Seán Power (Kildare South, Fianna Fail)

The Deputy is aware that the description of metabolic syndrome is of fairly recent origin, having first been described by Dr. Gerald Reaven in 1988. The syndrome has a set of risk factors, which include abdominal obesity; a decreased ability to process glucose, or insulin resistance; dyslipidemia, or unhealthy lipid levels; and hypertension. In a recent joint statement, the American Diabetes Association and the European Association for the Study of Diabetes questioned the diagnosis of metabolic syndrome. An editorial in this week's British Medical Journal noted that the debate on the existence of the syndrome will continue. The concept of metabolic syndrome provides a useful practical way for clinicians to identify patients with multiple factors which place them at a high risk of developing type 2 diabetes and cardiovascular disease. The concept also provides a rational basis for linking the actions in public health programmes like the cardiovascular strategy with the recommendations of the task force on obesity.

International literature has estimated that the prevalence of metabolic syndrome in the adult population of developed countries is between 22% and 39%, depending on the definition used and on ethnicity. There is not much information on the incidence of the syndrome. As there is no specific ICD code for metabolic syndrome in the ninth revision — clinical modification — of the international classification of diseases, it is not possible to state how many cases of metabolic syndrome are routinely identified and treated in Ireland. The prevalence of cardiovascular disease, type 2 diabetes and obesity is well documented, however. Some 39% of adults in Ireland are overweight and 18% are obese. Approximately 5% of the population is diabetic and over 40% of all deaths result from cardiovascular disease. It is well known that risk factors for these diseases are significantly inter-related.

Additional information not given on the floor of the House.

Lifestyle modifications are the primary interventions which help to reduce metabolic risk factors and manage short-term and long-term risk. Such lifestyle interventions include weight loss to achieve a desirable weight, defined as having a body mass index of less than 25 kg/m2; increased physical activity with a goal of at least 30 minutes of moderate intensity activity on most days of the week; and healthy food habits which include reduced intake of saturated fat and cholesterol.

The Government established the national task force on obesity in response to this country's obesity trends. The remit of the task force is to set out a strategic framework that identifies best practice for prevention, detection and treatment of overweight and obesity. The report of the task force, which was launched in May, makes 93 recommendations which relate to actions across six broad sectors: high-level government; education; social and community; health; food commodities, production and supply; and the physical environment. The report's main aim is to create a society that enables people to eat healthily and to be physically active. An implementation plan for the report is being developed by the Department of Health and Children's health promotion unit. Additional funding of €3 million has been made available to the HSE in the Book of Estimates to support the implementation of the report's recommendations. I would like to outline some of the key recommendations.

The report of the national obesity task force recommends that every child should be able to achieve a minimum of 30 minutes of dedicated physical activity every day, in all educational settings. As part of their school development planning, all schools should be encouraged to develop consistent policies to promote healthy eating and active living, with the necessary support from the Department of Education and Science. Such policies should address opportunities for physical activity and what is being provided in school meals. The report recommends that the Department of Arts, Sport and Tourism should co-ordinate with the Department of Education and Science the shared use of sports and physical activity facilities by schools and communities. Community skills-based programmes should be developed to provide skills such as food preparation, household budgeting and those which can promote physical activity. The health services, in their strategic planning and delivery, should advocate and lead a change in emphasis from the primacy of individual responsibility to environments which support healthy food choices and regular physical activity. An education and training programme for health professionals in the appropriate and sensitive management of overweight and obesity should be developed and implemented. Programmes should include training in developing life skills for healthy eating and active living and counselling.

The report of the task force recommends that the Departments of Enterprise, Trade and Employment and Health and Children, together with the private sector and consumer groups, should take multisectoral action on the marketing and advertising of products which contribute to weight gain, particularly those aimed at children. The Department of Agriculture and Food should review policies in partnership with other Departments to promote access to healthy food. Such policies should encompass positive discrimination in the provision of grants and funding to local industry in favour of healthy products. Guidelines for food and nutrition labelling should be reviewed to ensure labelling is accurate, consistent, user-friendly and contains information on portion sizes and nutrient content. The Department of the Environment, Heritage and Local Government should develop coherent planning policies for urban and rural housing, transport, amenity spaces and workplace settings to encourage spontaneous increases in physical activity in adults and children. The task force also recommended that the Irish Financial Services Regulatory Authority should examine the high costs of public liability and their impact on physical activity and should foster initiatives to address such costs.

A new campaign, Every Step Counts — Small Changes Make the Difference, which was developed in 2004 in response to the increase in the levels of overweight and obesity, promoted two main lifestyle areas — healthy eating and regular physical activity. The 2005 campaign, which is due to be launched later this month, will focus on promoting physical activity and the consumption of five portions of fruit and vegetables daily. The health promotion unit of the Department of Health and Children is also developing a national nutrition policy. It is envisaged that the policy will provide strategic direction on nutrition for the next five to ten years. The policy's target group is young people under the age of 18 and its priority actions are obesity and food poverty. A national consultation has taken place and the policy is due to be published early in 2006.

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