Poor diets are a major concern and one of the greatest public health challenges of the 21st century. Many campaigns promoting healthy eating and physical activity have been launched in an attempt to reverse this trend, but have they been shown to be effective? If not, how can that be improved? The European Union-funded project EATWELL is tasked with finding these answers.
Unhealthy eating in Europe
Overweight and obesity are the most visible manifestation of poor diets, but diet quality matters too - western societies consume too little fruit and vegetables and omega-3 fatty acids, too much saturated fatty acids, trans fats, salt and sugar.
Overweight (Body Mass Index (BMI) 25-29.9) affects 30–80% of adults in Europe and the proportion of people suffering from obesity (BMI ≥ 30) is dramatically increasing, over one in four adults in some countries (e.g., Italy, Spain).1 The trend in obesity is especially alarming in young people, as about 20% of children and adolescents are overweight, and a third of these are obese.2
Obesity is recognised as having a negative impact on quality of life, increasing susceptibility to other chronic diseases (e.g., heart disease and type-2 diabetes) and potentially leading to premature death. According to the World Health Organization (WHO), obesity is already responsible for 10-13% of deaths in different parts of Europe and 2-8% of health costs.3 Additionally, overconsumption of salt, sugar and saturated fats and underconsumption of fruit and vegetables cause almost 70,000 premature deaths annually in the UK alone.4 Indeed, poor diets do not only impact on European citizens’ health, but also increase the economic burden through absenteeism, higher insurance costs and a greater dependency on health services. In response, European Union (EU) Member States have initiated a variety of national policy interventions to encourage physical activity and healthy eating, such as promotion of fruit and vegetable consumption, nutrition labelling, regulation of school meals and public sector canteens to ensure healthy food offerings. However, such interventions have rarely been evaluated in a systematic way.
The EATWELL project, full name “Interventions to Promote Healthy Eating Habits: Evaluation and Recommendations”, is a 3.5-year multi-centre project funded by the European Commission (running from April 2009 to October 2012). It aims to provide EU Member States with best practice guidelines to develop appropriate policy interventions that will encourage healthy eating.
The project brings together nine consortium partners, including leading European universities, institutes, not-for-profit organisations as well as representatives of the food industry and communication agencies. They will work together and share their complementary expertise in consumer behaviour, nutrition, economics, communication and health policy.
Lessons learned from the past
EATWELL will identify policy interventions focusing on nutrition and healthy eating habits, as well as the relevant campaign evaluations. There is also an abundance of secondary data available across the EU and beyond containing rich information on aspects relating to healthiness of diets, which have been insufficiently exploited in nutrition policy evaluation and will be included in this study. This will provide the EATWELL team with an overview of the actions undertaken and assist with identifying gaps, as well as success and failure factors for the campaigns.
Some interventions may be better received than others and different population groups may have different attitudes towards healthy eating and the role of policy in intervening to influence food choices. In a second phase, EATWELL will compare public acceptance for alternative interventions, across countries and individuals, focusing on different sub-groups of the population (e.g., parents vs. non-parents, education level, etc.). EATWELL will also assess policy acceptance by other stakeholders including manufacturers, retailers and non-governmental associations.
The private sector has considerable experience with tools aimed at influencing consumer food choice. Particular attention will therefore be paid to lessons that can be learned from the private sector that are applicable to public efforts to promote healthier eating.
Impact of interventions
Once campaigns have been identified and the methodology of evaluation determined, the impact on consumers’ health and quality of life, as well as the costs and savings for the society will be assessed to highlight the return on investment of such campaigns. The evaluation will also include results on acceptance by the general public.
Improving the future of healthy eating policies
Based on this analysis, consortium partners will develop a range of consumer behaviour models, harmonised methods for intervention evaluation and make recommendations for use in the evaluation of future policy interventions. A best-practice guide will indicate actions appropriate and acceptable at European and Member State levels and their transferability across cultures.
- Berghöfer A et al. (2008). Obesity prevalence from a European perspective: a systematic review. BMC Public Health 8:200.
- WHO Europe (2007). The challenge of obesity in the WHO European Region and the strategies for response.
- WHO Europe website. Obesity section.
- UK Cabinet Office Strategy Unit (2008). Food Matters: Towards a strategy for the 21st Century.