcare professionals
This refers to our work under OBTAINS-E translating SCOPE online obesity modules into French,
developing new obesity modules, organising SCOPE School events and providing scholarships to
healthcare professionals from lower-income EU member states.
The outcomes include providing access to best practices in obesity management to French-
speaking healthcare professionals throughout Europe. 6 new modules have already been
developed which address health inequalities improving obesity education within the EU.
A total of 4 SCOPE School events have been funded including 2 in lower-income EU member
states. Attendance at one of these events in Athens is up over 200% from the year before and over
95% of delegates of SCOPE School London had their objectives met. 83 scholarships have been
provided to healthcare professionals from the following lower-income EU member states to make
obesity education more accessible: Bulgaria, Czech Republic, Estonia, Poland, Slovakia, Romania,
Greece, Cyprus, Latvia, Portugal, Lithuania, Hungary, Malta and Slovenia.
Promoting informed debate and policy-making around obesity with an accessible data portal
This refers to our work on the data portal providing facts, figures, graphics and downloadable
presentations in 5 European languages. We’ve developed over 100 new graphics with EU-relevant
data, translated 140 graphics into 5 languages (French, German, Spanish, Portuguese, Polish), and
interactive atlas and country cards for all EU member states.
The work we’ve done with the data portal provides researchers, policymakers and the public with
reliable evidence across all EU member states. The translations ensure that the data portal is
accessible across all European regions including Southern and Eastern Europe. This data is vital to
improving health and economic wellbeing across the EU ensuring that policies and community
interventions are effective for the country in which they are applied.
36
Mohamad Qutub World Obesity Forum, London, UK
37
Mohamad is the Head of Education at the World Obesity Federation, a medical association
representing over 30,000 members in 54 countries. He has over 6 years experience in professional
and higher education. His work is focussed on improving care through the development of
evidence-based clinical pathways.
Mohamad has overseen the development of the SCOPE certification in obesity management
reaching over 13,000 healthcare professionals globally. Since launching, it has been translated
into 3 languages and accredited over 50 live-training events in 23 countries. This includes annual
SCOPE School events and International Congresses on Obesity.
World Obesity Federation, a medical association
ntries. He has over 6 years experience in professional
i i th h th d l t f
Hunting misconceptions and myth about the value of physical activity on health – The core facts on Physical Activity and Health Based on accumulated scientific evidence WHO issued in 2010 global physical activity
recommendations for health. The core recommendations are: Children and youth aged 5–17
should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity every
day. Adults and older adults should do at least 150 minutes of moderate-intensity aerobic physical
activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity
throughout the week.
After these generic recommendations increasing number of studies have addressed the impact of
different types and forms of physical activity (PA) on health.
Health-enhancing physical activity can take place in occupation, domestic shores, transportation
or leisure-time. Using the risk of death as a measure of health evidence shows that all-cause
mortality is reduced through participation in occupational PA by 17%, domestic PA by 36%,
transportation PA by 12%, leisure-time PA by 26%, and exercise and sports by 34%, compared with
non-participation.
Walking and cycling are compliant activities to most people. Observational studies show that
cycling for transport reduces all-cause mortality by 12%. Intervention studies show consistently that
among inactive adults and older adults walking reduces adiposity, blood pressure and blood
glucose, and increases aerobic capacity.
Sports and exercises offer ample opportunities for vigorous-intensity activity. However, until recently
little has been known about the health effects of specific sport disciplines and exercises. A new
study shows that among adults and older adults participation in cycling, swimming, racquet balls
games and aerobics reduces all-cause mortality by 15%, 28%, 47% and 27%, respectively. Likewise,
running reduces mortality and football improves many physiological functions.
High levels of physical inactivity or sedentariness have been shown to be associated with increased
mortality, independent of physical activity. Recent evidence shows that regular participation in
moderate-intensity physical activity can attenuate and even eliminate the increased risk of
inactivity.
Robust scientific evidence indicates that the health benefits of physical activity contribute
significantly to public health. The outstanding challenge remains to make more people more
active.
38
Pekka Oja UKK Institute Tampere, Finland
39
After the graduation at the University of Jyväskylä, Finland in 1970 and the completion of his
doctoral studies at the Pennsylvania State University, USA in 1973, Pekka Oja began his scientific
work as the director of the Work Physiology Unit at the Institute of Occupational Health in Helsinki,
Finland. In 1981 he was invited to join the Urho Kaleva Kekkonen Institute for Health Promotion
Research in Tampere, Finland where he worked as the Head Researcher and subsequently as
the Scientific Director until 2003. After his retirement from the UKK Institute he worked as a visiting
professor at the Karolinska Institute, Stockholm, Sweden until 2008.
Pekka Oja has served as an expert and adviser for the Finnish Government, Council of Europe,
European Union, World Health Organisation, European College of Sport Science, International
Council of Sport Science and Physical Education, International Olympic Committee and the
European Network for the Promotion of Health-enhancing Physical Activity (HEPA Europe). He has
participated in several international consensus projects evaluating the evidence on physical
activity and health. During his retirement he has continued to be active nationally and
internationally in the area of health-enhancing physical activity with special interest in the dose-
response issues of physical activity and health, and in the environmental aspects of physical
activity promotion. In 2008 he was the recipient of the Philip Noel-Baker Research Award
presented by the International Council of Sport Science and Physical Education.
Research into Policy to enhance Physical Activity (REPOPA) Physical activity policymakers can benefit from support by researchers. The EC funded REPOPA
project found practical ways to support policymakers in their use of research evidence in
developing physical activity policies. Simulation policy game, locally tailored policymaking
interventions, indicators to assess policies’ evidence-base as well as national internet platforms are
examples of the REPOPA products.
REPOPA stands for REsearch into POlicy to enhance Physical Activity; a five year project (October
2011- September 2016). The project was funded by European Union, 7th Framework Program.
Researchers from six EU countries of Denmark, Finland, Italy, the Netherlands, Romania, UK, plus
Canada were project partners. The results from the project were presented at the Final Symposium
in Brussels, September 8th, 2016. Read more and see publications and Symposium presentations at
www.repopa.eu
Why do we need integration of research and policymaking? Researchers, EC, WHO and others
provide recommendations for policymakers to take physical activity seriously and integrate it in
everyday lives of people. This is more easily said than done! Policymakers juggle with numerous
pressures, points of views and resources. Research evidence presented in scientific publications is
not the primary driver of their work; instead, political pressures, local priorities, values and resources
influence their decisions. REPOPA researchers took the challenge to work hand-in-hand with real-
world policymakers to learn how best to co-create policies so that research evidence is taken into
account.
REPOPA found several issues researchers can help policymakers with: available and applicable
research when needed and getting rid of academic jargon. More should be done to build
procedures to gather research knowledge and to have meetings with researchers. Games are
nowadays an attractive way to learn: simulation policy game proved to increase mutual
understanding between policymakers and researchers, it also showed the importance of
organizational and leadership collaboration across sectors. The practical outcome here is a model
for policy games, which is already applied outside REPOPA.
REPOPA researchers also joined real world physical activity policy groups and helped them use
research evidence. These locally tailored interventions helped policymakers to take into account
needs and values of the people whom the policies concern. They also triggered politicians to
request for more research evidence. Here the practical outcomes are best practice interventions in
three countries to co-create evidence-informed policies locally.
REPOPA used physical activity as the theme in its work; however, the lessons learned and tools
developed can be applied to other fields, especially in the area of healthy living.
40
Arja R Aro University of Southern Denmark, Unit for Health Promotion
Research, Denmark
41
Arja R Aro (PhD, DSc) is Professor of Public Health and functioned 2005-2015 as Head, Unit for
Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark. She also
functioned as interim Head, Centre for Maritime Health and Society from February 2013 to
August 2016. She is Finnish by her nationality and worked 17 years at the National Public Health
Institute in Helsinki, Finland. She has also worked at three universities in the Netherlands. She has
two academic educations, in health psychology and in health services research. She holds also
an adjunct professorship (docent) at Turku University, Finland since 2001, and from 2012 she has
been Academic Supervisor and Quality Chef of BSc programs (Health Education and Promotion,
and Epidemiology) at Princess Nora Bint Abdulrahman University (PNU), Riyadh, Saudi Arabia.
The current research of Professor Aro focuses on evidence-informed health promotion and policy
development as well as public health ethics. Her previous research activities have been related
to health screening, cancer prevention and quality of life in cancer care, women’s health, as
well as user perspectives of public health genomics.
She has published over 200 papers. She teaches and supervises students actively both in
Denmark and Saudi Arabia. Before the REPOPA Coordinator role (October 2011-September
2016), she participated in several EC-funded projects both as partner and WP leader. She has
also wide experience as expert evaluator of international projects as well as in the research
council work in several countries.
Raising awareness for the public health perspective in journalism - Health Reporting Training for Journalists (HeaRT) The Health Reporting Training Project- HeaRT was a 2-year Leonardo da Vinci, Grundvig and
Dissemination project co-funded by the Education, Audiovisual and Culture Executive Agency
(2010-2012).
HeaRT’s primary goal was to develop vocational training, so as to offer specialized knowledge and
skills to journalists to improve health reporting in the EU, aiming at reliable health information
dissemination and education for the general public. Media provide important information
regarding health on a daily basis, while playing a key role in the dissemination of such information
and setting issues on the public agenda. At the same time, there appears to be limited
educational opportunities available for journalists covering health issues, while journalists themselves
express interest in specialized training programs.
Initiated by the Athens-based Institute of Preventive Medicine, Environmental and Occupational
Health, Prolepsis, HeaRT brought together a geographically diverse consortium of experts from
Germany, Portugal, Romania, Great Britain, Finland, Estonia and Spain. This multi-disciplinary group
with partners offered knowledge and experience from the fields of health and journalism, as well as
media training and education.
An on-line course database was developed including existing training courses on health reporting
EU-wide. A survey was also conducted among journalists to further explore the issues and needs
related to health journalism. 176 journalists from 7 EU partner countries participated in the survey.
Only a small proportion of journalists had received specialized training in the past, who also
considered it more necessary than their counterparts. Journalists believed they needed more
training to acquire specific skills related to evaluating conflicts of interest, interpreting medical
research reports and understanding statistics, so as to analyze specific health topics, such as
medical research and science, health policy and business/economics of health care.
Based on the research outcomes, a training methodology and 11 training modules were designed,
among which a module dedicated to Public Health and a module on Consumer/ Lifestyle health
which included the issues of nutrition and physical activity. The latter was also included in a book
related to health reporting, aiming to become a useful tool for any journalist that specializes in the
health sector.
There is a need for specialized training on reporting health issues. Based on the evaluation of
HeaRT’s training activities the project succeeded in providing professional journalists and journalism
students with specialized skills and knowledge that were considered important for reporting issues
relating to health. HeaRT could provide good practices and insights towards developing
educational programs in journalism schools and educational centers across Europe and beyond.
42
Afroditi Veloudaki Institute of Preventive Medicine Environmental & Occupational
Health, Prolepsis, Greece
43
Afroditi Veloudaki holds a bachelor degree in Mass Media and Communication from the
National Kapodistrian University of Athens, Greece. After working in the Hellenic Audiovisual
Institute (IOM) in Athens as a researcher on communication issues, she continued her education
in Boston, U.S.A. Honored with a Fulbright Scholarship and a Merit Award from Emerson College,
she specialized in Health Communication at Emerson College and Tufts University School of
Medicine, where she obtained her MA degree. While in the US she completed a six-month
internship at the renowned Children’s Hospital Boston, where she had the opportunity to work
next to physicians and professors of Harvard University, and, then, worked at the Marketing
Department of St. Elizabeth’s Medical Centre.
Upon her return in Greece in 2007 she started working at the scientific nonprofit organization
Institute of Preventive Medicine Environmental and Occupational Health, Prolepsis, initially as a
health communication consultant. Since 2012, Ms. Veloudaki holds the general management of
Prolepsis Institute, directing the activities of Prolepsis’ departments, including project
management supervision, advocacy efforts, development of new proposals and programs on
National and European level. Among others, she was the project manager of "Health Reporting
Training – HeaRT", a 2-year Leonardo da Vinci, Grundvig and Dissemination project co-funded by
the Education, Audiovisual and Culture Executive Agency. She currently is the project manager
of the Food Aid and Promotion of Healthy Nutrition program, a large scale school-based food
aid program currently implemented in underprivileged areas across Greece, which has
benefited over 90.000 student during a 5-year period.
Ms. Veloudaki currently pursues her PhD degree at the Medical School of the National and
Kapodistrian University of Athens, where she is also a scholar at the Department of Hygiene,
Epidemiology and Medical Statistics.
Session 02: Enabling a healthy start in life and counteracting childhood
obesity
44
How young people campaign to promote healthy eating and physical activity to peers vulnerable to obesity - European Youth Tackling Obesity (EYTO) The teenage years are pivotal in determining the longer- term risk of obesity, and as they get older,
their behaviours are harder to change. For this reason, adolescence provides a vital window of
opportunity to help young people develop healthier lifestyles.
The European Youth Tackling Obesity (EYTO) project was led by the UK based National Children’s
Bureau (NCB) in partnership with organisations in Spain (Technological Center of Nutrition and
Health & Rovira i Virigili University), Portugal (Companhia de ideias) and the Czech Republic
(Komunikujeme). The EYTO partnership was borne over shared concern over the levels of youth
obesity, and a lack of innovative and targeted work to tackle the complex issues that adolescents
face as compared to younger children.
The EYTO partnership developed an innovative peer-led social marketing approach were young
people were involved and encouraged to use social media to promote healthy eating and
physical activity and stem the rise in obesity amongst young people, aged between 13 and 18
years old living in disadvantaged areas who are vulnerable to obesity.
The main objectives of the project were to improve motivation about healthy eating and physical
activity among young people aged 13-18 old living in socio-economic deprived communities; to
incorporate young people, partners, stakeholders, policy makers and planners at a local, national
and European level; to create evidence-based information to share and replicate good practices
among EU member states to transcend cultural barriers and support national and international
health promotion efforts.
A project of this nature, helped youth to gain different skills, competences and reinforce their
awareness of their community confirming that their views matter and that they can influence
change. The effective messages were positive and inspirational messages that promote benefits of
healthy lifestyles more than the harm of obesity. Also, social marketing and social media are
effective approaches for connecting and cascading health messages among teenagers.
Adolescence is a window of opportunity and an ideal life period for performing interventions of
lifestyles improvement. There is a need to implement new strategies (e.g. social marketing, peer-led
education, and social media use) in health promotion efforts. Furthermore, youth needs to be
involved in the solutions for public health problems that affect them (e.g. obesity). All the efforts
performed do not only shape lifestyles, but also create the sense of responsibility for young people
to live these lifestyles. Project ran from September 2013 to September 2015 and received funding
from the EU in the framework of the Health Programme 2008-2013.
46
Magaly Aceves-Martins Technological Center of Nutrition and Health, Reus, Spain
47
Magaly Aceves-Martins obtained her Master’s degree of Clinical Nutrition and Metabolism at the
Barcelona University; and her Ph.D. of Biomedicine at the Rovira i Virgili University in Tarragona,
Spain. Currently, she is part of the Technological Center of Nutrition and Health as a
collaborative researcher at the Functional Nutrition, Oxidation and Cardiovascular Disease
Group in Catalonia, Spain.
Her main research is focused on health promotion activities and strategies that effectively
improve lifestyles, especially in children and adolescents living in disadvantaged areas. She has
collaborated at national and international research and health promotion projects, such as the
European Youth Tackling Obesity Project. She has presented her work in national and
international journals, workshops and conferences. She performed a research internship at the
World Health Organisation Collaborating Centre for International Child and Adolescent Health
Policy and Child and Adolescent Health Research Unit of the University of St. Andrews in
Scotland.
Promoting life-long healthy eating - from pregnant & breast feeding women and early years through to seniors We Love Eating (2013-2015) encouraged conscious eating focusing on the pleasure food thanks to
tools such as games, recipes, leaflets, posters and its website. It also promoted more physical
activity in daily life, offering realistic ways to adopt a healthier and more active lifestyle.
The project targeted children, pregnant women and older people who are in key life stages where
good nutrition is particularly important. It was launched in seven cities of seven Member States
(Banska Bystrica, Slovakia - Bradford, UK - Cluj Napoca, Romania - Deventer, Netherlands -
Granollers, Spain - Poznań, Poland and Roncq, France).
With clear and positive messages, like “enjoy drinking water” or “enjoy shopping for healthy food”,
as well as fun activities to put them into action, 'We love eating' made participants reflect on their
current lifestyles and start improving them.
At the end of the project, parents were more aware that children actually enjoy eating healthily;
their children now eat more vegetables or have a glass of water more frequently. Likewise, more
seniors are now eating fruit and vegetables. They also increased their daily water consumption. It
also triggered three out of four pregnant women to think about their lifestyles. 'We love eating'
made them realise that it is good for their unborn children if they themselves enjoy eating
balanced, home-cooked meals with fruit and vegetables, and are physically active.
Similar to 'We love eating', the 'Together' (2015-2016) project specifically targeted pregnant and
breastfeeding women in: Prague (Czech Republic), Manchester (United Kingdom), Murcia (Spain),
Varna (Bulgaria),Odense and Kolding (Denmark).
Together made an extra effort to also reach young mothers, immigrants and women with lower
income who sometimes struggle to access fresh foods and other healthy lifestyle options.
More than half of the women who participated confirmed their knowledge of healthy behaviour
whilst pregnant or breastfeeding improved through the 'Together' project, and an additional 25%
admitted that, even though they were already well informed before, 'Together' motivated them to
actually improve their lifestyle.
Even after giving birth, the women are still keeping up some of their healthy habits. Over half are still
eating more fruit and vegetables, drinking more water, and cooking more meals at home. And of
course, what’s healthy for mum is healthy for the whole family.
48
Begoña García Campos PAU Education, Barcelona, Spain
49
Begoña is an experienced corporate and institutional communications officer with a sound
knowledge of European institutions and policies. Fluent in Spanish, Catalan, English and French,
since joining P.A.U Education, she has been responsible for the management of several health
promotion projects, including We Love Eating! and Together projects, both for the European
Commission DG for Health and Food Safety.
As project manager, her main duties include the coordination of several communication
deliverables, including printed publications and websites. She is the main contact point for the
client, liaising with team members to ensure that the project outcomes correspond to the client’s
expectations.
Health promoting schools – The evidence for different types of interventions and activities and ideas for implementation (SHE Network). More and more studies show links between different health initiatives in school and improved health
as well as improved wellbeing and academic achievement. This presentation provides evidence
for the link between different types of health initiatives and their outcome on health, wellbeing as
well as academic achievement.
The different types of health initiatives are: 1) active breaks from classroom teaching; 2) physical
training; 3) physical activity integrated into classroom teaching; 4) Physical education; 5) free play /
recess; 6) active transport to and from school; 7) food
Health: Physical activity affects many biological processes in the body, and a high level of physical
activity reduces the level of several known risk factors for heart disease, type 2 diabetes and many
other diseases. In particular, there is a strong relationship between low physical activity / low fitness
rating and the development of metabolic syndrome (an accumulation of risk factors for
cardiovascular diseases in the same person). The children with the worst fitness has more than ten
times more likely than the others to such risk factors. One of the benefits of making school the arena
for health promotion is the availability of all children and not just the children that are active in for
example sport clubs. The health benefits of physical activity are high for children that are physically
inactive.
Wellbeing: Childrens wellbeing can be affected trough physiological, social and psychological
mechanisms as a result of physical activity. Some studies have shown that physical activity overall
has a positive impact on children's well-being especially when measured as physiological
wellbeing. Other studies show that children's experiences of physical activity are essential for
wellbeing. Sports activities organized so they give the children an experience of coping, positive
social relationships and participation, is conducive to wellbeing. Whether the activity creates such
experiences depends on the social environment surrounding the activity.
Academic performance: There are several studies showing a positive correlation between
cognitive functions, academic goals or brain functions and physical activity. Most major studies
that have looked at school-based interventions have examined the effect of additional or
improved physical education. Some studies find positive effects, but it does not apply to all subjects
and / or age groups. Most studies found positive results in academic achievement with active
breaks, physical training at school or physical activity integrated into classroom teaching. Some
studies used a multi-component approach and thus cannot be categorized into one of the seven
categories used in the presentation. The multi-component studies show a tendency that physical
activity improves academic performance, but also results in the opposite direction, why several
large studies of longer duration and better quality is needed to draw definite conclusions.
50
Jesper von Seelen Hansen University College South Denmark, Denmark
51
Dr. Jesper von Seelen works in the department of applied science at University College South in
Denmark where he coordinates all research and development activities on health promotion for
children and youth. The research program that Jesper von Seelen coordinates runs about 25
projects on health promotion in different areas such as public schools, nurseries, hospitals, sports
clubs and families. Most projects are small projects but the program also participates in large
scale randomized controlled trials.
Dr. Jesper von Seelen is the acting SHE-network coordinator. The SHE network is a European
network of health promoting schools. In the nine years Dr. Jesper von Seelen has work at
University College South health promoting schools has been his main area of research. From
2007-2010 Dr. Jesper von Seelen was chairman of the board of a private foundation that ran
projects on health promotion and physical activity in schools. Dr. Jesper von Seelen is sitting on
several national advisory boards.
Promoting milk consumption through a food aid and healthy nutrition program in schools of underprivileged areas in Greece – participation in the European School Milk Scheme In Greece, it is estimated that 686,000 children (35.4%) are at risk of poverty (UNICEF 2014), while
childhood obesity is one of the largest in the EU. In light of the socioeconomic crisis, since 2012 the
Program on Food Aid and Promotion of Healthy Nutrition – DIATROFI is implemented with a dual
goal. It provides free, daily, healthy and nutritious meals to tackle food insecurity and hunger
among students of schools located in disadvantaged areas across Greece. At the same time, it
promotes healthy nutrition through educational activities targeted to students and their families.
The meal includes a cereal-based food item every day (wholemeal sandwich with cheese/
chicken/egg and vegetables; or vegetable pie), pasteurized white milk (1.5-1.8% fat content) or
yogurt with honey 3-4 times/week, and fresh seasonal fruit every day. Since 2012 the DIATROFI
Program has reached 23 prefectures across Greece, over 530 schools and 90,000 students. It has
distributed over 12,8 million meals.
The Program is implemented by Prolepsis Institute with founding donor the Stavros Niarchos
Foundation and the contribution of public and private organizations and individuals. For the past
two years, through the DIATROFI Program beneficiary schools also participate in the European
School Milk Scheme, which subsidises part of the cost of the milk distributed, aiming to encourage
consumption among children of healthy dairy products and contribute to a healthy way of living
and to nutritional education.
Based on matched pre-post questionnaires completed by parents upon entrance to the DIATROFI
Program and at the end of the school period, results in regards to milk and dairy products were the
following: (1) 2014-2015 school year: 77.9% of students who did not consume milk or yogurt now did;
(2) 2015- 2016 school year: 67.1% of students who did not consume milk or yogurt now did.
In addition, according to 89.7% and 89.2% of parents respectively, their child consumed more dairy
products by the end of the Program. The Program in general also appears to effectively address
weight problems, with 16.4% of students who were obese at the beginning reaching a normal
weight at the end and 33.7% who were overweight at the beginning reaching a normal weight at
the end.
Key messages:
The European School Milk Scheme has contributed to the efforts towards combating food insecurity
and improving dietary habits in regards to milk consumption in Greece through the DIATROFI
Program. Milk or yogurt offered 3-4 times per week to all students of a school in combination with
health promotion efforts increases the students’ consumption of milk or yogurt.
52
Afroditi Veloudaki Institute of Preventive Medicine Environmental & Occupational
Health, Prolepsis, Greece
53
Afroditi Veloudaki holds a bachelor degree in Mass Media and Communication from the
National Kapodistrian University of Athens, Greece. After working in the Hellenic Audiovisual
Institute (IOM) in Athens as a researcher on communication issues, she continued her education
in Boston, U.S.A. Honored with a Fulbright Scholarship and a Merit Award from Emerson College,
she specialized in Health Communication at Emerson College and Tufts University School of
Medicine, where she obtained her MA degree. While in the US she completed a six-month
internship at the renowned Children’s Hospital Boston, where she had the opportunity to work
next to physicians and professors of Harvard University, and, then, worked at the Marketing
Department of St. Elizabeth’s Medical Centre.
Upon her return in Greece in 2007 she started working at the scientific nonprofit organization
Institute of Preventive Medicine Environmental and Occupational Health, Prolepsis, initially as a
health communication consultant. Since 2012, Ms. Veloudaki holds the general management of
Prolepsis Institute, directing the activities of Prolepsis’ departments, including project
management supervision, advocacy efforts, development of new proposals and programs on
National and European level. Among others, she was the project manager of "Health Reporting
Training – HeaRT", a 2-year Leonardo da Vinci, Grundvig and Dissemination project co-funded by
the Education, Audiovisual and Culture Executive Agency. She currently is the project manager
of the Food Aid and Promotion of Healthy Nutrition program, a large scale school-based food
aid program currently implemented in underprivileged areas across Greece, which has
benefited over 90.000 student during a 5-year period.
Ms. Veloudaki currently pursues her PhD degree at the Medical School of the National and
Kapodistrian University of Athens, where she is also a scholar at the Department of Hygiene,
Epidemiology and Medical Statistics.
The transformative power of sports – improving physical fitness, health and wellbeing of people with intellectual disabilities through year around sport and health programs (Special Olympics) Official WHO statistics show that people with intellectual disabilities have a poorer overall health status, have lower educational access, experience barriers in daily life, particularly in access to health care and health education. Key risk factors for poor health issues have been documented such as no specialized disability training for health professionals, a lack of physical activity, limited access to basic health care services, and an overall lack of understanding on Intellectual Disability by the medical/clinical community. Different studies suggest that people with ID: (1) have a wide range of chronic and acute health issues and conditions. In many instances, more frequent and severe symptoms than the general population; (2) are twice as likely to have significant visual problems and at much younger age; (3) are hardly ever engaged in vigorous physical activity and find it difficult to make themselves understood when speaking with health professionals; (4) health conditions are may be similar to the general population, the impacts can be greater on those with ID; (5) Experience higher mortality rates as a result of higher rates of cardiovascular diseases.
People with intellectual disabilities are one of the most neglected and underserved population in the world and although social health care systems are in charge for special needs groups people with ID still face health disparities and less opportunities for physical activities and wellness. Our data show that: (1) Ca. 40 percent of the athletes have untreated tooth decay; (2) Ca. 17 % are in need for urgent dental treatment; (3) Ca. 40 % need new prescription eye glasses; (4) Ca. 7% have a permanent hearing loss; (5) 15 % of age under 18 are obese, 18 % are overweight; (6) 38% of adult athletes are obese, 34% are overweight.
There are about 15 Million people with ID living in the European Union (according to WHO 2-3% of the population have an ID). Special Olympics Europe/Eurasia is trying to address the above mentioned issues by providing year around training and competition opportunities in Olympic type sports, health programs, family programs, athlete leadership programs and UNIFIED sport experience across all 28 EU member states. SOEE serves for over 230,000 children and adults (athletes) with an ID in the EU and is engaging over 40,000 coaches, family members, health care professionals and other volunteers. In 2015 over 15,000 sport events have been organized in the EU 28 promoting the abilities of people with ID and helping to improve physical fitness and well being of those at the same time. Also in 2015 88 “Healthy Athletes” (health screening events in six medical areas namely vision, hearing, dentistry, podiatry, physiotherapy and health promotion and were conducted in 12 EU countries performing over 10,500 screenings and interventions including education on healthy life style choices. The goal of these screenings and interventions is to improve the athletes ability to train and compete in Special Olympics, to train healthcare professionals and to raise awareness of health issues people with ID are facing as well as to promote improved health care policy for people with special needs across the EU.
Special Olympics Europe/Eurasia vision is to improve the life of all people with ID in Europe through the transformative power of sport and physical activity as well as through quality health care that is accessible for all people with an intellectual disability.
54
Bjoern Koehler, Special Olympics Europe/Eurasia
Arpad SZABO and Orsolya Kárpáti Special Olympics Athlete
55
Dipl. Sport Scientist Björn Köhler has been working for Special Olympics Europe/Eurasia since 2008
and is managing the Special Olympics Europe/Eurasia Health programs overseeing 36 national
programs implementing the Healthy Athletes initiative and other sport and health programs. He is
working together with health care professionals across Europe and Eurasia with the goal to
implement Special Olympics health programs, organizing training for health care professionals
and students, raising awareness of critical health care needs for people with intellectual
disabilities and facilitating research in the area of health care, prevention and treatment needs
of people with intellectual disabilities. Björn Köhler started volunteering for Special Olympics
Germany back in 2006.
Arpad SZABO is 39 years old, lives and works in Budapest, and does basketball. He was a
member of the basketball team competing in Los Angeles at the Special Olympics World Games
2015. He won gold with the team.
Session 03: Providing policy options for communities
56
Local health ambassadors promoting health among children, young people and their families (Healthy Children). The Healthy Children project developed and implemented the “Healthy Children Concept”, which
is a concept focusing on training of and assistance from local voluntary health ambassadors. The
concept contains 6 specific areas, and within each area the project developed a specific
recommendation and supporting tools;
Political and Strategic Commitment: The Healthy Children Concept recommends that local health
authorities establish strong political and strategic commitment to support the concept of working
with volunteers as local health ambassadors, which should be seen as an investment for the local
authorities.
Creating Local Partnerships: The Healthy Children Concept therefore recommends that local health
authorities consider strategically how they want to work with Civil society organisations and identify
which specific organisations in the local area are the most obvious to collaborate with, taking the
socio cultural factors into considerations, when local health authorities want to reach children and
young people in deprived areas
Competence and Needs Analysis: The Healthy Children project has revealed that what is really
needed in the local communities is “unskilled assistance”. The Healthy Children Concept underlines
that what the health ambassadors need most of all to be “good people” who like to do something
with and for others. Hence, human skills are probably even more important than specific health
skills. The health ambassadors need to know how to interact with children, young people and
families, being able to ask questions and be curious and last but not least, being able to create
trustful relations with children and young people.
Recruitment of Volunteers: The Healthy Children Concept recommends that the recruitment of
volunteers to become health ambassadors is based on the strategic considerations of the local
health authorities and looks to create local partnerships and make working relationships with civil
society organisations. Hence, it is preferable that local health authorities develop a recruitment
strategy which is based on the strategic decisions that civil society organizations develop in order
to reach children and young people in deprived areas.
Training and Education: The Healthy Children Concept recommends that the overall philosophy of
the training program is based on the understanding that the quality, effectiveness and the
sustainability of health promotion activities depend on the degree of participant involvement, the
empowerment of target groups, and the creation of practical knowledge within the target group.
Health Promoting Activities: The Healthy Children Concept recommends that Local health
authorities should have a broad understanding of what good health is and the huge range of
health promoting activities that are possible58
Henriette Hansen South Denmark European Office, Belgium
59
Henriette Hansen has worked as EU Project manager in South Denmark European Office since
1999, and has a long track record of successfully managed projects within areas such as health
promotion, health and welfare technologies, science communication, education and training.
Besides managing projects she also represents the Region of Southern Denmark in the European
Innovation Partnership on Active and healthy Ageing and participates in several action groups.
Her substantial experience has permitted her to work as external expert towards the Consumers,
Health and Food Executive Agency.
Henriette has a Master of Science in Business Administration for Copenhagen Business School
and a Master of European Studies from the College of Europe in Bruges.
Promotion of physical activity as a mean to tackle inequities - (MOVE). Core messages from the presentation:
• “Speak “MOVE”” - why the term “Sport” is not useful (or even harmful) to reduce inequality in
physical activity
• “Is the health sector MOVing” - why the ownership of physical activity promotion fails in public
health; and in governments in general.
• “MOVE more” - the seven (long) steps from physical inactivity to sustained activity
• “We know enough to MOVE” - is the current balance between research and practice in
physical activity promotion the right one? And how does knowledge actually transfer between
the “do’ers” in Europe?
• MOVE outside the box” - the unusual suspects in physical activity promotion
• “MOVING Europe” - how lack of action ignited Europe's largest physical activity promotion
campaign NowWeMOVE.
60
Jacob Schouenborg International Sport and Culture Association, Denmark
61
Secretary General in International Sport and Culture Association (ISCA). Jacob Schouenborg has
been overall resposible for more than 10 health-focused projects in ISCA, and is presently driving
the development of the European Campaign for physical activity NowWeMove. Experience prior
to working at ISCA includes working in the Danish Ministry of Culture as well as in the Nordic Youth
Associations.
Helping local authorities to improve their planning and implementation practices within the field of health promotion towards children, young people and their families (PoHeFa). In order to ensure that health promoting activities has a better and long lasting effect, the PoHeFa
Project seeked to increase the awareness on how the socio-cultural context has an effect on
healthy lifestyle choices and the health status within families.
The project included participants from universities and municipalities in Denmark, Great Britain,
Germany, Finland, Cyprus and Italy. Based on a close collaboration between the partners, The
PoHeFa Method was developed, tested and disseminated showing how to improve local health
strategies, programmes and implementation practice.
Three aims are set out: (1) To make municipal health strategies more coherent and initiatives more
efficient and effective. (2) To create better coherence between projects and programming. (3) To
improve local implementation processes of practical health promoting initiatives.
First an analysis of existing policies and practices for health promotion in the municipalities was
made in order to generate both recommendations and input for future policies and practices in
the municipalities. The study results were obtained by a triangulation approach and rested on data
and knowledge generated by document studies as well as on data and knowledge produced
through focus group interviews with key persons in the municipalities.
Based on the gathered data, a number of pilot projects were planned and implemented in
selected municipal settings, e.g. preschools and schools.
Furthermore, a number of methods, tools and recommendations were conceptualised and aimed
at both political-administrative decision-makers and professional practitioners.
Four core messages were identified:
1. Create a common understanding among local politicians and practitioners about the concept
of health.
2. Take the socio cultural context, in which policies and interventions are going to be
implemented, into consideration.
3. Include staff and users more actively in development and implementation processes.
4. Install a structured cross-organisational and cross-disciplinary approach, through a closer
collaboration and dialogue between different groups of professional practitioners.
For further information, please see: www.pohefa.eu
62
Anette Schulz University College Southern Denmark, Denmark
63
Anette Schulz, Senior Consultant at Research Centre for Health Promotion, UCS.
Years of experience working with strategic health promotion both at an institutional level and at
a community level.
Specific focus areas are inequality in health, qualification of health promoting practises in pre-,
primary- and secondary schools and development municipal health strategies.
Strengthening the methodology of Community Based Programmes through EPODE methodology - Reducing socio-economic inequalities as a mean of tackling obesity (OPEN and EPHE) EPODE for the Promotion of Health Equity project (EPHE project): The creation of a favourable health
environment for families can reduce the health gap. That is the main conclusion of the EPHE study.
By involving the entire community, parental practices are strengthened and that has positive
effects on all populations. Following targeted interventions such as workshops in the schools on
beverages or sleep, parent-teacher conferences on how to manage nagging behaviour and city
festivities with healthy buffets, the study demonstrated that parents of low socio-economic status
are now less permissive when it comes to fruit juice consumption and screen time.
After 2 years of intervention, EPHE showed promising results: improved energy-balance related
behaviours are observed within the low education groups in Belgium: TV time on weekdays is
lowered. Determinants of behaviours are also improved in some of the countries involved: Belgium:
on monitoring of the child’s TV exposure. Greece: on parental efficacy to manage child’s TV
exposure. Portugal: on having less soft drink availability at home and on avoiding rewarding/
comforting child by giving fruit juice. The Netherlands: on avoiding using the computer in the child’s
presence.
Obesity Prevention through European Network (OPEN project): The OPEN project succeeded in
having a positive impact on adolescents’ healthy behaviours in 13 European countries.
13 countries participate in the European OPEN project, which aims at up-scaling the methodology
of community-based programmes (CBPs) and at implementing targeted activities to encourage
adolescents from underprivileged areas to eat better and move more. The project has reached
over 1,6 millions adolescents and after 2,5 years, significant and positive results have been noticed,
showing the importance of developing adapted strategies.
The OPEN project, a collaborative and multidisciplinary initiative, aims to overcome these barriers,
to facilitate and accelerate behaviour and environmental change in Europe through Community-
Based Programmes (CBPs).
The use of EPODE – a methodology aiming at preventing childhood obesity – combined with WHO
Good Practice Appraisal Tool for appraising the methodology of 13 participating CBPs. Qualitative
results show the reaching of progress objectives in all the CBPs involved.
The 13 CBPs involved in OPEN integrated the 6 strategies identified by VUmc University Medical
Center Amsterdam to develop actions towards adolescents living in deprived areas. They have
managed to reach 1,6 millions adolescents in Europe. Positive behavior change are observed in 12
CBPs on physical activity, sedentary time and on eating habits.
64
Julie Mayer PROTEINES SAS, France
65
Julie Mayer, Msc, is the coordinator of the OPEN project. She has over 10 years experience in the
fields of sociology of food and health, public health, communication and behaviour change.
She works for public and private entities at Proteines SAS and also as a freelance consultant.
She focuses on cross-disciplinary exchanges for a better understanding and dissemination of
knowledge.
For the OPEN project, her goal is to constitute a sound input on childhood obesity prevention
methodologies, for other entities working in this field.
Supporting successful community-activities - Web based learning platform (HEPCOM). The long term aim of this project is to contribute to preventing overweight and obesity among
children and young people within the EU. In order for the EU to reach this aim, it is widely
acknowledged as a way forward to engage local communities in a more structured way in order
for them to be more active and competent in this area. Therefore it is important to raise awareness
among local communities and provide easy access to good practice on promoting healthy eating
and physical activity interventions. This access will assist local communities and schools to apply
more strategic approaches and use actively some of the innovative tools and whole community
approaches which have been developed and proposed through a number of former and existing
PHP and other European projects.
In order to reach the long term aim, the overall objective of the HEPCOM project is to increase the
quality and level of local community and school interventions all over Europe on promoting healthy
eating and physical activity among children and young people, by up scaling good practice and
results from previous and current PHP and FP7 projects, based on networking and dissemination,
through the development of a sustainable European web based learning platform.
The overall vision of the HEPCOM learning Platform is that it will be used in all European current and
future projects on childhood obesity prevention and promotion of healthy eating and physical
activity on local level, as a main dissemination channel. The HEPCOM learning platform should be
seen as a “one stop shop”, making it easier to disseminate and upscale valuable results in the area
from European project.
A needs analysis report has been developed based on interviews with the 45 local pilot
communities. It focuses on what local communities need in relation to tools and methods in order
to work more strategically on promoting health among children and young people. Next to the
needs assessment a mapping exercise has been done in which community based initiatives to
reduce childhood obesity, together with tools and methods, developed within European projects,
are described and analysed in relation to scope, target group, implementation and evaluation.
Subsequently gaps between the mentioned needs and the mapping results have been reported.
Based on these results we are now preparing the online HEPCOM learning platform which will be
tested by 45 communities in Europe.
A mapping of a great number of EU projects has been carried out, which has helped us to cluster
more than 240 tools from EU projects in 5 different categories, making it easier for the audience to
find relevant tools. The tools on the HEPCOM learning platform will be divided into these 5
categories: Policy and vision development; Strategic development and planning; Action Planning;
Implementation of activities and interventions; Evaluation
The HEPCOM learning platform will be launched in summer 2017.
66
Henriette Hansen South Denmark European Office, Belgium
67
Henriette Hansen has worked as EU Project manager in South Denmark European Office since
1999, and has a long track record of successfully managed projects within areas such as health
promotion, health and welfare technologies, science communication, education and training.
Besides managing projects she also represents the Region of Southern Denmark in the European
Innovation Partnership on Active and healthy Ageing and participates in several action groups.
Her substantial experience has permitted her to work as external expert towards the Consumers,
Health and Food Executive Agency.
Henriette has a Master of Science in Business Administration for Copenhagen Business School
and a Master of European Studies from the College of Europe in Bruges.
Session 04: Encourage Physical Activity – health benefits diet-independent and
healthy aging.
68
Building policy capacities for promotion of physical activity among elders - theory to practice (PASEO and EUNAAPA). The problem: Lack of exercise is a major problem among older people. Promotion of physical
activity can improve older people's quality of life significantly. In recent years, a large number of
physical activity programmes for older people has been developed, but too few of these
programmes actually get implemented.
The solution: The EUNAAPA (2006–2008) and the PASEO (2009–2011) projects employed innovative
approaches to foster the implementation of successful evidence-based policies and programs.
Instead of “transferring” or “translating” ready-made scientific solutions for application, they directly
engaged professionals and policy-makers to produce new knowledge, build capacities, and
develop specific actions to promote physical activity among older people. Specific measures
included the evaluation of existing assessment instruments and interventions, the development of a
network of researchers, professionals, and policy-makers, and the establishment of national
alliances to strengthen policy capacities.
Project results: The EUNAAPA project resulted in the establishment of the EUNAAPA network, which
links researchers and professionals interested in physical activity promotion for older people.
Network activities include a course curriculum for professionals, summer schools, and policy
advocacy related to physical activity for older people.
PASEO successfully forged national or regional policy alliances in 15 EU Member States. More than
130 organizations were involved, including several national and regional ministries. The alliances
developed catalogues of action with more than 110 specific measures overall. Several allliances
have been sustained, e.g. in Lithuania, where the PASEO alliance became the basis for the
broader National Alliance for Health-enhancing Physical Activity, and in Austria, where PASEO
continues as a project run by the regional government of Vienna. Other alliances continued to
operate at the local and regional level (France, Italy) or focused on specific issues (Netherlands,
Portugal).
Take-home messages: While there are many programs to promote physical activity for older
people, far too few of them actually get implemented. The EUNAAPA and PASEO projects used
innovative approaches to engage professionals and policy-makers and to develop new
knowledge and capacities together with them. Sustainable outcomes of the two projects include
the EUNAAPA network that links researchers and professionals, and policy alliances that continue to
influence policy-making in several EU Member States.
For further information, visist www.eunaapa.org.
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Peter Gelius Friedrich-Alexander-Universität, Germany
71
Dr. Peter Gelius is a lecturer and research associate at the Institute of Sport Science and Sport
(ISS) at Friedrich-Alexander University Erlangen-Nuremberg, Germany (FAU). He received his
education at FAU and at Duke University in Durham, NC, USA. He holds a Ph.D. in Political
Science from FAU. Since 2008, he has been part of the Division of Physical Activity and Public
Health (Prof. Dr. Alfred Rütten) at the ISS. Since 2014, he has also been a team member of the
WHO Collaborating Centre on Physical Activity and Public Health at the ISS. In 2014, he worked
as a consultant at the WHO Regional Office for Europe in Copenhagen, Denmark, supporting the
development of the WHO European Physical Activity Strategy.
His research interests include health promotion theory, physical activity policy at the
international, national, and local level, community-based approaches to physical activity
promotion, physical activity infrastructures, and sport facility development. He has been
involved in the scientific coordination of several multi-national research projects funded by the
European Commission, as well as in projects funded by the German Federal Government and
the Bavarian State Government. His recent co-authored international publications include
theoretical papers on the interplay of structure and agency in health promotion (SocSci&Med
2011, HPI forthcoming), a study on the implementation of the EU Physical Activity Guidelines in
the 28 Member States (European Commission 2016), an article on capacity building and
interactive knowledge-to-action in physical activity policy-making (HPI 2013), and a bibliography
on physical activity promotion (Oxford university Press, 2014).
Healthy ageing through empowerment of elders (HASIC). HASIC project (Healthy Ageing Supported by Internet and Community) aimed to empower older
people (65+) in Europe to adopt healthy lifestyles which include a healthy diet, physical activity,
moderate alcohol consumption and social participation. In addition, attention was paid to the
mental health of older people, such as prevention of loneliness and supporting of self-esteem.
Based on the results of the project it can be concluded that the objectives of HASIC project were
relevant across Europe and there definitely is a proven need for further development and updating
of preventative elderly care services. Knowledge about health and well-being of this special 65+
target group and practical tools for preventative work with older people are limited.
Empowerment and healthy lifestyles of older people were promoted in HASIC with different means.
Firstly, HASIC mentor education and toolkit was developed for elderly volunteers, professionals and
students. The aim of the education was to provide the target groups with the skills and knowledge
needed for the health promotion of elderly. Based on the experiences of the education carried out
in all seven partner countries HASIC toolkit was produced. The HASIC toolkit includes both
theoretical and evidence-based information about the holistic health of elderly as well as various
tools which can be used in practical health promotion work.
Secondly, peer group activities and peer group mentoring were developed. Peer group activities
were mainly targeted to older people in a risk of exclusion and health loss. Peer groups were
primarily led by educated 65+ voluntary mentors who have taken part in HASIC mentor training. If
needed professionals supported volunteer mentors. In the peer group sessions different aspects of
healthy lifestyle were discussed together based on the activities found in the HASIC toolkit.
Thirdly, online platform called Hasicplus was developed and piloted. Hasicplus offers several tools
for self-assessment and self-monitoring of the health for older people. It was developed and piloted
together with 65+ target group in order to guarantee maximal user-friendliness and usability in this
specific target group since their IT skills are often a bit more limited than the skills of the younger
generations. Hasicplus platform can be used both with PCs and mobile devices.
Finally, series of workshops were carried out among regional service providers. Workshops showed
that there is a wide variety of services available for older people in each country, but links between
different services are often weak. Availability of preventative services is limited although they are
very cost effective. Users also find services often old-fashioned.
HASIC project started in January 2014 and ended in June 2016. HASIC was co-funded by the EU
2nd Health Programme. Project was implemented in seven European countries: Finland, Norway,
Estonia, Spain, Germany, Hungary and the Netherlands. All project partners were higher education
institutions but in practice project was implemented in regional level by various municipalities and
NGOs. Coordinator of the project was Turku University of Applied Sciences in Finland.
72
Katariina Felixson Turku University for Applied Sciences, Finland
73
Katariina Felixson works as a research group leader and a lecturer in social services in Turku
University of Applied Sciences in Finland. Lately she has been active especially around the
themes of preventative elderly care and well-being of older people.
Over the years she has worked as a project manager in several EU funded projects. Currently she
is involved in SIPPE project (Promoting Social Inclusion of Elderly through Well-being Parties) co-
funded by the Central Baltic Programme 2014-2020 and implemented in Finland and Estonia. In
autumn 2016 she completed HASIC project (Healthy Ageing Supported by Internet and
Community) implemented in 2014-2016 in seven European countries and co-funded by 2nd
Health Programme.
Harnessing football passion towards adoption of healthy lifestyles (EuroFIT) The trial was conducted at 15 football clubs in Portugal, Norway, the Netherlands and UK
(England). In each club, 60--80 men, aged 30 to 65 years, with a self-reported BMI ≥27 kg/m2 was
recruited.
The EuroFIT programme is designed to support men to become more active, less sedentary,
improve their diet, and maintain these changes long term. It is delivered through twelve, weekly,
90-minute, group sessions delivered by club community coaching staff. They include classroom-
based learning activities and physical activity training using club facilities. The programme is
gender-sensitised in relation to context, content and style of delivery. In relation to context, delivery
through top professional football clubs aims to attract men by tapping into the powerful loyalty
and affiliation they feel towards the club they support and to engage them by appealing to their
existing identities as football fans. In relation to content, the men receive scientific information
delivered simply (“science but not rocket science”) and a “toolbox” of skills and behaviour change
techniques they can apply to make changes and maintain them long-term. The men also receive
a state-of-the-art self-monitoring device (the SitFIT) that allows them to self-monitor increases in
physical activity (through walking) and time spent standing in their daily lives. In relation to style of
delivery, the programme is designed to maximise the time spent in interaction with peers and
coaches on specific topics to encourage vicarious learning and mutual support. Clubs will also
organise a re-union session, which will take place at a time of the clubs’ choosing after the
programme has finished. Coaches are trained to provide a positive social environment that
supports men to make changes that suit them in the context of their own lives. Both intervention
and comparison group participants will receive an advice leaflet at baseline measurement.
Comparison group members will be offered the intervention after the trial.
Core messages of the presentation are;
• Club loyalty is a great attraction
• Men are interested in PA and losing weight – if presented in the right way and in the right
environment
• Results from the focus groups shows that they really liked the programme
74
Eivind Andersen Norwegian School of Sport Sciences, Norway
75
Eivind Andersen has a PhD from the Norwegian school of sport sciences, where he ran a
randomised controlled physical activity intervention on Pakistani immigrant men. Andersen has a
broad research interest and is, besides running EuroFIT in Norway, involved in projects on
preschool children, obese patients, immigrants and schizophrenic.
Cycling – a key approach to a more active lifestyle (LIFE CYCLE) The LIFE CYCLE project was launched and ran from 2008 – 2011 by the European Union’s Public
Health Programme. The aim of the project was to identify and test practical initiatives encouraging
uptake and maintenance of life-long cycling across all age groups. The idea was that people can
change their mobility behaviour, and adapt a healthier lifestyle, principally by cycling for transport.
A collection of successful concepts have been tested across Europe by the ten organisations
collaborating in the LIFE CYCLE project.
Mobility change opportunities – Opportunities to start/intensify bicycle use: Pregnancy and
following the birth of a child; Kindergarden and crèche first cycling; Primary school – cycling
licenses - Start of secondary school; Starting a family/joint household; Changing residence; Change
of employment; Retirement.
Pregnancy is a good entry point for bicycle related information. Young families are often think
about buying a/second or bigger) car to meet their changed mobility needs. At that time pre-birth
information about using a bicycle, cargo bike or bicycle trailer is essential. It turned out that
midwifes are the best providers of this information. At the same time it is possible to hand over
information about bicycle related children toys
Kindergarten and crèche – the magic moment of keeping the balance: To keep the balance on a
scooter or on a bike is a magic moment for children and their parents. It was a major aim to
convey the fun and joy that can be experienced whilst cycling to children all over Europe. Rather
than focusing on the safety issues the program consisted of many elements that focused on the
positive emotions associated with cycling. (Cycle stories, “I-can cycle” certificate, Scooters and
run-bikes for kindergartens, awards for kids brought by bike to the kindergarten)
Primary school – cycling licenses – gain independent mobility: Some countries, such as Austria and
Hungary, have programmes that award “cycling licenses” to children who can demonstrate their
ability to cycle safely in road traffic. This creates opportunities to further bond children with cycling
and helps to reduce the number of car journeys to-and from schools that would otherwise be
made by parents. Most important is to offer the children a training programme that helps them to
learn to cycle in the real traffic situation.
Retirement as game changer towards cycling: People’s lives change significantly at the point of
retirement, as mobility patterns connected to work are replaced by those connected to leisure and
social engagement. In addition, the awareness for a healthy lifestyle and a dynamic appearance
is high this provides opportunities to promote sustainable forms of transport such as cycling with and
without electric support . Cycling can also be positioned as beneficial for increasing social contact
in ways that cannot be accomplished by driving cars.
76
Karl Reiter Austrian Mobility Research Institute, Austria
77
Founder of Austrian Mobility Research (FGMAMOR)
Researcher, trainer, presenter and project creator in the field of sustainable mobility and liveable
public space.
Specialities: active mobility, awareness raising, sustainable transport socialisation, transport and
health, emission free logistics, cycling policy and planning
Engaged in European projects like: BAMBINI- Moving smart from the start, TRENDY-TRAVEL, Active
Access, BICY, LifeCycle, BIKE2WORK, BYPAD-BicyclePolicyAudit, CycleLogistics
How people empowerment contributes to their health and wellbeing - The Credits System (C4H) Quattrini S.1, Brandi ML., Dep. of Surgery and Translational Medicine – University of Florence, Italy
The world’s health is undergoing an unprecedented transition on several fronts, particularly
concerning epidemiological, nutritional and demographic issues. Many researches confirm the
looming pandemic of Non Communicable and Chronic Diseases, which represent the worldwide
major cause of death.
“Credits for Health” (C4H) is a social innovation and health promotion project, intended to fight the
increasing prevalence of lifestyle-related diseases through an innovative multi-stakeholder
approach based on people empowerment. It is funded by the European Commission under
the FP7 Framework Programme (Grant agreement number: 602386) and run by a Consortium
consisting of national and local government bodies, enterprises, non-profit organizations,
universities and research centres. The project aimed at designing, developing, and testing a
preventive healthcare system consisting in an ICT (Information Communication Technology)
Platform, developed in order to stimulate people to become more physically active and follow a
Mediterranean diet, in the frame of participation to social life.
The main aims pursued are the follows: Reduce sedentary behaviours. Enhance the level of
physical activity. Foster the adoption of healthy dietary styles in people living in the Euro-
Mediterranean Countries. C4H aim was to gently support people to pursue a healthy lifestyle: make
people's lives healthier, preserving the liberty to choose what one likes (the so called “Libertarian
Paternalism”). This model have been tested in three European countries (Italy, Spain, Greece) on
about 2700 healthy subjects in a phased approach to gradually test each component (3 Pilot
studies; the last one an RCT study).
From the three Pilot studies it’s emerged that the system is really efficient in stimulating healthy
dietary habits and in enhancing the level of physical activity: socio-psychological assessments,
nutritional questionnaire, physical activity questionnaire and anthropometric measurements have
been evaluated before and after the intervention period and demonstrated a significant
improvement in the attitude to healthy behaviours, in the dietary habits and in the increase of
exercise, respectively. In conclusion, we can say that an ICT Platform is useful to stimulate people
to:
• Enhance people engagement and motivation in improving lifestyle and adopting an healthy
behaviour.
• Plan daily physical activities and self-monitor both nutritional habits and exercise (through
dietary and physical activity diaries).
• Reinforce people motivation through an incentive system and a community where sharing
common experiences and issues.78
Maria Luisa Brandi University of Florence, Italy
79
Full Professor of Endocrinology, University of Florence, Medical School, Florence, Italy
Education/Training Positions: MD, University of Florence, Florence, Italy, 1977; School of
Specialization in Endocrinology, University of Florence Hospital, 1977-1980; National Institutes of
Health (NIH) Visiting Scientist in Metabolic Diseases, Metabolic Diseases Branch, NIH, Bethesda,
Maryland, USA, 1984-1990; Ph.D. in Cell Biology, University of Rome, 1988; Assistant, Associate and
Full Professor of Endocrinology, University of Florence, 1990-to present; Director, Regional Center
on Hereditary Endocrine Tumors, University Hospital of
Florence, 1998-to present; Director Clinical Unit on Metabolic Bone Disorders, University Hospital of
Florence, 2007-to present; Delegate, Italy/USA Academic Interactions, Florence University,
2000-2003; Director of the University Master on Metabolic Bone Disease: From the Gene to the
Cure, University of Florence, 2004-to present; Scientific Director, DeGene Spin-off, University of
Florence, 2005-2009; President, Fondazione Italiana Ricerca sulle Malattie dell’Osso (F.I.R.M.O.),
2006 - to present; Consultant for the Tuscany Region on Osteoporosis, 2008 - to present; Member
of the Commission for Osteoporosis of the Italian Ministry of Health, 2009 – 2011; Scientific Attaché
for the City of Florence 2015 - to present; Delegate of the Rector of the University of Florence for
Health Education in the City of Florence, 2016 – to present; Member Steering Committee of the
European Reference Centers Network on Rare Bone Diseases, 2016 to present.
Honors and Awards: Roussel Italia Award, 1988; The European Foundation Award, 1989; Schering
Award, Italian Endocrine Society, 1990; The Sandoz Foundation for Gerontological Research
Award, 1991; Helena Rubinstein Award “Women in Science”, 1998; Italian Endocrine Society
Senior Award, 2003; AILA Award, 2004, Pierre Delmas IOF/ESCEO Prize 2013; Top Italian Scientist,
2016.
Session 05: Research and Monitoring
80
Toolbox for development, evaluation and implementation of interventions aiming at improving lifestyle behaviours. (DEDIPAC). The Determinants of Diet and Physical Acticity Knowledge Hub (DEDIPAC KH) uses joint research programming and funding across different countries in Europe to work towards better research harmonisation and collaboration in the field of behavioural nutrition and physical activity research. Over the past two years, a DEDIPAC toolbox was devised for policy-makers, researchers and practitioners who want to develop, monitor and/or evaluate a policy or multicomponent intervention targeting physical activity, sedentary behaviour or dietary behaviour.
The Toolbox is now available, in a preliminary version, via https://www.dedipac.eu/toolbox/
The toolbox guides users through the process of developing a policy or multi-component intervention, includes guidelines and specific instruments to evaluate them, and contains supporting documents, instruments and tools necessary for the process of implementation and/or process evaluation. In addition, practical examples of policies and multi-component interventions are provided. The functionality of the toolbox has been pilot-tested in various natural experiments, devoted to the evaluation of policies to promote physical activity, healthy dietary behaviours and the reduction of sedentary behaviours.
82
Jeroen Lakerveld VU University Medical Center, The Netherlands
83
Dr. Jeroen Lakerveld is an epidemiologist and senior researcher with the Department of
Epidemiology and Biostatistics at the EMGO-VUmc, Amsterdam. He leads a small but ambitious
centre of expertise on environmental determinants of physical activity, dietary behaviours and
chronic disease risk in adults: 'the Upstream Team'. His research interests are in the individual and
environmental determinants of lifestyle behaviours and chronic disease risk, in particular how
they can be measured, how they interact and how they can be changed.
Jeroen succesfully coordinated the recently finished SPOTLIGHT project, an EU-FP7 funded
project focusing on the sustainable prevention of obesity through integrated strategies. Next to
other projects, he co-manages the Determinants of Diet and Physical Activity Knowledge Hub
(DEDIPAC KH). The DEDIPAC KH currently involves over 300 researchers from 46 consortia across
12 EU member states. DEDIPAC facilitates the integration and development of an infrastructure
for research on determinants of diet and physical activity.
Measuring the economic impact of policies/interventions – importance of the harmonisation of methods (EConDA) The EConDA project showed how primary prevention is the key to a healthy future.
The project, which lasted 2.5 years, showed how ‘upstream’ prevention interventions focusing on
reducing people’s exposure to risk factors before a chronic disease has occurred is generally more
cost-effective in terms of healthcare savings – including social care, welfare costs and losses in
productivity - than treating an individual for a chronic condition. Chronic diseases are the first
cause of mortality in Europe, causing the death of 9 out of 10 citizens. They also represent a major
economic burden with a total estimated cost the EU economy of € 700 billion annually.
According to EConDA, obesity rates will be increasing across Europe and in all social groups, with
better educated people projected to be less obese than those with lower education levels. This will
have an important impact on health inequalities, with the less educated being subject to a greater
burden of obesity-related chronic diseases such as type 2 diabetes. Portugal represents an
interesting exception to this trend, as the social gradient is predicted to reverse by 2050, with the
more educated men and women projected to be more obese or overweight than those with lower
education levels. A similar pattern in the future is predicted for obesity in the Netherlands. More
encouragingly, by 2050, smoking prevalence is forecast to decrease largely as a result of important
policy measures such as tobacco taxation and bans on smoking in public places. Provided that
these and other policies are maintained to prevent take up of smoking and help existing smokers to
give up, this downward trend is set to continue.
A user-friendly tool has been developed for researchers and policy makers to test the impact of
interventions which aim to reduce obesity and smoking on the future burden of chronic diseases.
This tool can be downloaded here: http://econdaproject.eu/tools.php
The consortium included partners from 8 European countries: UK Health Forum (Project Leader),
European Heart Network (Belgium), European Society of Cardiology (France), Health Equalities
Group (UK), International Diabetes Federation Europe (Belgium), Lithuanian University of Health
Sciences (Lithuania), National Instute of Health Doutor Ricardo Jorge, IP (Portugal), University of
Groningen (Netherlands). Collaborating Partners: World Health Organization, Organisation of
Economic Cooperation and Development, European Society for Medical Oncology (Switzerland),
European Cancer Organisation (Belgium), European Respiratory Society (Belgium), European
Kidney Health Alliance (Belgium), European Association for the Study of the Liver (Switzerland),
University of Helsinki (Finland), Foundation of European Nurses in Diabetes (UK).
This model aimed to show how the costs of chronic diseases in 8 EU countries will alter both currently
and into the future based on existing chronic disease trends.
84
Laura Webber UK Health Forum, London, UK
85
Laura joined the UK Health Forum public health modelling team in 2011 and is now director of
the team. She manages a multi-disciplinary team of epidemiologists, mathematicians, analysts
and computer programmers and coordinates global, European and national projects. Projects
include the European Commission funded project ‘EConDA’ (Economics of Chronic Diseases -
econdaproject.eu), the Trust For America’s Health funded project ‘F as in Fat’ modelling obesity
across each US state (http://healthyamericans.org/assets/files/TFAH2012FasInFatFnlRv.pdf), and
various projects for Public Health England. The team builds country-specific microsimulation
models to assess the future health impact of changing rates of risk factors on chronic disease,
analysing outputs and writing reports and papers for publication. Laura holds an MA (Hons) from
Cambridge University, and a PhD in childhood obesity from University College London. She is
honorary lecturer at the London School of Hygiene and Tropical Medicine within the Health
Protection Research Unit and has been an advisor to the World Health Organization and World
Bank. She is lead author and co-author on a number of peer-reviewed publications and major
reports and has recently co-authored the book ‘Stress-free feeding’. Laura was nominated for
the Young Investigator of the year at Europrevent, Amsterdam (2015).
Connecting transport and health – Promoting active mobility as a mean to improve health (PASTA) On behalf of the PASTA* consortium
In the urban mobility sector planning experts develop and implement measures to encourage
citizens to walk, bike or use public transport more often. The aims of increasing active mobility like
walking and cycling are to reduce consumption of space for motorized transport infrastructure,
energy use, air pollution and noise for the benefit of an improved walkability and quality of urban
life. At the same time, active mobility comes more and more into focus and gains interest of health
experts, as one opportunity to increase physical activity among citizens. Sedentary behavior and
physical inactivity raise chronic diseases in cities all over the world.
Only 1/3 of the European population is estimated to meet the minimum recommended levels of
physical activity by the WHO of 30 minutes of moderate-intensity activity 5 times per week. Active
mobility has a high potential to bring more physical activity into everyday life considering that we
spend on average 80 min per day in transit and 50% of all trips are shorter than 5 km. Improving
physical activity by active mobility serve goals of transport planners and health experts but requires
collaborations between the disciplines. PASTA “Physical activity through sustainable transport
approaches”, funded by the EC under the 7th framework programme, addresses and analyzes this
promising link between transport and health. It pursues an interdisciplinary approach involving
scientists and leading experts from a range of disciplines, including (among others) transport and
urban planning, public health, environmental sciences, climate change and energy, and transport
economics.
The approach of PASTA is a linkage of transport and health research in seven European case study
cities (Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich). The city framework as well
as transport and health policies are explored by means of workshops and interviews with
stakeholders and experts in each case study city. They were asked about measures to promote
active mobility in their cities, their enabling factors and barriers. Together with the interviews, city
indicators were collected to describe the cities. The centre of the PASTA project is a longitudinal
study among the general public in each case study city aiming for 2000 participants per city. A set
of online questionnaires incorporating gold standard approaches from the physical activity and
transport fields have been developed, piloted and are now deployed in each case study city. As
result of the project, good practice examples will be selected and HEAT, the health impact
assessment tool for walking and cycling will be improved.
* PASTA – Physical Activity through sustainable transport approaches. (2013 – 2017) ; Project funded by the EC under FP7-
HEALTH-2013-INNOVATION-1; Project team: BOKU, UZH, VITO, CREAL, TRIV, ICL, LBN, RSM, UOXF, DSHS Cologne, GÖG FP,
POLIS, ICLEI, WHO, TUD
86
Mailin Gaupp-Berghausen University of Natural Resources and Life Science, Austria
87
Mailin Gaupp-Berghausen (Dipl. Ing.) is Scientific Associate at the University of Natural Resources
and Life Sciences Vienna, Institute for Transport Studies since 2015. She made her master degree
in Environment and Bio Resources Management at BOKU Vienna (2014). Her research focuses on
travel behaviour, active mobility research and mobility management.
Currently she is working in the administration and management team of 2 European projects on
promoting active mobility (PASTA – Physical Activity through Sustainable Transport Approaches,
SWITCH – Encouraging a SWITCH from car-based to active mobility using personalised
information and communication technology approaches).
Effective integrated intervention approaches – factors associated with success and failure of interventions (SPOTLIGHT) Obesity is a major public health problem determined by individual-level factors as well as upstream
drivers in the physical and social environment. Community based health promotion interventions
are recommended to reduce obesity levels. But can we identify what works? And how? As part of
a study into obesity and obesogenic environments, a cross-European, EC funded collaboration
(SPOTLIGHT) investigated over 100 community projects and followed this up with three in-depth
studies, one each in the UK, Denmark, and the Netherlands.
The first lessons learnt from this study is that the projects could be effectively evaluated using a five-
category framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM).
Reach is the extent to which the target population took part in the intervention, while effectiveness
is the impact on the participants. Adoption refers to the extent to which the staff or target
institutions take up the intervention, and implementation the extent to which the intervention
components were delivered as intended. Maintenance refers to the extent to which the
intervention has become institutionalised (maintenance at the setting level), and the sustainability
of the health gains (maintenance at the individual level).
The findings of the qualitative evaluation on enhancing and impeding factors across the RE-AIM
domains echoed previous findings that projects should avoid being “top-down” by ensuring that all
participants (beneficiaries, staff, funders) are involved in the planning process when the project is
first mooted. This is often a problem, because there is usually no money to undertake this planning
until a project gets funded, but the funding is only provided after the project has been described
and the funding application submitted. A solution would be to encourage funders to offer two-
phase funding, with money available for the planning phase.
Lastly, complex community-based interventions can experience tensions between delivering a
high-quality, effective project in a short period of time on the one side, and achieving
engagement in the community and its organisations and leaders on the other. Funders should be
clear on their expectations for short-term process results and longer-term outcomes in terms of
engagement and empowerment in the community.
Details of nearly 100 initiatives across the European Union have been published as a map-based
interactive website. A briefing paper summarising the results of the wider SPOTLIGHT project can be
found here.
88
Jeroen Lakerveld VU University Medical Center, The Netherlands
89
Dr. Jeroen Lakerveld is an epidemiologist and senior researcher with the Department of
Epidemiology and Biostatistics at the EMGO-VUmc, Amsterdam. He leads a small but ambitious
centre of expertise on environmental determinants of physical activity, dietary behaviours and
chronic disease risk in adults: 'the Upstream Team'. His research interests are in the individual and
environmental determinants of lifestyle behaviours and chronic disease risk, in particular how
they can be measured, how they interact and how they can be changed.
Jeroen succesfully coordinated the recently finished SPOTLIGHT project, an EU-FP7 funded
project focusing on the sustainable prevention of obesity through integrated strategies. Next to
other projects, he co-manages the Determinants of Diet and Physical Activity Knowledge Hub
(DEDIPAC KH). The DEDIPAC KH currently involves over 300 researchers from 46 consortia across
12 EU member states. DEDIPAC facilitates the integration and development of an infrastructure
for research on determinants of diet and physical activity.
Session 06: Promoting supportive environments – to make the healthiest choice the easiest choice, supportive commuting systems and addressing
disadvantaged groups' particularities.
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Chair: Susanna Kugelberg WHO Regional Office for Europe, Copenhagen
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Susanna is a public health consultant to the WHO Regional Office for Europe, Nutrition, Physical
Activity and the Division of Noncommunicable diseases and the Lifecourse since 2013.
Her work as a consultant has included policy analysis related to on public health, governance
and stakeholder engagement, fundraising and project management, and a larger evaluation of
the WHO regional programmes from a gender, equity and rights perspective. She is partner in a
company to provide comprehensive public health analysis, covering data collection,
stakeholder engagement to web visualisation of results and analysis.
Occasionally, Susanna gives lectures on public health policy-making at Karolinska Institutet,
Stockholm. She holds a MSc in Political Science from Lund’s University and a PhD in Medical
Sciences from Karolinska Institutet, Sweden. Her previous work experience includes technical
work in the area of higher education and gender policy at UNESCO/HQ in Paris.
Providing tools to promote leisure-time physical activity - Planning, financing, building, and managing of local infrastructures for physical activity (IMPALA) The Situation: The promotion of health-enhancing physical activity (HEPA) through sport requires
action in several areas. One is the provision of safe and adequate infrastructures (e.g. parks,
walkways, recreational facilities) to ensure better access to HEPA and sport participation. Solving
these issues requires the involvement of multiple sectors (e.g. organized sport, public health, urban
planning, and education).
Challenges: Unfortunately, there is still a gap between high-level policy agendas for infrastructure
development and local HEPA and sport promotion. Inter-sector cooperation is also difficult,
especially between the sport and the public health sector, which have different priorities regarding
HEPA promotion. In order to resolve these differences and integrate decision-making, infrastructure
development should be located at the intersection of relevant sectors (e.g. sport, health, urban
planning, recreational management) and of governance levels (e.g. local, regional, national).
How the IMPALA guidelines can help: The IMPALA Guidelines provide a set of practical, policy-
oriented activities for national, regional and local organisations. They can be used to plan, build,
finance and manage infrastructures such as sports facilities, parks, green spaces, bike paths,
swimming pools and public beaches. Successful completion of IMPALA activities can result in
increased sport/HEPA offers and improved access to sport at the grassroots level. The Guidelines
are currently available in English, German, French, Czech, and Portuguese. A Dutch, Italian, and
Lithuanian version are currently under preparation.
The EU Council Recommendation on HEPA (2013) urges Member States to implement the
Guidelines and will monitor their progress in the next two years using a special Monitoring
Framework. Currently, a follow-up project to IMPALA (called IMAPAL.NET) provides assistance in six
Member States to foster the systematic implementation and dissemination of the Guidelines.
Stakeholders in these countries have developed national action plans, which help them comply
with the EU Council Recommendation and enable sports organisations to take a leading role in the
process.
Take away messages: (1) Developing infrastructures for leisure-time physical activity requires
collaboration between different sectors and levels. (2) The IMPALA guidelines are a hands-on step-
by-step guide to support local actors in the planning, building, managing and financing of HEPA-
promoting infrastructures. (3) Countries such as Austria, Finland, Germany, Italy, Lithuania and the
Netherlands have already developed national action plans to implement the European IMPALA
guidelines. Further information and guidelines download: http://impala-net.org/
92
Peter Gelius Friedrich-Alexander-Universität, Germany
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Dr. Peter Gelius is a lecturer and research associate at the Institute of Sport Science and Sport
(ISS) at Friedrich-Alexander University Erlangen-Nuremberg, Germany (FAU). He received his
education at FAU and at Duke University in Durham, NC, USA. He holds a Ph.D. in Political
Science from FAU. Since 2008, he has been part of the Division of Physical Activity and Public
Health (Prof. Dr. Alfred Rütten) at the ISS. Since 2014, he has also been a team member of the
WHO Collaborating Centre on Physical Activity and Public Health at the ISS. In 2014, he worked
as a consultant at the WHO Regional Office for Europe in Copenhagen, Denmark, supporting the
development of the WHO European Physical Activity Strategy.
His research interests include health promotion theory, physical activity policy at the
international, national, and local level, community-based approaches to physical activity
promotion, physical activity infrastructures, and sport facility development. He has been
involved in the scientific coordination of several multi-national research projects funded by the
European Commission, as well as in projects funded by the German Federal Government and
the Bavarian State Government. His recent co-authored international publications include
theoretical papers on the interplay of structure and agency in health promotion (SocSci&Med
2011, HPI forthcoming), a study on the implementation of the EU Physical Activity Guidelines in
the 28 Member States (European Commission 2016), an article on capacity building and
interactive knowledge-to-action in physical activity policy-making (HPI 2013), and a bibliography
on physical activity promotion (Oxford university Press, 2014).
Improving eating choices of employees during their working day (FOOD) The European FOOD -Fighting Obesity through Offer and Demand- programme was created as a
project in 2009 with the co-funding of the EU Health Programme, to promote healthy eating habits
during the working day. Benefiting from the unique network of meal vouchers used by millions of
worker each day, messages and actions could be led towards two complementary target groups:
workers and restaurants.
By working in parallel with these two groups, a coherent and effective project could take place,
following a five- step methodology. Workers were reached during their office hours with the support
of their company and restaurants were reached in order to help them offer healthier meals at
lunch time. The demand and offer sides were then reconnected.
Most of the 28-month project were dedicated to understand the habits and knowledge of the
target groups in order for the partners to generate adapted recommendations. They had to be
simple, ready to apply but at the same time ambitious enough. Several recommendations could
be common to the six countries, enhancing the European added value of the project. They all
reached 4,2 million workers and 352.000 restaurants through national communication campaigns. A
strong evaluation followed, enabling the adaptation of the messages and communication tools
and then a stronger dissemination.
Despite the end of the EU funding in April 2011, the partners decided to take advantage of the
actions and results and continued under a long-term programme. The health Ministries in Slovakia,
Portugal and recently Austria joined the Consortium. Each new country applied the same five-step
methodology and created a dedicated network of FOOD restaurants where employees can have
access to healthy options.
In 2016, 380 communication tools reached 4,7 million employees, 200.000 companies and 480.000
restaurants in the 9 participating countries and the FOOD network numbers more than 4.800
restaurants.
The FOOD barometers: As part of the evaluation of the programme, European barometers have
been launched every year since 2012 in order to understand and analyse needs of employees and
restaurants. In 2016, eight countries participated (Austria, Belgium, Czech Republic, France, Italy,
Portugal, Slovak Republic and Spain) with 11.749 workers and 1.526 restaurants’ owners answering
the questionnaires.
In 2016, close to 80% of employees considered the nutritional quality of their lunch as important or
very important. This figure rose by 8 points of percentage since 2012. Regarding what workers will
choose as a meal, the balance of the dish has been the second most selected criterion since 2013.
Concurrently, the percentage of restaurants’ owners noticing an increase in the demand for
balanced meals has more than doubled, going from only 17% in 2012 to 36% in 2016.
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Nolwenn Bertrand Edenreed, Belgium
Giuseppe Masanotti University of Perugia, Italy
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Nolwenn BERTRAND managed the EU FOOD programme for 7 years. As coordinator she ensured
the development of the actions and the annual evaluation as well as the relationship with all the
partners. She enabled the transition from a EU funded pilot project to a long-term programme
and extended it to new countries. Now, as Public Programme Manager, she is still supervising the
development of FOOD while developing new programmes worldwide.
She has a Master degree in History at La Sorbonne, Paris IV and a Master diploma in European
Affairs Management from South Bank University, London. Her first experience at UBIFRANCE
opened her carrier to the development of EU affairs and project management before starting as
European Affairs Developer at Edenred (formerly ACCOR Services).
amme for 7 years. As coordinator she ensured
valuation as well as the relationship with all the
Medical Doctor, Specialisation in Hygiene, Preventive Medicine and Public Health, PhD in Health Promotion and Education and expert in Occupational Health. Member of the Italian Society of Hygiene, Preventive Medicine and Public Health since 1998 and Member of the European Network for Workplace Health Promotion since 1999. Professor/researcher, Faculty of Medicine, University of Perugia since 2006. In 2008 head of the research group on health promotion in the workplace of the university of Perugia, today (2016) coordinator of the Experimental Center for Health Promotion and Education. Main research activity is in the field of public health, with a particular eye on promotion of health and safety in the workplace and health organization.
eventive Medicine and Public Health, PhD t i O ti l H lth M b f th
Coaching toolkit – enhancement of the young's health while addressing socially determined health inequalities (Health25) The project HEALTH25 – Promoting health among disadvantaged young people, has been carried
out in 5 European countries from 2011 to 2014. The aim of the project was therefore to help young
people (NEETs) attain a healthier lifestyle and, through sport among other things, to bring about
changes in behavioural patterns and an improvement of motivation as well as general health.
After almost 2 years of preparatory work To gain important information about the target group,
their expectations and subjective needs as well as possibilities for a health intervention, the project
partners began with the development of a health and training programme which was then piloted
and evaluated in all 5 partner countries.
The programme should be made up of 7 sessions with a duration of 1.5 hours per training session
with a combination of sports and learning activities on healthy lifestyles.
• Welcome and Introduction
• Goal Setting and Motivation
• Understanding the Principles of Healthy Eating
• Unterstanding the Principles of Physical Activity
• Understanding Tobacco
• Understanding Alcohol
• Reflecting on our Success
Results: As a result of the project, a document with guidelines for trainers was created, which looks
at promoting engagement, motivation and ensuring continuous participation in a health
programme.
The results of the pilot training sessions show that the NEET target group can be motivated to
participate in a health and education programme.
In several cases there were even measurable changes observed in the young people’s behavior
like they smoked less, ate more healthily, drank less alcohol or none at all and did more sports.
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Sylvia Schanner Berufliches Bildungs- und Rehabilitationszentrum Oesterreichs,
Austria
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Sylvia Schanner, project leader of the youth project “Productionsschool Kapfenberg” and
assistant in European project (specific with the target group youngsters and young adults)
Closing Session: Promotion of healthy diets and physical activity - The future
ahead
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Chair: Belina Rodrigues ICVS (Life and Health Sciences Research Institute), School of
Medicine, Braga, Portugal
99
Belina Rodrigues joined ICVS in September 2016 as a PhD student under the scope of the PANINI
training network. Working with the elderly has been one of her passions since the completion of
her Bachelor’s Degree in Dietetics and Nutrition. This interest was only strengthened through her
posts at Continuing Care Centres where she worked as a clinical dietitian. She holds a European
MSc in Food Science, Technology and Nutrition, during which she carried out a cross cultural
adaptation of a self-screening malnutrition tool for the Portuguese speaking community-dwelling
elders living in eastern and southern Massachusetts, USA.
Her interest in cross-border cooperation led her to gather international experience in institutions
such as the Food and Agriculture Organization of the United Nations (FAO) and Chafea
(Executive Agency of the European Commission).
Now, she will be focusing on the effects of nutrition on wellbeing and cognitive function in
ageing.
Keynote speech: From the past research to the future ahead The creation of public health policy and implementation of sound measures requires investigation
that can provide a reliable foundation for decision making. A public health system must be
adaptable to a population’s health needs and can only affect change when those involved at
every level, from policy-makers, health workers and educators, to those in research are able to be
proactive.
Epidemiological research has and remains an essential field. Population-based research projects
are an established way to afford knowledge to support a robust public health system. Monitoring
public health developments and the value of current prevention policies while contributing to the
identification of disease risk factors is the role of long-term epidemiological morbidity and mortality
studies.
Where past research in the field of public health can be defined by a period of regional or national
data collection, policies and analysis, the present sees a need for data compatibility at the
European and even global level alongside the ever-pressing demand for data analysis based
information. Compatible data allows for comparative studies to be conducted. This is instrumental
in countries being able to compare the health of their populations and health policies and their
implementation, in order to identify common risks, trends and importantly the development of
common policy measures.
In the future, specific fields of research will remain or rise in importance, for example, an already
identified area that will grow in relevance is to address differences in health, due to inequalities as
in access to medical care.
There is a current public health demand to prevent health conditions which lead to increased
morbidity and mortality among the rapidly increasing elderly population which will become more
and more urgent in the future. A contemporary pivotal research project example, utilising existing
studies to provide more broadly relevant data and analysis, is the Consortium on Health and
Ageing: Network of Cohorts in Europe and the United States (CHANCES). Data for the incidence of
such conditions exist in cohort studies worldwide which, however, differ in various aspects. The
CHANCES project harmonized data from existing major longitudinal studies for the elderly. Different
research hypotheses are investigated with meta-analyses. The results which are or will be produced
can help international organizations, governments, and policy-makers to better understand the
broader implications and consequences of ageing and thus make informed decisions.
Just as with the CHANCES project where we see the innovative harmonization of past localized
research, future research projects will ideally use the knowledge gained to move towards
standardized data collection with the ultimate goal of providing current and relevant data.
100
Antonia Trichopoulou World Health Organization Collaborating Centre of Nutrition,
Medical School, University of Athens
101
Antonia Trichopoulou, MD, PhD, is President of the Hellenic Health Foundation, Director of the
World Health Organization Collaborating Centre of Nutrition, Medical School, University of Athens
and Professor Emeritus, School of Medicine, University of Athens. She has served as president of
the Federation of the European Nutrition Societies (FENS) and as chairperson or key member of
numerous Greek, European Commission and World Health Organization Committees. She has
received numerous honors and awards and was decorated by the President of the Greek
Republic with the Golden Cross of Honor for her work in nutrition and public health. In 2011, she
received the Federation of European Nutrition Societies (FENS) Award for her “outstanding
nutritionist career”.
Her scientific work has focused on public health nutrition and nutrition epidemiology, with
emphasis on the health effects of the Mediterranean diet and traditional foods.
Antonia Trichopoulou has been included in the 2014 Thomson Reuters list of the Highly Cited
Researchers in the field of Social Sciences, General.
Keynote speech: Childhood obesity in Europe – upstream prevention and the role of the information systems. Actions to address the issues of childhood obesity and overweight are rightly, and sadly, a priority
across Europe. However, good public health practice seeks to achieve prevention, and one
means is by addressing and counterbalancing the causes of a problem. With regard to obesity,
this includes tackling the behaviours that contribute to the gaining of excess weight prior to this
occurring.
One project which sought to address this was funded by the EU Public Health Programme, and led
from the Technical University of Dresden. It identified that patterns of nutrition (calorie input) and
physical exercise (calorie burn-off) were two sets of contributors. Initially focussed on adult
obesogenic behaviour, the project then moved on to consider the separate factors for children.
A set of indicators was devised for each stage of the child lifecourse, since issues for infants are very
different from those for adolescents. For each child lifecourse stage, four groups of indicators were
identified through systematic review of the scientific literature:
Nutrition behaviour: (1) Population behaviour statistical measures; (2) Policy indicators
Exercise behaviour: (1) Population behaviour statistical measures; (2) Policy indicators
For each of these measures potential sources of comparable data were identified, then the
availability of that data in each EU Member State.
A framework, with demonstrated feasibility, was thus provided and formed the focus of the report
to the Commission:
Denise Alexander, Michael Rigby, Rosa Guiseppa Frazzica, Michael Sjöström, Christiane Hillger, Grit
Neumann, Wilhelm Kirch (Editors). Challenges and Findings in Measuring the Behavioural
Determinants of Obesity in Children in Europe; Keele and Dresden Universities, 2007, 2 volumes.
Vol 1 The Challenge; Vol 2 Available Information Sources
Additionally, a publicly available book was produced:
Alexander D, Rigby M, Sjöström M, Frazzica RG, Hillger C, Neumann G, Kirch W (Editors).
Challenges and Findings in Measuring the Behavioural Determinants of Obesity in Children in
Europe; Huber, Bern, 2010, ISBN 978-3-456-84864-8, 250pp.
The research process, and the resultant monitoring framework for upstream indicators, will be
outlined in the presentation.
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Michael Rigby Imperial College London and Dublin City University, Ireland
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Professor Michael Rigby is Emeritus Professor of Health Information Strategy at Keele University,
and Visiting Professor in the Section of Paediatrics in Imperial College London. He is Deputy
Leader of the Horizon 2020 funded project Models of Child Health Appraised (MOCHA) -
www.childhealthservicemodels.eu, which seeks to identify best models of delivery of primary
care to children in all EU and EEA states. He now lives in Ireland, where he is Adjunct Professor at
Dublin City University.
Michael Rigby's initial career was in researching community health service needs in England,
from which he progressed to health service planning in the NHS. He became Regional Service
Planning Officer for the then Mersey Region of the NHS. he then moved to Keele Uni9veristy to
research and teach health service management, particularly focussing on information, service
quality, and child health. Within the EU Public Health Programme project to assess Behavioural
Determinants of Obesity, organised by the Technical University of Dresden, he led the
component on children. Earlier, he designed and led the Child Health Indicators of Life and
Development (CHILD) project. He is now an expert adviser and reviewer for a number of bodies
including CHAFEA.
Cluster Meeting
NUTRITION AND PHYSICAL ACTIVITY: HOW EUROPEAN UNION CONTRIBUTES TO PUBLIC HEALTH PRIORITIES INCLUDING OBESITY
30 November - 2 December 2016, Budapest
In Europe, six of the seven biggest risk factors for premature death are directly linked to how we eat, drink and move. Moreover, rising of overweight and obesity across Europe is a great concern and can contribute to or aggravate many chronic diseases, including type 2 diabetes, hyper-tension, heart disease, stroke, and some cancers. To tackle this problem actions are needed at national level, but also at European level. More than 20 pan-European actions have been co-
nd and 3rd EU Health Programmes with the aims to exchange best practices, to develop recommendations, and to improve standardized methods of data collection. The European Commission’s Consumers, Health, Agriculture and Food Executive Agency (Chafea1) is monitoring the progress of these actions and is promoting the obtained results.
From 30 November to 2 December 2016, the European Commission (Chafea and DG SANTE) organises, with the support of the Hungarian Ministry of the Human Capacities, a meeting to
the community in general. In addition to interested participants and National and European policy makers, this meeting will be gathering journalists from all Members States.
Presentations will be given by the EU project leaders, representatives of World Health Organi-
perfect occasion to know more about concrete actions taken to tackle unhealthy lifestyles at the European and national levels. Journalists will have the opportunity to exchange ideas with health professionals, social workers, citizens and other fellow colleagues, who daily work on counteracting unhealthy lifestyles. It is also the chance to clarify common wrong beliefs and
For more information, contact Dirk MEUSEL ([email protected]) and/or Abigail MORENO GINÉS ([email protected]).
1 http://ec.europa.eu/chafea/
