FAHRE - Food and Health Research in Europe - Analysis of gaps and overlaps for existing food and health research needs in Europe Thematic Expert Report OBESITY WORK PACKAGE LEADS AUTHORS OBESITY WP2. Research needs assessment Mark Mccarthy (UCL) Lilia Ahrné (SIK) Tim Lobstein and Andrea Aikenhead, IASO 1 Acknowledgement This report forms part of the deliverables from a project called "FAHRE" which has received funding from the European Community's Seventh Framework Programme FP7/2007-2013 under grant agreement n° 244459. The Community is not responsible for any use that might be made of the content of this publication. FAHRE aims to investigate how to improve the coordination of food and health research in Europe. The project runs from January 2010 to December 2011, it involves seven partners and is coordinated by Sociedade Portuguesa de Inovação (SPI). More information on the project can be found at http://www.spi.pt/fahre or by contacting the project manager Rachel Newton (rachelnewton@spi.pt). This document has been developed by the partners for recording expert information only. It is not an official publication from the project. OBESITY 2 Foreword: some definitions for ‘food and health research’ ‘Food and health research’ for this report refers to research about the production, marketing, choice, regulation and policy for food as it affects health, and the mechanisms and control of diet-related diseases, nutrition and obesity. It covers positive and negative impacts of food on health as well as issues related to under and over consumption of food (undernutrition and obesity). It draws on a wide range of disciplines including psychological, social, management and political sciences, laboratory sciences, clinical medicine, environment and epidemiology, and is undertaken by public, independent and industry organisations. Programmes for food and health may be structured in different ways. In developing the 'thematic experts' side of FAHRE, we have identified 8 areas for experts, four broad 'fields' of research, and compared these with three issues in Joint Programming Initiative 'Healthy Food for a Health Life' Interim Report (March 2010). However, they form a continuum, with overlaps. They are set out in the table below. The analysis of the gaps and overlaps for the research fields in each area should consider all the aspects relevant to supporting research in the area. It should examine how the needs of the field can be met with regard to research commissioning, major equipment or technical facilities, available technology tools, and expertise with particular attention to improving the functioning of the field as a European Research Area. Thus it will analyse organisations undertaking research or commissioning research, networks, training programmes, databases, technical facilities and comment on their effectiveness in moving towards the ERA goals, in particular for greater mobility, joint research infrastructures, knowledge-sharing, Joint Programming and International Science & Technology Cooperation. FAHRE Research FAHRE Country Report thematic areas Programme research fields JPI interim report Food production and products Diet and food production: Establish reliable data on consumer food preferences and acceptance in order to develop new food products and to redesign how foods are produced. Enable redesign and optimisation of food processing and packaging. Foods must always be safe and should be produced in a sustainable way. Food safety Regulation, claims, and food policy for health Production field: design of food (components…), its preparation (processes…), its manufacturing and also home cooking matters linked to health and disease, interface between industry and the scientific sector. Policy field: regulation (labeling, salt, sugar and fat contents, claims…) and consumers, which will have an impact on diet and Consumer therefore on health. It could also behaviour and what focus on programmes more influences it economically oriented, linked to Lifestyle: Consumer behaviour and food choice understanding of consumer behaviour with regard to food and also to raise consumer understanding of healthy foods and food consumption patterns. Measuring food purchase and consumption behaviour taking into account cultural 3 marketing, participation, public expression and access. differences, and subsequently, developing reliable models of consumer choice processes. Effective communication strategies with consumers need to be developed to induce behavioural change directed to improving consumer health and social responsibility. Population surveys causes and control Population field: at human and Horizontal issues: population level, epidemiologic approaches (including biological, Health policy for social and psychological food, nutrition, diet determinants) and observational and and obesity interventional research on behaviours that can explain eating disorders leading to chronic diseases. Food causing disease – excess, imbalance, sensitivity Nutrition microelements, malnutrition, gene interactions, Biomedical field: nutrition and dietary research relating to molecular and clinical aspects, in the pathways and causes of disease, and the mechanisms at different periods of the life course. It could also include food safety, both toxicology and biological. Chronic diseases: preventing food-related, chronic diseases and increasing the quality of life: 1) understanding of brain function in relation to diet; 2) the effects of diet-gut interaction on intestinal and immune functions; 3) the link between diet and metabolic function (obesity and associated metabolic disorders). 4 Content Introduction to the Expert´s Area: Obesity ................................................................................ 6 Research at European level in Obesity ............................................................................. 7 Main programmes and projects relevant to Obesity .................................................... 7 Infrastructures & equipment relevant to Obesity ......................................................... 8 Major research groups relevant to Obesity .................................................................. 8 Networks relevant to Obesity ....................................................................................... 9 Current Training Programmes relevant to Obesity .................................................... 10 Publications & Congresses relevant to Obesity .............................................................. 11 Publications ................................................................................................................ 11 Congresses.................................................................................................................. 13 Comparison of country reports: obesity research ........................................................... 14 Countries .................................................................................................................... 14 Overview .................................................................................................................... 15 Towards 2020: assessing needs for obesity research ...................................................... 17 Knowledge needs ....................................................................................................... 17 Significant research questions .................................................................................... 17 Ways to organise research: priorities, developing agendas ....................................... 17 Interaction between public research and industry ...................................................... 18 Gaps and Overlaps for further research .......................................................................... 19 Structures.................................................................................................................... 19 Infrastructures ............................................................................................................ 19 5.3 Ways to organise research ............................................................................................. 20 Conclusions and Proposals ............................................................................................. 21 Research fields ........................................................................................................... 21 Research organisation, structures and infrastructures ................................................ 21 Annex: details of obesity research provided in the country reports (to be updated from the revised country reports) ........................................................................................................ 22 5 Introduction to the Expert´s Area: Obesity Obesity is a medical condition that raises the risk of many chronic diseases: it affects some 10% of children and 20% of adults in the EU. The dramatic increase in the prevalence of obesity in the European population (and among populations in most of the world) has led to a rapid growth in the research effort to understand the condition and to find ways to prevent it. Our current understanding is that obesity has multiple causal pathways which result in metabolic energy imbalance, in which food energy is consumed in greater amounts than it is ‘burnt’ through physiological metabolism and the excess energy is stored as body fat. Public-funded research investigations have considered a very wide range of issues, including genetic predisposition, cellular and endocrinal functions, neural pathways of appetite control, pharmacological intervention in energy balance, individual dietary patterns of nutrient intake, social and cultural eating behaviour, clinical interventions and treatments, health promotion campaigns, and national and international policies which may be considered ‘upstream’ influences on energy balance – including food prices, food advertising, portion sizes, product labelling, but also including agricultural policies, transport policies, the built environment and issues of social inequalities. In addition an increase in monitoring and surveillance has been undertaken in order to understand the changing prevalence of overweight and obesity in population groups, and also the patterns and trends in food consumption, physical activity and sedentary behaviour. Private sector funding of research has been directed towards potential market opportunities for obesity-related products: these include pharmaceuticals, surgical equipment, slimming products, reformulated food products and products able to carry health claims. Related concerns include the fashion and clothing industry and issues of body image, especially among women but increasingly among men and among younger children. The results of the research effort to date are (a) a failure to find an effective and acceptable pharmaceutical intervention to treat or prevent obesity, (b) only weak evidence for effective interventions in the community to change individual dietary behaviour or physical activity and (c) recognition that the successful reversal of the obesity prevalence trends will require inter-sectoral action across many interlocking areas of human activity. At the European regional level, various policy initiatives have been made in the last decade. Those that concern food include two five-year Action Plans on food and nutrition policy (2000-2005 and 2007-2012) from the European Office of the World Health Organization, a European Charter on Obesity signed by virtually all 50 of the WHO European region member states, a number of EU presidency initiatives (e.g. from Denmark, France, the UK and Finland), and policy instruments from the European Council of Ministers, the European Parliament and the European Commission, including the latter’s White Paper on Diet and Physical Activity, and the creation of the European Commission Platform on Diet, Physical Activity and Health. Research issues: The failure to find a satisfactory ‘cure’ for obesity has led to increased research into the effective prevention of the condition. Reviews of the evidence-base for obesity prevention policy – including the widely influential 2007 UK government Foresight review1 – have recognised the difficulty of undertaking public health research at population level. Modelling work on the potential impact of the obesity epidemic shows the high levels of future costs that may arise, not only in the health services but in terms of lost productivity and lost employment opportunity, social and household costs and lost quality of life. Population surveillance can be undertaken, and is essential, but interventions such as controlled trials are extremely difficult to perform in large and heterogenous groups. Evidence gathered to date focuses on individual interventions such as clinical treatment or small group interventions such as health promotion in schools or workplaces. This creates a significant bias in the settings and approaches for which ‘hard’ evidence is available. The impact on health of population-wide policies affecting food supply and consumption – including policies affecting price, availability, promotional marketing, food formulation, portioning, packaging and labelling – has received remarkably little research attention. 1 See www.bis.gov.uk/foresight/our-work/projects/current-projects/tackling-obesities/reports-and-publications 6 Research at European level in Obesity A number of European research projects have been undertaken in relation to obesity, including many which specifically include a food-related interest. . Main programmes and projects relevant to Obesity We searched health and policy-related areas of the European Commission’s website, including Cordis, DG SANCO, DG RELEX, DG AGRI and DG AIDCO, for obesity-themed research. Project descriptions or abstracts published in databases on these websites were searched using the term ‘obesity’, identifying a total of 148 EC-funded projects. Table 1.1: EC-funded programmes 2000-2010 involving obesity and food Funding body Call Number of projects DG Research calls under FP5 21 FP6 49 FP7 55 DG SANCO / calls for work in the field of public EAHC health, health inequalities, health 20 determinants, health promotion DG RELEX calls for policy development in 1 (External international frameworks Relations) DG AGRI calls for work regarding food 2 consumption patterns and obesity Projects undertaken before 2000 were not included. Together these projects represent EUR 275.9M in Commission funding, of which the current FP7 programme is responsible for EUR 92.3M. The figure below presents these projects according to their funding body, showing that the vast majority (84%) of obesity related research is funded by DG Research. A range of obesity-related issues were mentioned in the introduction; examples of EC-funded research projects that fall within these categories include: genetic predisposition Genetic susceptibility for type 2 diabetes and obesity among immigrants in Europe - prevention and treatment (FP6) cellular and endocrinal functions The role of adipose tissue in insulin resistance and inflammation - the way to obesity and type 2 diabetes (FP6) neural pathways of appetite control NEUROFAST: The Integrated Neurobiology of Food Intake, Addiction and Stress (FP7) pharmacological intervention in energy balance ADAPT: Adipokines as drug targets to combat adverse effects of excess adipose tissue (FP7) individual dietary patterns of nutrient intake V is for vegetable: Applying learning theory to increase liking and intake of vegetables (FP7) 7 social and cultural eating behaviour EUROBESE: Ethics and the Obesity and Overweight Epidemic: Image, Culture, Technologies and Interventions (FP6) clinical interventions and treatments Neuromodulation of vagal activity for the treatment of obesity (FP5) health promotion campaigns PRO GREENS: Promotion of fruit and vegetable consumption among schoolchildren in Europe (DG SANCO) national and international policies StanMark: Developing international standards for marketing foods and beverages to children (DG RELEX) Infrastructures & equipment relevant to Obesity A wide range of research facilities have been used for obesity-related projects, including laboratory analytical equipment for genetic, cellular and biochemical research, human testing laboratories for eating patterns and energy expenditure, and community settings such as schools and workplaces for surveillance and interventions. Concerns over the reliability of self-reported measures of body weight have led to recommendations that surveillance should use trained staff to collect measured information on weight and height, and to include other measures of adiposity, such as waist circumference, whenever feasible. Major research groups relevant to Obesity Consortiums which include academic departments, voluntary organisations and commercial organisations have featured in most of the EC-funded research projects. The wide range of research possibilities for tackling obesity has allowed a number of different disciplines to participate in joint projects. An examination of the coordinating bodies for EC funded research projects revealed that 111 institutions had each been awarded projects, of which 18 institutions had a total of 55 projects between them and a further 93 institutions had one project each (see Table 1.2). In terms of regional patterning, the industrialised countries of western Europe tend to lead the research endeavour (see Table 1.3). Facilities and surveillance opportunities in southern and eastern regions have led to their involvement in many projects, but only occasionally in a coordinating role. Table 1.2: EC funded projects by coordinating institution Coordinator University Of Cambridge Karolinska Institutet Institut National De La Sante Et De La Recherche Medicale (Inserm) Erasmus Universitair Medisch Centrum Göteborg University King’s College London Rowett Research Institute University College London University Of Dundee University Of Oxford Country UK Sweden France Netherlands Sweden UK UK UK UK UK # Projects 10 6 5 3 3 3 3 2 2 2 8 Fundación Para La Gestión De La Investigación Biomédica De Cádiz Institut National De La Recherche Agronomique Universiteit Maastricht Wageningen Universiteit University Of Patras Universidade De Santiago De Compostela Eidgenössische Technische Hochschule Zürich International Association for the Study of Obesity 93 other institutions France France Netherlands Netherlands Greece Spain Switzerland UK - 2 2 2 2 2 2 2 2 1 each Table 1.3: EC funded projects by country of the coordinating institution Country UK Spain France Netherlands Germany Italy Sweden Finland Greece Switzerland Austria Belgium Denmark Ireland Cyprus Czech Republic Norway Portugal Russia FP5 6 2 3 1 3 1 1 FP6 16 4 3 6 6 1 3 2 2 1 1 1 1 FP7 15 9 7 4 3 4 2 2 4 2 1 1 1 1 1 1 1 1 DG Agri 1 1 EAHC 2 2 2 2 1 1 2 1 1 1 1 2 DG Sanco 2 DG Relex 1 Total 40 18 15 12 11 10 10 6 5 4 3 3 3 2 1 1 1 1 1 Networks relevant to Obesity Many networks promote scientific debate and research endeavour. However, only a few actually participate in formal research projects in any role other than that of dissemination. The International Association for the Study of Obesity (IASO) based in the UK has research capacity and has been principal investigator for two EC-funded projects (PolMark: Policies on Marketing Food and Beverages to Children, and StanMark: International Standards for Marketing Food and Beverages to Children) , and work package leader for several others (HOPE, DYNAMO-HIA, ENERGY, TOYBOX). IASO also organises meetings and congresses including the 4-yearly International Congress of Obesity, runs training programmes (e.g. an online course for certification in obesity management) and publishes several peer-reviewed scientific journals on obesity research. Apart from IASO, the exchange of information on obesity research focuses on a number of networks acting through journals, newsletters and conferences. The leading conference is the annual European Congress on Obesity organised by the European Association for the Study of Obesity to provide a dissemination forum for research advances in the field and to identify, debate and promote innovative preventive and treatment strategies for obesity. The congress draws over 2500 participants 9 from more than 75 countries, who are experts and opinion leaders representing a range of professions within the field. Smaller events are also organised: the annual meeting of the European Child Obesity Group (<500 participants) arranges meetings for active researchers in childhood obesity, as does the Scandinavian Paediatric Obesity Conference (<500 participants). There is also a high-level policy network organised by the European Commission: The EU Platform for Action on Diet, Physical Activity and Health designed as a forum for actors at European level who are capable of committing themselves to action on the issues of diet, physical activity and health. It is designed to stimulate, rather than pre-empt, other initiatives at national, regional or local levels. To date the Platform involves over 30 member EU organisations, ranging from food industry to consumer protection NGOs, who have worked on more than 200 commitments covering activities in key fields including consumer information, education, advertising targeting children, labelling and product reformulation. Platform members monitor and evaluate the performance of these commitments. A Monitoring Progress Report by RAND in 2007 concluded that some Platform members are struggling with the monitoring of their commitments; the mean quality score of monitoring forms falls just short of an “adequate” level. A large number of other relevant networks for information exchange exist. A summary of many of these is available at http://www.iaso.org/site_media/uploads/Updated_HOPE_Network_Oct_2010.pdf which was developed from a listing of relevant networks concerned with obesity research and policy making, and compiled as part of the EC-funded HOPE project (see www.hopeproject.eu). This listing includes academic and professional networks, health promotion and advocacy organisations, intergovernmental bodies and agencies, and trade and industry networks. Current Training Programmes relevant to Obesity The only cross-European training programme specifically on obesity is SCOPE – the Specialist Certificate of Obesity Professional Education – which includes face-to-face courses in European countries (and some outside of the EU) and an internet-based on-line course in English and Spanish. It is run as an educational service by the International Association for the Study of Obesity (see www.scope-online.org). Other opportunities for training in related fields exist through the relevant associations and professions – such as those organised by academic departments of public health, nutrition, dietetics and related subjects, and offered to students from all EU member states. Their international status is usually shown through being taught in the most common second language in Europe, i.e. English. 10 Publications & Congresses relevant to Obesity Research activity in the field of obesity can be estimated from online library sources of scientific publications and the organising of meetings on relevant research activities. Publications Journals Scientific, peer-reviewed papers on obesity are published in a number of journals specialising in medical, biological and pharmaceutical sciences, and in recent years the number of journals with a specialist emphasis on obesity have increased in number and in impact factor over the last decade. There are now at least six journals specialising in obesity with impact factors above 3.0. Table 2.1. Leading obesity journals Impact factor in 2008 Journal Diabetes, Obesity and Metabolism Obesity Reviews International Journal of Obesity International Journal of Pediatric Obesity Obesity Obesity Surgery Obesity Facts 5.11 5.34 4.06 3.95 3.37 3.08 2.11 (2009) However, a recent paper by Baier et al 20102 highlights the true multifactoral nature of this, finding that journals specialising in obesity capture less than 20% of clinical obesity care research, leaving more than 80% scattered across 249 non-obesity journals. Papers The volume of obesity research was assessed across seven different categories: gene, cell & metabolic, treatment & comorbidities, eating & physical activity, food science (concerned with the technical aspects of food), social & epidemiology, community, and policy. A detailed search of the medical and scientific literature resulted in a total of 96,457 and 52,883 non-review articles in PubMed and Web of Science respectively, excluding the overlap between categories. There was a dramatic increase in the numbers of papers published (see Figure 2.1). The typology devised for this report proved robust: analysis revealed that the seven categories encapsulate 95% and 97% of all research papers identified using only ‘obesity’ as a search term in PubMed and Web of Science respectively. 2 Baier LA, Wilczynski NL, Haynes RB. Tackling the growth of the obesity literature: obesity evidence spreads across many journals. Int J Obes (Lond). 2010 Oct;34(10):1526-30 11 Figure 2.1: Growth in the number of obesity-related research papers 1979-2009 12000 # PubMed articles 10000 8000 6000 4000 2000 0 1979 1989 1999 2009 Publication year However, the nature of the research undertaken is not uniformly spread across different research disciplines. Figure 2.2 below indicates the numbers of research papers published in each of the categorieres described above. Figure 2.2 Research papers in obesity according to main research interest 70,000 PubMed articles WOS articles 60,000 # articles 50,000 40,000 30,000 20,000 10,000 Policy Community Social/ Epidemiology Food Science Eating & PA Treatment/ Comorbidities Gene, Cell & Metabolic - It can be seen from this analysis that the emphasis of obesity research has been on biological and medical aspects of the topic, with relatively smaller outputs on food science, public health and social policy issues. From this evidence, that from the changing themes in congresses (see below) and that from statements of research need (see section 4), it is clear that the surveillance of obesity and its determinants remain in urgent need of a stronger research effort. Food composition (including formulation and portion sizes), food marketing (including labelling, packaging and advertising), food 12 behaviour (including factors influencing choice) and food accessibility (including pricing, supply and location) remain particularly poorly researched. Congresses The major congress in Europe relating to obesity is the annual European Congress on Obesity, attracting some 2,500 participants from the medical, research and allied health workers and relevant research organisations. Increasingly the congresses have extended their remit from ‘hard’ research concerning genetic, physiological and behavioural studies to survey reports, interventions in the community and policy-related research on issues such as food labelling, health claims, marketing policies, food prices and food supplies, as these are recognised as potential ‘upstream’ drivers of obesity. Poster abstracts from European and International Congresses on Obesity were classified according to the categories presented in Section 2.1. Figure 3 below reflects the described trend to a certain degree, although some poster ‘tracks’ straddled multiple categories making classification difficult and obscuring the pattern. Figure 2.3 Obesity research presented at European and international congresses % of posters per congress 70% 1998 2000 2004 2006 2008 2010 60% 50% 40% 30% 20% 10% Policy Social & Epidemiology Eating & PA Treatment/Comorbidities Gene, cell & metabolic 0% Category In addition, the European Child Obesity Group now has an annual meeting attracting some 200 participants, as does the Scandinavian Paediatric Obesity Conference. Networks in related disciplines (i.e. nutrition, health promotion, physical activity or any of the comorbidities accompanying obesity, such as diabetes and cardiovascular disease) whose meetings often include sessions on obesity include the European Heart Network annual congress, the European Society of Cardiology annual congress, the meetings of the International Union for Health Promotion and Education, and the International Society of Behavioral Nutrition and Physical Activity. A relatively new type of event is emerging where two disciplines with overlapping interests organise a joint congress. An example of this is the 2010 Cancer and Obesity conference in Valencia, Spain, organised jointly by the International Association for the Study of Obesity, the Union for International Cancer Control and the World Cancer Research Fund. Whilst the focus is on the link between obesity and cancer, other nutrition and dietary aspects of cancer are also considered. 13 Comparison of country reports: obesity research Countries Research themes or projects as specified in the country reports were categorized using broadly the same categories as used in Section 2 of this report, in order to identify areas of focus in each country (see Table 3.1). The majority of countries (21 of 31) are undertaking lifestyle and prevention research, or community and population studies and programmes. Finland, Romania, Switzerland and the UK appear to be leaders in the latter category, with Lithuania at the forefront in the latter, and the Netherlands and Italy as big players in both. Table 3.1 presents a summary of the activities described in the country reports that are relevant to obesity. More extensive details are given in the Annex to this report. Table 3.1 Summary of country reports on obesity research. Country Number of named institution s Gene/ Cell/ Metabolic Themes/Research areas/Objectives Food Treatment/ Lifestyle/ Psychology science/ Comorbidities Prevention Technology Austria 6 Belgium 5 1 Bulgaria 8 2 Croatia 3 Cyprus 6 Czech Republic 9 6 9 Denmark 6 1 2 1 4 Estonia 4 1 1 1 Finland 7 3 2 1 10 France 4 10 1 5 2 Germany 17 6 3 2 4 Greece 4 1 Hungary 4 Iceland 1 Ireland 3 8 + 18 RA 3 1 2 1 Lithuania 6 2 1 1 Luxembourg 6 3 1 Malta 7 1 Netherlands 10 Poland 3 Portugal 21 Romania 15 Italy Latvia 1 1 2 2 2 1 5 2 2 4 4 1 1 1 3 1 2 1 7 2 5 3 1 3 2 2 2 1 2 6 1 1 3 1 2 2 2 1 2 Policy 3 5 3 1 3 Community/ Population 10 1 1 2 2 8 3 1 2 3 1 10 1 5 2 3 7 5 8 1 1 1 3 9 7 2 7 4 12 1 4 14 Slovakia ? Slovenia - Spain 7 3 Sweden 12 Switzerland 20 Turkey UK 1 1 2 3 1 5 1 5 8 2 3 10 3 5 11 2 5 3 6 12 3 7 4 25 1 4 5 RA = Regional authorities Bolded figures indicate research areas/themes/objectives that feature prominently in the research described in country reports focus Level of disclosure Country reports showed a great deal of variation in the degree of detail provided for project or programmes. Some countries specified the objectives of individual research projects or referred to them by name, in which case it was possible to ascertain whether or not the activity was specifically concerned with obesity. Others, however, stated a general programme of research lasting for several years and encompassing multiple projects (i.e. public health nutrition), national action plans, calls for action, or the research focus areas for a department at an institution (i.e. healthy lifestyles across social groups, or psychology of food choice). Some country reports mentioned topic areas related to obesity and food but did not indicate if research in these areas was actually being undertaken. Institutions Accordiong to the country reports, almost all obesity-related research is conducted in public institutions throughout Europe, with the exception of Finland where a public-private partnership undertakes work on products to prevent and treat obesity, and several food companies in Portugal and Romania focus on the development of reformulated food products. The types of instuitutions identified include: universities (most commonly), government health, social, agriculture and education departments, not-for-profit organisations, national research institutes, industry, and publicprivate partnership bodies. Collaborative research Nineteen countriy reports indicated collaborative work on European projects, including those funded by the European Commission. Of those, six (Denmark, Italy, Latvia, Netherlands, Portugal and Switzerland) specified projects that were obesity-related. Five countries are collaborating on an international scale, and four acknowledged plans to do so or the importance of this type of collaboration. Fifteen countries reported involvement in Joint Programming Initiatives, either ‘Health, food and diet for a healthy life’ or ‘Health, food and the prevention of diet-related diseases’. Funding Financial information for obesity-related projects and programmes was very limited in the country reports. There was no discussion of national funding available for obesity research, and only a few countries indicated specific amounts, either available under certain calls for research or as budgets awarded for projects. Overview The complex nature of obesity and the many risk factors and co-morbidities make the scope for obesity-related research very wide. Some country reports disclosed very specific research areas or objectives related either directly to obesity (e.g. impact of obesity on digestive functions and enteric nervous system; nature of dietary lipids and early development of adipose tissues; metabolic and 15 functional effects of consumption of dairy fractions among overweight; identification of genes influencing body weight; implementation of measures to prevent obesity or overweight) or indirectly (e.g. early recognition of diabetes, food consumption analyses, product development of new healthy foods; relationship between physical environment and eating habits and physical activity; evaluation of food labels reading; socio-demographic, psychosocial and environmental predictors of healthrelated behaviours). The country reports do not provide quantitative data but do indicate a substantial volume of research relevant to obesity currently being conducted in most countries. The UK, Switzerland, Sweden and the Netherlands appear to be most active in the field of obesity research with 30, 27, 20 and 18 projects or programmes reported respectively across 23, 18, 12 and 10 different institutions respectively. The country reports provide encouraging evidence that a range of obesity-related topics are being addressed in the research fields by different types of institutions and with various approaches. The apparent volume of work being undertaken and the number of institutions involved points to the importance of collaboration and the need to develop tools to track and share data and disseminate the results in order to prevent duplication of efforts and to encourage synergies. 16 Towards 2020: assessing needs for obesity research European and national research in obesity faces a number of research challenges which are being met, and further challenges which remain to be tackled. Knowledge needs In order to identify the research challenges regarding obesity, we first need to identify the major ‘consumers’ of research and the requirements they have expressed. As noted earlier, the there has been a concerted research effort by the health sector and the commercial sector with health care interests (including medical equipment, pharmaceuticals and treatment solutions) but this has led to only partial success. Treatments for obesity are being intensively researched but without a significant breakthrough, which has led researchers to turn their attention towards non-medical approaches to obesity management and prevention. These focus on the environment (physical, financial, social, educational, regulatory etc) of the individual, along with the social policies which determine that environment. Food-related health behaviour plays a major role in this recent research endeavour. Significant research questions Recognising the need for non-medical approaches to obesity management and prevention has led to a demand for products, facilities and policies to help individuals manage their bodyweight. Products and facilities include slimming aids, reformulated foods and beverages, and improved food labelling. Policies are increasingly recognising the need for population-wide strategies to make ‘healthy choices the easy choices’. This latter issue has meant that policy-makers have started to seek answers to questions which researchers have only just started to consider, such as those shown in table 4.1. Table 4.1: Examples of policy-led research needs Policy option Evidence need Taxes on sugar-sweetened soft drinks Ban on TV food advertising to children ‘Traffic light’ nutrition guidance on food packages Levies on foreign direct investment Central purchasing to nutritional standards Extending free school meals Restricting fast food premises near schools Effects of purchasing, consumption, total dietary intake Effectiveness in terms of dietary patterns, bodyweight change, cost effectiveness of DALYs saved, impact on health inequalities, business impact Consumer understanding, effect on purchasing, effect on total diet, effect on product reformulation Effect on types of product brought to market, effect on local food supplies Effect on producer prices, consumer prices, consumer purchasing and diet Effect on foods consumed, effect on total diet, effect onchild growth Effect on foods consumed, effect on total diet, effect onchild growth Ways to organise research: priorities, developing agendas As noted above, the consumers of research include the commericial sector and the policy-making sector. The commericial sector includes slimming products and reformulated food products as well as medical products for obesity treatment. The slimming sector has manifestly failed to find a reliable and acceptable ‘solution’ (some would argue that they have no interest in finding such a product) while the food industry struggles to find products which they can sell with an adequate 17 added-value margin, when the public health advice is to eat foods with low added value (eg fresh fruits and vegetables, wholegrains, lean meats and fish) and a reduced quantity of foods overall. Policy-related research is the greatest challenge. In order to focus research and ensure it responds to policy needs, research funding agencies should take into account the policy strategy documents developed by European government and inter-governmental agencies, non-governmental advocacy bodies and policy-oriented research institutes. The lead organisation is the World Health Organzation (at global and European Regional levels), along with strategy documents on obesity from other UN agencies, the European Commission, the Council of Europe and the European Parliament, and documents produced by member state governments during their EU presidencies. Considerable opportunities exist for the development of a coordinated research effort to survey and monitor the obesity-driving food environment across Europe, and to develop policy-specific evaluations of member state interventions to make use of ‘natural experiments’ when policies are introduced – such as the UK ban on TV advertising of unhealthy food to children, the Danish increase in tax on sugared beverages, the French ban on vending machines in schools or the Norwegian subsidies given for the distribution of fruit and vegetables. Evaluations were conducted for some of these interventions: Ofcom calculated that the UK ban resulted in a 37% reduction in children's exposure to HFSS (high fat, sugar or salt) advertising and a significant shift in the balance of food and drink advertising on television towards non-HFSS products, and the Norwegian fruit and vegetable subsidy was found to encourage consumption. Additional resources can be found in the non-governmental sector. Bodies such as the International Association for the Study of Obesity, the European Heart Network and others involved in obesityrelated issues (diabetes, cancers, dietary behaviour etc) have the potential to provide valuable perspectives on policy needs and the gaps in the evidence base. These organisations already organise networking activities but more effort could be made to involve them in the development of research funding strategies for funding organisations, including the European Commission. Interaction between public research and industry There are potential conflicts of interest when involving the commercial sector in determining the directions of public health policy, including public health research priorities. Public health advice to reduce the consumption of fatty, sugary and salt-laden foods in order to reduce the over-consumption of food energy can sit uncomfortably with industry’s underlying need to ensure continuing sales growth through increased quantity or increased apparent added value (processing) of foods. For food companies, the challenge is to develop products or ingredients which can generate rising sales while reducing the food energy consumed (and – for the sake of other diet related diseases – the amount of fats, sugars, salt etc consumed). ‘Diet’ drinks, fibre-rich ‘filling’ foods and other products are offered, but the challenge remains: how to develop products which fulfil public health needs while generating adequate returns on investment. There is an argument for not involving public funding in this quest to solve a commercial question, but the approach which might best suit all parties is to consider whether market incentives can be generated from the public sector to help companies reduce their dependence on sales of less healthful products and encourage companies to invest in the supply of healthful products. Thus publiclyfunded research into product reformulation and substitution might be justified, but the wider policy picture also needs research support from public or public-private funding – for example research projects to find the most effective use of the public sector’s food purchasing power, the use of taxation and subsidy, the use of agricultural policies and industrial investment policies, retail planning policies and economic stimulation policies – directed towards public health benefits. 18 Gaps and Overlaps for further research To identify gaps in current obesity research, the volume of obesity research in various categories (see Section 2 of this report) was evaluated against the EC-funded projects (see Section 1). Figure 5.1 below shows that EC-funded research matches the general research pattern with some exceptions – an extra emphasis has been put in the EC-funded research on genetic associations with food and obesity (this includes the ‘nutri-genomics’ research) and there is greater emphasis in EC-funded research on community-based interventions to prevent obesity and on policy analysis relating to obesity prevention. EC-funded research can be seen as falling short of the general research pattern in the area of social drivers of obesity and surveys of obesity prevalence. Obesity research by category 60,000 PubMed articles 120 50,000 EC funded projects 100 10,000 20 - 0 Policy 40 Community 20,000 Social/ Epidemiology 60 Food Science 30,000 Eating & PA 80 Treatment/ Comorbidities 40,000 # EC funded projects 140 Gene, Cell & Metabolic # articles 70,000 Structures As noted above, research priorities can be assisted through policy analyses and the development of more coherent links between policy-makers and the research community. An under-used resource in this respect is the community of public health professional bodies and public health advocacy organisations who monitor policy developments and can provide strategic commentary on these. A Europe-wide consultative forum, perhaps derived from the membership of the DG Sanco Platform on Diet, Physical Activity and Health in combination with member state representation on the High Level Group on Nutrition and Physical Activity. Infrastructures There are no obvious shortfalls in physical infrastructure. There is a need for greater accessibility and dissemination of information. This should include a ‘one stop shop’ for research funding, where food, nutrition and related public health research calls can be viewed. 19 Ways to organise research With the current restrictions on public sector spending, there is a need for more support to be found from the private sector, but mechanisms need to be found to reduce the risk of conflicted interests mentioned earlier. Possible solutions may be suggested, such as a blind trust into which industry and foundation support can be placed, or a form of research levy taken from the commercial operators who benefit from the research. 20 Conclusions and Proposals Obesity research in Europe is unevenly distributed, poorly integrated and driven in part by commercial needs and in part by local policy needs. The research field would benefit from increased coordination and better understanding of the drivers of the obesity epidemic. Research fields For over a decade the larger part of the research budget into obesity has been dominated by basic science and medical science, with few resources put into research into obesity prevention in the community. This has changed recently, with small but increasing research funding for projects in health behaviour, including food choices and dietary patterns. This is to be welcomed, but there remain large gaps in the understanding of the causes of obesity, especially in terms of the social and environmental drivers of health behaviour and food choices – for example in terms of the differential pricing of different foods, the availability and promotion of different foods, the causes of social inequalities in food access and food choices, along with increased surveillance of food intake patterns and their changing trends. As more information about the ‘upstream’ causes of obesity and poor diets emerges, there follows a need for a further research effort into the most appropriate policies for intervention to reduce obesity prevalence and prevent obesity in healthy populations. Policy-led research is relatively new to the research community, but the idea of ‘policy-based evidence-making’ is gaining strength as policymakers seek information on best practices and seek understanding of the cost-effectiveness of different policy options. Research organisation, structures and infrastructures Obesity is a pan-European health concern and the drivers of obesity are similar across all member states in the Community. Health policy and research policy are competences shared between member states and Community institutions, leading to a variety of research initiatives that involve multiple institutions. This should be encouraged as it provides significant added value, especially for smaller member states. However, the research effort is uneven: the country reports indicate that four countries are undertaking extensive activity (see Section 3 above), and there is a need for the results of this activity to be more widely shared and disseminated. Several bodies could be more involved in the coordination of research and the identification of policy-related research needs. The role of the European Centre for Disease Prevention and Control could be extended to include chronic disease and related conditions such as obesity, as the Centers for Disease Control and Prevention does in the United States. Another body that could provide a valuable contribution to the coordination of pan-European obesity research is the World Health Organization, whose European Regional Office led the 2006 intergovernmental Charter on Obesity, signed by all member states in the region. Finally, there could be an opportunity to discuss research priorities and policy needs in the context of the European Platform on Diet, Physical Activity and Health (along with the High Level Group on Diet and Physical Activity) coordinated by DG Sanco. The Platform includes food industry, health professionals and health advocates at European level, and already convenes on a regular basis to consider policy-related activities across the region. 21 Annex 1: Details of obesity research provided in the country reports The following table presents activities described in the country reports that are relevant to obesity. Country Austria Institution Competence Center Nutrition and Prevention (CC PREV) Programme Federal Ministry of Health (BMG) and Department of Nutritional Sciences of University of Vienna Federal Ministry of Health (BMG) and the Austrian Agency for Health and Food Safety (AGES) Fund Healthy Austria Medical University of Vienna Austrian nutrition report University of Vienna Belgium Belgian Food and Drink Federation (FEVIA), Belgian Olympic Committee and the association NUBEL European Confederation of Food and Drink Industries (CIAA) FEVIA National Food Platform - Flanders' Food National Food Platform - WagrALIM Bulgaria Medical University Pleven Medical University Plovdiv Medical University Sofia Medical University Stara Zagora Medical University Varna Military Medical Academy National action plan nutrition Department of Paediatrics and Adolescent Medicine Department of Nutritional Sciences Happy Body Research Programme Themes/Research areas/Objectives Apply scientifically proven diet recommendations to the people with the aim to improve health conditions and reduce diet-related diseases; Support and evaluation of prevention programmes Describe and document current nutritional situation in Austria Improve the eating habits of Austrian people; Reduce food associated diseases and control the increase of overweight by 2020 Supports projects dealing with health, sport and nutrition Obesity; Psychology and communication for prophylaxis of for example obesity Biomarkers to describe diet-related diseases; Diet surveys; Health and diet reports Applied research on obesity Food and consumer policy Public Fund for Food & Health Recognizes projects that encourage healthy diet and exercise; Functional foods (health effects, healthy diet, nutrition, health claims); Consumer trends regarding healthy products Healthy Food (premium food quality, sensorial aspects); Reduction/substitution of fat, sugar content Healthy Food; Network of excellence on Consumer Science to build capacity in this area and support national and regional programmes to provide consumers with safe, healthy and affordable food produced in a sustainable manner Nutrition and nutrition-related diseases Nutrition and nutrition-related diseases Effect of certain ingredients on population’s obesity Nutrition and nutrition-related diseases Nutrition and nutrition-related diseases Nutrition and nutrition-related diseases 22 Country Croatia Cyprus Institution Ministry of Healthcare National Centre for Public Health Protection Funded by Ministry of Health and Social Welfare Funded by Ministry of Health and Social Welfare Funded by Ministry of Health and Social Welfare Ministry of Agriculture, Fisheries and Rural Development University of Zagreb Cyprus Consumer Association Cyprus University of Technology, Faculty of Health FoodLab Government funded Themes/Research areas/Objectives Reduce risk of food and nutrition-related diseases Monitoring of the food intake and the nutrition status of the population; Implementation of specialized software for nutrition assessment at all Regional inspections for Public Health Protection and Control; Update the recommended values for nutrition intake of the Bulgarian population, development of guidelines; Elaboration of National recommendations for healthy nutrition of the Bulgaria population, promotion of the recommendations Nutrition and nutrition-related diseases National programme of health care of persons with diabetes National strategy for health Decrease risks of side effects of diabetes; Early recognition of diabetes Programme of health care of the population living on the islands Call for Proposals - allocation of Grants for the Food Industry School of Medicine Better availability of any health needs of island population, including nutritional aspects and healthy food delivery Food production and nutrition CYKIDS Academy of Sciences Social, Economic and Humanitarian Sciences: Society Sports for All Health and biological sciences: Science and Food Biotechnology Social, Economic and Humanitarian Sciences: Society MENTOR (Programme for Health Promotion) Institute of Physiology Charles University Department of Nutrition Czech Ministry of Health Research and Development programme of the Ministry of Health II (2008-2011) Ministry of Education National Framework Programme, DESMI, 2009-2010 National Framework Programme, DESMI, 2009-2010 Czech Republic Programme National Food and Nutrition Action Plan Education of population of health risks (incl. nutritional aspects) Obesity Food and health in relation to the policy level and the rights of the consumer Overweight and obesity in preadolescent children and their parents; urbanization and dietary habits Nutritional value determination Psychological conditions such as anorexia, bulimia, obesity Importance of sports and healthy lifestyle at schools Nutrition and health Psychological conditions such as anorexia, bulimia, obesity Healthy diet for primary school children Obesity; Diabetes; Hereditary metabolic disorders; ex. Induction of mitochondria in white fat: a common target for treatments ameliorating obesity and insulin resistance Nutrition epidemiology; Diabetes; Metabolism; Nutrition status of population groups; ex. Active lifestyle in a biosocial context Nutrition, metabolism, diabetology; ex. Effectiveness of diet and exercise in obese women and influence of variants of the candidate genes of obesity in population; Relative abundance of macrophages and other cell populations in adipose tissue in relation to obesity and associated metabolic complications; Additive effects of omega-3 polyunsaturated fatty acids and pioglitazone in the treatment of type 2 diabetes mellitus; The Effect of a 23 Country Institution Programme Czech Ministry of Health Research and Development programme of the Ministry of Health III (2010-2015) Ministry of Agriculture - Institute of Agriculture Economics and Information Ministry of Public Health Ministry of Public Health National Technology Platform Food for Life Institute for Clinical and Experimental Medicine Institute of Endocrinology Sunfood Faculty of Medicine in Hradec Kralove, Dept. Gerontology and Metabolism COST Denmark Bispebjerg Hospital Danish Agency for Science, Technology and Innovation or the Danish Food Industry Agency or the Danish National Advanced Technology Foundation Danish Agency for Science, Technology and Innovation or the Danish Food Industry Agency or the Danish National Advanced Technology Foundation Danish Agency for Science, Technology and Innovation or the Danish Food Industry Agency or the Danish National Advanced Technology Foundation National Research Programme II (20062011) Institute for Preventive Medicine Indo-Danish programme for strategic research collaboration within biotechnology Themes/Research areas/Objectives Low-Fat Vegetarian Diet and Physical Activity on Insulin Resistance in Type 2 Diabetes mellitus; Genetic and factors of life style by children with metabolic syndrome and their dependents; Cost effectiveness of diagnostic and therapy in endocrine and metabolic diseases; Mechanisms and consequences of the accumulation of lipids in liver associated with metabolic syndrome - the possibilities of nutritional and pharmacological intervention; Nutrigenomic interactions in different weight reducing diets; Childhood obesity surveillance Nutrition, metabolic and endocrine diseases. Focus is on metabolic and nutrition disorders – Diabetes mellitus type II, osteoporosis, tyreopathy, dyslipidemics, obesity, malnutrition related to grave diseases, nutrigenomics and personalised nutrition Food consumption analyses; Food pricing; International comparisons related to food production and consumption; Food trade; Trends in food sector Diabetology; Metabolism; Nutrition Metabolism; Diabetology; Obesitology Development of products with positive properties and beneficial effects on overall health particularly obesity and cardiovascular diseases; Research and development of food with modification of fat and mineral component aimed at prevention of obesity Safe quality foods focused on overweight reduction Diagnostics and treatment of nutritional and metabolic disorders (diabetology, obesitology, lipid metabolism diseases) Insulin Resistance, Obesity and Diabetes Mellitus in the Elderly; Adipose Tissue: A Key Target for Prevention of the Metabolic Syndrome Sub-programme: Healthy life and healthy environment which covers research in healthy food and nutrition Food & health research - mainly obesity; Leads the Danish Obesity Research Centre (DanORC), a Danish research network that includes almost all Danish research institutes working on Obesity; EU funded Diogenes (Diet, Obesity and Genes). Healthy lifestyle focused on foods and nutrition Interdisciplinary research programme on the relationship between food, nutrition and health Interaction between nutrition, health perceptions and food consumption, including food related diseases Strategic research in health, food and welfare Connection between food, health and lifestyle 24 Country Institution The Technical University of Denmark The Technical University of Denmark Estonia Finland University of Copenhagen Ministry of Social Affairs Ministry of Social Affairs and Institute of Health Development Tallinn University of Technology University of Tartu University of Tartu Finnish Association for the Study of Obesity Helsinki University Central Hospital Ministry of Agriculture and Forestry, Finnish Food Safety Authority Programme FoodDTU Network (institutes engaged in food) National Food Institute Faculty of Life Sciences National Institute for Health Development Population Health Development Plan 20092020 Department of Food Processing Department of Sociology Faculty of Medicine National Strategy for Prevention of Cardiovascular Diseases 2005-2020 Promote consumer access to healthy and safe food products; Prevent dietrelated disorders Metabolic diseases; Diabetes Health promotion and monitoring programmes including nutrition Improvement of population’s nutrition and eating habits; Decrease the proportion of overweight and obese by 33% Nutrition surveys for children in schools and nurseries Determinants of food habits Food related diseases like diabetes, obesity Improvement of eating habits Obesity Division of Medicine and Geriatrics National Nutrition Council MTT Agrifood Research Finland National Consumer Research Centre Strategic Centres for Science, Technology and Innovation - Health and well-being (Public-private partnership) University of Eastern Finland Themes/Research areas/Objectives Health and nutrition SalWe Ltd - Health & Well-Being (Obesity and metabolic syndrome is one of 4 focus areas) Unit of Clinical Nutrition Agri Food Research – eight programme Health and Welfare of Children and Young People SKIDI-KI’DS Nutrition, Food and Health (ELVIRA) Responding to public health Challenges (SALVE) SAPUSKA ValueFood for International Markets Obesity and lifestyle interventions Co-ordinate and observe the action plan concerning nutrition in the Government resolution for promoting healthy diet and physical activity; observe the development of nutrition policy in Europe; Observe and improve the nutritional situation in Finland by making Nutrition Recommendations, giving Action Programmes and observing how Action Programmes are fulfilled Production and development of new healthy foods Food economy and food culture; Sustainable diet; Changes in dietary practices; Healthy eating Develop products, services and practices to prevent and treat diseases with major public health and economic impact, and comprehensively maintain and improve the functional capabilities of an individual Role of diet and individual foods and food components, and other lifestyle factors and genetic factors in the maintenance of health as well as in the etiologic and treatment of diet related chronic diseases; Nutrigenomics; Metabolics; Nutrition and chronic diseases; Food and health; Health promotion with nutrition Product development of new healthy foods Challenges for children’s health and the promotion of health Research themes are: Nutrition, genetic factors and metabolism; consumer behaviour, lifespan and health Health-protecting and health-promoting factors; Life-course approaches and critical periods of life; Health inequalities and clustering of ill health; ex: type 2 diabetes; health effects of diet rich in plant-based food and fish Development of neighbour market, healthy food and food with health impact and food safety 25 Country France Institution ANR (Research National Agency) ANR ANR Programme ALIA (Programme de Recherche en Alimentation et Industries Alimentaires) 2008 ALIA 2009 PNRA 2005 ANR PNRA 2006 ANR PNRA 2007 CNRS (Centre national de la recherche scientifique) Calls for proposal of integrated support to Major Interest Field (DMI) of the Ile de France Region Consumer Sciences INRA (French National Institute for Agricultural Research) INRA & Ministry for higher education and research INRA (French National Institute for Agricultural Research) INSERM (Institut National de la Santé et de la Recherche Médicale) BMBF Universities BMBF Universities, MRI, German Cancer Research Institute Impact of Obesity on the Digestive functions and Enteric Nervous System Nature of dietary lipids and early development of adipose tissue; Influence of a high calorie diet on mitochondrial activity: involvement in obesity and metabolic syndrome; Effect of sensory learning on preferences and eating behaviors of children aged from 8 to 10 years; Detection of nutrients and control of food intake: The impact of nutritional imbalances. Searching for early markers of metabolic dysregulations associated with weight gain by a metabonomic approach; Metabolic and functional effects of consumption of dairy fractions among overweight. Modulating effects of dietary fibre on bacterial flora and inflammation for the prevention of metabolic disorders induced by a fatty diet; Dietary fats and inflammatory response: involvement in development of sarcopenia obesity; Role of fatty acid transport FAT/CD36 in the detection of lipids in tongue, intestine and brain: impact on feeding behaviour and health; Eating behaviors of adolescents and cultural backgrounds; Socio-economic, psychosocial and territorial behaviour determinants in food: a search based on the SIRS cohort in Ile-de-France; Study of the relationship between physical environment and eating habits and physical activity; Food and Consumer Nutrition Information Policy: What respective contributions to the control of health risk / benefit? Obesity Dietary behaviours, consumer behaviour and dietary habits, food and wellbeing A healthy diet for a healthy life Effects of food and nutrients on main physiological functions of human beings Circulation, metabolism, nutrition; Diabetes, metabolic disease National Health and Nutrition Program (PNNS) Nutrinet Germany Themes/Research areas/Objectives Preferences and eating behaviors towards fat, salty and sweet; Effect of physical activity in adolescence on food habits and attitudes National Genome Research Network (Genome Network Adipositas) Functional Food Research (2005-2008) Improve the health of the entire population by acting on one of its major determinants: nutrition To highlight the specific role of nutritional factors: measure accurately food intake but also take into account other determinants, such as physical activity, weight, smoking, family history ... and watch links with health and disease risk. Identification of genes influencing body weight and subsequent clinical, epidemiological and functional characterization of these genes Examination of the molecular and function of food that could prevent foodrelated diseases (bio-active food) 26 Country Institution BMBF, FIDAM, Bavarian Association of Statutory Health Insurance Physicians, German Diabetes Centre, HGFMRI, German Cancer Research Institute BMBF Universities, FhGFIDAM, Bavarian Association of Statutory Health Insurance Physicians, German Diabetes Centre, German Cancer Research Institute BMELV BMG Deutsches Institut für Ernährungsforschung (German Institute of Human Nutrition) FKE Leibniz Ministry of Food, Agriculture and Consumer Protection and Ministry of Health MRI: Max Rubner Institut (Federal Research Institute of Nutrition and Food) MRI Programme Network Molecular Food Research Themes/Research areas/Objectives Research on etiology, pathogenesis, diagnosis and therapy as well as basic research on diabetes Disease Related Competence Network Adipositas Diabetes Research on genesis and prevention etiology, pathogenesis, diagnosis and therapy of adipositas IN FORM – Germany’s Initiative for Healthy Nutrition and More Exercise National Nutrition Survey II Department of Nutritional Behaviour; Department of Physiology and Biochemistry of Nutrition Research Institute for Infant Nutrition Robert Koch Institute State Lower Saxony Universities, Deutsches Institut für Lebensmitteltechnik Universities Universities Universities, MRI, industry, public sector research institutes Greece Harokopio University, Department of Dietetics and Nutritional Science Research Cooperation Agricultural and Food Science Lower Saxony Focal Point of Support: Food Research National Genome Research Network (Genome Network Adipositas) Networks of Competence for Agriculture and Food Competition of Young Researchers: Molecular Fundamentals of Human Nutrition Health Research Programme Nutritional behaviour “National Health Survey”, including nutrition behaviour Understanding the molecular basis of nutrition-dependent diseases, and of developing new strategies for prevention, treatment and nutritional recommendations Nutrition behaviour, food epidemiology with focus on children and adolescents only. Prevention of diabetes and medical care. Increase of exercise, reduction of obesity and their interrelated diseases Nutritient and energy intake of 14-80 year olds in Germany; current food consumption, lifestyle and eating behaviour Nutrional behaviour, physiology and biochemistry of nutrition Food behaviour, food epidemiology, and physiology with the focus on children and adolescents Overweight and Obesity Among Children and Adolescents; Identify effective prevention strategies important determinants at an early stage of life Bioactive food ingredients for healthy products, healthy nutrition and consumer acceptance Role of food components for the prevention of food related diseases Identification of genes influencing body weight and subsequent clinical, epidemiological and functional characterization of these genes To contribute to the global challenges of malnutrition and obesity. Meaning of food components for the development of metabolic diseases; metabolism and its modulation by specific food ingredients Prevention of food related diseases by basic research of food and interventional research on behaviour Health aspects of food 27 Country Institution NSRF 2007-2013 Strategic plan for the development of R&D and innovation Hungary Programme Developing high value-added food and new products to meet specific needs and preferences Agriculture, Fishery, Livestock Farming, Food and biotechnology University of Athens, Department of Medicine Corvinus University, Budapest, Faculty of Food Science “Food for Life” National Technology Platform National Institute for Food and Nutrition Science Themes/Research areas/Objectives Development of high nutritional value, better and healthier lifestyle in relation to modern diseases such as metabolic syndrome Foodstuffs priority includes: Consumer behaviour and preferences, healthy eating, development of high value-added foodstuffs and new products to meet specific needs and preferences Nutritional epidemiology, epidemiology of chronic diseases Research on healthy nutrition and production of healthy and functional food National Institute for Health Development (NIHD) National Infant and Child Health Program National Public Health Programme Iceland The Public Health Institute Nutrition Ireland Department of Agriculture, Fisheries & Food Department of Agriculture, Fisheries & Food (DAFF), Department of Health & Children (DHC) and the Health Research Board (HRB) Food Institutional Research Measure (FIRM) Food for Health Ireland - 2008 Technologies to drastically reduce sugar, salt and fat levels in food products without comprising sensory priorities Monitors food consumption patterns and provides analytical services based on accredited and standardised analysis methods; Elaborates and updates dietary guidelines, organizes public health projects and takes part in the decision making process of food and nutrition policies both at national and international levels. Improve the health of the Hungarian population, to develop disease prevention and to promote healthy lifestyles; special emphasis on tackling inequalities in health Strategic priority: Nutrition - Unhealthy diets and inadequate meal combinations can lead to obesity among school-aged children and may also increase the risk of cardiovascular and other system diseases in later life. Healthy lifestyle and environment, including healthy nutrition with the aim to transform poor nutritional habits and popularize up-to-date dietary habits as part of comprehensive information on healthy lifestyles; Preventing illness and reducing the burdens of disease, including screening and continuing care for hypertension and diabetes and improving the health of elderly Main objective: influence the nation’s food habits towards a healthier way, i.e. closer to the national recommendations on diet and intake of nutrients. Special emphasis is laid on increasing vegetable, fruit and fish consumption, and on decreasing intake of salt and saturated fat. These measures are to be achieved by increasing education in nutrition and by making access to healthy foods easier, and thereby making healthy choices easier. National food surveys and data are gathered on consumption and sales of food. Special programmes as to diet and exercise are targeted at children, teenagers and their families. Food & health, nutrition, food quality Many of these bioactive ingredients are derived from milk proteins, carbohydrates and fats and are being tested for their impact on early infant development and their ability to reduce the risk of infection, heart disease and obesity 28 Country Italy Institution Department of Agriculture, Fisheries & Food (DAFF), Department of Health & Children (DHC) and the Health Research Board (HRB) Programme HRB Centre for Diet & Disease Department of Agriculture, Fisheries & Food (DAFF), Department of Health & Children (DHC) and the Health Research Board (HRB) JINGO – National Nutrition Phenotype Database Department of Agriculture, Fisheries & Food (DAFF), the Health Research Board (HRB) National Adult Nutrition Survey 18 Regions A system surveys about the behavioural risk in children aged 6-17 years CCM Consorzio di ricerca per l’innovazione tecnologica, la qualità e la sicurezza degli alimenti Interdepartmental program National Prevention Plan Control of quality, functional and toxicological safety and traceability Lattonerie Carpenterie Meridionali S.R.L. Enhancement of buckwheat through process innovation (grinding) and product (gluten-free foods, dietary and functional) Ministry of Health National Centre for Disease Prevention and Control (CCM) Gaining health Good practices in the care of eating disorders; social prevention in eating disorders Themes/Research areas/Objectives Provide an evidence base for public policy, health promotion and clinical practice on the prevention and management of obesity, diabetes and related metabolic disorders; Population health modelling, diet obesity and health in early life and pregnancy, cross-sectional and longitudinal analyses from diabetes and heart disease studies, clinical management of severe and morbid obesity in children and adults, consumer cognitive response to food. Gene-diet interaction research by identifying those nutrients which interact with particular genes to increase the likelihood that an individual will develop a certain disease, aiding in the prevention of obesity and chronic diseases of ageing where gene-nutrient interactions are emerging as key factors. Annual survey of food consumption representative of the ROI population as a whole; Databases will be designed to address both nutrition and food safety issues of relevance to development and implementation of public health policy and to the needs of the food industry; Data will be also be collected on body weight, blood pressure, lifestyle, including physical activity, attitudes to food and health, and determinants of food choice Define and implement a national system for gathering data on anthropometric measures, dietary habits and physical exercise in children between 6-17 years old. Obesity Improve food raw materials, food and manufacturing processes currently in use by providing new Tools, knowledge and models for the analysis of nutritional and healthy food Creating a "community of promoters" to support physical activity and proper nutrition; Training plan aimed at operators of Services of food hygiene and nutrition (SIAN) for the implementation of measures to prevent obesity; Support for the European strategy to combat obesity; Good practice for nutrition and physical activity in preschoolers: the promotion and surveillance Develop a chain of buckwheat for obtaining food (pasta and baked goods) gluten-free diet and functional properties of great value to the dietary treatment of diseases with high prevalence in the population and the greatest social impact such as diabetes, hypertension, arteriosclerosis, celiac disease el'ipercolestemia. Improper eating habits; Physical inactivity 29 Country Institution National Research Institute for Food and Nutrition (INRAN) Programme Region Toscana, Emilia Romagna, Puglia, Veneto Training of SIAn operators in the implementation of measures to prevent obesity Good practices of social care and prevention of eating disorders Region Umbria University of Pavia WHO Latvia Lithuania HR, Institute of Food Safety, Animal Health and Environment (BIOR), Food & Veterinary Food Service (FVS FC) University of Latvia Lithuanian Science and Studies Foundation Lithuanian Science and Studies Foundation, University research fund Lithuanian Science and Studies Foundation, Welcome Trust fund, and Oslo university Ministry of Health Support for the European strategy to counteract obesity Latvian national food consumption survey, 2007-2009 Institute of Experimental and Clinical Medicine Determinants of Cardiovascular diseases in Eastern Europe European Childhood Obesity Surveillance Initiative Determinants of Cardiovascular diseases in Eastern Europe Links between food information and choice of foodstuffs from public health point of view Themes/Research areas/Objectives Foodstuffs and their role in maintaining health and preventing risk of nutrition-related diseases; Monitoring of eating habits and nutritional status of the Italian population; Evaluation of national nutritional quality of food products; Development of more effective food and nutrition policies; Develop and test new methods for communication activities, information and food education; Compilation of "Tables of Composition of Foods."; Developed the "Guidelines for a Healthy Italian Food," Relationship between diet and health, particularly with regard to food and typical bioactive components that characterize the Mediterranean diet, the eating habits and lifestyles of the Italians; Conducting studies and interventions on population groups to correlate diet, lifestyle and health status; Analysis of tastes, habits, preferences and motivations of Italian food choices; Continuous monitoring of food consumption to assess national food issues; Relationship between overweight/obesity and dietary/lifestyle factors among Italian adolescents Support SIAN operators in the implementation of measures to prevent obesity and overweight Good practices of care and social prevention in eating disorders; develop collection of best practices in prevention, research and treatment of eating disorders, which may constitute a reference point and example for updating and / or redefining Guidelines released in 1998. Randomised controlled trial of effects of dietary supplements on compliance with diets in overweight subjects Initiate a more formal approach agreed at European level to set common basis for interventions preventing obesity Collection and processing of information related to Latvia inhabitants food consumption and nutrition behaviour Neuroendocrinology and abnormalities of body weight regulation; Coronary and peripheral atherosclerosis; Metabolic syndrome, diabetes mellitus and other endocrine disorders; Role of gene polymorphisms in the development of cardiovascular diseases and diabetes. Dietary risk factors of cardiovascular disease Monitoring of growth, nutrition and physical activity habits of primary school children in Lithuania Dietary risk factors of cardiovascular disease; Gene-nutrients interactions Evaluation of food labels reading 30 Country Institution Ministry of Health Programme National Nutrition Survey Research Council of Lithuania National Science Programme - Chronic Noncommunicable Disease (call for projects) Interaction of genes and diet in assessing risk of dyslipidaemias and obesity in Lithuanian population Behavioural risk factors for chronic noncommunicable diseases among adolescents The trends and inequalities in behaviour related to risk of chronic diseases among Lithuanian population Schoolchildren eating habits and quality of nutritional services at school Research Council of Lithuania Research Council of Lithuania Research Council of Lithuania State budget State budget State budget (Ministry of Health), Lithuanian Science and Studies Foundation, WHO State budget, international collaboration State budget, WHO, international collaboration Students Health and Health Behaviour Survey CINDI Nutrition Survey Health Behaviour Survey in School-Aged Children Health Behaviour Survey among Lithuanian Adult Population State Food and Nutrition Strategy and Action Plan 2003-2010 Luxembourg Centre de Recherche Public-Henri Tudor Centre de Recherche Public-Santé Centre Hospitalier Luxembourg International Network for Studies in Technology, Environment, Alternatives, Development (INSTEAD) Laboratoires Réunis University of Luxembourg Malta Department of Health Promotion and Disease Prevention Department Health Care Technologies Public Health – Epidemiology Unit Departments of: Cardiology and CVD, Endocrinology and Diabetology Faculty des Lettres, des Sciences Humaines, des Arts et des Sciences de l'Education National Obesity Campaign Themes/Research areas/Objectives Evaluation of nutrient intake in national random sample of Lithuanian adult population Diet as a risk factor for noncommunicable disease Evaluate interaction between genetic and dietary factors associated with dyslipidaemias and obesity among Lithuanian adult population. (budget: €71,200) evaluate trends in food habits of adolescents and to predict changes in risk of chronic noncommunicable diseases in adults examine the trends and social inequalities in health behaviour including food habits among Lithuanian population aged 25-64 Study eating habits of schoolchildren (9 and 11 grades) and quality of services supplying meal at school; to analyse trends of these data over 4 years period Evaluation of health behaviour, including nutrition habits, prevalence of overweight and obesity among students of Kaunas universities Evaluation of nutrient intake, dietary habits and prevalence of dietary related risk factors of chronic noncommunicable diseases in rural regions of Lithuania Monitoring of health behaviour, including nutrition habits, also prevalence of overweight and obesity in School-Aged Children of Lithuania Monitoring of health behaviour, including nutrition habits, also prevalence of overweight and obesity in different social groups of Lithuanian adult population Promotion of healthy nutrition of the Lithuanian population; Improvement of access of food of high quality for all social groups; Monitoring of nutritional status and nutrition-related health problems Nutrition and chronic diseases Chronic diseases including CVD, diabetes, obesity Risk factors of diabetes and diagnostics, chronic disease in general, obesity Health state and determinants; Social factors and health; Obesity Chronic diseases – prevalence/diagnostic Psychology and health (e.g. dietary habits, food sensory) Raising awareness about obesity and its adverse effects on health, promoting healthy eating and portions, encouraging activity, weight management classes 31 Country Institution Department of Health Promotion and Disease Prevention Director General for Education Programme Obesity Strategy Themes/Research areas/Objectives In preparation Healthy Eating Lifestyle Plan (2007) Guidelines and resources to help schools design, implement and monitor a healthy eating lifestyle plan Developed low-sugar and low-calorie versions of a number of their products Developed a no-salt, no-sugar high-fibre loaf Preventing illness and promoting healthy lifestyles to improve population health Dietary habits and obesity, including targets and actions to achieve them Foster Clark Products Ltd. Golden Harvest Ltd. Ministry for Health, Elderly and Community Care Ministry for Health, Elderly and Community Care Netherlands Health Promotion and Disease Prevention Department Strategy for the Prevention and Control of Noncommunicable Diseases in Malta (2010) National Statistics Office Lifestyle Survey 2007 University of Malta Department of Food Studies and Environmental Health Nutrition Policy - "Healthy Nutrition, From Start to Finish"; Overweight Policy Dutch Ministry of Health, Welfare and Sport Erasmus University Dept of Public Health, Determinants of Health-related Behaviors Maastricht University Ministries of Economic Affairs, LNV and VWA Nutrition and Toxicology Research Institute (NUTRIM) Innovation programme Food and Nutrition Top Institute Food and Nutrition (TIFN) Research institutes Wageningen UR Food and Biobased Research Rijksinstituut voor Volksgezondheid en Milieu (RIVM) (National Institute for Public Health and the Environment) Rijksinstituut voor Volksgezondheid en Milieu (RIVM) (National Institute for Public Health and the Environment) Centrum voor Preventie en Zorgonderzoek (Centre for Prevention and Health Services Research) Centrum voor Voeding en Gezondheid (Centre for Nutrition and Health) Rijksinstituut voor Volksgezondheid en Milieu (RIVM) (National Institute for Public Health and the Environment) National Institute for Public Health and the Environment (RIVM) Collection of data on weight and height, alcohol consumption and eating habits such as consumption of fresh fruit and vegetables, and fried foods Nutrition and obesity; Assessing dietary habits and identifying barriers to a healthier diet; Intervention aiming to modify dietary behaviour Enable consumers to achieve healthy dietary patterns by: educating consumers on making healthy food choices and encouraging the commercial sector to supply the public with healthier food options Socio-demographic, psychosocial and environmental predictors of healthrelated behaviours; Develops interventions to promote healthy lifestyles and studies the effectiveness and implementation of these interventions Nutritional health benefits and risks focussing on metabolic and chronic inflammatory diseases Develop innovative products and technologies that respond to consumer demands for safe, tasty and healthy foods with regard to major health concerns such as obesity and metabolic syndrome Motivation of food choices; the influence of the interior and the assortment on the food choices among consumers is studied Healthy and unhealthy lifestyle choices Collects and analyses data on all aspects of food consumption, food composition and eating habits in the Netherlands; Assesses dietary patterns against standards and guidelines; Manages national databases on food composition (Dutch Food Composition Database) and food supplements; Conducts literature-based and epidemiological studies on the relationship between diet and nutrition on lifestyle and on chronic diseases such as obesity; Quantifies the effects of diet and nutrition on health, advises on appropriate measures and studies the impact of such measures Health consequences of diet 32 Country Institution The Centre for Specialised Nutrition of Danone Research TNO Kwaliteit van Leven (TNO Quality of Life) TNO Kwaliteit van Leven (TNO Quality of Life) Programme Vrije Universiteit Amsterdam Wageningen University Section Nutrition and Health Division of Human Nutrition Healthy Food Voedingsconcepten die passen in een gezonde(re) eet- en leefstijl Innovation programme Food and Nutrition Food & Nutrition Delta (FND) Programma Gezonde Voeding TIFN - Nutrition and Health TIFN – Sensory and structure Poland Food and Nutrition Research Institute, Ministry of Health, Ministry of Science and Higher Education Portugal BIOCANT - Associação de Transferência de Tecnologia (private) Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Universidade do Porto Centro de Investigação em Desporto, Saúde e Desenvolvimento Humano (CIDESD), Universidade de Trás-osMontes e Alto Douro Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana - Universidade Técnica de Lisboa National Programme of prevention overweight and obesity and chronic non infectious diseases via improvement of nutrition and physical activity Themes/Research areas/Objectives Complex interaction between nutrition, biological processes and disease mechanisms in the human body Overweight/obesity and gut health Investigate how a healthy diet can contribute and reduce of overweight and its complications; Develop new concepts and methods to reduce food intake by stimulating satiety or inhibiting hunger; Investigate the inhibition of inflammation processes in obesity to prevent chronic disease and complications of overweight Determinants and health consequences of obesity Controlled dietary interventions at the individual level; Observational studies at population level; Nutrition and Health; Nutrition and Epidemiology; Sensory Science and Eating Behaviour Translation of knowledge and generated leads on food & health to concrete products, processes and services Increase knowledge how dietary patterns can contribute to the prevention of diet-related chronic diseases, specifically focussing on low SES, children and elderly; Increase knowledge how consumers can be actively encouraged to make a healthy choice regarding dietary patterns; Determinants of nutritional behaviour Obesity, metabolic syndrome; Provide the industry partners with leads for the development of new healthy foods with regard to major health concerns; Discover and validate molecular biomarkers for the early detection of metabolic stress in nutrigenomics, to enable the development of novel food components for dietary management and prevention of metabolic stress, and ultimately metabolic syndrome Developing foods that can be used to control food intake by inducing satiation and increasing the duration of feeling satisfied Social education of people on role of nutrition and physical activity and their positive relations on health EU project ‘Diabetes, Obesity and Medicine’ Research relating obesity to physical activity, focussed on children Health Research Group Previous work includes a national study on the influence of sociodemographic factors on the prevalence of childhood obesity Investigating lifestyle weight management in overweight and obese women and the impact of continuous contact and structured exercise in long-term maintenance after weight loss 33 Country Institution Concurso de Projectos de Investigação e Desenvolvimento de Sistemas de Informação Médica, no Âmbito do Acordo de Cooperação entre Portugal e a Harvard Medical School Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto (FCNAUP) Grupo UNICER (private) Programme Eating Out: Habits, Determinants, and Recommendations for Consumers and the European Catering Sector Water with anti-oxidant properties, that claims to reduce the appetite and to restore energy during high activity Health determinants, principally on the main causes of diseases related to environmental, lifestyle and psycho-social factors Instituto de Medicina Preventiva, Faculdade de Medicina, Universidade de Lisboa Instituto Nacional de Recursos Biológicos (INRB) Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA) Ministry of Health New University of Lisbon Portuguese Society for Diabetology Portuguese Society for Food and Nutrition Science Portuguese Society for the Study of Obesity (SPEO) SCC -Sociedade Central de Cervejas e Bebidas, S.A (private) Technical University of Lisbon Technical University of Lisbon University of Minho University of Lisbon University of Oporto University of Oporto Themes/Research areas/Objectives Early beginnings - tackling childhood obesity National Health Plan ENSP (National Public Health School) Beneficial effects on health of consuming fish products rich in omega 3 fatty acids, particularly for the prevention of cardiovascular disease and in the treatment of obesity Health and disease determinants, cardiovascular diseases, life style impact on health, gastrointestinal infections, applied nutrition Epidemiological studies in connection with pre-obesity and obesity and its associated risk factors; control of diabetes Childhood obesity Diabetes Current status of diet and lifestyle among the Portuguese population Epidemiology, dietary behaviour, physical activity and medical complications of obesity. In the National Platform on Obesity and Weigh Control (CONOCOP) implementing national and regional epidemiological studies Water with fibre that claims to help control appetite and weight CIISA (Interdisciplinary Centre of Research in Animal Health), Faculty of Veterinary Medicine Social Adventure Project, Faculty of Human Mobility CIPSI - Centre of Psychology Research, School of Psychology Nutrition and Metabolism Unit, IMM (Institute for Molecular Medicine), Faculty of Medicine Faculty of Medicine, of the University of Oporto (FMUP) ISPUP (Institute of Public Health) Lycopene and oleic acid related to inflammatory and aterotrombogenic biomarkers in obesity and metabolic syndrome EU FP7 project child/ adolescent eating patterns & weight status Prevention/treatment of eating disorders and obesity, epidemiology of dietary behaviour Nutrition and dietary related diseases (e.g. obesity, malnutrition, diabetes) Obesity; diet and diabetes Nutritional epidemiology, obesity 34 Country Institution Science & Technology Foundation (FCT) Programme FCT Projectos de I&D (R&D Projects) 2008 Romania Banat’s University of Agricultural Sciences and Veterinary Medicine Financed by Norwegian Government and Romanian Ministry of Public Health Food Science and Technology Ministry of Agriculture Ministry of Public Health Ministry of Public Health National Authority for Scientific Natural research SRL (private) N&V ’96 Impex SRL (private) PROPLANTA SA (private) Research Department Academy of Agricultural and Forestry Sciences Research Centre of Biotechnology and Engineering Science-Valhi University from Targoviste Romanian Academy SC HOFIGAL SA (private) SN PLAFAR SA (private) The Society of Nutrition University of Medicine and Pharmacy “Victor Babes’ Slovakia Themes/Research areas/Objectives Prevalence and severity of fatty liver in morbid obesity: correlation and mechanisms related with the role of ectopic fat in insulin resistance; Early development of obesity and the metabolic syndrome; Eating habits in preschool children: a longitudinal approach to the identification of determinants and effects on body composition; Peripheral body fat, lifestyles and adipokines Food and diet related diseases; Dietary food patterns and health Increasing access to the services of primary medical prevention for children and teenagers in Romania Institute of Food Bioresources Department of Food Hygiene and Nutrition – Institute of Public Health National Health Program 2007 National Plan for Research Development and Innovation for the period 2007-2013 Prevention for children; healthy nutrition and physical activity Faculty of Food Science Food and nutrition policy; Food and diet related diseases; Dietary food patterns and health Research Department Petru Poni” Institute of Macromolecular Chemistry Food and nutrition policy; Food and diet related diseases; Dietary food patterns and health Nutritional Clinical Trials National Programme for Obesity Prevention Programme for Nutritional Sanitation Slovenia - - Spain CSIC, Agencia Estatal Consejo Superior de Investigaciones Científicas Instituto de Salud Carlos III, ISCIII Food Science and Technology CIBER projects Biomedical Research Networking Centres Nutrition, production of food for specific diseases: diabetes Food and nutrition policy; Food and diet related diseases; Dietary food patterns and health Diabetes and nutrition diseases Ideas programme: basic and clinic research into cardiovascular diseases, cancer, diabetes, obesity Dietary patterns and health Food and diet related diseases Nutrigenomics; dietary food patterns and health Food and nutrition policy Food and diet related diseases Food and diet related diseases Guideline for a healthy diet Food and diet related diseases; Dietary food patterns and health Prevent overweight and obesity of children, to stop the increasing number and reduce number of people suffering from overweight and obesity Enhance nutritional status and in direct dependency the health of inhabitants of the Slovak Republic and prevention of different lifestylerelated diseases Implications of nutrition on human health, in order to improve health and prevent the appearance of certain nutrition-related diseases Pathophysiology of obesity and nutrition; Diabetes and associated metabolic disorders 35 Country Institution Instituto de Salud Carlos III, ISCIII Ministry of Health and Consumption, Spanish Agency for Food Safety and Nutrition Ministry of Health and Social Policy Ministry of Health and Social Policy, Ministry of Education, Regional ministries of health and education University of Granada University of Valencia Sweden Antidiabetic Food Centre at Lund University Good Food Practice (Centre for clinical tests of food) Gothenburg University Gothenburg University Gothenburg University Programme Health Strategic Action. Subprogram of Health Research projects Strategy for Nutrition, Physical Activity, and Obesity Prevention Total Diet Study PERSEO programme (Pilot Programme in Schools for Health, Physical Exercise and against Obesity Institute of Nutrition and Food Technology Department of preventive medicine and public health Food, Consumption and Health WHO-Europe Programme for the compilation and evaluation of actions in Spain in the area of obesity prevention VINN Excellence Center programme (VINNOVA) 2007-2017 Department for food and nutrition, and sport science FAS – Project funding 2007-2013 VR - Project funding 2009-2011 Gothenburg University, Sahlgrenska University Hospital Karolinska Institutet Sahlgrenska Academy Lund University Faculty of Engineering Lund University Formas 2010-2012 Lund University Functional Food Science Centre National Food Administration Probi (Swedish research company that develops probiotics for both Functional Food and Dietary Supplements) Skåne Food Innovation Network (SFIN) VINNVÄXT (VINNOVA) – Innovationer i Gränsland Themes/Research areas/Objectives Diabetes and obesity Raising awareness of the population about the problem that obesity means for the health and promoting all the initiatives that contribute to incorporate healthy lifestyle in the population especially in children and young people mainly through a healthy diet and regular practise of physical exercise National Survey on Food Consumption Promoting the incorporation of healthy lifestyle habits and stimulating the regular physical practice between schoolchild, to prevent obesity and other illness Nutrition and metabolism in childhood Nutrigenomics in obesity Food design aimed at reducing risk factors for lifestyle related diseases, such as obesity, age-related diabetes and cardiovascular disease. Help companies to investigate the effect of food on health Children’s lifestyle and obesity, food commercial dedicated to children and the relation of food and genetics on coronary diseases and obesity Children’s lifestyle and obesity: Food commercial dedicated to children Determinants and health consequences of overweight in Children from India- Extension of a European multicenter study, IDEFICS Obesity Endocrinology and metabolism that relates to many diseases such as diabetes, obesity Relation between food composition and its properties to human health, where special focus is on developing foods that inhibits bowel diseases and insulin resistance Green leaf membranes as target molecules for regulation of appetite and energy balance Lifestyle related diseases, such as obesity and age-related diabetes, to gain knowledge that will work as a basis for food design aimed at reducing risk factors for these diseases Fair practices in the food trade (i.e. labelling); Healthy eating habits Metabolic syndrome (including cardiovascular disease, type 2 diabetes and obesity) Food and health/functional foods; International marketing to consumer 36 Country Switzerland Institution The Swedish Food Federation, Svensk Dagligvaruhandel (business organisation for groceries) Tvärvetenskapligt forskningsprogram för livsmedel (Formas, VINNOVA, Li, SLF, SDH) Umeå University Programme Uppsala University Department for clinical nutrition and metabolism Formas – Multidisciplinary research 20072012 Formas – Multidisciplinary research 20082010 VINNOVA 2008-2013 Basel University Hospital Decanat Faculty of Medicine Universite de Geneve CMU, University Childrens Hospital, University Hospital Zurich Federal Office of Public Health Federal Office of Public Health Federal Office of Public Health Federal Office of Public Health Federal Office of Public Health Federal Office of Public Health FIAL (Federation of Swiss agro-food Industries) Funded by FP7 Themes/Research areas/Objectives Programme for health and nutrition statements concerning labelling and marketing of foods Food and consumer; Food and health; Safe food; Food quality and food production; The Food value-chain; Sustainable food production COST (European Cooperation in Science and Technology) Action BM0602 Analyse Monitoring-Projekte im Themenbereich Ernährung und Bewegung in der Schweiz (Analysis of monitoring projects related to nutrition and physical activity in Switzerland) Background on Food Habits Betreuung und Aktualisierung der Indikatorensammlung Ernährung und Bewegung (Supervision and Actualisation of the Collection of Indicators Nutrition and Physical Activity) 2009-2011 Data Analysis of the Blood Pressure Campaign Indikatoren-Sammlung Ernährung und Bewegung (Collection of Indicators Nutrition and Physical Activity) 2008-2009 National Programme on Diet and Physical Activity 2008-2012 European energy balance research to prevent excessive weight gain among Metabolism, including obesity-related diseases; Paediatric nutrition mapping the molecular mechanism in which obesity leads to serious public diseases Brain’s appetite regulation and the digestive tracts absorption of nutrition Sustainable Eating Children´s Way. Promoting healthy food habits among children 10-12 Children as co-researchers for healthy food Effect of lifestyle and food on obesity for children and development and validation of new innovative methods for investigating children’s Nutrition and adiposity; Appetite and satiation Adipose Tissue: A Key Target for Prevention of the Metabolic Syndrome; Advance knowledge on the pathogenesis and prevention of obesity and the specific role of adipose tissue in the development of the metabolic syndrome Critical view on monitoring projects related to nutrition and physical activity in Switzerland Consumer behaviour, decision behaviour, food habits Indicators related to nutrition and physical activity of monitoring projects in Switzerland Blood pressure in connection with the weight and the food and physical activity behaviour of the Swiss population Indicators related to nutrition and physical activity of monitoring projects in Switzerland Public health and overweight; National strategy for encouraging people in Switzerland to eat a balanced diet. Nutrition and obesity Promoting healthy behaviour in children and adolescents 37 Country Institution Geneva University Hospital Geneva University of Applied Sciences of Health School of Life Sciences and Facility Management – Zurich University of Applied Sciences SGE (Swiss Society for Nutrition) Swiss Federal Institute of Technology Zurich/ ETH Swiss Federal Institute of Technology/ EPFL Swiss Food Research Programme youth (ENERGY) Psychology and food addiction Obesity and nutritional behaviour HECTOR: Eating out - Habits, Determinants and Recommendations for Consumers and the European Catering Sector Department of Agriculture and Food Sciences; Institute of Food, Nutrition and Health Laboratory of Integrative and Systems Physiology - Nestlé Chair in Energy Metabolism Food for Life Switzerland technology platform Swiss Redcross Migration and healthy nutrition Swiss Society for Nutrition on behalf of the FOPH University of Bern Healthy Choice Label University of Fribourg, funded by the German Research Foundation University of Fribourg, funded by the German Research Foundation Binge Eating Disorder in Childhood University of Fribourg: University of Zurich Vaud University Hospital / Lausanne University Zurich University Hospital Zurich University of Applied Sciences Institute Food Technology Themes/Research areas/Objectives Institute of Social and Prevention Medicine Internet-based guided Self-Help for Overweight and Obese Patients with Binge Eating Disorder: A Multicenter, Randomized-Controlled Trial (INTERBED) Department of Medicine/Physiology, Department of Psychology Institute of Social and Prevention Medicine Dept of Clinical Nutrition, Faculty of Biology and Medicine NutriScope Enhance knowledge on eating out through evaluating out-of-home dietary pattern and identifying practices applied in European catering enterprises, including SME's to develop and evaluate strategies and concrete measures for promoting healthy out-of-home dietary choices among European consumers to exploit the use of data on out-of-home food expenditure Inform the population about healthy nutrition Prevention of diseases related to nutrition; Physiology and pathopysiology of the neuro-endocrine regulation of food intake (incl. obesity and diabetes); Consumer behaviour how regulatory proteins act as sensors for molecules of nutritional, metabolic or pharmacological origin, and translate this into altered gene expression and protein patterns affecting metabolic function Food for a healthy lifestyle (offering specific customer sectors appropriate food with the clear aim of ensuring that the easy choice is the healthy one for consumers) Prevention in the field of healthy nutrition and healthy body weight for the target group migrants Inventory of labels, feasibility study how to develop, introduce and manage a ‘healthy choice label’ in Switzerland Lifestyles and healthy behaviour; Health literacy related to nutritional behaviour Psychosocial factors in the etiology, maintenance, and natural course of binge eating in 8-13 year old children Efficacy of an internet-based guided self-help program (GSH-I) Cardiovascular and metabolic effects of soft drinks; Influence of the nutrition on body composition; Binge eating disorder and psychology Analyses on obesity and other nutritional problems in Switzerland Nutrition deficit after bariatric surgery; Nutrition and metabolism; Nutrition and physical activity Pathophysiological effect of fructose; Nutrition and lipid metabolism Implementation of measurements related to nutritional policy; Prevention of disease related to nutrition; Nutritional value declarations and influence of nutritional behaviour Promotion of healthy nutrition to reduce health expenditures related to nutrition; Optimizing parameters determining quality, safety and health along the food chain, from “farm to fork” 38 Country Turkey Institution Universities and public institutes UK Biotechnology and Biological Sciences Research Council Biotechnology and Biological Sciences Research Council/Diet and Health Research Industry Club Bristol University British Heart Foundation Cambridge MRC units Department of Environment, Food and Rural Affairs (Defra) Department of Health Department of Health Economic and Social Research Council Programme Support Programme for Scientific and Technological Research Projects Themes/Research areas/Objectives Epidemiologic Study on Diabetic, Hypertension, Obesity and Endocrinologic Diseases Psychology of food choice; Maintenance of health through diet Improved understanding of healthier diets Understanding the basis of taste, texture and flavour at a fundamental level to enable reductions in food components e.g. salt, sugar and fat levels without adversely effecting consumer response; Understanding the influence of food structure on human nutrition and physiology to enable foods to be designed with precise nutritional and physiological properties to enable a healthy diet; Understanding the methodology of satiety and investigating the role of food constituents, particularly minor food components, on energy intake via the impact on satiety Food and behaviour Department of Experimental Psychology Mapping obesity research Centre for Obesity and Related Metabolic Disease The Food Strategy 2030 Healthy Weight, Healthy Lives: A CrossGovernment strategy Reviews of evidence on childhood obesity Diet/Behaviour Food safety and hygiene regulation and governance Food Standards Agency Food Standards Agency Standing Committee on Nutrition London School of Hygiene & Tropical Medicine Medical Research Council Influence of early life nutrition on later chronic disease risk Nutritional Group Biomedical Research Unit for Nutrition, Diet & Lifestyle National Obesity Observatory National Prevention Research Initiative How consumption patterns evolve and what they indicate about future patterns; Food behaviors and information Food behaviours and information; Dietary surveys, food acceptability and choice; Healthy eating advice; Food choice inequalities; Obesity-related work to improve food choice and develop dietary recommendations (may include dietary and behaviour change interventions to prevent unhealthy weight gain) Nutrition related chronic diseases Strategic Review of Nutrition and Energy Balance Medical Research Council National Institute for Health Research Causes and prevention of diabetes and obesity; How obesity is related to insulin resistance, diabetes and cardiovascular disease Policies: Reverse the trend in diet-related disease, including obesity; Improving access for socially excluded groups; Consumers adopt healthy, sustainable diets; Clear information and advice on healthy and sustainable diets Centre for Public Health Research Excellence in Diet and Physical Activity Research priorities: Living a long and healthy life: Genetics and disease; Life course perspective; Lifestyles affecting health; Environment and health Prevention, diagnosis and treatment of ill-health related to nutrition, diet and lifestyle Surveillance data for obesity, develops data presentation tools, and undertakes evaluation of weight management interventions Establish links between lifestyle factors and disease to help individuals change behaviour 39 Country Institution National Prevention Research Initiative Programme Public Health Research programme National Prevention Research Initiative Newcastle University Reading University Rowett Institute, University of Aberdeen Scottish Public Health Network Southampton Human Nutrition Centre Human Nutrition Group University College London Health Behaviour Research Centre University College London University of Glasgow, Division of Developmental Medicine University of Leeds University of Surrey University of Surrey University of Ulster Obesity Strategy and Routemap Epidemiology Resource Centre, Institute of Human Nutrition Human Nutrition Biological Psychology Food, Consumer Behaviour and Health Research Centre Food, Consumer Behaviour and Health Research Centre Centre for Food & Health Human Nutrition Research Themes/Research areas/Objectives Evaluates whether the Royal Horticultural Society’s (RHS) ‘Campaign for School Gardening’ increases intake of fruit and vegetables in primary school children Risk factors (including obesity) of chronic heart disease, cancer and diabetes Public health nutrition Food and dietary components related to cardiovascular disease, obesity Obesity and metabolic health Environmental determinants of musculoskeletal, cardiovascular and metabolic disease throughout the lifecourse; Developmental origins of health and disease; Metabolic syndrome; Nutrition and public health Healthy lifestyles across social groups; theory and methodology in food choice research Nutrition in relation to body composition, metabolism Childhood energy balance; Diet and chronic disease; Gut, food and metabolism Feeding behaviour and appetite control consumer attitudes, perceptions and behaviour and the impact of society economics and management within the food sector and its impact on consumer choice Health psychology areas including diabetes, obesity Factors that affect the amount of food that an individual consumes, including: portion size; energy density; and, satiety. 40 41