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Supporting the most vulnerable groups so that all people living in the WHO European Region have the benefits of an affordable, healthy diet and an active life at a time of limited resources is an ethical imperative.

It is based on ongoing and related work at regional level, notably in the areas of environmental health, physical activity, healthy ageing, child and adolescent health and continuing efforts to ensure food safety in the European Region.

Furthermore, in , ministers of countries of the European Region adopted the Vienna Declaration on Nutrition and Noncommunicable Diseases in the Context of Health , which calls for decisive, concerted action.

It acknowledges that strategies to improve dietary health require government-led action in a broad range of areas and should be informed by increasing evidence of the efficacy of a comprehensive response incorporating a core set of policies.

It also recognizes that successful adoption and implementation of these policies requires continuing emphasis on health-in-all-policies and whole-of-government approaches for the creation of healthy and sustainable food systems, in line with the European Health strategy.

Therefore, much of what is required lies outside the health sector. As social and economic factors strongly contribute to unhealthy diets and poor nutrition, population-wide strategies, policies and targeted interventions are required by governments, with a strong role for health ministries.

This will help ensure that the environments in which we live support and encourage healthy patterns of consumption and healthy diets.

During implementation of this Action Plan, WHO will continue to support, stimulate and provide strategic advice to Member States on nutrition and health in the context of Health , thereby contributing towards the overall goal of achieving a sustainable, healthy life for all.

The policies and tools to support implementation described in this Action Plan are relevant to all countries in the Region, but retain flexibility in design and are adaptable to national contexts, existing legislation and the important cultural dimensions of nutrition.

This Action Plan contains recommendations for innovative evidence-based policies and tools that are priorities for tackling malnutrition in all its forms, including the development of common approaches to respond to common regional challenges.

Member States will work together through these effective approaches to promote healthy diets and dietary patterns by addressing priorities such as excessive intake of energy, saturated fats and trans fats, sugar and salt, and inadequate consumption of vegetables, fruits and whole grains.

Simultaneously, Member States will work to reduce energy, protein and micronutrient deficiencies and unacceptable levels of food and nutrition insecurity for certain vulnerable populations, such as older people, pregnant women and populations of low socioeconomic status.

Experience with national nutrition policies in the WHO European Region has shown the intrinsic value of having shared or common tools and a focus on knowledge translation and transfer.

In addition, comprehensive monitoring mechanisms are important to identify trends and to measure the impact of policies over time, so that accountability for health and equity is ensured.

Within this Action Plan, Member States will also work together with the support of the WHO Regional Office to develop common tools, share experiences, improve the availability of data and enhance capacity for monitoring and surveillance, including assessment of implementation and the impact of policies.

In order to accelerate progress to resolve malnutrition in all its forms, food and nutrition strategies must also address governance.

Following the guidance on governance provided by Health , government leaders and policy-makers should establish governance mechanisms that safeguard the integrity of effective policy-making, but also mobilize political commitment to reduce malnutrition through intersectoral cooperation among government departments, national and local institutions, experts, civil society and, where appropriate, the private sector.

Multifaceted cross-government approaches can secure political involvement, define the roles and responsibilities of different parts of government and facilitate agreement on shared goals, objectives and agendas.

Engagement with the private sector is needed, given its role in food production, distribution and retail; however, such engagement should be related to the core activities of the stakeholders and be set within the context of standards and incentives established by the government in order to meet nutrition and health goals; care must be taken to avoid conflicts of interest in policy-making.

Healthy diets will also contribute to existing voluntary global targets on maternal, infant and child nutrition.

Vision Mission To achieve universal access to an affordable, balanced, healthy diet, with equity and gender equality in nutrition for all citizens of the WHO European Region through intersectoral policies in the context of Health Strategic goals To avoid premature deaths and significantly reduce the burden of preventable diet-related NCDs, overweight, obesity and all other forms of malnutrition still prevalent in the WHO European Region, which are strongly influenced by social determinants of health and have a profound negative impact on well-being and quality of life.

This goal will be achieved by taking integrated, comprehensive action in a range of policy areas through a whole-of-government, health-in-all-policies approach.

The Action Plan is intended to support the coordinated, comprehensive implementation of national strategies, action plans and policies for improving food system governance, minimizing nutritional risk factors and reducing the prevalence of diet-related diseases, with an emphasis on integration throughout life.

Furthermore, it will provide overall direction for the development, expansion and consolidation of sound, feasible action.

Scope The Action Plan focuses on food and nutrition as the leading factors in health and wellbeing in the European Region, with particular attention to the associated burden of NCDs.

It covers all forms of malnutrition, including overweight and obesity, throughout the life-course. Guiding principles Reduce inequalities in access to healthy food, as stated in Health A reduction in social inequalities will contribute significantly to health and well-being, including nutritional status and diet-related outcomes.

The causes of inequality are complex and deeply rooted, reinforcing disadvantages and vulnerability throughout the life-course and across generations.

Health and the Vienna Declaration both reflect an increasing will to tackle poor nutrition and unhealthy diets in countries and throughout the Region, particularly among the most vulnerable groups.

Tackling avoidable inequalities in diet and achieving universal access across social gradients age, gender, ethnicity, disability or socioeconomic position will be necessary to achieve the best results and will support human capital and the economy in all Member States at a time of limited resources.

Policies that have the effect of improving the availability, affordability and acceptability of healthy diets for the most vulnerable groups thereby influencing the accessibility of healthy diets can contribute to reducing their risks for disease and, in tandem with policies in other areas, may help to close the gap.

When devising policies and taking action to implement them, consideration should be given to the impact on inequalities.

Ensure human rights and the right to food Proper nutrition and health are internationally recognized as fundamental human rights.

Respect for and the promotion and protection of human rights are integral to effective prevention and control of malnutrition and diet-related NCDs and strategies must be formulated and implemented accordingly.

Achieving the right to food, which is now guaranteed by the constitutions of many countries, requires sustainable, equitable, accessible, resilient food systems that ensure comprehensive food and nutrition security and the supply and consumption of foods that provide nutrition for health and the prevention of NCDs.

The focus should be on addressing the determinants of food and nutrition security sustainable and adequate supplies; hygienic, consistent quality; widespread availability, affordability and accessibility and also determinants of consumer choice and consumption patterns.

People and communities should be empowered and involved in the prevention and treatment of malnutrition and diet-related NCDs, including through policies to create healthy food environments and ensure the protection of consumer rights.

Particular consideration should be given to participatory approaches, to engage the public and leverage their support for action on these issues.

Promote a life-course approach This approach is key to the prevention and control of diet-related NCDs and malnutrition in all its forms.

The approach starts by addressing maternal nutritional status and health before and during pregnancy and continues with proper infant feeding practices, including promotion of breastfeeding.

Action to encourage healthy diets for children, adolescents and young people is reinforced and sustained by promotion of a healthy diet during the working life, nutrition for healthy ageing and nutritional care for elderly people with diet-related NCDs and micronutrient deficiencies.

It also includes nutritional care for patients with disease-related nutritional problems. Use evidence-based strategies Strategies for the prevention and control of diet-related NCDs, overweight, obesity and all other forms of malnutrition, including micronutrient deficiencies, must be based on the best available scientific evidence and public health principles and should be free from conflicts of interest.

The main emphasis should be on implementing evidence-based actions, taking further steps from the development and sharing of good practices to institutionalized, scaled-up implementation of effective measures.

Special attention should be given to knowledge translation and exchange. Time frame Furthermore, the Regional Office will support Member States by preparing specific tools and technical guidance on policy development, with input from Member States, including meetings of the WHO knowledge and action networks and online consultations.

The Regional Office will submit an interim progress report in This framework will be used by the Regional Office for Europe, in cooperation with Member States, to assess progress in implementing the recommendations contained in this Action Plan.

Member States should develop or expand, according to the national context, strategies and action plans that address the Action Plan objectives, which are closely aligned with the Vienna Declaration on Nutrition and Noncommunicable Diseases in the Context of Health Due consideration should be given to incorporating or adapting as necessary the priority policy actions and tools proposed.

Create healthy food and drink environments Adopt strong measures that reduce the overall impact4 on children of all forms of marketing of foods high in energy, saturated fats, trans fats, sugar or salt.

Ensure adequate provision for independent monitoring and evaluation to assess whether they achieve this objective. Use common tools in the context of policies to reduce marketing to children of foods high in energy, saturated fats, trans fats, sugar or salt, such as nutrient profiling.

Consider economic tools, including supply chain incentives, targeted subsidies and taxes, to promote healthy eating, with due consideration to the overall impact on vulnerable groups.

Promote, through government leadership, product reformulation, improvements to the nutritional quality of the food supply, use of easy-to-understand or interpretative, consumerfriendly labelling on the front of packages and healthy retail environments.

Engage in cross-government collaboration to facilitate healthier food choices in settings such as schools, kindergartens, nurseries, hospitals, public institutions and workplaces, including by setting standards.

Examples might include school nutrition policies, such as school fruit schemes, and nutrient- and food-based standards for foods available in public institutions, which can contribute to reducing inequalities.

Promote the gains of a healthy diet throughout the life-course, especially for the most vulnerable groups Invest in nutrition at the earliest possible stage, before and during pregnancy, including protecting, promoting, supporting and addressing barriers to adequate breastfeeding, while providing for appropriate complementary feeding.

Improve the ability of citizens to make healthy choices, taking into account the needs of different age groups, genders and socioeconomic groups, through multicomponent initiatives to improve food and health literacy and enhance food and nutrition skills.

Pre-school and school settings represent excellent entry points, but attention should also be given to opportunities to reach the active and working-age population.

Encourage the use of social media and new techniques to promote healthy food choices and healthier lifestyles. Adopt tools and strategies to address the special nutrition needs of vulnerable groups, including older people, for both those living in the community and those in care.

Reinforce health systems to promote healthy diets Ensure that all health care settings remain committed to health promotion and that nutrition and healthy eating are priorities in people-centred health and social care systems, including brief interventions and nutrition counselling in primary health care settings.

Ensure universal health coverage for preventable and treatable diet-related problems, with a continuum of high quality nutrition services and appropriately qualified and resourced health professionals, ranging from health promotion and prevention to hospital services and care.

Establish nutritional assessment and intervention procedures in the most relevant settings for different age groups, especially children and the elderly, including primary health care and home care services.

Support surveillance, monitoring, evaluation and research Consolidate, adjust and extend existing national and international monitoring and surveillance systems, such as the Childhood Obesity Surveillance Initiative and the Health Behaviour in School-aged Children study.

Establish and maintain nutrition and anthropometric surveillance systems for nutritional risk factors, which allow disaggregation by socioeconomic status and gender, and establish and expand food composition databases as a priority.

Make effective, proper, good use of available data, including through knowledge translation and transfer, to inform policy-making.

Monitor and evaluate diet-related activities, interventions and policies in different contexts in order to determine their effectiveness and to disseminate good practice.

Strengthen governance, intersectoral alliances and networks for a health-in-all-policies approach Strengthen coordinated action at different administrative levels and across government departments to ensure coherence among all policies that influence food systems and the food supply, with a view to promoting, protecting or reinstating healthy and sustainable diets high in vegetables, fruit and whole grains, with limited intake of saturated fat, trans fats, sugar and salt.

Some diets in parts of Europe are consistent with the characteristics of a healthy diet, notably the Mediterranean diet5 and the new Nordic diet.

Support mechanisms that enhance multistakeholder action and empower communities at local and regional levels, such as Healthy Cities, the Schools for Health in Europe network and other initiatives, taking care to avoid conflicts of interest.

Opportunities to leverage the power of local action should be used, including planning and short supply chain approaches such as farmto-school programmes.

Participate in and support networks of countries, such as the European Salt Action Network and the European Network on reducing marketing pressure on children.

Establish strong measures to reduce the overall impact on children of all forms of marketing of foods high in energy, saturated fat, trans fats, sugar or salt.

The leading categories of food being advertised are high in energy, saturated fats, trans fats, sugar or salt, such as breakfast cereals, sugar-sweetened beverages and confectionary.

At present, television remains the dominant medium for promotional marketing of foods and beverages, but it is only one of many media, including the Internet and social networks, through which advertisers are now able to promote products, build brand awareness and generate consumer loyalty in a more integrated approach.

The WHO framework for implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children provides guidance to Member States on policy design and implementation.

The Regional Office will continue to support Member States in this area. Experience suggests that self-regulatory, voluntary approaches have loopholes and government leadership is required to establish the criteria for policy and for independent monitoring to achieve optimal implementation and ensure progress in strengthening and expanding controls over time.

Independent complaints procedures and sanction mechanisms are also required to protect the rights of children and consumers in this regard.

Schools and other settings in which children gather should be free from all marketing of foods high in energy, saturated fats, trans fats, sugar or salt.

Member States, with support from WHO, may consider developing monitoring frameworks to assess the extent of marketing in their country.

Aanstaande Zaterdagmiddag zitten we op het Neude in een soort terrarium. Kom maar kijken En aanstaande zondagavond tussen 21 en 22 uur ben ik te gast bij de Chinese Radio Amsterdam.

Ik zal dan in het engels spreken over dit project. But can still use some help! Stiekem droom je dat iedereen zo'n pracht film meteen omarmd en dat het dan van zelf gaat.

Een mens heeft het druk en heeft veel keuzes. Desalniettemin is het een interessant proces om dit te doen. Als ik bijvoorbeeld allemaal bedrijven via riool.

Kan dus nog wat vergaderingen duren De film speelt zich immers af in het riool, dus leek mij een mooie link. Notabenen zullen dergelijke bedrijven zelden voor cultuur benaderd worden, was mijn gedachte.

Een andere sponsoring bron die ik nu aanboor is de wereld van Nederland-China bedrijven. De film zal immers vaak in China te zien zijn.

Maar ik kan natuurlijk ook nog andere donaties gebruiken, alles is welkom! Niet te lang wachten, want de teller moet echt stuk hoger komen.

Oude romaanse munt gevonden in het allereerste riool systeem van onze beschaving de cloaca maxima. I'm going to write something slightly different here then above.

It's really great to have this support from the US where crowd funding is much more developed then here in Europe.

I had no idea it was such a hard work. I'm now focussing on two kinds of businesses to approach for sponsoring this movie.

Large companies in the field of sewers, the setting of my film and companies with strong china ties. We will see what happens.

It's a slow process. If you have any idea's please let me know, it will be highly appreciated. There's been some media coverage but only dutch websites so far.

An Animation by Serge Onnen. Crowdfunding teaser:. In short Cloacinae is the name of the roman goddess of the first sewer of modern civilization, the cloaca maxima, in Rome.

What's so special about this project? Visual arts and animation As a visual artist animation takes an important role in my work. Irritating money The 1 cent coin has interested me for a number of years.

If everything goes well the film can be released early Quote that inspired the maker Every modern society is built on two invisible man made systems.

When something goes wrong with any of these, our civilization is in danger. Serge Onnen. Miranda Lambert is my favourite US contry singer.

She is young, beautiful and charming woman in her 30s. Her strong voice takes me away from all troubles of this world so I can enjoy my life and listen songs created by her.

The concerts scheduled for this year, up to the 23th of November. Tickets are available for all men and women with different income.

If you are a country music lover as me, then you must visit at least one Miranda's concert. Open the website and make yourself familiar with all powerful Miranda Lambert concerts in !

Breaking Benjamin is my favourite band of 90s. Breaking Benjamin had so many hit songs! These are real masterpieces, not garbage like today!

And it is sooo good that Breaking Benjamin have a tour in ! And I'm going to visit Breaking Benjamin concert in Check it out and maybe we can even visit one of the performances together!

Chris Stapleton is my favourite country singer. His strong voice takes me away from all troubles of this planet and I can enjoy my life and listen songs created by his.

The concerts scheduled for this year, up to the November 2. If you love country music as mush as I, then you must visit at least one Chris' concert.

Visit the website and make yourself familiar with all Chris Stapleton concerts in ! And Bye. Florida Georgia Line is my favourite country music band.

Headliners Brian Kelley and Tyler Hubbard are those guys that could make anyone sing along. It's the reason I like to attend their concerts.

Leave a comment for the filmmaker! Only logged in users can post comments. Log in. Confucius Instituut co-producent Cloacinae and other news.

Cloacinae nieuws. Dear friends of Cloacinae, I'm going to write something slightly different here then above. This project was successfully funded on So a thousand thanks to you!

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The focus should be on addressing the determinants of food and nutrition security sustainable and adequate supplies; hygienic, consistent quality; widespread availability, affordability and accessibility and also determinants of consumer choice and consumption patterns.

People and communities should be empowered and involved in the prevention and treatment of malnutrition and diet-related NCDs, including through policies to create healthy food environments and ensure the protection of consumer rights.

Particular consideration should be given to participatory approaches, to engage the public and leverage their support for action on these issues.

Promote a life-course approach This approach is key to the prevention and control of diet-related NCDs and malnutrition in all its forms.

The approach starts by addressing maternal nutritional status and health before and during pregnancy and continues with proper infant feeding practices, including promotion of breastfeeding.

Action to encourage healthy diets for children, adolescents and young people is reinforced and sustained by promotion of a healthy diet during the working life, nutrition for healthy ageing and nutritional care for elderly people with diet-related NCDs and micronutrient deficiencies.

It also includes nutritional care for patients with disease-related nutritional problems. Use evidence-based strategies Strategies for the prevention and control of diet-related NCDs, overweight, obesity and all other forms of malnutrition, including micronutrient deficiencies, must be based on the best available scientific evidence and public health principles and should be free from conflicts of interest.

The main emphasis should be on implementing evidence-based actions, taking further steps from the development and sharing of good practices to institutionalized, scaled-up implementation of effective measures.

Special attention should be given to knowledge translation and exchange. Time frame Furthermore, the Regional Office will support Member States by preparing specific tools and technical guidance on policy development, with input from Member States, including meetings of the WHO knowledge and action networks and online consultations.

The Regional Office will submit an interim progress report in This framework will be used by the Regional Office for Europe, in cooperation with Member States, to assess progress in implementing the recommendations contained in this Action Plan.

Member States should develop or expand, according to the national context, strategies and action plans that address the Action Plan objectives, which are closely aligned with the Vienna Declaration on Nutrition and Noncommunicable Diseases in the Context of Health Due consideration should be given to incorporating or adapting as necessary the priority policy actions and tools proposed.

Create healthy food and drink environments Adopt strong measures that reduce the overall impact4 on children of all forms of marketing of foods high in energy, saturated fats, trans fats, sugar or salt.

Ensure adequate provision for independent monitoring and evaluation to assess whether they achieve this objective. Use common tools in the context of policies to reduce marketing to children of foods high in energy, saturated fats, trans fats, sugar or salt, such as nutrient profiling.

Consider economic tools, including supply chain incentives, targeted subsidies and taxes, to promote healthy eating, with due consideration to the overall impact on vulnerable groups.

Promote, through government leadership, product reformulation, improvements to the nutritional quality of the food supply, use of easy-to-understand or interpretative, consumerfriendly labelling on the front of packages and healthy retail environments.

Engage in cross-government collaboration to facilitate healthier food choices in settings such as schools, kindergartens, nurseries, hospitals, public institutions and workplaces, including by setting standards.

Examples might include school nutrition policies, such as school fruit schemes, and nutrient- and food-based standards for foods available in public institutions, which can contribute to reducing inequalities.

Promote the gains of a healthy diet throughout the life-course, especially for the most vulnerable groups Invest in nutrition at the earliest possible stage, before and during pregnancy, including protecting, promoting, supporting and addressing barriers to adequate breastfeeding, while providing for appropriate complementary feeding.

Improve the ability of citizens to make healthy choices, taking into account the needs of different age groups, genders and socioeconomic groups, through multicomponent initiatives to improve food and health literacy and enhance food and nutrition skills.

Pre-school and school settings represent excellent entry points, but attention should also be given to opportunities to reach the active and working-age population.

Encourage the use of social media and new techniques to promote healthy food choices and healthier lifestyles. Adopt tools and strategies to address the special nutrition needs of vulnerable groups, including older people, for both those living in the community and those in care.

Reinforce health systems to promote healthy diets Ensure that all health care settings remain committed to health promotion and that nutrition and healthy eating are priorities in people-centred health and social care systems, including brief interventions and nutrition counselling in primary health care settings.

Ensure universal health coverage for preventable and treatable diet-related problems, with a continuum of high quality nutrition services and appropriately qualified and resourced health professionals, ranging from health promotion and prevention to hospital services and care.

Establish nutritional assessment and intervention procedures in the most relevant settings for different age groups, especially children and the elderly, including primary health care and home care services.

Support surveillance, monitoring, evaluation and research Consolidate, adjust and extend existing national and international monitoring and surveillance systems, such as the Childhood Obesity Surveillance Initiative and the Health Behaviour in School-aged Children study.

Establish and maintain nutrition and anthropometric surveillance systems for nutritional risk factors, which allow disaggregation by socioeconomic status and gender, and establish and expand food composition databases as a priority.

Make effective, proper, good use of available data, including through knowledge translation and transfer, to inform policy-making.

Monitor and evaluate diet-related activities, interventions and policies in different contexts in order to determine their effectiveness and to disseminate good practice.

Strengthen governance, intersectoral alliances and networks for a health-in-all-policies approach Strengthen coordinated action at different administrative levels and across government departments to ensure coherence among all policies that influence food systems and the food supply, with a view to promoting, protecting or reinstating healthy and sustainable diets high in vegetables, fruit and whole grains, with limited intake of saturated fat, trans fats, sugar and salt.

Some diets in parts of Europe are consistent with the characteristics of a healthy diet, notably the Mediterranean diet5 and the new Nordic diet.

Support mechanisms that enhance multistakeholder action and empower communities at local and regional levels, such as Healthy Cities, the Schools for Health in Europe network and other initiatives, taking care to avoid conflicts of interest.

Opportunities to leverage the power of local action should be used, including planning and short supply chain approaches such as farmto-school programmes.

Participate in and support networks of countries, such as the European Salt Action Network and the European Network on reducing marketing pressure on children.

Establish strong measures to reduce the overall impact on children of all forms of marketing of foods high in energy, saturated fat, trans fats, sugar or salt.

The leading categories of food being advertised are high in energy, saturated fats, trans fats, sugar or salt, such as breakfast cereals, sugar-sweetened beverages and confectionary.

At present, television remains the dominant medium for promotional marketing of foods and beverages, but it is only one of many media, including the Internet and social networks, through which advertisers are now able to promote products, build brand awareness and generate consumer loyalty in a more integrated approach.

The WHO framework for implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children provides guidance to Member States on policy design and implementation.

The Regional Office will continue to support Member States in this area. Experience suggests that self-regulatory, voluntary approaches have loopholes and government leadership is required to establish the criteria for policy and for independent monitoring to achieve optimal implementation and ensure progress in strengthening and expanding controls over time.

Independent complaints procedures and sanction mechanisms are also required to protect the rights of children and consumers in this regard.

Schools and other settings in which children gather should be free from all marketing of foods high in energy, saturated fats, trans fats, sugar or salt.

Member States, with support from WHO, may consider developing monitoring frameworks to assess the extent of marketing in their country. These frameworks should also capture the impact of policies or regulations in terms of reducing the overall impact on children power and exposure of all forms of marketing of foods high in energy, saturated fats, trans fats, sugar or salt.

Such a framework might also clarify the potential impact of cross-border marketing. Develop and adopt approaches to nutrient profiling for the purposes of restricting the marketing to children of foods high in energy, saturated fats, trans fats, sugar or salt.

Nutrient profiling has emerged as a valuable tool for policy development and implementation to promote healthier food supplies.

A nutrient profiling tool for the Region, which may be adopted or adapted according to the national context on a voluntary basis, would make clear which food products may and may not be marketed to children.

Lessons from the use of nutrient profiling in 6 Such settings include nurseries, schools, school grounds and pre-school centres, playgrounds, family and child clinics, paediatric services and all sporting and cultural activities held on these premises.

Consider the range of economic tools, including supply chain incentives, targeted subsidies and taxes, that could decrease or increase price, notably at point of purchase, and that could improve the affordability of a healthy diet and discourage the consumption of food products high in energy, saturated fats, trans fats, sugar or salt.

Due attention should be paid to the overall impact on vulnerable groups. Possible actions include creating or adjusting incentives along the food supply chain, such as through investments in production, supply chain logistics and procurement policies, in order to realign broader food system policies with public health goals and improve the availability and affordability of healthy diets.

Simultaneously, Member States might choose to introduce targeted subsidies to influence the affordability of, and thus improve access to, vegetables, fruits and whole grains, particularly for vulnerable groups.

One option might be to include subsidized fruit and vegetables in food and nutrition assistance programmes. Member States should develop monitoring frameworks to identify trends in food prices and assess the impact of these economic measures on price, availability, purchase and consumption of targeted products and potential substitutes, including the overall impact on the quality of diets.

When possible, this data should be disaggregated by gender and socioeconomic status. Promote, through government leadership, product reformulation and improvements to the nutritional quality of the food supply.

In many countries, a large majority of the population do not meet the targets for saturated fat, trans fats, sugar or salt intake, particularly groups of low socioeconomic status.

These measures should be directed at actors in the food supply chain, notably producers, processors and retailers including caterers , in order to bring about significant reductions in the levels of the target nutrients in the full range of products and in all market segments, which will contribute to a reduction in population-level consumption.

Their success depends on monitoring, stakeholder engagement and establishment of benchmarks and targets, with sophisticated population awareness initiatives.

The primary objective is to take a stepwise approach to reducing sodium content, with a view to adaptation of consumer taste preferences over time.

Sodium replacements, where necessary, must be shown to be safe. As salt reduction and salt iodization programmes are compatible, the latter should continue to be used as the most effective public health measure to counteract generalized iodine-related problems, which are still common in the WHO European Region.

WHO is preparing a salt reduction toolkit to assist Member States that are either planning to implement or are implementing salt reduction strategies in order to reach the global target.

A generalized ban would eliminate concern about potentially high intake by the most vulnerable groups but should be implemented in the context of improvements to the overall nutritional quality of food products, notably with no increase in saturated fats.

WHO will support Member States to identify policy approaches appropriate to national contexts. Increase consumer-friendly labelling by establishing easy-to-understand or interpretative front-of-package labels that help consumers to identify healthier options.

Front-of-package labelling can facilitate consumer understanding of the nutritional content of many foods, especially complex processed foods, and might also have an effect on diets by encouraging food producers and retailers to reformulate their products.

Easy-to-understand or interpretative frontof-package labelling can limit consumption of foods high in energy, saturated fats, trans fats, sugar or salt in the context of overall improvements to the nutritional quality of diets.

WHO will provide guidance on possible approaches, including best practices from the Region for defining nutrition criteria. Member States may also formulate policy measures directed at food retailers and caterers to explicitly address the availability, affordability and promotion of fruit and vegetables in these settings and simultaneously set rules for in-shop promotion of foods high in energy, saturated fats, trans fats, sugar or salt.

Decisions made by retailers about location, product selection, prices and other in-shop promotions have significant implications for diets, affecting the accessibility of food, particularly in low-income areas.

Generalize schemes to promote healthy diets, particularly in schools and public institutions. Member States are encouraged to develop or expand school nutrition policies that set nutrition- and food-based criteria for foods that are available or provided, including restrictions that limit the availability of foods high in energy, saturated fat, trans fats, sugar or salt.

Consideration should be given to developing such criteria for foods available in other public institutions. School nutrition policies should also improve the accessibility of fruit and vegetables, such as in a subsidized fruit and vegetable scheme.

Within this Action Plan, WHO and Member States consider the European Union School Fruit Scheme and other similar national schemes as examples of a broad partnership between the education, health and agriculture sectors for improving the availability and affordability of vegetables and fruits.

We recommend its extension to more schools and encourage an increase in the amount or frequency of vegetables and fruits provided.

Increase measures to protect and promote breastfeeding, including through policies and standards, supported by education about the benefits of breastfeeding.

The promotion of a healthy diet and nutrition before conception, during pregnancy and for infants and young children is critical to ensuring growth and development and also to prevent NCDs.

In this context, Member States commit to implement comprehensive monitoring of the International Code of Marketing of Breast-milk Substitutes and the Baby-Friendly Hospital Initiative or standards that are of equal or greater strictness and to strengthen the capacity of health providers and services to support optimal child feeding through appropriate training, good maternity care practices and early childhood services to promote breastfeeding.

Member States and WHO will also prepare guidance for nutrition during pregnancy, particularly in relation to nutritional status and weight gain.

Member States reaffirm the need to promote appropriate complementary feeding practices, notably by adopting national guidelines, in addition to monitoring and establishing standards for the marketing of complementary foods.

Particular attention should be paid to the importance of appropriate complementary feeding in helping to establish healthy taste preferences.

Adopt comprehensive interventions and community-based initiatives to improve nutrition and prevent overweight and obesity among pre-school and school-aged children, in addition to including nutrition and cooking skills in school curricula.

Scientific evidence has shown that the effectiveness of community- and school-based interventions in changing eating behaviour and preventing overweight and obesity depends on design; multicomponent behaviour change interventions are the most effective, especially when supported by changes to the school food environment.

Consideration should be given to interventions and initiatives that focus on food and nutrition skills for example, cooking and school gardens as these not only improve knowledge, competence and attitudes, but may amplify the impact of other policies, such as nutrition labelling, and help to reduce inequalities.

Member States should explore mechanisms to ensure longer-term sustainability and generalizability of interventions and initiatives.

Opportunities to expand the reach of behaviour change communication through social media should also be considered.

Guarantee healthy ageing and maximize healthy life years by preventing all forms of malnutrition and frailty among older people, taking into account the importance of healthy nutrition throughout life, including among the active adult population.

In order to achieve the ultimate goal of healthy, active ageing and to prevent disease, this Action Plan recognizes the need to take an intersectoral approach and build on existing WHO policy frameworks relevant to healthy and active ageing.

Specific priorities within this Action Plan may include a commitment to expand surveillance of nutritional status among older groups and to consider the food and nutritional needs of older populations living in institutions and those living in the community.

Promote gender equality by taking into account the social, cultural and biological factors that influence nutritional health outcomes and, in so doing, improve programme efficiency, coverage and equity.

The challenge of gender imbalance will be tackled by nutrition policies that include raising awareness and collecting and analysing gender-disaggregated data for nutrition policies.

Member States are encouraged to consider ways to ensure that policies and interventions are of overall benefit to all population groups, including specific targeted interventions when necessary.

Improve capacity and training for primary health care professionals, including guidance on appropriate nutrition counselling and weight monitoring and management.

Member States will prioritize and coordinate their nutrition policies with primary health care or people-centred health care policies to meet the Health principles and priorities.

Information, brief interventions and counselling about healthy diets and their influence on overall health and nutritional status will be included in care paths, with a particular focus on primary care and home care services.

Improve capacity and training for professionals in nutrition in order to secure a skilled public health workforce in addition to delivering high-quality nutrition services in health care settings.

Member States, under WHO guidance, will provide public health and health care professionals with evidence-based information on nutrition in professional education systems and through best practice examples, guidance and guidelines.

Further develop and integrate existing surveillance tools with valid, representative, comparable and preferably measured data for inferring trends.

Identify through surveillance current inequalities in risk factors and health outcomes, with a view to better targeting interventions.

WHO will play a leading role in supporting Member States to ensure that data from surveillance are accompanied by accurate analyses, interpretation and evidence-based policy recommendations.

In so doing, Member States and WHO should consider ways to engage with national experts, academic institutions and civil society.

Consolidate and enlarge the Childhood Obesity Surveillance Initiative, which is already the largest database of its kind containing comparable data, involving 25 countries in the Region and supported by the European Union.

Simultaneously, with support from WHO, Member States should consider expanding the Health Behaviour in School-aged Children study to cover a broader range of age groups.

Member States, with support from WHO, should also continue to strengthen and expand nationally representative diet and nutrition surveys and should, as a priority, establish national food composition databases.

Continue commitment to monitoring and evaluating nutrition interventions, programmes and policies to assess impact and effectiveness, including across different age groups and socioeconomic groups.

Where possible, common repositories, such as the WHO European Database on Nutrition, Obesity and Physical Activity created in collaboration with Member States and the European Union, should be promoted to provide comparable information.

This database contains surveillance data and details of more than national and subnational policies in the European Region.

Governments will consistently and coherently implement the recommendations set out in Health to improve governance for health, including nutrition.

At the same time, incentives should be aligned throughout the food system to ensure the availability and affordability of a healthy diet.

Support the development of formal mechanisms to promote cross-government cooperation, particularly for local action and, where appropriate, engage stakeholders such as civil society.

Some of the most promising initiatives for preventing overweight and obesity are based on comprehensive integrated programmes implemented at local level.

For example, Member States could encourage and support local actions, such as planning, establishment of food councils and community coalitions, and work with regional and local policy-makers in the 7 For example, emerging evidence suggests that overweight and obesity are more prevalent on some island regions than on the mainland, yet little research has been carried out to determine why this is the case.

Specific actions might include establishment of farm-to-school programmes, community gardens and kitchens.

These measures must be sustainable and equitable and therefore require leadership, with training and improved competence for local policy-makers.

They also require adequate surveillance and monitoring and sustained investment. Multisectoral collaboration, communication and community participation should be promoted to raise awareness and create an enabling environment for wider policy action.

Special consideration should be given to mechanisms to strengthen links between the agro-food, education, local government and health sectors.

WHO facilitates various action networks, such as the European Salt Action Network and the European Network on reducing marketing pressure on children, which consist of groups of countries committed to implementing specific activities.

The networks are led by volunteer countries, and the Regional Office closely follows and supports their work.

Action networks are important for sharing country experiences and exchanging policies among Member States. Bibliography A framework for implementing the set of recommendations on the marketing of foods and nonalcoholic beverages to children.

Geneva: World Health Organization; J Pediatr Gastroenterol Nutr. Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries.

The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food.

Am J Public Health. Grocery store beverage choices by participants in federal food assistance and nutrition programs.

Am J Prev Med. Andreyeva T, Luedicke J. Federal food package revisions: effects on purchases of whole-grain products.

Clin Nutr. Low nutrient intake is an essential component of frailty in older persons.

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