Obesity - the policy challenges: The report of the National Taskforce on Obesity

Click here to download PDF The prevalence of overweight and obesity has increased with alarming speed over the past twenty years. It has recently been described by the World Health Organisation as a ‘global epidemic’. In the year 2000 more than 300 million people worldwide were obese and it is now projected that by 2025 up to half the population of the United States will be obese if current trends are maintained. The disease is now a major public health problem throughout Europe. In Ireland at the present time 39% of adults are overweight and 18% are obese. Of these, slightly more men than women are obese and there is a higher incidence of the disease in lower socio-economic groups. Most worrying of all is the fact that childhood obesity has reached epidemic proportions in Europe, with body weight now the most prevalent childhood disease. While currently there are no agreed criteria or standards for assessing Irish children for obesity some studies are indicating that the numbers of children who are significantly overweight have trebled over the past decade. Extrapolation from authoritative UK data suggests that these numbers could now amount to more than 300,000 overweight and obese children on the island of Ireland and they are probably rising at a rate of over 10,000 per year. A balance of food intake and physical activity is necessary for a healthy weight. The foods we individually consume and our participation in physical activity are the result of a complex supply and production system. The growing research evidence that energy dense foods promote obesity is impressive and convincing. These are the foods that are high in fat, sugar and starch. Of these potentially the most significant promoter of weight gain is fat and foods from the top shelf of the food pyramid including spreads (butter and margarine), cakes and biscuits, and confectionery, when combined are the greatest contributors to fat intake in the Irish diet. In company with their adult counterparts Irish children are also consuming large amounts of energy dense foods outside the home. A recent survey revealed that slightly over half of these children ate sweets at least once a day and roughly a third of them had fizzy drinks and crisps with the same regularity. Sugar sweetened carbonated drinks are thought to contribute to obesity and for this reason the World Health Organisation has expressed serious concerns at the high and increasing consumption of these drinks by children. Physical activity is an important determinant of body weight. Over recent decades there has been a marked decline in demanding physical work and this has been accompanied by more sedentary lifestyles generally and reduced leisure-time activity. These observable changes, which are supported by data from most European countries and the United States, suggest that physical inactivity has made a significant impact on the increase in overweight and obesity being seen today. It is now widely accepted that adults shoud be involved in 45-60 minutes, and children should be involved in at least 60 minutes per day of moderate physical activity in order to prevent excess weight gain. Being overweight today not only signals increased risk of medical problems but also exposes people to serious psychosocial problems due mainly to widespread prejudice against fat people. Prejudice against obese people seems to border on the socially acceptable in Ireland. It crops up consistently in surveys covering groups such as employers, teachers, medical and healthcare personnel, and the media. It occurs among adolescents and children, even very young children. Because obesity is associated with premature death, excessive morbidity and serious psychosocial problems the damage it causes to the welfare of citizens is extremely serious and for this reason government intervention is necessary and warranted. In economic terms, a figure of approximately â,¬30million has been estimated for in-patient costs alone in 2003 for a number of Irish hospitals. This year about 2,000 premature deaths in Ireland will be attributed to obesity and the numbers are growing relentlessly. Diseases which proportionally more obese people suffer from than the general population include hypertension, type 2 diabetes, angina, heart attack and osteoarthritis. There are indirect costs also such as days lost to the workplace due to illness arising from obesity and output foregone as a result of premature death. Using the accepted EU environmental cost benefit method, these deaths alone may be costing the state as much as â,¬4bn per year. The social determinants of physical activity include factors such as socio-economic status, education level, gender, family and peer group influences as well as individual perceptions of the benefits of physical activity. The environmental determinants include geographic location, time of year, and proximity of facilities such as open spaces, parks and safe recreational areas generally. The environmental factors have not yet been as well studied as the social ones and this research gap needs to be addressed. Clearly there is a public health imperative to ensure that relevant environmental policies maximise opportunities for active transport, recreational physical activity and total physical activity. It is clear that concerted policy initiatives must be put in place if the predominantly negative findings of research regarding the determinants of food consumption and physical activity are to be accepted, and they must surely be accepted by government if the rapid increase in the incidence of obesity with all its negative consequences for citizens is to be reversed. So far actions surrounding nutrition policies have concentrated mostly on actions that are within the remit of the Department of Health and Children such as implementing the dietary guidelines. These are important but government must now look at the totality of policies that influence the type and supply of food that its citizens eat and the range and quality of opportunities that are available to citizens to engage in physical activity. This implies a fundamental examination of existing agricultural, industrial, economic and other policies and a determination to change them if they do not enable people to eat healthily and partake in physical activity. The current crisis in obesity prevalence requires a population health approach for adults and children in addition to effective weight-reduction management for individuals who are severely overweight. This entails addressing the obesogenic environment where people live, creating conditions over time which lead to healthier eating and more active living, and protecting people from the widespread availability of unhealthy food and beverage options in addition to sedentary activities that take up all of their leisure time. People of course have a fundamental right to choose to eat what they want and to be as active as they wish. That is not the issue. What the National Taskforce on Obesity has had to take account of is that many forces are actively impeding change for those well aware of the potential health and well-being consequences to themselves of overweight and obesity. The Taskforce’s social change strategy is to give people meaningful choice. Choice, or the capacity to change (because the strategy is all about change), is facilitated through the development of personal skills and preferences, through supportive and participative environments at work, at school and in the local community, and through a dedicated and clearly communicated public health strategy. High-level cabinet support will be necessary to implement the Taskforce’s recommendations. The approach to implementation must be characterised by joined-up thinking, real practical engagement by the public and private sectors, the avoidance of duplication of effort or crosspurpose approaches, and the harnessing of existing strategies and agencies. The range of government departments with roles to play is considerable. The Taskforce outlines the different contributions that each relevant department can make in driving its strategy forward. It also emphasises its requirement that all phases of the national strategy for healthy eating and physical activity are closely monitored, analysed and evaluated. The vision of the Taskforce is expressed as: An Irish society that enables people through health promotion, prevention and care to achieve and maintain healthy eating and active living throughout their lifespan. Its high-level goals are expressed as follows: Its recommendations, over eighty in all, relate to actions across six broad sectors: high-level government; education; social and community; health; food, commodities, production and supply; and the physical environment. In developing its recommendations the Taskforce has taken account of the complex, multisectoral and multi-faceted determinants of diet and physical activity. This strategy poses challenges for government, within individual departments, inter-departmentally and in developing partnerships with the commercial sector. Equally it challenges the commercial sector to work in partnership with government. The framework required for such initiative has at its core the rights and benefits of the individual. Health promotion is fundamentally about empowerment, whether at the individual, the community or the policy level.

2006 Healthy Ageing Conference Proceedings: Nutrition and Older People in Residential and Community Care Settings

2006 Healthy Ageing Conference Proceedings: Nutrition and Older People in Residential and Community Care Settings The conference attracted over 230 delegates from the statutory, voluntary and private sectors, and provided the opportunity for delegates to focus on issues facing particular vulnerable groups of older people. Click here to download PDF 928kb

National Men's Health Policy 2008-2013

National Mens Health Policy 2008-2013 Click here to download PDF 1.3mb Reference Document PDF 1.3mb Progress Report PDF 92kb

Your Guide to Healthy Eating Using the Food Pyramid

Do you want to feel good and have more energy? Do you want to maintain a healthy weight and help reduce your risk of becoming ill from high blood pressure, high cholesterol, heart disease, type 2 diabetes, cancer and other chronic diseases?Eating healthy food and being physically active are two of the most importantsteps that you can take to improve your health. To help you do this, follow the Healthy Eating Guidelines, use the Food Pyramid Guide and the Physical Activity Guidelines. Click here to download PDF 540kb FSAI Resource Publication -Healthy Eating and Active Living for Adults, Teenagers and Children over 5 yearsâ?" A Food Guide for Health Professionals and Catering Services:www.fsai.ie/WorkArea/DownloadAsset.aspx?id=11387

Healthy Ireland - A Framework for Improved Health and Wellbeing 2013 - 2025

Healthy Ireland is a new national framework for action to improve the health and wellbeing of our country over the coming generation. Based on international evidence, it outlines a new commitment to public health with a considerable emphasis on prevention, while at the same time advocating for stronger health systems. It provides for new arrangements to ensure effective co-operation between the health sector and other areas of Government and public services, concerned with social protection, children, business, food safety, education, housing, transport and the environment. It also invites the private and voluntary sector to participate through well-supported and mutually beneficial partnerships. It sets out four central goals and outlines actions under 6 thematic areas, in which all people and all parts of society can participate to achieve these goals. Click here to download PDF 4.72MB

The Healthy Weight Challenge

To help encourage, facilitate and empower people to adopt healthy lifestyles and to raise awareness of obesity and its causes in order to reduce its prevalence within the target community. Outcome Through Health Classes, Leaflets and Posters, people have developed their knowledge and understanding of obesity. The relationship between members of the community and the pharmacist has also developed as as has the Pharmacists links with GPs, Dieticians, Leisure Centre Management etcï_… All participants thought the healthy weight challenge was a good idea, made them more aware of health and the pharmacy was able to offer advice, information, support and health checks. regular monitoring also helped have a positive impact on participants desire to lose weight and also had positive impact on their efforts to have healthier lifestyle.

Enjoy healthy eating

This leaflet aims to increase public awareness and understanding of healthy eating messages. The leaflet includes the new eatwell plate, information on the five main food groups, along with top tips for cutting down on fat and what to choose when eating out. It also includes sections on the importance of breakfast and cutting down on salt.

Promoting healthy eating at work: a guide for employers

This booklet is part of the Work Well aimed at promoting health in the workplace. It outlines to employers the benefits of promoting healthy eating at work, what action can be taken, the range of healthier food options that can be provided in a canteen or by using external caterers, ways of promoting healthy eating among employees that do not have to be expensive or time consuming, and key steps for action.

Are you packing a healthy lunch? (English and Irish)

This booklet is designed toimprove pupils' nutrition and implement healthier eating and drinking practices. It containspractical tips for parents, carers and children on how to pack an appetising, healthy lunchbox.

Packing a healthy punch for lunch

In Northern Ireland over 127,000 children bring their own food to school so it is important to ensure that food is both appetising and is good for health. Recent surveys looking at Childrens lunchboxes revealed that they are often too high in fat, salt and sugar, with just under half of the lunchboxes containing no fruit. To help parents and carers make lunchboxes healthier, the PHA has produced a leaflet, Are you packing a healthy lunch? in collaboration with safefood, the Department of Health, Social Services and Public Safety and the Department of Education.It will be distributed to every child in primary school and contains practical tips for parents, carers and children on how to pack an appetising, healthy lunchbox.

Getting a good start: healthy eating from one to five

This booklet outlines advice on many key nutritional issues for children aged one to five. It includes information on how to provide a healthy, balanced diet for this age group, guidance on suitable snacks and drinks, feeding a vegetarian child, vitamin supplements and iron, making the most of mealtimes and how to deal with fussy eaters.

Healthy child, healthy future: speech and language therapy for children

This resource is designed to reinforce a collaborative approach between speech and language therapists, referrers and parents in the identification and management of children with developmental speech and language and communication needs (including children with feeding and/or swallowing difficulties). It includes a comprehensive key skills section, which provides details on the communication-related skills a child should have acquired at each stage in his/her early years development. It also includes specific criteria and guidelines for referral, should there be concern about whether the child has a significant problem. The resource provides additional guidance on: • communication and child play; • speech sound development; • dummies; • stammering; • dysphonia; • bilingualism; • feeding and swallowing difficulties. Lists of supplementary leaflets, handouts and websites, as well as a bibliography, are also included.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 1. Does my child speak clearly?

This factsheet describes how parents can help their child speak more clearly.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 2. Helping your young non-fluent child

This factsheet outlines how parents can help their child speak more fluently, without stammering.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 4. Dummies and talking

This factsheet gives advice to parents on the use of dummies and their effect on a child's speech.