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The European Commission’s science
and knowledge service
Joint Research Centre
Recent developments and publications
Jan Wollgast, JRC.F.1 Health in Society
Meeting of the EU Platform for Action on Diet, Physical Activity
and Health, Luxembourg, 1 June 2018
Disclaimer: This presentation and its contents do not constitute an official position of the European
Commission or any of its services. Neither the European Commission nor any person acting on behalf of the
Commission is responsible for the use which might be made of this presentation or its contents
Steering Group on Promotion and Prevention (SGPP)
and Marketplace Workshop for Best Practices
Marketplace workshop on nutrition and
physical activity best practices, 15-16
March 2018, Ispra (Italy):
• Showcase best practices (BP)
• In-depth discussion sessions
• Member States' representatives informed
https://ec.europa.eu/health/non_communicable_diseases/steeringgroup_promotionprevention_en
themselves on BP, including on practical
details of implementation
• BP presentation slides and video clips:
https://ec.europa.eu/health/non_communicable_diseases/events/ev_20180315_en
Updates on Health Promotion and Disease
Prevention Knowledge Gateway
https://ec.europa.eu/jrc/en/health-knowledge-gateway
New release of EFSA's Comprehensive European Food Consumption Database • Most recent data collected in EU Member States • Covering more population groups and food categories (e.g., energy drinks) • Now including data collected under EFSA's EU Menu project • All data in the database now classified according to FoodEx2 “Making available harmonised and detailed data on food consumption across the EU has been one of EFSA’s long-standing goals. Today this has become reality thanks to the hard work of Member States.” https://www.efsa.europa.eu/en/food-consumption/comprehensive-database
WHO/Europe Health Evidence Network
Synthesis Report
• Exploring the implementation and effectiveness in reducing NCDs
of policies based on the New Nordic (ND) and Mediterranean (MD)
diets.
• 15 countries in the WHO European Region currently recommend
or implement MD or ND policies, interventions or programmes
• 13 with food-based dietary guidelines (FBDG) based on MD/ND
• Need to develop systems/tools to assess impact of measures
and/or adherence to MD/ND on NCDs
http://www.euro.who.int/en/publications/abstracts/what-national-and-subnational-interventions-and-
policies-based-on-mediterranean-and-nordic-diets-are-recommended-or-implemented-in-the-who-
european-region,-and-is-there-evidence-of-effectiveness-in-reducing-noncommunicable-diseases-2018
WHO & SACN consultations on guidelines • Saturated fats
IARC monograph on red & processed meat and
carcinogenic risks to humans
From the Q&A:
• Red meat -> Group 2A, probably carcinogenic to humans
• Processed meat -> Group 1, carcinogenic to humans
• IARC Groups -> strength of evidence ≠ level of risk
• Every 100 gram portion of red meat eaten daily increases the risk
of colorectal cancer by about 17%
• Every 50 gram portion of processed meat eaten daily increases the
risk of colorectal cancer by about 18%
http://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Evaluation-Of-Carcinogenic-Risks-To-
Humans/Red-Meat-And-Processed-Meat-2018
http://monographs.iarc.fr/ENG/Monographs/vol114/mono114.pdf
https://www.iarc.fr/en/media-centre/iarcnews/pdf/Monographs-Q&A_Vol114.pdf
3rd WCRF/AICR expert report on Diet, Nutrition,
Physical Activity and Cancer: a Global Perspective
The evidence for cancer risk: a summary matrix
https://wcrf.org/dietandcancer
WHO Global Action Plan on Physical Activity (GAPPA)
"more active people for a healthier world"
• Presented to and endorsed by MS at the 71st WHA
(http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_18-en.pdf )
• Aimed at increasing participation in physical activity by people of all ages, to
promote health and combat NCDs
• Providing MS with a prioritised list of actions to address the multiple cultural,
environmental and individual determinants of physical inactivity
• Goal: 15% reduction in the global prevalence of physical inactivity in adults
and in adolescents by 2030
http://www.who.int/ncds/governance/physical_activity_plan/en/US: '2018 Physical Activity Guidelines Advisory
Committee Scientific Report'
• Systematic review of the scientific evidence on physical activity, sedentary behaviour, fitness, and health, including
• Prevention of obesity, dementia, depression, anxiety, falls, chronic disease progression or development of multiple chronic conditions;
cancers of the breast, colon, bladder, endometrium, oesophagus, kidney, lung, and stomach
• Improvement of cognitive function, bone health, insulin sensitivity, blood pressure, quality of sleep, quality of life and physical function,
• Benefits (newly) substantiated for 3-5 year old children, older adults, pregnant women and postpartum, individuals with chronic
conditions
• The report says:
"Some benefits happen immediately. A single bout of moderate-to-vigorous physical activity can improve that night's sleep, reduce anxiety
symptoms, improve cognition, reduce blood pressure, and improve insulin sensitivity on the day that it is performed. Most of these
improvement become even larger with the regular performance of moderate-to-vigorous physical activity. Other benefits, such as disease
risk reduction and physical function, accrue within days to weeks after adopting a new physical activity routine."
• The report will inform the next edition of the Physical Activity Guidelines for Americans
https://health.gov/paguidelines/second-edition/report/pdf/PAG_Advisory_Committee_Report.pdf/KIGGS study – Wave 2 report • Survey methods and key data of the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), including • Overweight/obesity prevalence and trends • Physical activity levels and trends • Soft drink consumption https://www.rki.de/EN/Content/Health_Monitoring/Health_Reporting/GBEDownloadsJ/Journal-of- Health-Monitoring_01_2018_KiGGS-Wave2_first_results.pdf?__blob=publicationFile
PHE 1st progress report on sugars reduction programme • 2% reduction (2015->2017) in sales weighted average (SWA) sugars content • Reduction observed in 5 out of 8 product categories • 2% reduction in SWA calories per portion • Reduction in 4 out of 6 product categories • Out of home products have generally similar sugars content, but higher calories per portion • For soft drinks: -11% SWA sugars content and -6% SWA calories per portion https://www.gov.uk/government/publications/sugar-reduction-report-on-first-year-progress
Public health and the food and drinks industry: The governance and ethics of interaction (UK Health Forum) • A 'casebook' with 12 experiences of public-private interactions • Highlighting examples of the ethical and governance challenges of different types of interactions with corporate actors • Complementing a new WHO tool: 'Safeguarding against possible conflicts of interest in nutrition programmes' (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_23-en.pdf ) • Key lessons for public health actors http://www.ukhealthforum.org.uk/prevention/pie/ukhf-publications/?entryid43=58305
Articles in scientific (peer-reviewed) journals
Alcohol industry corporate social responsibility
initiatives and harmful drinking: a systematic review
Objective:
• To summarise and examine what is known about CSR initiatives undertaken by alcohol
industry actors globally, regarding the reduction of harmful drinking.
Findings:
• Five types of CSR initiatives identified: (1) Alcohol information and education provision; (2)
drink driving prevention; (3) research involvement; (4) policy involvement; and (5) the
creation of social aspects organisations.
• There is no robust evidence that alcohol industry CSR initiatives reduce harmful drinking.
• There is evidence that CSR initiatives are used to influence the framing of the nature of
alcohol-related issues in line with industry interests (and in conflict with a public health
conceptualisation of harmful drinking).
Author's suggestions/ conclusions:
• Alcohol policy measures to reduce harmful drinking are needed, and the alcohol industry
CSR initiatives studied so far do not contribute to the attainment of this goal.
• Research in this area is at an early stage of development.
European Journal of Public Health (2018); http://dx.doi.org/10.1093/eurpub/cky065Contribution of alcohol use disorders and other
modifiable risk factors to dementia burden in France
• Alcohol use disorders was the strongest
modifiable risk factor
• >3 fold increased risk for dementia
• All alcohol-related conditions; tobacco
smoking, high blood pressure, and diabetes
(but not obesity, hyperlipidaemia); CVD
were independent risk factors for dementia
Copyright © 2018 The Author(s). Published by Elsevier
Lancet Public Health 2018, 3: e124–32; https://doi.org/10.1016/S2468-2667(18)30022-7
Ltd. This is an Open Access article under the CC BY-
NC-ND 4.0 license Terms and ConditionsImpact of Healthy Lifestyle Factors on Life
Expectancies in the US Population
• Adherence to 5 low-risk lifestyle-related factors (never smoking, a healthy weight, regular
physical activity, a healthy diet, and moderate alcohol consumption) could substantially
reduce premature mortality and prolong life expectancy
• Estimated life expectancy at age 50 with 0, 1 , 2, 3, 4, 5 low risk factors is:
• for females: 29.0; 31.5; 34.0; 36.7; 38.9; 43.1 years
• for men: 25.5; 27.7; 30.4; 32.2; 35.4; 37.6 years
• Prevention should be a top priority for national health policy
Circulation. 2018 [E-pub ahead of print]; https://doi.org/10.1161/CIRCULATIONAHA.117.032047Physical activity, diet and other behavioural interventions
for improving cognition and school achievement in children
and adolescents with obesity or overweight (Review)
• Some evidence suggests that school programmes that
encourage healthier child weight may also provide ‘co-
benefits’ of thinking skills and school performance
• Changing knowledge about nutrition, and the food
offered in schools can lead to moderate improvements
in general school achievement of teenagers with obesity
• Rather low quality of evidence -> future well-designed
studies might change these review outcomes Potential causal links between obesity and impaired cognitive function,
school achievement and future success. Reverse causation may also occur
when cognitive function, school achievement and future success can impact
the 'mediating factors', and both in turn may cause worsening of obesity.
Cochrane Database Syst Rev. 2018; Issue 3 :CD009728; http://dx.doi.org/10.1002/14651858.CD009728.pub4Equity impacts of price policies to promote healthy behaviours • Addressing the issue of using fiscal policies to affect prices and reduce unhealthy consumption patterns versus unfair financial burden on low-income households • Expenditure on potentially unhealthy products increases more for high-income than for low- income households • However, as a share of all household consumption, price increases are often a larger financial burden for low-income households • Large health benefits often accrue to individual low-income consumers because of their strong response to price changes • The financial burden on low-income households created by taxation could be mitigated by a pro-poor use of the generated tax revenues Lancet 2018; 391: 2059–70; http://dx.doi.org/10.1016/S0140-6736(18)30531-2
Portion size effect (PSE) and overconsumption – towards
downsizing solutions for children & adolescents
• Existing evidence suggests that large portion sizes of high energy density (HED) foods increase
total energy intake and this might promote weight gain
• In laboratory settings, the PSE is robustly confirmed, reliable, enduring
• Perceptual errors (not realising to overeat) or heuristics ('clean the plate', and children following
external cues as prime to eat and how much to eat) are possible explanations
• However, individuals differ in reacting to external over internal (satiation/hunger) cues
• Downsizing HED meals, snacks, drinks is an obvious approach, however limited but growing
evidence suggests mixed effect in adults and unclear effects in children (->data/research need!)
Nutrition Bulletin (2018), 43, 61–68; http://dx.doi.org/10.1111/nbu.12307Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition • Interest in vegetarian diets is growing in Italy and elsewhere • Vegetarian diets that include a wide variety of plant foods provide adequate nutrient intake • Vitamin-fortified foods/B12 supplements, higher protein intakes (due to reduced plant protein digestibility), choosing good dietary sources/strategies to enhance bioavailability of Ca, Fe and Zn are strongly recommended • A healthy and nutritionally adequate vegetarian diet can be obtained from the variety of plant foods available/traditionally consumed in Italy • Government agencies and health/nutrition organizations should provide more educational resources to help Italians consume nutritionally adequate vegetarian diets Nutr Metab Cardiovasc Dis. 12, pp 1037-1052 (2017); https://doi.org/10.1016/j.numecd.2017.10.020
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