ABSTRACT
OBJECTIVE: To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS). DESIGN: Structured interviews using multicriteria mapping, a computer-based, decision-support tool. SETTING: Nine European countries. SUBJECTS: A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors. MEASUREMENTS: A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. RESULTS: The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important. CONCLUSION: There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.
Subject(s)
Health Education/organization & administration , Health Promotion/organization & administration , Nutrition Policy , Obesity/prevention & control , Public Policy , Advertising , Europe/epidemiology , Humans , Obesity/epidemiology , Policy Making , Public Health , Public OpinionABSTRACT
INTRODUCTION: The preliminaries of the cardiovascular diseases can be traced back to the childhood. The authors tried to find relationship between parents with early onset myocardial infarction (AMI) and incidence of risk factors for ischemic heart disease in their children as compared to respective data for families with no incidence of myocardial infarction. METHODS: The study population consisted of 38 persons with early onset AMI myocardial infarction (age < 55 y) and their 66 children, and 38 adult control subjects and their 33 children. In each person arterial blood pressure, body weight, body height, waist circumference were recorded and body mass index (BMI: kg/m2) was calculated. Eating habits and life style practices were recorded in a questionnaire in the case of each participant. Laboratory variables were determined in the blood sera as follows, glucose, triglycerides (Tg), total cholesterol (T-C), HDL-cholesterol, LDL-cholesterol, apolipoprotein-A, apolipoprotein-B, and lipoprotein (a). The atherogenic index (LDL-C/HDL-C) (LDL-cholesterol/HDL-cholesterol) was also calculated. STATISTICAL EVALUATION: Data were evaluated statistically using the SPSS for Windows 9. RESULTS: According to the mean BMI values all groups of parents belonged to the overweight category. The mean cholesterol levels of all adults were in the borderline high category. In males with early onset myocardial infarction sera concentrations of HDL-cholesterol and apolipoprotein-A were significantly lower, whereas triglyceride and atherogenic index were significantly higher than respective data for control parents. In all groups of parents, fasting mean serum glucose concentrations were higher than the reference value, serum total-cholesterol concentrations were in the borderline high category. In the daughter of the parents with early onset myocardial infarction had a higher atherogenic index than that of controls. Eating habits did not essentially differ between case vs. control families. Consumption of milk, dairy products, fruit and vegetables was insufficient in each group. Incidences of smoking for parents and children were 55% and 35% in the myocardial infarction group and 44% and 37% in the control group, respectively. Physical activity was completely insufficient in each group studied. CONCLUSION: Since no considerable differences were seen between the case vs control families in the parameters tested, therefore it is presumed that the offspring born to parents with or without early onset myocardial infarction are at equal risk to develop cardiovascular diseases unless lifestyle practices are profoundly changed.