NUTRITION

CHALLENGES IN
EUROPE AND THE
POLICY RESPONSE
Francesco Branca
Regional Adviser
Nutrition and Food Security
Overweight in women (2000-2006)

≤25%
26-34.9%
35-44.9%
45-54.9%
55-64.9%
≥65%
No data
Source: WHO Regional Office for Europe, 2006.
Measured
 Trends of overweight
among school children
40 Denmark, 6-8 years
Denmark, 14-16 years
35
Prevalence of overweight (including obesity) (%) France, 5-12 years
France, 5-6 years
30 Germany, 5-10 years
Germany, 11-14 years
25 Germany, 5-6 years
both genders

Iceland, 9 years
20 Netherlands, 9 years
Spain, 6-7 years
15 Spain, 13-14 years
Sweden, 6-11 years

10 Sweden, 9-11 years

Switzerland, 6-12 years

5 UK, 5-10 years

UK, 4-11 years

0
UK, 11-12 years

1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Survey year Source: WHO Regional Office for Europe, 2006.

 Double burden of child malnutrition
25.0

Underweight Overweight

20.0
Percentage (%)

15.0

10.0

5.0

0.0

ia

ia
n

ia

n
an
ria

ia

n
ia

na
us

ne

n
ia

ia

o
ta

ja

ta
tio

ta

an
en

an
gr
on
at

rg

rb

st
vi
ar

ai
ga

ai
zs

is
is
ro

ne

lb
ra

om
eo

Se

go

kh
kr
ed
el

rb

jik
ek
ul

gy

A
C

de

te
B

U
G

za

ze
ac

ze
B

Ta
zb
yr

on
Fe
a

A
M

er
K

U
K

M
H

an
of

si
YR

an

us
TF

R
ni
os
B

Source: Adapted from Cattaneo A et al. Child nutrition in CEE and CIS countries: report of a situation analysis. Geneva,
UNICEF, 2007.
 Anaemia in Preschool Children

Category of public health significance

Normal (<5.0%)
Mild (5.0-19.9%)
Moderate (20.0-39.9%)
Source: de Benoist B et al. Worldwide prevalence of anaemia 1993-2005: WHO Global Database on Severe (≥40.0%)
Anaemia. Geneva, World Health Organization, 2007 (in press). No data
 Food safety problems

„ Microbiological, including zoonoses and

antibiotic resistance
„ Chemical
„ Radioactive isotopes
„ Risks from new production, packaging
and processing technologies
Positive developments, but
still far from targets
 Childhood obesity epidemic
levelling off in Sweden since 2000?

„ Göteborg : OW decreased in girls

„ Stockholm : OW + OB decreased in
girls and OB decreased in boys
„ Karlstad, Umeå, Västerås Ystad : OB
decreased in boys and girls

Source : Lissner et al., IJO 2007

 % Energy
Is

0
2
4
6
8
10
12
14
16
18
ra
Po It el
rt aly
u
Se ga
r l
Sp bia
Cr a
i
Nooat n
B rw ia
ul a
K P ga y
az o ri
ak lan a
Un hs d
ite G
G re tan
d e e
K o ce
i r
Li ngd gia
th o
u m
Fi an
G n l ia
er an
Hu ma d
Sl n g n y
ov ar
Ic en y
De ela ia
n n
Sw m a d
ed rk
Fr e
Be an n
B la ce
el ru
g
A iu s
higher than recommended

us m
tr
ia
Intake of saturated fatty acids is
 Supply of fruit and vegetables is below
the recommendations in many countries

>600g/person/day
<600g/person/day
Source: FAOSTAT 2003
Food safety : uneven progress

„ Improved situation in many EU

countries due to rigid regulation
„ Major food safety challenges in the
Balkan and CIS region
„ Foodborne diseases incompletely
reported
„ New threats will occur
The modern food system
„ Globalisation of food trade
„ Longer and more centralised food
chain
„ Concentration of food retail
„ Urban food deserts
„ Increased consumption of industrially
processed foods
„ Increased consumption of foods out-of-
home
 Diet is influenced by features of
supply and demand
SUPPLY DEMAND

Food production, Individual

processing and retail Agricultural policies
choices
distribution Trade and fiscal policies
Social policies Knowledge,
Price Urban planning policies attitudes,
Availability Consumer protection policies practices
Quality Educational policies
Income
Safety
The Revised Action Plan for
Food and Nutrition Policy
 Why a Revised Action Plan?

FOOD AND NUTRITION

„ The 2000 Action Plan ACTION PLANS IN THE WHO
promoted the development of EUROPEAN REGION

nutrition policies 100%

„ Nutrition policies are not fully 80%
implemented 60%

„ New challenges 40%

20%
„ New policy developments
0%
1994/95 1998/99 2005

Yes No
What is new in the Food and
Nutrition Action Plan 2007 ?

„ Common goals
„ Detailed action areas to influence
supply of food and consumers’
behaviours
„ International dimension and national
specificities
„ Implementation steps : actors,
partnerships, priorities
 Goals

„ Nutrition : saturated fat, trans fatty acids,

free sugars, fruit and vegetables, salt
„ Food safety :risk based and tailored
(salmonella, campylobacter, brucellosis)
„ Food security : reduce hunger (MDG)
 The development of the Action Plan
2005 2006
Outline 2 drafts Final draft
Member States Consultation, Copenhagen

57th Regional Committee, Belgrade

Ministerial Conference, Istanbul
2007

Counterparts meeting, Paris

Comments of
drafting group
2 Written
consultations

Oct Nov Jun Sep

 Challenges and action areas

HEALTH
CHALLENGES ACTION AREAS

Diet related 1. Supporting a healthy start

noncommunicable 2. Ensuring safe, healthy and
diseases sustainable food supply
3. Providing comprehensive
Obesity in children
information and education
and adolescents
to consumers
Micronutrient 4. Implementing integrated actions
deficiencies 5. Strengthening nutrition and
food safety in the health sector
Foodborne 6. Monitoring and evaluation
diseases
 Ensuring safe, healthy
and sustainable food supply
1. Improve the availability of fruit
and vegetables

2. Promote the reformulation of

mainstream food products

3. Promote appropriate
micronutrient fortification of
staple food items and develop
complementary foods with
adequate micronutrient content

4. Improve food supply and food

safety in public institutions
 Ensuring safe, healthy
and sustainable food supply
5. Ensure that the commercial offer of food
products is aligned to food-based dietary
guidelines

6. Explore the use of economic tools (taxes,

subsidies)

7. Establish targeted programmes for the

protection of vulnerable groups

8. Establish intersectoral food safety systems

with a farm to fork approach
Providing comprehensive information
and education to consumers
1. Develop food-based dietary
guidelines and food safety
guidelines, complemented
by physical activity
guidelines
2. Conduct public campaigns
aimed at informing
consumers
3. Ensure appropriate
marketing practices
4. Promote adequate labelling
of food products
 The actors

„ Governments
„ Civil society and professional networks
„ Economic operators
„ International actors
 Role of WHO

„ Promoting political commitment

„ Providing technical and policy support
„ Supporting and building capacity
„ Performing policy analysis
„ Generating evidence
„ Assessing trends in nutrition and food
safety
„ Reporting on implementation
 For more information
„ Nutrizione e sicurezza
alimentare
www.euro.who.int/nutrition

„ Obesità in Europa
www.euro.who.int/obesity

„ HEPA Europe
www.euro.who.int/hepa