Meeting Report on Japan-WHO Regional Consultation for ...

Meeting Report

Japan-WHO Regional Consultation for Promoting Healthier Dietary Options for Children

26–29 March 2012Saitama, Japan

Japan-WHO Regional Consultation for Promoting Healthier Dietary Options for Children

Saitama, Japan, 26–29 March 2012

WPR/DHP/NCD(1)/2012

Report series number: RS/2012/GE/08(JPN) English only

REPORT

JAPAN-WHO REGIONAL CONSULTATION

FOR PROMOTING HEALTHIER DIETARY OPTIONS FOR CHILDREN

Convened by:

WORLD HEALTH ORGANIZATION

REGIONAL OFFICE FOR THE WESTERN PACIFIC

Saitama, Japan

26 – 29 March 2012

Not for sale

Printed and distributed by:

World Health Organization

Regional Office for the Western Pacific

Manila, Philippines

May 2012

NOTE

The views expressed in this report are those of the participants in the Japan-WHO

Regional Consultation for Promoting Healthier Dietary Options for Children and do not

necessarily reflect the policies of the Organization.

This report has been prepared for the World Health Organization Regional Office for the

Western Pacific for the use of governments from Member States in the Region and for

those who participated in the Japan-WHO Regional Consultation for Promoting Healthier

Dietary Options for Children held at the National Institute of Public Health, Saitama,

Japan, from 26 to 29 March 2012.

SUMMARY

Unhealthy diet is a significant and modifiable risk factor for noncommunicable

diseases (NCDs) and improving population nutrition is a key NCD prevention strategy.

The risks associated with unhealthy diets commence in childhood and accumulate over a

life span. The effects of unhealthy diets may manifest as malnutrition and obesity, and

these co-exist in many societies and populations. Where obesity levels are low, there is a

valuable opportunity to intervene to prevent potential escalation and minimize risks of

dramatic increases in NCDs.

The Regional Office for the Western Pacific and the Japanese Government jointly

organized the Japan-WHO Regional Consultation for Promoting Healthier Dietary

Options for Children.

The objectives of the meeting were:

(1) discuss the WHO recommendations on the marketing of foods and non-

alcoholic beverages to children in the context of Member States in the

Western Pacific Region;

(2) review existing policies and programmes in the Region for restricting

marketing of foods high in saturated fats, trans-fatty acids, free sugars or

salt and non-alcoholic beverages to children; and

(3) identify approaches for the implementation and monitoring of the set of

recommendations on the marketing of foods and non-alcoholic beverages

to children, including school-based approaches, using the WHO

framework for implementing the set of recommendations on the marketing

of foods and non-alcoholic beverages to children.

There is a range of evidence-based interventions to promote healthier diets,

including actions to reduce food marketing, health-promoting school initiatives, fiscal

strategies and banning trans fats. WHO has worked out recommendations and resources

to guide Member States in addressing NCD. In particular, WHO is a partner in a number

of global initiatives on school health and has produced a School Policy Framework and

has drawn up an Implementation Framework following World Health Assembly

resolutions endorsing recommendations on marketing of foods and non-alcoholic

beverages to children.

In addressing the topic of improving dietary options for children, this consultation

meeting focused on school nutrition initiatives and the Implementation Framework for

action to address marketing of foods and non-alcoholic drinks to children. These themes

were complementary and convergent, as one of the WHO recommendations on food

marketing to children specifically addresses “settings where children gather” and states

that these “should be free from all forms of marketing of foods high in saturated fats,

trans-fatty acids, free sugars or salt”.

The consultation meeting sought to strengthen policy and programme initiatives

across the 11 participating countries and to bolster systems for ensuring communication

of accurate nutrition information across school and community settings consistent with

national dietary guidelines.

Each of the countries has some nutrition and/or school programmes that provide

starting points for further action on improving children’s dietary options. Some countries

are very advanced, with well-developed systems for nutrition education across population

groups, including children.

While all countries have identified concerns regarding the high prevalence of

marketing of unhealthy food and beverages, some had conducted specific studies to guide

policy development.

All countries were able to identify key stakeholders relevant to implementing

WHO recommendations on marketing of foods and non-alcoholic beverages to children

and existing policy or infrastructure that provides a basis for further policy development.

Some countries had formulated and implemented regulations or guidelines restricting

unhealthy food and beverage marketing; others were in the process of working out

policies.

Each country identified appropriate policy approaches and priorities for

improving dietary options for children, which were consistent with their existing

infrastructure. The value of an incremental approach to initiatives to reduce unhealthy

food marketing was accepted widely. Some countries identified new ways of getting

started and to increase capacity for addressing the negative impact of unhealthy food

marketing while others identified ways of extending existing efforts to implement WHO

recommendations on marketing of foods and beverages to children.

All participants supported the value of establishing new regional systems to

exchange information and experience regarding efforts to limit unhealthy food marketing

across countries. Countries also sought continuing technical support and guidance from

WHO. Cross-border food marketing was a specific issue, which was identified as

requiring leadership by international agencies (including WHO) and which could not be

addressed at a country level in the first instance.

A set of specific recommendations addresses the conclusions of the meeting

regarding the value of continuing communications and technical exchanges among

Member States, WHO and resource people.

Contents

SUMMARY

1. INTRODUCTION

1.1 Background ..................................................................................................................... 1

1.2 Objectives ........................................................................................................................ 1

1.3 Participants ...................................................................................................................... 2

1.4 Organization .................................................................................................................... 2

1.5 Opening ceremony........................................................................................................... 2

2. PROCEEDINGS

2.1 Session 1 - Overview of NCD prevention and control and objectives of the

consultation................................................................................................................. 3

2.2 Session 2 - Approaches for improving dietary options for children................................ 3

2.3 Session 3 - Experiences of Japan in improving healthier diets for children.................... 4

2.4 Session 4 - Set of recommendations on the marketing of foods and non-alcoholic

beverages to children .................................................................................................. 4

2.5 Session 5 - Country presentations ................................................................................... 5

2.6 Session 6 - A framework for implementing the set of recommendations on the

marketing of foods and non-alcoholic beverages to children ..................................... 6

2.7 Session 7 - Regional experience and potential interventions .......................................... 7

2.8 Session 8 - Consumers' perspectives ............................................................................... 9

2.9 Session 9 - National nutrition policy and the role of regulatory agencies

2.10 Session 10 - Group discussions on potential country-level actions to address unhealthy

food marketing.......................................................................................................... 10

2.11 Session 11 - Promoting better dietary habits for children in Japan ............................... 11

2.12 Session 12 - An underweight epidemic? Current nutritional problems regarding child

health in Japan .......................................................................................................... 11

2.13 Session 13 - Site visit to school ..................................................................................... 12

2.14 Session 14 - School-based interventions and approaches.............................................. 12

2.15 Session 15 - Monitoring and surveillance of children’s nutrition ................................. 13

2.16 Session 16 - Identifying priority actions and next steps in countries ............................ 13

2.17 Session 17 - Closing ceremony ..................................................................................... 15

3. CONCLUSIONS AND RECOMMENDATIONS

3.1 General conclusions....................................................................................................... 16

3.2 Recommendations ......................................................................................................... 16

ANNEXES

1. List of participants, temporary advisers, resource persons, observers and secretariat

2. Programme of activities

3. Summary of country presentations (session 5)

4. Next steps (session 16)

5. Evaluation of the consultation

6. Background paper

1. INTRODUCTION

1.1 Background

Unhealthy diet is a significant and modifiable risk factor for NCDs and improving population nutrition is a key NCD prevention strategy. Unhealthy (or poor) diets contribute to NCD risk through high blood pressure, high blood glucose, abnormal blood lipids and overweight and obesity. While prevention can occur across the course of life, children are a particularly important target group for NCD prevention strategies. The risks associated with unhealthy diets commence in childhood and accumulate over the life span1, and poor childhood nutrition is associated with overweight and obesity as well as increased risk of immediate and long-term health problems. There is a strong and accumulating global commitment to NCD, further endorsed by the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases in September 2011.

NCDs are a significant public health concern for countries in the Western Pacific Region, and there is a Regional Action Plan (2008-2013) to guide prevention initiatives in support of the implementation of the Global Strategy on Diet, Physical Activity and Health2. Promoting dietary options for children is a key aspect of this strategy and regional action plan. A briefing paper summarizing the work to date and evidence specifically related to Asian countries had been disseminated to all participants before the meeting.

A meeting of senior policy-makers from ministries of health, food policy and administration and information and communication from Member States, along with experts, was held at the National Institute of Public Health, in Saitama, Japan, from 26 to 29 March 2012. 1.2 Objectives

(1) To discuss the WHO set of recommendations on the marketing of foods and non-alcoholic beverages to children in the context of Member States in the Western Pacific Region.

(2) To review existing policies and programmes in the Region for restricting marketing of foods high in saturated fats, trans-fatty acids, free sugars or salt and non-alcoholic beverages to children.

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(3) To identify approaches for the implementation and monitoring of the set of recommendations on the marketing of foods and non-alcoholic beverages to children, including school-based approaches, using the WHO framework for implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children.

1.3 Participants

The meeting was attended by 26 delegates from Member States and temporary advisers and resource people. The participating Member States were Brunei Darussalam, Cambodia, China, Hong Kong (China), Japan, the Republic of Korea, the Lao People’s Democratic Republic, Malaysia, Mongolia, the Philippines, Singapore and Viet Nam. The meeting was hosted by NIPH. Two WHO staff from the Western Pacific Regional Office and one from WHO Headquarters in Geneva, Switzerland, formed the Secretariat for the meeting. The list of participants, temporary advisers, resource persons and Secretariat members are in Annex 1.

1.4 Organization

The meeting comprised 15 sessions and the opening and closing ceremonies. The sessions included presentations from temporary advisers, resource people, WHO Secretariat and Country Representatives. Participants also were engaged in group discussions and presentations on current policy and programme arrangements in their countries and potential next steps for action in their countries. The programme also included a visit to a school. A full outline of the programme is presented in Annex 2. A background paper was drawn up with a brief review of the current situation and potential actions and was provided to the participants (Annex 6). 1.5 Opening ceremony

The meeting was opened by Dr Haruka Sakamoto, International Affairs Division, Minister's Secretariat Ministry of Health, Labour and Welfare, Japan; Dr Hai-Rim Shin, Team Leader, National Health Policy (NHP), Western Pacific Regional Office; and Dr Kenji Hayashi, President, National Institute of Public Health (NIPH), Japan. This meeting formed the seventh round of the Japan-WHO international visitors programme, which began in 2005.

Dr Shin addressed the importance of NCD prevention and “whole-of-society” approach specifically tailored to each country’s situation. Dr Hayashi described Japan’s

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commitment to chronic disease prevention through Health Japan 21 and the promising results to date. Dr Tomofumi Sone, Director of the Department of International Health and Collaboration, NIPH, Japan, also provided further information about the work of the institute in training and capacity-building.

2. PROCEEDINGS

2.1 Session 1 - Overview of NCD prevention and control and objectives of the consultation

Dr Cherian Varghese, Medical Officer (NCD), Western Pacific Regional Office, presented the objectives of the consultation and explained the key concepts underpinning the topic of Improving Dietary Options for Children. Unhealthy diet, which is taken to refer to diets high in salt, sugar and saturated fats and low fruit and vegetable consumption, is a major modifiable risk factor for NCDs. The effects of unhealthy diets may manifest as malnutrition and obesity and in many societies and populations, these co-exist. Where obesity levels are low, there is a valuable opportunity to intervene to prevent potential escalation and to minimize risks of dramatic increases in NCDs.

Unhealthy diets are influenced by a range of individual and societal factors, including poverty, lack of availability of healthy food choices and food marketing of foods high in fat, sugar and salt. There is a range of evidence-based interventions to promote healthier diets, including actions to reduce food marketing, health-promoting school initiatives, fiscal strategies and banning trans-fats. The WHO recommendations on marketing of foods and non-alcoholic beverages to children and the framework for implementation of these recommendations guide Member States in planning, policy development surveillance and monitoring.

2.2 Session 2 - Approaches for improving dietary options for children

Lesley King, Executive Officer, Physical Activity Nutrition Obesity Research Group, The University of Sydney, introduced three main action areas for improving dietary options for children: providing accurate and balanced information and limiting dissemination of contrary messages; agricultural programmes consistent with a healthy diet; and school policies and programmes. These action areas are particularly important in the context of the increasing availability of food and beverages that are high in fat, sugar and/or salt, as well as total energy, and the marketing of such products3.

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The heavy marketing of foods and beverages high in saturated fats, trans-fatty acids, free sugar or salt is a specific aspect of the food environment which is known to have a significant and independent effect on children’s food preferences and food consumption and is amenable to change3,4. The use of persuasive messages to promote foods and beverages high in saturated fats, trans-fatty acids, free sugar or salt competes with health and nutrition messages and creates misinformation among community members. Thus there is a strong rationale for reducing children’s exposure to the marketing of unhealthy foods.

2.3 Session 3 - Experiences of Japan in improving healthier diets for children

Dr Megumi Haga, from the Office for Life-Style Related Diseases Control, General Affairs Division, Health Service Bureau of the Ministry of Health, Labour and Welfare, Japan, described Japan’s intersectoral approach to improving population food and nutrition, which encompasses the education sector (school education and lunches), agriculture (food production), consumer affairs (food labelling), health (surveillance, dietary guidance) and “Shokuiku promotion”. Shokuiku refers to the Japanese approach to food and nutrition education, which recognizes nutrition as the foundation for living and the basis of intellectual, moral and physical education.

2.4 Session 4 - Set of recommendations on the marketing of foods and non-alcoholic beverages to children

Dr Godfrey Xuereb, Team Leader, Surveillance and Population-based Prevention

(SPP), Headquarters, described the process for the development of the WHO set of recommendations on the marketing of food and non-alcoholic beverages to children. In May 2010, the World Health Assembly Resolution WHA63.14 specifically endorsed these recommendations and urged Member States to take necessary measures to implement them.

The recent United Nations High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases (September 2011) also called upon Member States and private industry to implement the recommendations. The issues addressed by these recommendations were also noted by Prof Olivier De Schutter, the United Nations Special Rapporteur on the right to food (2011), including the statement: “Significant concerns are expressed today about the marketing practices of the agrifood industry, particularly as regards marketing to children. The range of such practices is wide. Self regulation by the agrifood industry has proven ineffective…”.

The WHO 2010 food marketing recommendations were formulated on the basis of the work of an Ad Hoc Expert Group, which considered the peer-reviewed empirical

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evidence, material generated through WHO meetings with international nongovernment

organizations (NGOs), global food and beverage industries and the advertising sector

and input from Member States.

In particular, the expert group advice to WHO took account of evidence on the

effects of food marketing to children, the nature and extent of food marketing and

available policy and regulatory options for reducing the impact of food marketing on

children. As a result, the WHO recommendations provide a sound framework of

principles to guide actions by Member States to reduce the impact of food marketing.

The WHO recommendations and Implementation Framework have adopted a

broad definition of marketing, which includes paid advertising, product placement, paid

sponsorship and other self-promotional methods such as websites and shop promotions.

Increasingly, companies conduct integrated marketing, which uses a range of methods

simultaneously. Marketing works through the use of persuasive messages (the content of

the message, giving the marketing “persuasive power”) and reaching large proportions of

the population or target group (the “reach”), and frequently is seen repeatedly over a

given period (the frequency or volume of exposure).

The stated purpose of the WHO recommendations are "to guide efforts by

Member States in designing new and/or strengthening existing policies on food

marketing communications to children in order to reduce the impact on children of

marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt". The 12

recommendations are structured into five sections: rationale; policy development; policy

implementation; monitoring and evaluation; and research.

2.5 Session 5 - Country presentations

Each of the participating countries provided an overview of the situation in each

country, with information regarding:

(1) NCD mortality/premature mortality; (2) prevalence of diet-related risks, including obesity and undernutrition; (3) dietary guidelines and nutrition policies; (4) school nutrition initiatives;(5) food marketing patterns; (6) opportunities for promoting-health diet to children and limiting unhealthy

food marketing; and (7) relevant regulations, responsibilities, stakeholders and framework for further

actions.

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2.5.1 All countries had some form of school nutrition initiatives, such as:

(1) school lunches (e.g. Hong Kong (China), Japan, Mongolia);

(2) food guides for school lunches or school canteens (e.g. Hong Kong (China),

Brunei Darussalam, Malaysia);

(3) nutrition education (e.g. Japan, China, Hong Kong (China), Viet Nam, the

Philippines); and

(4) school health eating accreditation (e.g. Singapore, Hong Kong (China).

2.5.2 Some countries had specific government regulation on food marketing:

(1) Special Act on the Safety Management of Children’s Dietary Life (the

Republic of Korea);

(2) Guideline on Advertising of Fast Foods to Children and Nutrition Labelling

2008; Development of Guideline of Marketing of Food and Beverages to

Children in Malaysia, 2011 (Malaysia); and

(3) Formulation of guidelines for food advertising targeted at children in

progress (Singapore).

Many countries also noted their regulations restricting tobacco advertisements

and how these may provide an example as a basis for further NCD prevention initiatives.

Table 1 in Annex 3 provides further details on each country’s nutrition policies

and school nutrition policy and initiatives, while Table 2 presents information on the

status of food marketing regulations in each participating country. Annex 3 also provides

an integrated summary of relevant policy arrangements as presented by participating

countries in this session. This information provides an update on information reported in

previous studies on international regulatory arrangements5,6.

2.6 Session 6 - A framework for implementing the set of recommendations on the

marketing of foods and non-alcoholic beverages to children

The World Health Assembly Resolution WHA63.14 recommends Member States

take necessary measures to implement the WHO recommendations, while taking into

account existing legislation and policies, as appropriate. WHO recently has created a

framework to guide Member States in their implementation processes. The same

resolution also requires WHO to report on implementation of the recommendations to

the 65th World Health Assembly in 2012.

Dr Xuereb presented the Implementation Framework section by section: What is

marketing; policy development; policy implementation; and monitoring, evaluation and

research. As part of their policy development processes, countries may want to undertake

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situation analyses and determine the policy approach most suitable to their circumstances.

In most cases, an incremental approach is warranted. The policy development process

requires specification of key parameters, including:

(1) definition of “child”;

(2) selection of applicable communication channels;

(3) determining cut-off time periods or locations when or where

restrictions would apply; and

(4) specifying nutritional criteria for determining foods inappropriate

for advertising to children and subject to restriction.

Many Member States receive media across borders and it is recognized that

international cooperation is needed to initiate cross-border restrictions and regulation to

avoid dumping of advertising.

WHO recommends that the policy development process be undertaken by

governments in consultation with stakeholders but that industry not be involved directly

in the process. WHO has recommended that governments take a lead role in self-

regulation by setting key specifications, as occurs in Spain, for example.

2.7 Session 7 - Regional experience and potential interventions

In this session, King drew from the emerging regional situation analyses and

discussed ways of getting started and implementing policy interventions, consistent with

the WHO Implementation Framework. Situational analyses and local research can be

particularly valuable in guiding policy development for limiting food marketing to

children. Table 3 presents ideas on ways of getting started, with examples of practical

actions discussed in the meeting.

Two case study examples of how research information can be used to guide

policy specifications were presented: television food marketing and outdoor advertising

around schools. Table 4 provides an outline of the basic research methods for

investigating television and outdoor food marketing, drawing from published studies in

these topics7, 8.

Monitoring is also an important part of the WHO Implementation Framework.

This can occur at many levels, and in the first instance comprises tracking countries’

capacity and policy initiatives. WHO has a system for monitoring and reporting on

countries’ health promotion, partnership and collaboration activities in relation to NCD

prevention, which specifically includes two relevant items: initiatives to regulate food

marketing to children and enforcement of food marketing regulations. There may be a

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potential to refine and clarify reporting on these items to generate more specific

information.

Table 1. Getting started on implementing recommendations on marketing of foods and beverages to children

Action steps Examples

OVERALL

General nutrition and school health

initiatives

National dietary guidelines; Food guides

Nutrition communication and education

School health programmes; health-promoting

schools

Maternal and child health programmes; Baby-

friendly health services

Nutrition and health surveys

Other nutrition initiatives: food labelling; food

re-formulation (e.g. salt reduction); promoting

local foods; healthy foods in restaurants

RESEARCH

Generating evidence on the extent

and nature of the problem and need

for policy on food marketing

Research studies that measure the nature, extent

and effects of children’s exposure to high fat,

sugar and salt food and beverage marketing

Research on the extent of outdoor food

marketing around schools

Information on media audiences

PARTNERSHIPS AND STAKEHOLDERS

Government contributions to

building momentum

Collating available information on food

marketing , inquiries and cross-sector discussion

Supporting further research

Formulating guidelines for food and drinks in

schools

Engaging with community and

professional stakeholders

Link with health and education professionals

Links , meetings with parent groups

Communication and advocacy;

awareness raising

Continuing teacher education

National and local workshops on food marketing

Translating key WHO documents

Focus on positive messages

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Table 2. Basic steps for investigating television and outdoor food marketing

OUTDOOR ADVERTISING

1. Identify sample locations (e.g. schools)

2. Map the study area

3. Walk and scan – recording details of all food advertisement

4. Classify advertised food products according to nutritional profile

5. Calculate average number of HEALTHY and UNHEALTHY food advertisement per square km in zone around sites (e.g. schools)

6. Identify most frequently advertised types of unhealthy foods

TELEVISION FOOD ADVERTISING

1. Identify most popular TV channels (using commercial audience data if possible)

2. Identify sample time periods, including weekday and weekend days

3. View the broadcasts, and record information on all advertised food products, TV programme, broadcast time

4. Classify advertised food products according to nutritional profile

5. Calculate average number of HEALTHY and UNHEALTHY food advertisement per hour, for weekdays and weekend days

6. Identify most frequently advertised types of unhealthy foods

2.8 Session 8 - Consumers' perspectives

Satya Sharma, Regional Project Officer, Consumers International (CI) Office of

the Asia Pacific and the Middle East, Malaysia, described the work of CI in campaigning

against the marketing of unhealthy foods to children. CI has produced reports

documenting research on food marketing in the Region, as well as a manual to guide

monitoring of food marketing9, a model international code on marketing food and non-

alcoholic beverages to children10, and calls to governments to take action. He promoted

opportunities for building stronger links among professionals, governments and

consumers within each country.

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2.9 Session 9 - National nutrition policy and the role of regulatory agencies

Dr Hye-Kyung Park, Director General of the Nutrition Policy Office of the

Korean Food and Drug Administration (KFDA), gave a presentation on policy and

regulatory initiatives in the Republic of Korea, where they have as a regulatory base the

“Special Act on the safety assurance of food and eating/nutrition environment of

children (Safenet)”. This act was endorsed in association with a set of nutrition

standards, which vary according to food type and are based on serve size. The act limits

the advertisement of high energy, low nutritional value foods, including snacks and meal

substitutes popular among children during the hours 17:00-19:00. Violations are subject

to fines of up to US$10 million.

The act also creates a green food zones where food advertisements are not

permitted within 200m of schools. The regulations for restrictions on food

advertisements came into effect in 2010, with a sunset clause requiring a review in 2012.

The specifications were worked out following research on TV food marketing in the

Republic of Korea. Initial evaluation data, based on TV programme monitoring

conducted every three months, indicates reductions in children’s exposure to TV

advertising and changes in the nutritional composition of some food products. A review

report is due to be presented in July 2012.

2.10 Session 10 - Group discussions on potential country-level actions to address

unhealthy food marketing

Each country identified relevant policy and regulatory systems and stakeholder

groups using a standard format. Annex 3 summarizes relevant policy and regulatory

arrangements as presented by participating countries. While there were differences

among countries, the types of stakeholders were similar (see Box 1).

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Box 1. Examples of key Government stakeholder groups

Ministry of Health

Food administration and food safety agencies

Ministry of Food and Agriculture

Nutrition councils or high-level committees

Ministry of Education;

Maternal and infant health/ Family health agencies;

Ministry of Information and Communication

Advertising standards authorities

Office of the Prime Minister, State Council or equivalent

2.11 Session 11 - Promoting better dietary habits for children in Japan

Dr Noriko Kato, Research Managing Director of NIPH-Japan, outlined Japan’s

comprehensive system for maternal and child health (MCH), and the value of this

system in promoting healthy dietary choices for children. The system is organized

around the use of an MCH handbook and a set of antenatal and child health checks. The

MCH handbook system has been operating since 1938, with a revised version to be

released in the near future. The handbook uses a version of the spinning top food

guidance tool, tailored to pregnancy.

2.12 Session 12 - An underweight epidemic? Current nutritional problems regarding

child health in Japan

Dr Hidemi Takimoto, Chief Senior Researcher Department of Health Promotion

NIPH-Japan, presented information on the weight status of Japanese children and adults.

Obesity in Japan is defined as BMI >25. During the period 1986 -2009, obesity had

increased in males, although reduced in women aged 50-59 and 60-69 years old. The

prevalence of underweight (BMI<18.5) is high, particularly in women 20-29 years old,

at 22%. The prevalence of underweight has increased in women up to the age of 49

years old during the period 1986-2009.

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Also for girls aged 15-19 years old, underweight prevalence is up to 25%,

particularly in metropolitan areas. The prevalence of low birth weight in newborn infants

also has increased since 1993. Japan has endorsed guidelines for weight gain during

pregnancy and for infant feeding in 2007 (note that the recommendation is to introduce

solids 5-6 months old, based on their national research).

Skipping breakfast also has been identified as increasing and potentially may be

related to changes in weight patterns, although skipping breakfast is particularly high in

young men.

2.13 Session 13 - Site visit to school

The delegation visited the Minami Elementary School in Sakado City, where we

toured the school, participated in a school lunch and were given information about the

system for preparing school lunches in their school. Sakado City has a strong mayoral

leadership for promotion of healthier diets among all citizens in collaboration with

Kagawa Nutrition University, which is located in the city.

School lunches have a long tradition in Japan, and are associated with nutrition

education and Shokuiku promotion. They also could be associated with hygiene

education and training of table manners. The school lunch programme greatly

contributes to maintaining well-balanced diets among Japanese school children.

2.14 Session 14 - School-based interventions and approaches

This session included presentations from China, Hong Kong (China), Malaysia,

Philippines and Singapore.

China described the “Happy10” classroom physical activity programme (a 10

minute structure), which has been developed systematically from an initial pilot

programme, to an evaluation study and is now disseminated as a government supported

programme across China.

Hong Kong (China) has adopted an “EatSmart School Accreditation Scheme”

under the “[email protected] (ESS) Campaign” across primary school setting and has

launched an “EatSmart@restaurant (ESR) Campaign” targeting the catering industry.

Training workshops on healthy lunches and snacks are provided under the ESS

campaign. Riding on the success of that campaign, promotion of healthy eating has been

expanded to preschool children 2-6 years old with the launch of the

[email protected] Campaign since January 2012. Hong Kong (China) has launched

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a “Live it! Use it! Nutrition Labelling Promotion Award Scheme” and incorporated

nutrition and nutrition labelling in the school curriculum.

Malaysia presented an account of the development and implementation of its

current healthy school policy. It has a guideline regarding appropriate foods and the

policy applies to canteens, vending machines and mobile food vendors outside schools.

The Philippines’ delegates described their integrated school health and nutrition

programme. Specific initiatives, including school vegetable gardens, are designed and

implemented to reach more disadvantaged areas.

In Singapore, healthy eating in schools forms part of an overall strategy, which

also comprises nutrition and physical activity guidelines, school environment and

physical activity initiatives and the CHERISH award system. The healthy eating in

schools programme involves 80% of schools and is being extended to preschools. Other

initiatives include monitoring, counseling for obese students and capacity-building to

support the school curriculum in nutrition.

2.15 Session 15 - Monitoring and surveillance of children’s nutrition

Dr Miki Miyoshi, Head of the Section of International Nutrition Research and

Development NIPH-Japan, presented Japan’s system for surveillance and monitoring of

children’s nutrition. The current key surveillance system comprises the National Health

and Nutrition Survey (previously a national nutrition survey). The implementation

processes for the current survey system are governed by the Health Promotion Law. The

survey includes dietary surveys and physical and biomedical measures. Japan has a

workforce of dietitians and registered dietitians engaged in health centres, local

governments and schools that support implementation of various forms of nutrition

education, guided by survey results.

2.16 Session 16 - Identifying priority actions and next steps in countries

Each country made final presentations outlining their plans for action following

the meeting. A summary of draft next steps as presented by delegates in this session is in

Annex 4. Countries’ plans included the following steps:

(1) Further situational analyses regarding current food marketing practices

(including outdoor advertising) and regulatory arrangements and

opportunities.

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(2) Communicating with other government stakeholders regarding the impact of

food marketing on children and the WHO recommendations on marketing of

food and non-alcoholic beverages.

(3) Building links with a range of stakeholder groups, including NGOs,

consumer groups and key industry groups.

(4) Convening structured meetings and forums, at national and regional levels,

to build awareness of the issues across stakeholders.

(5) Further situation analyses, development and expansion of school health

initiatives.

(6) Identifying opportunities to reduce or ban unhealthy food marketing in

school settings and school environs, similar to the Republic of Korea’s green

food zone.

(7) Implementation of complementary collaborative initiatives between

governments and food industry groups related to food reformulation,

including salt reduction, food labelling and taxation of unhealthy high fat,

salt, and sugar foods.

(8) Pilot studies to refine implementation arrangements for any new initiatives.

(9) Strengthen and continue nutrition education for school teachers.

(10) Strengthen and continue nutrition surveillance and monitoring.

There was consensus that the capacity for action on improving dietary options for

children and implementation of WHO food marketing recommendations could be

supported and strengthened through:

(1) Continuing information exchange and linkages among countries regarding

actions, particularly food marketing regulatory initiatives and country

negotiations with food industry groups.

(2) Collaboration with local consumer groups and Consumers International.

(3) Technical advice and support from WHO, including continuing input

regarding implementation of recommendations on food marketing and the

monitoring and evaluation of nutrition and health activities.

- 15 -

(4) WHO technical guides, tools and expert representation and participation in

support of national forums and meetings with policy-makers and food

industry groups (e.g. overview presentations).

(5) Assistance with school health food guidelines (e.g. Cambodia, the Lao

People’s Democratic Republic).

(6) Technical assistance for conducting surveys regarding children’s food

consumption patterns and children’s media exposure.

(7) Initiatives by WHO, Consumers International and other international

agencies to address cross-border marketing

An evaluation of the consultation was conducted. The structured questionnaire

used and detailed results are in Annex 5. The overall impression of the meeting

generally was excellent (63%), the rest was good (37%). A good proportion of

participants also have indicated that they have collected information in the sessions and

have learnt from the experiences of other countries.

2.17 Session 17 - Closing ceremony

WHO thanked delegates for their contributions and, similarly, delegates were

appreciative of Western Pacific Regional Office and NIPH for hosting the meeting.

- 16 -

3. CONCLUSIONS AND RECOMMENDATIONS

3.1 Conclusions

The objectives of the consultation meeting on strategies to improve dietary options for children were met and the meeting successfully engendered an exchange of experience and expertise among Member States, WHO and resource people. Suggestions for strengthening regional networks and communication also will be advanced through further consultation.

3.2 Recommendations

3.2.1 Countries have the option to do the following:

(1) Member States may want to implement a communications strategy on initiatives for improving dietary options for children as part of their overall efforts to address NCDs. The communications strategy may engage with other government portfolios, parent and consumer groups and private industry.

(2) Member States may want to undertake situational analyses to systematically identify policy opportunities and key stakeholders related to children’s nutrition and support monitoring and research on children’s nutrition and key factors influencing nutrition.

(3) Member States may want to implement and/or extend implementation of school-based initiatives to improve children’s nutrition, such as school food guidelines and healthy zones around schools, as a stepping stone or part of a more comprehensive strategy.

(4) Member States may want to plan and adopt an incremental approach to implementation of WHO recommendations on marketing of foods and non-alcoholic beverages to children, taking account of benefits and opportunities for guidelines, policy and regulation.

(5) Member States may want to implement systems for monitoring and evaluating implementation of WHO recommendations on marketing foods and beverages to children, which include reporting on policy actions, impact of policies on marketing practices and children’s exposure and policy compliance.

- 17 -

(6) Member States may want to work with food and beverage industries for responsible marketing of foods and beverages to children that are consistent with WHO recommendations and objectives and implement them consistently across Asian-Pacific countries to reduce children’s exposure to cross-border advertising.

(7) Member States may want to obtain consistent and accurate information of the marketing practices of food and beverage industries.

3.2.2 Partners have the option to do the following:

(1) Partner NGO and academic organizations may want to support the adoption and implementation of strategies for improving children’s nutrition through advocacy, independent research and monitoring and disseminating information.

3.2.3 WHO can do the following:

(1) Provide continuing technical guidance and tools to support countries in their communications strategy on initiatives for improving dietary options for children in designing and implementing policies and for related complementary initiatives such as food reformulation and salt reduction in food.

(2) Provide continuing technical support for Member States, including dissemination of information on international policy developments, implementation and monitoring and model programmes and initiatives that can be implemented across countries.

- 18 -

REFERENCES

1. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in

young adulthood from childhood and parental obesity. The New England Journal

of Medicine. 1997;337:869-73.

2. World Health Organization. (2004) Global Strategy on Diet, Physical Activity

and Health. Geneva, World Health Organization.

(http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.

pdf; downloaded 5 February 2012)

3. Cairns G, Angus K, Hastings G. The extent nature and effects of food promotion

to children: a review of the evidence to December 2008. Prepared for the World

Health Organization. United Kingdom: Institute for Social Marketing, University

of Stirling 2009

4. McGinnis MJ, Gootman JA, Kraak VI. Food Marketing to Children and Youth:

threat or Opportunity? Food and Nutrition Board, Board on Children, Youth and

Families, Institute of Medicine of the National Academies 2006 [6 January 2012];

Available from: http://books.nap.edu/catalog/11514.html

5. Hawkes C. Marketing food to children: the global regulatory environment.

Geneva: World Health Organization; 2004.

6. Hawkes C, Lobstein T. Regulating the commercial promotion of food to children:

A survey of actions worldwide. International Journal of Pediatric Obesity 2011;

6(2): 83-94

7. Kelly B, Chapman K, King L, Hebden L. Trends in food advertising to children on free-to-air television in Australia. Aust N Z J Public Health 2011; 35(2): 131-134.

8. Kelly B, Cretikos M, Rogers K, King L. The commercial food landscape: outdoor food advertising around primary schools in Australia. ANZJPH 2008; 32(6): 522-528.

9. Consumers International. (2011) Manual for Monitoring Food marketing to children.

10. International Association for Study of Obesity, Consumers International,

International Obesity TaskForce (2010) Recommendations for an international

code on marketing foods and non-alcoholic beverages to children.

ANNEX 1:

W O R L D H E A L T H

ORGANIZATION

ORGANISATION MONDIALE

DE LA SANTE


BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL

JAPAN-WHO REGIONAL CONSULTATION WPR/DHP/NHP(01)/2012/IB/2

FOR PROMOTING HEALTHIER 21 March 2012

DIETARY OPTIONS FOR CHILDREN

Saitama, Japan ENGLISH ONLY

26-29 March 2012

1. PARTICIPANTS

BRUNEI DARUSSALAM Mr Norsal Haji Salleh

Senior Dietician

Community Nutrition Division, SPG 32-37 B30

Anggerek Desa Flat, BB 3713

Tel. No.: (6732)2334895

Fax No.: (6732)334897

E-mail: [email protected]

CAMBODIA Ms Svay Sary

Infant and Young Child Feeding Coordinator

National Nutrition Program

National Maternal and Child Health Center

#31A, French Street (47), Sangkat Srah Chak

Khan Daun Penh, Phnom Penh

Tel. No.:(855) 023428388


CHINA, PEOPLE'S

REPUBLIC OF

Ms Zhenhong Li

Program Officer

Bureau of Disease Control, Ministry of Health

No. 1 Xizhimenwai Nan Lu, Xicheng District Beijing

Tel. No.: (8610) 68792758

Fax No.: (8610) 68792370


Dr Guansheng Ma

Deputy Director/Professor

National Institute for Nutrition and Food Safety

China CDC

7 Pan Jin Yuan Nan Li, Beijing 100021

Tel. No.: (8610) 67776285

Fax No.: (8610) 67711813


Mr Lei Shi

Head of the Department, Food and Drug

Administration

Building No. 2, 26 Xuanwumen Xidajie, Beijing

Tel. No.: (8610) 88330784

Email: [email protected]

HONG KONG (China) Dr Pui Hong Chung

Senior Medical and Health Officer (Public Health

Information)

Department of Health

18/F Wu Chung House, 213 Queen's Road East, Wan

Chai

Tel. No.: (852) 29618803

Fax No: (852) 25754110


JAPAN Dr Haruka Sakamoto

Section Chief

Department of International cooperation, Minister’s

secretariat, Ministry of Health, Labour and Welfare

Address: 1-2-2, Kasumagaseki, Chiyoda-ku, Tokyo

Tel. No.: +81-3-3595-2402


Dr. Shiho Takaoka

Deputy Director

Department of International cooperation, Minister’s

secretariat, Ministry of Health, Labour and Welfare

Address: 1-2-2, Kasumagaseki, Chiyoda-ku, Tokyo

Tel. No.: +81-3-3595-2402


LAO, PEOPLE'S

DEMOCRACTIC

REPUBLIC

Mrs Viengxay Vansilalom

Acting Director, Food Control Division, Food and

Drug Department, Ministry of Health

Simouang Road, Vientiane 01000

Tel. No.: (856) 214013-4

Fax No.: (856) 214015

Email: [email protected]

MALAYSIA Dr Feisul Idzwan Mustapha

Disease Control Division, Ministry of Health

Address: Level 2, Block E3, Complex E, 62590

Putrajaya

Tel. No.: +603-88924413

Fax No: +603-88834150


Ms Norzakiah Othman

Deputy Director, Content Monitoring and Compliance

Department

Malaysian Communications and Multimedia

Commission

63000 Cyberjaya

Tel. No. +603-8688 8000

Fax No: +603-8688 1003

E-mail: [email protected] or

[email protected]

Ms Surainee Binti Wahab

Senior Assistant Director, Nutrition Division, Ministry

of Health

Level 2, Block E3, Complex E, 62590 Putrajaya

Tel. No.: +603-8892 4457


MONGOLIA Ms Bolorchimeg Bold

Officer-in-charge, Public Health Policy

Implementation and Coordination Department

Ministry of Health, Government Building VIII

Olympic Street 2, Sukhbaatar District Ulaanbaatar

14210

Tel. No.: (976) 99020045


Mr Bayarbold Dangaa Head of the Health Inspection Division

General Agency for Specialized Inspection

Government Building 12, Builders Square 13,

Ulaanbaatar 151170

Tel. No.: (976) 91113003


Ms Azzaya Erdenebayar

Officer, Cooperation Department of Food Production,

Trade

and Service Policy Implementation

c/o Ministry of Health Mongolia, Government Building

VIII

Olympic Street 2, Sukhbaatar District, Ulaanbaatar

14210

Tel. No.: (976) 99903794

Fax No: (976) 11453121


PHILIPPINES Dr Ivanhoe C. Escartin

Officer-In-Charge, Director IV

National Center for Health Promotion

Building 18, 2nd Floor, San Lorenzo Compound

Rizal Avenue, Sta Cruz, Manila 1003

Tel. No.: 09209080141


Ms Maria-Bernardita Tresvalles Flores

Executive Director IV, National Nutrition Council and

Assistant Secretary, Department of Health

Nutrition Building

2332 Chino Roces Avenue Extension, Taguig City

Tel. No.: (632) 8164162

Fax No: (632) 8187403

E-mail: [email protected];

[email protected]

Ms Elane Vargas Malalay

Food-Drug Regulation Officer II, Food and Drug

Administration

Civic Drive, Filinvest, Corporate City, Alabang,

Muntinlupa City

Tel. No.: (632) 8425606

Fax No.: (632) 8425606


SINGAPORE Dr Ling Li Foo Deputy Director, Youth Health Programme

Development 1

Health Promotion Board, 3 Second Hospital Avenue

Singapore 168937

Tel. No.: (65) 6435 3672/(65) 9012 4856


Ms Elaine Tan

Senior Executive, Center of Excellence for Nutrition

Health Promotion Board, Singapore

3 Second Hospital Avenue, Singapore 168937

Tel. No.: (65) 6435 3827 (O); (65) 66114163 (H);

(65) 9005 2255 (M)

Fax No.: (65) 6538 3609

E-mail: [email protected] ; [email protected]

VIET NAM Ms Hoa Thi Thuy Pham

Director, Food and Nutrition Training Center

National Institute of Nutrition

488B Tang Bat Ho Hanoi

Tel. No.: (844) 39724030

Fax No: (844) 39724030


Mr Nguyen Phan Phuc

Inspector

Ministry of Information and Communications

18 Nguyen Du Hanoi

Tel. No.: (844) 35563966

Fax No: (846) 35563966


Mr Phuong van Nhu

Chief of General Administrative Office

Viet Nam Food Administration, Ministry of Health

138A, Giang Vu, Ba Dinh, Hanoi

Tel. No.: 0904165078


2. TEMPORARY

ADVISERS

Dr Miki Miyoshi

Head, Section of International Nutrition Research

and Development

National Institute of Health and Nutrition

1-23-1 Toyama, Shinjuku-ku

Tokyo 162-8636, Japan

Tel. No.: (813) 32035721

Fax No: (813) 32023278


Dr Hye-Kyung Park

Director General

Nutrition Policy Office, KFDA

OHTAC, 187 Osongsaemgmyeong-2-ro Osong-eup,

Chungwon-gun, Choongbuk, 363-700, Republic of

Korea

Tel. No.: (043) 7192251; Mobile : 017-253-6870

E-mail : [email protected]; [email protected]

Mr Satyanarayana Sharma Renduchintala

Regional Project Officer, Consumers International

Office of the Asia Pacific and the Middle East

Lot 5-1 Wisma WIM, 7 Jalan Abang Haji Openg

Taman Tun Dr Ismail, 60000 Kuala Lumpur, Malaysia

Tel. No.: (603) 77261599

Fax No: (603) 77268599

E-mail: [email protected] ; [email protected]

3. REPRESENTATIVES/OBSERVERS

MINISTRY OF HEALTH Mr Zakaria Kamis

Head of Nutrition and Dietetics Division

Health Promotion Center, Ministry of Health

Tel No. +6738841808

E-mail address: [email protected]

KOREA HEALTH

INDUSTRY

DEVELOPMENT

INSTITUTE,

REPUBLIC OF KOREA

Dr Cho-il Kim

Director, Department of Health Industry & Policy,

Korea Health Industry Development Institute

OHTAC, 187 Osongsaemgmyeong-2-ro Osong-eup,

Chungwon-gun, Choongbuk, 363-700, Republic of

Korea

Tel. No.: (82 43) 7138611; (mobile): (82 16) 2646681

Fax No.: (82 43) 7138907


SEOUL NATIONAL

UNIVERSITY

Dr Yoon Jihyun

Associate Professor, Department of Food and Nutrition,

Seoul National University

1 Kwnak-ro, Kwanak-gu, Seoul 151-742, Republic of

KoreaTel. No.: (82 2) 880 8750

Fax No.: (82 2) 884 0305


4.

SECRETARIATWHO/W

PRO

Dr Hai-Rim Shin

Team Leader, Noncommunicable Diseases and Health

Promotion

WHO Regional Office for the Western Pacific

P.O. Box 2932 1000 Manila, Philippines

Tel. No.: (632) 5289860

Fax No: (632) 5260279


Dr Cherian Varghese (Responsible Officer)

Medical Officer, Noncommunicable Diseases and Health

Promotion

WHO Regional Office for the Western Pacific

P.O. Box 2932 1000 Manila, Philippines

Tel. No.: (632) 5289866

Fax No: (632) 5211036


WHO/HQ Dr Godfrey Xuereb

Team Leader

Surveillance and Population-based Prevention

Unit(SPP)

World Health Organization

Department of Chronic Diseases and Health Promotion

20 Avenue Appia, CH-1211 Genève 27, Switzerland

Tel. No.: +41 22 791 26 17

Fax No: +41 22 791 1581


National Institute of Public

Health

Dr Tomofumi Sone

Director

Department of International Health and Collaboration

National Institute of Public Health, Japan

2-3-6 Minami, Wako City, Saitama, 351-0197 Japan

Tel. No.: (8148) 4586159

Fax No: (8148) 4692768


Dr Tetsuji Yokoyama

Director

Department of Health Promotion



Tel. No.: (8148) 4586128

Fax No: (8148) 4586714


Dr Hiroko Miura

Research Managing Director



Tel. No.: (8148) 4583208

Fax No: (8148) 4586288


Dr Noriko Kato

Research Managing Director



Tel. No.: (8148) 4586191

Fax No: (8148) 4693716


Dr Hidemi Takimoto

Chief Senior Researcher




Tel. No.: (8148) 4586192

Fax No: (8148) 4586714


Dr Nobuyuki Hyoi


Department of International Health and

Collaboration



Tel. No.: (8148) 4586152

Fax No: (8148) 4692768


Dr Dai Shimazaki


Department of Environmental Health



Tel. No.: (8148) 4586296

Fax No: (8148) 4586272


Dr Midori Ishikawa

Senior Researcher




Tel. No.: (8148) 4586230

Fax No: (8148) 4697863


Ms Naoko Tomita

Senior Researcher

Department of International Health and Collaboration



Tel. No.: (8148) 4586132

Fax No: (8148) 4692768


5. RESOURCE

PERSONS

Ms Lesley King

Executive Officer, Physical Activity Nutrition Obesity

Research Group

Adjunct Senior Lecturer, Sydney School of Public Health

The University of Sydney

Level 2 Medical Foundation Building, K25 NSW 2006

Sydney, Australia

Tel. No.: (612) 90363291

Fax No: (612) 9036 3184


Ms Marie Clem B. Carlos

Department of Epidemiology and Biostatistics

University of the Philippines

103 P. Mariano St. Ususan, Taguig City

Philippines

Mobile: +639267585082; +632-6426157


ANNEX 2:

W O R L D H E A L T H

ORGANIZATION

ORGANISATION MONDIALE

DE LA SANTE


BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL

JAPAN-WHO REGIONAL CONSULTATION

FOR PROMOTING HEALTHIER DIETARY OPTIONS FOR CHILDREN

Saitama, Japan, 26 to 29 March 2012

PROGRAMME OF ACTIVITIES

Monday, 26 March 2012

09:00-09:30 Registration

09:30-10:15 Opening ceremony Dr Haruka Sakamoto

Dr Hai-Rim Shin

Dr Kenji Hayashi

10:15-11:00 Coffee break and group photo

11:00-11:20 Overview of NCD prevention and control Dr Cherian Varghese

and objectives of the consultation

11:20-11:40 Approaches for improving dietary options Ms Lesley King

for children

11:40-12:00 Experiences of Japan in promoting healthier Dr Megumi Haga

diets for children

12:00-12:20 Set of recommendations on the marketing Dr Godfrey Xuereb

of foods and non-alcoholic beverages to children

12:20-12:30 Discussion

12:30-13:30 Lunch

13:30-15:30 Country presentations Dr Hai-Rim Shin

Brunei Darussalam, Cambodia, Lao People's

Democratic Republic, Viet Nam

15:30-16:00 Coffee break

16:00-16:40 China, Mongolia, Philippines

16:40-17:30 Hong Kong (China), Republic of Korea,

Malaysia, Singapore

18:00-19:00 Reception

Tuesday, 27 March 2012

09:00-09:15 Recap of Day 1 Dr Cherian Varghese

09:15-10:00 A framework for implementing the set of Dr Godfrey Xuereb

recommendations on the marketing of foods

and non-alcoholic beverages to children


10:30-11:00 Regional experience and potential Ms Lesley King

interventions

11:00-11:20 Consumers' perspectives Mr R.S.N. Sharma

11:20-11:40 National nutrition policy and role of Dr Hye-Kyung Park

regulatory agencies


12:30-13:30 Lunch break

13:30-15:30 Group work Dr Godfrey Xuereb

Group 1 - Brunei Darussalam, Cambodia, and Ms Lesley King

Lao PDR, Viet Nam

Group 2 - China, Mongolia, Philippines

Group 3 - Hong Kong (China), Malaysia,

Republic of Korea, Singapore


16:00-17:30 Group presentations and discussion

Wednesday, 28 March 2012


09:15-09:35 Promoting better dietary habits Dr Noriko Kato

for children in Japan

09:35-10:00 An underweight epidemic? Dr Hidemi Takimoto

Current nutritional problems regarding


10:30-15:00 Site visit to Minami Elementary School, NIPH

Sakado City


15:30-17:30 School-based interventions in Hong Kong (China) Dr Hai-Rim Shin

School-based approaches in the Malaysia

School-based approaches in Singapore

School-based approaches in the Philippines

Thursday, 29 March 2012


09:15-09:45 Monitoring and surveillance of children's Dr Miki Miyoshi

nutrition



10:45-12:00 Identifying priority actions and next steps

in countries

12:00-13:00 Lunch break

13:00-15:00 Presentation by countries Dr Cherian Varghese

15:00-15:15 Closing ceremony Dr Hai-Rim Shin

Dr Kenji Hayashi

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mp

reh

ensi

ve

Hea

lth

Pro

mo

tio

n P

oli

cy a

nd

Hea

lth

Pla

n, 2010, in

cludin

g n

utr

itio

n g

oal

s.

Ko

rea

Fo

od

an

d D

rug

Ad

min

istr

atio

n f

oo

d a

nd

nu

trit

ion

po

lici

es.

Nat

ion

al D

ieta

ry G

uid

elin

es

Fo

od

bal

ance

wh

eel

Tra

ffic

lig

ht

foo

d l

abel

ing

(co

lou

r n

ot

shap

e)

Sch

oo

l M

eals

Act

, 2

00

6 (

gu

idel

ine

for

school

lunch

es, ban

sal

es o

f hig

h e

ner

gy

foo

ds)

Sp

ecia

l A

ct o

f S

afet

y C

on

tro

l o

n

Ch

ild

ren

’s F

oo

d a

nd

Eat

ing

/ N

utr

itio

n

En

vir

on

men

t, 2

00

8

Sch

oo

l lu

nch

pro

gra

mm

e

Nu

trit

ion

Tea

cher

Sy

stem

Gre

en f

ood z

one

ban

nin

g f

ood

adv

erti

sem

ents

20

0m

aro

un

d

sch

oo

ls

Sin

gap

ore

2

01

1 D

ieta

ry G

uid

elin

es.

Hea

lth

ier

Ch

oic

e S

ym

bo

l P

rog

ram

me

Hea

lth

pro

mo

tin

g s

cho

ols

Hea

lth

y e

atin

g f

or

chil

dre

n

Hea

lth

pro

mo

tin

g s

cho

ol

can

teen

Vie

t N

am

Nat

ion

al D

ieta

ry G

uid

elin

es

Fo

od

py

ram

id

Nat

ion

al I

nst

itute

of

Nu

trit

ion

S

cho

ol

mil

k (

26

Pro

vin

ces)

Nu

trit

ion

ed

uca

tio

n

Tab

le 2

. F

oo

d m

ark

etin

g r

egu

lato

ry e

nv

iro

nm

ent

G

over

nm

ent

regu

lati

on

food

mark

etin

g

Ind

ust

ry s

elf-

reg

ula

tio

n

Bru

nei

N

o r

egu

lati

on

s N

o

Cam

bo

dia

N

o

No

Ch

ina

Ch

ina’

s A

dv

erti

sin

g L

aw (

19

95

): a

dv

erti

sem

ents

mu

st n

ot

be

har

mfu

l to

th

e p

hy

sica

l an

d m

enta

l h

ealt

h o

f m

ino

rs a

nd

dis

able

d

per

son

s.

Sel

f-re

gu

lato

ry g

uid

elin

es f

or

spir

itual

civ

iliz

atio

n i

n a

dv

erti

sin

g

(Ch

ina

Ad

ver

tisi

ng

Ass

oci

atio

n 1

997):

chil

dre

n’s

adver

tisi

ng

sho

uld

be

ben

efic

ial

to c

hil

dre

n’s

men

tal

and

ph

ysi

cal

hea

lth

,

and

sh

ou

ld e

stab

lish

go

od

mo

ral

stan

dar

ds.

Ho

ng

Ko

ng

(C

hin

a)

No

No

Jap

an

No

No

Th

e L

ao P

eop

le’s

Dem

ocr

atic

Rep

ub

lic

No

No

Mal

aysi

a G

uid

elin

e on

Ad

ver

tisi

ng

of

Fas

t F

oo

ds

to C

hil

dre

n a

nd

Nu

trit

ion

Lab

elin

g 2

00

8

Th

e M

inis

try

of

Hea

lth

is

in t

he

pro

cess

of

form

ula

tin

g a

Gu

idel

ine

on

Mar

ket

ing

of

Fo

od

an

d B

ever

ages

to

Ch

ild

ren

in

Mal

aysi

a (i

nit

iate

d i

n D

ecem

ber

20

11

)

Als

o,

a M

inis

try

of

Info

rmat

ion

Ad

ver

tisi

ng

Co

de

of

Eth

ics

stat

ing

th

at “

all

adv

erti

sem

ents

on

fo

od

s an

d d

rin

ks

mu

st s

ho

w

the

nec

essi

ty o

f a

bal

ance

d d

iet”

. (S

tatu

s u

ncl

ear)

Mal

aysi

an A

dv

erti

sin

g S

tan

dar

ds

Au

thori

ty M

alay

sian

Code

of

Ad

ver

tisi

ng

Pra

ctic

e.

Mo

ng

oli

a N

o

No

Th

e P

hil

ippin

es

No

NB

: B

road

cast

Co

de

Ch

ild

ren

’s T

elev

isio

n A

ct

Yes

; A

ds

Sta

nd

ard

s C

ou

nci

l P

hil

ipp

ine

Ad

ver

tisi

ng

Bo

ard

;

Nat

ion

al C

ou

nci

l fo

r C

hil

dre

n’s

Tel

evis

ion

The

Rep

ubli

c of

Ko

rea

Sta

tuto

ry r

egu

lati

on

res

tric

tin

g f

oo

d a

dv

erti

sin

g t

o c

hil

dre

n

(Sp

ecia

l A

ct o

f S

afet

y C

on

tro

l o

n C

hil

dre

n’s

Fo

od

an

d E

atin

g/

Nu

trit

ion

En

vir

on

men

t, 2

00

8);

in

eff

ect

fro

m 2

01

0. R

elat

es t

o

TV

(in

clu

din

g c

able

, ra

dio

an

d I

nte

rnet

) ad

ver

tise

men

ts f

or

ener

gy

-den

se a

nd

lo

w n

utr

itio

nal

qual

ity f

ood, off

erin

g f

ree

toys

in f

ast

foo

d a

dv

erti

sin

g. R

estr

icti

ons

apply

5-7

pm

.

Ko

rea

Fed

erat

ion

of

Ad

ver

tisi

ng

Ass

oci

atio

ns,

Co

de

of

Ad

ver

tisi

ng

Eth

ics.

Ko

rean

Fo

od

an

d D

rug

Ad

min

istr

atio

n r

evie

ws

all

new

fo

od

pro

du

cts

in t

erm

s o

f n

utr

itio

nal

cri

teri

a; w

ith

mo

nth

ly u

pd

ates

.

Res

tric

ted

fo

od

s ar

e d

eter

min

ed b

y s

pec

ific

nu

trie

nt

crit

eria

bas

ed

on

ser

vin

g s

ize

for

snac

ks

and

mea

l su

bst

itute

s (e

.g.

no

od

le s

ou

ps,

ham

bu

rger

s, p

izza

) ta

rget

ed t

o c

hil

dre

n.

Th

is a

ct a

lso

res

tric

ts t

he

on

sal

e o

f fo

od

s w

ith

in t

he

imm

edia

te

vic

init

y o

f sc

hools

(gre

en f

ood z

on

e) a

nd

In

tern

et a

dv

erti

sin

g

Ch

ild

ren

co

nsi

der

ed a

s th

ose

un

der

12

yea

rs o

ld.

Nat

ion

al a

nd

lo

cal

go

ver

nm

ent

mo

nit

ori

ng

; R

evie

w i

n 2

01

2.

Sin

gap

ore

H

ealt

h P

rom

oti

on

Bo

ard

in

pro

cess

of

form

ula

ting g

uid

elin

es f

or

foo

d a

dv

erti

sin

g t

arg

eted

at

chil

dre

n.

Sin

gap

ore

Co

de

of

Ad

ver

tisi

ng

Pra

ctic

e (S

CA

P),

lim

itin

g a

ll

adv

erti

sem

ents

in

ch

ild

ren

’s p

rog

ram

mes

to

14

min

ute

s p

er h

ou

r

Vie

t N

am

No

No

Tab

le 3

. C

urr

ent

Po

licy

Arr

ang

emen

ts R

elev

ant

to I

mp

rov

ing

Ch

ild

ren

’s N

utr

itio

n (

Par

t A

)

FO

OD

MA

RK

ET

ING

ISS

UE

FO

R A

CT

ION

Brunei

Darussalam

Cambodia

China

Hong Kong

Lao PDR

OV

ER

AL

L P

OL

ICY

CO

NT

EX

T

Hea

lth

an

d n

utr

itio

n

Lo

cal

TV

Sta

tio

n i

s n

ot

allo

wed

to

ad

ver

tise

Bre

ast

Mil

k s

ub

stit

ute

s

(19

80

)

Su

b-D

ecre

e o

n

Mar

ket

ing

of

Pro

du

cts

for

Infa

nt

and

Y

ou

ng

Ch

ild

Fee

din

g

Law

of

Man

agem

ent

of

Qu

alit

y a

nd

Saf

ety

of

Pro

du

cts

and

Ser

vic

e

Yes

Y

es

Ch

ild

ren’s

wel

fare

an

d

hea

lth

E

arly

Ch

ild

ho

od

Car

e

and D

evel

opm

ent

Yes

Y

es

Dev

elo

pm

ent

of

foo

d

clas

sifi

cati

on

or

nu

trie

nt

pro

fili

ng

No

Yes

PO

LIC

Y R

EL

AT

ED

TO

SP

EC

IFIC

CO

MM

UN

ICA

TIO

N C

HA

NN

EL

S

Ad

ver

tisi

ng

in

gen

eral

N

o

No

No

No

Fo

od

Law

, ar

t. 3

7,

Reg

.

TV

adver

tisi

ng

N

o

Journ

alis

t an

d

Ad

ver

tisi

ng

law

Rad

io a

dv

erti

sin

g

N

o

Journ

alis

t an

d

Ad

ver

tisi

ng

law

Pri

nt

adver

tisi

ng

No

Journ

alis

t an

d

Ad

ver

tisi

ng

law

Sch

oo

l-b

ased

mar

ket

ing

A

dvoca

te t

he

WH

O

reco

mm

end

atio

ns

to

chil

dre

n t

o s

cho

ols

Oth

er c

hil

dre

n’s

sett

ing

s e.

g. sp

ort

s

N

o

Ou

tdo

or

adv

erti

sin

g

N

o

Journ

alis

t an

d

Ad

ver

tisi

ng

law

Sp

ort

s sp

on

sors

hip

No

- o

n d

iscu

ssio

n

Inte

rnet

ad

ver

tisi

ng

No

Fo

od

ret

ail

env

iro

nm

ent

N

o

Fo

od

Law

, re

gu

lati

on

586 M

OH

Fo

od

pac

kag

ing

L

abel

ling o

f fo

od

pro

du

cts

Nu

trit

ion

lab

elli

ng

sch

eme

Fo

od

Law

Art

. 3

6,

regula

tion 5

86 M

OH

Cro

ss-b

ord

er b

road

cast

med

ia

N

o

Tab

le 3

. C

urr

ent

Po

licy

Arr

ang

emen

ts R

elev

ant

to I

mp

rov

ing

Ch

ild

ren

’s (

Par

t B

)

RE

GU

LA

TO

RY

/PO

LIC

Y

DO

MA

IN

Malaysia

Mongolia

Philippines

Korea

Singapore

Viet Nam

Hea

lth

an

d n

utr

itio

n

Sch

oo

l H

ealt

h &

Nu

trit

ion

Pro

gra

mm

e

S

ale

of

Fo

od

Act

,

Sin

gap

ore

Fo

od

Reg

ula

tions

(Chp.

283 /

56(1

))

Ch

ild

ren’s

wel

fare

and

hea

lth

Nat

ion

al N

utr

itio

n

Po

licy

of

Mal

aysi

a

20

05

C

hil

d a

nd

Yo

uth

Wel

fare

Co

de

Act

s an

d

Reg

ula

tions

Dev

elo

pm

ent

of

foo

d c

lass

ific

atio

n o

r

nu

trie

nt

pro

fili

ng

No

ne

spec

ific

fo

r

chil

dre

n

F

oo

d l

abel

lin

g

reg

ula

tio

n

Fo

od

San

itat

ion

Act

,

Food C

ode

Hea

lth

ier

Ch

oic

e

Sy

mb

ol

Pro

gra

mm

e

– F

OP

lab

elli

ng

sum

mar

y s

ym

bol

(Volu

nta

ry)

Ad

ver

tisi

ng

in

gen

eral

Fo

od

Act

19

83

N

o

Bro

adca

st C

od

e o

f

the

Ph

ilip

pin

es

Ph

ilip

pin

es A

ds

Sta

nd

ard

s

Act

s an

d

Reg

ula

tions

Sin

gap

ore

Ad

ver

tisi

ng

Co

de

of

Pra

ctic

e (S

CA

P)

N

ote

: N

utr

ien

t

con

ten

t sp

ecif

ic

clai

ms

on

fo

od

pro

duct

s ar

e

go

ver

ned

un

der

th

e

Fo

od

Reg

ula

tio

ns

and

Han

db

oo

k o

n

Nu

trit

ion

Lab

elli

ng

in S

ingap

ore

No

TV

ad

ver

tisi

ng

F

oo

d A

ct 1

98

3

C

hil

dre

n’s

Tel

evis

ion

Act

of

19

97

Sp

ecia

l A

ct o

n t

he

Saf

ety

Man

agem

ent

of

Ch

ild

ren

’s

Die

tary

Lif

e

Sin

gap

ore

Ad

ver

tisi

ng

Co

de

of

Pra

ctic

e (S

CA

P)

Rad

io a

dv

erti

sin

g

Fo

od

Act

19

83

Sel

f-re

gu

lati

on

(Co

de

of

Eth

ics)

S

CA

P

Pri

nt

adv

erti

sin

g

Fo

od

Act

19

83

Sel

f-re

gu

lati

on

(Co

de

of

Eth

ics)

S

CA

P

Sch

oo

l-b

ased

mar

ket

ing

Ad

min

istr

ativ

e Y

es

Sch

oo

l C

ante

en

po

licy

S

CA

P

Oth

er c

hil

dre

n’s

sett

ing

s e.

g. sp

ort

s

Ad

min

istr

ativ

e

SC

AP

Ou

tdo

or

adv

erti

sin

g

No

ne

spec

ific

fo

r

chil

dre

n

Sp

ecia

l A

ct o

n t

he

Saf

ety

Man

agem

ent

of

Ch

ild

ren

’s

Die

tary

Lif

e

SC

AP

Sp

ort

s sp

on

sors

hip

N

on

e sp

ecif

ic f

or

chil

dre

n

S

CA

P

Inte

rnet

ad

ver

tisi

ng

N

on

e sp

ecif

ic f

or

chil

dre

n

Sp

ecia

l A

ct o

n t

he

Saf

ety

Man

agem

ent

of

Ch

ild

ren

’s

Die

tary

Lif

e

SC

AP

Fo

od

ret

ail

env

iro

nm

ent

Food A

ct 1

983

S

CA

P

Fo

od

pac

kag

ing

F

oo

d A

ct 1

98

3

Fo

od

Fo

rtif

icat

ion

Law

Sal

e o

f F

oo

d A

ct,

Reg

9, 11, 12

Han

dbook o

n

nu

trit

ion

lab

elli

ng

in

Sin

gap

ore

Cro

ss-b

ord

er

bro

adca

st m

edia

AN

NE

X 4

: N

EX

T S

TE

PS

, S

ES

SIO

N 1

6

AC

TIO

N S

TE

PS

B

run

ei D

aru

ssala

m

Cam

bod

ia

Ch

ina

Hon

g K

on

g (

Ch

ina)

Lao P

DR

Go

ver

nm

ents

to

en

gag

e

and

/or

stre

ng

then

tie

s

wit

h v

ario

us

stak

eho

lder

s

(hea

lth

an

d n

on

-hea

lth

sect

ors

, ci

vil

so

ciet

y)

En

gag

emen

t ac

ross

go

ver

nm

ent,

wit

h c

ivil

soci

ety

an

d p

riv

ate

sect

ors

S

eek

ing

co

op

erat

ion

wit

hin

go

ver

nm

ent

(hea

lth

an

d n

on

-hea

lth

),

civ

il s

oci

ety

an

d p

riv

ate

ind

ust

ry

Lin

ks

acro

ss g

ov

ern

men

t

sch

oo

l se

cto

r, c

ater

ing

indust

ry a

nd N

GO

s.

Rev

iew

exis

ting p

oli

cies

and

gu

idel

ines

an

d/o

r

enac

t n

ew o

nes

Th

rou

gh

Nat

ion

al

Co

mm

itte

e o

n H

ealt

h

Pro

mo

tio

n,

in p

roce

ss o

f

dev

elo

pin

g a

nd

en

acti

ng

new

poli

cies

and

gu

idel

ines

(e.

g.

sch

oo

l

can

teen

s)

Dev

elo

p p

oli

cy g

uid

elin

e

for

sch

oo

l h

ealt

hy

die

t;

and

pil

ot

imp

lem

enta

tion

in P

hn

om

Pen

h

Bu

ild

on

* N

atio

nal

Fo

od

an

d

Nu

trit

ion

20

11

-20

20

*N

CD

Pre

ven

tio

n a

nd

Cu

re2

01

2-2

01

5

Act

ion

s

*N

utr

itio

n I

mp

rov

ing

Act

ion

fo

r R

ura

l

Stu

den

ts

*L

egis

lati

on o

n N

utr

itio

n

Imp

rov

ing

Co

mm

itte

e fo

r C

hil

dre

n

Hea

lth

Bu

ild

on

NC

D s

trat

egie

s

and

fra

mew

ork

.

Dev

elo

p g

uid

elin

es f

or

sch

oo

ls a

nd

par

tici

pat

ing

rest

aura

nts

Rev

ise

the

sch

oo

l h

ealt

hy

die

t g

uid

elin

e; i

ncl

ud

e

hea

lth

y m

eals

fo

r

chil

dre

n

Rev

iew

th

e sc

ho

ol

hea

lth

pro

gra

mm

e an

d p

lan

of

acti

on

, re

spo

nsi

bil

itie

s.

Leg

isla

tio

n d

evel

op

men

t

for

sch

oo

l h

ealt

hy

die

t

and

mar

ket

ing

res

tric

tio

n

for

jun

k f

oo

d,

alco

ho

l

dri

nk

an

d t

ob

acco

An

aly

ze c

urr

ent

situ

atio

n

(exis

ting p

rogra

mm

es,

foo

d c

on

sum

pti

on

,

reg

ula

tio

ns,

med

ia

infl

uen

ce,

etc,

) an

d u

se

this

in

form

atio

n a

s

evid

ence

,

Use

oth

er c

ou

ntr

y's

exp

erie

nce

s fo

r a

star

t if

loca

l dat

a is

no

t av

aila

ble

Bas

elin

e N

atio

nal

Nu

trit

ion

Su

rvey

dat

a

un

der

an

aly

sis.

Ad

vo

cacy

req

uir

ed t

o

infl

uen

ce f

oo

d i

mp

ort

s.

An

aly

ze c

urr

ent

situ

atio

ns

on

sch

oo

l

hea

lth p

rogra

mm

e

Info

rmat

ion

an

d D

ata

Sh

arin

g w

ith

WH

O,C

I.W

BW

TO

Bas

elin

e st

ud

ies

on

nu

trit

ion

sta

tus

at t

he

school

sett

ings.

AC

TIO

N S

TE

PS

B

run

ei D

aru

ssala

m

Cam

bod

ia

Ch

ina

Hon

g K

on

g (

Ch

ina)

Lao P

DR

Co

mm

un

icat

ion

acti

vit

ies.

Uti

lize

med

ia a

s a

mea

ns

for

hea

lth

pro

mo

tio

n

(rad

io, T

V, n

ewsp

aper

)

Dis

sem

inat

ion

of

avai

lab

le e

vid

ence

Co

nd

uct

nat

ion

al

adv

oca

cy m

eeti

ng

fo

r

lead

ers

of

MO

E, M

OH

,

MO

IC, D

P’s

D

isse

min

atio

n o

f

avai

lab

le e

vid

ence

Dis

sem

inat

ion

of

do

cum

ents

an

d

gu

idel

ines

fo

r sc

ho

ols

Reg

ula

r co

mm

un

icat

ion

wit

h s

cho

ols

an

d

Eat

Sm

art

rest

aura

nts

via

new

slet

ters

On

lin

e /

off

lin

e p

ub

lici

ty

Co

nd

uct

nat

ion

al

adv

oca

cy m

eeti

ng

fo

r

lead

ers

of

MO

E, M

OH

,

MO

IC,D

P’s

Dis

sem

inat

e d

ocu

men

ts

and

gu

idel

ines

fo

r sc

ho

ol

hea

lth

y d

iet

in L

ao

lan

gu

age

Str

eng

then

ex

isti

ng

init

iati

ves

Use

Hea

lth

Pro

mo

tio

n

Blu

epri

nt

2011-2

015 a

s a

fram

ewo

rk.

P

rom

ote

eat

ing

of

trad

itio

nal

hea

lth

y f

oo

d

En

forc

emen

t o

f th

e

Nu

trit

ion

Lab

elli

ng

Sch

eme

Lau

nch

of

the

Sta

rtS

mar

t@sc

ho

ol.

hk

Cam

pai

gn

tar

get

ing

to

pre

sch

oo

l ch

ild

ren

ag

e 2

-

6 s

ince

Jan

uar

y 2

01

2

Pil

ot

imp

lem

enta

tio

n o

f

hea

lth

y d

iet

in s

cho

ol

in

Vie

nti

ane

cap

ital

an

d

inco

rpo

rate

wit

h o

ther

exis

tin

g i

nit

iati

ves

(W

FP

,

Fo

od

sec

uri

ty a

nd

nutr

itio

n p

rogra

mm

e)

Mo

nit

ori

ng

an

d e

val

uat

e

the

pil

ot

sch

oo

l h

ealt

h

pro

gra

mm

e an

d

imp

rov

emen

t

Str

eng

then

nu

trit

ion

edu

cati

on

pro

gra

mm

es

for

sch

oo

l te

ach

ers

and

chil

dre

n

D

evel

op

nu

trit

ion

edu

cati

on

pro

gra

mm

e fo

r

sch

oo

l te

acher

s an

d

trai

nin

g

Dev

elo

p m

edia

fo

r

sch

oo

l h

ealt

h p

rom

oti

on

O

ng

oin

g n

utr

itio

n

trai

nin

g t

o s

cho

ol

teac

her

s an

d s

cho

ol

lun

ch s

up

pli

ers

Dev

elo

p m

edia

fo

r

sch

oo

l h

ealt

h p

rom

oti

on

(rad

io, T

V, n

ewsp

aper

)

Acc

ess

reso

urc

es t

o

ensu

re i

nit

iati

on

an

d

con

tin

uat

ion o

f in

itia

tiv

es

Sp

ecif

ical

ly s

eek

reso

urc

es w

ith

in B

run

ei

Fin

anci

al s

up

po

rt

req

uir

ed

Fu

nd

s an

d D

on

atio

ns:

Inte

rnat

ion

al, N

atio

nal

,

Pri

vat

e se

cto

r

NG

O p

artn

ers

nee

d

gra

nts

an

d s

up

po

rt f

rom

NG

Os

Fin

anci

al s

up

po

rt

req

uir

ed

WH

O s

up

po

rt

Tec

hn

ical

ad

vic

e o

n

Tec

hn

ical

su

pp

ort

AC

TIO

N S

TE

PS

B

run

ei D

aru

ssala

m

Cam

bod

ia

Ch

ina

Hon

g K

on

g (

Ch

ina)

Lao P

DR

mo

nit

ori

ng

an

d

eval

uat

ion

AN

NE

X 4

:

NE

XT

ST

EP

S (

SE

SS

ION

16)

AC

TIO

N S

TE

PS

M

ala

ysi

a

Mon

goli

a

Ph

ilip

pin

es

Sin

ga

po

re

Ko

rea

V

iet

Na

m

Go

ver

nm

ents

to

eng

age

and

/or

stre

ngth

en t

ies

wit

h

var

iou

s st

akeh

old

ers

(hea

lth

an

d n

on

-

hea

lth

sec

tors

, ci

vil

soci

ety

)

TW

G p

rov

ides

a

stru

cture

for

consi

der

atio

n o

f

issu

es.

To

p d

ow

n a

pp

roac

h

mo

st a

pp

rop

riat

e,

thro

ugh N

SP

-NC

D

& C

abin

et-l

evel

Co

mm

itte

e, a

nd

man

dat

e fr

om

Hea

lth

Min

iste

r.

Th

ere

are

net

wo

rkin

g

op

po

rtu

nit

ies

bas

ed

on

UN

Po

liti

cal

Dec

lara

tio

n o

n

NC

D,

WH

A

Res

olu

tio

n. W

ou

ld

also

nee

d t

o s

eek

app

rov

al t

hro

ug

h

Nat

ion

al C

ou

nci

l o

f

Lo

cal

Go

ver

nm

ents

(ch

aire

d b

y D

epu

ty

Pri

me

Min

iste

r,

mem

ber

s in

clu

de

Ch

ief

Min

iste

rs o

f

Sta

tes)

Engag

e w

ith

nat

ion

al a

nd

reg

ion

al

stak

ehold

ers;

Bu

ild

in

ter-

sect

ora

l

coo

per

atio

n

mec

han

ism

s an

d

esta

bli

sh w

ork

ing

gro

up

wh

ich

in

clu

de

rep

rese

nta

tiv

es f

rom

pu

bli

c an

d p

riv

ate

sect

ors

Nee

d t

o o

bta

in

sup

po

rt o

f S

ec o

f

Hea

lth

to

focu

s o

n

foo

d m

ark

etin

g,

in

add

itio

n t

o t

he

spec

ific

inte

rven

tio

ns

in

nat

ion

al s

trat

egy

.

Hold

sec

tora

l R

TD

wit

h p

rofe

ssio

nal

gro

up

s, m

ark

etin

g

ind

ust

ry,

med

ia

pra

ctit

ion

ers.

Incl

ud

e in

ag

end

a o

f

reg

ula

r m

eeti

ng

s o

f

loca

l n

utr

itio

n

com

mit

tees

. In

form

the

pro

vin

cial

, ci

ty,

mu

nic

ipal

, an

d

vil

lag

e n

utr

itio

n

com

mit

tees

ab

ou

t

the

“pro

ject

”

thro

ug

h c

ircu

lar

of

NN

C c

hai

r o

r D

ILG

secr

etar

y.

Hig

h-l

evel

mee

tin

g

for

Cab

inet

mem

ber

s

and

hea

ds

of

org

aniz

atio

ns;

an

d

G

ov

ern

men

t re

vie

w

of

exis

tin

g

reg

ula

tio

ns

Est

abli

sh t

he

stee

rin

g c

om

mit

tee

to i

mp

rov

e h

ealt

hie

r

die

tary

op

tio

ns

for

chil

dre

n u

nd

er 1

8

age

yea

rs o

ld

AC

TIO

N S

TE

PS

M

ala

ysi

a

Mon

goli

a

Ph

ilip

pin

es

Sin

ga

po

re

Ko

rea

V

iet

Na

m

Lo

cal

po

liti

cal

off

icia

ls

Rev

iew

ex

isti

ng

po

lici

es a

nd

gu

idel

ines

an

d/o

r

enac

t n

ew o

nes

Fu

rth

er d

evel

op

men

t

of

po

licy

/ g

uid

elin

es

Cap

acit

y b

uil

din

g

Su

pp

ort

to

dev

elo

p

po

licy

pap

ers

Ex

isti

ng

m

ark

etin

g

and

ad

ver

tisi

ng

reg

ula

tio

ns

an

d

circ

ula

rs

(of

FD

A,

Dep

ED

) ca

n b

e

reto

ole

d,

adju

sted

or

amen

ded

to

be

mo

re

app

rop

riat

e an

d

sup

po

rtiv

e t

o t

he

ob

ject

ives

of

the

“pro

ject

”

En

gag

e th

e ch

air

of

the

loca

l le

gis

lati

ve

bo

dy

res

po

nsi

ble

fo

r

hea

lth

to

su

bm

it a

nd

def

end

a l

oca

l

ord

inan

ce t

o r

estr

ict

mar

ket

ing

of

UF

NF

B

to c

hil

dre

n.

Co

nti

nu

e

consi

der

atio

n o

f

reg

ula

tory

op

tio

ns

Go

ver

nm

ent

rev

iew

of

exis

tin

g

reg

ula

tio

ns

Dev

elo

p r

egu

lati

on

Dev

elo

p g

uid

elin

e,

tech

niq

ue

on

mar

ket

ing

An

aly

ze c

urr

ent

situ

atio

n (

exis

tin

g

pro

gra

mm

es,

foo

d

con

sum

pti

on

,

reg

ula

tio

ns,

med

ia

infl

uen

ce,

etc,

) an

d

use

th

is i

nfo

rmat

ion

as e

vid

ence

Use

oth

er c

ou

ntr

ies’

So

urc

e A

C N

iels

en

dat

a o

n m

edia

rese

arch

Fo

rmal

ize

po

siti

on

in r

elat

ion

to

ind

ust

ry

Co

nti

nu

e to

see

k

info

rmat

ion

an

d

exp

erie

nce

s fr

om

1. S

itu

atio

n s

urv

ey

on

cu

rren

t

con

sum

pti

on

of

jun

k

food

2. D

etai

led

dat

a o

n

dis

trib

uti

on

an

d

sale

s fo

r ce

rtai

n

pro

du

cts

wh

ich

so

ld

by

sh

op

s n

ear

sch

oo

ls

3. S

itu

atio

n a

nal

ysi

s

Sy

nth

esiz

e

info

rmat

ion

bas

e o

f

WH

O

reco

mm

end

atio

n

Rev

iew

lit

erat

ure

fo

r

new

res

earc

h

Co

nd

uct

of

con

sum

er/

mar

ket

ing

rese

arch

So

urc

e in

form

atio

n,

dat

a, a

nd

pu

bli

shed

lite

ratu

re,

un

pu

bli

shed

co

un

try

exp

erie

nce

s an

d d

ata

(Ko

rea,

UK

,

Mal

aysi

a, N

orw

ay

and

Den

mar

k,

Fra

nce

); s

tud

ies

fro

m L

iver

po

ol,

Yal

e-R

ud

d

On

go

ing

res

earc

h o

n

foo

d m

ark

etin

g

pat

tern

s an

d f

oo

d r

e-

form

ula

tio

n.

Pro

vid

e ev

iden

ce o

n

conse

quen

ce o

f

un

hea

lth

y f

oo

d t

o

chil

d’s

hea

lth

AC

TIO

N S

TE

PS

M

ala

ysi

a

Mon

goli

a

Ph

ilip

pin

es

Sin

ga

po

re

Ko

rea

V

iet

Na

m

exp

erie

nce

s fo

r a

star

t if

lo

cal

dat

a is

no

t av

aila

ble

oth

ers

on

cu

rren

t re

gu

lati

on

on

fo

od

mar

ket

ing

(med

ia

adv

erti

sem

ent

etc.

..)

4.

Det

aile

d

info

rmat

ion

on

mar

ket

ing

bu

dg

et f

or

cert

ain

pro

du

cts

5.

Res

earc

h o

n

wh

eth

er t

hey

hav

e

pro

per

to

pic

s o

n

hea

lth

y d

iet

in

curr

ent

sch

oo

l

curr

icu

lum

6.

Cu

rren

t si

tuat

ion

on

hea

lth

y d

iet

pro

mo

tin

g

pro

gra

mm

es v

ia

med

ia (

TV

, ra

dio

,

fm,

new

spap

er

arti

cle)

.

7.

In

form

atio

n o

n

wh

eth

er s

cho

ols

hav

e th

eir

ow

n

reg

ula

tio

ns

on

foo

d/d

rin

ks

sell

ing

wit

hin

th

e sc

ho

ol

pro

per

ty.

8. M

on

ito

r cu

rren

t

med

ia p

rog

ram

mes

Co

nd

uct

val

idat

ion

surv

eys

re

con

sum

pti

on

pat

tern

s, m

edia

exp

osu

re o

f ch

ild

ren

,

etc.

Dev

elo

p ‘

My

Pla

te’

foo

d g

uid

e.

Lea

rnin

g f

rom

our

“pre

dec

esso

rs”’

pro

mo

te s

har

ing

of

bes

t-pra

ctic

e

Dev

elo

p p

roce

sses

for

coll

atin

g,

shar

ing

info

rmat

ion

on

ind

ust

ry m

ark

etin

g

acro

ss c

ou

ntr

ies

(e.g

.

e-p

latf

orm

, C

I)

Co

mm

un

icat

ion

acti

vit

ies.

Uti

lize

med

ia a

s a

R

egio

nal

lev

el

stak

ehold

er

mee

tin

gs;

sub

reg

ion

al

Co

nd

uct

in

form

atio

n

dri

ve

abo

ut

the

“pro

ject

“ u

sin

g b

ig

nu

trit

ion

ev

ents

li

ke

Hig

h l

evel

nat

ion

al

wo

rksh

op

acr

oss

go

ver

nm

ent

sect

ors

.

AC

TIO

N S

TE

PS

M

ala

ysi

a

Mon

goli

a

Ph

ilip

pin

es

Sin

ga

po

re

Ko

rea

V

iet

Na

m

mea

ns

for

hea

lth

pro

mo

tio

n (

rad

io,

TV

, n

ewsp

aper

)

mee

tin

gs.

Org

aniz

e

adv

oca

cy m

eeti

ng

to

loca

l g

over

nm

ent

Ad

vo

cacy

; tr

ainin

g;

stu

dy

to

ur

Incr

ease

pu

bli

c

awar

enes

s on

neg

ativ

e h

ealt

h

con

seq

uen

ces

of

fast

foo

d a

nd

so

ft d

rin

ks

in t

he

die

t.

Org

aniz

e ca

mp

aig

n

to p

rom

ote

hea

lth

y

die

t am

on

g

go

ver

nm

ent

org

aniz

atio

ns

incl

ud

ing

sch

oo

ls

nu

trit

ion

mo

nth

,

nat

ion

al c

on

ven

tio

ns

of

pro

fess

ion

al

gro

up

s w

ith

par

tici

pat

ion o

f lo

cal

med

ia n

etw

ork

s an

d

infl

uen

tial

s e

.g. w

ife

of

may

or

Dis

sem

inat

ion

thro

ug

h m

ult

iple

-

med

ia,

trai

nin

g

wo

rksh

op

.

Str

eng

then

ex

isti

ng

init

iati

ves

Inte

gra

te t

he

“pro

ject

“ i

n t

he

nu

trit

ion

act

ion

pla

ns

of

vil

lag

e, c

ity

,

mu

nic

ipal

ity

,

pro

vin

ce w

ith

app

rop

riat

e b

ud

get

cov

er

E

xte

nd

wo

rk t

o

ach

iev

e so

diu

m

inta

ke

red

uct

ion

.

Rev

ise

PE

M

pro

gra

mm

e.

Pil

ot/

ex

pan

d

pro

gra

mm

es.

Str

eng

then

nu

trit

ion

edu

cati

on

pro

gra

mm

es f

or

sch

oo

l te

acher

s an

d

chil

dre

n

F

un

d c

om

pet

itiv

e

gra

nts

am

on

g

sch

oo

ls,

pu

bli

c,

pri

vat

e se

ctor

for

new

in

itia

tives

fo

r

chil

dre

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to M

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tate

s).

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ss-b

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TV

,

inte

rnet

?)

ANNEX 5: EVALUATION OF THE CONSULTATION

A. Questionnaire

Evaluation of Japan-WHO Regional Consultation for

Promoting Healthier Dietary Options for Children

26-29 March 2012

This evaluation aims to

-- know the participants' impressions and achievements in the consultation on Promoting Healthier Dietary

Options for Children.

This evaluation takes 10 minutes to complete, on the average, and this will be used to identify the

achievements obtained by the participant and to further improve international joint meeting designs.

We sincerely appreciate your very kind assistance.

(Please check)

I was a participant

a facilitator/a resource person

an observer

a secretariat

Questionnaire 1 – Overall impression

Please rate your impression of this meeting by filling the applicable number.

1: Excellent 2: Good 4: Not very good 5: Not good

A. The participation in this meeting was

Comments, if any.

B. The facilitation in this meeting was

Comments, if any.

C. The leadership in this meeting was

Comments, if any.

D. Transport for the meeting was

Comments, if any.

E. Facilities of this meeting was

Comments, if any.

F. Accommodation for this meeting was

Comments, if any.

G. Meals of this meeting were

Comments, if any.

H. The overall impression of this meeting was

Comments, if any.

Questionnaire 2 – What have you achieved?

Please rate your achievement by filling the applicable number.

1: Excellent 2: Good 4: Not very good 5: Not good

Day 1 “Overview and situational analysis”

a. to understand the objectives

b. to participate in discussion (i.e., questions, analyses, or remarks)

c. to collect information

d. to exchange views and information in group discussion

e. to learn from the experience of other countries

f. Please add any examples you actually achieved.

Day 2 “WHO set of recommendations on marketing of foods and non-alcoholic beverages to children-

options for implementation”







Day3 “Japan experience and school-based initiatives”







Day4 “Identifying next steps and monitoring”







Questionnaire 3 – Comments and suggestions

Please let us know your comments and suggestions. Please provide a maximum of 5 comments per question.

I. School-based interventions

A. How can your sector/department/agency contribute in improving healthier dietary options for children?

B. What are the additional support/information that will help you to do this work?

II. Implementation of the WHO set of recommendations on marketing of foods and non-alcoholic

beverages

A. How can your sector/department/agency contribute in implementing the set of recommendations on the

marketing of food and non-alcoholic beverages to children?

B. What are the additional support/information that will help you to do this work?

B. Results

QUESTIONNAIRE 1

5 4 2 1

The participation in this meeting was 53% 47% 0% 0%

The facilitation in this meeting was 73% 27% 0% 0%

The leadership in this meeting was 77% 23% 0% 0%

Transport for the meeting was 55% 45% 0% 0%

Facilities of this meeting was 83% 17% 0% 0%

Accommodation for this meeting was 45% 55% 0% 0%

Meals of this meeting were 33% 60% 7% 0%

The overall impression of this meeting was 63% 37% 0% 0%

QUESTIONNAIRE 2

Day 1 “Overview and situational analysis” 5 4 2 1

to understand the objectives 52% 48% 0% 0%

to participate in discussion (i.e., questions, analyses, or remarks) 39% 61% 0% 0%

to collect information 45% 55% 0% 0%

to exchange views and information in group discussion 45% 55% 0% 0%

to learn from the experience of other countries 54% 46% 0% 0%

Day 2 “WHO set of recommendations on marketing of foods and non-alcoholic beverages to

children-options for implementation”






Day3 “Japan experience and school-based initiatives”






Day4 “Identifying next steps and monitoring”






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