The recommendations appear in a campaign document entitled A Unified Prevention Approach and included:

• Nutrition: Make efforts to reduce fat, sugar and salt content in food, increase supply and access to affordable fresh fruit and vegetables, ban the marketing of unhealthy food to children.
• Physical activity: Ensure children have access to physical education every day at school and improve PE facilities, set urban planning priorities for non-motorised transport and parks.
• Tobacco: Harmonise tobacco taxation across Europe, devote 80 per cent of cigarette packaging to visual health warnings, ban internet sales of tobacco and cigarette vending machines.
• Alcohol consumption: Ban alcohol advertising on television and radio, introduce uniform minimum EU taxes on alcohol and create educational programmes to raise awareness of excessive alcohol consumption.
• Human and financial costs

The report also stresses that chronic diseases place an unsustainable financial burden on health care budgets, as well as having individual human costs.

Sources: Diabetes UK and Medical News Today, 19 July 2010.

The first response to the country’s growing CVD burden was the ‘Weqaya’ Population-wide Screening Programme, launched in 2008. The screening tests were based on the core Framingham indicators with a few additions. The Framingham Risk Score was determined for the Weqaya population using the Framingham General CVD 10-year Risk Score to predict the number of CVD events in Abu Dhabi. The results generated are being used by the health sector for individual-level interventions and public health planning and for the reviewing of models of delivery of health care. The Framingham Risk Score was determined for the Weqaya population using the Framingham General CVD 10-year Risk Score to predict the number of CVD events in Abu Dhabi. In addition, the information is a key driver for the non-health sector response.

Ambitious targets for the CVD risk control programme include:

• the creation of a dramatic impact through coordinated activity of government, private, and civic sectors;
• reducing Framingham-predicted cardiovascular events by 75% over 25 years;
• make Abu Dhabi one of the healthiest environments to live in the World by 2030 and
• systematically influence decisions at the key levels involving the health as well as non-health sector, public and private.

Source: ProCor, 20 July 2010.

Food insecurity clearly has a huge impact on diet and therefore potentially on chronic diseases as eating unhealthily is a risk factor. The relationship between food insecurity and chronic disease constitute a major intertwined social problem.

Source: New England Journal of Medicine, 1 July 2010.

The paper argues that the omission of diabetes and other chronic diseases from the MDGs has created the illusion that communicable diseases seen as being the most pressing to address can be dealt with without also addressing the increasing prevalence of diabetes. However, an integrated approach is required, especially in light of the fact diabetes is associated with a three-fold increased risk of tuberculosis. Diabetes is the only major risk factor for tuberculosis that is projected to grow substantially in the coming decade, meaning that with diabetes on the rise tuberculosis control would be increasingly difficult. Approximately one in five cases of new smear-positive pulmonary tuberculosis in India is thought to be attributable to diabetes. The paper’s authors placed great emphasis on prevention, and held hope that the UN General Assembly summit on non-communicable diseases in September 2011 was evidence of ‘emerging, effective, international action for their prevention.’

For more information on the MDGs and chronic disease, see the C3 discussion paper on 3FOUR50: http://www.3four50.com/NCD-development/

Source: The Lancet, 26 June-2 July 2010.

Help 2.0 actively aimed to empower young individuals to be in control of their health and lifestyle, rather than seeing them as passive receptors of media targeting. Help 2.0’s creative strategy focused on the collection, presentation and implementation of tips, be they serious or fun, around the traditional tobacco-control themes of prevention, cessation and passive smoking.

HELP was named overall winner in the ‘Government Bodies and Related Organisations’ category, an award that recognises excellence in social marketing. The campaign has won 11 awards since its launch in 2008, including the 2008 and 2009 Empreintes Grand Prix, the 2008 Top Com Consumer marketing Grand Prix, the Cannes Lion 2008 and the Paris E-Marketing 2009 double award

Sources: European Commission, Public Health and Paper Blog, 5 May and 1 July 2010.

On the one hand, while the cyclist may benefit from increased physical activity, on the other hand the activity may increase the pollutants inhaled due to increased breathing rate. Researchers in The Netherlands evaluated the risks and benefits for both the individual who shifts from car driving to cycling and for society as a whole. In the study, the relative risks comparing car driving and cycling were derived from a hypothetical scenario based upon statistics in The Netherlands. This is important to take into account because in The Netherlands there is extensive cycling infrastructure, including restrictions on car use through traffic calming in residential areas and car-free zones, that help to facilitate regular and safer cycling. The Netherlands also is one of the safest countries for fatal traffic accidents, particularly in comparison to other European countries such as France, the United Kingdom and Spain where the risk of a fatal traffic accident for cyclists is substantially higher.

The principal finding from the study was that for those who shift mode of transport, increased rates of physical activity due to cycling resulted in around a nine times greater gain in life years than would be lost in life years due to air pollution and traffic accidents. The benefits for the society as a whole due to reduced air pollution were greater still. The beneficial effect for cyclists is three to fourteen more months gained over and above the potential mortality effect from air pollution and increase in traffic accidents.

Would these benefits be translated to other cities? The researchers repeated the traffic accident calculations for the UK, where the risk of fatality is higher. However, the overall benefits of cycling were still seven times greater than the associated risks.

In terms of using this study for interventions that encourage physical activity, policies would need to be accompanied by efforts and measures to limit risk factors that would reduce the benefits of cycling. This could include careful infrastructural choices (e.g. not placing cycling lanes in close proximity to major roads to reduce inhalation of pollutants) and by managing car traffic through limitations or bans in certain areas. If concerned about the increasingly common obesogenic environments in which large proportions of populations live, urban planners and those working in policy related to the built environment should think carefully about how to integrate accessible and safe cycling infrastructure into cities.

Source: Environmental Health Perspectives, 30 June 2010.

Douglas Smallwood, chief executive of Diabetes UK, said the findings were ‘truly alarming’, particularly in light of the fact that ‘Avoidable in so many cases, the Type 2 diabetes epidemic is a clear example of where the new government’s rhetoric of tackling health problems through prevention must be turned into action.’ He warned that failure to take action and push preventative measures would result in a ‘bleak future’ for public health and incur great costs to the National Health Service.

Source: StaffNurse.com, 30 June 2010.

Research published in the New England Journal of Medicine has added to evidence that school can have a positive impact on children’s health. Through encouraging healthy eating and improving physical education classes, levels of obesity can be reduced. Obesity is a key risk factor for type 2 diabetes, and this study focused particularly on whether the risk factors for the condition could be reduced.

The study was carried out by UC Irvine, focused on schools with at-risk, high-ethnic-minority populations, as type 2 affects minorities and those on a low-income disproportionally. Out of the 42 schools involved in the research, half were chosen at random to undertake the study’s programme of longer PE classes and access to more nutritional food, as well as separate education and awareness campaigns that encouraged healthy behaviour. At the start of the study, almost half of the children in the intervention group were overweight or obese, 16 per cent had high blood glucose levels, and nearly 7 per cent had elevated fasting insulin levels, all of which are risk factors for developing type 2 diabetes. At the end, the children who had been identified as being at risk had a 21 per cent lower rate of obesity than children in the control schools. The children on the programme also had lower average levels of fasting insulin.

Source: Diabetes.co.uk, 30 June 2010.

In the past year, levels of obesity in the United States have steadily increased, with rates rising in 28 states. According to a report released this week entitled ‘F as in Fat: How Obesity Threatens America’s Future 2010’, eight states have obesity rates of more than 25 percent, and nearly a third of American children are classified as obese. The results highlight the worsening of the problem of obesity in America. In 1991, no state in the country had obesity rates higher than 20 per cent; now, Colorado is the only one that has an adult obesity rate of less than 20 per cent.

There are serious issues around the perceptions of obesity, a separate poll conducted by Greenberg Quinlan Rosner Research and American Viewpoint has found. While 80 per cent of Americans realised that childhood obesity is increasing  and one-third of American children are obese, 84 per cent of parents said they thought their own children were at a healthy weight. This disparity between perception and reality poses a big challenge in tackling obesity.

There are also racial and class gaps in obesity rates. More blacks and Hispanics were obese in 40 states, and more than one-third of adults who earned less than $15,000 per year were obese compared with 24 per cent who made $50,000 or more.

Source: The Washington Times, 29 June 2010.

Among the projects to be launched in 2010 are research initiatives on:

• Preventing diabetes among urban youth in Kenya
• Seeking synergy between school and community (developing and testing innovative participatory approaches to health promotion)
• Diabetes and obesity – integrating frontiers in epidemiology, medicine and education
• The workplace as a setting for prevention

Lise Kingo, executive vice president at Novo Nordisk, commented: ‘The fact that the new centre will do research in both prevention and patient education while at the same time being able to study the results in clinical practice – that is fantastic. You don’t see that in many other places.’

The centre is expected to have 15–20 employees by the end of 2010.

Sources: Press release and website.