A global change in food culture glamorizing quick and tasty snacks, packed with sugar and salt, has made even Europe’s pants bulge. Now with a majority of adults overweight, and over 20 percent obese, the World Health Organization (WHO) has identified obesity as one of the greatest public health challenges facing Europeans.

At a conference on nutrition and noncommunicable diseases held in July in Vienna, Austria, member states of the United Nations signed a declaration to work toward a healthy food and drink environment. With cardiovascular and cancerous diseases burdening Europe more than any other part of the world, lifestyle choices cause 8 in every 10 deaths in the region.

Sections of a new WHO plan, Health 2020, aim to diminish those numbers by revitalizing past plans to implement government regulations on the marketing of unhealthy food and also to promote healthy education for children.

A plus-size problem

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According to the European Commission, nearly 22 million children in the European Union are considered overweight or obese, with numbers growing by 400,000 every year. Levels of childhood obesity in Europe reach as high as 35 percent in countries such as Scotland and Spain.

Within the last few years, a number of reports put out by WHO, the International Association for the Study of Obesity and the European Commission encourage member states to reduce exposure of marketing on young children. In a 2013 update on the marketing of high fat and high sugared foods to children by WHO, research showed that children may be incapable of separating commercial intent from the cartoons they watch, therefore making marketing tactics highly influential.

Because television plays an everyday role in many children’s lives, Bulgarian researchers suspect television to be a main influence in unhealthy eating habits. After filming 41.5 hours of children’s television programming across the top three national Bulgarian networks, Dr. Sonya Vasileva Galcheva found that 97 percent of food commercials marketed unhealthy foods, and none marketed fruits or vegetables. The report states that these commercials used themes of adventure and animation to attract the attention of children and information on the product was based off taste as well as prizes the child could win. Galcheva’s research also said three-fourths of the commercials were shot with normal-weight actors, giving children a false perception of the consequences to eating unhealthy foods.

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Despite existing national recommendations for a healthy diet as well as a national plan on nutrition, combined overweight and obesity rates in Bulgarian boys has risen to nearly 30 percent.

The Health 2020 plan also accredits high obesity numbers to a problem of inequality in education and access to healthy foods. The policy focuses on a “life-course approach,” starting at birth, because young children learn better and are more likely to retain healthy habits in adulthood.

In a speech during the conference, Zsuzsanna Jakab, WHO regional director for Europe, emphasized government action as a priority in reversing an unhealthy food environment. “Yes, we need to invest in information. We need engaged and informed citizens,” Jakab said. “But we also need the state to use all its powers to create a healthful environment, notably by acting on food production, consumption, marketing, availability, access and price.”

Do governmental policies have real influence?

Since 2004, when the European Commission called on member states to reduce the exposure of children to the marketing of high fat, high sugar foods, many more policies such as WHO’s 2010 and now Health 2020 recommendations continue to repeat the same message.

“I call upon [industry] not merely to seek voluntary agreements that limit the power of governments to regulate, but truly to engage with product reformulation, improving labeling and marketing products in a way that makes industry part of the solution,” said Jakab.

WHO’s report on marketing toward children shows that only 9 percent of countries in the European region have fully implemented restrictions, but 29 have started to introduce policy.

Joao Breda, WHO program manager on nutrition, physical activity and obesity, said considering the different stages of development of the countries in the region, huge progress has been made in Europe since the first call to act on obesity in 2006. “Health 2020 is challenging and a major step forward because it’s trying to promote ways of interaction between sectors, actors,” he said. “Above all it’s trying to help member states to devise the best means of policy actions, recognizing the complexity of health.” Breda describes the plan as an invitation for countries to learn how to better deal with nutrition problems. However, he said it is up to individual governments to implement policy as they see fit. For many, he said, they depend on food industries to self-regulate.

In an ISAO report released in 2012, Tim Lobstein criticized the effectiveness of self-regulation by industries as a project “failing across Europe.” “The figures show that self-regulation achieved only a 29% fall in children’s exposure to unhealthy food, which is deeply disappointing,” he said. “Exposure is now creeping up again in some countries. In the report, Lobstein said that because industries are allowed to set their own standards on what is healthy and what is not, he found over 30 high fat, high sugar foods classified as unhealthy in government-approved plans, yet considered healthy by manufacturers.” Asking the companies to restrict their own marketing is like asking a burglar to fix the locks on your front door. They will say you are protected, but you are not,” said Lobstein.

The future of obesity

If the current obesity epidemic remains unchanged, the Harvard school of public health predicts that by 2020, 9 percent of preschoolers world-wide will become overweight or obese, or some 60 million children. Some countries are taking action to make sure that doesn’t happen.

According to an article in the Norway Post, the Ministry of Health and Care Services in Norway agreed this year to ban all unhealthy food products marketed at children 16 and younger. While the ban sparked negative reactions from the food industry, the ban does not include production, placement or store displays.

Other countries such as France have mandated healthy messages on TV and radio commercials when advertising products with added sugar or salt. Messages encourage viewers to eat at least five fruits and vegetables a day, to avoid snacking and to practice regular exercise.These government policies have left France and Norway with some of the lowest levels of obesity in Europe and may be an indication towards change.

The WHO regional committee for Europe will meet September 16-19 to discuss guidelines for effective implementation of the Health 2020 plan.