Porgrow results from Finland

1
Porgrow results from Finland
Patrik Borg Mikael Fogelholm UKK Institute for
Health Promotion Research Tampere Finland
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Increase in obesity (25-64 y)

Finriski 2002
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Proportion of overweight boys
Source National Public Health Institute
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Trends in food intake
Copied from National Public Health Institute data
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Intake of some unhealthy foods in 1985 and 2002
(milj. portions)
(thousand kg 1990-2002)
(thousand litres)
(thousand kg)
(thousand litres)
(thousand litres)
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Leisure exercise in Finland
The proportion of adults (25-64 y) with leisure
exercise at least two times a week. (National
Public Health Institute, 2003)
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Commuting physical activity in Finland
The proportion of adults (25-64 y) with commuting
to and from work (walking, biking) at least 15
min/day (National Public Health Institute, 2003)
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Total physical activity in Finland- Tampere
region as example
7
6
Optimal M 21 W 24
Adequate M 24 W 21
Weekly frequency of leisure exercise (gt30
mins/day)
5
4
3
Adequate M 17 W 21
Inadequate M 38 W 35
2
1
0
0
15
30
45
Lifestyle physical activity (mins/day)
(Tampere City Health Profile, Paronen et al.,
2006)
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Obesity-related initiatives and debates

• Debates and future
• Food marketing (especially children)
• PE in schools
• Food pricing VAT change
• Vending machines in schools

• Initiatives
• T2D prevention program
• Marketing to children
• School yard infrastructure (neighbourhood sports
  facility)

• Implemented
• Strong recent
• PA promotion
• Traditions in promotion
• and coordination of
• healthy diet
• Health education
• in school
• Catering in
• occupational settings
• School meals
• Food labelling
• but due to CVD reduction!!

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Results
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Rank Means for Perspective - All Participants
1. Change planning and transport policies (C)
2. Improve communal sports facilities (C)
20. Physical activity monitoring devices (D)
4. Controlling sales of foods in public
institutions (C)
(RULED OUT BY SOME 2) 6. Subsidies on healthy
foods (C)
(RULED OUT BY SOME 3) 7. Taxes on
obesity-promoting foods (C)
(RULED OUT BY SOME 2) 11. Controls on food
composition (D)
(RULED OUT BY SOME 1) 12. Incentives to improve
food composition (D)
14. Provide healthier catering menus (D)
(RULED OUT BY SOME 2) 5. Mandatory nutritional
information labelling (C)
(RULED OUT BY SOME 3) 3. Controls on food and
drink advertising (C)
(RULED OUT BY SOME 1) 19. Control of marketing
terms (D)
8. Improve training for health professionals (D)
10. Improved health education (D)
15. Food and health education (D)
13. More obesity research (D)
16. Medication for weight control (D)
(UNAPPRAISED) 17. Substitutes for fat and sugar
(D)
18. New government body (D)
9. Common Agricultural Policy reform (D)
0
10
20
30
40
50
60
70
80
90
100
12
Most highly ranked options
Include food and health education more strongly
in the school curriculum Improve communal sports
facilities Improve training for health
professionals Improved health education (to the
public)
Controlling sales of foods in public
institutions Subsidies on healthy foods
Worst ranked options
Common agricultural policy reform Create a new
governmental agency Medication to control
bodyweight
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Scores for Efficacy, All Stakeholders
1. Change planning and transport policies (C)
2. Improve communal sports facilities (C)
20. Physical activity monitoring devices (D)
4. Controlling sales of foods in public
institutions (C)
(RULED OUT BY SOME 2) 6. Subsidies on healthy
foods (C)
(RULED OUT BY SOME 3) 7. Taxes on
obesity-promoting foods (C)
(RULED OUT BY SOME 2) 11. Controls on food
composition (D)
(RULED OUT BY SOME 1) 12. Incentives to improve
food composition (D)
14. Provide healthier catering menus (D)
(RULED OUT BY SOME 2) 5. Mandatory nutritional
information labelling (C)
(RULED OUT BY SOME 3) 3. Controls on food and
drink advertising (C)
(RULED OUT BY SOME 1) 19. Control of marketing
terms (D)
8. Improve training for health professionals (D)
10. Improved health education (D)
15. Food and health education (D)
13. More obesity research (D)
16. Medication for weight control (D)
(UNAPPRAISED) 17. Substitutes for fat and sugar
(D)
18. New government body (D)
9. Common Agricultural Policy reform (D)
0
10
20
30
40
50
60
70
80
90
100
14
Cluster 1 Physical activity promotion 1. Change
planning and transport policies 2. Improve
communal sports facilities 20. Increase the use
of physical activity monitoring devices

• Options 1 and 2 generally were generally
  preferred by all and considered effective
• The perceived feasibility was higher in option 2
• Increasing the use of monitoring devices rarely
  appraised often considered as avoidance of real
  issues

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Cluster 2 Modifying the supply of, and demand
for, foodstuffs 4. Control sales of foods in
public institutions 6. Provide subsidies on
healthy foods 7. Impose taxes on
obesity-promoting foods 11. Control the
composition of processed food products 12.
Provide incentives to improve food
composition 14. Provide incentives to caterers
to provide healthier menus

• Actions with a more positive or a carrot
  effect (incentives and subsidies) were ranked
  better than those imposing regulation and
  restrictions (taxes, regulations)
• The more the action is likely to affect
  commercial interests, the more poorly is was
  ranked (feasibility etc)

16
Cluster 3 Information-related initiatives 5.
Require mandatory nutrition labelling 3.
Controls on food and drink advertising 19.
Control the use of marketing terms (diet,
light etc)

• Controversial and divided opinions
• Not essential, but often considered as an
  important part of a larger portfolio

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Cluster 4 Educational and research initiatives
8. Improve training for health professionals in
obesity care and prevention 10. Improve health
education for the general public 15. Include
food and health in the school curriculum 13.
Increase research into obesity prevention and
treatment

• Educational initiatives were ranked highly among
  all perspectives
• Traditional and not threatening thus feasible
• Effectiveness also considered to be high
• Increased obesity research appraised by few
  often considered not essential

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Cluster 5 Technological innovation 16.
Increase the use of medication to control
bodyweight 17. Increase the use of synthetic
fats and artificial sweeteners

• Generally, medication was disliked or considered
  of minor importance
• No appraisals in no 17.

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Cluster 6 Institutional reforms 18. Create a
new governmental body to co-ordinate policies on
obesity

• As such, disliked nearly by all
• Still, improved coordination (cross-sectoral
  cooperation) of present agencies was raised by
  several stakeholders

20
Finnish results in European perspective

• PA promotion ranked higher than average
• Options with restrictions and controls received
  more pessimistic values than average
• Options regarding pricing policies received most
  optimistic rankings

Most highly ranked options
Include food and health education more strongly
in the school curriculum Improve communal sports
facilities Improve training for health
professionals Improved health education (to the
public)
Controlling sales of foods in public
institutions Subsidies on healthy foods