Directions: The following text is abridged from a welcome address delivered by Markos Kyprianou, EU Commissioner for Health and Consumer Protection at EU Conference on Prevention of Type 2 Diabetes. Read through the text, try to capture the key information and write a well- structured, coherent summary of 300 words based on its main ideas. Write your version on the Answer Sheet.

Let me thank you for the opportunity to speak at the opening of this important conference, which addresses one of the most serious public health challenges that we are facing.

It is estimated that about 25 million Europeans are presently living with diabetes in the European Union’ s member states. The average prevalence rate in these countries is estimated at 7. 5 % of the adult population. And to make matters worse, the experts think that as much as 50 % of those with diabetes are unaware of their condition.

Diabetes is a chronic and progressive disorder that impacts on almost every aspect of life. In the midst of our populations, this disease takes a terrible toll. Diabetes is a leading cause of blindness. People with diabetes are also at higher risk for heart disease, kidney failure, amputations, and other chronic conditions.

And if we turn our eyes from the patients and look at society as a whole, we see that the cost to our over- burdened health care systems and our economies in general is just as unacceptable as the human suffering that goes along with this disease. The total cost of diabetes across the EU is estimated at 2. 5-15% of total health care spending, and that does not include the wider costs to the economy—working days lost, and early retirement.

What makes matters worse is that diabetes is a risk that many Europeans seem to know surprisingly little about. There is little awareness of the fact that people with diabetes are far more likely to have a heart attack or stroke than those without diabetes. With cardiovascular disease being one of the biggest killers of our citizens, this ignorance can be fatal.

In fact, diabetes increases the risk of having a stroke by a factor between two and four, and around 80% of all diabetes patients die from CVD.

The increase in diabetes, which we see, is strongly linked to the prevalence of obesity, which is rising rapidly. Put bluntly, today’ s obese children are tomorrow’ s middle- aged heart attack victims. Tackling childhood obesity now is a highly effective way of preventing diabetes and heart disease in the future. Type 2 diabetes Was once a disease of adults 40 and older, referred to as “mature onset diabetes” . Now it’ s found in children as young as eight. Why? Because our children are more sedentary and overweight than ever before. In fact, in some of our member states the number of overweight children has tripled in just two decades. Yet as somber as this picture is, there is also good news. Although medical research and technology provide invaluable support, and offer hope of more effective screening, treatment and management of the disease, fighting diabetes is largely a low-tech exercise.

Prevention is the key. The overwhelming majority of diabetics suffer from Type 2 diabetes, which is largely preventable. And prevention is surprisingly easy. The major battlefields here are influencing the lifestyle choices that individuals make—and shaping the environments in a way to make healthy choices easy. In order to win this battle, coordinated and coherent efforts are required across a broad range of policies, by a large number of different stakeholders, and at levels ranging from the local to the international level.

As there is an almost linear relationship between body mass index and diabetes risk, weight management is the best strategy to prevent the development of Type 2 diabetes. Modest and easily achievable increases in our level of physical activity, and paying more attention to the food we eat, can work wonders. It is proven that moderate physical activity can substantially reduce the risk of developing Type 2 diabetes—not to mention heart disease, colon cancer, high blood pressure and obesity. Research also shows that eating more fruits and vegetables can help prevent not just diabetes, but also cancer and heart disease.

In our efforts, we should put particular emphasis on providing our children with the skills they need to lead healthy lives. We need to get them off the junk food, and we need to make them more physically active, off the play consoles and onto the playgrounds. I call on the schools to help parents in their efforts, and I call on town and city planners to allow more places for children to play, cycle and generally exercise, and to ensure that walking and cycling to school is safe again.

These examples show that preventing diabetes is closely linked to preventing obesity, CVD, or certain forms of cancer. In fact, all these chronic conditions are closely linked to our physical, social and cultural environments, and to the way we live our lives within it. It is the lifestyle determinants, and the wider determinants of health—social, cultural and economic—which form the matrix from which many chronic conditions arise.

And because these major chronic diseases have common or related risk factors, it makes sense to follow a common approach to address them at the prevention stage—it being understood that interventions further down the road, particularly when it comes to screening and treatment, will have their own particular characteristics.

We have in fact managed to engage all relevant stakeholders at the European level in a joint effort to pledge more action towards healthy eating and towards promoting physical activity. In March 2005, I have launched the European Platform on Diet, Physical Activity and Health together with the Presidents of the Health council and of the European Parliament’ s Health Committee. The Platform aims, quite simply, to catalyze action that encourages healthier diets and more physical activity.

Its members include the key EU-level representatives of the food industry, advertisers, retailers, fast-food restaurants, the cooperative movement, the consumer movement and health NGOs.

As a first step, the Platform has established a baseline, mapping what each of its members has already been doing to promote healthy eating and regular exercise.

Members have now drawn up action plans of the new initiatives, which they plan to launch in the framework of the Platform process, and of the new investments they plan to make in the future. As part of a transparent process, these plans can be followed in a publicly accessible database on the Commission’ s web site.

Although it is still too early to draw definite conclusions, I think that the Platform is moving in the right direction, and I have been encouraged by some of the responses of industry and other stakeholders to this process so far. As an example, the European soft drinks industry has committed itself, as a result of the Platform process, not to engage in any direct commercial activity in primary schools.

I will meet all the Platform members later this month in order to discuss progress so far. And I have made crystal clear what I want to see coming out of this process:

I want to see a significant increase in the collective effort devoted to fighting obesity and overweight in Europe. Warm words and a few token initiatives will not be enough. We are looking for concrete and sustainable results.

In parallel with the Platform process, which aims at quick and effective action, we have to develop comprehensive policies to address chronic conditions such as diabetes and CVD.

With this objective, the Commission adopted in December last year a Green Paper “Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases” , which will pave the way towards the establishment of an EU strategy on diet, physical activity and health.

I would also like to mention that apart from tackling the determinants of the disease, the Commission is also committed to promoting research into the causes and the treatment of the disease. Under the 5th Research Framework Program alone, about € 40 million were spent on diabetes research. On a more moderate scale, the Public Health Action Program also offers possibilities for the funding of dedicated diabetes prevention projects. One example is the project “Diabetes in Europe-Prevention Using Lifestyle, Physical Activity and Nutritional Intervention” , which will be presented at this conference.

Finally, let me also mention that the prevalence of diabetes will also continue to be monitored under the health information strand of the public health program.

In conclusion, let me say that I am extremely grateful to the Austrian Presidency for raising awareness to the need for diabetes prevention. We just cannot accept the toll that a largely preventable disease such as Type 2 diabetes takes amongst our populations. I very much admire the leading NGOs in this field for their commitment and determination to raise awareness on the disease, and to improve the quality of life of diabetes patients. And I can assure you that I will do everything in my power to make sure that tackling the factors behind the diabetes epidemic will continue to be a priority on the European Union’ s health agenda.