7.4 Healthy lifestyles and healthy nutrition
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The dissemination and adoption of healthy habits is a decisive factor in the defense of individual health, as well as a key factor in the promotion of Public Health.
With the Ministerial Decision No. PG/oc.146/29.12.2020 "Defining Strategic Goals of the Ministry of Health for the year 2021", it was defined as the 2nd Strategic Goal "Health and well-being for all, at all ages" with the following Areas of Intervention:
1. Improving Perinatal Care.
2. Design and implementation of National Screening Programs.
3. Ensuring mental health throughout the population.
4. Strengthening the care of drug users.
5. Improvement and intensification of the anti-smoking policy.
6. Strengthening the processes of environmental protection and sustainable development, implementation of the institution of "green" hospitals - health structures and their building upgrade.
7. Application of modern technologies and up-to-date indicators for the protection against air, water and sea pollution, as well as for the sanitary management of liquid waste and solid waste of hospitals.
8. Improvement of eating habits and elimination of all forms of poor nutrition (malnutrition, obesity), especially of vulnerable groups, such as infants, children, adolescents, pregnant women, nursing mothers and the elderly. - Formation of a framework for dealing with eating disorders in general and related programs.
9. Protection and promotion of health in third age.
According to the aforementioned Ministerial Decision, "Primary Prevention - Interventions and actions aimed at reducing diseases, disabilities or injuries and are carried out before their occurrence".
a) Implementation of the National Program for the Promotion of Physical Exercise and Healthy Eating (EPPSAYD/NPPPEHE)) for the control and management of risk factors related to poor nutrition and lack of physical exercise.
b) Implementation of the National Alcohol Treatment Program (EPAA/NATP) and the strengthening of the protective factors that affect the incidence of this specific disorder. c) National Immunization Program (EPEMB/NIP), which is aimed at special and vulnerable groups of the population, children, minors and adults, mobile populations and populations at risk.
d) Interventions to prevent psychosocial problems and promote the mental health of children and adolescents.
e) Provision of dental care, with an emphasis on preventive dentistry, to all children and adolescents aged 6-18 years.
f) National Program of Pre-symptomatic Control (EPPE/NPPC), in the general population for the early detection of high prevalence diseases.
g) National Program of Systematic Prenatal and Perinatal Control (EPPGE/NPSPPC), which addresses the population to protect their health during the prenatal and perinatal period.
Encouraging healthy lifestyles and healthy nutrition for young people
The National Plan for Public Health foresees specific actions to encourage healthy lifestyles and a healthy nutrition for young people.
Actions against Smoking
• Preparation of the 2019-2023 Strategic Plan "HEALTH UNITES US". The Plan covers all aspects of tobacco consumption and sets specific targets and measurable indicators of effectiveness. It is stated, in an advisory capacity, by an Expert Committee consisting mainly of members of the academic community with distinguished scientific activity in the specific field including actions in four (4) Priority Axes, emphasizing the axis of Promotion and Prevention.
• Formation of the Committee of Experts for the control of smoking headed by Mr. Panagiotis Behrakis, Pulmonologist - Intensivist, PhD (McGill).
• Information campaigns for the implementation of the Plan "HEALTH UNITES US". The initial campaign was implemented with the participation of popular personalities, focusing on the necessity of full implementation of the Smoking Ban Legislation as well as raising awareness - mainly - of young people up to the age of 18.
• Update the legislative framework, adopting the complete ban in indoor common areas • Ratification of the FCTC Protocol to Eliminate Illicit Trade of Tobacco Products.
• Cooperation with the National Transparency Authority and other co-competent Ministries to coordinate audits by the auditing bodies and the Hellenic Police for the implementation of the anti-smoking law.
• Re-operation of the telephone line 1142, as a communication line for Smoking.
• Issuance of the JMD 80727/15.11.2019 regarding new fines and the method of imposing, collecting the fines and creating an electronic fee (e-paravolo) for the Ministry of Health, for the collection and return of the fines, related to the violations of the Anti-Smoking Law.
Actions to adopt healthy eating habits
• Formulation of a National Nutrition Policy Plan
In November 2019, the National Nutrition Policy Committee duly submitted a "National Nutrition Policy Plan" to improve the eating habits of the Greek population. This Plan is formed in 3 main axes, including proposals for actions, which are also priorities of the European Union's policy on eating habits.
• Through the competent Department of the Directorate of Public Health, the following were promoted:
- Nutritional recommendations for the healthy population and special population groups (infants, children, adolescents, pregnant women, nursing women, people aged over 65), as well as recommendations for the introduction of solid foods in the 1st year of life
- Representation of the General Secretariat of Public Health in a Working Group of the Hellenic Statistical Authority (EL.STAT.), which formed the questionnaire of the 2019 Health Survey, which included for the first time a questionnaire assessing the adherence of the population to the Mediterranean Diet.
- Creating and sending a special electronic questionnaire for the collection of statistical data concerning children’s nutrition in public and private nurseries and daycare centers
- Continuous cooperation with supervised and co-competent public bodies, such as the Children's Health Institute, EFET (Hellenic Food Authority) and the Ministry of Rural Development and Food, educational research institutions, SEBT (Hellenic Food Industry Association) and professional bodies (Panhellenic Association of Dietitians - Nutritionists, Union of Dietitians-Nutritionists of Greece)
- The implementation of information and education activities for students regarding nutrition in the school environment, during the 2019-2020 school year, and the publication of informative brochures regarding healthy snacks and the implementation of a thematic axis - intervention on the issue of "Nutrition Education" as well as ‘’Exercise - Activity - Play in the life of the child and the adolescent" within the course of "Health Education".
- Recommendation on the food specifications, provided in the "School Meals" Program of the Ministry of Labor and Social Affairs. The proposed diets, which are based on the Mediterranean dietary pattern and meet the national nutritional recommendations, were approved by the National Nutrition Policy Committee.
• National Program for the Promotion of Healthy Nutrition and Physical Exercise (EPPSAYD) This is the development of an Action Plan aimed at the control and management of risk factors related to a healthy diet and physical exercise.
Actions to deal with the harmful consequences of alcohol consumption
• Supervision and coordination of supervised bodies of the GGDY as well as continuous cooperation with University Institutions, which develop actions to deal with the problematic use of alcoholic beverages.
• Utilization of NSRF resources 2014 – 2020 by the supervised bodies for the development of infrastructures for Physical Detoxification (OKANA, KETHEA, PSNA, Ioannina CHATZIKOSTA Hospital) along with the development of Prevention and Awareness actions in the general population with an emphasis on adolescents.
• Update of the Finding of the "Working Group to address the harmful consequences of alcohol consumption", as it was filed in July 2019.
• Maturation of the National Alcohol Treatment Program (EPAA) and the strengthening of the protective factors, which affect the incidence of this disorder, with key axes:
- the implementation of educational programs mainly in schools about the detrimental consequences of the harmful alcohol consumption, with the cooperation of the Ministry of Education and Religious Affairs and the Institute of Education Policy (IEP), the intensification of controls at the points of alcohol distribution, especially with regard to any act of illegal distribution in minors,
- the formulation of proposals to update and tighten the penalties for violations, provided for by the current legislation,
- the strengthening of drug addiction centers and the information and awareness campaign of the population with an emphasis on minors, drivers and pregnant women,
- the formation of telephone support and communication structures regarding alcohol dependence, and finally
- the implementation of interventions focusing on minors, pregnant women and people with problematic behavior related to reckless alcohol consumption as well as interventions for appropriate road behavior.
Health education and healthy lifestyles education in schools
Health Education in schools in Greece is an eminently interdisciplinary activity, which contributes to the upgrading of school life and the connection of school with social reality. The purpose of Health Education is to protect, improve and promote the mental and physical health and social well-being of students, on the one hand by developing their social skills and critical thinking, on the other hand by upgrading their social and physical environment. General objectives of Health Education are the defense and promotion of mental and physical health and social well-being. Preventing the exclusion of young people from society and the labor market. The development of skills and the formation of people with a critical attitude. The reduction of school failure and early leaving of compulsory education.
The main axes of cognitive content are the following:
- Interpersonal relationships
- Mental health
- Prevention of the use of addictive substances
- Consumption and health
- Sexual Education
- Interracial relationships
- Physical exercise and health
- Traffic Law
- Environment and health
- Dealing with emergency situations (developing skills to deal with anxiety, fear, etc.)
Peer-to-peer education approaches
Currently, there are no top-level guidelines, programs projects or initiatives facilitating or relying on peer-to-peer education
Partnerships and collaborations
The National Program for the Promotion of Physical Exercise and Healthy Eating (EPPSAYD) introduces partnerships to control and manage risk factors related to poor nutrition and lack of physical exercise.
a) The main axes of application of this program in terms of promoting healthy nutrition are:
b) the submission of proposals for the implementation of relevant educational programs as a priority for teachers of school and pre-school children, with the cooperation of the Ministry of Education and Religious Affairs and the Institute of Educational Policy (IEP),
c) the cooperation of the State with the food industry to improve the composition during the production of standardized industrial foods, with the aim of reducing the addition of salt, sugars, saturated fatty acids and industrially produced trans fatty acids,
d) the submission of proposals for the implementation of intervention programs for the optimization of sports spaces and conditions in the school environment, with the cooperation of the Ministry of Education and Religious Affairs and the Institute of Educational Policy (IEP) ,
e) the synergy with the Local Authorities (OTA) of the first and second degree in terms of supporting sports programs in the local sports facilities, as well as the formation of sports programs for all age groups of the population,
f) the undertaking of joint action with the Ministry of Education and Religious Affairs και το Ministry of Culture and Sports for the provision of additional incentives for sports in the infrastructure of each level of education.
Raising awareness of healthy lifestyles and on factors affecting the health and well-being of young people
The Organization Against Drugs implemented the first systematic effort to implement a prevention policy in the country.
Regarding Prevention, OKANA has developed, in collaboration with the Local Government and local agencies, a network of Addiction Prevention Centers and Psychosocial Health Promotion throughout the territory.
In this context, currently it scientifically supervises and evaluates the programs and actions implemented in the 75 Centers for Prevention of Addictions and Promotion of Psychosocial Health.
Prevention Centers aim at:
• empowering, supporting and educating young people to adopt a positive life attitude
• informing and raising awareness in relation to addictions and addictive behaviors
• family counseling and strengthening the parental role
• in raising the awareness of the educational community in matters of prevention and support of their pedagogical role
• informing, raising awareness and mobilizing the wider community.
The Counseling Station and the Telephone Line for HIV/AIDS, Sexually Transmitted Diseases and Hepatitis, was the first state structure established in the country with the aim of promoting prevention by providing information and counseling to the general population, as well as psychosocial support of people suffering from HIV.
C.S. and T.L. are a single service, with a common scientific approach and goals. Their main objective is the specialized psychosocial intervention in HIV/AIDS and other STDs (Sexually Transmitted Diseases), with the aim of timely and effective prevention, as well as the appropriate treatment of the various psychological and social needs of HIV-positive people, people in their environment, but also the public in general, with the ultimate goal of preserving and promoting health.
The Ministry of Health published the ‘’National Strategy and Action Plan Against Smoking 2019-2023 – Health Unites Us’’, which aims to curb and eliminate the phenomenon of smoking in Greece and sets specific goals and measurable indicators of effectiveness.
Priority Axes of the aforementioned National Strategy are:
- Information campaign targeted at parents and pregnant women.
- Continuous training of teachers of all levels for compliance with the Legislation and for modern and documented smoking prevention strategies
- Creation of educational material about the dangers of smoking and its inclusion in the educational programs (curricula) of Primary and High School
- Expansion of the points prohibiting the use of tobacco products (Especially in places where the frequent presence of minors is observed)
- Informing and raising awareness of the general population using innovative technological channels (Mobile app to provide information on statistics, current measures, ways to quit smoking, integration of anti-smoking games and films for children)
- Creation of anti-smoking informative material using traditional information media, e.g. newspaper ads, posters, radio and television messages (Traditional public media and emblematic actions with a local character)
- Promotion of physical activity and sports, in general, as a modern way of life
- Policy of awards and distinctions of innovative anti-smoking actions in the community