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From national policies to local coordinated action: the added value of the EPODE methodology

susan jebb Dr. Susan Jebb, Head of Nutrition and Health Research at the Medical Research Council (UK), presents the stakes of the governments and other actors in the prevention of childhood obesity, from national policies to local coordinated action, and the added value of the EPODE methodology.


Dr. Susan Jebb is Head of Nutrition and Health Research at the medical research council Human Nutrition Research Unit (UK). Her research focuses on the role of dietary factors in the aetiology and treatment of obesity and its related metabolic diseases. She also leads the HNR Communications team who focus on the translation of nutrition science into policy and practice, working with policymakers, industry, health professionals, NGOs and the media across a broad range of activities. She is an advisor to government on issues related to obesity and to nutrition. Currently she is Chair of the cross-government Expert Advisory Group on Obesity and a member of the Change4Life Board. She was an Expert Advisor to the Cabinet Office Strategy Unit Review on Food. Dr. Susan Jebb participates at the EPODE European Network (EEN) activities more specifically in the "Scientific Evaluation and Dissemination" group under the leadership of Prof. Jaap Seidell, (Free University of Amsterdam).

In a recent interview for BBC radio, Dr. Jebb reiterated that Europe is suffering from an epidemic of obesity:

"An indication of just how much of an issue this is, is that over the last thirty years, the levels of obesity in the United Kingdom have roughly trebled, and that even the average weight is already overweight."

In the United Kingdom a cross-government strategy the ‘Healthy Weight: Healthy Lives' was adopted in January 2007, it reflects the diverse determinants of obesity in society, includes explicit links to different stakeholders, recognising that many of the levers of change lie outside government. Futhermore, recent data from national surveys provides some grounds for optimism that the rate of increase in adults, and especially in children, has slowed.

Arresting and ultimately reversing the growing prevalence of obesity is a major health challenge and one that is being dealt with all around the world.
Dr. Susan Jebb continues by saying that "it is clear that a great number of factors that favour inactive lifestyles and over consumption are working against the best interests of individuals. The conclusion therefore is that a wide range of external groups share the responsibility for the nation's health, including the food industry, leisure sector and the media. The ‘Healthy Weight: Healthy Lives' strategy alone though is not the solution to obesity, but it does provide a framework for action and a point of reference against which progress can be assessed. The emphasis must now shift to concrete action and implementation, especially at a local level. Emerging evidence from research studies around the world suggests that locally-led community-based interventions are an important element in tacking the problem of overweight and obesity."

The crucial question is what does it take to make the system work? Dr. Jebb remarks, "there are a number of key success factors we can identify that provoke action and make a real difference on the ground. These are: clear leadership - including political and workforce leadership; a willingness to work for a common cause; enough resources; an aligned workforce; receptivity of the community; and the co-operation of private enterprises. It has become clear that there are synergistic benefits to getting different stakeholders working together, as the EPODE programme has demonstrated.

Dr. Jebb added "we need to energise local people to go beyond their silos and think/work with their colleagues down the road, and down the hall. Tackling obesity will and does require unprecedented change in attitudes and behaviour. Everyone must recognise the issue and buy into the common goal, and everyone can contribute: providing healthier school meals, making sure that physical activity is an integral part of the school day (by re-enforcing sports time for example), encouraging leisure centres to be health centres in the community, families too have an important role to play - they aspiring to better health and progress. In my opinion, we are nearing a tipping point."

In conclusion, she says, "it is vital and urgent to reverse the obesity trend if we are to avoid the later consequences such as type 2 diabetes and heart disease. And for this to happen, it'll mean that everyone must be focussed on the problem. Just as the prevalence of being overweight is due to a combination of factors, so the resulting cure needs to be an integrated response. In short, we must make eating less, and exercising more, normal again."