The European Commission has made tackling obesity a public health priority. It claims that some 14 million children in Europe are currently overweight, of whom more than three million are obese. In all, it believes that across the EU-25, almost one in four children are overweight and that this is rising by around 400,000 a year. It is estimated that in the European Union, obesity-related illnesses accounts for up to seven per cent of total health care costs.1

In light of the growing obesity trend, the Commission has launched a number of initiatives designed to promote co-ordinated action at EU level, as well as in Member States, and involving a broad range of stakeholders. In particular, the Commission issued a Green Paper on promoting healthy diets and physical activity in December 2005, launching a consultation on these issues.2 On the basis of the responses received to this consultation, it now intends to issue a White Paper setting out possible policy options at the beginning of 2007.

BACKGROUND – THE GREEN PAPER AND CONSULTATION

The Green Paper on promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases was used as the basis of a broad ranging stakeholder consultation at the beginning of 2006 on practices required to promote a healthier diet. Among others, the Green Paper consulted on a broad range of activities including efficiency of self-regulation by the industry and adequacy of consumer information.

The consultation covered the following six key areas of intervention:

  • recommendations for nutrient intakes and the development of food based dietary guidelines
  • consumer information, advertising and marketing
  • consumer education
  • focus on children and young people
  • food availability, physical activity and health education in the workplace
  • incorporating overweight and obesity prevention and treatment into health services.

The Green Paper acknowledged that the rising prevalence of obesity across Europe is multi causal and to this end it stressed the need for a multi faceted approach across many sectors. It also encouraged action at national as well as EU level.

RESPONSES TO THE GREEN PAPER CONSULTATION

In all, the Commission received some 270 contributions from a range of stakeholders including civil society, government, industry, professional organisations and individuals.

The Green Paper consultation asked a series of questions on a range of issues and as a result a number of key themes have emerged from the responses that are likely to form the central core of the upcoming White Paper.

In particular, key themes include:

  • the need for a multi sector approach
  • the advertising of the food and drink products
  • information to the consumer and
  • food-based dietary guidelines.

A multi sector approach

There was strong support among consultees for the Community to contribute to and encourage a multi sector approach, involving different policy areas, such as agriculture, transport and urban planning, and a range of stakeholders at national, regional and local level. Linked to this, respondents also advocated the need for consistency and coherence between EU policies, as well as the co-ordination and exchange of best practices across the EU Member States.

Similarly, the incorporation of health in all policies was reportedly strongly supported by some respondents. As well as more use of health impact assessment and cost-benefit analysis of policies and interventions to raise awareness of decision makers, greater availability and comparability of data on obesity was highlighted as an area where important improvements could be made. The EU’s Public Health Action Programme is suggested as one way of supporting further integration and dissemination of data and to improve interlinkages between policies.

The Commission also reports that the "European Multi stakeholder Platform for Action on Diet, Physical Activity and Health" (the "Platform"), launched by the European Commission in March 2005 as part of its overall strategy on promotion of healthy diets and lifestyles, provides a strong basis for cross-sector dialogue. The Platform’s purpose is to develop (under the leadership of the Commission) methods of promotion of healthy diets and lifestyles as an alternative to legislation. The potential areas of intervention foreseen within the ambit of the Platform are largely the same as those listed above in relation to the Green Paper.

Advertising and marketing of food and drink products

Advertising and marketing of foods, particularly energy-dense foods and beverages to children, is highlighted as the most controversial issue in the Green Paper. This is a concern being shared by others, including the World Health Organisation ("WHO") and the European Parliament. The Commission acknowledges however that opinions of respondents are divided and underlines the difficulty in whether to take a hard-law (legislative) approach as recommended by healthcare professionals, consumer organisations and non-governmental organisations or a soft-law (self-regulatory) approach as proposed by industry, including manufacturers and retailers. In particular, health professionals, consumer organisations and NGOs do not appear to believe that self-regulation will be effective in limiting advertising of energy-dense and micronutrient poor foods. This was one of the key questions in the consultation.

The European Parliament is due to adopt a Resolution on the Green Paper at its January 2007 plenary session in Strasbourg. The position taken by the Members of the European Parliament (MEPs) will be influenced by the report from the MEP Mrs Frederique Ries. Whilst Mrs Ries’s report on the Green Paper does not condemn a particular category of food outright it does request restrictions on advertising of foods to children. MEPs have also recently put forward amendments at Committee level to the proposal to amend the Television without Frontiers Directive ("TWF Directive") with the objective of introducing restrictions on advertising to children of products high in fat, sugar and salt. Whilst there are opposing views in the EP on these amendments, and they may yet be rejected at plenary in Spring 2007, they do illustrate the strength of feeling in some quarters that self-regulation by industry is not sufficient. The recent adoption of new restrictions on the television advertising of certain foods to children and young people in the UK (see separate article on Ofcom’s new restrictions on page 19) could also add impetus to the European Parliament’s debates.

In anticipation of the EU legislator’s conclusions on this issue, the International Chamber of Commerce (ICC) released in October its new "Code on Advertising and Marketing Communication Practice" supported by the World Federation of Advertisers. This Code deals with marketing practices to children, and health and safety issues. This Code’s aim is to promote grounds for self-regulation whilst offering principles underpinning legislation on marketing and consumer protection.

Information to the Consumer

Respondents to the Green Paper consultation believe, according to the Commission, that consumer information, including promotion and labelling, should be clear, consistent and evidence-based and should be disseminated through a number of channels. Such channels include the media, health sector, schools, government and other bodies.

Linked to this, respondents were also asked how consumers can be best able to make informed and healthy choices. As well as better nutritional information, respondents suggested that there is a need to create and raise awareness and to increase knowledge, for example, about diet and health and the importance of physical activity, particularly at school and in the work-place.

One area highlighted is the importance of improving the nutritional value of school meals. According to some respondents, this can be achieved by education programmes for healthy diet for children, offering free or subsidised fruit, vegetables and drinking water and improved training for kitchen staff. Some respondents also advocated the introduction of general guidelines for school meals, including regular control and enforcement.

The importance of promoting physical activity via schools and the workplace was another area that reportedly received wide support. Physical activity should be promoted by financial incentives according to some respondents and there is also a need to ensure that sufficient facilities exist which are accessible, safe and affordable.

Food-based dietary guidelines

The Commission has long-harboured ambitions to encourage the development of European dietary guidelines. In particular, its White Paper on Food Safety of 2000 indicated its intention to table a proposal for Council Recommendations on this; however, this was not done and it subsequently indicated that whilst it believes there is a need for a comparison of national guidelines there is not necessarily a need to harmonise such guidelines at EU level.

More recently, the Commission has requested the European Food Safety Authority ("EFSA") to produce an opinion on food-based dietary guidelines, which is due to be completed in 2007.

In the Green Paper, it asked stakeholders for their views on how best social, cultural and regional differences in dietary habits could be taken into account in food-based dietary guidelines at EU level. It also asked how such guidelines can best becommunicated to consumers and whether a nutrient profiling system could contribute to such developments. Many contributors, reportedly, supported the need for general, neutral, science- based and flexible food-based dietary guidelines at a European level that can be adapted to different cultures, regions and countries. They also supported the role of the EFSA in the process of developing these guidelines.

In respect of the best way to communicate the guidelines to consumers, nutrition labelling is reportedly considered to be an important aspect. However, the Commission notes that most manufacturers, primary producers and retailers do not support the concept of a nutrient profile scoring system.

CONCLUSION

In light of the increase in obesity particularly amongst children, it is evident that national and EU public authorities increasingly believe that some degree of policy and regulatory intervention is required. What remains unclear for industry, however, is whether future changes will legislative or whether self-regulatory approaches will be accepted. The forthcoming White Paper is likely to give a clearer indication of both legislative and non-legislative measures that will be put forward over the coming years.

The European Health and Consumer Protection Commissioner, Markos Kyprianou, has indicated on several occasions that he favours public-private partnerships and that effective and robust self-regulation may be an appropriate approach to tackle obesity. However, some public health Ministries and most consumer and public health associations remain sceptical, particularly in respect of advertising and marketing of certain foods. Industry itself will therefore have to demonstrate over the coming 12- 18 months a high level of commitment to effective self-regulation if it is to convince policymakers to accept the self-regulatory approach, otherwise legislative restrictions appear inevitable.

Footnotes

1 European Commission, IP/06/1169, Brussels 11 September 2006.

2 Food, feed and drink quarterly update, March 2006, page 1.

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