7.4 Healthy lifestyles and healthy nutrition
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National Health Targetsand Child and Youth Health Strategy
The aims of the National Health Targets and the Child and Youth Health Strategy depicted in Chapter 7.1 and Chapter 7.2 also emphasize a healthy lifestyle and nutrition. Particularly, Austrian Health Target 1 aims for health-promoting living and working conditions for everyone, Health Target 3 envisions an enhancement of health literacy in the population, and Health Target 7 aims to provide a healthy diet for all. In the Health strategy for Children and Young people (Kinder- und Jugendgesundheitsstrategie), Target 3 promotes a healthy development through education and the promotion of a healthy diet of children and young people.
Austrian Nutrition Action Plan
The Austrian Nutrition Action Plan (Nationaler Aktionsplan Ernährung) was launched in 2011 and aims to implement effective measures in a transparent and intersectoral way to prevent over-, under- and malnutrition, to reverse the rising overweight and obesity rates by 2020 and to prevent diet-related non-communicable diseases. Existing activities were combined in one strong strategy and a nationwide commitment.
The Action Plan is designed to establish and maintain a structured continuous dialogue and cross-sectoral cooperation. It is embedded in the Austrian Health Targets, part of the Austrian Prevention Strategy (Österreichische Suchtpräventionsstrstrategie) and is being updated on a regular basis advised by the National Nutrition Commission (Nationale Ernährungskommission, NEK), which was established in 2011 as a multidisciplinary nutrition advisory board for the Minister of Health. All relevant players are involved in the development of the Austrian nutrition policy.
The update of the Austrian Nutrition Action Plan in 2013 was focused on infants, children and young people, pregnant and nursing women as well as on the further development of tools for communicating information and empowerment. The aim of nutritional prevention is the prolongation of a healthy life, it thus contributes to improving the quality of life.
- Improvement of health and quality of life by enhancement of nutritional and health behaviour in Austria
- Strengthening the field of nutrition in all areas of society
- Dismantling of health inequalities (social, age, gender)
- Accessibility of a healthy diet for all
- Prevention of disease or age-associated malnutrition
- Strengthening of nutrition therapy in the health care system
Further nutrition relevant policies and actions:
A self-regulatory code of audio-visual media companies is in place dealing inter alia with the marketing of food to children and was strenghtened based on EU legislation. In addition, everybody can file a complaint with a special complaint body (Werberat) if a special marketing activity or advertisement is perceived to harm children, to take them at a disadvantage, to be misleading or exploiting the inexperience of children. The procedure is transparent, each complaint and the outcome of the subsequent examination is available online.
Austrian Addiction Prevention Strategy
The first Austrian Addiction Prevention Strategy (Österreichische Suchtpräventionsstrategie) has been published in 2015 and provides a good starting point for taking appropriate steps at the federal, provincial and local level to meet the challenges of the next years, based on what has already been achieved. The strategy addresses illicit drugs, new psychological substances, psychotropic medications, smoking, drinking, gambling, other behavioural addictions and doping/neuro-enhancement. Like Health policy in general, addiction policy concerns all policies through the principle of 'health in all policies'. People’s health can only be effectively and sustainably fostered if all political actors involved join forces, and measures taken in the health sector are appropriately aligned with measures in other policies, particularly those that touch on areas of life where factors that foster the development or prevention of addiction have been identified. This strategy is not only targeting youth but the whole population. A brief overview over the key objectives and elements is provided bellow:
Social conditions that enable healthy lifestyles, paralleled by addiction prevention measures, shall keep the number of people who develop problematic patterns of alcohol use as low as possible. The regulations on youth protection regarding alcohol primarily apply to public spaces, while the private sphere should give young people the opportunity to learn an appropriate approach to drinking. The trading and catering industries play a key role and carry responsibility regarding implementation and control. Protection of minors (Jugendschutz) is the competence of the Federal States. While details differ between regions, generally young people under 16 can't buy and (publically) consume alcoholic beverages, and distilled alcohol ('hard liquor') can't be bought (consumed) until the age of 18. In 2019, the federal states have agreed to harmonise youth protection laws in the areas of smoking, alcohol and curfews, however a solution hasn't yet been reached.
Prevention measures that target children and young people are particularly important so that as few people as possible start smoking. Comprehensive measures are needed to protect people, particularly children, from exposure to second-hand smoke indoors. Efforts must be made to ensure adherence to all anti-smoking regulations, especially those enshrined in youth protection laws as well as smoking bans. Across the Federal States, the legal age to purchase and make use of tobacco has been raised to 18 (Jugendschutz). After years of discussion, in 2019 finally a full smoking ban (Nichtraucherschutz in der Gastronomie) in bars and restaurants has come into force. According to Statistik Austria, in the time span 2014 - 2019 the greatest decreases in smoking were seen in the younger population and here especially among women.
Both prevention measures and statutory measures need to be taken in order to keep down the number of people who develop problems relating to games of chance or similar activities, such as sports betting. Gambling must be controlled in such a way for it to be primarily a harmless entertainment, and so that heavy financial losses are unlikely. Efforts must be made to ensure that the regulations protecting young people and gamblers are complied with. Young people under 18 are not allowed to participate in gambling, including online gambling, and are not allowed to enter places where money is played for (e.g. betting office, casino). Lottery tickets can be bought from age 16 onwards.
Harmonised regional laws for the protection of youth regarding drinking, smoking and gambling are an important aspect of addiction policy, and must be implemented effectively and in line with the state of the art. Since 2019, Austria has largely uniform - however not completely harmonised - provisions on the purchase and consumption of alcohol and tobacco, as well as on curfews in the respective provincial laws that regulate the protection of minors (Jugendschutz). Further fields of action include alcohol-induced violence within and outside of families, as well as driving under the influence of alcohol.
Target groups of the strategy are abstinent people, low-risk users, problem users, addicted patients and third-parties affected. Children and young people are the primary target group of prevention activities. Measures specifically designed for this group must be taken to encourage them to turn to help services whenever problems arise and to prevent problems from arising in the first place. Attention needs to be paid to those children and groups with a higher risk of developing addiction – for instance, children from families with addiction problems. Early detection, early intervention, as well as life skills and risk competence approaches, have proven their worth as professional approaches to prevention. Life skills approaches are effective not only in preventing addiction, but also in preventing violence. Appropriate prevention measures targeting adults are also envisioned. (Further) training programmes in prevention for key persons and multipliers as well as peers make it possible to reach a very large number of people (of the direct target group). Providing the public with well-founded, appropriately prepared, objective information on problem substances and patterns of behaviour, as well as on help services, is of great importance. To achieve prevention goals in a sustainable way, systematic steps need to be taken, based on socio-scientific findings and coordinated with all stakeholders. At the provincial level, the addiction prevention units serve as competence centres, and any prevention activities in individual areas – e.g. in school and recreational settings, or prevention in the workplace – as well as the involvement of experts from other fields (e.g. the police), is coordinated with them. The funding is provided by the federal and provincial governments and the social insurance funds, and/or through revenue from taxes on alcohol, tobacco and gambling.
This policy brief is one of a new series to meet the needs of policy-makers and health system managers. The aim is to develop key messages to support evidence-informed policy-making.
Strategies of the Federal Provinces
Besides the national strategies and action plans, strategies of the federal states exist. Thus, countless measures supporting both, the national and the federal states' strategies are implemented at the federal state level but not further described.
'Children eat healthy' (Kinder essen gesund)
An Austria-wide initiative for better nutrition of children. Within the framework of this initiative, useful tools are disseminated for parents, educators as well as those responsible for meals in kindergartens, after-school care centres and schools. These include guides and manuals as well as teaching materials, games, and videos. All tools offered have been checked according to scientific criteria and correspond to current findings on healthy nutrition. The focus is on the promotion of scientifically based projects, and broad-based press and public relations work. The project is supported by the Ministery of Health, Ages, Fonds Healthy Austria, and Gesundes Österreich GmbH.
In 2011, the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection launched a nationwide initiative financed by the Federal Health Agency on healthy eating in school cafeterias. The initiative called 'our school buffet' ("unser Schulbuffet") is geared towards cafeteria owners. They get an onsite counselling free of charge how to improve their food and drink basket based on a guideline published by the Ministry while considering their individual environment aiming at sustainable improvements based on healthy nutrition recommendations and their economic viability. When meeting the standards cafeterias get certified by the Federal Ministry of Social Affairs, Health, Care and Consumer Protection (Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz). Overall, around 25% of all school buffets in Austria took part in the initiative until the end of 2014. 240 000 pupils were thus able to benefit from an improvement of the catering offered at schools. To be able to continue the initiative, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection (Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz) has been looking for cooperation partners in the individual provinces so that the initiative can be continued on a regional basis and so that the financing in these provinces is ensured. The Ministry provides the concept, all necessary documents and the know-how. The cooperation partners assume responsibility for the mobile advisory services which are the centrepiece of the Our School Buffet initiative. The mobile coaches are well-prepared for their tasks thanks to a training course.
'The good choice' (Die gute Wahl)
The initiative is linked to the project 'our school buffet'. Healthy dishes at the school buffet are labelled with the good choice label. The information on this project was presented by the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection and AGES (Österreichische Agentur für Gesundheit und Ernährungssicherheit / Austrian Agency for Health and Food Safety) in March 2016.
Further measures in the framework of the Austrian nutrition action plan targeting youth
- ÖGE-Seal of Quality for caterers and commercial kitchens which provide health-promoting meals.
- Further training of parent trainers in the field of family health.
- Regional measures of the federal states are described in the action plan.
Health education and healthy lifestyles education in schools
The Federal Ministry of Education, Science and Research has noted international studies to show that
- the self-confidence of pupils strongly depends on how comfortable they are in school
- well-being and self-confidence have a positive impact on the physical and mental state of health
- health behaviour is influenced by the school.
As health and academic achievements correspond, healthy pupils show a better performance. High-achieving pupils act healthier. Targeted interventions result in improved stress management and problem-solving among teachers and subsequently in a less detrimental work attitude.
Health promotion is a process which sensitises for health correlations and thereby provides options, for everybody involved, to actively contribute to the preservation of health. Differently to prevention, which aims at the avoidance of risks, health promotion wants to strengthen people physically, mentally and socially to reduce the likeliness of diseases and to enable handling of existing health risks (e.g., stress). School influences the health of teachers and pupils via the social climate and the organisation of classrooms and equally by the quality of the lighting, the ergonomics of the furniture as well as by break arrangements and food offers. Thus, school affects the physical, mental and social health of all people.
- Embedding of health promotion as an organisation-wide approach - it is important for the school management and staff to support this idea.
- Knowledge development and development of personal action competence.
- Organisation of the school as a health-supporting social environment.
- Regular thematisation in the committees of the school community
- Anchorage of health promotion in the school programme or school profile
Furthermore, books like 'Me and my world' („Ich und meine Welt“) have been developed to enhance health competence.
Health education as a teaching principle
Health education is a teaching principle for all school types in Austria. The former Federal Ministry of Education, Arts and Culture issued the fundamental decree on health education (Grundsatzerlass zum Unterrichtsprinzip Gesundheitserziehung) which describes the duties, objectives and bases of health promotion in schools and the regarding implementation in 1997 (GZ 27.909/15-V/3/96, circular No., 7/1997). According to the decree, school health promotion includes information about health issues, influencing the behaviour of individuals, and designing a health-promoting living space. Health promotion as an expanded concept thus emphasises physical, mental as well as social health. The decree is based on experience fro the ‘Health Promoting School’ programme, which was implemented in pilot schools from 1993-1996 within the framework of an international network of the World Health Organisation (WHO), the Council of Europe (CoE) and the European Union (EU).
The main goals implementation areas of the decree are
- Shaping schools as a health-promoting living environment involving all persons in everyday school life
- Promotion of personal competences and potentials of pupils with regard to health-conscious, self-responsible action and knowledge
- Networking of school and regional environment
- Promotion of communicative and cooperative competences of teachers, parents and pupils as well as communication structures between teachers, pupils and parents.
- Documentation and dissemination of innovative projects and measures
TheAustrian beverages and snack licence (Der österreichische Trink-und Jausenführerschein)
The project conveys the relevance of healthy nutrition and school snacks to pupils. Free teaching materials are provided for the subject Biology in the 5th grade, including regular practical exercises. More than 80,000 pupils at over 700 schools have already carried out the project, which has been rated as ‘very good’ by educators. The project was developed and implemented by SIPCAN on behalf of the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection.
Environment and health education fund (Umwelt- und Gesundheitsbildungsfonds)
The Federal Ministry of Education, Science and Research financially supports the realisation of environment-oriented and/or health-supporting project teaching at schools.
Teaching principle of sex education and personal relationships education
Sex education is a teaching principle for all school types in Austria. The Federal Ministry of Education, Science and Research has published the updated fundamental decree on sex education (Grundsatzerlass Sexualpädagogik) which describes the duties, objectives and bases of sex education in schools and the regarding implementation in 2015 (BMBF-33.543/0038-I/9d/2015).
It is the duty of the school, in the cooperation with teachers, pupils and parents as the school community, to promote pupils in their personality as a whole. Sexual development is a part of the whole personality development of the person and takes place at cognitive, emotional, sensory and physical levels. Today, contemporary sexual educationtheory is a form of education at school which begins accordingly to age in the early childhood and continues until the adult's age. In this process, sexuality is understood as apositive potential being inherent in the person. Within the scope of a comprehensive sexual education information and competence should be conveyed to children and youth to be able to act responsibly with themselves and others. Beside institutions like kindergartens and schools, parents play a central role in this process.
General principles of sex education in the decree
- Positive educational position towards sexual development
- Sexual development as the base for sex education
- Sex education supports personality development
- Support of the capability of expression and the discussion ability
- Enhancement of fact-based knowledge
- Enhancement of body competence
- Arrangement of social rules
The Federal Ministry of Education, Science and Research provides teaching material for the promotion of responsible handling of sexuality, for the prevention of abuse and for HIV. The website school psychology: sexual health - sex education has been implemented (schulpsychologie.at: Sexuelle Gesundheit - Sexualerziehung).
A peer-to-peer approach for the prevention of alcohol abuse was launched with the project PartyFit! which was included in the Austrian Child and Youth Health Strategy. Commissioned by the Institute for Addiction Prevention, PartyFit! is aimed at teenagers and young adults who like to party. On site at events, they directly inform their peers on the topic of alcohol.
The project GAAS (Projekt GAAS) had the aim to promote health competence of young people who are not in education, work or training. According to the principle, 'no intervention without diagnosis' measures were adapted for the promotion of health competence to the needs of the young people. Due to the integration of students of dietetics and physiotherapy, the peer-to-peer approach was very successful.
Health competence in youth work
Professional open youth work in Austria(youth centres, mobile open youth work, and youth street work) deal with health competence in their facilities. The nationwide network Health-Competent Youth Work (Gesundheitskompetente Jugendarbeit) has been founded and representatives of the field developed standards for health-competent professional open youth work. It thereby became visible that the local settings, both in urban areas and in more rural municipalities, are of great importance when it comes to supporting health competence of young people in the setting of open youth work.
The umbrella organisations for professional open youth work (bundesweites Netzwerk Offene Jugendarbeit, bOJA) and for youth information centres (Bundesnetzwerk Österreichische Jugendinfos, BÖJI) published the handbook health competence in extracurricular youth work (Leitfaden: Jugendarbeit - Gesundheitskompetenz). The development of the handbook was supported by the Fund for a Healthy Austria (Fonds Gesundes Österreich, FGÖ), the Federal Ministry Civil Services and Sports and the Department for Families and Youth at the Federal Chancellery.
Chosen facilities of open youth work and the youth information centres in Styria, Salzburg and Tyrol compiledcriteria for health-competent youth centres or the health-competent mobile youth work and health-competent youth information centres. Peer-to-peer-approaches are pursued in this area. Young people realise offers and workshops for other young people.
Health-competent open youth work in local settings
The project 'health-competent open youth work in local settings' aims for facilities of open youth work to systematically deal with their organisational health competence and commit themselves to the concept of health-competent open youth work. This happens in narrow cooperation with the respective local authority. The aim is capacity building of health competence in the field of open youth work, which is strengthened by activities to interlink and transfer knowledge and know-how. Thus, open youth work significantly contributes to an increase of health competence. The project took place from 2017 until 2020. Concrete measures were the development and implementation of a 3-step validation system for health-competent youth centres and health-competent mobile open youth work respectively in municipalities.
Flanking the process of implementing health competence in the field of open youth work, activities on health-competent youth work were envisioned: the network Health-Competent Youth Work is continued and further developed and a website with recent information on health competence was launched. A close link to the Austrian platform health competence is planned and will assure the quality of the activities. The project is funded by the FGÖ, the main association of Austrian social security institutions and the Department for Families and Youth at the Federal Chancellery.
Brochure on sex and love
The umbrella organisation of youth information centres (Bundesnetzwerk Österreichische Jugendinfos, BÖJI) published an extensive brochure on sex and love (Erster Sex und große Liebe) in 2016, updated March 2017. The development was financially supported by the Department for Families and Youth at the Federal Chancellery.
As according to § 46 of the school education act (§ 46 Schulunterrichtsgesetz, SchUG) of 2014 schools have been opened to offers from leisure time education, schools can make use of these offers as well.
risflecting® - teaching risk management
risflecting®teaches (young) people to anticipate and manage risks and to reflect upon their behaviour. The programme of risk management from drug and alcohol consumption has been expanded to areas of consumer spending, gambling, driving, and extreme sports. Sponsoring organisations are: Youth Department Vienna (Landesjugendreferat Wien), Youth Department Salzburg (Landesjugendreferat Salzburg), Office for Youth Work Bolzano (Amt für Jugendarbeit Provinz Bozen), Austrian Alpine Club (Alpenverein ÖAV), Youth Department Lower Austria (Landesjugendreferat Niederösterreich), and Verein Vital.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
Information providers and counselling structures
Several public bodies are in charge of health and health information in Austria. Additionally, a wide range of non-public bodies supports health promotion.
First of all, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection(Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz) provides information on a large variety of health topic, from alcohol and drugs, nutrition to travel information and environmental health.
The Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology (Bundesministerium für Klimaschutz, Umwelt, Energie, Mobilität, Innovation und Technologie) is responsible for key quality-of-life issues and for questions which are essential in creating a liveable future for children and young people.
The public health portal Gesundheit.gv.at offers quality assured information on health and diseases. Beside medical topics, the structures of the health care system are explained.
The Fund for a Healthy Austria (Fonds Gesundes Österreich) has chosen the motto 'health for everyone'. This nationwide contact and promotion service sets manifold activities to promote health and prevent risks. Information regarding health and prevention is found on its website. Since 1999 the Fund carries out large scale information and awareness campaigns to improve the consciousness and knowledge of a healthy lifestyle. Physical activity, neutrino, lifestyle and non-smoking were up to now the central subjects. A collection of campaigns and initiatives for the whole population is provided online.
The Gesundheit Österreich GmbH is the national research and planning institute in the health care sector. The competence centre for health promotion links up several business divisions and offers comprehensive professional information its website.
The nationwide service centre GIVEis an initiative of the Federal Ministry of Education, Science and Research, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection (Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz) and the Austrian Youth Red Cross. Activities for teachers and educational experts are the focus of this initiative. However, on the website, there is also a lot of useful material and information for young people.
The Austrian Agency for Health and Food Safety (AGES) is a company of the Republic of Austria, owned by the Austrian Federal Ministry of Health and the Federal Ministry of Environment and was founded in 2002. AGES supports the management of the federal government in questions relating to public health, animal health, food safety, medical and drug safety, food security and consumer protection along the food chain by providing professional and independent scientific expertise (as stated in Article 8 of the Austrian Health and Food Safety Act).
The hotline 'Rat auf Draht' presents a series of health-related articles on the website. In addition to the hotline, information on, among others, smoking and eating disorders is provided.
The Austrian Youth Portal (Jugendportal) helps young people in finding information on how to maintain a healthy diet (Ernährung). It also provides a link collection on health and well-being services provides in Austria.
Several youth organisations provide information and campaigns concerning health related subjects, such as, among others, sex education and addiction prevention.
Special youth-targeted information campaigns
'Live your life. Without smoke. YOLO!' is the slogan of the tobacco prevention initiative for 10 to 14-year-olds by the federal Ministry of Health and the Fund for a Healthy Austria. On this occasion, a website and a hotline have been installed. Initially the campaign was supposed to last until December 2015, but was then further extended until 2018. A quiz app can be downloaded .
In 2006, the nationwide campaign 'Mehr Spaß mit Maß' ('More fun with moderation') stimulated young people to an independent and reflected consumption of alcohol.
Measures in the framework of the Austrian Nutrition Action Plan targeting youth
- Best practice guide 'beverages' (Praxisleitfaden „Getränke“) developed and implemented by SIPCAN on behalf of the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection.
- Best practice guide 'dairy products' (Praxisleitfaden „Milchprodukte“) developed and implemented by SIPCAN on behalf of the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection.
- Best practice guide 'sweets' (Praxisleitfaden „Süßigkeiten“) developed and implemented by SIPCAN on behalf of the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection.
- International and national youth conferences (health)
- Nutrition hotline
- Graphical illustration of nutrition pyramids and development of nutrition recommendations for children by the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection.
- Generation blue (information on water)
- Regional measures of the federal states