New research, as part of our work in the CO-CREATE project on adolescent obesity in Europe, looks at what governments across Europe are doing to enable healthy diets and physical activity. This recognises the importance of these 2 key factors for health, which affect people’s likelihood of developing non-communicable diseases (NCDs), including cancer.
We know that overweight and obesity affects 1 in 5 adolescents in Europe, and that excess weight in adolescence poses health consequences that can continue into adulthood. To tackle the urgent and growing crisis of obesity in children and young people, a country has to have the right policies in place, and those policies need to be well-designed.
Unfortunately, our new research into nutrition and physical activity policies in 30 European countries shows governments are missing many opportunities to create environments that make it easier for young people to eat healthily and stay active.
What we did
For the past 4 years, we have been developing indexes to show how countries are doing, with a policy status snapshot for each of the 30 countries. A key part of the CO-CREATE project is enabling young people to be involved in tackling obesity. As well as the indexes, we have created a set of advocacy tools to enable young people to push for better policies and hold their governments to account.
These tools can support an array of actors – in particular civil society, including youth groups. These tools include 2 policy briefs and country snapshots on nutrition and physical activity policy respectively. The tools investigate how policy changes create environments that help prevent adolescent obesity, support youth advocacy for policy change, and most importantly, hold governments accountable for action on NCD prevention through tackling unhealthy diets and promoting physical activity.
What we found
When we talk about government, we mean national governments. The remit of this work did not extend to policies at a local, regional or provincial level. Our analysis looked at whether a government has taken action in a certain area, and whether the policy design was poor, fair, moderate, good or excellent. Only one country – Denmark – got “excellent” for one area of nutrition policy, and only one country – France – got “excellent” for one area of physical activity policy, which shows there is a lot of work for European governments to do.
Action on nutrition
Across 30 European countries, governments have taken most action, with moderate to good policy design, in 4 policy areas:
- nutrition labelling on food packaging – including European labelling regulations and any additional action on front-of-pack labelling taken by countries;
- standards for healthy foods in schools and other settings – focusing on standards on food served in schools and their vicinity, as well as in settings such as hospitals;
- setting nutrient limits or targets for the improvement of food products – specifically attempts to reformulate food products to lower nutrients such as salt, sugars or trans fats;
- policies to inform people on healthy eating – such as public information campaigns.
Most need for improved policy design is found in:
- advertising and marketing unhealthy foods to young people – such as online advertising, but also marketing in/around schools;
- nutrition education and skills – in schools to young people, but also to health professionals or caterers;
- nutrition counselling in healthcare settings – including primary care and school healthcare.
There is insufficient government action on:
- using economic tools to address food affordability and purchase incentives – such as subsidies on healthy food;
- ensuring coherence between food supply chains and health – such as procurement standards for public bodies;
- setting incentives and rules to create a healthy retail and food service environment – such as planning restrictions on food service outlets.
Action on physical activity
With regards to physical activity, we see moderate or good policy design in:
- promoting physical activity in schools and the wider community;
- offering physical activity opportunities in the workplace (and training in physical activity promotion across multiple professions);
- public communication policies which build behaviour change skills.
In contrast, we see poor or fair assessments in the 2 MOVING policy areas that target the active environment, specifically:
- structures and surroundings which promote physical activity;
- transport infrastructure and other opportunities that support active societies.
Finally, there was least government action on physical activity training, assessment and counselling in healthcare settings, with little to no focus on training for healthcare professionals in this area.
Our policy indexes give an at-a-glance assessment of how well countries in Europe are doing to create environments that enable people to eat a healthy diet and be physically active. The indexes highlight strengths, weaknesses and gaps in nutrition and physical activity policy along with providing recommendations on where greater action is needed. The advantage of these indexes is their ability to compare results with other countries and by policy area. In doing so, countries can see how well or poorly they are doing comparatively at a European level.
In each country, civil society and other key actors can use our findings to:
- Learn how well or not your country is doing in nutrition and physical activity policy at a national level.
- Find out more about the policy status of Europe and compare your country with other European countries.
- Identify weaknesses that can inform advocacy efforts to improve the policy environments, either in your country or across Europe.
- Call for policymakers to implement policy actions to ensure better health for future generations.
The new indexes are part of a package of tools that can be used to examine nutrition and physical activity policy in Europe. These tools establish the foundations of a research infrastructure to explore changes in the number of people living with overweight, obesity and related behaviours, and see whether implemented policies are working.
These tools as a package are:
- The NOURISHING and MOVING frameworks – a set of recommended policies
- Databases – where we collect policies from Europe, and around the world
- Benchmarking tools – what good policy design looks like for nutrition and physical activity
- The new policy indexes – summarising where countries are at
Our policy indexes were launched in May 2023. Dr Ioana Vlad, our Senior Policy Research Manager, and Jennifer O’Mara, our Policy & Public Affairs Officer, have been leading this research. Get in touch with them email@example.com.