Reports from the “Lifestyle Determinants of Obesity” Scientific Platform Project Published

The Work Package (WP) in which CRPRC Studiorum was invited to be partner institution from Macedonia is part of the project �Scientific Platform of the Working Party �Lifestyle and other Health Determinants� carried out by the Research Association for Public Health at Technische Universit�t Dresden, Germany. The objective of the work package is the preparation and dissemination of the following two reports:

1. “Inventory of Health Information Activities on Physical Activity and Nutrition – A Report to summarize activities carried out by the European Commission, WHO, European Networks and National Examples”;
2. “Special Report on: Available Health Information on �Lifestyle� Determinants of Obesity in Children”.

REPORT (1)

The first report is intended to give a general overview about Health Information Activities, which are typically related to physical activity and nutrition. All Health Information Activities that were included in the inventory cover the EU countries, EEA countries and candidate countries.

Within this context, the research also includes national examples for several countries. Regarding these national examples the research during the compilation of this report included projects that started in 1990 or later. Furthermore the national examples could meet the criteria that, within the timeframe of preparing the report, they were still running or were approved but not yet started. Besides the inventory was established on a database that should be available for interested scientists as well as persons working in the field of Health and Health-related topics, the report is planned to recommend future Health Information actions that outline open issues that were not yet covered. Additionally, it is designed to judge also the quality and the usability of the underlying Health Information Activities. Thus, interpretations of the results are the basics for further discussion and steps that have to be considered as well as future actions that have to be taken into account. Regarding to the circumstances and the framework of the report, the purpose was not to evaluate each Health Information Activity that was implemented into the database. While including projects into the database all scientific co-workers that contributed within the report concentrated on Health Information Activities in general. Health Information Activities cover abroad scope.

REPORT (2) – under preparation

This report focuses on available health information on lifestyle determinants of obesity in children. The report will extend the data basis from the first report to the particular field of obesity reduction in children. The report will interpret existing data to recommend particular action for the prevention of obesity in children as well as to suggest further health information activities. Not only is overweight and obesity recognized as an emergent modern health problem, but this problem is particularly of concern amongst children and adolescents. The Year 2 element of the Scientific Platform Project is specifically tasked with ascertaining the availability of routine data on Nutrition and Physical Activity as determinants of obesity in children. Not only are children a significant proportion of the population, but behavior and metabolic patterns established in childhood will be likely to endure into adulthood. However, the capture of data about children provides very clear challenges.

The Challenges

The issues facing gathering of data of Nutrition and Physical Activity for children have several dimensions:

1. Data Collection
   In general, children do not complete surveys or questionnaires (with some important exceptions for older school children). Similarly, it is generally unethical to expect children to provide blood or urine samples as they are not able to give informed consent to invasive or intrusive procedures.
2. The Life Course
   Children are not homogenous. The nutrition patterns of infants are self-evidently different from younger school children, and these in turn are different from those of adolescents. The child population therefore has to be considered as a number of subpopulations.
3. Data Sources
   As less data can be gathered directly from the subject population – children – far more has to be obtained from other sources. This in turn creates problems, for instance parents may give an �expected` view of the pattern of feeding of their children, rather than the reality. Older children may underplay play the degree to which they purchase unhealthy foods on their way to and from school. Thus some indirect sources of evidence may be helpful to complement the picture.
4. Innovation
   Given the above challenges, and the desire for European added value out of the Scientific Platform Project, there are advantages to identifying aspects which were considered out of scope for Year 1, such as examples of good practice on information gathering from surveys, or on scientifically-underpinned population-based information policy development, so as to be able to signpost good practices which could be considered for future Euro-wide development. This is based on the anticipation that the volume of formal entries to the original type of database of population-based surveys run on a repeated basis covering Nutrition and Physical Activity data will be small.

The Life Course – Age Groups

Having identified that the child population needs to be split into age groups, the project is operate on a variant of the age groups adopted by the European Regional Office of the World Health Organization in its Child and Adolescent Health and Development Strategy 2005 (adopted by all European nations). The sub groups adopted for the Scientific Platform Project therefore are:

• Infants < 1 year
• 1 – 4 years inclusive
• 5 – 9 years inclusive
• 10 – 14 years inclusive
• Young adolescents – ideally 15 – 17 years inclusive, but other bands such as 15 – 19 may have to be accepted as long as these are clearly indicated

Gender

It is self-evident that children`s behavior, not least over exercise patterns, eating, and self-care, vary between boys and girls. Gender differences in health are inadequately studied, not lest because of paucity of recorded data on gender in heath statistics. Whilst it will be unrealistic to seek out gender-specific data, where routine data do exist with a sex breakdown we believe it important to record that added attribute, as a step to encouraging such analysis.

Nutrition and Physical Activity

As before in Year 1, there will be two elements to the behavioral determinants of overweight and obesity. Nutrition indicates the food and energy intake, and Physical Activity the exercise and energy consumption.

Bulimia and Anorexia Nervosa

Separate from the main determinants of overweight and obesity should be considered the behavioral issues that lead to the eating disorders of Bulimia and Anorexia Nervosa. Whilst there may be a number of indirect causes of these, including emulation of �model` figures, nevertheless anxiety about body image including over-anxiety to avoid becoming overweight, may be triggers of these serious conditions. They will be included as an additional dimension of the study.

The report “Physical Activity and Nutrition – Health Information Activities of the EU, WHO, European Networks and National Examples” published in Journal of Public Health, Springer

The first report of the Work Package (WP) in which CRPRC Studiorum was invited to be partner institution from Macedonia iartf th, as part of the project �Scientific Platform of the Working Party �Lifestyle and other Health Determinants� carried out by the Research Association for Public Health at Technische Universit�t Dresden, Germany, has been published in Journal of Public Health, volume 15, supplement 1 (October 2007).

You can find more information about this publication on the following link: http://www.springerlink.com/

Materials

�Report 1 Brochure�.

Links

Technische Universitat Dresden