An Overview

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An Overview on the EatSmart Campaigns
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Diet and Disease

• Three NCDs account for almost 60 of all
  registered death in Hong Kong
• Cancer (32.4)
• Heart diseases (15.2)
• Cerebrovascular diseases (8.9)
• Unhealthy dietary habits
• increase the risk of chronic illnesses
• cause overweight and obesity

2006 data
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Self-reported BMI in Adults
Overweight Obese
2005 27.1 35.9 36.0 2006 32.0 51.4 41.0
Data source Behavioral Risk Factor Surveillance
System
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Childhood Obesity

• 1997/98 16.4
• 2005/06 19.4
• 2006/07 20.3

Data Source DH Student Health Service
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Nutrition is One of the Prority Action Areas of
CHEU, DH
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EatSmart Campaigns
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Strategies

• Supportive environment
• Publicity and communication
• Education and empowerment
• Research and evaluation
• Strengthen Community Actions
• Build partnerships

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Strategies

• Supportive environment
• Publicity and communication
• Education and empowerment
• Research and evaluation
• Strengthen Community Action
• Build partnerships

Community Dietetic Service database
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Community Dietetic Service database
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Community Dietetic Service Database
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Today Session

• Update EatSmart_at_school
• Introduce EatSmart_at_restaurant
• QA

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Update ofEatSmart_at_school.hk Campaign

• Department of Health

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EatSmart_at_school.hk
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Aim

• To improve eating habit of
• primary school students

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In 2006/07 academic year
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Strategies

• Alliance building
• Publicity and advocacy
• Creating supportive environment
• Education and empowerment
• Research and evaluation

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Target groups
School personnel
Students
Lunch Suppliers
Parents
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Steering Committee, Task Force and Working Groups
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Alliance Building Ceremony
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Publicity and advocacy

• 39 briefings (dietitians, school administrators,
  parents, caterers, District Councilors)
• Media activities
• 11 press conference
• 13 press release
• 94 media interview
• TV ads/road shows
• gt200 visits to schools and caterers
• School based events

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Supportive environment

• Making healthier choices easier in schools
• Nutritional guidelines on school lunch (Apr 06)
• Nutritional guidelines on school snack (Jun 06)
• A guide book to lunch suppliers (Aug 06)
• Revision of EDB guidelines (May 07)

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Education materials

• Dedicated thematic website
• Web-based teaching kits
• Pamphlets to parents

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www.eatsmart.gov.hk
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gt 50 10 schools took part
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Students

• Strengthen curriculum
• Peer Educators collaborated with Scouts and
  Brownies
• Fruit Day 2007

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230,000 students took part in Fruit Day 2007
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E-card Competition
Eat more vegetables , eat more fruits.Drink more
water , feel so good.Healthy life with healthy
food.
Slogan Competition
??????,?????,?????,?????
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School NutriAgent Project (SNAP) targeting
school personnel and parents
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Healthy Lunch Cooking Competition
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Nutritional workshop for chef
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In 2007/08 academic year
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Way forward

• Advocate healthy eating policy in schools
• Strengthen educational efforts
• Enhance collaboration with caterers
• Sustain community interest and demand for healthy
  food choices

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Lunch Guidelines Revision

• Aim
• To ensure the content of the guidelines is
  relevant and sound from public health, dietetic,
  supplier and practical points of view

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Major Amendments
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Amendment 1

• Clarification of 321 message

Grains cereals, vegetables and meat should be
in the ratio of by volume
2
1
3
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Amendment 2 Encouraged Food Items

• Old version
• Whole grains
• Reduced fat dairy products or other calcium-rich
  food items

• New version
• Whole grains or grains and cereals with added
  vegetable

Lunch suppliers should include the following food
category in AT LEAST ONE menu choice on ALL
school days
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Amendment 3Strongly Discouraged Food Items

• Food belongs to this category are strongly in ALL
  menu choices in order to help reduce consumption
  of total fat (especially saturated fat and
  artificial trans fat), salt and sugar by students.

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Amendment 4Strongly Discouraged Food Items

• Old version
• Desserts or beverages with more than 10 grams or
  2 teaspoonfuls of added sugar in each serving.

• New version
• Desserts with added sugar or beverages in Snacks
  to Choose Less category

Snacks to Choose Less in Nutritional
Guidelines on Snacks for Primary School Students
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Amendment 5Healthy Lunch Box Checklist
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Other Amendments

• Clarifications of the original concepts or
  guidelines
• Further elaborations with examples

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Schools

• Set healthy eating policy
• Join SNAP
• Select the right lunch supplier (19.12)
• Carry out school lunch and snack surveillance
• 4.17 Fruit Day 2008

Principal Summit
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Parents

• Join SNAP 07/08
• Strengthen parental education effort
• Territory-wide publicity exercise
• HEAT Program
• Letters to parents

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Students

• Strengthen curriculum
• Healthy Eating Ambassador Program collaborated
  with Scouts and Brownies
• 417 Fruit Day

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Lunch Suppliers

• Set up regular working group
• Equip chef with skills to make healthy lunch
• Build a database of suppliers and healthy snack
• Suggest protocols for selection of lunch suppliers

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We need your help

• Public education
• Problem-solving skills
• A nutrition-sensible environment
• Watch out for health demotive practices!

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Thank you
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EatSmart_at_restaurant.hk Campaign
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How often do you dine out? A. 0-5x/wk B.
6-10x/wk C. 11x/wk
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Any healthier choices?
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Baseline Study in early 2007

• To examine peoples dinning out habits
• To solicit peoples view on healthy eating
  promotion in restaurants

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Dinning out for 5x/wk
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Source BRFSS, DH, 2005
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Comments on Dishes
Source Baseline Survey for ESR Campaign, DH, 2007
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Asking for More Healthy Choices
Age
Source Baseline Survey for ESR Campaign 2007, DH
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Task Force and Working Group
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Content

• Principles
• Criteria to become an EatSmart Restaurant (ESR)
• Experience of the Pilot Project
• Final Launch of the Campaign
• Role of Dietitians / Nutritionists

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Principles
Supportive Environment to Healthy Eating
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Point of Purchase Information

• Provide information when food is being chosen or
  purchased

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? Availability and Accessibility

• Larger variety and quantity
• The lack of healthier choice is one of the key
  barriers to the adoption of healthy eating
  habits
• Source Qualitative study on dietary and
  exercise practices of people of Hong Kong,
  Department of Health, 2004

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To make healthier choices easier!
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An ESR.

• Provides EatSmart Dishes of More Fruit
  Vegetables and 3 Less
• Indicates the EatSmart Dishes clearly

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More Fruit and Vegetables
means that either fruit and vegetables are the
sole ingredients of the dish or they occupy at
least twice as much the amount of meat present in
the dish
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3 Less

• means that the dish has less fat or oil, salt and
  sugar, meeting the 3 Less requirement

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Definition of 3 Less
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Definition of 3 Less
Example Fats Oils / Salad Dressing / Spread
Suggestions Examples of healthier ingredients Examples of less healthy ingredients
Use healthy vegetable oil Use low- or reduced-fat salad dressing Use spread which is reduced-fat and without added sugar Corn oil, olive oil, canola oil, reduced-fat peanut butter, jam without added sugar Butter, lard, coconut oil, margarine containing trans fat, salad dressing, jam with added sugar
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Definition of 3 Less
Example Grains and Cereals
Suggestions Examples of healthier ingredients Examples of less healthy ingredients
Use grains and cereals which is low in fat and without added sugar White bread, whole wheat bread, white rice, red rice, egg noodles, spaghetti, rice vermicelli, Chinese noodles Croissant, pastry, cocktail bun, pineapple bun, bun with lotus seed paste, stir-fried rice and noodles, fried instant noodles, E-Fu noodles
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Definition of 3 Less
Example Seasonings
Suggestions Examples of healthier ingredients Examples of less healthy ingredients
Use natural ingredients to replace seasonings or sauce which are high in salt or fat Garlic, ginger, spring onion, onion, lemon or lime juice, vinegar, parsley Shrimp paste, fermented soybean curd, salted black bean, chicken powder. MSG, ready-to-use sauces (e.g. black pepper sauce, curry, satay), oyster sauce
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Definition of 3 Less
Example Food Preparation / Cooking Methods /
Mode of Serving
Suggestions Examples of healthier cooking Examples of less healthy cooking
Replace frying with blanching to prepare meat Blanch canned vegetables to reduce sodium content Use low-fat cooking methods Boiling, steaming, grilling, baking, stewing, stir-frying or pan-frying with small amount of oil Deep-frying (including the frying process of meat prior to cooking), Pour salad dressing or condiments over the dishes
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Checklist for the 3 Less Dishes

• Use as the final Ax
• 3 Less dishes must pass all the 12 criteria in
  the checklist!!!

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Is the idea feasible?
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Pilot Study in Aug 2007
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?????? Restaurant Interventions
Door decal
Table tent
Certificate
Door decal
Table tent
Menu
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vegetables occupy at least twice as much the
amount of meat present in the dish
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Pilot Study

• Healthier dishes offered on any day in August
  2007 685 dishes
• Pre-intervention 243 dishes
• Data from 50 outlets

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Sales in EatSmart Restaurants
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Sales

• 94.5 of restaurant staff perceived more
  customers choosing Healthier Dishes
• 62 of restaurants reported increased sales in
  healthier dishes
• 98.0 of restaurant staff thinks it is viable to
  promote healthy eating in restaurant settings

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Customers feedback
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Customers

• gt95 are satisfied with the healthier dishes
• 85.8 said the campaign attracted them to choose
  the EatSmart Dishes
• 98.8 supported restaurants providing the
  healthier dishes
• 75.2 would patronize this restaurant again for
  the healthier dishes

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Awareness and Ordering pattern
500 Customers
Awareness of the Pilot Project
? 263
? 237
Ordered Healthier Dish
? 114
? 123
? 27
? 236
48.1
10.3
4.7 times more likely to order
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Staff

• Welcomed the campaign
• Difficulties encountered
• Matching ingredients
• Knowing the customers want

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ESR campaign is feasible!
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Benefits to ESR

1. Brings business
2. Exclusive use of the EatSmart Decal
3. Free use of More Fruit and Vegetables and 3
   Less logos
4. Identification as customer-centric business
   operators

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Benefits to ESR

1. Free promotion materials
2. Listed on the EatSmart Website for maximum
   exposure
3. ES Campaign promotional activities and
   collaborative programmes.
4. Training, resources and professional support

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Posters, API, pamphlets
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www.eatsmart.gov.hk
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7.30 Press Event in an EatSmart Restaurant
Hit rate of CHEU web
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Media monitoring
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Entry requirement

• Licensed food premise
• Compulsory attendance in a 2-hour nutrition
  training session
• Submission of 5 healthy recipes
• Provide clear point-of-purchase information
• Committed to healthy eating promotion and
  incentive programme

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Time Table
Dec 2007 Recruitment Training
Mar 2008 Territory-wide launch Kick-off ceremony Launch of the ESR website Serial of promotion activities
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Your Role!
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Roles of Dietitians / Nutritionists

• As a patron
• Recommend to your family members, friends and
  also clients
• Provide dietetic service to the ESRs
• Recipe development
• Recipe vetting
• Promotion strategies

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Thank you!