Proposition 53K0688

Proposition de résolution relative à la politique fédérale de nutrition-santé.

General information ¶

Authors

Ecolo Muriel Gerkens, Thérèse Snoy et d'Oppuers
Groen Eva Brems

Submission date

Nov. 24, 2010

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

health risk health policy resolution of parliament nutritional disease public health

Voting ¶

Voted to adopt

CD&V Vooruit LE PS | SP Open Vld MR

Abstained from voting

Groen Ecolo ∉ N-VA LDD VB

Party dissidents ¶

• Bernard Clerfayt (MR) abstained from voting.
• Peter Luykx (CD&V) abstained from voting.
• Olivier Maingain (MR) abstained from voting.
• Damien Thiéry (MR) abstained from voting.

Contact form ¶

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Discussion ¶

July 18, 2012 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, Mr. Minister, Ladies and Gentlemen, this resolution has been under consideration by the Public Health Committee since March 2011. As its title suggests, its authors initially wanted to influence the development of the second five-year Health Nutrition Plan.

While, in the majority, the members of the committee shared the finding that motivated the drafting of this text, namely that the Belgians adopt new eating habits with adverse consequences on their health, it appeared necessary to have, before continuing the examination of the proposal, evaluations of the first National Nutrition Plan Health (PNNS). It was finally in April that they were presented. Regarding their content and exchanges, I allow myself to refer to the written report.

Furthermore, the members of the commission were reminded that the agreement on the Sixth State Reform provided for the transfer of this matter to federal entities. To respond to the conclusions of the first-plan assessments and to take into account this upcoming transfer of competence, amendments have been submitted. Ms. Snoy, the main author of the draft resolution, submitted eleven; Ms. Burgeon and colleagues submitted one which replaces the entire text. This amendment was approved by 11 votes and 5 abstentions. The amended text was adopted by eight votes and four abstentions.

Mr. Speaker, Mrs. Minister, Ladies and Gentlemen, as a reminder, the competent Belgian authorities put on the rails in 2006 the National Nutrition Health Plan. Some of the actions he proposed were very effective. These include, for example, the encouragement of breastfeeding, the qualitative improvement of nutrition in hospitals and retirement homes, the reduction of the salt content in processed products. Unfortunately, all the expectations of the stakeholders involved in the project have not been met.

It is true that the external and internal evaluations of the PNNS have shown that, since its launch, the ⁇ complex institutional framework of our country has been a major brake. In order to prevent further issues of competence between federal authorities and federal entities and to prevent, in the end, competent authorities from achieving ambitious nutritional objectives, on the basis of Ms. Snoy’s text, I and my colleagues submitted a comprehensive amendment. For, without questioning the relevance of the majority of the initial requests, we found that the draft resolution did not sufficiently take into account this upcoming transfer of competence and budget and did not insist sufficiently on the leverage available to the federal government.

Indeed, the relevance of inserting the problem of the good to consume, of being healthy, on the federal political agenda is not the subject of any discussion. The diet obviously has an impact on the physical and mental health of individuals. The facts are known. Never has our country counted so many people in overweight; never have people suffering from obesity been so many; never have overweight and obesity been responsible for so many cases of mortality and morbidity that could have been avoided.

By recentralising the text on this request, we wanted to make the text more precise and above all we wanted to take into account the particular institutional context of this matter. In particular, we would like to avoid stigmatizing foods considered harmful to health, so that eating is considered a pleasure. We also found it necessary to involve not only the Minister of Public Health, but also the Ministers in charge of Agriculture, Economy and the Secretary of State in charge of Social Integration. Indeed, if this challenge concerns health care, it involves actions in many other areas. I will mention product standards regulation, pre-packaged food labelling regulation, product traceability regulation, advertising regulation, etc. Finally, we also wanted to draw the government’s attention to the importance of developing and supporting a sustainable diet. This goal has also been added to the Parliamentary contribution to the definition of a long-term strategic vision for sustainable development.

Even if this does not fall within our jurisdiction, I would like to take advantage of my presence at this tribune to remind that, given the matter, prevention, education, information of people remain the most effective tools if one wishes to change behaviors, eating habits sustainably. And if the Communities are already acting in this field, let us bet that the next transfer of skills and budgets relating to the PNSS will enable to strengthen their actions so that one day we can come to an end of these too rich diets, of this system according to which it is more expensive to eat even than to eat poorly.

On the basis of today’s debate is the National Nutrition and Health Plan. This plan, as well as the previous ones, has – rightly – come into being after it was established that there is a global trend to switch to a high-calorie diet that is poor in nutrients. All this is combined with too little physical activity. This unhealthy lifestyle leads to the development of serious conditions, such as increased blood pressure, cardiovascular disease, diabetes, certain cancers and overweight.

Nor does Belgium escape this trend. The figures we know today are worrying. More than half of Belgian men and 40% of women are overweight. What is even more worrying is that 20% of our youth, who are still in full growth, also suffer from this.

Given the serious consequences of an imbalanced lifestyle, Mrs Snoy’s initiative is very good. She is right when she says that it is imperative that the government pay attention to this problem. The question is of course how.

The original recommendation ⁇ contained some good ideas, but for some of the themes the Communities are competent and for another part regulations will need to be developed at European level. The agreement on the sixth state reform also stipulates that the further follow-up of the nutrition and health plan is transferred to the federated entities. This does not exclude, of course, that a number of powers will still be succeeded by the federal government and that initiatives can be taken in the meantime.

Because of these elements and on the basis of the evaluation reports, a number of priorities were therefore pushed forward and the resolution was revised. The present resolution gives two strong signals. The first strong signal we send from Parliament is that we want a coherent policy and that we therefore ask the government to provide its support to the actions developed by the counties. Another strong signal is that our Parliament wants a long-term policy and that we need to make good agreements with the food industry on the salt, sugar and fat content in the diet.

With the proposed long-term policy, we want to ensure that everyone can follow a dietary pattern that provides at least all the elements a person needs to live a healthy life.

Finally, I emphasize that it remains our biggest challenge for the future to find a healthy balance between nutrition as a socio-cultural given and nutrition as a nutritional given. There is still a long way to go; that is clear. While I was drawing up my report last night, my stepfather spontaneously offered me some bits of cheese and some cut sausage and, I must admit, I ate it all with a lot of pleasure.

Mr. Speaker, Mrs. Minister, dear colleagues, in November 2010, following a conference gathering numerous nutrition specialists, we had filed this resolution in order to strengthen the future Health Nutrition Plan which should have been created in 2011. It was before the institutional agreement that provided for the regionalization of this Plan, regionalization that we do not contest.

We were inspired by alarming figures from the Institute of Public Health on the health status of the Belgians. 54% of men and 40% of women are overweight, 14% of our compatriots are obese and 18% of young people aged 2 to 17 are overweight. The connection with food is obviously not exclusive, but it is very often determining. Along with this population weight gain, we see an exponential increase in our consumption of sugar and new types of fats, especially in prepared foods. There is also an evolution in our way of eating, the time we take to eat as well as sedentaryness, the lack of physical activity.

In general, it can be said that malnutrition is seriously damaging our health, the functioning of society, people’s well-being and public finances.

Faced with the magnitude of this challenge, our resolution was intended to lay the foundations for a federal nutrition-health policy that fully respects the competences delegated to the Regions and Communities. We set new goals, new means and proposed new measures.

Our goals focused on sustainable development. The first was to tackle health inequalities. The other was sustainability in agricultural production systems, which must effectively provide the population with food of good nutritional quality.

We had to set public health goals, such as reducing the prevalence of overweight and decreasing cardiovascular disease. It is not impossible to set quantitative public health targets. I had cited the example of Finland, which has decreased by 65% in 30 years, the incidence of cardiovascular disease by defending healthier nutritional systems.

We also wanted the policy to set nutritional intake targets in order to reduce fat intake and to balance the ratio between the health-determining fatty acids – omega-3 and omega-6. We demanded that this idea of nutrition be integrated into all policies.

We called for a regulatory approach, rather than a voluntary agreement approach, in which the industry sometimes pulls too much! Other examples have been cited in this regard.

We called for new measures, in particular, the strengthening of the nutritional dimension in all health care, the accompaniment of overweight people. We talked about a whole series of federal matters. Thus, the idea was that companies guarantee employees the time to eat properly during noon, as this is very important for not gaining weight. In fact, eating at night does not allow you to spend the calories absorbed.

All these indications have been ⁇ to us by nutritionists. This involves a different social organization.

We also wanted a regulation of advertising because we think it plays a big role in eating habits. Advertising targeted to children in particular forms them to consume unhealthy foods.

This resolution was somewhat frozen. We have waited a long time before the government takes note of the previous National Health Nutrition Plan (National Health Nutrition Plan, NNS) assessment and can communicate it to us.

On the day that the Minister spoke to us about this assessment and her beliefs on nutrition-health policy, I found my optimism back because I found that the Minister was taking on most of our claims and the elements contained in this resolution. I believed very sincerely, ⁇ naively, that this resolution was likely to come into being, with some amendments, to ensure compliance with the institutional agreement.

The minister told us how much she believed that the federal authority should continue the efforts made and believed that she had a lot of competence to do so. She wanted, among other things, to continue the consultations with the private sector, address the issue of marketing and advertising, strengthen the quality of care, the training of hospital staff, the care of nutrition in hospital care, at the level of screening and care of the diabetic patient. She also wanted this integration of the sustainability dimension into nutritional policy. She cited, among other things, the important issue of agricultural production, in connection with our consumption of animal protein in particular. She mentioned the fact that 18% of greenhouse gas emissions are attributable to livestock farming, that excessive meat consumption leads to cardiovascular diseases and cancer risks. It therefore proposed to add a 8th nutritional goal on reducing the consumption of animal protein.

As is well known, it was very quickly challenged by agricultural organizations that – I regret – misunderstand this goal of reducing the consumption of meat and do not take advantage of it to improve the quality of the meat offered.

Then, the minister believed that federal authorities should continue the actions undertaken in the field of research and take tax measures to encourage the consumption of healthy foods.

After such remarks that matched almost all the intentions of our initial resolution, we were very disappointed to see the majority submit an entirely warm and minimalist amendment!

In his second point, he is afraid of stigmatizing a particular food. We all know what it is about. There is no need to use the word meat. Especially not to say "less meat", at the risk of being treated as a salad, like the minister when she had a moment of political courage!

This resolution ignores the role of the medical world and health professionals in the nutritional issue. As if it was not important to talk about nutrition to the sick! As if it was not important to take care of fighting malnutrition of people in rest and care homes! As if it wasn’t important to care about overweight and obese people, with a comprehensive view of their problems, and to accompany them to improve their health. And not just with miracle pills!

This resolution makes it as if the sustainable diet we want should be considered in the long term. No to No! There is a way to apply it today. It also acts as if the voluntary measures coordinated with the industry would be enough to protect the entire population from the junk food that is thrown into the pubs on television!

There is nothing else in this resolution on advertising that targets children and whose regulation is indeed a federal competence. So our dear little ones can continue to be formed to eat mars and soda!

The resolution calls on the government to work at European level for better labelling of fats and oils "to enable consumers to avoid harmful fats". Why should we accept harmful fats in foods, even with good labelling? As if the problem would be solved with more and more unreadable and less and less read labels!

Nor is there anything in this text about the inevitable regulatory measures when the agro-food industry does not follow.

Voluntary agreements take a lot of time. The automotive sector has delayed the implementation of pollutant emission standards at European level by not applying voluntary agreements.

We also find nothing about the essential question of food time to guarantee to the workers. We demanded that companies be required to give workers enough time to eat at noon, given the importance of this meal for our calorie needs.

Nothing about animal food. In fact, as we eat animal products, it is ⁇ important to think about how animals feed themselves. It is known that animals overfeeding with cereals and soybean give too high-fat omega-6 products at the expense of omega-3 fatty acids. Therefore, it is important to consider the diet of animals. I hope Ms. Warzée will be able to confirm this point.

Given the mediocrity of this text presented to us, in view of the enormous challenges of food for our health, for the environment, for the social functioning of society, we cannot adhere to it. We will abstain, with great regret, because it still contains our signature.

We had made an effort to submit amendments to correspond in all respects to the institutional agreement. The PNNS will be regionalized, of course, but there is still a lot to do at the federal level. As the Minister says, policy consistency must be ensured. The federal level must apply this principle: nutrition in all policies as health in all policies.

The PNNS assessment pointed to the fragmentation of measures that prevented the adoption of appropriate measures, pointed to the insufficient application by the interested parties. And above all, the evaluation of the previous plan recommended greater political support, sufficient means for achieving the goals, more attention to health inequalities, a coordination structure and a follow-up of federal actions after the Sixth State Reform.

I wonder to what extent these recommendations have been heard: the text we vote today does not prove this. Where will we go with such a soft text? Is our parliamentary duty really fulfilled by voting this text? The answer is in the question.

I would simply say that our text has a general purpose, it is true.

It should also not be allowed to believe that before this resolution, which is a good initiative since the former PNNS has been evaluated, no one was concerned with this topic. The stakeholders are very active in this area. Therefore, it is worth avoiding caricaturing this proposition by calling it minimalist. We have developed a general, federal vision corresponding to the powers that the federal state will retain as a result of institutional reforms.

In particular, we emphasized two important points. First, nutrition should be considered as a social and cultural phenomenon, and not merely nutritional. Mrs. Deiège reminded me of it. Everything is a matter of balance. Certain products, such as meat, should not be stigmatized. Everything is a matter of dosage, in protein as well as in fat.

Then, we pledged to keep the federal state in its role as responsible for investigating the eating habits and lifestyle of the Belgians. We know that the evolution of obesity is not very positive. In any case, without regular investigations, we cannot solve the problems that arise. In addition, they will allow the Communities to continue to carry out their actions.

Many factors influence the emergence of pathologies such as cardiovascular diseases, cancers, obesity, diabetes, osteoporosis, which are in part related to the environment and to our lifestyle, whether tobacco smoking, alcoholism or lack of exercise.

Among these different factors, it is now established that nutrition plays an essential role. Food is often overlooked in our society – we often eat anything, any way and any time – while healthy eating is an ally of choice and a major asset for ⁇ ining health. This point is all the more important since nutrition is a factor on which intervention possibilities exist both at the individual level and in terms of public health and prevention. This includes information on the composition of a balanced daily diet, the strengthening of the training of health professionals, the improvement of school restoration, etc. This is why the National Health Nutrition Plan, initiated in 2006 by the federal government, provided a reference framework and produced many tools and incentive mechanisms to support actions.

As confirmed by the evaluations of previous National Health Nutrition Plans, we measure that much remains to be done in terms of nutrition. That is why we want, through this resolution, that the government strengthen its policy in this area.

Nutrition is everyone’s business. Effective progress in nutrition can only be achieved if all relays, all actors mobilize, each at its own level. The government agreement of 1 December last year provided for the upcoming communityization of Plan Nutrition Health. In this context, we advocate that the federal state supports the actions developed by the federated entities to increase their mobilizing effect. This is the purpose of point 1 of this resolution.

We believe that coordination and cooperation between the different levels of power must be developed structurally in order to conduct a coherent policy, obtain broad support and effective execution of actions at all levels. In fact, situations should be avoided where the federal prepares effective tools but where it is imperative to find that the monitoring is not carried out at the level of the federal entities.

As an example, I will only mention the three charges that have been prepared for food supply in school canteens, business restaurants and automatic distributors. The above-mentioned charges prepared at the federal level have been handed over to the community ministers, notably of Education, but at the level of the French Community, the teaching officials have not yet seen anything coming.

I would also like to focus on point 2 of this resolution. In my opinion, it is important that through the National Nutrition Plan and the resulting communication – I am, here, in total disagreement with my colleague Ms. Snoy – we do not stigmatize any food. Indeed, as part of a balanced diet, they all have a full place. You may have understood: I think, in particular, of meat. This is a food rich in nutrients, protein, vitamin D, vitamin B (especially vitamin B 12), iron, zinc, selenium. Consumed in moderation, it therefore has its role to play in a balanced diet. We therefore advocate for a positive communication to be developed on the necessary diversification of our diet. We all know the negative impact that communication that stigmatizes a specific food can have on a sector.

As for animal feeding, it should be known that currently farmers are specialists and that there are livestock nutritionists who determine balanced rations. Therefore, it is not the farmers who fix the proportions of this or that food, especially dry food. Determined portions are the result of serious studies conducted by specialists.

Mr Warzée, we generally agree that the meat consumption should be moderated because the latter has impacts that cannot be denied. It all depends on the type of agriculture and the type of livestock. Everyone knows that in our regions, cattle feed primarily on grass and benefit from good nutrition and an achieved balance of fatty acids. These are good products. But, as you said, meat should be consumed with moderation. We aim at the excessive consumption of meat that exists today and which has been encouraged by the intensive production of a whole range of feed animals. At this level, the nutritional balance necessary for the health of the consumer is not aimed at.

It is designed to produce a lot of meat, as much meat as possible at the lowest cost. This is why farmers are advising farmers.

It is not the farmers who choose how they feed their animals. They are bound by market constraints. But this market, we challenge its rules!

I contest your words!

We have had this debate in the committee and we will not start it again.

I would just like to add the following comment.

Rather than asking what to replace meat with, it is better to ask yourself about the best way to follow a balanced diet, with menus allowing meat consumption in a moderate way.

I’m not going to extend your words about the feeding of cattle. I do not agree with these at all!

Finally, I think it is important to combine the food industry, the large distribution and the horeca sector in order to succeed in reducing the content of salt, added sugar and saturated fats in food products.

Mr. Speaker, dear colleagues, the MR Group will support the Federal Health Nutrition Policy resolution proposal as it is convinced that it is part of the continuity of the previous National Health Nutrition Plan and that it traces strong guidelines to strengthen the various future actions in this area.

I wish everyone a good appetite. Eat the meat!