Intended for healthcare professionals


The Vienna declaration on nutrition and non-communicable diseases

BMJ 2013; 347 doi: (Published 15 July 2013) Cite this as: BMJ 2013;347:f4417
  1. Debbie A Lawlor, professor of epidemiology1,
  2. Neil Pearce, professor of epidemiology and biostatistics2
  1. 1MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, Bristol BS8 2BN, UK
  2. 2Centre for Global NCDs, London School of Hygiene and Tropical Medicine, UK
  1. d.a.lawlor{at}

Time to look upstream

Vienna is sometimes called the “city of dreams” because of its central role as the birthplace of psychoanalysis. Now it is playing a central role in a very different type of health problem, that of non-communicable diseases. On 5 July the Vienna declaration was launched at the World Health Organization ministerial conference on non-communicable diseases in the context of Health 2020.1 Of particular concern was “the rapid rise of overweight and obesity, especially in children.”

However, whether this declaration will result in effective action is unclear. It highlights the need for a multiagency approach and high level political support, but the main emphasis is on downstream (individual level) solutions and individual responsibility for lifestyle change.

Children (and adults) become fatter because they consume more energy than they expend.2 Genetics also plays a role, but genetic factors cannot be responsible for the recent epidemic in overweight and obesity.3

Government recommendations increasingly acknowledge the varied ways people can achieve healthy levels of physical activity, but they tend to emphasise leisure time physical activities, such as sport, running, and going to the gym for adults, and school time activities for children.4 5 However, such activity accounts for only a small part of …

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