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Obesity in Finland activity to prevent adverse trends

Marjaana Lahti-Koskidevelopment manager, health promotion

Adjunct prof, PhD, MSc (nutrition), Finnish Heart Association

marjaana.lahti-koski@sydanliitto.fi

16.3.2011

Prevalence of obesity (BMI>30 kg/m2) in Finland (aged 25-64 years)

0

5

10

15

20

25

1967-72*

1978-80**

1982 1987 1992 1997 2000** 2002 2007

%MenWomen

Rissanen et al. IJO 1988;FINRISK-Surveys 1982-2007, Lahti-Koski et al. IJO 2000,EJCPR 2007, Obes Rev 2009

*/** ikäryhmä >15-v/>30-v

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Changes in obesity stage in 20 years aged 30-64 years*

BMI>35

1978-80 2000-01

BMI>40

1978-80 2000-01

Men 1.1

(0.9-1.3)

4.1

(3.7-4.5)

0.1

(0.1-0.1)

0.9

(0.7-1.1)

Women 3.7

(3.3-4.1)

6.3

(5.8-6.8)

0.6

(0.5-0.7)

2.0

(1.7-2.3)

Lahti-Koski et al. Obes Rev 2010;11:171-6* Prevalence (95%CI)

Prevalence of obesity, BMI>30

Lahti-Koski et al. Eur J Public Health 2008

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BMI by age, women

22

23

24

25

26

27

28

29

1982 1987 1992 1997 2002 2007

55-64

45-54

35-44

25-34

Männistö et al SLL 2004,Peltonen et al. KTL B34/2008

*

Obesity in men by age- change in 20 years

0

5

10

15

20

25

30

35

30-44 45-54 55-64 65-74 75+

%

1978-80

2000-2001

mean 1978-80

mean 2000-01

Lahti-Koski et al. Obes Rev 2010;11:171-6

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Obesity in women by age- change in 20 years

0

5

10

15

20

25

30

35

30-44 45-54 55-64 65-74 75+

%

1978-80

2000-2001

mean 1978-80

mean 2000-01

Lahti-Koski et al. Obes Rev 2010;11:171-6

Prevalence of overweight (%)boys aged 12–18-years

Source: The Adolescent Health and LifestyleSusanna Kautiainen 2008

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Prevalence of overweight (%)girls aged 12–18-years

Source: The Adolescent Health and LifestyleSusanna Kautiainen 2008

Prevalence of obesity (BMI>30 kg/m2) by education 1987-2002, women

0 5 10 15 20 25 30

highest

middle

lowest

%

2002

1997

1992

1987

Lahti-Koski et al. EJCPR 2007;14:398-404

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How about waistline?

photo: www.hyvis.net

Abdominal obesity (%) (waist; ,men>100 cm, women>90 cm)

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Waist >100 cm by age, 1987-2002, men

0 10 20 30 40 50

25-34-v.

35-44-v.

45-54-v.

55-64-v.

%

2002

1997

1992

1987

Lahti-Koski et al. EJCPR 2007;14:398-404

Waist >90 cm by age, 1987-2002, women

0 10 20 30 40 50

25-34-v.

35-44-v.

45-54-v.

55-64-v.

%

2002

1997

1992

1987

Lahti-Koski ym. EJCPR 2007;14:398-404

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Men

0

5

10

15

20

25

18 20 22 24 26 28 30 32 34 36 38 40

BMI (kg/m2)

%

1987

2002

Men

0

5

10

15

20

25

67,5 72,5 77,5 82,5 87,5 92,5 97,5102

,5107

,5112

,5117

,5122

,5127

,5132

,5137

,5

cm%

1987

2002

Lahti-Koski ym. EJCPR 2007;14:398-404

BMI vs. waist men

Women

0

5

10

15

20

25

16 18 20 22 24 26 28 30 32 34 36 38 40

BMI (kg/m2)

%

1987

2002

Women

0

5

10

15

20

25

57,5

62,5

67,5

72,5

77,5

82,5

87,5

92,5

97,5

103

108

113

118

123

128

133

138

cm

%

1987

2002

Lahti-Koski ym. EJCPR 2007;14:398-404

BMI vs. waist women

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Obesity prevention in national action plans and programmes

Government Resolution on development guidelines for health-enhancing physical activity and nutrition 2008

URL: http://www.stm.fi/julkaisut/nayta/_julkaisu/1069549

Obesity integrated in several action plans and programmes, e.g:•Health promotion - Government policy programme (2008)•Action programme for implementing national nutrition recommendations (2003)

•Programme for the prevention of type 2 diabetes in Finland (2003)

•Action Plan for Promoting Finnish Heart Health for the years 2005-2011 (2005)

Government Resolution on development guidelines for health-enhancing physical activity and nutrition 2008

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”TOPI”

• was published in June 2005

• gives guidelines and strategies for actionsto prevent CVD

• nutrition and physical activity keyelements

• implementation:

Finnish Heart Plan –population strategy

Finnish Heart Plan- Population strategy

Small decision a day

Walking programme

Healthymeal services

Healthy lifestyle from the very

Beginning- SMART FAMILY

Populationstrategy

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The Smart Family exercise and nutrition guidance method

• Provides support, tools and knowledge for personnel at primary health care to promote good dietary and physical activity habits at the level of the entire family.

• Based on STRIP (Special Turku coronary Risk factor Intervention Project for children) project; evidence for early prevention of CHD

• 1st phase: Maternity and well-baby clinics

• 2nd phase: Schools (and day care)

The Smart Family working tools for public health nurses

• Card: exercise and nutrition habits mother + father + child

• Information pack

• Image pack

• Education

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Communication campaign- The little one follows the big one’s example

• Background: The aim - healthy lifestyle from the very beginning

• Key messages:– It is up to adults

– You have the responsibility

– You are the example/hero

• For parents, professionals working with children, policy makers

In the eyes of a child you are a hero

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The child follows the example of the adult. In everything.

Photo: Finnish Heart Association

Photo: Finnish Heart Association

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Heart Symbol on market since 2000

• Labelling system for foods

• Helps consumers to make better choices at groceries

• Currently >750 products with the symbol on the Finnish market

• Well recognised by consumers

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Product groups

• Milk and milk (dairy) products and other similar products

• Fats and oils• Processed meat• Bread and cereals• Convenience food, semi-processed food, meal

components• Spices and seasoning sauces• Vegetables, fruit and berries (since Aug 2007)• Meat and fish (since Dec 2009)

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Awareness

THL: Health behavior of Finnish adults

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Heart symbol expanded tothe plate

• Meals can be labelled with the symbol

• The symbol helps:

– customers: to make tasty and healthy choices when eating out

– caterers: to inform customers of healthy choices on offer and to improve their service related to the nutritional quality of the meals

Goals

• To increase the know how of food service employees about improving the nutritional quality of the food they prepare

• To increase the demand for healthier meals

• To help consumers to make better choices when eating out

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Meals with the Heart symbol

• Components for better meals

– Main dish: energy, fat (quantity and quality), salt

– Other meal components to be available:

• Non-fat milk/sour milk

• Low-salt bread + spread (fat quality)

• Fresh vegetable + salad dressing (fat quality)

Customer information• Heart Symbol helps the customer to

put together a healthy meal step by step

• Main dish and meal components marked with symbol on buffet

• Model meal to be on view

Wednesday

Karelian beef stew

Baltic herring steaks

Meatballs

Mushroom soup

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