Interventions to promote healthy eating habits: evaluation and recommendations

Although in several EU Member States many public interventions have been running for the prevention and/or management of obesity and other nutrition-related health conditions, few have yet been formally evaluated. The multidisciplinary team of the EATWELL project will gather benchmark data on healthy eating interventions in EU Member States and review existing information on the effectiveness of interventions using a three-stage procedure (i) Assessment of the intervention's impact on consumer attitudes, consumer behaviour and diets; (ii) The impact of the change in diets on obesity and health and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality-adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology and economics disciplines. Particular attention will be paid to lessons that can be learned from private sector that are transferable to the healthy eating campaigns in the public sector. Through consumer surveys and workshops with other stakeholders, EATWELL will assess the acceptability of the range of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one-stop guide to methods and measures in interventions evaluation, and outline data collection priorities for the future.

Identifying and investigating pesticide application types to promote a more sustainable pesticide use: the case of smallholders in Boyacá, Colombia

The present paper investigates pesticide application types adopted by smallholder potato producers in the Department of Boyacá , Colombia. In this region, environmental, health and adverse economic effects due to pesticide mis- or over-use respectively have been observed. Firstly, pesticide application types were identified based on input-effectiveness. Secondly, their determinants of adoption were investigated. Finally suggestions were given to develop intervention options for transition towards a more sustainable pesticide use. Three application types were identified for fungicide and insecticide. The types differed in terms of input (intensity of pesticide application), effect (damage control), frequency of application, average quantity applied per application, chemical class, and productivity. Then, the determinants of different pesticide application types were investigated with a multinomial logistic regression approach and applying the integrative agent centred (IAC) framework. The area of the plot, attendance at training sessions and educational and income levels were among the most relevant determinants. The analysis suggested that better pesticide use could be fostered to reduce pesticide-related risks in the region. Intervention options were outlined, which may help in targeting this issue. They aim not only at educating farmers, but to change their social and institutional context, by involving other agents of the agricultural system (i.e. pesticide producers), facilitating new institutional settings (i.e. cooperatives) and targeting social dynamics (i.e. conformity to social norms).

Policy interventions to promote healthy eating: a review of what works, what does not and what is promising

Unhealthy diets can lead to various diseases, which in turn can translate into a bigger burden for the state in the form of health services and lost production. Obesity alone has enormous costs and claims thousands of lives every year. Although diet quality in the European Union has improved across countries, it still falls well short of conformity with the World Health Organization dietary guidelines. In this review, we classify types of policy interventions addressing healthy eating and identify through a literature review what specific policy interventions are better suited to improve diets. Policy interventions are classified into two broad categories: information measures and measures targeting the market environment. Using this classification, we summarize a number of previous systematic reviews, academic papers, and institutional reports and draw some conclusions about their effectiveness. Of the information measures, policy interventions aimed at reducing or banning unhealthy food advertisements generally have had a weak positive effect on improving diets, while public information campaigns have been successful in raising awareness of unhealthy eating but have failed to translate the message into action. Nutritional labeling allows for informed choice. However, informed choice is not necessarily healthier; knowing or being able to read and interpret nutritional labeling on food purchased does not necessarily result in consumption of healthier foods. Interventions targeting the market environment, such as fiscal measures and nutrient, food, and diet standards, are rarer and generally more effective, though more intrusive. Overall, we conclude that measures to support informed choice have a mixed and limited record of success. On the other hand, measures to target the market environment are more intrusive but may be more effective.

The responsibility to record civilian casualties

The responsibility to record civilian casualties in both armed conflict and civil disturbances must be an integral element of the responsibility to protect, particularly in the application of the just cause principles. The first part of this article examines the threshold issue of the possibility of large-scale civilian casualties which triggers the international community’s responsibility to react. The reports recommending the responsibility to protect emphasise the need to establish the actuality or risk of ‘large scale’ loss of life which is not possible in the current context without a civilian casualty recording structure. The second part of the article outlines the international legal obligation to record civilian casualties based on international humanitarian law and international human rights law. Thirdly, the responsibility to protect and the legal obligation to record casualties are brought together within the framework of Ban Ki-moon’s reports on implementation of the Responsibility to Protect. The fourth and final part of the article reviews the situations in Sri Lanka and Syria. Both states represent egregious examples of governments hiding the existence of casualties, resulting in paralysis within the international community. These situations establish, beyond doubt, that the national obligation to record civilian casualties must be part and parcel of the responsibility to protect.

Building synergies in development research: The application of the mosaic model to animal health research

Development research has responded to a number of charges over the past few decades. For example, when traditional research was accused of being 'top-down', the response was participatory research, linking the 'receptors' to the generators of research. As participatory processes were recognised as producing limited outcomes, the demand-led agenda was born. In response to the alleged failure of research to deliver its products, the 'joined-up' model, which links research with the private sector, has become popular. However, using examples from animal-health research, this article demonstrates that all the aforementioned approaches are seriously limited in their attempts to generate outputs to address the multi-faceted problems facing the poor. The article outlines a new approach to research: the Mosaic Model. By combining different knowledge forms, and focusing on existing gaps, the model aims to bridge basic and applied findings to enhance the efficiency and value of research, past, present, and future.

Establishing field margins to promote beetle conservation in arable farms

This study investigates the function of non-cropped field margins in arable farming systems for enhancing the biodiversity value of beetle communities. Three different sown seed mixtures were used to establish field margins, a Countryside Stewardship mix, a fine grass and forbs mix and a tussock grass and forbs mix. The structure of beetle communities in the first full year of establishment was found to show no difference between the tussock grass and Countryside Stewardship margins. However, both differed from the fine grass margins, which supported lower overall abundance and species richness of beetles. This was attributed to small-scale architectural differences between species of fine and tussock grasses, rather than differences in plant composition. Body size distributions of beetles showed distinct similarities between the Countryside Stewardship and tussock margins. A greater abundance of large beetles was found in fine grass margins, although in all cases these body size distributions were attributed to a small number of species or a taxonomically distinct group. All three margin types included beetle species of conservation value. The importance of these results was discussed in the context of the value of these seed mixtures for invertebrate conversation. (c) 2004 Elsevier B.V. All rights reserved.

Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programme's Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete.

The design of probiotic studies to substantiate health claims

The EC Regulation No. 1924/2006 on Nutrition and Health claims made on foods has generated considerable debate and concern among scientists and industry. At the time of writing, the European Food Safety Authority (EFSA) has not approved any probiotic claims despite numerous human trials and meta-analyses showing evidence of beneficial effects. On 29th and 30th September 2010, ten independent, academic scientists with a documented record in probiotic research, met to discuss designs for future probiotic studies to demonstrate health benefits for gut and immune function. The expert panel recommended the following: (i) always formulate a precise and concrete hypothesis, and appropriate goals and parameters before starting a trial; (ii) ensure trials have sufficient sample size, such that they are adequately powered to reach statistically significant conclusions, either supporting or rejecting the a priori hypothesis, taking into account adjustment for multiple testing (this might necessitate more than one recruitment site); (iii) ensure trials are of appropriate duration; (iv) focus on a single, primary objective and only evaluate multiple parameters when they are hypothesis-driven. The panel agreed that there was an urgent need to better define which biomarkers are considered valuable for substantiation of a health claim. As a first step, the panel welcomed the publication on the day of the meeting of EFSA's draft guidance document on immune and gut health, although it came too late for study designs and dossiers to be adjusted accordingly. New validated biomarkers need to be identified in order to properly determine the range of physiological functions influenced by probiotics. In addition, validated biomarkers reflecting risk factors for disease, are required for article 14 claims (EC Regulation No. 1924/2006). Finally, the panel concluded that consensus among scientists is needed to decide appropriate clinical endpoints for trials.

Virulotyping and antimicrobial resistance typing of salmonella enterica serovars relevant to human health in Europe

The combination of virulence gene and antimicrobial resistance gene typing using DNA arrays is a recently developed genomics-based approach to bacterial molecular epidemiology. We have now applied this technology to 523 Salmonella enterica subsp. enterica strains collected from various host sources and public health and veterinary institutes across nine European countries. The strain set included the five predominant Salmonella serovars isolated in Europe (Enteritidis, Typhimurium, Infantis, Virchow, and Hadar). Initially, these strains were screened for 10 potential virulence factors (avrA, ssaQ, mgtC, siiD, sopB, gipA, sodC1, sopE1, spvC, and bcfC) by polymerase chain reaction. The results indicated that only 14 profiles comprising these genes (virulotypes) were observed throughout Europe. Moreover, most of these virulotypes were restricted to only one (n = 9) or two (n = 4) serovars. The data also indicated that the virulotype did not vary significantly with host source or geographical location. Subsequently, a representative subset of 77 strains was investigated using a microarray designed to detect 102 virulence and 49 resistance determinants. The results confirmed and extended the previous observations using the virulo-polymerase chain reaction screen. Strains belonging to the same serovar grouped together, indicating that the broader virulence-associated gene complement corresponded with the serovar. There were, however, some differences in the virulence gene profiles between strains belonging to an individual serovar. This variation occurred primarily within those virulence genes that were prophage encoded, in fimbrial clusters or in the virulence plasmid. It seems likely that such changes enable Salmonella to adapt to different environmental conditions, which might be reflected in serovar-specific ecology. In this strain subset a number of resistance genes were detected and were serovar restricted to a varying degree. Once again the profiles of those genes encoding resistance were similar or the same for each serovar in all hosts and countries investigated.

The potential for community groups to promote sustainable living

In recent times there has been a growing recognition amongst policy-makers of the role for community-based action in contributing to the broader aims of energy policy and climate change. In this paper, we will examine the potential for existing community groups to use their influence and elements of internal cohesion to encourage more widespread understanding and adoption of sustainable lifestyle habits; both amongst their members and within the broader communities of which they are a part. Findings are presented from recent empirical work with a range of well-established community groups for whom environmental issues are not their main priority. A central aspect of the research was to explore both the current status and potential role of groups that may have the capacity to reach and influence a broader sphere of the public than energy/environment specific initiatives of recent times have been able to achieve. Representing a diversity of interests, age groups and functionality, the results suggest that the potential for more effective ‘bottom-up’ engagement on climate change and sustainable living might be given fresh impetus by these types of established community groups and their networks. An assessment of what motivates participation and membership in the groups highlights a series of factors common to all groups and a smaller number that are significant for particular groups individually. It is argued that an appreciation of motivating factors can be useful in understanding more clearly how such groups are able to survive and maintain cohesion over time. The findings also suggest that climate change action means different things for different groups, with the diversity of the groups bringing with it the challenge of making sustainable living relevant to a range of interests and different shared values.

Community-based climate change adaptation strategies for integrated prawn-fish-rice farming in Bangladesh to promote social-ecological resilience

Farming freshwater prawns with fish in rice fields is widespread in coastal regions of southwest Bangladesh because of favourable resources and ecological conditions. This article provides an overview of an ecosystem-based approach to integrated prawn-fish-rice farming in southwest Bangladesh. The practice of prawn and fish farming in rice fields is a form of integrated aquaculture-agriculture, which provides a wide range of social, economic and environmental benefits. Integrated prawn-fish-rice farming plays an important role in the economy of Bangladesh, earning foreign exchange and increasing food production. However, this unique farming system in coastal Bangladesh is particularly vulnerable to climatechange. We suggest that community-based adaptation strategies must be developed to cope with the challenges. We propose that integrated prawn-fish-rice farming could be relocated from the coastal region to less vulnerable upland areas, but caution that this will require appropriate adaptation strategies and an enabling institutional environment.

Food and Health Forum meeting - nutritional approaches to cardiovascular health: workshop report

This report summarises the proceedings of a meeting held by the Food and Health Forum at the Royal Society of Medicine, London, on 12 October 2011. The objective of the meeting was to highlight nutritional strategies targeted at cardiovascular health. This included a review of the effects of various foods, nutrients and ingredients on maintenance of healthy cholesterol levels, endothelial function and blood pressure