Malta’s fight against childhood obesity

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Malta’s fight again­st child­hood obesity

Malta, long known as Europe’s fat­test nation, could finally shake this unen­vi­able pos­i­tion.
While it is still lead­ing in rank­ings for the over­all pop­u­la­tion, recent data from the World Health Organ­isa­tion (WHO) shows Malta has fallen back to bet­ter pos­i­tions in rat­ings on the share of obe­se and over­weight chil­dren. This is a sign that bodes well for the future.
Obesity is on the rise in south­ern Europe. (Pho­to: Tony Alter)
The bad news, how­ever, is that this is because the prob­lem has worsened in coun­tries such as Greece, Spain and Ita­ly.

The 40 per­cent
In Malta, the share hov­ers around 40 per­cent, des­pite the fact that since 2012 Malta has been work­ing on one of the most elab­or­ate anti-obesity action plans of all EU coun­tries.

Ambi­tions even stretch bey­ond its own bor­ders: Malta made the fight again­st child­hood obesity a pri­or­ity of its cur­rent Coun­cil of the EU pres­id­ency.

The fail­ure to shrink bul­ging waist­lines may there­fore seem rather dis­ap­point­ing.

Dr Char­maine Gauci, Malta’s super­in­tend­ent of pub­lic health, explained to EUob­server why, des­pite the high polit­ic­al pro­file of the prob­lem, it was so dif­fi­cult to reverse the trend.

“This is a very com­plex issue. We have already made huge pro­gress in many areas, but there is need for very many people, also bey­ond the health sec­tor, to work togeth­er,”” she said.

The point of depar­ture for Malta’s strategy has been to work with chil­dren, she added.

Vir­tu­ally all schools in Malta today are teach­ing kids as young as five about the need to eat more health­ily, although the les­sons mostly resemble games.

They get to play with food, or watch pup­pet shows where a chef char­ac­ter informs chil­dren on how they should eat.

The next step is to make sure schools are send­ing a con­gru­ent mes­sage. Tuck shops — small, food-selling retail­ers — shouldn’t be selling junk food, for instance.

The prob­lem is doing this without break­ing EU rules, which say pub­lic con­tracts should go to busi­nesses with the cheapest offer.

Dr Gauci and her col­leagues have developed a toolkit on how to for­mu­late pub­lic tenders without breach­ing EU pro­cure­ment rules. These could now be trans­lated by the European Com­mis­sion for use in oth­er coun­tries.

EU action
EU action is import­ant.

For Malta, a densely pop­u­lated lime­stone archipelago that imports around 80 per­cent of the food, it’s dif­fi­cult to tackle the prob­lem alone without involving for­eign food pro­du­cers.

But the EU, although sym­path­et­ic, some­times adds to the prob­lem through well-mean­ing policies.

EU health com­mis­sion­er Vyten­is Andri­ukait­is sug­ges­ted earli­er last week to step up EU fruit, veget­able and milk schemes, under which the EU gives ““free”” — cour­tesy of tax-pay­ers — pro­duce to schools in a plan to pro­mote the con­sump­tion of allegedly healthy foods.

But Malta, which bans sug­ary drinks in its schools, only man­aged to scrap fruit juices after lengthy battles, and juice is still included in oth­er coun­tries’ schemes.

EU health min­is­ters last week dis­cussed the mid-term eval­u­ation of the EU child­hood obesity plan, which runs from 2014 – 2020 and aims to sup­port nation­al strategies with EU-level actions.

They found that the most pro­gress has been made on top­ics such as issu­ing nutri­tion­al guid­ance, encour­aging breast­feed­ing, ban­ning vend­ing machines and encour­aging phys­ic­al activ­it­ies in schools.

Malta’s min­ister of health, Chris Fearne, also said that it would be help­ful to re-intro­duce the Medi­ter­ranean diet, which has been linked to good health — sug­gest­ing it’s not the diet of choice in coun­tries such as Malta, Greece and Spain today.

Many pro­du­cers of fizzy drinks in Europe have also taken steps to reduce sug­ar con­tent by 10 per­cent.

“That’s good but we want more. And we cer­tainly don’t want to pass the mes­sage that sug­ary drinks are ok,”” said dr Gauci.

Sug­ar tax
There has been less pro­gress on more con­tro­ver­sial issues, such as higher tax­a­tion of products with a high level of salt, sug­ar or fat; food labelling and curbs on mar­ket­ing of such foods. Ini­ti­at­ives to involve fam­il­ies and to help obe­se chil­dren are also trail­ing behind.

Min­is­ters dis­cussed wheth­er to intro­duce a tax on sug­ar. As the EU lacks tax­ing capa­city, such a levy would have to be intro­duced at nation­al level.

Malta last year intro­duced a small fee on sug­ary drinks. But Dr Gauci said that one has to be care­ful before intro­du­cing these ““sin”” taxes. Maltese health experts are also car­ry­ing out a study of people’s eat­ing habits, to see if it would make sense to apply higher taxes to food with high fat, salt or sug­ar con­tents.

“Again, it’s a com­plic­ated ques­tion. We need to make sure that such a tax doesn’t hit hardest again­st people from a poor back­ground,”” she said.

Mem­ber states are also wait­ing for the revi­sion of the audi­ovisu­al media ser­vices dir­ect­ive (AMSD), which also reg­u­lates advert­ising.

“We know that pub­li­city — not only on tele­vi­sion, but also through tab­lets and mobiles — has a sig­ni­fic­ant impact on chil­dren. Parties are tak­ing steps to a stronger pledge to reg­u­late this under the AMSD revi­sion, and after­wards we will see if there is any­thing else we can do,”” Gauci said.

She noted that it was dif­fi­cult to com­pletely ban the pro­mo­tion of cer­tain types of food. Even the use of cer­tain col­ours, such as yel­low and red, in advert­ising, as table cloths in res­taur­ants, or as food col­our­ing addit­ives, could make people feel hun­gri­er than they really are.

“Fight­ing obesity is a long-term effort, and a ques­tion of employ­ment, fin­ances and edu­ca­tion,”” she said.

Already halt­ing the increas­ing rates of obe­se and over­weight chil­dren was a suc­cess.

The min­is­ters’ dis­cus­sion will feed into the upcom­ing coun­cil con­clu­sions on child­hood obesity, and Malta hopes that the next EU pres­id­en­cies will fol­low up on its work.

“We hope they will con­tin­ue with food guidelines for hos­pit­als and eld­erly homes, for instance,”” she said.

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-ġlieda Malta kon­tra l-obeżità fit-tfuli­ja

Malta, ilhom magħru­fa bħala nazz­jon fat­test Ewro­pa, set­għet final­ment ħawwad din il-pożizz­joni unen­vi­able.
Fil­waqt li għadu ewli­eni fil-klas­si­fiki għall-popolazz­joni ġen­er­ali, data reċenti mill-Organizza­zz­joni Dinji­ja tas-Saħħa (WHO) juri Malta naqas lura għal pożizz­jon­iji­et aħjar fil-klas­si­fikazz­jon­iji­et fuq is-sehem ta tfal obeżi u piż żejjed. Dan huwa sin­jal li jawgura tajjeb għall-futur.
L-obeżità hija fuq il-lok fin-Nof­sin­har. (Rit­ratt: Tony Alter)
L-aħbar ħażina, madankollu, huwa li dan huwa minħab­ba l-prob­lema mar­ret għall-agħar fil-pajjiżi bħall-Greċ­ja, Span­ja u l-Ital­ja.