Why is obesity so high in Malta
Why do these two countries have among the lowest obesity rates in Western Europe?
Obesity is complex
A number of studies place the UK high on the obesity league table. A 2022 report by the WHO, for instance, ranked the UK third (behind Turkey and Malta) for having the most obese adults of the 52 countries in the WHO European region. Despite many studies highlighting France and Italy for having the lowest rates in Europe, in this report they ranked 31st and 43rd respectively much lower than the UK but not at the bottom.
The Organisation for Economic Cooperation and Development (EOCD) also places the UK well ahead of France and Italy in obesity prevalence. Its most recent report states that 64% of the UK population aged 15 and over is overweight or obese, compared with 46% in Italy and 45% in France.
Consistently, it seems the UK has higher rates of obesity than Italy and France. However, comparing the prevalence of obesity across countries is not clear cut, warns Rachel Jackson Leach, science director of the World Obesity Federation.
She explains that some studies use self-report data, where people report their height and weight themselves. Certain studies use corrected data, which adjusts for errors in this self-reporting, while other data is based on measured height and weight. We always advise against using self-report data with measured data, says the expert.
World Obesity Federation figures compare obesity rates (which dont include everyone classed as simply overweight) across countries using estimated data and are the most accurate, continues Jackson Leach. By this measure, around 30% of women and 28% of men in the UK live with obesity, compared with 22% of women and 23% of men in France, and 20% of women and 21% of men in Italy.
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Malta
Annex III to Regulation (EC) No 1925/2006 of the European Parliament and of the Council as regards trans fat, other than trans fat naturally occurring in fat of animal origin
Measures to limit or virtually eliminate industrially-produced trans fatty acids in food intended for the final consumer and/or for supply to retail. Adopted by The European Commission from April 2019. (Available in multiple languages)
| Categories: | Evidence of Marketing Guidelines/Policy |
| Year(s): | 2019 (ongoing) |
| Target age group: | Adults and children |
| Organisation: | The European Commission |
| Linkeddocument: | Download linked document |
| References: | Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en/node/36162 (last accessed 12.07.22) |
Weight Management Programme
"The programme consists of two sessions per week for a period of 12 weeks. Each session is of 2 hours duration, various topics relating to healthy nutrition and weight loss are presented and discussions take place in a group setting."
NCD Country Profiles 2018 (Obesity Targets)
The profiles also provide data on the key metabolic risk factors, namely raised blood pressure, raised blood glucose and obesity and National Targets on Obesity (as of 2017)
| Categories: | Evidence of Obesity Target |
| Year(s): | 2017 (ongoing) |
| Target age group: | Adults and children |
| Organisation: | World Health Organisation |
| References: | Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. |
School Fruit, Vegetables and Milk Scheme
"Applicable since 1 August 2017, the EU school fruit, vegetables and milk scheme combines two previous schemes (the school fruit and vegetables scheme and the school milk scheme) under a single legal framework for more efficiency and an enhanced focus on health and educational. The scheme supports the distribution of products, educational measures and information measures.The scheme supports the distribution of fruit, vegetables, milk and certain milk products to schoolchildren, from nursery to secondary school. EU countries approve a list of products (in collaboration with their health and nutrition authorities) which will help achieve the schemes objective of helping children to follow a healthy diet.Priority is for fresh fruit and vegetables and for plain milk. In order to support a varied diet and/or specific nutritional needs, EU countries may also make processed fruit and vegetables such as juices and soups and certain milk products such as yoghurt and cheese, available. Additionally, under stricter conditions, milk-based drinks may be included." - EU Commission
Dietary Guidelines for Maltese Adults
The dietary guidelines in Malta were updated and published in 2016 and include a graphical representation of a 'Healthy Plate'
| Categories: | Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan |
| Year(s): | 2016 (ongoing) |
| Target age group: | Adults |
| Organisation: | Ministry of Health |
| Findoutmore: | health.gov.mt |
| Linkeddocument: | Download linked document |
GNPR 2016-2017: Infant and young child nutrition - Breastfeeding promotion and/or counselling
This programme was reported by countries for the 2nd WHO Global Nutrition Policy Review 2016-2017 module on actionsrelated to infant and young child nutrition. Information provided by WHO GINA Programme.
| Categories: | Evidence of Breastfeeding promotion or related activity |
| Year(s): | 2016 (ongoing) |
| Target age group: | Children |
| Findoutmore: | extranet.who.int |
| References: | Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en |
The Mediterranean Diet Campaign
As part of the OPEN (Obesity Prevention through European Network) project, the Mediterranean Diet campaign is a multi-media campaign aiming to reach out to various sectors of the population. It focuses on the Mediterranean Diet as outlined in the new Food Based Dietary Guidelines and the various services being offered across the health sector to prevent unhealthy weight.
| Categories: | Evidence of Community Interventions/Campaign |
| Year(s): | 2016 (ongoing) |
| Target age group: | Adults and children |
| Organisation: | Ministry of Health |
| Findoutmore: | deputyprimeminister.gov.mt |
A whole school approach to a healthy lifestyle: Healthy Eating and Physical Activity policy
This policy aims to get schools working together with policy makers, parents and communities to create an environment where students eat healthily, become physically fit and develop lifelong habits that contribute to wellness.
| Categories: | Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action planEvidence of Physical Activity Guidelines/Policy |
| Year(s): | 2015 (ongoing) |
| Target age group: | Children |
| Organisation: | Ministry for Education and Employment |
| Findoutmore: | ehealth.gov.mt |
| Linkeddocument: | Download linked document |
Food and Nutrition Policy and Action Plan for Malta 2015-2020
A plan that sets out priority action areas in order to address the main public health challenges facing the Maltese Nation in the area of nutrition and food security.
| Categories: | Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan |
| Year(s): | 2015-2020 |
| Target age group: | Adults and children |
| Organisation: | Health Promotion and Disease Prevention Directorate, Parliamentary Secretariat for Health |
| Findoutmore: | ehealth.gov.mt |
| Linkeddocument: | Download linked document |
Lunchbox Campaign 2015
The Health Promotion and Disease Prevention Directorate has teamed up with the Education Authorities to launch a campaign to encourage healthier lunchboxes. This is one of the implementation measures of the Whole of school approach to healthy lifestyles: healthy eating and physical activity.
| Categories: | Evidence of Community Interventions/Campaign |
| Year(s): | 2015 (ongoing) |
| Target age group: | Children |
| Organisation: | The Health Promotion and Disease Prevention Directorate |
| Findoutmore: | deputyprimeminister.gov.mt |
| Linkeddocument: | Download linked document |
Move for Health Day 2015
The day provides a focal point to generate public awareness of the benefits of physical activity in the prevention of non-communicable diseases.
| Categories: | Evidence of Community Interventions/Campaign |
| Year(s): | 2015 (ongoing) |
| Target age group: | Adults and children |
| Organisation: | Government of Malta |
| Findoutmore: | deputyprimeminister.gov.mt |
National Breastfeeding Policy And Action Plan 2015-2020
The 2015-2020 National Breastfeeding Policy and Action Plan updates the previous policy in line with current scientific evidence on the short and long term benefits of breast feeding to the mother and child, to achieve higher exclusive breastfeeding rates for the first six months and thereafter for breastfeeding to continue with appropriate complementary foods.
| Categories: | Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan |
| Year(s): | 2015-2020 |
| Target age group: | Children |
| Organisation: | Health Promotion and Disease Prevention Directorate |
| Linkeddocument: | Download linked document |
European Union (EU) Action Plan on Childhood Obesity2014-2020
EU Action plan. To contribute to halting the rise in overweight and obesity in children and young people (0-18 years) by 2020
A healthy weight for life 2012-2020
A national obesity strategy to address the prevalence of obesity, and reduce the health, social and economic consequences of excess body weight. Includes nutrition and physical activity strategies.
| Categories: | Evidence of National Obesity Strategy/Policy or Action planEvidence of Nutritional or Health Strategy/ Guidelines/Policy/Action planEvidence of Physical Activity Guidelines/Policy |
| Year(s): | 2012-2022 |
| Target age group: | Adults and children |
| Organisation: | Public Health, Ministry for Health,the Elderly and Community Care (Malta) |
| Findoutmore: | deputyprimeminister.gov.mt |
| Linkeddocument: | Download linked document |
| References: | Public Health Ministry for Health, the Elderly and Community Care 'A Healthy Weight for Life': A National Strategy for Malta. Available from: https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/hwl_en.pdf (Accessed 13th October 2020) |
EU Regulation 1169/2011
Passed in 2011, EU Regulation 1169/2011 on the Provision of Food Information to Consumers requires a list of the nutrient content of most pre-packaged food to be provided on the back of the pack from October 2011.
| Categories: | Labelling Regulation/Guidelines |
| Year(s): | 2011 (ongoing) |
| Target age group: | Adults and children |
| Organisation: | European Parliament and the Council of the European Union |
| Findoutmore: | eur-lex.europa.eu |
| References: | Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en/node/22917 (last accessed 28.06.22) |
Evaluation of the EU school milk and fruit scheme
European Court of Auditors (2011) Are the school milk and school fruit schemes effective? Special Report No 10. Publications Office of the European Union, Luxembourg.
| Categories: | Health Effectiveness Reviews (obesity related) |
| Year(s): | 2011 (ongoing) |
| Target age group: | Children |
| Organisation: | EUROPEAN COURT OF AUDITORS |
| Linkeddocument: | Download linked document |
| References: | Information provided with kind permission of World Cancer Research Fund International from their NOURISHING framework www.wcrf.org/NOURISHING |
Healthy Eating Lifestyle Plan (HELP)
This document is aimed primarily at schools to encourage them to give high priority to healthy eating and healthy lifestyles. It aims to design, implement and monitor school healthy eating lifestyle plans.
| Categories: | Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan |
| Year(s): | 2007 (ongoing) |
| Target age group: | Children |
| Organisation: | Ministry of Education, Youth and Employment |
| Findoutmore: | education.gov.mt |
| Linkeddocument: | Download linked document |
EU health and nutrient claims regulation
Regulation n 1924/2006 establishes EU-wide rules on the use of specified health and nutrient claims. The European Commission approves claims provided they are based on scientific evidence and accessible consumers. The European Food Safety Authority is responsible for evaluating the scientific evidence supporting health claims. Nutrition claims may only be used on food defined as "healthy" by a nutrient profile.
Broadcasting code for the protection of minors
"Maltese subsidiary legislation 350.05 Broadcasting Code for the Protection of Minors, whichcame into force on 1 September 2000 and was amended in 2010, states in paragraph 19:Advertisements for confectionery and snack foods shall not suggest that such products maybe substituted for balanced meals - WHO
GNPR 2016-17 (q7) Breastfeeeding promotion and/or counselling
WHO Global Nutrition Policy Review 2016-2017 reported the evidence of breastfeeding promotion and/or counselling (q7)
| Categories: | Evidence of Breastfeeding promotion or related activity |
| Target age group: | Adults |
| Organisation: | Ministry of Health (information provided by the GINA progam) |
| Findoutmore: | extranet.who.int |
| References: | Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en |
NCD targets for Malta
Malta's NCD targets include: Reduce the prevalence of obesity within the population over the age of 15 years from 22% to 18% by 2020 Keep the prevalence of obesity among 13 year olds below 15% by 2020.
On the Move Programme
"This programme offers all age groups to enjoy sports in various localities through Malta and Gozo" The mission of this programme is "moving a nation through the promotion and development of sport for a healthy, inclusive and successful Malta'
No actions could be found for the above criteria.
Prevalence of obesity in Malta
Abstract
Background: Obesity is a global epidemic with the Mediterranean island of Malta being no exception. The World Health Organization (WHO) has identified Malta as one of the European countries with the highest obesity prevalence.
Method: A cross-sectional study was conducted (2014-2016) under the auspices of the University of Malta. The prevalence of overweight-obesity in Malta was calculated and then age stratified for comparisons with previous studies.
Results: The study identified 69.75% (95% CI: 68.32-71.18) of the Maltese population to be either overweight or obese. The men overweight/obese prevalence (76.28% 95% CI: 74.41-78.14) was statistically higher than that for women (63.06% 95% CI: 60.92-65.20) (p = 0.0001). Age stratification revealed that both genders had the highest overweight prevalence rates between 55 and 64 years (Men = 23.25% 95% CI: 20.43-26.33; Women = 24.68% 95% CI: 21.44-28.22). Men obesity prevalence rates were highest in the 35 to 44 years group (22.52% 95% CI: 19.65-25.68) while for women it was highest in the 55 to 64 years group (28.90%, 95% CI: 25.44-30.63).
Conclusion: Over a 35-year period, an overall decrease in the normal and overweight BMI categories occurred with an increase in the prevalence of obesity. An exception was observed in the women, where the prevalence of normal BMI increased over this time period. Also, it appears that while the total population obesity prevalence increased (for 2016), a percentage of the women have shifted from an obese to an overweight status.
Keywords: Epidemics; Malta; obesity; overweight.
