Opinion of the Commission for Sustainable Development on A strategy for Europe on nutrition, overweight and obesity related health issues
Date: 2008-02-07
Institutions: European Committee of the Regions
Subjects: consumer information, health policy, nutritional disease, public awareness campaign, public health

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Official Journal of the European Union

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Opinion of the Commission for Sustainable Development on ‘A strategy for Europe on nutrition,
overweight and obesity related health issues’

(2008/C 105/08)

THE COMMITTEE OF THE REGIONS

— argues that tackling public health issues, particularly nutrition, overweight and obesity aspects, entails
the integration of policies across the board, from food and consumer affairs to sport, education and
transport, production and consumer affairs, with particular attention being focused on the social
aspect of the problem,

— believes that greater attention should focus on knowledge from the various national experiences, and
that this should be done at Community level. This would help to reduce the differences in working
approaches, and to create new instruments to tackle harmful lifestyles effectively,

— is convinced that promoting partnerships is the most effective way of resolving the problems of nutri-
tion, overweight and obesity, and that no single approach can possibly be sufficient. The only possible
way of preventing health problems — of which poor nutrition is the main cause — is for all stake-
holders, at international, national, regional and local levels, to take action,

— asks the European Commission,

to earmark specific
resources that can be used under the Structural Funds to achieve the aims described in the present
opinion,

financial programming period,

in its next

— recommends that the individual Member States and the regions undertake to protect their own citi-
zens from media messages, especially on television and radio, that advertise high fat- or sugar-content
foods. States and regions could, furthermore, impose high ‘advertising costs’, or even demand that the
labelling of certain products provide additional information on their possible harmful effects,

— supports stronger alliances between public bodies and external, non-health bodies involved in food

production (e.g. the farm sector) and distribution, with the accent on local operators.

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Rapporteur: Mr Mario MAGNANI, Vice-President of the Trentino-Alto Adige/Südtirol Regional Council

Reference document

White Paper on A Strategy for Europe on Nutrition, Overweight and Obesity related health issues

COM(2007) 279 final.

Policy recommendations

THE COMMITTEE OF THE REGIONS

1.
considers that health is a priority for all Community poli-
cies and activities: they must ensure a high level of health
protection. Under Article 152 of the EC Treaty, the Community
is indeed required to play an active role in ensuring human
health protection, taking measures which cannot be taken by
the individual Member States in keeping with the principle of
subsidiarity;

emphasises that consumer protection requirements should
2.
be taken into account in defining and implementing other Com-
munity policies and activities. The Union must promote the
right of consumers to information, education and to organise
themselves in order to safeguard their interests, and can encou-
rage healthy eating and lifestyles;

gical guidelines to encourage the creation at regional and local
level of networks between genuinely effective and efficient
services is a crucial instrument for achieving this aim;

7.
notes that in order to produce an optimal response to the
problems arising from nutrition, overweight and obesity, both
complementarity and integration between the various relevant
strategic sectors (horizontal approach) and the various levels of
action (vertical approach) must be promoted;

supports the white paper's objectives, and considers that
8.
regional and local authorities have a key role to play in
preparing implementation projects capable of
reducing the
harm caused at all levels by poor nutrition and lifestyles;

9.
welcomes the Commission's position that, in several areas,
the main levels for action are not only national or local, but
also transnational,
cooperation between
communities located in different countries, but which share
cultural, territorial and social features;

characterised by

recalls

that Community

3.
action is directed towards
improving public health, preventing human illness and diseases,
and obviating sources of danger to human health, and that it
complements national policies;

therefore urges the Commission to respect the responsibil-
4.
ities of the Member States for the organisation and delivery of
health services and medical care, while recognising that it may
— in order to make action more efficient — put forward the
operational models implemented by those regions that have
achieved the best results;
it also recalls that, regarding the
promotion of sport and physical activity, European Union
action must necessarily accompany that taken by the Member
States and their local and regional authorities, with the possible
involvement of other bodies such as university and non-univer-
sity educational centres;

that

notes

the Council has repeatedly called on the
5.
Commission to take action in the field of nutrition and physical
activity. The consultation on the green paper showed that the
expected contribution of the EU entails working with a range of
national, regional and local stakeholders, and has highlighted
firstly, the need to ensure that Community policies are consis-
tent and secondly, the importance of a multisectoral approach;

therefore,

recommends,

that EU action be geared to
10.
complementing, enhancing and disseminating actions under-
taken at national or regional level, or to tackling problems that
fall within the specific scope of Community strategies;

is

11.
convinced that no strategy can succeed unless
supported by activities at regional level and by practical initia-
tives on the part of local authorities, and therefore considers it
desirable, on the basis of Article 152 of the EC Treaty, for
regional and local bodies to be involved in EU activities;

12.
underlines that the existence of nutrition, overweight and
obesity-related problems in the different Member States does
not necessarily call for a single, Europe-wide, solution;

is pleased that the Commission acknowledges the impor-
13.
tance of variation in diets across Member States, and the
different policy approaches applied in Europe, and that
the
Commission stresses that it is essential for actions to continue
to be carried out at the regional and local levels, as these are the
closest to EU citizens, specifically stating that ‘interventions at
these levels are vital to tailor designed and validated general
approaches to specific local contexts’;

considers the purpose of the white paper under discussion
6.
to be to set out an integrated EU approach to help reduce ill
health due to poor nutrition,
lack of physical activity, over-
weight and obesity. It also considers that drafting methodolo-

14.
considers that reducing ill health is a long-term effort.
Consequently, funding for measures to combat excess weight
and obesity should be seen in a multi-annual perspective;

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On the principles for action

argues that

15.
tackling public health issues, particularly
nutrition, overweight and obesity aspects, entails the integration
of policies across the board, from food and consumer affairs to
sport, education and transport, production and consumer
affairs, with particular attention being focused on the social
aspect of the problem. It emphasises, however, that the health
aspect has the greatest impact on public finances and on the
quality of life;

points

to the

inadequate

Implementing projects

16.
identification of possible
stakeholders, particularly in the public sector, as a serious
and
problem.
economic resources are effectively available, and ensuring that
clearly-defined integration and cooperation protocols exist,
requires that two priorities be taken on board: firstly, regular
cataloguing of existing resources, especially in the public health
sector and, secondly, drafting cooperation protocols in advance
of plans for any action;

for which technical

is

effective

developing

considers that primary prevention in order to avoid
17.
disease
approach to
the most
weight-related health problems, obesity, cardiovascular condi-
tions, diabetes, strokes and so on. It has indeed been scientifi-
cally proven that nutrition and lifestyle are crucial such illnesses
to whether such diseases are prevented or not. Secondary
prevention projects — to control complications, in other words,
to treat obesity — need to be implemented for overweight or
obese individuals in order to control complications;

18.
considers it essential to act directly on the determinants
of proper, healthy eating, and on all the factors which together
contribute to maintaining appropriate body weight such as
information,
physical activity, culture, customs and traditions,
the socio-economic context, agricultural production, the food
industry, infrastructure and transport;

19.
is of the opinion that actions should aim to address the
underlying causes of health risks, and that they should touch
upon a range of strategic government sectors and levels of
government, making it clear that the regional and local levels
are crucial to the success of the project;

believes it essential that the strategy proposed by the
20.
Commission should entail intervention by private actors such as
the food industry and civil society, as well as local stakeholders
such as schools, other educational centres and health bodies,
within which specific services should be set up or reinforced;

21.
believes that greater attention should focus on circulating
knowledge from national experiences, deriving for example
form specialist postgraduate schools of nutritional science, and
that this should be done at Community level. This would help
to reduce the differences in working approaches, and to create
new instruments to tackle harmful lifestyles effectively;

emphasises the importance of

22.
large-scale monitoring
over the next few years. It is however convinced of the urgent
need to adjust the parameters applied by statistical institutes in
compiling data on populations' eating habits. Quantitative data,
albeit approximate, is needed for such surveys. Given this, the
Committee believes it is also important to monitor and measure
the impact of existing measures;

On the partnership approach

23.
is convinced that promoting partnerships is the most
effective way of resolving the problems of nutrition, overweight
and obesity, and that no single approach can possibly be suffi-
cient. The only possible way of preventing health problems —
of which poor nutrition is the main cause — is for all stake-
holders, at international, national, regional and local levels, to
take action;

24. maintains that only an approach involving a partnership
between public and private actors can bring about cultural,
environmental and economic changes that will have an impact
on behaviour and habits that are ‘harmful’ to health. Official
public agencies must, however, be responsible for coordination
and supervision;

25.
emphasises that on the social front, and not least in
order to narrow existing socio-economic gaps, steps to promote
healthy eating should target individuals and, at the same time,
provide backing for ‘structural’ measures involving all the rele-
vant stakeholders: knowledge-based initiatives should be built
into policies aimed at ensuring easier access to healthy food;

it

essential

considers

26.
alliances between
decision-makers in the health, economic, agricultural and social
policy spheres, together with producers, distributors, retailers
and consumers;

to forge

therefore considers it necessary to develop partnerships
27.
intervention at European level and to strengthen local
for
networks with a view to future action, by distributing specific
methodological and scientific guidelines.
It also believes that
backing should be given to the introduction of food science as a
recommended subject in health-related university courses;

Strengthening local networks and the role of Community policies

28.
welcomes and supports that idea that the EU should also
be responsible for coordinating the Member States' efforts,
providing guidelines on ‘informed consumers’,
‘proposals for a
healthy and balanced diet’ and ‘physical activity’, and should
have a scientific support function through its committees and
the EFSA;

recommends that account be taken of the experience
the
(ENHPS)

29.
accumulated and the best practices developed under
European Network of Health Promoting Schools
programme;

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30.
considers, in this respect, that it is up to the EU to act,
by monitoring the Member States' efforts, to facilitate the disse-
mination and mutual comparison of experiences, generating a
those
introduction of
virtuous circle leading to the general
models that have proved themselves to be most effective;

underlines the importance of organising a yearly meeting
31.
of European regions that have devised and applied the preven-
tion model producing the best results;
for this reason the
Commission should consider setting up a database to provide
the Member States with easy access to different experiences;

asks the European Commission,

32.
financial
programming period, to earmark specific resources that can be
used under the Structural Funds to achieve the aims described
in the present opinion;

in its next

Member State action

33.
welcomes the Commission's recognition that the actions
to be taken within its competence should serve the purpose of
backing up or completing actions by Member States. It recalls
that Article 152(2) of the EC Treaty stipulates that the Com-
munity shall encourage cooperation between the Member States
in this area and, if necessary, lend support to their action; agrees
that the Commission should be able, in close contact with the
Member States, to take any useful
initiative to promote such
coordination; and underlines the need for the Member States to
focus
their action primarily on nutrition, overweight and
obesity related issues;

furthermore,

34.
recommends, in this regard, that the individual Member
States and the regions undertake to protect their own citizens
from media messages, especially on television and radio, that
advertise high fat- or sugar-content foods. States and regions
could,
impose high ‘advertising costs’, or even
demand that the labelling of certain products provide additional
information on their possible harmful effects (for example,
compulsory indication of the presence of trans fats, and the
percentage of saturated, monounsaturated and polyunsaturated
fats). It also believes that a further feasible measure might be to
provide economic incentives for the use of ‘healthy’ ingredients
and powerful economic penalties for the use of nutritionally
unbalanced or inappropriate foodstuffs;

35.
considers, with a view to improving information about
healthy lifestyles — especially for the ‘children/young people’
target group — that ‘virtual tools’ are particularly useful infor-
mation vehicles. Experience from existing projects is positive,
and has proven remarkably cost-effective;

Regional and local authority action

36.
‘healthy alternatives’

urges the local and regional authorities to propose
to unhealthy patterns of behaviour,

applying the ‘life-stage’ approach and informing the public on
the lifelong healthy eating practices they should follow;

37.
points out that training and information programmes
should be carried out in all regions to prevent excessive and
rapid weight gain in expectant mothers, as these have a direct
and very clear impact on the unborn child and its future weight.
It also emphasises the need to avoid excessive weight gain
during the first five months of life and during the early school
years, such gains paving the way for a predisposition to over-
weight in the future;

38.
recommends focusing on both the general and competi-
tive aspects of youth sport and that both types should be
inspired by values that build on fun, play and the right of
everyone to take part according to their ability, so as to
encourage physical activity not only for the individual, but for
the whole family: active families produce active children;

39.
points to the need to tackle the convenience culture: the
culture of industrial food production is a trap which has turned
pleasure in food into a choice between fatty and sugary food-
stuffs on one side, and restrictive diets on the other;

notes with regret that the pleasure of physical movement
framework, as a coercive

40.
is often confined to an ‘exercise’
activity that many people resist;

41.
restates its support for play for children and youths: as
the white paper underlines, it is crucial to increase knowledge of
food-related and behavioural choices,
the determinants of
but there is also a need to take a modern approach to fostering
a
previously
underpinned traditional societies, where obesity and unhealthy
lifestyle-related conditions were almost entirely absent;

new social

culture

that

one

like

the

42.
encourages physical space to be given back to people:
free infant and child play should be encouraged, both under
school auspices and through setting aside spaces in homes and
cities. Removing parking spaces to turn them into play areas
would not only prevent overweight and obesity, but would also
ward off high blood pressure and cardiovascular conditions,
which are the primary cause of death in Europe;

43.
recommends that the provision of ‘safe’ walking routes
to schools of all types and levels, as well as safe sports facilities,
facilities, should be a part of
playgrounds and recreational
spatial planning;

Promoting healthy eating

calls

for active

44.
in the Healthy Cities
involvement
programme supported by the World Health Organisation. This
is not only about people eating healthily, but also about main-
taining a healthy environment, an active life in society and
physical movement of all kinds as a source of health;

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45.
considers it necessary to plan regular food education
programmes (based on the principle of less animal fats, more
use of fruit and vegetables) and to draw up ‘regional guidelines’
in agreement with the European Commission;

46.
considers it essential that consumers be better informed
on the importance of their own diet and lifestyles to their own
health, and emphasises that
they should be protected from
misleading or insidious advertising. To this end, the EU could
harness the scientific know-how of EFSA (the European Food
Safety Authority), for instance, in relation to the composition of
certain foodstuffs, the use of additives, and regarding the truth-
fulness of messages in advertising and labelling;

advocates

47.
education
programmes at schools of all types and levels, particularly in
pre-primary and primary establishments;

implementation of

food

the

believes that

54.
regional and local authorities can also
promote physical activity for the general public by making use
of local environmental resources, both by building up urban
routes (cycle routes, walking areas, non-motorised transport
with safety guarantees) and by promoting opportunities for
out-of-town activities (biking and walking) that reflect the right
to mobility of the differently able by full access to such facilities;

underlines

the necessity for health operators

55.
to be
trained on the importance of promoting physical activity
among the general public. General practitioners must be aware
of international recommendations, based on their proven effec-
tiveness, and must be able to provide full information on the
types of activity they advise, and available options within their
catchment areas, if they are to perform their ad hoc counselling
function adequately. Basic and further training for healthcare
workers — especially doctors — should include a health promo-
tion component;

in order to promote healthy eating from school age
48.
onwards, urges the direct involvement of school catering stake-
holders,
teachers, paediatricians and school health
services, who can play a significant role in food education;

families,

The role of private operators

49.
sees monitoring of overweight/obesity, with special refer-
ence to children of school age, as a necessity, subjecting any
prevention initiatives that may be introduced to assessment, and
focusing in particular on eating disorders;

Promoting physical activity

50.
welcomes the implementation of large-scale, high-inten-
sity information campaigns that use the main information
media, and supports the production of information guides for
the general public which also promote everyday physical
activity, unconnected with closed and/or specialist environments
(gyms);

51.
urges regional and local authorities to launch initiatives
aimed at promoting physical activity, for example by displaying
posters at strategic points (such as access to lifts) in public build-
ings, suggesting that people use the stairs;

the importance of
52.
calls for a greater awareness of
physical activity in school education curricula,
starting at
primary and lower secondary level. Teachers must therefore be
properly informed and asked to make use of the structural
resources available in all schools, imparting worth and value to
physical activity;

53.
welcomes the broadening of opportunities for adults to
engage in structured physical activity that entails cooperation
between public agencies and locally-based bodies or associa-
tions. It highlights the need for access to activities to be made
easier (membership fees, timetables geared to the target group)
and for the quality of the proposed initiatives to be monitored
(type of activity, duration, appropriate premises, transport for
ease of access, instructors' training and qualifications);

56.
considers that private operators have a decisive part to
play in promoting consumer choice and enabling them to make
choices geared to a healthy lifestyle: their actions in this area
can complement government policies and legislative initiative at
European and national level;

with a view to making best use of

57.
the partnership
approach proposed by the Commission, welcomes the involve-
ment of managers of major gathering points (e.g. shopping
centres), caterers and distributors in producing healthy dishes
and promoting them clearly on menus;

58.
encourages the food industry, either on a voluntary basis
or through cooperation with consumer associations, to develop
‘codes of conduct’ and/or to ‘readjust’ the calorific and nutri-
tional make-up of
its products, by devising incentives —
including economic ones — for industries that decide to work
to this end;

59.
is convinced that the media — television, radio, internet
and the press — could be involved in various types of partner-
ship, in nutritional education campaigns, and by signing up to
self-regulation codes on ‘harmful’ publicity;

60.
supports stronger alliances between public bodies and
external, non-health bodies involved in food production (e.g. the
farm sector) and distribution, with the accent on local opera-
tors;

International cooperation

points out that, under Article 152(3) of the EC Treaty,
61.
the Community and the Member States must foster cooperation
with third countries and the competent international organisa-
tions in the sphere of public health;

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62.
notes that it would be advisable for the regions to act in
agreement and cooperation with their national ministries (for
health, social policy, education, etc.). To this end, it recommends
cooperation with the World Health Organization's Regional
Office for Europe: the WHO has already offered to provide coor-
dination with other international organisations (FAO, UNICEF,
ILO and the OECD) in supporting the implementation of initia-
tives to identify the needs of individual regions, define the situa-
tion, trends and the strategies put in place, and compile, analyse
and disseminate scientific evidence on the effectiveness of
completed actions;

63.
it also considers that it is necessary to cooperate with the
WHO in preparing a nutrition and physical activity surveillance
system, partly with a view to adopting the second food and
nutrition action plan;

64.
underlines the particular importance of cooperating with
countries that have introduced their own obesity strategies, in
order to swap experience and know-how;

65.
calls for full use to be made of knowledge on local habits
and lifestyles that have the capacity to act against overweight,
obesity and metabolic disorders (diabetes and degenerative
diseases). It recalls, in this respect, that the WHO has promoted
experiments to reinstate traditional
treatment and
healthy lifestyles among certain populations and ethnic groups;

forms of

supports the conduct of epidemiological studies on over-
66.
weight, obesity and diabetes, insofar as they are disorders that
should now be seen as a genuine emergency.

Brussels, 6 February 2008.

The President

of the Committee of the Regions

Luc VAN DEN BRANDE