European Commissioner for Health and Consumer Protection
“Food for Thought - Nutrition and Public Health Policy”
Children and Nutrition Congress
Berlin, 8 July 2003
Ladies and Gentlemen,
First may I express my sincere thanks to the Federal Ministry of Consumer Protection, Food and Agriculture, and Renate Künast in particular, for the excellent and timely initiative in organising today's conference.
The statistics contained in the Verbraucherzentrale Bundesverband (VZBV) report on the situation in Germany regarding child nutrition and health are alarming in particular regarding the rise in obesity amongst children.
But Germany is, of course, far from alone in its predicament. Similar patterns can be observed right across Europe and indeed beyond our borders indicating a seemingly relentless tide of increasing obesity and nutrition related diseases affecting the whole of our society.
The WHO's Europe region estimates that up to 20-30% of adults in Europe are overweight. It says that poor diet and lack of physical activity is also linked with cardiovascular diseases. In Europe, cardiovascular diseases are responsible for 40% of all deaths and will be for the next 20 years.
My address today is entitled “Food for Thought Nutrition and Public Health Policy”. I will first say a few words on “cause and effect” and then focus on three principal areas information, education and finally some thoughts on responsibility.
But before I do so, allow me to make an initial observation.
The subject of obesity has been in the shadows for far too long. Admittedly it is a sensitive issue and, of course, we must take care not to stigmatise anyone who suffers from this condition.
But there are encouraging signs. Obesity is fast rising up both the political and social agenda. Indeed this very conference is a concrete and visible recognition of the essential need to find successful solutions.
The increasing profile and attention given to obesity are good news. The time is now right to build on this raised awareness and to concentrate our efforts towards building a healthier future for all.
Legislation alone cannot combat obesity. However, I am sure we all agree on the urgent need for all those involved to fully address the issue of nutrition.
Left unchecked, rising obesity will constitute a drain on public resources in future. Healthcare spending could go through the roof while the overall effects on society could be extremely severe.
But in addition to and possibly even above economic considerations, our duty to act comes sharply into focus when we consider the personal suffering that a lifetime of obesity can entail.
And the social effects are particularly pronounced amongst children. Children, as we know, can be very cruel in their social interactions. And as the VZBV report shows, the incidence of bullying and name-calling suffered by obese children is extremely high. And this is only likely to increase a child's sense of isolation and lower his or her self-esteem, thus exacerbating the problem.
Cause and effect
We know that the factors influencing obesity are complex. They encompass genetic, societal and environmental factors, including, of course, diet and lifestyle.
It is, however, clear that excess weight gain and obesity generally arise from an imbalance between the calories we consume and the energy we expend. Maintaining a constant and healthy weight is in essence largely a question of getting the balance right.
Clearly for many individuals, young and old, this balance is not being achieved. Although energy intakes appear to have actually declined in recent decades, the supply of fuel still outstrips the demand for energy. If we look at the way lifestyles have changed over the years this trend can be easily explained.
On the supply side there has been a general drift away from home-prepared meals towards a lifestyle of eating on the run often not conducive to overall dietary balance.
The food industry today provides the basis of our diet and caters to our diverse needs for taste, nutrition, variety and convenience. While processed foods make a significant and often positive contribution to our dietary intakes, consumers may not be aware of the hidden fats, as well as the sugar and salt content of the foods they choose. And the consumption of fruit and vegetables, which provide key nutrients for health, is also often insufficient.
On the demand side, life is quite simply less physically active than it used to be. How many of us here drive or take public transport to get to work or take the lift instead of the stairs?
And many children today are more likely to be found watching TV or playing computer games than participating in active pursuits. The energy required to be slumped in front of a screen or push a mouse around a mousemat is vastly reduced when compared, for example, to chasing a ball around a park or going swimming.
So we know the problem but how can we best move forward? In short, we need to encourage citizens of all ages to establish a broad equilibrium between what they eat and drink and the energy they expend.
It sounds very simple. But getting there will take a massive effort. There is no magic bullet. The problem needs to be addressed from a number of angles and requires active collaboration from the whole range of stakeholders right across society.
Ensuring that consumers are provided with sufficient, reliable information on which to base their choices is one of the principal objectives I pursue in my position as European Commissioner for Health and Consumer Protection.
As far as food and drink are concerned I intend to make three important proposals for new legislation in the near future.
The fine details of these proposals have yet to be formally agreed, but I can give you a broad flavour of what they are likely to include.
The first proposal will cover nutrition and health claims. It will be on the Commission's agenda next week. The aim is to ensure that consumers are not misled and that any claim promoting a health or nutritional benefit is scientifically justified.
Nutrition claims are those claims that state suggest or imply that a foodstuff has particular nutritional properties due to its energy value or its nutrient content. For example “with added vitamin C”; “high in fibre”; or “fat free”.
Health claims are those claims that state, suggest or imply a relationship between a foodstuff or food component and health. For example “calcium fortifies the bones”. These may include claims for reduction of a disease risk factor such as “whole grain may reduce the risk of heart disease”.
The important point is that all claims should be verifiable and should not give false or misleading impressions of the purported benefit of a particular food.
For example 90% fat-free is often misunderstood to mean “low fat”, whereas a 10% fat content is in fact relatively high. We intend to insist on the latter that is, the indication of actual content rather than an inverted expression of what a food does not contain.
The second proposal concerns the harmonisation of measures concerning the fortification of foods with, for example, vitamins and minerals. Measures currently in place vary across the Member States.
We are discussing a framework to allow for criteria to be drawn up to prohibit foods from bearing claims or being fortified unless they have an appropriate nutritional profile.
Such an appropriate profile could include limitations, in particular, of the content of fat, saturated and trans fatty acids, sugars and salt.
This would not, however, amount to classifying foods as either “good” or “bad”. No product would be barred from the market, no product would be subject to a negative labelling as a result of this new approach.
However, products which do not meet the nutrient profiles because of their high content in a nutrient that has been identified as having a negative impact on health (fat, salt, sugar) would not be eligible for bearing a nutritional or health claim nor will they be eligible for fortification. This prevents them from being marketed as “good food”, which they are not.
In the interest of consumer protection, we want to ensure that consumers are not potentially misled through the use of claims about the contribution of a specific food towards a balanced diet.
A similar approach has been enforced for nearly a decade in the U.S. where food with a content in salt, fat or cholesterol higher than the limits specified by the FDA may not be marketed as “healthy” food.
I am not suggesting that confectionery or potato crisps for example should be avoided but instead that such foods should form only a small part of a person's diet. Food producers should not be permitted to push the consumption of such foods through the use of nutrition and health claims.
Such an approach to nutritional profiling is based on the WHO/FAO report on “Diet, Nutrition and the Prevention of Chronic Diseases” of February this year, in which the WHO calls for limitation of intakes of certain nutrients.
This new approach will be a key component of a new nutrition policy I will propose in order to respond to the formidable challenge of diet-related chronic diseases. The reform of the EU rules on nutrition labelling will constitute another major component of this policy.
We will seek to improve our current legislation to facilitate consumers' understanding and use of nutrition labelling in choosing balanced diets.
One of the points under consideration is whether nutrition labelling should be made mandatory so that consumers can find the same information, presented in the same format, across the majority of foods that they choose.
The possible introduction of mandatory nutrition labelling could also present a valuable opportunity to educate consumers about the nutrition label, and how to interpret and utilise nutrition information in selecting healthy diets.
These measures, taken together, amount to a major overhaul of European food labelling legislation with the aim of helping consumers to make informed choices about what they choose to buy.
But while such information represents an important enabling factor, it cannot in isolation lead to dietary and behavioural change. The Eurodiet and WHO/FAO reports, and other public health nutrition experts, all highlight the need for co-ordinated, multi-sectoral and population wide strategies.
Our efforts to inform need to be matched by educational measures to help individuals better understand and use the information on food labels to meet their specific needs.
We need to motivate and encourage positive change not only in relation to diet but also to promote an increase in physical activity.
The active involvement of a range of key stakeholders is essential for the development of clear understandable motivational messages to encourage positive behavioural change.
The new EU public health programme, which came into force on 1 January of this year, provides the framework and the means to take forward important work in the area of nutrition and health.
The establishment of a Nutrition and Physical Activity Network paves the way for the development of more coherent strategies with an emphasis on obesity prevention. It also facilitates the sharing of ideas and the transfer of best practices throughout the European Union.
In order to influence behaviour we need to understand better what people eat and how dietary patterns are changing. This will facilitate the drawing up of “nutrition action plans” taking into account the needs of specific sectors of the population the young and the elderly, for example. The collection and analysis of nutrition-related data is continuing under the DAFNE project.
I should also mention the Health Promoting Schools project, jointly supported by the WHO, the Council of Europe and the European Commission, which seeks to instil sound dietary and lifestyle habits in school children.
Before I finish, I want to touch on the issue of responsibility in putting into practice the behavioural changes we are keen to promote.
First governments and civil society need to ensure that health and nutrition is given the priority it deserves as indeed many within the European Union are actively doing. This includes the promotion of good dietary habits and the importance of exercise.
It also includes ensuring that positive and consistent messages are relayed to children through national education systems. We need to ask ourselves the question “Is it right that children often have access to processed snacks and high sugar drinks in schools, but not fruit?”
Education should strive to give children not only a better understanding of food but also appreciation of its diversity in order to foster sound dietary habits. Educational strategies should communicate direct and perceivable benefits associated with healthy eating and encourage a positive body image among children and teens.
Second the food industry has a responsibility to ensure that healthy choices become easy choices for their consumers a point made by Dr Brundtland of the WHO, in particular with regard to children.
Science has shown the need to reduce the fat, sugar and salt levels in the diet overall, while we also wish to see an increase in consumption of fruit and vegetables.
The food industry must respond to this challenge by providing foods that meet consumers' expectations for taste and convenience while addressing today's nutritional concerns.
I very much welcome recent initiatives by industry to promote healthier eating by e.g. limiting the size of its portions.
Given its direct contact with consumers, the food industry has a unique and important role to play in communicating the importance of good nutrition, as well as the contribution of specific foods, to consumers in a responsible and reliable manner. Indeed the WHO is already engaged in constructive dialogue with the food industry on these important issues.
The food industry also needs to address the marketing of food products to children. In recent years the advertising industry has recognised and exploited the power of selling brands and images rather than products in isolation associating a particular lifestyle with a product.
The use of sport stars, for example, to sell high sugar, high fat or high salt foods is a case in point. This can create a misleading impression, especially to children, of the effect that a food might have.
I should add here that I recently made a proposal for a European Directive on unfair commercial practices in general, which would cover the banning of specific aggressive practices.
This includes “Advertising to children in a way which implies that their acceptance by their peers is dependent on their parents buying them a particular product.” Advertising to children needs to be responsible, and to take into account the way an average child would respond.
And finally with regard to the consumer personal responsibility. All the measures I have mentioned here today can only go so far. Ultimately they rely on a positive reaction from citizens.
Whilst institutions can inform, educate and point out the benefits of eating healthily, taking exercise and controlling weight, ultimately the responsibility for taking personal action lies with the individual.
Similarly, parents must bear a large part of the responsibility for the dietary and exercise habits of their children.
Ladies and Gentlemen, I have covered a fair amount of ground in a short space of time.
To conclude, I see that this afternoon's session is entitled “Is there any way out of this?” There is an air of desperation about this question.
Without wishing to pre-empt this afternoon's discussions, I firmly believe that collectively we can continue to develop a comprehensive range of initiatives that, if properly co-ordinated and supported, on both a national and European level, could help to first stem the increase of dietary related problems and then help to reverse the current trends.