EPODE methodology, education in
nutrition & childhood obesity
prevention
Jean-Michel BORYS, MD
EPODE European NETWORK Director
Paris
jmborys@proteines.fr
EIN Seminar, BRUXELLES Nov 2011
EPODE
Introduction
 EPODE was developed to upscale the encouraging results from a
pilot study(1) conducted in Northern France between 1992 and
2004 (FLVS)
 EPODE (Together let’s prevent childhood obesity) launched in 10
French pilot towns involved in 2004, today more than 500
communities are involved
 With the support of the EC-DG SANCO, launch of the EPODE
European Network (2008-2011) to facilitate the implementation
of the EPODE methodology in Europe (2)
 Today, EPODE International Network’s global mission is to
reduce childhood obesity prevalence through sustainable
strategies built on Community Based Programmes (CBPs).
(1)
(2)
Romon & Al., Public Health Nutrition, 2009; 12: 1735–1742
Borys & Al. Preventing Childhood Obesity, Lavoisier, 2011, 266p.
EPODE Methodology
at a glance
 EPODE is a coordinated, capacity-building approach
for communities
 EPODE’s goal is to enable community stakeholders to
implement effective and sustainable strategies to prevent
childhood obesity at the local level
 By changing the social lifestyle norms and behaviours
especially in the field of nutrition and physical activity
 Encouraging changes in the local environment to be
less obesogenic
In each country/region a multilevel and multi-stakeholder
approach
5
EPODE Results
17,8% 18,0% Pilot Study (1) Sample size= 804
 The mobilisation of the
whole community (20002004) is the key to
decrease the obesity
prevalence in children.
Overweight
(including obesity)
Rate %
In first EPODE towns (2) Sample size = 23617
 EPODE results
after 5 years of
implementation
16,0% P < 0,0001
14,0% 14,3% 12,6% Comparison towns FLVS towns 12,0% 10,0% 11,4% 8,8% 8,0% 1992 21,0% 2000 2004 20,6% 20,5% P < 0,0001
20,0% 19,5% 19,0% 18,8% Overweight
(including obesity)
Rate %
18,5% 18,0% 2005 2009 6
(1) Romon M. & Al., "Downward trends in the prevalence of childhood overweight in the setting of 12-year school- and community-based programmes",Public Health Nutr. 2008 Dec 23:1-8.
(2) Romon M, Duhamel A, Salleron J, Lommez A, Meyer J, Borys JM. Évolution de la prévalence du surpoids et de l’obésité chez les enfants de 4 à 11 ans entre 2005 et 2010 dans les villes « EPODE ». Nutrition
clinique et métabolisme. 2010;24(S1):58.
EPODE Pilot study 2/2
• The pilot study shows not only that we are able to decrease the
obesity prevalence in children but also the inequality of obesity
prevalence between the upper and lower SES populations
CT
FLVS
26.9
16.9
5.6
5.7
Upper SES
NS
7.0
Middle SES
p<0.01
Sample size = 804
(1)
15.2 15.2
Romon & Al., Public Health Nutrition, 2009; 12: 1735–1742
Lower SES
p<0.01
Evolution of the number of towns
involved in EPODE programs in EUROPE
VIASANO - Belgium
EPODE - France
250
226
16
200
15
167
150
127
13
10
100
50
20
5
2
10
0
0
2004
2006
2008
2004
2010
THAO - Spain
50
32
20
5
2006
2010
13
5
2
0
0
2004
14
12
10
8
6
4
30
10
2008
PAIDEIATROFI - Greece
42
40
2006
2008
2010
2004
2006
2008
2010
EPODE Outreach
• Over 500 cities
• In 8 Countries
• Helping 20 Million
people
• EPODE European
Network involving 4
major universities
• EPODE
INTERNATIONAL
NETWORK’s
objective: 40
programmes &
countries involved
by 2015
9
Sustainable resources
(central level)
– At central level, to secure the funding of central support
services, evaluation and local implementation.
– The funding could be public and/or private (PPP)
10
EPODE European Network
EPODE European Network
 GOAL: European project run from 2008 to 2011 to enrich the EPODE methodology
and facilitate the implementation of EPODE-similar programmes in other
European countries
 Supported by the Directorate General for Health and Consumers of the European
Commission
 Support from private partners and involvement of 4 Major European Universities
EEN book of recommendations and
EPODE Paper in Obesity Reviews
Reference
 Preventing Childhood Obesity, EPODE European
Network Recommendations. Borys JM, Le Bodo Y, De
Henauw S, Moreno LA, Romon M, Seidell JC, Visscher
TLS. Lavoisier. Paris. 2011. ISBN: 978-2-7430-1383-7
Reference
EPODE approach for childhood obesity prevention:
methods, progress and international development= obr
in press
 JMB (S. Jebb (UK), J. Seidell (NL), B. Swinburn (AUS), D.
Richard (CAN), C. Summerbell (UK)) and the Chairs of
the EEN committees
EPODE International Network
Mission & Targeted Aim
EPODE International Network’s mission is
to reduce childhood obesity prevalence through sustainable
strategies based on Community Based Programmes (CBPs)
Targeted & measurable aim
By 2015, the aim is to mobilise key stakeholders in more than
20 countries on 5 continents and support 40 large-scale CBPs involving more than 400 million people worldwide
15
Members of EPODE International Network
1. Active Members with voting right:
-Existing or new large scale and sustainable Community-based
Programmes aimed at preventing obesity and/or NCDs
1. Observer Members:
-Leading scientific experts involved in obesity & NCDs prevention
-Public and Political representatives and policy makers
-Civil Society Organisations representatives
-Corporate sector including food industry
16
Targeted Results
1.
Mobilization of 20 countries by 2015
2.
By 2015 increase the number of EIN member CBPs to more than 40 large-scale
programmes from around the globe - involving 400 million people worldwide
3.
Greater awareness and visibility of EPODE and similar CBPs around the world
4.
Greater dialogue between all the multistakeholders at the global level
5.
Greater practice sharing: experience and materials
6.
Optimised evaluation frameworks for optimised results (decrease in prevalence, decrease in
BMI in countries around the world)
7.
Increased number of Scientific Publications presenting outputs and outcomes,
opportunities and challenges of CBPs for the benefit of the member CBPs around
the globe
Optimised sustainability of
non-stigmatising obesity prevention
17
Contacts and websites
www.epode-international-network.com
www.epode-european-network.com
18
Thank you