The food and nutrition policy and action plan for Malta launched earlier this year urges better dietary habits to prevent several chronic diseases. Charmaine Gauci, director of the Health Promotion and Disease Prevention Department, gives us the low-down.

Obese people are at risk of several chronic diseases such as hypertension, ischaemic heart disease, stroke and some types of cancer. Photo: Darrin Zammit LupiObese people are at risk of several chronic diseases such as hypertension, ischaemic heart disease, stroke and some types of cancer. Photo: Darrin Zammit Lupi

Unhealthy eating is responsible for a wide array of health problems that plague today’s society: from obesity to several chronic diseases such as hypertension, ischaemic heart disease, stroke and some types of cancer.

In line with the Ministry for Health’s mandate of “a society that fosters an environment that is conducive to persons attaining their maximum potential for health and well-being”, it was determined that the 1990 Food and Nutrition Policy for Malta needed to be revised and an action plan formulated.

The Healthy Weight for Life – National Strategy for Malta to counteract obesity, launched in 2012, also aimed to get the Maltese population on a healthier diet.

The World Health Organisation-Malta Biennial Collaborative Agreement (BCA) funds made it possible to start the process and in 2012, WHO technical expert Joao Breda held a series of meetings with various local stakeholders.

That is how the new policy for Malta, Better Dietary Habits to Maximise Health for Maltese People, was formulated. It aims to “address the main public health challenges facing the Maltese nation in the area of nutrition associated with diet-related non-communicable diseases”.

The main public health challenges are the high prevalence of obesity in adults, adolescents and children; the high intake of salt, sugar and fat, especially saturated fat, and the low intake of fruit and vegetables.

The action plan aims to improve services relating to diet and physical activity

The guiding principles of the plan include the need for ‘health in all policies’, since food choices by the population largely lie outside the health sector – mainly agriculture, education, environment, finance, trade and the media.

All these sectors are considered to have a high influence on the quality of foodstuffs that are available in Malta.

The action plan takes a life-course approach. It aims to strengthen our health system at both primary and secondary care settings to improve services relating to diet and physical activity. It also focuses on achieving equity by addressing the social determinants to reduce health inequalities.

The following areas were identified as ‘priority’ for Malta.

• To develop a communication strategy for the Food and Nutrition Action Plan engaging all stakeholders.

• To develop a comprehensive system for surveillance and monitoring of food consumption. This will incorporate existing surveillance systems and a new nutrition surveillance programme for all ages that will include information on dietary behaviour. Studies are also necessary to provide food composition knowledge of local products.

• To develop the capacity for research in the area of food and nutrition. This must deliver adequate training to upgrade local knowledge.

Strategies for a healthier population

• To review the Maltese Food-based Dietary Guidelines (including guidelines for healthy eating for men and women as they age), based on a systematic review of evidence on the Mediterranean diet adapted to the local Maltese culture.

• To carry out feasibility studies on fiscal/price policies in order to create a framework of incentives to ensure affordability and accessibility of healthy food for all.

• To engage with agriculture and fisheries on the promotion, accessibility and affordability of fish, fruit and vegetables.

• To introduce agreed mechanisms to reduce salt and sugar, limit saturated fat and eliminate trans fatty acids in local and imported food, with minimal change in taste.

• To evaluate and monitor people’s salt intake; evaluate and monitor the salt content of local food products; continue raising public awareness on salt reduction and work to offer salt-free or salt-reduced local food products.

• To support a healthy start to life by continuing to promote, support and protect breastfeeding through the adoption and statutorisation of the WHO International Code of Breastmilk Substitutes and related products and enforcement of this legis-lation. It aims to create incentives within workplaces and public places to support and protect breastfeeding mothers.

• To further consolidate current school initiatives intended to promote and protect healthy diets, drinking of plain safe water and physical activity through the development of a School Nutrition Programme.

• To create awareness of the negative impact sugary drinks have on oral health and to monitor and evaluate their consumption. Schoolchildren’s oral health can be highly improved through reduced sugar intake from food and beverages.

• To prevent malnutrition by ensuring the affordability and accessibility of food for older people, thus guaranteeing a well-balanced nutritious diet.

• To enhance workplace health promotion on food availability and consumption. The workplace provides a unique opportunity to increase awareness and provide life skills (particularly among males) to avoid the main risk factors for non-communicable diseases such as unhealthy diets, lack of physical activity, excess weight, binge drinking and smoking.

• To evaluate, reduce and monitor the impact of marketing pressures on children from the media (including social media). Further action is needed to ensure that legislation is adequate and properly enforced.

• To improve the capacity of the health systems to adequately address the health needs of the population in the area of nutrition, improved training of healthcare professionals, referral of patients to the appropriate services and ensuring there are adequate numbers of registered nutrition professionals in both primary and secondary care.

• To ensure that this action plan is monitored and evaluated in a timely manner.

The action plan is currently in the consultation phase and any feedback is appreciated on health.pro@gov.mt.

For more information one can contact the Health Promotion and Disease Prevention Directorate on 2326 6000.

Overweight and obesity figures

  % Overweight % Obese % Overweight & Obese
Children aged 8 24.85 18.85 43.7
Adolescents - - 25.0
Adults 36.0 22.0 58.0
Sources: ECOSI (2008), HBSC (2010) and EHIS (2008)

Biological risks

Risk factor % self-reported
Hypertension 22.7
Diabetes 8.05
Hypercholesterolaemia 8.9

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