Obesity is more common in Finland than in the other Nordic countries, and around two thirds of men and about half of women of working age are at least somewhat overweight.
When Seinäjoki, a city of 62,000 in South Ostrobothnia, first launched a programme to fight diabetes among children and adolescents, it was found that obesity and excess weight was on the rise in these age groups. For example, 17 percent of schoolboys were deemed overweight in 1997 and 23 percent by 2013.
"Something had to be done about this," says the town's Coordinator of Health and Welfare Promotion, Ulla Frantti-Malinen.
Health a universal possibility
In 2013 Seinäjoki set a target to reduce obesity and excess weight among children and adolescents. The goal was to promote healthy changes in the lifestyle of children and families with lifestyle guidance, nutrition and physical exercise.
"We established monitoring indicators, offered education, upgraded lifestyle guidance, and began creating a path toward dealing with children's weight and the risks of weight gain," Frantti-Malinen explains.
Preventive measures are focused on families, early education and schools. This demands that risks and healthy lifestyle choices are discussed openly and without assigning guilt.
"It's often asked how much pressure we put on families and on the children, but we aren't working on obesity. Instead, we are providing all children with the opportunity to eat healthy food. The model avoids passivity and encourages a culture of physical activity," Frantti-Malinen adds.
The model implemented in Seinäjoki includes nutrition services at schools and early childhood education facilities that meet "heart friendly" standards, with fats, sugars, salt and fibre content all carefully monitored. At daycare centres, children's birthdays are marked with physical activities rather than sweets or birthday cakes. Schools have long recesses during the day and the playgrounds of schools and daycare centres are designed to encourage sports and physical activity.
Guidance in healthy childhood lifestyles begins at maternity clinics even before a child is born.
Overcoming obesity is not a project with a separate budget, rather a part of general public service policy. All municipal sectors in Seinäjoki, up to and including zoning and civil engineering departments, are involved in the programme.
"The core of Seinäjoki's healthy children model is multi-disciplinary cooperation," says Helli Kitinoja, who directs global education services at the Seinäjoki University of Applied Sciences.
The model has aroused interest both in Finland and abroad. The World Health Organization (WHO) first reported in 2015 on how childhood obesity in the city was being curbed by integrating health in all local policies.
"Every Finnish municipality has the same services. Maybe we were just lucky that the WHO provided us with some PR. On the other hand, if someone is able to do even something small about such a difficult public health issue, it's worth noticing," points out Frantti-Malinen.
Interest in the programme has also become a draw for the city. This week, Seinäjoki is hosting an international "Healthy Kids of Seinäjoki" conference which is intended to be a recurring event for dialogue on challenges on health and welfare promotion and obesity prevention.
More work to be done
"It was sensational when weight averages showed significant drops for 2009-2015, but now they have started rising again. Last year, the dental health of children below school age had declined, and it can be seen in weight statistics, too. Is it possible that families don't have the resources they need, for example to make sure children's teeth are brushed?" Frantti-Malinen wonders.
Both Frantti-Malinen and Kitinoja stress, however, that rather than worrying about weight and preventing gains as such, it is better to focus on general health.
"If we can influence even just a few children to grow to adulthood with well-balanced weight development, it will be like winning the lottery for the city," says Frantti-Malinen.