7.4 Healthy lifestyles and healthy nutrition
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The Strategy For Health Promotion And Prevention (Estrategia de Promoción de la Salud y Prevención) was launched in 2013 by the Interterritorial Council (Consejo Interterritorial) integrated by the General Government Administration and the Autonomous Regions. Proposes the progressive development of interventions aimed at gaining health and preventing disease, injury and disability. The ones responsible for carrying out the strategy are the professionals related to health as well as of the central and autonomous sanitary administrations.
The general objective is to promote the health and well-being of the population by promoting healthy environments and lifestyles and enhancing safety against injuries.
The strategic lines that are addressed are: empowerment of public health, coordination and territorial governance, equity in health, reorientation of health services, intersectoral health, health empowerment, healthy and safe environments, as well as community participation and action.
Although the strategy is aimed at the Spanish community in general, it is planned in areas of implementation and action, with those being under 15 being prioritised first of the population to carry out the actions of the plan.
In order to monitor the plan, there will be a biennial report, which consists of an evaluation and a monitoring record. It will contain an analisis and improvement measures, as well as a global evaluation, which will start after the completion of the 1st phase (2014-2020). For that purpose, general indicators to measure the impact in health and lifestyle have been established, besides evaluation criteria defined by the abovemention indicators.
Strategy for Nutrition, Physical Activity and Obesity Prevention (Estrategia para la Nutrición, Actividad Física y Prevención de la Obesidad (NAOS)):
In force since 2005, it is a health strategy framed in the policies of the international health agencies (WHO, the EU) and its main objective is to reverse the trend of the prevalence of obesity by promoting a healthy diet and the practice of physical activity. Although the strategy targets the entire population, it fundamentally prioritises; children, the youth and the most disadvantaged population groups, focusing on gender and avoiding inequalities in health. The responsible authority for the strategy is the Spanish Agency for Consumer Affairs, Food Safety and Nutrition (Agencia española de Consumo, Seguridad alimentaria y Nutrición (AECOSAN)) dependant on the Ministry of Consumer Affairs (Ministerio de Consumo). It has as main strategic lines of action:
- Health protection: it proposes to facilitate access to a varied diet, balanced and moderate in terms of caloric consumption, of fats and sugars.
- Prevention and promotion of health: it tries to reduce the exposure of people to risk factors such as inadequate feeding, sedentariness and inactivity. Following up, monitoring and evaluation: created with the intention of controlling the prevalence of obesity and overweight, as well as its determinants.
Spain is hosting the initiative promoted by the European Region of the WHO for the monitoring of childhood obesity, WHO European Childhood Obesity Surveillance Initiative (COSI), with the aim of developing a joint system to combat obesity in children. With the joint cooperation of the member countries, an improvement is pursued in the evaluation of the policies and measures implemented for the prevention and eradication of the patterns of overweight and obesity.
Within this initiative, three waves have been carried out in Spain (2011, 2013 and 2015) of the Study on Food, Physical activity, Child Development and Obesity (Estudio de Alimentación, Actividad física, Desarrollo Infantil y Obesidad (ALADINO)), which aims to gather information on the healthy habits of children between 6 and 9 years old, as well as information on their anthropometric measurements.
Promotion of Health and Prevention in childhood, Ministry of Health (Promoción de la Salud y Prevención en la infancia, del MSCBS); Healthy lifestyles web of the Ministry:
- Map of content related to Children (Mapa de contenidos relacionados con Menores). This map of content aims to give information on healthy lifestyles for children under 5 years old.
- Youth-related content map (Mapa de contenidos relacionados con Jóvenes). The proposed content map also offers information on healthy lifestyles but with a target group of minors between 5 to 17 years old.
Guide promoting the healthy adaptation of our adolescents from the Ministry; Promotion of Health and Prevention in adolescence, MSCBS (Guía Promoviendo la adaptación saludable de nuestros adolescentes) Promoción de la Salud y Prevención en la adolescencia).
The Organic Law for the Improvement of the Quality of Education (LOMCE), provides in its regulations the subject of Health Education, which is a cross-cutting subject. Each Autonomous Region can make use of this subject as it deems appropriate.
A study by the Spanish Association Against Cancer (Asociación Española Contra el Cáncer) in 2017 on the situation of health education in primary and secondary schools (Situación de la educación para la salud en centros de primaria y secundaria) shows that 43.5% of Spanish schools devote between 12 and 20 hours per year to Health Education, approximately one to two hours a month. As for the activities that are carried out most often in primary and secondary schools there is an emphasis on those related to physical activity and healthy eating; while safety and prevention of risks, injuries, and accidents are dedicated less time. From the teacher’s and school director’s perspective the results show that most of those interviewed agreed on the importance of health education, and point out two priorities: raise the parents’ awareness about health education (87.1% of the respondents agreed) and train the teachers in this matter (73.8% agreed).
Since there is no single curriculum in the Spanish territory on Health Education, there is not a total similarity of the subject between the Autonomous Communities, although the areas usually taught in schools are associated with the physical activity and healthy eating; wellbeing and emotional health; affective-sexual education; safety and risk prevention of injuries and accidents; and education on drug addiction (alcohol, tobacco and illegal drugs).
Health and sex education in Spain:
Sex education in Spain is not regulated at the national level and is relegated to the criterion of educational institutions. However, there are programmes developed by the city councils, Autonomous Communities and other institutions, such as the Sexual and reproductive health program (Programa de salud sexual y reproductiva) from the Madrid Health Department for the educational calendar 2018-2019, implemented in schools who voluntarily accept to adopt it.
The aim of this programme is to educate Young people, as well as other groups, such as persons from the LGBTI-community and with social vulnerabilities by divulging information about contraceptive methods, AIDS, Sexual orientation and organizing workshops around these sexual education.
There is no online resources available on programs, projects and/or national strategies for peer education approaches. However, peer education and learning has worked in different educational settings. The Community of Extremadura, for example, has launched the "Peer Support" Programme Accompanying students" (Programa "Ayuda entre iguales. Alumnos acompañantes") for primary and secondary education, with which it is proposed to involve the students in the process of teaching with the objective of preventing, detecting and solving conflicts of coexistence.
Another case is the proposal of Youth 4 Youth, coordinated by Mediterranean Institute of GenderStudies (MIGS). It is a 2013 program about awareness, training and peer education in formal and non-formal education environments. It was developed in the framework of the transnational project Youth4Youth: reinforcing young people in the prevention of gender-based violence through peer education, co-funded by the EC. The programme was carried out with the participation of young people from countries like Cyprus, Spain, Italy, Greece and Lithuania. Because of the programme, a Youth4Youth manual has been developed to promote its implementation in schools and youth centres.
The monitoring and evaluation process will depend on the centres that implement the proyect by feedbacks and questionnaires, proving the impact peer education really has on the knowledge of the students involved.
Collaborations for the NAOS strategy:
The NAOS strategy works in a coordinated manner with the Ministries of Health of the Autonomous Communities through a technical working group, which is coordinated with the Ministry of Agriculture and Education when addressing matters within their competence.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
The main offcial information provider on healthy lifestyles is the Ministry of Health Consumption and Social Welfare. The ministry through different websites, initiatives and institutions disseminates information on health promotion and prevention, like Spanish Agency for Consumer Affairs, Food Safety and Nutrition (AECOSAN). Young people can acces to information through the webpage of the Ministry, depending if they are in childhood or adolescense.
Alcohol and youth campaigns (Campañas sobre alcohol y jóvenes):
The Ministry of Healh, Consumption and Social Welfare has at the disposal of Spanish citizenship a website that aims to provide information about the consumption of alcohol in young people. Within it, it is possible to find several campaigns aimed at preventing the consumption of this substance:
- "Alcohol destroys you twice": To inform and alert parents of the dangers and consequences that alcohol consumption has on health.
- "Alcohol can take you away".
- To reduce youth consumption of alcohol and increase the perception of the risk it poses to health.
Nutrition and Physical Activity Campaigns (Campañas de Nutrición y Actividad Física):
The Spanish agency AECOSAN of Ministry of Health has developed a series of Nutrition and Physical Activity Campaigns:
- Activate Movement: 2014 campaign on the importance of acquiring healthy habits, aimed at adolescents aged 13 to 17. On its website Movimiento Actívate they have audiovisual materials with information, links and resources for the promotion of physical activity and healthy eating.
- Activilandia: is a Virtual Theme Park focused on healthy eating, varied physical activity and active leisure, in addition to other healthy habits, aimed at children between 6 and 12 years, their parents or guardians.
- "Wake Up, Breakfast"(“Despierta, desayuna”): A communication campaign in 2006 whose objective was to promote in young people under the age of 13 the habit of having breakfast and understanding the importance of a full and balanced breakfast.