01.11.2011 Global strategies for dealing with global problems require national implementation!
Diet and physical activity. According to the World Health Organization (WHO), non-communicable diseases (diabetes, cardiovascular diseases, cancer and chronic respiratory diseases) accounted for 63% of deaths in the world in 2008. The increase in such conditions and the associated impact on the healthcare and social welfare systems and on the economy constitute a major challenge for many countries.
The increase is due primarily to our present-day lifestyle. Five of the seven main risk factors for non-communicable diseases have to do with diet and physical activity: high blood pressure, high blood cholesterol levels, overweight, low consumption of fruit and vegetables, and physical inactivity. The other two risk factors are smoking and excessive alcohol consumption.
To counter this trend, the UN General Assembly convened a high-level meeting on 19–20 September 2011 on the topic of «Non-communicable Diseases» with the aim of developing effective global solutions to deal with the steady increase in such conditions.
Overweight and obesity are risk factors
The promotion of a healthy lifestyle to prevent non-communicable diseases has been a key goal of both the European Union (EU) and the WHO for many years. More and more people in Europe are overweight or obese. Most of us nowadays consume too many calories and do not take enough exercise. The WHO and the EU have therefore made a balanced diet and regular physical activity key priorities of their respective health policies.
World Health Organization
As far back as May 2004, the WHO approved the «Global Strategy on Diet, Physical Activity and Health» and called on governments to adapt it to their respective national requirements. Two years later (November 2006), the European health ministers meeting in Istanbul approved the «European Charter on Counteracting Obesity». In May 2010, the WHO recommendations on the sale of high-energy food products and non-alcoholic drinks to children were approved by the governments. The aim of this measure is to diminish the impact of advertising that targets children for food and drinks containing high levels of saturated fats, trans-fatty acids, sugar or salt.
In May 2007, the European Commission approved the White Paper «A Strategy for Europe on Nutrition, Overweight and Obesity Related Health Issues», which calls for a greater focus to be put on action-based partnerships in this field. The most important goals include strengthening personal responsibility, improving consumer information, checking the contents of food products (less salt, less sugar and a better quality of fat), improving the body of data available and promoting research. The launch of the EU Action Platform on Diet, Physical Activity and Health provided a forum for key representatives of, among other players, the food industry, retailing, advertising and organisations active in the health sector. A High Level Group composed of government representatives from all member states was also set up for the purpose of facilitating the rapid exchange of knowledge and experience for the solution of obesity-related problems. In 2009 and 2010, the High Level Group asked the Commission to convene a group of experts in order to prepare the foundations for the following initiatives: the salt strategy (2008/2009) and the framework strategy on the reduction of fat and sugar levels in food, which will include communal catering (2010/2011). The European Food Safety Authority (EFSA) is concerned – in addition to traditional food safety issues – with questions arising in the field of nutrition such as approval of health claims for food and recommended dietary allowances.
Implementation in Switzerland
Switzerland has played an active part in the international strategy development work of the WHO and WHO Europe. The WHO Europe Charter, the WHO Strategy and the EU White Paper provided essential foundations on which to draw up the National Programme on Diet and Physical Activity 2008–2012 (NPDPA) and are seminal for FOPH activities in the implementation phase. The insights generated by the EFSA and the High Level Group (in which Switzerland participates) are taken into account in the Swiss projects, strategies and recommendations of the NPDPA. Switzerland’s salt strategy is a good example of how WHO recommendations and the EU’s global salt strategy led to the creation of a national strategy.
A high level of salt intake increases the risk of cardiovascular disease. In the report «Diet, Nutrition and the Prevention of Chronic Diseases» the WHO therefore recommends a daily salt allowance of less than five grams a day. Daily salt intake in Switzerland is much higher, being estimated at approximately ten grams per person.
This is due primarily to processed food such as bread, cheese, sausages and other meat products, soups and ready-made meals, which contain a lot of «hidden» salt. The aim is to reduce daily salt intake to eight grams per person by 2012, i.e. by up to 16% (or 4% a year). The long-term aim is to achieve the recommended maximum intake of five grams a day.
The implementation of the Swiss salt strategy is intended to significantly reduce the risk factor of high blood pressure, enhance quality of life and improve public health. The salt strategy is being implemented in the framework of the actionsanté initiative.
Liliane Bruggmann, Head of the Nutrition and Physical Activity Section, firstname.lastname@example.org