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Commercial Determinants of Noncommunicable Diseases in the WHO European Region

This report highlights the substantial impact of commercial determinants on noncommunicable diseases (‎NCDs)‎ in the WHO European Region. Nearly 7500 deaths per day in the Region are attributed to commercial determinants, such as tobacco, alcohol,processed food, fossil fuels and occupational practices. These commercial products and practices contribute to 25% of all deaths in the Region. The report’s chapters systematically explore various facets of how commercial interests exacerbate NCDs and key strategies used by commercial actors to negatively influence NCD-related policies at the national and international level. The reportalso provides selected case studies from the Region to illustrate key strategies and outcomes of industry influence on health policies.The report then calls for urgent and coordinated action to address the commercial determinants of NCDs. It advocates for building coalitions based on the values of equity, sustainability, and resilience. Public health actors are urged to develop competencies in economic and legal frameworks, enforce transparency, and manage conflicts of interest effectively. The report underscores the need for robust financial reforms and strict regulation to curb industry power and protect public health. By implementing these strategies, the Region can accelerate progress towards global NCD targets and Sustainable Development Goals by 2030.

Guidelines for the Prevention and Treatment of Obesity (2024)

Version 5 of the German guidelines for the prevention and treatment of obesity. These evidence-based guidelines are intended for all professionals involved in treating and preventing obesity.

JA PreventNCD

Joint Action to Prevent Non-Communicable Diseases and Cancer (JA Prevent NCD) is a three year project funded by the EUforHealth 2021-2027 programme. It is designed to reduce the burden of cancer and NCDs across Europe by supporting member states (22 EU member states and Iceland, Norway, and Ukraine) to implement effective prevention strategies by focusing on both personal and societal risk factors. The project aims to reduce fragmentation and duplication of actions.

National Education and Communication Strategy on Diabetes Mellitus

The aim of this strategy is to systematise, strengthen, and consolidate diabetes prevention in Germany by developing and implementing quality-assured and evidence-based education and information programs.

National Cycling Plan 2020 "Ride your bike!" (Nationaler Radverkehrsplan 2020 "FahrRad!")

The National Cycling Plan aims at highlighting cycling opportunities within the framework of an integrated transport policy. The main objective of the plan is to initiate new methods and implementation strategies for the promotion of cycling in Germany. The plan provides recommendations for action and aims at contributing towards creating a bicycle-friendly environment.

Annex III to Regulation (EC) No 1925/2006 of the European Parliament and of the Council as regards trans fat, other than trans fat naturally occurring in fat of animal origin

Measures to limit or virtually eliminate industrially-produced trans fatty acids in food intended for the final consumer and/or for supply to retail. Adopted by The European Commission from April 2019. (Available in multiple languages)

European practical and patient-centred guidelines for adult obesity management in primary care

This article aims to provide obesity management guidelines specifically tailored to GPs, favouring a practical patient-centred approach. The focus is on GP communication and motivational interviewing as well as on therapeutic patient education. The new guidelines highlight the importance of avoiding stigmatization, something frequently seen in different health care settings. In addition, managing the psychological aspects of the disease, such as improving self-esteem, body image and quality of life must not be neglected.

Guidelines for the Treatment and Prevention of Obesity in Children and Adolescents (2019)

Version 4 of the clinical guidelines for the prevention and treatment of obesity in children and adolescents in Germany

Nutri-Score labelling

The Nutri-Score labelling system is a 5-point colour coded nutritional rating system. It was originally implemented in France and has since been adopted by multiple countries in the WHO European region. The German government recommend the voluntary implementation of the Nutri-Score system, since the policy was adopted by the Food Minister in 2019.

Treatment Guideline for Obesity & Pregnancy

Treatment guildeline for obesity and pregnancy (only available in German)

2018 National reduction and Innovation strategy for Sugar, fats and salt in finished products

Information on the Sugar, fat and salt content of finished products will be provided as well as the energy content.

Guideline on surgery for obesity and metabolic diseases (2018)

Version 2 of the German evidence-based guidelines on "Surgery for Obesity". (In German)

Food-based dietary guidelines - Germany

The German dietary guidelines were first published in 1956 and have been regularly updated since then. The current version was published in 2017 and it is expected to be updated by 2022.

NCD Country Profiles 2018 (Obesity Targets)

The profiles also provide data on the key metabolic risk factors, namely raised blood pressure, raised blood glucose and obesity and National Targets on Obesity (as of 2017)

School Fruit, Vegetables and Milk Scheme

"Applicable since 1 August 2017, the EU school fruit, vegetables and milk scheme combines two previous schemes (the school fruit and vegetables scheme and the school milk scheme) under a single legal framework for more efficiency and an enhanced focus on health and educational. The scheme supports the distribution of products, educational measures and information measures. The scheme supports the distribution of fruit, vegetables, milk and certain milk products to schoolchildren, from nursery to secondary school. EU countries approve a list of products (in collaboration with their health and nutrition authorities) which will help achieve the schemes objective of helping children to follow a healthy diet. Priority is for fresh fruit and vegetables and for plain milk. In order to support a varied diet and/or specific nutritional needs, EU countries may also make processed fruit and vegetables such as juices and soups and certain milk products such as yoghurt and cheese, available. Additionally, under stricter conditions, milk-based drinks may be included." - EU Commission

GNPR 2016-2017: Infant and young child nutrition - Breastfeeding promotion and/or counselling

This programme was reported by countries for the 2nd WHO Global Nutrition Policy Review 2016-2017 module on actions related to infant and young child nutrition. Information provided by WHO GINA Programme.

Guidelines to Prevent Obesity in Childhood and Adolescence

Reccomendations by the 'German Alliance of Non-communicable Diseases' include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children.

Join the Health Boat

Kindergarten and pre-school targeted intervention aiming to increase fruit and vegetable intake and physical activity and decrease sugar sweetened beverages and total screen time.

National recommendations for movement and Promotion of physical activity

Germany physical activity strategy addressing overweight and obesity prevalence.

White paper on obesity

"Weißbuch Adipositas", the White Paper on Obesity, was authored by German scientists from the IGES Institute in 2016.

White paper on obesity 2016

White paper on obesity [article in german].

Eat Better, Move More

"Eat Better, Move More" is a German initiative to reduce childhood obesity by involving children and families. Part of the wider INFORM project.

European Union (EU) Action Plan on Childhood Obesity 2014-2020

EU Action plan. To contribute to halting the rise in overweight and obesity in children and young people (0-18 years) by 2020

Guidelines for the Prevention and Treatment of Obesity

Evidence-based guideline on the prevention and treatment of obesity, aiming to improve the perception of the health problem of obesity,and give specific information and recommendations on prevention.

Interdisciplinary guideline of quality S3 for Prevention and treatment of obesity

Interdisciplinary guideline of quality S3 for Prevention and treatment of obesity [article in german]

Ten guidelines for wholesome eating and drinking from the German Nutrition Society

These guidelines aim to help people enjoy eating and maintaining a balanced diet.

EU Regulation 1169/2011

Passed in 2011, EU Regulation 1169/2011 on the Provision of Food Information to Consumers requires a list of the nutrient content of most pre-packaged food to be provided on the back of the pack from October 2011.

Evaluation of the EU school milk and fruit scheme

European Court of Auditors (2011) Are the school milk and school fruit schemes effective? Special Report No 10. Publications Office of the European Union, Luxembourg.

Let's go - every step counts

Promotes physical activity through health hiking courses and a campaign to collect kilometres walked during one year to earn a hiking badge.

Obesity Surgery guidelines (S3-Leitlinie: Chirurgie der Adipositas)

Guidelines which expand and specifies surgical aspects of obesity therapy used in the Guidelines of the German Obesity Society (DAG) "Prevention and Treatment of Obesity ".

The Toy Box Study

The Toy Box intervention is a multicomponent, kindergarten-based, family-involved intervention, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families.

Healthy Start Young Family Network

The main aim of this network is to support pregnant women and young parents by providing uniform information on nutrition, physical activity and allergy prevention. The network publishes and regularly updates recommendations on nutrition and physical activity in infants and young children and during pregnancy. Dissemination of information is via face-to-face training of health professionals, development and distribution of materials and media such as flyers, stickers, posters, and apps, as well as an extensive PR work.

Verhaltensregeln des Deutschen Werberats über die kommerzielle Kommunikation für Lebensmittel

Voluntary marketing restriction: advertising aimed at children and young people shall not encourage or condone excessive consumption of foods and beverages containing substances the excessive consumption of which is not recommended, such as fats, trans fatty acids, salt or sodium and sugars. Adopted from July 2009. (Available only in German)

Fit In Seniority â Healthy Eating, Better Living

Promoting a healthy lifestyle for older people through information about healthy nutrition, physical activity and social interaction.

IN FORM: Deutschlands Initiative fÃr gesunde ErnÃhrung und mehr Bewegung, or Initiative for healthy nutrition and physical activity

The overall aim of INFORM is to promote healthy diets, physical activity and reduce obesity

KITA Vital

"KITA Vital" is an action for health-promoting children's day care facilities in the Rhein-Sieg district. The implementation is carried out by the association kivi in collaboration with the Health Office of the Rhein-Sieg-Kreis.

Fit50+

Aims at improving the general working ability among unemployed. Core elements are healthy living and eating, physical activity and coping.

EU health and nutrient claims regulation

Regulation nº 1924/2006 establishes EU-wide rules on the use of specified health and nutrient claims. The European Commission approves claims provided they are based on scientific evidence and accessible consumers. The European Food Safety Authority is responsible for evaluating the scientific evidence supporting health claims. Nutrition claims may only be used on food defined as "healthy" by a nutrient profile.

The JuvenTUM project; physical education program on physical activity, fitness, and health in children

A prospective study assessing eight Bavarian primary schools (n=724 children) randomized one to one to either an intervention school (427) or a control school (297). Children in the intervention school attended 10 health-related lessons at school over 1 year and their parents and teachers attended 2 and 3 educational health-related lessons,respectively, and received 10 newsletters on health issues. Daily physical activity, physical fitness, and anthropometric data were then obtained.

Fit am Ball

Fit Am Ball is a collaboration between schools and sports clubs to promote ball games, especially football, in extracurricular activities. The national scheme started in 2003 and targets children in grades 3-6.

Germany becomes fit , join us (Deutschland wird fit, Gehen Sie mit)

Act Against Unfair Competition

"According to federal law in Germany, marketing must comply with the legal framework established to control unfair competition. It prohibits any type of advertising that directly invites children to purchase a marketed product themselves or take up a marketed service themselves or cause their parents or other adults to do so. Advertising on the radio and on television as well as teleshopping are subject to the provisions on the protection of minors laid down in section 6 of the Interstate Treaty on the Protection of Human Dignity and the Protection of Minors in Broadcasting and Telemedia Services." - WHO

GNPR 2016-17 (q7) Breastfeeeding promotion and/or counselling

WHO Global Nutrition Policy Review 2016-2017 reported the evidence of breastfeeding promotion and/or counselling (q7)

IN FORM – German national initiative to promote healthy diets and physical activity

"The law prohibits any type of advertising that directly invites children to buy a marketed product themselves or to take up a marketed service themselves or cause their parents or other adults to do so. Advertising on the radio and on TV as well as teleshopping are subject to the provisions on the protection of minors laid down in section 6 of the Interstate Treaty on the Protection of Human Dignity and the Protection of Minors in Broadcasting and Telemedia Services." - WHO

NCD targets for Germany

NCD targets for Germany include the aim of permanently halting the increase of obesity rate among adults (18 years and older).

Peb Online

The Platform Nutrition and Exercise eV (peb) is an open alliance with numerous members from the public sector, science, business, sport, health care and civil society. At peb, they are all actively committed to a balanced diet and regular and sufficient exercise as essential components of a health-promoting lifestyle for children and adolescents. Many documents and links available on website.

Standards for meals in retirement homes

"Meals on Wheels" are privately purchased meals produced by a manufacturer and deliverty to customers directly. The German Nutrition Society provides quality standards and ceretifications for the manufacturers.

The FIT KID certification for day care centres

"Daycare centers can get certified for healthy eating in their facility. To do this, they have to use a checklist for four weeksDGE-Check the quality standard in the daycare center and take part in an audit. After passing the audit, the daycare centers are allowed to use the name FIT KID certification and advertise it. The certificate can be extended through regular re-audits."

The German Nutrition Society (DGE) Quality Standard for School Meals

The German Nutrition Society (DGE) school food guidelines are voluntary across Germany. The guidelines set regulations surrounding the quality and content of school meals. However, 2 states of Germany have passed these guidelines by Law. In 2014, Berlin set these guidelines as mandatory. The state of Saarland similarly enforces these guidelines on a mandatory basis.