Irish Nurses Cardiovascular Association

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Irish Nurses Cardiovascular Association

• Michael OShea
• 31st March 2006

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Cardiovascular Disease

• Background
• Decline in CHD Mortality in Ireland
• Obesity
• Background
• EU Green Paper
• EHN Recommendations
• Marketing of energy dense foods to kids
• Conclusions

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• Worldwide
• 17 Million deaths from CVD in 2003
• Europe
• Half of all deaths from CVD in 2002
• Smoking
• Increases chances of dying from heart attack
  stroke by 200/300.
• High Blood Pressure (gt140/90)
• 30 of adults worldwide suffer from high BP
• High Cholesterol
• Cause 1/3 of all CV Diseases worldwide

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Why have CHD death rates halved since the 1980s?

• Evidence based cardiology treatments?
• OR
• Risk factor reductions?

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Aim

• To explain fall in CHD mortality in last 15 years
  in Ireland
• IRISH IMPACT MODEL
• Compares population between 1985 2000
• Men Women
• All age groups 25- 84 years

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Building a comprehensive CHD Model

• IMPACT Model Includes
• CHD treatments
• Immediate AMI Treatments
• Secondary Prevention
• Post AMI, post CABG, post Angioplasty
• Chronic Angina CABG, Angioplasty, Aspirin
• Unstable Angina Aspirin, Heparin, PG IIB/IIIA
• Heart failure
• Hypertension
• Statins for primary prevention
• CHD Risk factors (surveys, local studies)
• Smoking, Population blood pressure, Cholesterol,
  obesity, diabetes, inactivity

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Results

• Using 1985 as base year, in 2000
• Expected number of deaths 8681
• Observed number of deaths 4918
• Fall in death numbers 3763
• 2440 fewer deaths in men 1323 in women
• ( 47 fall in men, 47 in women)
• IMPACT model explained approximately
• 92 of mortality fall

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Conclusions

• Ireland 1985-2000
• 47 CHD mortality fall
• Major contributions from medical therapies
• reductions in major risk factors
• Comprehensive CHD strategy important
• maximise effective treatments secondary
  prevention in eligible population
• actively promote primary prevention particularly
  healthy diet smoking reduction
• Importance of halting obesity

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Smoking Ban - Success

• Cotinine levels dropped by 80 in non-smoking bar
  workers
• Smoking rates down from 31 in 1998 to less than
  24 on Oct 2005
• Young people smoking levels - up
• Price Deterrent to young people
• Government inaction because of CPI

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Obesity

• 300m obese worldwide in 2000 (WHO)
• By 2025 half pop of USA will be obese (WHO)
• Ireland (OTFR)
• 18 Obese
• 39 Overweight
• 300,000 children obese or overweight
• 10,000 annually

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Obesity

• Obesity
• Diabetes type 2 hypertension angina heart
  attack osteoarthritis
• 2000 Premature deaths annually
• Estimated cost 4B annually

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Obesity

• EU Commission Green Paper on
• Promoting Healthy Diets Physical Activity A
  European dimension for the prevention of
  overweight, obesityand chronic disease

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EHN

• Enact EU Regulation on nutrition health claims
  on food products
• Make nutrition labelling mandatory
• TV without Frontiers directive be extended to ban
  advertising of energy dense foods to children and
  promotion of fruit and vegetables

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EHN

• Priorities for combating obesity in childhood
• Controlling sale of energy dense foods in public
  institutions
• Controls on advertising of energy dense foods
• Mandatory nutritional information labelling for
  all processed food
• CAP reform and subsidising healthy foods

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Marketing unhealthy foods to children in Europe

• A report of EU funded project
• Children, obesity and avoidable chronic
  diseases project April 2005
• European Heart Network
• BHF Health Promotion Research Group
• International Association of Consumer Food
  Organisations
• International Diabetes Federation
• International scientific evidence snapshot in
  20 countries 2003

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Hastings Review conclusions

• Big 5 pre-sugared cereals, soft drinks,
  confectionery, snacks and fast food dominate TV
  advertising to children
• There is sufficient evidence to show that food
  promotion has an effect on children, particularly
  their food preferences, purchase behaviour
  (including pester power) and consumption
• The evidence is likely to understate the effects
• Other marketing activity
• Indirect effects

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Key findings EHN Report

• Marketing of unhealthy food to children is on a
  massive scale
• Most food marketed to children is unhealthy
• Major spend is in TV but declining
• Schools a growing market
• The internet and SMS new and growing

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The recommended diet vs the advertised diet

• Around three-quarters of food advertising to
  children is for sugary, fatty and salty foods.
  For every 1 spent by the WHO promoting healthy
  diets, 500 is spent by the food industry
  promoting unhealthy foods

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Association between numbers of adverts for sweet
and fatty foods shown on childrens television
and the prevalence of overweight children in the
population Seven EU countries, USA and
Australia Correlation r0.86, plt0.005
Lobstein and Dibb, Obesity Reviews (6) 2005
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Marketing more than TV ads

• Schools
• Sponsorship
• Packaging characters, cartoons, incentives,
  token collection
• Internet
• Texting

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Marketing more than TV

• Packaging
• Give aways
• Link to website www.magic-kinder.com
• Link to texting

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Marketing more than TV

• Packaging
• Themes, characters
• Giveaway toys
• www.kindersurprise.com
• Website draws in email

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Marketing more than TV

• Packaging
• Character Licensing
• TV Character
• The Simpsons - Homer

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Marketing more than TV

• Packaging
• Characters Bear in the Big Blue House
• Website www.bearinthebigbluehouse.com
• Apeals to younger children
• Product placed on bottom shelf

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Product Placement
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Product Placement
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Regulation

• Regulation varies, mainly directed at TV
• TV ban in Norway and Sweden, (BCI code in
  Ireland) undermined by global satellite and
  cable.
• Internet least regulated

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What Irish consumers say

• Over 2 out of 3 Irish parents express concerns
  about advertising of unhealthy foods to children
• Rollercoaster (parents website) (2004)
• MOMS (mothers) (2004)
• HSE, Southern area (2004)
• Safefood (2004)

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And so

• Marketing of unhealthy foods to children on a
  massive scale across Europe.
• National and European measures needed to protect
  children

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Conclusions

• CVD Government Priority
• Funding for CVD Strategy
• Implement OTFR recommendations
• Protect children from aggressive marketing by BIG
  BUSINESS
• Regulate at EU level for Nutrition/Health Claims
  Labelling