The European Parliament adopted by 536 votes to 37, with 20 abstentions, a resolution in response to the Commission’s White Paper on nutrition, overweight and obesity-related health issues.

The own-initiative report had been tabled for consideration in plenary by Alessandro FOGLIETTA (UEN, IT) on behalf of the Committee on the Environment, Public Health and Food Safety.

The Parliament welcomes the White Paper on Nutrition as an important step in an overall strategy to stem the rise in obesity and overweight and address diet-related chronic diseases, such as cardiovascular disease including heart disease and stroke, cancer and diabetes, in Europe.

MEPs reiterate their call to Member States to recognise obesity as a chronic disease. They outline a number of recommendations to combat obesity through improved consumer information (notably by improved labelling) to the promotion of physical activity.

The report highlights the following issues:

§ putting in place a policy geared to food quality;

§ providing comprehensible information on labels enabling consumers to choose between good, better and less good nutrition;

§ setting up of the High-Level Group on Nutrition and Physical Activity aiming to improving knowledge and the exchange of best practice in the fight against obesity;

§ recognising the substantial role of self-regulation in fighting obesity, particularly when concerning children and calling for more tangible measures especially targeted at children and at-risk groups;

§ promoting consumer information so as to allow them to choose the best sources of nutrients needed to achieve and maintain the optimal nutrition intake best suited to their individual lifestyle and health;

§ improving the health literacy of citizens to empower them to make effective decisions about their own and their children's diets;

§ informing and educating parents on nutritional issues should be carried out via the relevant professionals (teachers, cultural events organisers and health professionals) at the appropriate locations;

§ linking a future school fruit programme to a broader educational strategy, for example by means of lessons on diet and health in primary schools;

§ encouraging physical exercise as a daily routine by creating opportunities in the local environment that motivate people to engage in leisure time physical activity;

§ encouraging girls in their later teenage years to participate actively in sporting activities;

§ encouraging the private sector to play a role in reducing obesity by developing new and healthier products.

Parliament draws attention to the fundamental role played by parents in nutrition education in the family and the decisive contribution they can make to combating obesity.

Towards a common approach : Parliament stresses that the European Union should take a leading role in formulating a common approach and promoting coordination and best practice between Member States. It is convinced that an important European added value can be provided in fields such as consumer information, nutritional education, media advertising, agricultural production and food labelling in particular with indication of trans-fat content. MEPs call for the development of European indicators such as waist size and any other risk factor relating to obesity (especially abdominal obesity).

Priority to children : Parliament invites the Commission and all actors to set as a priority the fight against obesity from the early stages of life. Proposed actions include: information campaigns to raise awareness among pregnant women about the importance of a balanced and healthy diet; urging Member States to propose guidelines drawn up by experts on how to improve physical activity as early as the pre-school period and to promote nutritional education already at this early stage. MEPs consider that it is primarily at school level that steps have to be taken to ensure that physical activity and balanced eating become part of the behaviour of a child. They are also asked to monitor and improve the quality and nutritional standards of school and kindergarten meals. The report advocates making fresh fruit and vegetables more available at points of sale and invites competent authorities to ensure that at least 3 hours a week of the school curriculum are devoted to physical activities. MEPs welcome a possible " fruit at school " project to be financially supported by the EU. Parliament calls on those Member States which have not yet done so to cut VAT on fruit and vegetables. It calls, in addition, for the Community texts in force to be amended to allow fruit and vegetables to benefit from a very low rate of VAT (under 5%).

Informed choices and availability of healthy products : Parliament believes that product reformulation is a powerful tool for reducing the intake of fat, sugar and salt in our diets. It encourages food producers to further engage in reformulation of energy-dense, nutrient-poor foods in order to reduce fat, sugar and salt and enrich their fibre, fruit and vegetable content. MEPs stress that nutrition labelling must be mandatory and clear to help consumers make a healthy choice of food and recommend that to enable consumers to compare the nutrient content in different food products (contrary to the committee responsible, Parliament does not wish for nutrition labelling to be expressed in 100g/100ml). MEPs call for an analysis of the role played by flavour enhancers such as glutamates, guanylates and inosinates. The industry is called on to review single-serving portion sizes, providing a broader range of smaller portion options.

Trans-fatty acids : Parliament stresses that the present state of scientific knowledge shows that an excessive consumption of trans-fatty acids (over 2% of total energy intake) is linked to significantly higher cardiovascular risks. Parliament deeply regrets, therefore, that only a few European governments to date have acted to reduce European consumers" cumulative exposure to the artificial trans-fatty acids and saturated fatty acids that are present in numerous processed products of low nutritional value. It calls for an EU-wide ban on artificial trans-fatty acids. It underlines the fact that industrially processed trans-fatty acids pose a serious, well documented and unnecessary threat to the health of Europeans and should be addressed with an appropriate legislative initiative seeking to eliminate effectively industrially processed trans-fatty acids from food products.

Media and advertising : additional incentives should be created to promote physical exercise. Although MEPs consider the voluntary approach adopted in the Directive on "Audiovisual Media Services without frontiers" on advertising food of poor nutritional value directed to children to be a step in the right direction, they ask the Commission to bring forward stricter proposals if the 2011 review of the Directive declares the voluntary approach to have failed in this field. The industry is called upon to restrict commercials for unhealthy foods targeted at children to protected times. Such restrictions should also cover new forms of media such as online games, pop-ups and text messaging.

Health care and research : Parliament asks for particular attention to be paid to research in health. It acknowledges that health professionals, especially paediatricians and pharmacists, should be made aware of their essential role in the early identification of patients at risk of overweight and cardiovascular disease. The Commission is called upon to develop European anthropometric indicators and guidelines on cardio metabolic risk factors associated with obesity. As regards malnutrition, the report highlights that 40% of patients in hospitals and between 40 and 80% of people in elderly care homes are malnourished. Therefore, Member States are asked to improve the quantity and quality of food in hospitals and elderly care homes. The Commission should also promote best medical practices, for example through the EU Health Forum, as well as information campaigns on obesity-related risks and abdominal obesity in particular drawing attention to the cardiovascular risks. The dangers of ‘home diets’ should also be emphasised. MEPs call on the Commission and Member States to fund research into the links between obesity and chronic diseases such as cancer and diabetes.

Lastly, Parliament insists on the need for full regulation of the qualification of medical professionals as "clinical dieticians" as well as "nutritionists.

The Committee on the Environment, Public Health and Food Safety adopted the own initiative report drafted by Alessandro FOGLIETTA (UEN, IT) on the White Paper on nutrition, overweight and obesity-related health issues. It welcomes the White Paper on Nutrition as an important step in an overall strategy to stem the rise in obesity and overweight and address diet-related chronic diseases, such as cardiovascular disease including heart disease and stroke, cancer and diabetes, in Europe.

MEPs reiterate their call to Member States to recognise obesity as a chronic disease. They outline a number of recommendations to combat obesity through improved consumer information (notably by improved labelling) to the promotion of physical activity.

The report highlights the following issues:

putting in place a policy geared to food quality; providing comprehensible information on labels enabling consumers to choose between good, better and less good nutrition; setting up of the High-Level Group on Nutrition and Physical Activity aiming to improving knowledge and the exchange of best practice in the fight against obesity; recognising the substantial role of self-regulation in fighting obesity, particularly when concerning children and calling for more tangible measures especially targeted at children and at-risk groups; promoting consumer information so as to allow them to choose the best sources of nutrients needed to achieve and maintain the optimal nutrition intake best suited to their individual lifestyle and health; improving the health literacy of citizens to empower them to make effective decisions about their own and their children's diets; informing and educating parents on nutritional issues should be carried out via the relevant professionals (teachers, cultural events organisers and health professionals) at the appropriate locations; linking a future school fruit programme to a broader educational strategy, for example by means of lessons on diet and health in primary schools; encouraging physical exercise as a daily routine by creating opportunities in the local environment that motivate people to engage in leisure time physical activity; encouraging girls in their later teenage years to participate actively in sporting activities; encouraging the private sector to play a role in reducing obesity by developing new and healthier products.

Towards a common approach: MEPs stress that the European Union should take a leading role in formulating a common approach and promoting coordination and best practice between Member States. They are convinced that an important European added value can be provided in fields such as consumer information, nutritional education, media advertising, agricultural production and food labelling in particular with indication of trans-fat content. They call for the development of European indicators such as waist size and any other risk factor relating to obesity (especially abdominal obesity).

Priority to children : MEPs invite the Commission and all actors to set as a priority the fight against obesity from the early stages of life. Proposed actions include: information campaigns to raise awareness among pregnant women about the importance of a balanced and healthy diet; urging Member States to propose guidelines drawn up by experts on how to improve physical activity as early as the pre-school period and to promote nutritional education already at this early stage. MEPs consider that it is primarily at school level that steps have to be taken to ensure that physical activity and balanced eating become part of the behaviour of a child. They are also asked to monitor and improve the quality and nutritional standards of school and kindergarten meals. The report advocates making fresh fruit and vegetables more available at points of sale and invites competent authorities to ensure that at least 3 hours a week of the school curriculum are devoted to physical activities. MEPs welcome a possible "fruit at school" project to be financially supported by the EU similar to the current school milk programme. The EU is urged to be more flexible over Member States’ application of lower VAT rates for necessities of a social, economic, environmental or health-oriented nature; in this respect; calls on those Member States which have not yet done so to cut VAT on fruit and vegetables, recalling that Community law authorises them to do so; calls, in addition, for the Community texts in force to be amended to allow fruit and vegetables to benefit from a very low rate of VAT (under 5%).

Informed choices and availability of healthy products : MEPs believe that product reformulation is a powerful tool for reducing the intake of fat, sugar and salt in our diets and encourage food producers to further engage in reformulation of energy-dense, nutrient-poor foods in order to reduce fat, sugar and salt and enrich their fibre, fruit and vegetable content. They stress that nutrition labelling must be mandatory and clear to help consumers make a healthy choice of food and recommend that to enable consumers to compare the nutrient content in different food products, nutrition labelling should be expressed in 100g/100ml. MEPs call for an EU-wide ban on artificial trans-fatty acids and urge EU Member States to follow good practice in controlling the content of substances (e.g. salt) in food. They also call for an analysis of the role played by flavour enhancers such as glutamates, guanylates and inosinates. The industry is called on to review single-serving portion sizes, providing a broader range of smaller portion options.

Media and advertising : additional incentives should be created to promote physical exercise. Although MEPs consider the voluntary approach adopted in the Directive on "Audiovisual Media Services without frontiers" on advertising food of poor nutritional value directed to children to be a step in the right direction, they ask the Commission to bring forward stricter proposals if the 2010 review of the Directive declares the voluntary approach to have failed in this field. The industry is called upon to restrict commercials for unhealthy foods targeted at children to protected times. Such restrictions should also cover new forms of media such as online games, pop-ups and text messaging.

Health care and research : MEPs ask for particular attention to be paid to research in health. They acknowledge that health professionals, especially paediatricians and pharmacists, should be made aware of their essential role in the early identification of patients at risk of overweight and cardiovascular disease. The Commission is called upon to develop European anthropometric indicators and guidelines on cardio metabolic risk factors associated with obesity. As regards malnutrition, the report highlights that 40% of patients in hospitals and between 40 and 80% of people in elderly care homes are malnourished. Therefore, Member States are asked to improve the quantity and quality of food in hospitals and elderly care homes. The Commission should also promote best medical practices, for example through the EU Health Forum, as well as information campaigns on obesity-related risks and abdominal obesity in particular drawing attention to the cardiovascular risks. The dangers of ‘home diets’ should also be emphasised. Lastly, MEPs call on the Commission and Member States to fund research into the links between obesity and chronic diseases such as cancer and diabetes.

PURPOSE: to propose a strategy for Europe on nutrition, overweight and obesity related health issues in the form of a White Paper of proposed actions.

CONTENT: the purpose of this White Paper is to set out an integrated EU approach to contribute to reducing ill health due to poor nutrition, overweight and obesity. The Paper builds on recent initiatives undertaken by the Commission, in particular the EU Platform for Action on Diet, Physical Activity and Health and the Green Paper "Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases" (see COM(2005)0637 ).

The last three decades have seen the levels of overweight and obesity in the EU population rise dramatically, particularly among children, where the estimated prevalence of overweight was 30% in 2006. This is indicative of a worsening trend of poor diets and low physical activity levels across the EU population which can be expected to increase future levels of a number of chronic conditions, such as cardiovascular disease, hypertension, type 2 diabetes, stroke, certain cancers, musculo-skeletal disorders and even a range of mental health conditions. In the long term, this will result in a negative impact on life expectancy in the EU, and a reduced quality of life for many.

There have been repeated calls from the Council for the Commission to develop actions in the field of nutrition and physical activity. The Green Paper consultation found a very broad consensus for the view that the Community should contribute by working with a range of different stakeholders at national, regional and local levels. The Green Paper was also followed by a European Parliament resolution (see INI/2006/2231 ).

Principles for action: according to the White Paper, EU public action in this area must aim at complementing and optimizing actions undertaken at other decision levels, be they at the national or Community level. The Commission's role is also critical in pooling interesting local or national initiatives and setting up pan European mechanisms of exchange of best practices to give added value from a European dimension to the actions taken.

In addition, to be effective the measures must:

· address the root causes of the health related risks: actions set out in the strategy should contribute to reducing all risks associated with poor diet and limited physical activity including, but not limited to, that associated with excess weight;

· bring together all actors involved at all levels, using a range of instruments including legislation, networking and public-private approaches, and engage the private sector and civil society;

· require action from private actors, such as the food industry and civil society, and actors at local level, such as schools and community organisations;

· be closely monitored: the number of activities aimed at improving diet and physical activity is already extensive and is growing year by year. However, there is often little or no monitoring taking place, resulting in limited assessment of what is and what is not working well.

A partnership approach: the Commission considers that the development of effective partnerships must be the cornerstone of Europe’s response to tackling nutrition, overweight and obesity and their related health problems, in particular within the framework of:

the EU Platform for Action on Diet, Physical Activity and Health in order to provide a common forum for all interested actors at European level; local networks for action: using the EU Platform model, relevant fora could be developed, characterised by the participation of a large number of actors at the local level; the media, in order to develop common messages and targeted campaigns; a High Level Group focused on nutrition and physical activity related health issues, combining the relevant decision-making bodies of the Member States.

Community level: given the Community’s limited competences in this area, the Commission intends, instead, to strengthen the legislative weaponry related to consumer information. The Commission also intends to give added value to each action taken at national level, where possible.

In this context, the White Paper proposes a series of measures that can be summarised as follows:

improve nutrition labelling and health claims on food so that consumers are not misled by inaccurate statements or confused; improve advertising and marketing of foods by requesting that those involved in advertising develop voluntary codes of conduct on advertising material aimed (mainly) at children; support, in cooperation with the Member States and relevant stakeholders, education campaigns to raise awareness of the health problems related to poor nutrition, overweight and obesity, with particular attention to children; ensure the availability of healthy foods on the European market (by mobilising CAP funds and encouraging children to eat fruit and vegetables…); work on the reformulation of foods to reduce the consumption of these nutrients (e.g. reformulation of salt content); encourage physical activity in urban areas by funding, in particular, projects that promote walking and cycling; aim a number of actions towards priority groups (mainly disadvantaged groups) and towards certain priority settings (urban areas); increase the level of nutrition education by funding health and physical education activities at school (specifically, through the Comenius programme for school education); develop an evidence base to support policy making at the relevant level and ensure monitoring of the actions taken.

Member State and private level: the Commission has set out a comprehensive range of actions within its competence to be taken forward across all sectors . However, in several of these sectors, the primary focus should be on measures taken by the Member States. Private actors also have a major role to play in developing the healthy choice for consumers and in empowering them to make healthy lifestyle decisions. The food industry (from producers to retailers) could make demonstrable improvements in areas such as the reformulation of foods in terms of salt, fats, particularly saturated and trans fats, and sugars for consumers across the EU. As for the Commission, it is working to promote better rules for advertising and marketing in all Member States, by meeting, at least, European Advertising Standards Alliance (EASA) benchmarks, and by encouraging self regulation, where possible. The Commission intends on strengthening monitoring systems, which are needed for self regulation to be effective.

Finally, future actions are planned to encourage cooperation and coordination with the actions taken by the WHO (World Health Organisation).

Monitoring: a review of progress will be carried out in 2010 in order to observe the extent to which policies have been brought in line with the objectives of the White Paper. This review will also reveal progress made in terms of industry self regulation.

PURPOSE: to propose a strategy for Europe on nutrition, overweight and obesity related health issues in the form of a White Paper of proposed actions.

CONTENT: the purpose of this White Paper is to set out an integrated EU approach to contribute to reducing ill health due to poor nutrition, overweight and obesity. The Paper builds on recent initiatives undertaken by the Commission, in particular the EU Platform for Action on Diet, Physical Activity and Health and the Green Paper "Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases" (see COM(2005)0637 ).

The last three decades have seen the levels of overweight and obesity in the EU population rise dramatically, particularly among children, where the estimated prevalence of overweight was 30% in 2006. This is indicative of a worsening trend of poor diets and low physical activity levels across the EU population which can be expected to increase future levels of a number of chronic conditions, such as cardiovascular disease, hypertension, type 2 diabetes, stroke, certain cancers, musculo-skeletal disorders and even a range of mental health conditions. In the long term, this will result in a negative impact on life expectancy in the EU, and a reduced quality of life for many.

There have been repeated calls from the Council for the Commission to develop actions in the field of nutrition and physical activity. The Green Paper consultation found a very broad consensus for the view that the Community should contribute by working with a range of different stakeholders at national, regional and local levels. The Green Paper was also followed by a European Parliament resolution (see INI/2006/2231 ).

Principles for action: according to the White Paper, EU public action in this area must aim at complementing and optimizing actions undertaken at other decision levels, be they at the national or Community level. The Commission's role is also critical in pooling interesting local or national initiatives and setting up pan European mechanisms of exchange of best practices to give added value from a European dimension to the actions taken.

In addition, to be effective the measures must:

· address the root causes of the health related risks: actions set out in the strategy should contribute to reducing all risks associated with poor diet and limited physical activity including, but not limited to, that associated with excess weight;

· bring together all actors involved at all levels, using a range of instruments including legislation, networking and public-private approaches, and engage the private sector and civil society;

· require action from private actors, such as the food industry and civil society, and actors at local level, such as schools and community organisations;

· be closely monitored: the number of activities aimed at improving diet and physical activity is already extensive and is growing year by year. However, there is often little or no monitoring taking place, resulting in limited assessment of what is and what is not working well.

A partnership approach: the Commission considers that the development of effective partnerships must be the cornerstone of Europe’s response to tackling nutrition, overweight and obesity and their related health problems, in particular within the framework of:

the EU Platform for Action on Diet, Physical Activity and Health in order to provide a common forum for all interested actors at European level; local networks for action: using the EU Platform model, relevant fora could be developed, characterised by the participation of a large number of actors at the local level; the media, in order to develop common messages and targeted campaigns; a High Level Group focused on nutrition and physical activity related health issues, combining the relevant decision-making bodies of the Member States.

Community level: given the Community’s limited competences in this area, the Commission intends, instead, to strengthen the legislative weaponry related to consumer information. The Commission also intends to give added value to each action taken at national level, where possible.

In this context, the White Paper proposes a series of measures that can be summarised as follows:

improve nutrition labelling and health claims on food so that consumers are not misled by inaccurate statements or confused; improve advertising and marketing of foods by requesting that those involved in advertising develop voluntary codes of conduct on advertising material aimed (mainly) at children; support, in cooperation with the Member States and relevant stakeholders, education campaigns to raise awareness of the health problems related to poor nutrition, overweight and obesity, with particular attention to children; ensure the availability of healthy foods on the European market (by mobilising CAP funds and encouraging children to eat fruit and vegetables…); work on the reformulation of foods to reduce the consumption of these nutrients (e.g. reformulation of salt content); encourage physical activity in urban areas by funding, in particular, projects that promote walking and cycling; aim a number of actions towards priority groups (mainly disadvantaged groups) and towards certain priority settings (urban areas); increase the level of nutrition education by funding health and physical education activities at school (specifically, through the Comenius programme for school education); develop an evidence base to support policy making at the relevant level and ensure monitoring of the actions taken.

Member State and private level: the Commission has set out a comprehensive range of actions within its competence to be taken forward across all sectors . However, in several of these sectors, the primary focus should be on measures taken by the Member States. Private actors also have a major role to play in developing the healthy choice for consumers and in empowering them to make healthy lifestyle decisions. The food industry (from producers to retailers) could make demonstrable improvements in areas such as the reformulation of foods in terms of salt, fats, particularly saturated and trans fats, and sugars for consumers across the EU. As for the Commission, it is working to promote better rules for advertising and marketing in all Member States, by meeting, at least, European Advertising Standards Alliance (EASA) benchmarks, and by encouraging self regulation, where possible. The Commission intends on strengthening monitoring systems, which are needed for self regulation to be effective.

Finally, future actions are planned to encourage cooperation and coordination with the actions taken by the WHO (World Health Organisation).

Monitoring: a review of progress will be carried out in 2010 in order to observe the extent to which policies have been brought in line with the objectives of the White Paper. This review will also reveal progress made in terms of industry self regulation.