Obesity

Health4EUkids - the european Joint Action for the implementation of Best Practice for health promotion and obesity prevention

Health4EUkids is a three-year european initiative launched in February 2023, officially titled "Joint Action for the implementation of best practices and research results on Healthy Lifestyle for the health promotion and prevention of non-communicable diseases and risk factors" (JA-Health4EUkids). Its primary goal is to promote children's health and prevent non-communicable diseases and associated risk factors. This Joint Action (JA) is among the eleven initiatives outlined in the European Union's EU4Health Programme for the 2021-2027 period.

Coordinated by Greece, the JA involves eleven countries: Belgium, Croatia, Finland, Italy, Lithuania, Malta, Poland, Portugal, Slovenia, Spain, and Hungary. These nations aim to promote healthy lifestyles and prevent childhood and school-age obesity by encouraging physical activity and healthy eating habits from the earliest stages of life, within families and communities. The implementation of two best practices, "Smart Family" and "Grünau Moves," across participating countries provides EU Member States with insights into sustainability and transferability based on acquired knowledge and experiences.

The specific objectives of Health4EUkids are:

1. Identify the requirements and prerequisites for implementing the proposed best practices.
2. Strengthen a cooperative approach to addressing childhood obesity by facilitating the exchange of knowledge and learning among participating states.
3. Select and implement actions based on the "Grünau Moves" and "Smart Family" best practices to promote health and combat childhood and school-age obesity.
4. Enhance the planning and development of policies to tackle childhood obesity at European, national, regional, and local levels.
5. Facilitate the transferability and sustainability of best practices among Member States.

The context

Over the past three decades, the prevalence of overweight and obesity has increased substantially. The high prevalence of overweight and obesity has severe health consequences: an increased body mass index (BMI) is a significant risk factor for diseases such as cardiovascular diseases, type 2 diabetes, and many types of cancer (including colorectal, kidney, and esophageal cancer).

Overweight and obesity in childhood and adolescence are associated with a significant reduction in quality of life and an increased risk of bullying and social isolation. Due to the rapid increase in prevalence and severe public health consequences, obesity is widely regarded as one of the most serious public health challenges of the early 21st century.

The determinants of obesity are complex and varied, and it is essential to recognize that only coordinated, intersectoral, and multi-level interventions, with particular attention to social and health inequalities, can counteract the rise in obesity. Actions to prevent obesity must be undertaken in different settings, incorporate various approaches, and involve a wide range of stakeholders. Therefore, long-term interventions at multiple levels are necessary: at the individual and community levels to achieve behavioral changes, and at the intersectoral level, involving agriculture, food production, education, transportation, and urban planning. Each intervention may have minimal effects if implemented alone, but it can be a significant component of an overall strategy. Efforts to prevent obesity in childhood should begin early, starting from pregnancy and infancy, and be closely integrated with other measures aimed at addressing all modifiable risk factors for non-communicable diseases (including tobacco use, alcohol consumption, unhealthy diet, and physical inactivity). Obesity prevention interventions should be incorporated into existing plans and programs aimed at improving nutrition and physical activity and, more broadly, into all interventions related to child and adolescent development. Therefore, actions implemented in specific settings should aim for integration: for example, schools represent an ideal environment for planning initiatives to promote the health and well-being of the entire school community. This should be done through a comprehensive and equity-based approach, integrated into curricular educational pathways. Health promotion in schools should include the development of individual and social knowledge and skills, policies for a healthy school environment, the protection of the physical and social environment, connections with the community, healthcare, and civil society.

Activity Program

The JA-Health4EUkids initiative is structured into six Work Packages (WPs), with the first four being transversal and the last two thematic. The responsibility for these WPs is distributed among five of the twelve participating countries:

• Greece (WP1 and WP2): Coordination and dissemination
• Hungary (WP3): Evaluation
• Italy (WP4): Transferability and sustainability
• Spain (WP5): Best practice "Grünau Moves"
• Finland (WP6): Best practice "Smart Family"

Specifically:

• WP1 ensures the coordination of all partners to achieve the project's objectives
• WP2 aims to ensure well-structured communication among all JA participants
• WP3 focuses on verifying and ensuring that the JA is implemented as planned and meets its defined objectives
• WP4 seeks to frame the actions and outcomes of all WPs within an integration and sustainability-oriented approach. This supports national efforts to combat childhood obesity and develop effective policies as part of a broader EU and Member State strategy
• WP5 aims to transfer the best practice "Grünau Moves," which promotes healthy environments by encouraging physical activity and healthy eating among children and families, particularly in disadvantaged neighborhoods across various European countries
• WP6 focuses on promoting health and healthy lifestyles among families with children based on the Finnish best practice "Smart Family."

Both best practices are community-based health promotion and obesity prevention programs designed for children and adolescents in areas facing specific social challenges.

The role of the Italian National Institute of Health

The National Center for Disease Prevention and Health Promotion of the Italian National Institute of Health participates in the JA by coordinating WP4 on "Transferability and Sustainability." The primary goal is to focus on governance and systems, specifically on health and equity in all policies at local, regional, national, and EU levels, considering the broader societal context.

The specific objectives of WP4 are:

• Increase interest and commitment in addressing childhood obesity and its causes among EU Member States
• Analyze the level of inclusion of health promotion actions for tackling childhood obesity in the political agendas of Member States
• Develop and implement a Health in All Policies (HiAP) approach
• Identify facilitating factors and challenges in the implementation of policies and measures to combat childhood obesity and promote health
• Engage policymakers at the European and national levels in discussions on the JA outcomes
• Support Member States in integrating the results and conclusions of the JA into national and European policy initiatives

To learn more about the work of the Italian National Institute of Health within WP4 of the JA-Health4EUkids project, read the dedicated article.

Kick-off Meeting of the Project

On February 8-9, 2023, the "Health4EUKids - Kick-off Meeting" was held in Athens. On the first day, the project's key themes were discussed, and the objectives and goals of the six Work Packages (WPs) were presented. On the second day, the focus shifted to operational aspects, setting up the initial actions for implementing the Smart Family and Grünau Moves best practices. Discussions also explored how to ensure the sustainability and transferability of these actions and the results achieved within this Joint Action (JA) to other EU Member States.