Fight against obesity
17-10-2007 (updated: 16-07-2014 )
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This article is part of our special report Food & Responsible Marketing.
Sedentary modern lifestyles and over-eating have raised obesity to the number one public health challenge of the 21st century, with rapidly increasing childhood obesity of particular concern to western nations. The Commission has given the food industry and advertising sector until 2010 to clean up its act.
According to the World Health Organization (WHO), the prevalence of obesity has more than trebled in many European countries since the 1980s. People consume more calories per day, in particular from fat, whereas their physical activity levels have gone down. According to a recent Eurobarometer survey on Europeans' physical-activity habits, only 15% are active in sports and an average EU citizen spends more than six hours per day seated.
Child obesity is of particular concern as eating habits and levels of physical exercise are often adopted very early and tend to persist throughout life. Therefore, obese young tend to become obese adults, with all the health risks this condition represents: heart disease, type-two diabetes, hypertension, strokes and certain types of cancer. According to the Commission, some 3,000,000 European schoolchildren are obese and some 85,000 more children become obese every year. Obesity-related illnesses are estimated to account for as much as 7% of total healthcare costs in the EU.
To tackle what it called an 'epidemic', the European Commission set up an EU platform for action on diet, physical activity and health. Since March 2005, the platform brings together industry, consumer groups and health experts to find ways to combat obesity. Its emphasis is on self-regulation and voluntary commitments from stakeholders (food industry, health NGOs).
In December 2005, the Commission put forward a Green Paper on obesity, inviting stakeholders from the business world, academics and NGOs to put forward policy recommendations.
In the World Health Organisation (WHO) European Ministerial conference on counteracting obesity in November 2006, the health ministers signed the European Charter pledging to place obesity high up on the European public health and political agendas and to halt the rise in obesity by 2015.
The Commission adopted a White Paper on a Strategy for Europe on Nutrition, Overweight and Obesity related health issues on 30 May 2007. The strategy aims to set out an integrated EU approach to contribute to reducing ill health due to poor nutrition and obesity and sets the development of effective cross-sectoral action-orientated partnerships at all levels as the cornerstone of Europe's response to tackling obesity and its related health problems. These would involve private actors and public health and consumer organisations.
The White Paper focuses on actions that can be taken at EU level:
Better information for consumers
The Commission is currently carrying out a review of nutrition labelling legislation. The new rules are set to address issues such as what is mandatory or voluntary information, how much information should be provided and where labels should be placed. In this regard, the food industry would like to see labelling based on estimates of the average daily nutrition requirements of healthy adults whereas some health and consumer organisations would prefer a colour-coded traffic-light systems indicating products high in salt, sugar and fat.
The new EU regulation on nutrition and health claims made on foods aims to ensure that the claims are based on reliable scientific evidence, so that consumers are not misled by inaccurate or confusing claims.
Evidence shows that advertising and marketing of foods influence, in particular, children's' diet, and in particular those of children. Following an Advertising Round Table exploring both law and self-regulation on the issue a best practice model for self-regulation was published, but the Commission is still urging the private sector to develop even stronger advertising codes.
Enabling healthy choice
Ensuring that healthy options are made available to consumers is considered equally important. With this regard, the Commission aims, with the Common Agricultural Policy (CAP) to boost Europeans' decreasing consumption of fruits and vegetables (F&V), and in particular to promote children's consumption of F&V by allowing surplus production to be distributed to educational institutions and children's holiday centres.
The EU executive is also encouraging food and retailing industry to reformulate the composition of manufactured foods, for example in terms of their levels of fat, saturated and trans-fats, salt and sugar.
At the end of 2006 Latvia became the first EU country to ban the sale of soft drinks, candy bars and potato chips in schools and kindergartens. The prohibited products will be replaced with "healthy alternatives" such as dried fruit, unsalted nuts, unsweetened fruit juice, wholegrain snacks, mineral water and milk. In a similar trend, French authorities are removing vending machines from their schools.
Encouraging physical activity
The Commission strategy highlights the importance of developing physical and social environments that are conducive to physical activity and encourage increase in individuals' daily exercise. The positive role of active commuting, travelling to and from work by walking, cycling or in any other active way, is also put forward, as well as the need to encourage sport organisations to develop advertising and marketing campaigns to encourage physical activity focusing in particular on children.
The Commission will present, in July 2007 a White Paper on Sport putting forward proposals to boost EU citizens' participation in sport and to extend the sport movement to include physical activity more generally.
"What consumers eat is up to them, but they should be able to make informed choices, and have a range of healthy options to choose from. That is why the Commission is reviewing the options for nutrition labelling, and calling on industry to advertise responsibly and reduce levels of salt, fats and sugar in food products," said Health Commissioner Markos Kyprianou.
However, "given the urgency of the matter, it is better to try with self-regulation at first and see, in 2010, if there's a need for legislation" said Kyprianou, arguing that "offering industry these two and half years", after which member states could decide to legislate, represented a "great incentive for industry to co-operate on the obesity problem", added Kyprianou.
The obesity phenomenon could in 10-20 years time undermine the central assumption about our demography , which is that we're all going to go on living longer and healthier lives," said Robert Madelin, director-general of the Commission's DG Sanco. "The situation is already very bad in the Mediterranean countries, where adolescent obesity rates now reach over 30% in Greece and Italy. The worst 'performing' countries in Europe, the UK and Poland, are now catching up with the United States," he added.
Health commissioner spokesman Philip Tod added: "A recent Eurobarometer survey reveals that consumers are, when it comes to food, less concerned about health than pleasure and taste and think that 'healthy food is dull'. The Commission is not saying that there are good and bad foods. Our aim is to communicate on healthy and unhealthy lifestyles."
In a non-binding report the European Parliament has highlighted schools' role in the fight against obesity and has called for the condition to be regarded as a political priority for the EU. It also urged local authorities to consider "the promotion of a healthy and active lifestyle when planning the location of schools" and urged member states to ensure sufficient sports and physical-activity facilities at school.
Confederation of the Food and Drink Industries of the European Union (CIAA) President Jean Martin said: "Food and drink industries are increasingly blamed for growing obesity in our societies, especially for childhood obesity, and many say that only new legislation on food and drink industry will help to fight obesity. I say that industry self-regulation, with strict monitoring, is the key. It is far faster and more effective. Just think of the EU nutrition-labelling Directive, which is on the EU table since 2003 and might finally be in place in 2007 - we, the industry, decided on and introduced changes to our labelling in only six months."
The association of television and radio sales houses (EGTA) has welcomed the strategy set out in the White Paper and the fact that "the Commission recognises the added value of and supports advertising self-regulation. When acknowledging that the individual is ultimately responsible for his or her lifestyle and that advertising and marketing are only wider information elements that shape an environment in which consumers take individual decisions, the European Commission is moving away from simplistic and ineffective additional restrictions to advertising of food products."
According to EuroCommerce: "The commerce sector is pleased to see that the White Paper acknowledges the effectiveness of multi-stakeholder approaches to fight against obesity. Voluntary initiatives are recognised as important tools to promote healthy lifestyles. EuroCommerce welcomes the fact that the Commission will give these time to produce results before proposing any new legislation."
"EuroCommerce members are confident that voluntary initiatives are more effective and tailor-made to help consumers understand the benefit of both good diets and healthy lifestyles."
The European Consumers' Organisation (BEUC) qualifies the strategy as "a disappointing, unambitious and minimalist response to the problems of obesity- and diet-related diseases that the White Paper itself identifies. BEUC has always highlighted the need to restrict marketing to children of foods high in fat, sugar and salt. On advertising of food for children the White Paper talks vaguely about partnerships and voluntary measures, with a review in 2010 – by which time there will be a new Commission."
"Reading the White Paper, it seems that Commissioner Kyprianou and the Barroso Commission have already decided to leave much of the work to their successors – who will no doubt themselves wish to 'review the situation' before deciding what to do," said BEUC Director Jim Murray, urging the Commission to do "much more before they go" and to at least to bring forward a "robust proposal for simplified nutritional labelling".
Sue Davies, principal food-policy adviser for British consumer association WHICH? said: "There are many areas in which we think that action is still needed, such as food labelling, where we are sceptical about industry being able to do that entirely, unless we see a big change, and legislation is required to bring that into an effect. We want the introduction of simple 'traffic lights' on the front of packages. Research shows that this is the most useful format for consumers."
"Another issue is advertising to children. We have heard that industry is moving on this, but we see that we're nowhere near of the kind of action that we think needs to be taken. We want the marketing of unhealthy foods (high in fat, sugar or salt) to children to be stopped. You can never get children to think positively about healthy food if they are continuously bombarded with unhealthy food adverts."
Euro Coop, the European Community of consumer co-operatives, was "expecting concrete measures from EU decision-makers, instead of what very much looks like procrastination". Euro Coop welcomes the White Paper's support and recognition of the obesity platform's achievements, but thinks that "with its disproportionate focus on self-regulation, the White Paper fails to strike the right balance between voluntary and regulatory proposals". The group added that education about the benefits of a balanced diet, coupled with physical exercise, should begin at a very early age.
The Standing Committee of European Doctors (CPME) considers children and young people to be the most important single target group to address in the struggle against obesity in Europe, as behavioural patterns established in childhood and adolescence often remain in adult life. Therefore, the Committee proposes "to stimulate school canteens to serve healthy food and beverages at reasonable prices and to reduce the amount of unhealthy food available as schools are important areas for teaching good nutritional habits". Further, "all pupils in schools should have at least one hour of physical activity a day (with a wide range of alternative activities) and schools should provide cooking education".
Michael Trinker, of the EU-Office of German Sports said: "It is crucial that all parties involved in the fight against obesity bring forward the same message: a message on the importance of balance between intake and physical activity. ie sport organisations refer to healthy nutrition and the food industry communicated the importance of being physically active."
"Markets should go before mandates and the invisible hand of markets [industry self-regulation] should be privileged to the heavy hand of governments," outlined the deputy secretary of the US Department of health and human services, Alex Azar, the American view on the issue and emphasised the importance of providing more info on healthy diets to the consumers so that they can make informed choices. Further, "there also needs to be a business case for healthy food" he added, meaning that healthy food will be produced if there is a market demand for it.
To read stakeholder reactions to the Commission's green paper on obesity, click here.
May 2006: First EU-US conference on obesity.
Nov 2006: World Health Organization (WHO) European Ministerial conference on counteracting obesity - signing of a European Charter on counteracting obesity.
22-25 April 2007: 15th European Congress on Obesity (yearly congress providing an international platform for discussion on the latest developments on science of obesity).
30 May 2007: Commission adopts White Paper on 'A Strategy for Europe on Nutrition, Overweight and Obesity related health issues', outlining self-regulatory measures for food industry.
June 2007: 3rd Annual Obesity Europe conference.
1 July 2007: The new regulation on health claims made on food entered into force.
11 July 2007: The Commission presented a White Paper on sport.
Autumn 2007: Establishment of a High-Level Group on nutrition, overweight and obesity related health issues to liaise the obesity platform at member state level to ensure exchange of best practice.
Autumn 2007: Joint Commission-UEFA campaign on physical activity.
18 Oct 2007: 1st European Parliamentary Symposium on Diet and Health.
23-24 Oct 2007: Annual food industry event, Healthy Foods European Summit.
27 May 2008: The Parliament's public health committee adopted a report on the White Paper on Nutrition, Overweight and Obesity.
2 Sept. 2008: Parliament plenary vote on the White Paper.
2008: Commission will initiate a study to explore the potential for the reformulation of foods to reduce the levels of nutrients that contribute to the development of chronic diseases.
2010: First review of the progress made in implementing the obesity White Paper. Legislative measures could follow if progress is deemed insufficient.
EU official documents
Commission White Paper:A Strategy for Europe on Nutrition, Overweight and Obesity related health issues(30 May 2007) [FR] [FR] [DE]
Commission:Impact Assessment prepared for the White Paper "A Strategy for Europe on Nutrition, Overweight and Obesity related health issues" summary of the impact assessment
Commission:Report on Contributions to Green Paper(October 2006) [individual contributions]
PreLex:Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases [FR] [FR] [DE]
Commission:Physical Activity and Health - EU Platform for Action
Physical Activity and Health - EU Platform for Action:Charter
Physical Activity and Health - EU Platform for Action:Commitments 2007(14 March 2007)
A report for the European Parliament:Current Situation and Prospects for Physical Education in the European Union(12 February 2007) [Multilingual executive summary]
Commission:Concrete projects against obesity(May 2006)
WHO European Ministerial Conference:European Charter on counteracting obesi(16 November 2006)
European Childhood Obesity Group (ECOG)
North American Association for the Study of Obesity (NAASO)
WHO - regional office for Europe:Obesity
WHO - regional office for EuropePhysical activity and health in Europe: evidence for action(15 November 2006)
International Obesity Task Force (IOTF)
French Health Ministry:Programme National Nutrition Santé (PNNS)
Sport England:Active People Survey(December 2006)
UK Department of Health:Forecasting Obesity to 2010(25 August 2006)
Ministère de la Jeunesse, des Sports et de la Vie associative:Le lancement d'une campagne nationale de promotion de l'activité physique et sportive(27 september 2006)
Ministère de la Jeunesse, des Sports et de la Vie associative:Le programme national de développement du sport 2006-2008(18 January 2006)
Germany:Health Prevention
WHO - regional office for Europe:Nutrition Policy Database containing data on nutrition policies, including policy documents, institutions for implementation and collaboration with stakeholders in WHO European Member States
Denmark:National Action Plan against obesity(2003)
Finland:Action Program for Implementing National Nutrition Recommendations(2003)
France:National Nutrition Health Program 2001-2005(2001)
Greece:Dietary guidelines for adults in Greece(2002)
Ireland:Obesity: The Policy Challenges(2005)
The Netherlands:Time to sport(2005)
Spain:Spanish Strategy for Nutrition, Physical Activity and Prevention of Obesity (NAOS)(2005)
Sweden:Background material to the Action Plan for healthy dietary habits and increased Physical Activity(2005)
The United Kingdom:Choosing Health? Choosing a Better Diet(2005)
EuroCommerce press release:Commerce welcomes the White Paper establishing an EU strategy to fight against obesity(30 May 2007)
EGTA - the association of television and radio sales houses press release:egta welcomes the European Commission's support of self-regulation in the area of advertising for food products(30 May 2007)
CIAA:Europe's food and drink industry marks two years of progress in the fight against obesity(19 April 2007)
Confederation of the food and drink industries of the European Union (CIAA):CIAA comments on the Green Paper on obesity(31 March 2006)
Pharmaceutical Group of the European Union (PGEU):PGEU submission to the Commission's Green Paper on obesity(17 March 2006)
Freshfel Europe - the forum for the fresh produce industry:Freshfel response to Green Paper on obesity
AMCHAM EU - American chamber of commerce to the EU:Position Paper on the Green Paper on Healthy Diets and Physical Activity(15 March 2006)
European Publishers Council (EPC):EPC Response to the Commission's Green Paper on "Promoting healthy diets and physical activity(14 March 2006)
Kfrat Foods:Europeans Slow to Move on Obesity Concerns - New Report Reveals Data on Attitudes to Controlling Obesity(February 2006)
World Federation of Advertisers:Responsible Advertising and Children (RAC) programme(2006)
Kraft Foods:Comments on the Green Paper "Promoting Healthy Diets and Physical Activity":(15 March 2006)
NGOs and Think-Tanks
BEUC press release:Nutrtion - The White Paper is like many slimming regimes – built on false hopes and unrealistic expectations(30 May 2007)
European Association of Consumer Cooperatives EuroCoop press release:White Paper On nutrition: A Missed Opportunity(30 May 2007)
European Heart Network (EHN):Policy options to prevent child obesity - Stakeholder consultations carried out in the context of the project on "Children, obesity and associated avoidable chronic diseases"(October 2006)
European Public Health Alliance (EPHA):Report Highlights Cost Factors in Choosing Healthy Foods(31 July 2006)
European Consumers' Organisation (BEUC):BEUC's Response to the Commission's Green Paper on obesity(16 March 2006)
EURO COOP - the European Community of Consumer Co-operatives:EURO COOP response to the Commission's Green Paper on obesity(13 March 2006)
Standing Committee of European Doctors (CPME):CPME contribution to the Commission's Green Paper on obesity(11 March 2006)
European Men's Health Forum (EMHF):Tackling overweight and obesity in men in Europe(March 2006)
Think tanks & Academia
European Association for the Study of Obesity (EASO):EASO Obesity Management Task Force 2007 Survey Highlights(22 April 2007)
University of Liverpool press release:TV food adverts increase obese children's appetite by 134%(24 April 2007)
European Association for the Study of Obesity (EASO) [members] [members] [publications]
International Association for the Study of Obesity (IASO)
Non-assigned links
Commission - public health portal:Nutrition
Commission - public health portal:Sports and leisure
Commission:Key documents on obesity
Eurobarometer:Health and food(9 November 2006) [FR] [FR] [DE]
Commission:Study on young people's lifestyles and sedentariness and the role of sport(October 2004)
Council:Conclusions on obesity, nutrition and physical activity(2 December 2003) [FR] [FR] [DE]
Eurobarometer:The citizens of the European Union and Sport(November 2004)
Commission:Health determinants - Lifestyle
Eurobarometer:Health, Food and Alcohol and Safety(December 2003)
Eurobarometer:Physical Activity(December 2003)