A First for Europe, Amsterdam reported a fantastic 12% drop in childhood overweight and obesity within the first three years of their ‘A Healthy Weight for All Children’ programme. This change was more pronounced in children from the poorer areas of Amsterdam.
Addressing the deprivation gap in childhood overweight and obesity is one of the biggest public health challenges. In Scotland in 2015/16 this gap was alarming: 18% of Primary 1 children from the least deprived areas were overweight or obese, compared to 26% of those from the most deprived areas. Primary 1 children are only 5 years old. This gap widens as the children get older.
This is why we visited Amsterdam to speak to the people who run and deliver the programme and learn from them. This page discusses what we learned and provides a range of resources.
Within three years of the programme, the number of overweight children decreased from 27,000 to 24,500. This was despite an additional 5,000 children (0-19 years old) in Amsterdam during this time.
The best results were seen for children with a low or very low socio-economic status:
‘A Healthy Weight for All Children’ is a programme run by the Amsterdam municipality since 2012. Amsterdam’s programme stems from the Dutch JOGG (Jongeren Op Gezond Gewicht, Young People at a Healthy Weight) which is based on the successful French project EPODE. EPODE (‘Ensemble Prévenons l’Obésité De Enfants’ or ‘Together let’s Prevent Childhood Obesity’) is a large-scale, centrally coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. Find out more about JOGG and EPODE.
Although the programme stems from JOGG, enormous local initiative and resources were given and contributed to their success. They secured 5 million euros a year and a team of 25 dedicated staff (plus another 75 linked staff) to solve this issue in a city where 27,000 children were classified as overweight or obese.
Why did Amsterdam do it?
Obesity and overweight rates in children in Amsterdam were the highest in the Netherlands. Amsterdam is a large multi-cultural city in which only half of the children are Dutch. Children from non-western ethnicities have double or treble overweight and obesity rates than Dutch and other Western children.
Strong leadership with a vison
Amsterdam’s transformation is led by a dynamic deputy mayor for healthcare and sport, Eric van der Burg, with full backing of the city’s politicians. The leaders recognised that it would take a generation to see a real change, so their mission is for all Amsterdam youngsters (0-19 years old) to have a healthy weight by 2033. This vision of healthy weight is a collective responsibility and everyone has a role in achieving it.
Apart from this long term goal, they also have stepping stones: they want all their 5 year olds to be healthy weight in 2018, and all the 0-10 year olds to be healthy weight in 2023.
Learn more about the importance of strong political leadership in:
IPES-Food. 2017. What makes urban food policy happen? Insights from five case studies. International Panel of Experts on Sustainable Food Systems
Sarah Boseley’s article for the Guardian
Amsterdam adapted the rainbow model of Whitehead and Dalgren (1991) as their theoretical framework.
They planned areas across all four levels of the framework. Starting from the individual level (age, sex and hereditary factors) they focused on care for children with overweight and obesity and on 1000 first days of life approach which includes counselling for pregnant women and mothers.
Then, at the individual lifestyle factor level, they focused on neighbourhoods, communities, training for professionals, targeting schools and improving digital facilities.
The level of living and working conditions, so the environment level, is tackled from many angles. They focus on education, health and care, healthy work environment, healthy food environment, youth policy, unhealthy poverty approach, sports, physical activity and healthy organised city.
Finally, on the general socio-economic, cultural and environmental level, they acknowledge the importance and role of the national policy, food industry and the ‘4 largest cities’ approach.
‘Health in all policies’ approach was adopted in Amsterdam and officials provided training across all areas, so everyone is clear on what it means.
A crucial task is to understand why people are making their decisions and adapt the programme and policies accordingly. The community approach plays a crucial role here and the municipality is in continuous conversation with the citizens. They engage with community associations and there is funding available for community activities that promote exercising together, healthy cooking and exchanging experiences. Organisations and individuals, often volunteers, providing such activities increase awareness of healthy lifestyle in their communities.
We have also written a blog piece about the programme http://www.obesityactionscotland.org/blog/119-it-takes-a-village-to-tackle-childhood-obesity