Today, 4th of March is World Obesity Day. We mark it to raise attention across the globe and inspire action to "build happier, healthier and longer lives for everybody". Obesity is quite a complex disease, we need to address its root causes and create healthier environments where everyone can thrive. Sandra Caldeira has been working on this area for more than 10 years.In this interview (conducted by Ricardo Passos Sousa) she talks about her work and the passion and commitment she shares with her colleagues to continue working to curb obesity and change the way it is addressed across society.
Ricardo Passos Sousa (RPS): Today is World Obesity Day and I know that you work on this particular topic. Do you want to tell us about it?
Sandra Caldeira (SC): Oh yes … I do want to tell you about it because it is a topic that I am truly passionate about. Obesity is an area where I see a lot of potential for improvement and making a difference. And where making a difference can mean so much. I think mostly about childhood obesity because that is where my heart goes but of course, the overarching goal is to curb and bring down obesity levels in general.
RPS: What do you have in mind, when you say making a difference can mean so much?
SC: Right! I have two aspects in mind… One is the importance to the individual that has obesity and the other is the importance of curbing obesity for the benefit of society and our healthcare systems.
The first one first; can you imagine for a moment what it means to be a child with obesity? It means for example, to become more tired than friends do when running or playing. It often means to be bullied, to have low self-esteem, to perform worse at school. Projecting the obesity into the future, it also means possible earlier onset of other diseases like type 2 diabetes, increased risk of some cancers, of depression as well as orthopedic problems. It can mean increased severity of COVID-19 and premature death as well. It means to be or to feel discriminated against, even passively – public transport, theatres, plane seats are not sized for people with obesity, not to find the clothes I want to wear in my size. If you are an adult with obesity, discrimination at the work place can be a reality.
For the second aspect, just think that, in the EU, more than half a million deaths can be attributed to a higher than ideal body mass index each year. This is a rather high number and EU member states spend almost 7 percent of their budgets on treating health conditions related to it; costs related to obesity can be as high as 70 billion EUR in the EU per year.
RPS: Do you have any data about the situation in Europe and in Portugal?
SC: Yes we do – and we actually just published a summary of all these facts and figures today. If you want to know more, you can read about it in our Knowledge Gateway .
I’ll just give you the data for children and adolescents in the EU. Pre-obesity (overweight) and obesity rates can be as high as 39% among children and adolescents but the variation between countries is considerable; the lowest rates seen are around 13-15 % among Irish, Danish and Dutch boys. The differences we see at EU level are also present at national and regional level. Take our country, Portugal, as an example. The prevalence of childhood overweight and obesity in Portugal varies across regions between approximately 21 % and 34 % (2016 data, six- to eight-years-old children). Zooming in, the same variation and differences exists within municipalities. Look at the data from Gaia, where the municipality runs an exemplary survey among all children in public pre- and primary school with body measurements for every child. You see the same differences and you can learn from this data - matched to socio-economic and urban infrastructure data, one can identify possible underlying reasons for the differences in body weight and levers to address them.
RPS: Do you have a concrete example of the type of work you do that can help us understanding how can we curb obesity?
SC: Actions to curb obesity can be taken many levels. Certainly, eating and drinking habits, physical inactivity, and sedentary behaviour are some of the most direct factors associated with this disease. But obesity is the result of a complex interaction of ‘genetic susceptibility, environmental as well as behavioural factors’. The reasons can differ from individual to individual. Preventing the onset of obesity is much less in the hands of people (in children that is even more obvious!) than commonly thought. To me and to many others in the field, the key lies elsewhere – it lies with addressing socio-economic factors and a number of other factors that shape the environments our children and we live in. I’m talking about urban planning, possibilities for active commuting (walking, cycling), exposure to marketing of foods high in fat, sugars, and salt, time to sleep and if you’re talking of children also school food policies, parents’ occupations and their free time for outdoor activities and many others. All these, together, frame the opportunities for health that children and adults alike have access to.
That is the area I like to work on and where I see so much potential; what governments and the EU can do to shape these environments and curb obesity.
RPS: And the examples Sandra!?
SC: Here they go: I can give you 3 examples of what we (and countries) are doing.
- We believe schools are a great place to promote health, they need to be healthy! We need to push for healthy schools, there is evidence that it will also improve education. We have been working on the food environment and the food offer in schools. We want schools – and other public institutions like hospitals, canteens, our work places in general - to use their purchasing power and procure foods with important health criteria.
- Making the healthier option the easier option. We are helping governments benchmarking and keeping track of the food offer. Countries are using different tools to try to reduce sugars content in food products for example, from negotiating with food business operators, to taxing those foods and beverages that are particularly high in sugars or fat or salt. As well as that, we are exploring the possibility of improving food labels so the nutrition value of each food or drink is clearer at a glance.
- Limit marketing and advertising to children especially of foods high in fat, sugars or salt but also limit alcoholic beverages advertising thinking of adolescents and young adults
These are just some examples as so much more can be done. For example, at local level to ensure cities and neighbourhoods are child friendly, encourage walking or physical activity.
RPS: What do you expect that 2021 will bring you and your work in this area?
SC: There is an amazing team effort behind all the work we are doing in this area; within the health promotion team but also with the member states and other colleagues. That work in all three areas I mentioned continues to develop and mature. There is also renewed impetus as the European Commission just launched the farm to fork strategy and the Europe’s beating cancer plan and these address many of the most insidious obesity risk factors. We are thus full of energy and enthusiasm to keep going at it and seeing the tide turning on this other pandemic!
Sandra Caldeira is Deputy Head of Unit Health in Society and Ricardo Passos Sousa is Deputy Head of Safety and Security Unit, Head of Security Service and Local Security Officer at the Joint Research Centre, European Commission.
* This website and the “Portuguese Semester” celebrations are organised by a group of volunteers at the European Commission’s Joint Research Centre (JRC) to promote and disseminate Portuguese culture, on the occasion of the 2021 Portuguese Presidency of the Council of the European Union (EU).
This is part of a tradition at the JRC, initiated back in 1992 with the first series of activities to mark the EU Council Portuguese Presidency at the time. Since then, cultural semesters have been organised, as a way to celebrate the culture and traditions of the EU member state that holds the rotating presidency of the Council and bring them closer to the JRC and local communities. *