May 8 2001 - Metropole Hotel, Llandrindod Wells

Monday 25 March 2002

Minutes of the Nutrition Strategy Steering Group on Tuesday May 8 2002 at the Metropole Hotel, Landrindod Wells.

Present

Mrs Joy Whinney
Mrs Ginny Blakey
Ms Teresa Owen
Professor Robert Pickard
Dr Jeremy Corson
Dr Jane Ludlow
Dr Mariella Borg
Dr Chris Llewelyn
Allan Davies

Apologies

Professor Claire Wilkinson
Keith Davies

FSA Wales

Phil Morgan
Dr Claire Paisley
Hilary Neathey
Jayne Griffiths

1. Chairman's introduction

Joy Whinney welcomed everyone to the second meeting of the steering group. Brief introductions of members/representatives then followed. Joy also welcomed Mariella Borg, public health trainee with Gwent HA, currently on secondment to the National Assembly, to the meeting.

The morning was devoted to the consideration of baseline data in order to obtain a clear picture of the current nutritional status of the people of Wales. Discussions later in the day focussed on establishing some key priorities for action.

2. Minutes of 28 March - matters arising

2.1 Actions

• Phil Morgan was shortly due to meet Paul Donovan from the WDA's Food -Agri partnership to discuss issues surrounding school milk, such as the WDA's school milk facilitators working with local education authorities and primary schools in Wales and other issues such as Objective one etc. He will feed back the outcome of his meeting to the group.

Action: Phil Morgan

• The meeting acknowledged the paper provided by Sue Bowker, Schools and Young People specialist, HPD on Healthy Eating initiatives in Welsh schools, and one produced by Chris Roberts, Head of Evaluation, HPD which set out the collection of nutrition data through NAW sponsored survey research.

• Dr Claire Paisley provided a paper covering NAO: tackling obesity in England; NFS Food survey data; FSA Wales consumer survey; policy documents; research projects and extracts from Scottish and Northern Ireland policy documents.

• FSA secretariat reported they were still actively pursuing the possibility of secondments to assist with the development of the nutrition strategy.

• Before his verbal presentation on the current epidemiololgy situation in Wales, Dr Jeremy Corson reported that he had spoken to Professor Claire Wilkinson and David Seal of the Wales Centre for Health regarding scope for influencing academic public health degree and diploma courses. This was agreed to be timely given the discussions surrounding public health training coming out of the overall public health review.

It was agreed that it would also be useful to know to what extent nutrition was already a component of public health training. Dr Corson agreed to summarise the current situation across Wales for the next meeting.

Action: Dr Jeremy Corson

• Terms of reference. The subsequent amendment to bullet point 4, proposed by Dr. Corson following the meeting on 28 March was accepted. This now reads as follows:
  'identify and address barriers to improving dietary behaviour for individuals at both an individual and public health level'.

3. Presentations

It was generally agreed that before the group was in a position to establish its key priorities it would first need to consider the current situation in Wales, starting with baseline epidemiology data. Data such as research projects and health surveys of relevance to establishing the current situation in Wales were presented to the meeting.

Dr Jeremy Corson, Dr Claire Paisley, Phil Morgan, Hilary Neathey and Jayne Griffiths provided verbal presentations, some of which were in support of previously tabled papers.

The key areas of focus were: the relationship between diet and health; food and health; food intake; barriers to improving healthy eating; current research and initiatives to improve healthy eating and UK and international policy.

4. Discussions

Jayne Griffiths gave an overview of the nutritional problems in the UK. This included the results from the Government 's programme for monitoring the nutritional status of the UK population. The links between diet and health to diseases such as cancer and cardiovascular disease were highlighted and attention drawn to the prevalence of obesity and anaemia.

Professor Pickard suggested that statistics for under 65s were examined to establish the extent of diet related disease. This would also help in setting a baseline against which the success of the strategy might be measured, for example, is Chronic Heart Disease in younger age groups declining?

Dr Jeremy Corson followed Jayne. He set the scene with regard to Health in Wales surveys, exploring targets and monitoring tools the group might want to recommend in relation to the revised Welsh policy framework, Better Health: Better Wales 2007. A discussion followed. Key points were as follows:

• The need to gather data by age/gender and socio-economic group, in order to monitor trends across all population groups.
• The role of nutrition in the management of obesity - particularly tracking the higher incidence of obesity amongst the young.
• The need to consider the relevance of fluoridation leading to improved oral health as a prerequisite to enjoying a healthy balanced diet.
• Between 1985 and 1996 there were improvements in healthy eating practices but incidences of overweight increased.

Dr Claire Paisley's presentation was in support of her earlier papers and addressed current understanding of food intake, surveys etc. The key points from the presentation and the subsequent discussion were as follows:

• The data appeared to hide some inequalities amongst disadvantaged groups.
• There was some discussion surrounding the diverse surveillance methods used to collect baseline data. The group was unanimous in its call for sound statistical techniques in order to set the benchmark for securing the overall evidence base.

Dr Claire Paisley, Dr Jeremy Corson and Professor Robert Pickard were tasked by the next meeting with preparing a further paper on this issue for consideration by the group.

ACTION: CP/JC/RP

Hilary Neathey gave a short presentation on the barriers to healthy eating. This included issues such as securing baseline data on the diets and nutritional status of low-income consumers; current NAW/FSA policy documents and initiatives and improved nutritional labelling. The group acknowledged that currently there was little information available on barriers in Wales.

Lunch

4. Discussion continued

Dr Claire Paisley drew attention to recently commissioned FSA Wales research to improve healthy eating. She gave initial results of focus groups with young people and outlined the scope of a number of other projects such as the evaluation of fruit tuck shop booklets and a baseline survey of school meals in primary and secondary schools.

Professor Pickard then handed out copies of two booklets 'The Sodexho School Meals Survey 2001' and The Caroline Walker Trust's Eating Well for Looked After Children and Young People; it was agreed copies would be made available to all steering group members.
ACTION: Secretariat

Jayne Griffiths gave an outline of some of the FSA /FSA Wales Education initiatives. The British Nutrition Foundation is a partner with the FSA in a number of projects targeted at schools and student teachers.

Professor Pickard agreed to give a demonstration of BNF's latest nutrition CDRom for secondary schools at the next meeting. He also agreed to make copies available to the group.

Action: Professor Pickard

Phil Morgan gave an overview of current UK and European policy, covering issues such as the Eurodiet project and Codex (Codex Alimentarius Commission).

The key points to emerge were as follows:

• The BNF-administered EU Flair- Flow 4 programme was outlined as a useful tool for disseminating the results of EU-funded food and nutrition research developments for health professionals, consumer groups and SMEs. The intention is to develop a dialogue between each of the target groups and researchers, and to stimulate structured feedback on activities. Free summaries are available from BNF.
• All agreed it was worth obtaining information on other nutrition strategies; Finland ( the North Karelian project), Norway, Australia, and Scotland and Northern Ireland were highlighted.

Action: FSA Secretariat

• Dr Claire Paisley agreed to circulate papers in relation to the Eurodiet project

Action: Dr Claire Paisley

• Information on physical activity across Europe was also regarded as important to the discussions.

Action: FSA Secretariat

5. Priorities

The group then turned their attention to a brief discussion of priorities. The Minister of Health and Social Services, Ms Jane Hutt, had asked that the strategy take particular account of disadvantaged groups. It was acknowledged that the needs of, for example, people on low incomes, required to be addressed across the whole range of action.

Thought would be given to focussing on one or two geographical areas to demonstrate what could be achieved through the community development approach, bringing together a range of agencies and initiatives. This would allow for the assessment of such an approach and the relative success of different methods within it.

Education, or children's nutrition, was also seen as a high priority area, and might be the overall priority within the strategy.

More in-depth discussions of priorities would be the next step when the group meets on Tuesday 26 June 2001 at the Institute of Medical and Social Care Research- University of Wales, Bangor.

Hilary Neathey