Charlene Vassallo

Scientific Officer- Nutrition

On behalf of

Dr Charmaine Gauci- Director of HPDPD

18th February 2018

2

Overweight and obesity in adults

(EHIS, 2008)

0.7% 2.4%

28.0%

44.7%

24.3%

2.6%

8.4%

40.0%

28.4%

20.6%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

<=18.00 18.01 - 20.00 20.01 - 25.00 25.01 - 30.00 >=30.01

BMI Group

Male Female

3

Overweight and obesity in adolescents

(HBSC, 2010)

4

Overweight and obesity in children

0 5 10 15 20 25 30

Boys

Girls

Boys

Girls

Boys

Girls

20

07

; 5

-6 y

ears

2

00

8;

6-7

yea

rs

20

10:

8-9

yea

rs

Obese %

O/W %

0

5,000,000

10,000,000

15,000,000

20,000,000

25,000,000

30,000,000

35,000,000

40,000,000

Attributable Cost 2008 (€)

Projected Attributable

Cost 2020 (€) if no change in obese rate

Projected Attributable

Cost 2020 (€) if 4.3% of obese shift to overweight

Projected Attributable

Cost 2020 (€) if 4.3% of obese shift to normal weight

CO

ST

S I

N E

UR

O

Scenario

Annual state health care costs attributable to overweight and obesity for 2008 and projected costs

for 2020

6

Prevalent cases avoided by scenario 1 (1% obesity reduction)

scenario 2 (5% obesity reduction)

Cancers CHD & Stroke Osteoarthritis Diabetes Hypertension

Scenario 1 9 51 2 71 296

Scenario 2 59 225 11 344 997

0

500

1000

1500

2000

2500

Pr

ev

ale

nc

e c

as

es

av

oid

ed

Prevalence cases avoided in 2030 per 100 000 of the population by scenario 1 and 2 Malta

Food consumption

11y 13y 15y adults

Breakfast 55 43 45

Daily fruit 42 41 34 74

Daily vegetables

16 15 15 54

Daily soft drinks

44 44 49 21

Cereal/Rice /pasta

28% consumed cereals >3 per week

30% rice or pasta

Fish 51.8% 1-2days/week

Chicken 71.8% 1-2 days/week

Sugar 38% never consume sugar

Add salt with cooking

47%

8

Objectives of FNAP

• To promote healthy nutrition as the basis for healthy behaviours for the population of Malta

• To increase the vegetable and fruit intake in the population of Malta

• To reduce salt intake in the Maltese population • To reduce the consumption of foods high in

saturated fats, trans fats and sugars • To halt and reverse the obesity trend in both

adults and children • To address inequalities in food accessibility

9

Overarching and guiding principles

• Whole of government approach ▫ Trade and Marketing Policies ▫ Fiscal Policies ▫ Climate Change ▫ Agriculture and Fisheries ▫ Education ▫ Social security ▫ Waste management

• Focus on Equity • Life Course Approach • Strengthening Health Systems

10

Whole of government approach • To develop a communication strategy for the Food

and Nutrition Action Plan engaging all stake holders.

• To engage with agriculture and fisheries on the promotion of, accessibility and affordability of fish, fruit and vegetables.

• To further consolidate current school initiatives ▫ promote and protect healthy diets ▫ Promote plain safe water ▫ Development of a concerted evidence-based School

Nutrition Programme.

11

Working with stakeholders

• Product reformulation

▫ reduce salt, sugar, limit saturated fat and eliminate trans fatty acids

▫ resulting in health benefits in terms of reducing risk factors leading to noncommunicable diseases

• Partnerships with employers

▫ enhance workplace health promotion

▫ Enhance healthy food availability, accessibility and consumption

12

Health systems

• To improve the capacity of the health systems to adequately address the health needs of the population in the area of nutrition:

▫ Enhanced training of health care professionals

▫ Referral of patients to the appropriate services

▫ Ensuring adequate numbers of registered nutrition / dieticians in both primary and secondary care

13

Research and Surveillance • Develop a comprehensive system for surveillance and

monitoring of food consumption in order to inform on the evaluation of this action plan. ▫ COSI, HBSC, HIS, EHES, NFCS ▫ food composition knowledge of local food products.

• To evaluate and monitor the salt intake of the Maltese population. To evaluate and monitor the salt content of all local food products.

• To develop the capacity for research in the area of food and nutrition.

• To identify potential malnutrition within vulnerable groups

14

Implementation and monitoring • To ensure that this action plan is monitored and

evaluated in order to ensure that actions within the different settings are achieved according to the timeframe set and within the allocated budget.

• To ensure coherence with

▫ Noncommunicable Disease Strategy (2010)

▫ Cancer Plan (2011)

▫ Healthy Weight for Life Strategy (2012)

▫ National Health Systems Strategy (2014)

15

Priority areas for action • To increase the information about the food

nutrition.

• To promote plain water consumption in schools.

• To increase the number of mothers that exclusively breastfeed up to six months.

• To reduce the availability and intake of foods high in fat, sugar and salt in schools.

• To develop a comprehensive surveillance and monitoring system on food consumption.