Oireachtas Joint and Select Committees
Tuesday, 18 December 2012
Joint Oireachtas Committee on Agriculture, Food and the Marine
Objectives and Activities in Promoting a Healthy Ireland: Discussion with Nutrition and Health Foundation
I welcome Dr. Muireann Cullen, manager of the Nutrition and Health Foundation, and thank her for coming before the committee to present on the foundation's objectives and activities in promoting a healthy Ireland. By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to this committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to do so, they are entitled thereafter only to a qualified privilege in respect of their evidence. Witnesses are directed that only evidence connected with the subject matter of these proceedings is to be given. They are asked to respect the parliamentary practice to the effect that where possible they should not criticise or make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such as way as to make him or her identifiable.
Dr. Muireann Cullen:
I thank the committee for giving us the opportunity to come before it and make a presentation. I am a dietician and manager of the Nutrition and Health Foundation. I have worked with the foundation since 2008 and prior to that I worked in hospitals, GP settings, food law research, private practice, public health nutrition and in the food industry.
With the Nutrition and Health Foundation, the consumer is the principal concern and the heart of our mission, which is to promote a healthier Ireland through co-operation with industry, internationally recognised scientists, key health professionals, the Government, its agencies and the consumer. It is about promoting a balance between physical activity and good nutrition, which is essential to maintaining a healthy lifestyle. All relevant stakeholders must work in partnership to promote this message and make a real difference to Irish society.
Since 2005, IBEC's Food and Drink Industry Ireland has invited different organisations to join the foundation to jointly address the health challenges. This multi-stakeholder body provides consumers with evidence-based information on nutrition and physical activity to help enable them to make informed lifestyle choices. To date, more than €2 million has been invested voluntarily in the organisation by a number of food and beverage companies. The initiative may come from the industry but the foundation takes direction from its council, which is comprised of industry and non-industry stakeholders.
I have provided a full listing of members in the presentation and in the interests of time I will not go through all of them. Examples include Glanbia, Mars Ireland, Coca-Cola, Danone, Kelkin, the Irish Nutrition and Dietetic Institute - the professional body for dieticians in Ireland - the Irish Society of Chartered Physiotherapists, and academic institutions like UCD, UCC, DCU, St. Patrick's College in Drumcondra, etc. It is about bringing together the different and relevant stakeholders with an interest in health to the table and working together.
It is a multi-stakeholder partnership approach, and contribution from all supporters is essential. All activities must be agreed by all stakeholders. The foundation does not speak on behalf of the industry, defend it or lobby on behalf of food companies. We are focused on the health agenda, with aim being to promote positive messages of balance within diet and lifestyle. We also ensure messages are compliant with the Government and other stakeholder messages.
There is the important question of what the foundation can do. It is about bringing balance to the obesity debate through evidence-based information on nutrition, physical activity and lifestyle. This is a multi-stakeholder group, with key professionals such as Professor Pat Wall, Professor Mike Gibney, Professor Donal O'Shea and Professor Niall Moyna, as well as non-governmental organisations and representatives from the industry. It is very much about thought leadership and comprehensive communications and initiatives.
There is also the question of what can be done for the foundation. That issue is about recognising, supporting and publicly endorsing the work of the foundation through party or individual statements. We all have a responsibility with regard to obesity, irrespective of the sector in which we work, and we must work together. There is a workplace well-being campaign that will be partially funded by Food and Drink Industry Ireland's Live Well initiative, which I know the committee has heard of previously.
One aspect of the foundation's activities is to enhance consumer understanding. I have brought a sample copy of a booklet that has just been launched, entitled Eat Smart, Move Smart. We have done this in working with the Camogie Association of Ireland, and it takes in nutrition, physical activity, food and supplements. It deals with different questions that teenage girls and players brought up with regard to lifestyle issues. It is a toolkit to try to promote continued involvement of teenage girls in sport.
We work with the European nutrition foundation network and we have developed a European food framework for use either in schools or outside them, targeted at six to 16 year olds, taking in nutrition, physical activity and energy balance. One cannot discuss energy in without talking about energy out, and there must be balance in the lifestyle. There is also the Kids Size Me, an initiative taken with the Restaurants Association of Ireland to deal with providing child size portions of adult meals in restaurants. It will work in addition to a children's menu, because when something is taken away, people look for it. It is about providing greater choice for parents and children when in a restaurant, and we have developed nutritional guidelines where meals are prepared that may be consumed by children. The initiative also extends to drinks and desserts offered.
We also work in research to enhance consumer understanding, and we have been involved with lifestyle behaviour change for general practice, which relates to a paper published by the Irish College of General Practitioners. There was partial funding of the Irish Universities Nutrition Alliance teenager survey from 2008, with our own research taking in motivational aspects of behavioural change. We are very much involved in research either as funders, partial funders or in an advisory capacity.
With regard to communication, we have been working within the Houses of the Oireachtas to lobby on the obesity issue and ensure it remains on the political agenda. We are also looking to work with the catering team on portion sizes and healthy options on menus. The work is ongoing, although there is great sadness because Mr. Don Rice has retired. I hope to work with Ms Gráinne Barrett in future, although Mr. Rice was a great advocate and is sadly missed.
The workplace well-being campaign is an initiative taking in workplace nutrition and physical activity, and free booklets are available to employees. There is information on what can be done during a working day with regard to nutrition and physical activity and improvement of overall choices. We hope that message will filter into homes. We have more than 100,000 employees and in excess of 300 organisations involved in that programme to date but we are looking to expand.
We also did work on Eat Smart week, a healthy eating week. We work with chefs and different organisations, and this year we dealt with My Kids Time. This shows people that healthy eating does not have to be complicated, expensive or boring. There is certainly an image of healthy eating by means of a carrot stick and lettuce leaf, when everyone else is getting stuck into a steak and chips. The information is available through the website. A balance to the healthy eating side of the process is the Move Smart week, which is about being out and physically active. No matter what we eat, we must burn off calories as well. The campaign was about showing that physical activity is not boring or hard to do and about showing easy ways to do it.
We also have a consumer-friendly website that takes in both nutrition and physical activity, as they go hand in hand and we cannot speak about one without the other. Anything we do is publicly available. We are working with the Spurling cinema group to carry out a survey of consumer behaviour at the cinema. It asks if consumers purchase food going into the cinema or outside it, what they purchase, the portion sizes, etc. This will indicate whether we can undertake an initiative taking in healthy options in cinemas, although that will depend on what consumers tell us. For example, they may argue that the cinema is a treat area and should be left alone. Nevertheless, we must get an idea of people's perceptions and behaviour when they go to the cinema.
We also have an annual seminar, which was kindly opened by the Chairman this year. That examines the role of public and private sectors in tackling obesity, bringing different groups to the table and offering the opportunity for members of the public to ask questions. It involves national and international academics, as well as representatives of the food industry and non-governmental organisations.
At the seminars, national and international academics, the food industry and NGOs address and debate research and initiatives in the fields of nutrition, lifestyle and physical activity. People can avail of this work as a networking opportunity.
It is important to acknowledge that many factors play a role in the prevention and management of overweightedness and obesity in Ireland, including Departments, education, the food and beverage industry, sectors that are responsible for physical environments and the social and community sectors. A co-ordinated, united, cohesive approach is necessary if we are to address obesity.
I thank members for their attention and I will happily address the questions they may have.
Dr. Muireann Cullen:
Acknowledgement of the work in party and individual statements. As we have initiatives that may be of interest in members’ constituencies, the committee could convey that information. Information on what we do is freely available through our website, for example, the workplace initiative and seminars.
The booklet is available to download for free on the Camogie Association of Ireland website. We will put it on our website shortly. The hard copies will be for sale and can be pre-ordered for €7.99, which is not expensive. It is another opportunity to convey healthy messaging, particularly to teenage girls in school. As they might have jobs and are trying to study, etc., a balance must be brought to their lives that sees them being physically active.
I thank Dr. Cullen for her informative presentation. Does the growing poverty trap mitigate against the foundation’s efforts to encourage healthy eating? Many people, particularly low income families, find healthy eating difficult. People will go for the cheapest food.
Dr. Muireann Cullen:
While that is the behaviour, we must send the message that people can buy cheaper cuts of meat and still reduce the fat content through the way they are cooked. The same applies to frozen fruit and vegetables. Fresh can be more expensive, although it depends on where one shops and what is available. Frozen fruit and vegetables are not as expensive and one need only use what one needs without wasting anything.
The message must be that healthy eating need not be too expensive or require the freshest food available. Often, frozen foods can be more nutritious, in that they are flash frozen immediately after being picked instead of sitting on shelves during transport and losing nutrients every day. It is just a matter of shopping wisely and encouraging people to make better choices.
I thank Dr. Cullen for her presentation. In today’s society, we can see the problems with obesity that future generations will face. Conveying the message is important.
Dr. Cullen mentioned that the foundation incorporates 14 industry members from which it receives €2 million in funding. From where does the rest of the funding come?
That was where I was going with my next question. Over seven years, 14 companies in the industry have provided €2 million. I am disappointed that more names are not on that list.
When funding is lacking, it is difficult to get the message out. This committee has an onus. As Dr. Cullen stated, the Nutrition and Health Foundation, NHF, does not make recommendations on any product. It is neutral. However, it would be of the utmost benefit to us. I am new to this committee in that I have only been a member for one and a half years and am only now discovering that something like the NHF, which relates to the nation’s health, is underfunded.
I do not know what interaction the NHF has with the HSE or the Department of Education and Skills or the Department of Health. Do they provide funding to convey this message? Relaying it would benefit the country. Obesity is a problem in other countries and we are destined for the same, given people’s lifestyles.
Dr. Muireann Cullen:
Yes. To be honest, we have not approached the other sectors for funding, as we recognise that these are financially constrained times. We have a relationship with the Department of Education and Skills and we liaise with the Department of Health to ensure that our activities are in line with the recommendations and to make the Departments aware of what work we will undertake. We also make the Department of Agriculture, Food and the Marine aware of what we are undertaking and would like to undertake.
I thank Dr. Cullen for her interesting presentation. From a communications point of view as much as anything else, the NHF seems to do excellent and important work. Does its work cross over with the work of other agencies? In a way, Senator O'Neill stole my question when he asked about how the NHF links with State agencies, and safefood forms part of this industry.
I am trying to understand the NHF's background. Dr. Cullen stated that it does not get involved in lobbying. For example, the issue of cheese was considered recently by the Broadcasting Authority of Ireland, BAI. Was the NHF involved?
Dr. Muireann Cullen:
No. We will start considering such work, but there are a few elephants in the room, as we call them. Given the fact that industry and non-industry actors are at the same table, there are divergent opinions on some issues. However, we will consider this area to determine whether we can develop position statements.
There are cross-overs with other agencies, for example, safefood and the Irish Nutrition and Dietetic Institute, INDI. The entire point of the NHF is to bring these groups together. Historically, debate centred on whether something was the private or public sector's fault. Everyone happily blamed everyone else. The NHF aims to cut that out and to get people to work together, as everyone has a responsibility and a role to play. If we are to achieve something, we must stand up at the table, be invested in health and work together on moving the situation forward.
Each of the organisations has its own activities. Under the umbrella organisation of the NHF, organisations work together on different activities to avoid cross-over. Anything that we undertake is agreed by all of our industry and non-industry members.
I thank Dr. Cullen for her presentation and I apologise for missing the beginning. I needed to step outside for a minute.
One of the slides in the presentation referred to bringing balance to the obesity debate through evidence-based information on nutrition. Where is the debate unbalanced or what type of balance did Dr. Cullen mean?
Dr. Muireann Cullen:
There are a number of aspects, for example, the demonisation of the food industry or particular foods. It can be easy to claim that something is the fault of the energy in side, but we need to consider the energy out side as well. As a nation, we are not as physically active as we used to be. Levels have gone through the floor. From research in the United Kingdom that will probably show to be the case in Ireland also, we know that carrot consumption has reduced in the past 60 years and that physical activity levels are abysmal. We would be lucky if 10% or 15% of teenagers met the requirements for physical activity. The same applies to adults.
It is a matter of achieving balance. Speaking as a health care professional, there is no such thing as a bad food. What matters is how often one eats it, how much of it one eats and how one cooks it. If one has a nice shiny apple and then deep fries it, one is doing it no favours. It is down to moderation.
My friend has a great expression that I love: "If you are sitting on it, you ate it."
We need to get up, get moving and be physically active. People do not realise how much effort it takes to burn off the calories we consume. A standard confectionery bar can be equivalent to 45 minutes on a treadmill. Have it as a treat but one should not have it on a daily basis or three or four of them in a day. There are many such foods. It is about moderation and conveying the message that we need to burn it off. We all have that responsibility and a role to play, be it the Government, industry, non-industry or the consumer. We have the power as consumers over the food we purchase and industry responds to what is being purchased. If we opt for healthier options all the time, industry will respond to that. It is reformulating products and looking at different portion sizes. We, as consumers, also have the power.
I thank Dr. Cullen for attending the meeting. I apologise for missing the start of the meeting. I am looking at the list of members, industry and non-industry. I am pleased to see that St. Angela's College, which is beside my home, is working with the foundation. Does the foundation deal with schools or liaise with secondary schools and third level colleges? Do members visit the classroom to talk to people?
Dr. Muireann Cullen:
No, because we do not have the resources. On a day to day basis, it is myself and another person working half-time. At present, I am fortunate to have interns with me as well, but they will leave at some point. We have developed the European food framework through the European Nutrition Foundations network, which I am happy to circulate to people. It is basically a guidance for use either in schools or outside regarding nutrition, physical activity and energy balance from five or six years old to 16 years of age. In some schools the social, personal and health education, and the healthy eating aspect, is very much promoted, but in other schools it is not promoted as much. It depends on the focus and recognising there are time constraints from a teacher's point of view as well.
However, it is about getting that message out in as many ways as possible and trying to find different ways of doing it, such as the Kids Size Me initiative, the cinema work and the camogie booklet. It is a case of trying to find alternative routes, because many areas are very crowded. Hopefully, people will hear the messages in different areas and then come across a booklet or whatever it might be, and seeing that in other areas as well. It is trying to get the message through subliminally as well. However, it is very much about positive messaging and encouraging people to get out, get active and eat healthily. As soon as one starts criticising somebody, it puts their back up immediately. It is a case of: "Who are you to come along and tell me what to do?" The approach we took with the camogie booklet is that we conducted focus groups with a number of teen squads to understand what their questions were, rather than us going to them and telling them that they need to know about X, Y and Z. Instead, we asked them what their concerns and issues were. Essentially, it is for them and by them at the end of the day.
There is. The purpose of the meeting today was to let members become aware of it. Deputy Ó Cuív and Senator O'Neill referred to what the committee or members could do. We all have websites, Facebook pages and Twitter accounts so the first thing we could do is put up a notice pointing to a link to the NHF website and the booklet, which is free online. That would be a start. The second thing, which has just been referenced by Senator Comiskey, is the fact that schools, particularly primary schools, have successfully developed the Green Flag programme. Joining with that in some fashion might allow it to become a module of the Green Flag. The programme was initially about recycling and then included energy saving, so it has moved beyond the first aspect of green. What we are talking about is sustainable eating, and the buzzwords "eat smart", "move smart" and "energy in, energy out" are easy to message to people. It is something we should encourage. The fact that the non-industry stakeholders outnumber the others is a healthy sign, even though the industry people provide all the cash. It is probably a balance one would like to see in other areas but it is hard to strike. The autonomy of the NHF must be preserved, and I know it is. As Dr. Cullen said, I opened this year's seminar and I was very impressed. It included Annalise Murphy, our unluckiest Olympian, who gave a very interesting talk.
It is a matter of creating awareness. We are all aware that obesity exists. Professor O'Shea and others who are doing a great deal of work on this are genuinely concerned about it. We all have a duty to ensure that we at least keep the issue on the agenda. When we get submissions from the Irish Business and Employers Confederation, IBEC, for various reasons we should continuously challenge that they are health-proofed. We had an issue with the cheese, as Deputy Heydon said, and the National Dairy Council became very exercised by it. It gave a graphic and factual demonstration of what was at stake and why, in its view, it was a flawed proposal. It was agreed to withdraw it afterwards. That is what we must continue to work towards.
I thank Dr. Cullen for attending. Perhaps she would send the link to that booklet to the secretariat of the committee. We will circulate it to the members and we can put it on our social interactive pages on the web so that people can read it and realise it is free. I suggest that members do that when they get the opportunity.
We will suspend the meeting to allow Dr. Cullen to withdraw and the new witnesses to take their seats.