Nutrition and physical activity policies in population-based prevention of non-communicable diseases and their evaluation.

The unsuccessful fight against the obesity pandemic has shown that the situation cannot be solved by education and interventions aimed at individual behaviour change alone. An environment that facilitates healthy choices and discourages unhealthy ones needs to be created through policy measures. The NOURISHING and MOVING tools have been developed in the context of addressing obesity, allowing for the evaluation of government policies on nutrition and physical activity. 10 key areas of action have been defined for nutrition and 6 for physical activity. In a comparison of 30 European countries, the biggest nutrition policy gaps were in limiting food advertising (29 out of 30 countries with poor ratings), harnessing supply chain and actions across sectors to ensure coherence with health (29/30), providing nutrition education and skills (28/30), and setting incentives and rules to create a healthy retail and food service environment (27/30). In the area of physical activity policies, the greatest gaps were in structures and surroundings which promote physical activity (29/30), physical activity training, assessment and counselling in healthcare settings (29/30), and transport infrastructure and active societies (26/30). The Czech Republic ranks among the four worst countries in nutrition policy, having introduced measures in only six areas, with the highest rating of "average" and only 10 out of 41 measures introduced. In physical activity, the Czech Republic also ranks among the 7 countries that have introduced measures in only four areas, with the highest rating of "adequate" and only 6 out of 23 measures introduced. Prevention in the form of government policy measures is crucial and without it, the rise in obesity and the risk of major non-communicable diseases will not be halted.