It Takes a Village to Tackle Childhood Obesity

Or in this case a city.

The city of Amsterdam.

Obesity Action Scotland has recently returned from a study trip to Amsterdam where our hosts were the public health department of the city of Amsterdam. Amsterdam is the first area in the world to see a decrease in rates of childhood obesity across all socio-economic groups. A unique and inspiring achievement given that in Scotland we are seeing a widening inequalities gap.

What is the secret of their success? What did we see while we were there?

Well the scale of investment is significant. 5 million euros and a team of 25 dedicated staff (plus another 75 linked staff) to solve this issue in a city where 27,000 children were classified as overweight or obese.
The health system they operate within is different to the Scottish one. They identified that there are 13 moments that children have their weight and height measured between the ages of 0 and 4.
One pillar of their success is a strong political champion within the Council who was and is prepared to be brave and outspoken but who also understands it is a long term effort.

There are lots of small, unique aspects to their approach but what about some of the bigger principles?

Healthy weight is a collective responsibility. This was a recurring theme and they were very clear that everyone was needed and that messages needed to be consistent. While each professional will have a different role to play, the message from the doctor, nurse, teacher, and politician must all be the same. They invested in training and awareness across all professionals.

Target and achievements had to be set and measured appropriately. They identified that this was a long term investment, that it would take time and patience to achieve goals but that they could set some interim targets to demonstrate success along the way and to ensure the appropriate achievement was made within political cycles. Therefore, the long term mission is for all young people in Amsterdam to be of healthy weight by 2033 but the first interim measure of success is for all 0-5 year olds to be a healthy weight by 2018.

The approach they take is unique. Whilst JOGG is the national Netherlands approach to tackling childhood obesity and is based on the French EPODE model, Amsterdam would readily admit that they have not adopted all aspects of the JOGG approach. They support and implement the JOGG framework but not necessarily the detailed methodology. Amsterdam have adopted it and made it unique. They avoid the commercial partnerships that are taken forward in other JOGG/EPODE models, in fact they lobby strongly for action on advertising and marketing of junk food. They keep ensuring that marketing of unhealthy foods and the food choices available are strictly controlled at events subsidised by Amsterdam Municipality.

They have a “health in all policies” approach that embraces decision making on everything from playgrounds to tackling poverty. They specifically target their efforts and resources to the heaviest neighbourhoods and schools with specific and unique programmes for certain schools, ethnic groups, neighbourhoods, parents. It is a complex mix of programmes based on three rules of thumb – healthy food and drink, active lifestyle and good sleep. It focuses on prevention but has a strong comprehensive care programme for those who are already overweight or obese.

What struck us most during our visit? Pride and ownership. We met a variety of people from a school head teacher to a local fishmonger and all of them had pride and ownership of their role in helping children improve their diet and grow up healthy.

What can we learn from this? Obesity Action Scotland is working hard to ensure we change the environmental conditions that surround us every day and that influence our food choices. This includes lobbying for action to control price promotions and advertising and marketing of unhealthy foods. Those changes, as important as they are, are only one part of the jigsaw. We must also see the local approach that we witnessed in Amsterdam. An approach where every professional and many community members understood what their role was in influencing healthy lifestyles. There are numerous examples of local led approaches in Scotland . Scotland has enthusiastic and clever individuals who want to make in change in their communities. It is time to harness, strengthen and develop that local work and focus on improving our village.

Watch their video and see for yourself how they do it!

Amsterdam YouTube

 

22nd June 2017

Taking Inspiration from the Nordic Approach

SP PresentationsOver the past 10 years the Nordic governments have collectively taken a new approach that seeks to change the food culture and consumption patterns of their people.

On Wednesday 14th June, the Scottish Parliament heard from a Dane who works for the Nordic Council of Ministers about “New Nordic Food”. The event titled ‘Food: a solution to a health crisis’ was organised by Obesity Action Scotland with the Scottish Food Coalition.
Liam McArthur MSP sponsored the event and gave a warm and clever introduction. Among the guests were MSPs, Nourish, RSPB, Federation of City Farms and Community Gardens, Cancer Research UK, Alcohol Focus Scotland, SPICe, Food Standards Scotland, NHS Health Scotland, Rowett Institute, Glasgow University and many others.
Mads Frederik Fischer-Moller who is a Senior Advisor on Food, provided illuminating views on Nordic food culture, nutrition policy and the impact of food programmes and activities in the Nordic Countries. The aim was to solve the problem of poor diet and to create a food culture and identity for Nordic food.
Government policies played a key role in promoting a new and more sustainable Nordic cuisine to international fame but others played their part including world renowned chefs and the private sector.
Through public-private partnerships, product innovations and reformulation these new ideas are being incorporated in everyday life in the Nordic countries.

What does it mean?
As Mads explained, if you visited a friend in the Nordics ten years ago you would most likely be served spag bol for dinner. Today, you would be proudly given fresh, seasonal, locally sourced produce.
The Nordic countries have seen the results already. Consumption of wholegrain products and traditional vegetables like cabbage and carrots are on the rise, with cabbage in hot-dog buns being extremely popular at music festivals. Moreover, salads are challenging hotdogs as the favourite fast food option and markets for local and organic products are growing 10% annually. 
Food is now the 2nd top reason to visit Nordic countries, right after nature. Ten years ago it was not even in the top 3. The restaurant Noma in Denmark has been voted the best restaurant in the world for four out of the last seven years. This massive change of perception brought with it not only improvement in health of the nation but also generated jobs. In Copenhagen over six thousand jobs were created in food businesses alone since 2009. This shift also translates to the development of rural areas, increased number of tourists and small business growth.

The Nordics have made a change: they focus on pleasure and gastronomy but based on strong nutritional recommendations. What were Mads key recommendations? Build trust-based partnerships between industry, government and NGOs. Change the food culture to give consumers and businesses something to aspire to.
The Nordics set out to deliver a vision of “New Nordic Food”. If our vision is to be a “Good Food Nation” then to truly own that term we must prioritise action to ensure a healthy diet for everyone in Scotland.

 Nordic Food

21st June 2017

A Parent Shares Their School Meals Experience

School Meals

Just over a year ago I decided to volunteer as a parent helper in my child's school.

Along with photocopying and helping with craft projects and classroom resources, one of my jobs is to oversee lunch in the dining hall. This has been the most eye opening experience of my life because I see what the children eat and do not eat every day.

All pupils must clear away their plates when finished their meal. They do this at a station at the end of the dining room, which has soapy water buckets for cutlery, bins for general waste and food. An adult always oversees what the children are disposing of. If we feel a child has not eaten enough we will often send them back to their table to try and eat some more.

What has actually amazed me more than anything is the amount of food wasted at school dinners. I see this every day – the weight of the food waste bin each day is shocking. The majority of the waste is, I am sorry to say, fruit and vegetables. Much of my time is spent encouraging the children to try their vegetables for me - even one pea is sometimes all I ask - but it is an uphill struggle and one which I feel I am losing.

I'm not even sure how you tackle this. The pupils can recite the information about vegetables being healthy and necessary to ward off disease. They can tell me all about healthy diets and what's good for you. They are surrounded by their own classwork on healthy eating on the walls of the dining hall, yet still it makes no difference to what is eaten.

I must admit to finding the food served in my school poor. After my first week I despaired as the quality and presentation leave a lot to be desired. My son stays for packed lunches as I can then provide him with a balanced and healthy appetising lunch, which the school dinner programme cannot do at this time. I also choose not to take the school lunch as even a simple thing like a baked potato was awful.

At home I cook all my food from scratch. I am very aware of the use of sugar, salt and fat in my cooking and the food groups needed to provide a healthy meal. It is disappointing that in order for something to be served as healthy at a school dinner it is made unappetising. A good example is the chicken burger, served in bread crumbs in a dry burger roll with a side of salad. It is almost universally thrown in the bin as the children find it too dry to eat! I actually tried to eat one after the children complained and found it very difficult not to gag. When I asked the dinner ladies why they served the burger like this, they replied “because it's healthy we’re not allowed to add anything to it!” This is madness - adding low fat mayonnaise or a low fat spread or even reduced-sugar tomato sauce, would make them more appealing. But no, they are thrown in the bin.

Even the atmosphere and the setting of the school dinner hall is not something that promotes healthy eating. Our school is at capacity so the school dinner hall is so full you can actually have pupils wandering around looking for tables. With only a 45 minute lunch break, many of the kids eat a few mouthfuls before rushing out to play.

We have lost our connection with real food and enjoying it as a social experience and it saddens me to see a whole generation growing up with poor quality, rushed meals in overcrowded dining halls.

Hashtag Eating Not Feeding

26th May 2017

Amsterdam’s Success in Tackling Childhood Obesity

AmsterdamTxtDo you want to be inspired?

Here is some good news: Amsterdam has been successful in tackling childhood obesity!

They launched the ‘Amsterdam Healthy Weight Programme’ and the whole city managed to reduce the total number of overweight and obese children by 10% within the first two years.
This means 2000 fewer overweight children.

Moreover, the programme proved especially successful for children from low socioeconomic backgrounds. 

Read More

World Obesity Day – Action vs. Talking

WorldObesityDay2016

Tuesday 11th October 2016 marked World Obesity Day. It was a day to take stock and assess the situation we are currently in, where 29% of adults and 15% of children in Scotland are obese and to look at the vision of universal healthy lifestyles and consider: how can we get there?
With adult obesity rates at unacceptable levels and a growing gap in obesity related to inequalities, we must be serious about how we tackle the obesity crisis.

Read More

Obesity, Physical Activity and Cancer

Map of a run round London

What do obesity and physical inactivity have in common?
If you said that they both sound unhealthy, you'd be right: they are serious cancer risks.

In fact, they increase the risk of many cancers: breast, bowel, prostate, uterus, liver, pancreas and others.

Read More

Elections, Elections, Elections!

Polling StationIt seems that we are visiting our local polling stations with some degree of regularity over the past few years and the most recent result of the general Election has still to fully play itself out.
This uncertainty and focus on other issues may, unfortunately, push obesity down the agenda and make it less clear what our future political landscape will look like. It does, however, offer us the opportunity - the necessity - to continue to communicate, engage, advocate, convince and persuade our politicians of the importance and urgency of the obesity crisis.
We must be unrelenting in communicating our message, our asks and our solutions to tackling obesity to politicians, the media, the health sector and the public to maximise on any opportunity that may be presented in these unprecedented times.
The Scottish Government has committed to a Diet and Obesity Strategy in 2017 and we are expecting a consultation launch in the coming months. That commitment must be met. The health of our nation is at stake.
So, let's not be distracted by the political manoeuvres that are playing out, but remain focused on our goals and our audiences to ensure that obesity does not slip down the political agenda.

16th June 2017

Put the Health of Young People First

JanUary2017In 2017, Scotland’s young people suffer from obesity more than any generation before them. Dr Anna Strachan, Policy Officer for Obesity Action Scotland, calls for urgent action to make the healthy choice the easy choice.

Monday 9th January marks the start of National Obesity Awareness Week. Organisations and companies from across the UK are coming together to invite everyone to ‘Do something good for JanUary’. Whether it’s cooking more healthily, avoiding snacks or being a little more physically active, the aim is to make a healthy New Year’s resolution now!

Read More

Dreaming About the 21st Century Food Policy: Unthinkable!

Girl with an apple

Smoke-free buses, hospitals, or pubs were a wild, unthinkable idea forty years ago. Yet, today the opposite is unthinkable. Big dreams change the world.

The 12th of December 2016 was a day to dream big at the 2016 City Food Symposium in London. A day of reflection on the past and the future of food policy, over thirty speakers, reasons to be depressed, reasons to be cheerful, effortless networking, comedy, drama, stories of lost battles and of success, all concluded with a festive cup of mulled wine.

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Body Fatness and Cancer

Annie AndersonGuest Blog: Professor Annie S. Anderson

For decades cancer has been associated with weight loss and under nutrition. Cancer survivors still report health care staff being concerned if they report a decreased body weight – even if this is due to intentional weight loss.

Today's paper from the International Agency for Research on Cancer (IARC) provides a timely reminder about why we need to take the growing evidence on excess body fat and the opportunity for cancer risk reduction seriously.

Read More

The UK Government has bottled it

COPlanCover

The UK Government has bottled it. They have backed out of the bold action needed to tackle the obesity epidemic within the UK. How did we get here? How did such a long wait in anticipation become such a frustrating disappointment?

In October 2015 the chief executive of PHE Duncan Selbie was being grilled by the UK Health Select Committee on PHE evidence on the actions needed to tackle sugar consumption. Duncan Selbie said at the time that this was a “marvellous moment” that Government was accepting PHE advice and the outcome would be a childhood obesity strategy that will work. “One which doesn’t exist in the world and we are on the cusp of having” were his exact words. The Heath Secretary and Prime Minister promised a “game-changing strategy” to tackle a “national emergency”.

Read More

Walking round Italy in speedy fashion!

Rome photograph

ItalyMap

 

 


We made it!

Two weeks ago we ‘arrived’ in Rome after our big walk round Italy. Logging our respective steps (all 1,691,922 of them!) got us round Italy and into Rome much faster than the 100 days we had allowed.

So perhaps the next walking challenge needs to be, well, more challenging!
We’ve still to arrange our Mediterranean feast to celebrate, but maybe we should use this as a carrot for our next walking adventure?
We are now embarking on a grand tour of Poland – home country of our Policy Officer, Anna.

A Guideline is Just a Guideline

Brazil Dietary Guidelines Report Cover

University of Edinburgh logo“Values are as important as evidence. Do we need a randomised control trial to tell us that eating food together is a good idea?”

A striking statement that stimulated reflection from the audience at a recent event we were delighted to co-host with the University of Edinburgh.

The event saw two representatives from Brazil, who were instrumental in the creation of the recently published Brazilian dietary guidelines, speak about the journey from concept to published dietary guidelines. A process filled with challenges, not least opposition from industry, but also from fellow nutritionists who were initially reluctant to see change.

The distinct and ground breaking aspect of the Brazilian work has been the move away from nutrient based guidelines to ones based on real meals. They used the ‘NOVA system’ which classifies foods according to the extent of processing involved.

Read More

Tackling Obesity: What we learned from nutrition labelling research

Nutrition label montage

At the end of June we co-hosted a ‘meeting-of-the-minds’ at the Psychology Department of Stirling University. The event aimed at developing multidisciplinary understanding and communication between stakeholders who are working to tackle obesity in Scotland.

The impact of nutritional labelling on food purchasing and consumption behaviour was the topic of the day. Attendees also found out about the interests and motivations of different stakeholders and had a chance to learn from the experience of experts. The meeting was designed to promote networking and help to shape communication and knowledge sharing within the proposed alliance to tackle obesity in Scotland.

After ‘speed-dating’ introductions, Professor Linda Bauld, Director of the Institute for Social Marketing at the University Stirling, discussed what those working to tackle obesity in Scotland can learn from the alliance against tobacco.

This was followed by presentations on the impact of nutritional labelling on behaviour.

  • Dr Seda Erdem from University of Stirling spoke about how our choices are influenced by food marketing and labelling, explaining her hot-off-the-press research which tracked eye movements when looking at food packaging.
  • Dr Julia Allan from University of Aberdeen talked about how to nudge people to make healthier choices. A simple scale showing calorie content of foods and drinks in a university canteen resulted in an average consumer buying 66kcal less every day. Accumulated over a year that could prevent a person from gaining 6lb!
  • Dr Rachel Crockett from the Psychology Department of University of Stirling finished the morning session with a passionate talk on how to modify the world around us to promote healthy choices, all supported by the evidence on nutritional labelling.
  • Dr Stephan Dombrowski from the University of Stirling rounded off the morning talks in humourous style!

We led the afternoon session, with workshops on joint working and knowledge sharing. Attendees’ role-played scenarios that required finding solutions to a problem. What we saw was that while it may be difficult to agree, it is important to talk and understand others, and while all roles are difficult and there is not always enough evidence, links between research and policy are crucial.

Take home messages from the day:

  • Lessons from tobacco showed that many small steps are a key to change; labelling should be one of the steps to transforming the obesogenic environment into one that promotes healthy weight
  • An obesity alliance in Scotland needs to keep effective communication at its heart
  • Researchers and policy makers must work together to make sure that the evidence needed to tackle obesity is available

A big thank you to University of Stirling Psychology Department for hosting a great event!

Obesity Alliance - Next Steps

Obesity Alliance logo

After our initial meeting in April, which supported the creation of an alliance to tackle obesity in Scotland, we have made steady progress. 

A small ‘planning group’ consisting of representatives from across the spectrum of potential alliance members e.g. third sector, public sector and academia will now form and shape the Alliance.

The initial role of this group is to draft proposals to present to the wider Alliance partners, opening discussion on; alliance purpose, structure, outline communications plan and potential priority issues.

The timeframe for this looks like:

  • Aug: planning group meeting
  • Aug-Sept: planning group communications
  • Oct Nov: meeting of alliance partners
  • Dec: alliance launch

Obesity Action Scotland will chair and co-ordinate the planning group process and will draft papers for consideration at planning group meetings.

For further information or any questions, please contact Lorraine Tulloch, Programme Lead on: lorraine.tulloch@rcpsg.ac.uk | 0141 465 7260

Meet Kirsty, the Holyrood Baby

Kirsty the Holyrood Baby

Have you met the Holyrood Baby?

A creation of Holyrood magazine, the Holyrood Baby, named Kirsty, emerged during the 2014 referendum when Nicola Sturgeon asked us to imagine a 'Kirsty' and what kind of Scotland we wanted her to grow up in. Born on 12th may 2016, Kirsty is growing up in the real Scotland and facing the same challenges that confront all newborn children in Scotland today.

We recently wrote about the future prospects for Kirsty in Holyrood magazine; she has an uncertain future in an environment that encourages weight gain and seems to accept it as inevitable.

Is this the kind of Scotland we want Kirsty to grow up in?

What will you do to help change it?

Is Our Obesity Epidemic as Bad as it Gets?

Obesity Action Scotland: the Chair's Blog

It is now a year since Obesity Action Scotland arrived on the scene.

A creature of the Academy of Medical Royal Colleges and Faculties in Scotland, hosted by the Royal College of Physicians and Surgeons of Glasgow and staffed by a dedicated 4 people, it has made an early and influential impact on approaches to preventing obesity in Scotland. 

The unit’s lead, Lorraine Tulloch, wrote recently about Kirsty, the Holyrood Baby, a creation of Holyrood magazine. This baby has an uncertain future in an environment that encourages weight gain and seems to accept it as inevitable. This future should not be the most likely outcome for babies that we are welcoming into the world in Scotland.

Read More

Tackling Obesity: What can we learn from Nutrition Labelling Research?

On Thursday we’ll be attending a ‘meeting-of-the-minds’ event at Stirling University, aimed at developing multidisciplinary understanding and communication between stakeholders who are working to tackle obesity in Scotland.
The event will focus on nutritional labelling and we’re looking forward to finding out more about the interests and motivations of different stakeholders working in the obesity field.
We will be leading workshops at the event to promote knowledge sharing and joint working to achieve greater success in tackling obesity.

University of Stirling logo

 

What's Next for Evidence Based Policy Planning?

We’ll be co-facilitating a workshop on obesity next week at the University of Glasgow as part of a one-day conference: 
Evidence for the Future - What's next for evidence based policy planning? 
The keynote speaker is Dr Catherine Calderwood, Chief Medical Officer for Scotland, and the event will explore the healthcare challenges facing us and discuss collaborative approaches to address these.
The workshops are intended to promote discussion around healthcare challenges, build on best practice and the lessons learned to gain new insights into how research can better support stakeholders in policy development and implementation for the benefit the health of communities across Scotland.
The line-up of speakers and facilitators looks really exciting and we’re delighted to have been invited to be part of the event.
We’re looking forward to learning about the ‘best and worst’ experiences of others to develop future collaborations.
Event info: http://bit.ly/22MoFai

The event is free but you need to register.

University of Glasgow logo

Taking Lessons from Brazil

We’re co-hosting a seminar in conjunction with the University of Edinburgh on 30th June where we’ll be exploring the ground-breaking dietary guidelines introduced in Brazil.
In 2014, the Brazilian government introduced world-leading new dietary guidelines that extend beyond the traditional confines of nutritional policy to engage with environmental sustainability and the social and cultural dimensions of food.
The guidelines take a new approach to categorising foods based on the extent of processing involved rather than with reference to nutrients. The aim is to encourage fresh, minimally processed foods and actively discourage consumption of ultra-processed foods and drink products.
The seminar will give us an opportunity to discuss the ‘Brazilian Experience’ and its lessons for approaches to public health in Scotland.

Event details:
The event is free to attend
Date: 30th June 2016
Time: 10.00-12.00
Venue: 6th floor staff room, Chrystal Macmillan Building, 15A George Square, Edinburgh, EH8 9LD

Download the pdf invitation

UniversityofEdinburgh

We are walking 'round Italy'

GenoaRome


We are undertaking an ambitious challenge to ‘walk round Italy’ in 100 days starting on European Obesity Day on 21st May.

Using the World Walking app, set up by Inverclyde Globetrotters, we will log our daily steps using the app, pedometers or fitness watches. This can cover anything from walking to work as part of the daily commute, holding walking meetings instead of traditional sitting meetings, going for walks at lunchtime through to ‘hidden’ steps taken during a typical day – like walking to the kettle to make a cup of tea.

100 Days
Setting the target to complete our Italian tour at 100 days will present a substantial challenge as this equates to almost 17,000 steps per day. While this might not sound ground-breaking when shared over four people, we are aware that being human can also mean forgetting to track steps on occasion, resulting in missed mileage on the journey – Ryan, this is mainly aimed at you!

Route 
The route we have chosen starts in Genoa, visiting beautiful cities, such as Milan, Venice and Florence before finishing in Rome. To celebrate completion, we are planning to hold a healthy Mediterranean lunch, but only if we can complete our Italian tour within 100 days!

We will be blogging about our progress, the highs and lows as well as the many ‘virtual’ sights we hope to see on our route.

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