Data from several studies suggest that childhood obesity has increased steadily in Europe over the past two to three decades. In Europe, almost 20% of children are overweight or obese. The highest prevalence levels are observed in southern European countries with up to 36% of 9-year-olds in Italy being overweight or obese.

Some of these obese children already have multiple risk factors for type-2 diabetes, heart disease and a variety of other co-morbidities.

Many interacting factors cause obesity and add to the complexity of tackling it. However, the rapid changes in the numbers of obese children within a relatively stable population indicate that genetic factors are not the primary reason for change, rather obesity-promoting environmental factors are the main culprit. An emphasis on the environmental causes of child obesity leads to certain conclusions:

• treatment for obesity is unlikely to succeed if we deal only with the child and not with the child’s prevailing environment;
• prevention of obesity will require a broad-based public health approach.

A public health approach requires multi-sectoral action. According to several publications on obesity, efforts to prevent obesity should include measures involving a wide range of actions, including:

• Protection of open urban spaces, provision of safer pavements, parks, playgrounds and pedestrian zones, creation of more cycling paths;
• Taxes on unhealthy foods and subsidies for the promotion of healthy, nutritious food;
• Dietary standards for school lunch programmes;
• Elimination or displacement of soft drinks and confectionery from vending machines in schools;
• Clear food labelling;
• Restrictions or bans on the advertising of foods to children;
• Limits on other forms of marketing of foods to children;
• Assessment of food industry initiatives to improve formulations and marketing strategies.

Such an approach also underlines that improving diet and increasing physical activity of individuals and populations are not achievable solely by promoting individual awareness and individual knowledge. Collective action, including the development of international strategies, together with supportive government policies, are essential in order to advance public health and minimise the hazards associated with a global epidemic of obesity.

Objectives of the project on Children, Obesity and Associated Avoidable Chronic Diseases

The aim of this project is to tackle the obesity epidemic among children and young people. The project has a specific focus on one of the environmental factors, namely marketing to children of foods that are high in fat, sugar and salt, as a short term action. A comprehensive research review carried out by the Food Standards Agency in the UK concludes that food promotion affects the preferences of children (type and brand of food they like to eat) and what they buy or pester parents to buy.

In its first phase (March 2004 – February 2005), the project measured the extent and nature of the food marketing to children. In the 20 countries involved in the project, information on food industry practices with regard to food marketing to children was collected.  The project also looked at existing measures (legislation, voluntary agreements, codes, etc) at national level with regard to food marketing to children.  This information is made available in the report of The marketing of unhealthy foods to children in Europe

Subsequent phases of the project, which ended in October 2006, built on the outcome of the data collection and analysis done in the first phase and looked at policy options available to prevent child obesity.  European and national stakeholder consultations were organised with a view to coming to a consensus on a limited number of policy options to prevent child obesity.  Countries involved in the project determined their own list of policy options and a stakeholder consultation was organised at EU level, leading to consensus on 5 policy options at EU level. A report on policy options to prevent child obesity was produced, which establishes that the awareness of the problems is high and that various national and international measures are being proposed.  It discusses the options available, tools for selecting policy options and gives an overview of international and national approaches towards preventing child obesity as well as the results of the Europe-wide stakeholder consultations.

The consensus documents setting out the preferred policy options lead to a number of guidelines in the participating countries.  For more information on this subject, please contact the European Heart Network or the national coordinators of the respective countries.

EHN received financial support from the European Commission Public Health Programme for the development of this project.