Newport Nutrition Improving nutrition is currently a public health priority. There are major concerns about the continuing rise in obesity rates – particularly in young people. It is becoming increasingly important to prevent nutrition-related health problems through joined-up, evidence-based action on nutrition. CONTENTS AUTUMN 2005-AUTUMN 2007 1 Introduction 2

2 Background 3 2.1 Direction 3 2.2 The Local Area 3 2.3 Diet, Nutrition and Health 5 2.3.1 Fruit and Vegetable Consumption 5 2.4 Local Health Needs 6 2.4.1 Overweight and Obesity 6 2.4.2 Breastfeeding 6 2.4.3 Chronic Illness 6 2.4.4 Oral Health 7 2.5 Physical Activity, Nutrition and Health 7

3 Priority Areas for Action 8 3.1 Priority Groups 8 3.2 Current Activities and Future Action 10 3.2.1 Development of Action Plans 10 3.2.2 Monitoring and Evaluation 10

Action Plans Birth to Pre-School 11 School 14 Young People and Adults 19 Older People 23

References 28

Appendices 30

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | CONTENTS | PAGE 1 1 INTRODUCTION This local nutrition action plan has been produced by agencies in Newport whose work is directly involved in the promotion of good nutrition (see Appendix 1). These agencies form the Newport Nutrition Action Group.

This local nutrition action plan has been The Newport Nutrition Action Plan is a produced by agencies whose work is 2-year plan from 2005 to 2007, to be directlyThe purpose involved of this Nutritionin the promotion Action Plan ofis togood map reviewedThe Newport annually Nutrition byAction the Plan Nutrition is a 2-year Action plan nutritionwhat is currently in Newport happening (see in AppendixNewport, identify 1). Group.from 2005 The to 2007, aims to ofbe thisreviewed action annually plan by are: the Thesespecific agenciesneeds, provide form a focusthe Newport for action Nutritionand avoid Nutrition Action Group. The aims of this action Actionduplication Group. of work. It should also provide further 1plan To are: improve the health and well opportunities for organisations to plan joint initiatives The purpose of this Nutrition Action Plan 1 Tobeing improve of thethe healthlocal populationand well being through of the and projects, and promote good practice. is to map what is currently happening in localthe promotionpopulation through of good the nutrition,promotion of Newport, identify specific needs, provide a goodparticularly nutrition, in particularly areas of in socialareas of social This document is the first of its kind in Newport, focus for action and avoid duplication of disadvantage.disadvantage. and should be viewed as a workable document work. It should also provide further 2To To provide provide agencies agencies in Newport in Newport with a clearwith that will be further developed and improved. A opportunities for organisations to plan joint focusa clear in promoting focus in goodpromoting nutrition good as part of workshop/conference will be held in summer 2006 initiatives and projects, and promote good thenutrition healthy aslifestyle part agenda.of the healthy lifestyle to encourage comments and feedback about the practice. This document is the first of its 3 Toagenda. promote and disseminate good practice. kinddocument, in Newport, build new and partnerships should beand viewed to review as 3 To promote and disseminate good ongoing work. This will also provide the opportunity a workable document that will be further For practice.further information or comments please contact: developedto incorporate and new improved.research, developments and strategic direction both nationally and locally. Angela Brain The Nutrition Action Group is divided into Health Promotion Manager fourThe Nutrition sub-groups Action targetingGroup is divided priority into groups. four National Public Health Service Thesesub-groups sub-groups targeting priority are: groups. These 01633 261 430 sub-groups are: Julia Osmond • Birth to pre-school (aged 0 to 5 years) • Birth to pre-school (aged 0 to 5 years) Senior Health Promotion Specialist • School children • School children National Public Health Service • Young people and adults (aged16 to • Young50 people years) and adults (aged16 to 50 years) 01633 261 430 • Older people (aged 50+) • Older people (aged 50+) Rachel Clark IIH Nutrition Project Co-ordinator Newport Local Health Board 01633 261 448

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | INTRODUCTION | PAGE 2 2 BACKGROUND

2.1 Strategic Direction The strong link between deprivation and an In February 2003, the Welsh Assembly Government individual’s health status has been widely (WAG) and Food Standards Agency (FSA Wales) acknowledged. The Welsh Assembly Government jointly launched ‘Food and Well Being: Reducing has established a ‘Communities First’ programme, inequalities through a nutrition strategy for Wales’1. which targets areas of social deprivation/dis- The strategy recognises poor diet as one of the advantage for regeneration according to the Welsh underlying factors contributing to ill health and Index of Multiple Deprivation (WIMD)3 (see health inequalities. It aims to improve the diet of all Appendix 4). Newport has four designated people in Wales – particularly those experiencing Communities First areas and a further six sub-wards disadvantages in accessing healthy foods through (see Appendix 5). There are substantial differences social, economic or geographical circumstances. in what people eat depending on their socio-eco- The strategy gives a series of recommendations nomic status, and in all age groups people living for action (see Appendix 2), which provide both on a low income have higher rates of diet-related context and structure for this local action plan. diseases than other people4. These areas of deprivation will therefore be prioritised within the Other documents (both local and national) that have Newport Nutrition Action Plan. provided strategic direction for this nutrition action plan are listed in Appendix 3. 2.3 Diet, Nutrition and Health 2.2 The Local Area Poor nutrition contributes to approximately one third Newport City has a population of 139,500 (48% of deaths from heart disease and a quarter of cancer male; 52% female)2 and is subdivided into 20 deaths in the UK. Evidence suggests that following electoral divisions / wards. A map showing these a healthy diet can help reduce the risk of some divisions is displayed in Figure 1. Generally the chronic diseases, including coronary heart disease most affluent wards are situated on the outside and stroke, type II diabetes and some cancers5,6,7. of Newport, with more deprived areas situated A varied and balanced diet is essential for good around the centre. health. The proportions of different foods needed

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | BACKGROUND | PAGE 3 Figure 1. Electoral ward Divisions of the City of Newport (2005)3

18 15 3 20

9 13 17 11 4 14 5 19 7 10 8 1 12 2

16

Newport 2005 Electoral divisions Levels of deprivation

1 Pillgwenlly 11 Beechwood Most deprived 2 Tredegar Park 12 Llanwern 3 Bettws 13 St Julian’s 4 Ringland 14 Allt-yr-yn 5 Alway 15 Malpas 6 Victoria 16 Marshfield 7 Stow Hill 17 Rogerstone 8 Gaer 18 Langstone Least deprived 9 Shaftesbury 19 Graig 10 Lliswerry 20 Caerleon

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | BACKGROUND | PAGE 4 are displayed as a pictorial plate known as the In 2004, only 37% of adults aged 16 and over Balance of Good Health (see Figure 2)8. A healthy reported eating at least five portions of fruit diet should be rich in fruit, vegetables and starchy and vegetables a day. Fifty-eight percent foods and low in fat, salt and sugar. reported eating some but less than five portions, and 5% eat none at all10. Despite Statistics show that the majority of the population this, in a recent consumer attitudes survey, are not meeting current government dietary the number of people across Wales claiming recommendations for health benefits9 (see to eat five portions of fruit and vegetables Appendix 6). per day had risen to over half of all consumers. Furthermore, awareness of the 5-a-day message 2.3.1 Fruit and Vegetable Consumption had increased from 47% in 2000 to 63% in In 1998, only 44% of adults in Newport aged 200411. This suggests that there is now a need between 18 and 65 reported eating fruit six for action to focus on behaviour change. to seven days a week. This figure is equal to This should be done through theory driven, the Wales average. This percentage was even evidence-based interventions. lower for vegetables, with only 32.3% of adults reported eating vegetables 6 to 7 days a week. In children and young people, daily consumption This percentage is less than the average of fruit is lower in Wales relative to many other for Wales10. European countries–-particularly in boys12.

Figure 2. The Balance of Good Health8

Fruit and vegetables Bread, other cereals and potatoes

Meat, fish and alternatives Foods containing fat Milk and dairy foods Foods and drinks containing sugar

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | BACKGROUND | PAGE 5 The number of 15 and 16 year olds eating fruit overweight, 4% (boys) and 2% (girls) of whom everyday in 2000 was less than 50%. This shows are classified as being obese. This pattern is a decrease since 1990. Moreover, an increase similar for fifteen year olds. in consumption of confectionary and drinks containing sugar was reported. The study also 2.4.2 Breastfeeding indicated that girls are less likely than boys to Breast milk provides optimal nutrition for a baby consume breakfast, lunch and dinner on a daily and has many benefits which will protect it basis–particularly those aged 15 and 16. In against numerous common infant illnesses and 2000, fewer than half of girls aged between 13 chronic disease later in life14. Breastfeeding also and 16 reported eating breakfast everyday. has many health benefits for a mother both during the feeding period and later on in her The above national data will be applied to lfe14. Despite this, breastfeeding rates remain l Newport’s situation in the absence of more ow. In Newport, the number of babies being specific citywide information. breastfed at birth is only 40%15. This is the sixth lowest score n Wales. 2.4 Local Health Needs The health of the population of Newport is comparable 2.4.3 Chronic Disease to the rest of Wales, but the number of deaths from Nutrition can have a major influence on chronic heart attack and stroke are marginally higher than illnesses, such as coronary heart disease the Wales average. Newport’s particular needs (CHD), diabetes and stroke. One third of adults surrounding health and wellbeing are documented in Wales are reported as having at least one in the Newport Needs Assessment (2004)10. chronic condition–this increases to two thirds in adults over the age of 6516. Rates of chronic 2.4.1 Overweight and Obesity disease reported in Newport and the There is concern about the rising levels of comparative figures for Wales are displayed obesity among both children and the general in figure 317. population. Currently, 46.2% of adults in Newport aged 18 to 65 are overweight or obese13. This 2.4.4 Oral Health figure has seen a steady increase of 10% over There is a rising trend in dental caries in the the last ten years, and shows little signs of under five year olds, which is partly due to high slowing down or reversing. consumption of sugary foods and fizzy drinks. Oral health problems tend to be more prevalent The figures for children are of equal concern. in deprived areas. In some areas of deprivation In the UK, 11% of nine year olds are currently in Newport, the mean number of decayed, obese.13 As part of a series of European surveys missing or filled teeth (dmft) in the under fives examining the health behaviour of school-aged is higher than the Wales average. This is of children obesity levels have been measured in particular concern, since dental problems 11, 13 and 15 year olds12. According to the starting in infanthood usually continue through surveys, the proportion of 15 year olds who are to older childhood. overweight and obese in Wales is higher than in Scotland and England. Among 13 year olds, Further details and statistics can be accessed 22% of boys and 17% of girls are currently via the Local Oral Health Action Plan for Newport18.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | BACKGROUND | PAGE 6 Figure 3. Recorded Rates of Chronic Disease in Newport and Wales17

14

12 12.5 12.1

10

8

6

Percentage of population Percentage 4 4.3 4.1 4.0 3.8 2 1.8 1.6 0 CHD Hypertension Diabetes Stroke

2.5 Physical Activity, Nutrition and Health There is increasing demand for interventions targeting The links between physical activity, nutrition and both nutrition and physical activity. A national action health are now widely acknowledged. Physical plan targeting food and fitness in young people inactivity plays a key role in the steady increase has undergone consultation and is due for release of overweight and obesity, and is also linked to in June 2006 (see Appendix 3 for details). cardiovascular disease, diabetes and stroke19. The majority of the population are not active enough for On a local level, planning is currently underway for health benefits. Only 28% of adults in Wales meet an initiative targeting healthy living in the population the current physical activity recommendations,20 of Newport. The initiative (‘Going for Gold’) is being and the situation in Newport shows little improvement. driven by Health Challenge Newport (the recently Only 30% of adults21 and 38% of children22 in re-branded Health Alliance). ‘Going for Gold’ will Newport are currently meeting the minimum be a ‘passport to healthy living’, made up of various physical activity requirements. Furthermore, over modules setting achievable targets at both a physical 60% of adults21 and 15% of children22 are sedentary. and cognitive level, thus tackling both exercise and nutrition. This initiative will commence later this year and should impact current local initiatives and new developments.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | BACKGROUND | PAGE 7 3 PRIORITY AREAS FOR ACTION

At a consultation workshop in June 2005, the Nutrition Action Group identified and agreed four priority groups according to local needs and problems, and national priorities. Reasons for selection and problems to be addressed within the groups are displayed opposite.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | STRATEGIC PRIORITY AREAS FOR ACTION | PAGE 8 3.1 Priority Groups

Rationale Key issues

Birth to • National and local strategies • Low rates of breastfeeding pre-school • Importance of promoting • Poor weaning practices healthy eating practices • Poor oral health leading to high from a young age, to levels of dmfs prevent future ill health • Increasing levels of obesity

School • National and local strategies • Steady rise in obesity and • Setting good foundations obesity-related illness for later life • Difficulty of putting policy into • Opportunity to demonstrate practice good practice within the • Competing demands between school setting what parents, schools and health professionals want • Lack of resources

Young • National and local strategies • Black Minority Ethnic (BME) People • Priority exists where there are groups particularly vulnerable and Adults vulnerable groups (see to some chronic diseases such problems) - these need to as CHD, diabetes, stroke and be targeted specifically hypertension • Vulnerable young people • Low-income groups

Older • National and local strategies • Poor mobility People • Help to achieve SAFF targets – • Specific health needs, poor reducing emergency eating patterns and existing admissions health problems • Priority exists where older • Malnutrition people are vulnerable

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | PRIORITY AREAS FOR ACTION | PAGE 9 3.2 Current Activities and Future Action 3.2.1 Development of Action Plans An action plan has been developed for each of the priority groups identified, based on recommendations from national strategy1. Each plan identifies the local objective, the timescale of the initiatives, the funding source and lead agencies. The action plans aim to provide a focus for action for the following two years, and are displayed in the next section of this document.

3.2.2 Monitoring and Evaluation The objectives set within the priority action plans will be regularly monitored and evaluated by individual sub-groups at a bi-monthly meeting. The Newport Action Group will continue to meet on a quarterly basis in order to receive updates from sub-group leaders, review and update objectives and monitor progress of work.

The Newport Nutrition Action Plan will be reviewed annually.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | PRIORITY AREAS FOR ACTION | PAGE 10 Recommendation One Birth to Increase the uptake of a healthy balanced diet amongst the general pre-school population, especially among the identified priority groups, with an emphasis (aged 0 to 5) on tackling food equality priorities, to help ensure that nutrient and micro nutrient levels meet recommended values

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To establish funding for a March 2007 To be identified GHC NHS Trust; community paediatric Dietetics; dietitian to lead on key Sure Start; objectives below. The post NPHS holder will play a key role in providing support, training and information to health professions and community based projects.

Recommendation Two Increase fruit and vegetable intake among the general population, especially among the identified priority groups

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To continue improving access Ongoing Within existing NPHS; to fruit and vegetables for budgets RRU; parents/carers of children in (sustainable IIH Projects identified areas via fruit and project) vegetable co-ops.

To monitor the Healthy Ongoing Within existing Sure Start Playgroup scheme, budgets incorporating the provision of fresh fruit.

Recommendation Three Initiatives to prevent and manage overweight and obesity

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To support the ‘Breastfeeding Ongoing Within existing NPHS and Promotion Group for Newport’ budgets Partner Agencies ACTION PLAN (meets bi-annually).

To provide support, information See Rec. One See Rec. One CPD and training to health professionals on weight management issues (0-4).

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - BIRTH TO PRE-SCHOOL | PAGE 11 EPR URTO CINPLAN ACTION NUTRITION NEWPORT (aged 0to5) pre-school Birth to wrns riigt bdesGHCNHSTrust; budgets NPHS; existing Within Ongoing Awareness Training to To provideBreastfeeding GHCNHSTrust; Additional SureStart fundingsought To be determined promoting UNICEFcommunity To investigatefeasibilityof oudt n vlaete e 05Wti xsig GHCNHSTrust; existing Within Dec2005 To updateandevaluatethe lpokfruewt M rus IIHNutrition; GHCNHSTrust (CPD) NPHS; budgets budget IIHNutrition SureStart; May2006 existing Within Flipbook forusewithBMEgroups. To developaBreastfeeding LeadAgency/ Ongoing Initiative acrossNewport. To extendthe‘ChangetoCup’ CPD) Weaning Flipbook. Funding (HealthVisitorsand ACTION Timescale(s) Budgets IIHNutrition Newport LocalObjective(s) IIHNutrition improvement Ensure publiciswellinformedaboutnutritionandtheneedfordietary existing Within Recommendation Six OCN trainingsite. Nov2005 GHCNHSTrust; Food andNutritionSkills GHCNHSTrust onwards becoming anaccredited To beidentified To investigatetheneedfor Trust GHCNHS Infant Feeding Guidelines. Jan2006 and implementationof Ongoingfrom To Oct2005 facilitatethedissemination to healthprofessionals. Infant Feeding Guidelines LeadAgency/ To providecopiesof key organisations. SureStart Funding Timescale(s) GHCNHSTrust; Newport LocalObjective(s) PLAN To beidentified Provide thenecessaryinformationandtrainingneededforkeyplayers Recommendation Five formula milk. determined initiative toreplacefree To be of `HealthyStart’–anational LeadAgency/ To investigatethepromotion breastfeeding initiativelocally. Funding Timescale(s) Newport LocalObjective(s) National schemesandpoliciestoassistimprovementsinhealthyeating Recommendation Four | 2005 – 2007 | ACTION PLAN -BIRTHTOPRE-SCHOOL | PAGE 12 oreAgencies Source Agencies Source oreAgencies Source GHC NHSTrust Recommendation Seven Birth to Ensure that appropriate local initiatives in place to tackle the main barriers pre-school to improving nutrition (aged 0 to 5)

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To expand the Breastfeeding Ongoing Sure Start Sure Start Peer Support Group (to include recruiting and training peer support volunteers).

To inform 5 major employers Ongoing until Health Alliance NPHS; and their employees about Jan 2010 NCC ‘Breastfeeding and Returning to Work’.

To investigate the source or Jan 2007 To be determined NPHS; production of multi-cultural Sure Start; weaning video. GHC NHS Trust (CPD); IIH Nutrition

Recommendation Eight Develop and promote initiatives with the food industry to improve healthy eating, especially initiatives relating to access to specific foods

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To prevent Code and Law 2005/06 Trading Standards Trading Standards Non-Compliance of Formula Feed Sales.

To initiate a ‘Breastfeeding May 2006 Health Alliance IIH Nutrition; Friendly Premises scheme’ NPHS; at 7 sites in Newport IIH Nutrition City Centre.

Recommendation Nine Ensure impact of activities resulting from the strategy are evaluated

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies ACTION PLAN Birth to pre-school sub-group Ongoing Within existing NPHS; to meet every two months. budgets Sure Start; GHC NHS Trust; IIH Nutrition

Lead person to collate all Ongoing Within existing All partners – information, write up and budget lead NPHS disseminate.

Action plan to be updates Ongoing All partners – and reviewed twice yearly. lead NPHS

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - BIRTH TO PRE-SCHOOL | PAGE 13 EPR URTO CINPLAN ACTION NEWPORT NUTRITION children School el i h eeeomn NCC CPD; budgets NHSS existing Within sourcing ofnewproducts of menus&recipesandthe Ongoing meals viatheredevelopment sugar andsaltinNCCschool To reducetheamountoffat, nacrac ihte CPD NewportLEA; NCC Nutritional Standardsfor in2005 NCC in accordancewiththe Tomenus forNCCschoolmeals commence To introducedietitianapproved ri n eeal naei NewportLEA NCC NCC school-aged childrenthrough a fruit andvegetableintakein Ongoing To developinitiativestoincrease epr oa betv()Tmsaes udn LeadAgency/ ‘traffic light’rewardsystem IIHNutrition Dietetics; NHSS Funding Timescale(s) Newport LocalObjective(s) among theidentifiedprioritygroups Increase fruitandvegetableintakeamongthegeneral population,especially Recommendation Two based standardsforschoolfood. Caroline Walker Trust nutrient- achieve compliancewiththe of changetomovetowardsand Working towards NHSS identify arequiredprogramme of currentschoolmealsand NewportLEA To reviewthenutritioncomponent NCC City viatheWAG initiative tobecompleted NCC bySeptember05. schools Primarysystem into allprimaryandsecondary system ofhealthyeating To introducea‘trafficlight’ School Meals LeadAgency/ Funding Timescale(s) Newport LocalObjective(s) nutrient levelsmeetrecommendedvalues. on tacklingfoodequalitypriorities,tohelpensurethatnutrientandmicro population, especiallyamongtheidentifiedprioritygroups,withanemphasis Increase theuptakeofahealthybalanceddietamongstgeneral Recommendation One fbekatcuswti h NewportLEA NCC WAG Ongoing of breakfastclubswithinthe To supporttheestablishment nftadsgrtobeconfirmed Dieteticfunding 2006-2007 2005-2006 Targeted trafficlightwork on fatandsugar Targeted trafficlightwork ACTIONPLANon salt | 2005 – 2007 | CINPA COLCHILDREN ACTION PLAN -SCHOOL non ob dniidNCC; To beidentified Ongoing secondary in2006 | AE14 PAGE oreAgencies Source oreAgencies Source nKySae2bde NewportLEA budget NHSS existing Within Ongoing in Key Stage2 To promotetheuptakeofmilk NHSS NewportLEA of freemealsandtoinvestigate schools, reducingdiscrimination 2005-2006 initiative withinallsecondary To introducetheSmartCard oices h ubro OgigNS NHSS PLAN ACTION NEWPORT NUTRITION NCC NHSS NHSS NHSS to 90% Ongoing desks policyfrom60% NCC NCC schools operatingwater@ NHSS To increasethenumber of during lunchtimes Ongoing NCC is availableandpromoted NCC/ To ensurethatdrinkingwater 2006-2007 vending insecondaryschools NCC To promotehealthierdrinks school milkbars Ongoing in secondaryschoolsvia LeadAgency/ To increasetheuptakeofmilk Funding Timescale(s) Newport LocalObjective(s) LeadAgency/ National schemesandpoliciestoassistimprovementsinhealthyeating Recommendation Four Funding See otherrecommendations. Timescale(s) Newport LocalObjective(s) Initiatives topreventandmanageoverweightobesity NHSS Recommendation Three CommunitiesFirst NHSS is afruitandvegetableco-op. April2005- March2006 a marketorbase,wherethere school ineachareaisusedas To ensurethatatleastone NHSS three years March2008 from 40%to70%inthenext April2005- tuck shopsinNewportschools To increasetheamountoffruit LeadAgency/ incentives forhealthyeating Funding Timescale(s) Newport LocalObjective(s) Recommendation Two | 2005 continued – 2007 | CINPA COLCHILDREN ACTION PLAN -SCHOOL oreAgencies Source oreAgencies Source Agencies Source | AE15 PAGE IIH Nutrition

ACTION PLANchildren School Recommendation Four continued

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To pilot a Healthy and Active § June 2005 NHSS NHSS Lifestyles policy within one school cluster

School To roll out a Healthy and Sept 2005 - NHSS NHSS children Active Lifestyles policy to March 2008 all Newport schools

To set up a working party for Sept 05 - GTCW grant NHSS D&T Food teachers, with a June 06 Teacher Working view to writing a healthy Party eating scheme of work for KS3

To support the heartbeat Ongoing Within existing NHSS award review budget

Recommendation Five Provide the necessary information and training needed for key players

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To continue to strengthen Ongoing Within existing All networking through the budget Nutrition Strategy Action Group

To develop a school meals 2005 - 2007 NCC NCC web page with nutrition advice and information

To assess the nutritional By Sept 2005 NCC NCC training needs of site supervisors

To plan a nutritional training By July 2006 NCC NCC event for site supervisors on an annual basis ACTION PLAN To develop a Healthy Schools By October 2005 NHSS NHSS website

To support WAG in the Ongoing WAG WAG setting up of a Healthy Schools database

To provide an annual training Ongoing BSF; NHSS event on food and nutrition NHSS for primary school teachers in Newport

NEWPORTT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - SCHOOL CHILDREN | PAGE 16 Recommendation Six Ensure public is well informed about nutrition and the need for dietary improvement

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

Ensure that current dietary Ongoing Within existing NCC recommendations from budget Newport LEA; FSA Wales are included on the NHSS School school meals website, Paediatric children newsletters and within school Community Dietician restaurants

Recommendation Seven Ensure that appropriate local initiatives are in place to tackle the main barriers to improving nutrition

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To investigate the potential 2005 - 2006 Within existing NCC uptake and effectiveness budgets Newport LEA; of a healthy take-away NHSS meals in schools Paediatric Dietitian Representative

To pilot a healthy lunchbox October 2005 - IIH Nutrition IIH Nutrition intervention at two April 2006 NHSS primary schools.

Recommendation Eight Develop and promote initiatives within the food industry to improve healthy eating, especially initiatives relating to access to specific foods

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To identify the number of 2006 - 2007 Within existing NHSS schoolsthat participate in the budgets Sainsburys ‘taste of success’ awards, and increase uptake by 10% annually.

To identify the number of 2006 - 2007 Within existing NHSS ACTION PLAN schools that participate in budgets the Asda ‘big healthy eat’ initiative, and increase uptake by 10% annually.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - SCHOOL CHILDREN | PAGE 17 Recommendation Nine Ensure the impact of activities resulting from the strategy are evaluated

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

School Aged Children and Ongoing Within existing NCC Young Peoples Group to budgets Newport LEA; meet twice a month. NHSS School Paediatric Dietitian children Representative

NCC, Pupils & Client Officer, Ongoing Within existing NCC Healthy Schools Officer to budgets Newport LEA; meet monthly NHSS

Action plan to be updated Ongoing Within existing NHSS and reviewed twice a year. budgets

Activities to be evaluated annually Ongoing Within existing NHSS budgets ACTION PLAN

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - SCHOOL CHILDREN | PAGE 18 To pilotthe IIHProjects NPHS; RuralRegeneration; IIHProjects; identified areasviafruitand young peopleandadultsin Ongoing to fruitandvegetablesfor budgets To continueimprovingaccess IIHNutrition existing Within Jan2006 initiatives, identifygaps to monitorongoing To establishasub-group To rollout EPR URTO CINPLAN ACTION NEWPORT NUTRITION across Newport. Dietetics IIHNutrition; LeadAgency/ NPHS; Funding Timescale(s) Newport LocalObjective(s) RuralRegeneration; Initiatives topreventandmanageoverweightobesity Recommendation Three IIHNutrition vegetable coops. March2006 to membersoffruitand recipes fordissemination nutrition informationand vegetable book,containing To developafruitand LeadAgency/ vegetable co-ops. Funding Timescale(s) Newport LocalObjective(s) among theidentifiedprioritygroups Increase fruitandvegetableintakeamongthegeneralpopulation,especially Recommendation Two LeadAgency/ and planfuturework. Funding Timescale(s) Newport LocalObjective(s) nutrient levelsmeetrecommendedvalues. on tacklingfoodequalitypriorities,tohelpensurethatnutrientandmicro population, especiallyamongtheidentifiedprioritygroups,withanemphasis Increase theuptakeofahealthybalanceddietamongstgeneral Recommendation One nacmuiyfrtae.Dietetics; in acommunityfirstarea. Tighten Up’ rgam oky Dietetics communities firstareas organisations in programme tokey Tighten Up’ ‘Lighten Up ‘Lighten up rgam 06IIH Nutrition programme 2006 riig omnte is;CommunitiesFirst; CommunitiesFirst; training | 2005 – 2007 a ac IHBgSse IIHBigSister; IIHBigSister Jan -March pi uy20 I i itr IIHBigSister; IIHBigSister; April -July2006 | CINPA ON PEOPLE& ADULTS PLAN -YOUNG ACTION oreAgencies Source Agencies Source oreAgencies Source | AE19 PAGE Communities First

ACTION(aged 16to50) & Adults People Young PLAN Recommendation Three continued

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To investigate the need Oct 2006 Within existing IIH Nutrition to initiate weight loss budgets programmes in the workplace setting.

Recommendation Four National schemes and policies to assist improvements in healthy eating

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To pilot a healthy Oct 2005 - Royal Gwent IIH Nutrition; vending machine at the Jan 2006 Catering; Royal Gwent Royal Gwent Hospital IIH Nutrition Catering Department

To investigate the cost Jun 2005 - Within existing IIH Nutrition; implication of healthier Dec 2005 budgets NCC Leisure vending machines at Services leisure centres in Newport

Young To pilot healthy vending Jan 2006 NCC NCC; People machines at an identified IIH Nutrition & Adults leisure centre in Newport. (aged 16 to 50) Recommendation Five: Provide the necessary information and training needed for key players

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To initiate a Nutrition Training Jun 2006 IIH Nutrition NPHS; Project for key organisations IIH Nutrition and professionals across Newport

To ensure that best practice Ongoing NPHS NPHS and evidence-based information is disseminated to local partners in all areas ACTION PLAN To identify and inform key Ongoing IIH Nutrition; IIH Nutrition; agencies / organisations IIH Big Sister; IIH Big Sister; of the FSA Get Cooking Communities First Communities First programme and establish Youth Service training needs to enable sessions to run within the community

To support key organisations Ongoing until IIH Nutrition; IIH Nutrition; in the delivery or the FSA July 2006 IIH Big Sister IIH Big Sister Get Cooking! Programme Communities First Youth Service

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - YOUNG PEOPLE & ADULTS | PAGE 20 Recommendation Six Ensure public is well informed about nutrition and the need for dietary improvement

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To evaluate Summer Splash Summer 2006 IIH Big Sister IIH Big Sister; programme and identify training Youth Service needs for Youth Service in relation to sustainability of ‘healthy eating’ as part of the ongoing programme.

To provide education sessions Ongoing until Within existing IIH Nutrition about the Balance of Oct 2006 budgets Good Health to identified priority groups, such as Sure Start Mums.

Recommendation Seven Ensure that appropriate local initiatives are in place to tackle the main barriers to improving nutrition

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies Young People To improve access to Ongoing IIH Big Sister IIH Big Sister; & Adults healthy food via community Youth Service (aged 16 to 50) cafes.

To investigate current food Dec 2005 Within existing IIH Big Sister and snack provision at budgets Sure Start play schemes across Newport.

To investigate the possibility Sure Start To be identified IIH Projects; of piloting a healthy drinks Sure Start; and snacks policy at two NCC play schemes in Newport.

To set up allotment projects Ongoing To be identified Communities First; in Community First areas. NPHS

Recommendation Eight Develop and promote initiatives within the food industry to improve healthy eating, especially initiatives relating to access to specific foods ACTION PLAN

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To make the ‘Eat Clever’ Ongoing Within existing Young Women’s accredited OCN available budgets Training Group in Newport. Partnership

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - YOUNG PEOPLE & ADULTS | PAGE 21 Recommendation Nine Ensure the impact of activities resulting from the strategy are evaluated

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

Monitor and evaluate Ongoing Within existing AII partners - all projects within the budgets IIH Nutrition as lead action plan.

Young people and Adults Ongoing from Within existing AII partners - sub-group to meet every Jan 2006 budgets IIH Nutrition as lead two months.

Action plan to be reviewed Ongoing Within existing AII partners - and updated twice yearly. budgets IIH Nutrition as lead

Young People & Adults (aged 16 to 50) ACTION PLAN

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - YOUNG PEOPLE & ADULTS | PAGE 22 ra i ri n IIHProjects To pilotthe NPHS; Unit; RuralRegeneration IIHProjects Ongoing areas viafruitand for olderpeopleinidentified access tofruitandvegetables To continueimproving budgets IIHNutrition existing Within Jan2006 identify gapsandplan to monitorongoinginitiatives, To establishasub-group okyognstosi Dietetics Communities Firstareas to keyorganisationsin Tighten Up’ To rollout‘ EPR URTO CINPLAN ACTION NUTRITION NEWPORT across Newport. IIHNutrition LeadAgency/ Funding WAG grants Timescale(s) Newport LocalObjective(s) Initiatives topreventandmanageoverweightobesity Recommendation Three IIHOlderPersons; areas. at 50clubsinCommunitiesFirst IIHNutrition fruit andvegetablesatnifty IIHOlderPersons ways ofcookingandusing Autumn2006 IIH Older Persons ; To providesessionsondifferent Spring2006 areas. 3 identifiedCommunitiesFirst To setupluncheonclubsin LeadAgency/ vegetable co-ops. Funding Timescale(s) Newport LocalObjective(s) among theidentifiedprioritygroups Increase fruitandvegetableintakeamongthegeneralpopulation,especially Recommendation Two LeadAgency/ future work. Funding Timescale(s) Newport LocalObjective(s) nutrient levelsmeetrecommendedvalues. on tacklingfoodequalitypriorities,tohelpensurethatnutrientandmicro population, especiallyamongtheidentifiedprioritygroups,withanemphasis Increase theuptakeofahealthybalanceddietamongstgeneral Recommendation One naCmuiyFrtae.Dietetics; in aCommunityFirstarea. Tighten Up’ Lighten Up ‘Lighten up riigporme omnte is CommunitiesFirst; Communities First training programme programme IIH Nutrition; | 2005 – 2007 pi uy20 I i itr IIHBigSister; IIHBigSister; April -July2006 a ac 06IHBgSse IIHBigSister; IIHBigSister Jan -March2006 | CINPA -OLDERPEOPLE PLAN ACTION oreAgencies Source Agencies Source oreAgencies Source | AE23 PAGE Communities First

ACTION(aged 50+) People Older PLAN Recommendation Four National schemes and policies to assist improvements in healthy eating

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To investigate the current May 2006 Within existing IIH Projects; catering practices in budgets GHC NHS Trust residential homes and sheltered accommodation.

Recommendation Five Provide the necessary information and training needed for key players

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To investigate the need for 2006 - 2007 To be Identified Dietetics; the provision of basic nutrition NPHS training to key organisations

Recommendation Six Ensure public is well informed about nutrition and the need for dietary improvement

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To identify other agencies June 2006 Within existing IIH Nutrition; currently dealing with budgets IIH Older Persons; Nutrition for older people. NPHS

Recommendation Seven Ensure that appropriate local initiatives are in place to tackle the main barriers to improving nutrition Older People Newport Local Objective(s) Timescale(s) Funding Lead Agency / (aged 50+) Source Agencies

To provide a ‘nutrition Autumn 2006 IIH Older Persons IIH Older Persons component’ at healthy living clubs.

To develop and pilot a May 2006 IIH Nutrition IIH Nutrition cooking skills programme Communities First ACTION PLAN with the over 50s in Somerton.

Recommendation Eight Develop and promote initiatives within the food industry to improve healthy eating, especially initiatives relating to access to specific foods

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

To encourage cafes and Ongoing Within existing All partner agencies catering establishments budgets to provide healthier options where possible.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - OLDER PEOPLE | PAGE 24 Recommendation Nine Ensure the impact of activities resulting from the strategy are evaluated

Newport Local Objective(s) Timescale(s) Funding Lead Agency / Source Agencies

Monitor and evaluate Ongoing Within existing IIH Nutrition; all projects within the budgets IIH Older action plan. Persons NPHS

Older persons Ongoing Within existing IIH Nutrition; sub-group to meet budgets IIH Older every two months. Persons; NPHS

Action plan to be Ongoing Within existing IIH Nutrition; reviewed and updated budgets IIH Older twice yearly. Persons; NPHS

Older People (aged 50+) ACTION PLAN

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | ACTION PLAN - OLDER PEOPLE | PAGE 25 Abbreviations

BME Black Minority Ethnic CAB Citizens Advice Bureau CD Community Development Worker CHD Coronary Heart Disease CPD Community Paediatric Dietitian DMFT Decayed, modified or filled teeth (over 5’s) dmft Decayed, modified or filled teeth (under 5’s) GHC NHS Trust Gwent healthcare NHS Trust IFGLG Infant Feeding Guidelines for Gwent IIH Inequalities in Health Projects NCC Newport City Council NHSS Newport Healthy Schools Scheme NPHS National Public Health Service PCD Paediatric Community Dietitian RRU Rural Regeneration Unit SS Sure Start

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | PAGE 26 This document is the first of its kind in Newport, and should be viewed as a workable document that will be further developed and improved.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | STRATEGIC PRIORITY AREAS FOR ACTION | PAGE 22 REFERENCES

11 Food Standards Agency / Welsh Assembly 17 Department of Health (1998). Government (2003). Nutritional Aspects of the Development of Food and Well Being: Reducing Inequalities Cancer. Report on Health and Social Through a Nutrition Strategy for Wales. Subjects, 48. Cardiff: Food Standards Agency Wales. London: HMSO.

12 Newport City Council / Newport Local 18 British Nutrition Foundation (2002). Health Board (2004). Balance of Good Health. The Health, Social Care and Well Being www.nutrition.org.uk/home.asp?siteId= Strategy for the People of Newport. 43§ionId=874&subSectionId=320& www.newport.gov.uk/xpedio/groups/ parentSection=299&which=1. public/ documents/plans_and_strategies/N_ 069205.pdf. 19 Department of Health (1991). Dietary Reference Values: A Guide. 13 Welsh Assembly Government. (2005). London: HMSO. Welsh Index of Multiple Deprivation. www.wales.gov.uk/keypubstatisticsfor 10 Newport Local Health Board (2003/04). wales/wimd2005.htm. Newport Wellbeing Strategy: A Needs Assessment for the People of Newport. 14 Press, V. (2004). www.newportlhb.nhs.uk. Nutrition and Food Poverty Toolkit. London: National Heart Forum. 11 Food Standards Agency (2005). Consumer Attitudes to Food Standards 15 Department of Health (1999). Wave 5 - Wales Report. Saving Lives: Our Healthier Nation. www.food.gov.uk/multimedia/pdfs/caswales The Stationary Office, London. 04.pdf.

16 World Health Organisation. (1990). 12 Welsh Assembly Government (2004). Diet, Nutrition and the Prevention of Health Behaviour in School-aged Children Chronic Diseases. (HBSC) survey: Physical Activity, Geneva: World Health Organisation. Sedentary Behaviour and Obesity. Research and Evaluation Branch. Health Promotion Division, Office of the Chief Medical Officer. Cardiff: Welsh Assembly Government. www.cmo.wales.gov.uk/content/ publications/reports/hbsc1-e.pdf.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | REFERENCES | PAGE 28 13 National Assembly for Wales (2004). 18 Newport Local Health Board (2005). Welsh Health Survey (2003-2004). Local Oral Health Action Plan 2005 - 2008. Chapter 4. Health Related Lifestyle. Newport: Newport Local Health Board. www.wales.gov.uk/keypubstatisticsfor wales/ content/publication/health/2005/ 19 Department of Health (2004). hs200304/hs2003-04.htm. At Least Five a Week: Evidence on the Impact of Physical Activity and its 14 Gwent Healthcare NHS Trust/ NPHS Relationship to Health. A Report from the (2005). Chief Medical Officer. Feeding Guidelines for Infants and London: Department of Health. Pre- school Children. www.wales.nhs.uk/sites3/docmetadata. 20 Welsh Assembly Government (2003). cfm?orgid=79&id=48458. Healthy and Active Lifestyles in Wales: A Framework for Action. 15 National Assembly for Wales (2004). Cardiff: Welsh Assembly Government. National Community Child Health Database. 21 Sports Council Wales (2005). Breastfeeding at Birth, Live Births to Adult Sports Participation and Club Welsh Residents by Local Health Board. Membership in Wales 2002/03. Sports www.statswales.wales.gov.uk/TableViewer/ Update (57). tableView.aspx?ReportId=2665. Wales: Welsh Assembly Government / National Lottery. 16 National Assembly for Wales (2004). Welsh Health Survey (2003 - 2004). 22 Sports Council Wales (2003). Chapter 3. Health Status, Illness and Other Primary School-aged Children’s Conditions. Participation in Sport. Sports Update (53). www.wales.gov.uk/keypubstatisticsforwales/ Wales: Welsh Assembly Government. content/publication/health/2005/hs2003- 04/hs2003-04.htm.

17 National Assembly for Wales (2005). Disease Prevalence in Wales: General Medical Services Quality and Outcomes Framework. www.wales.gov.uk/keypubstatisticsforwales/ content/publication/health/2005/sb38- 2005/sb38-2005.pdf.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | REFERENCES | PAGE 29 APPENDICES

Appendix 1 Members of Newport Nutrition Action Group 31

Appendix 2 Recommendations for Action 32

Appendix 3 Strategic Direction: List of Documents 33

Appendix 4 Ward WIMD Score and Rank 34

Appendix 5 Newport Wards and Sub-Wards 34

Appendix 6 Nutritional Recommendations for Health Benefits 35

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 30 Appendix 1 Members of Newport Nutrition Action Group

Miriam Bentley Trading Standards Officer, Newport City Council

Angela Brain Health Promotion Manager, Newport Local Public Health Team (NPHS)

Lisa-Marie Brown Deputy Chief Dietitian, Gwent Healthcare NHS Trust

Alison Burnett WI Representative, Gwent Federation of Women’s Institute

Rachel Clark IIH Nutrition Project Co-ordinator, Newport Local Health Board

Sue Hall Health Visitor, Newport Sure Start

Vicki Jones Senior Community Dentist, Gwent Healthcare NHS Trust

Sarah Morgan Teacher Advisor for PSE Health and Wellbeing, Newport Healthy Schools Scheme

Clare Norris Chief Dietitian, Gwent Healthcare NHS Trust

Julia Osmond Senior Health Promotion Specialist, Newport Local Public Health Team (NPHS)

Clayton O’Keefe IIH Nutrition Project Support Officer, Newport Local Health Board

Linda Prosser Pupil Support Client Officer, Newport City Council

Catherine Richards Programme Manager, Newport Sure Start

Karen Sterry Environmental Health Officer, Newport City Council

Geraldine Williams Environmental Health Officer, Newport City Counci

Mary Williams Development Manager for Newport Catering, Newport City Council

Glenys Phelpstead IIH Nutrition Project Co-ordinator, Newport Local Health Board (until January 2005)

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 31 Appendix 2 Recommendations for Action

The nine key recommendations in relation to nutrition upon which local and national should be based are as follows:

Recommendation 1 Increase the uptake of a healthy balanced diet among the general population.

Recommendation 2 Increase fruit and vegetable consumption intake among the general population.

Recommendation 3 Develop initiatives to prevent and manage overweight and obesity.

Recommendation 4: Ensure that national schemes and policies are in place to assist improvements in healthy eating.

Recommendation 5 Provide information and training to key players.

Recommendation 6 Ensure that the public is well informed about nutrition and the need for dietary improvement.

Recommendation 7 Ensure that appropriate local initiatives are in place to tackle the main barriers to improving nutrition.

Recommendation 8 Develop and promote initiatives with the food industry to improve healthy eating, especially initiatives relating to access to specific foods.

Recommendation 9 Ensure impacts of activities resulting from the strategy are evaluated.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 32 Appendix 3 Strategic Direction

Document Source Year Designed for Life Welsh Assembly Government, 2005

Wanless Review of Health Welsh Assembly Government, 2003 and Social Care in Wales

The Health, Social Care and Newport City Council / Well Being Strategy for the Newport Local Health Board, 2005 People of Newport

Health Challenge Wales - Welsh Assembly Government, 2005 Action on food and fitness for children and young people (Consultation Document)

Coronary Heart Disease Welsh Assembly Government, 2001 NSF for Wales

NSF for Children, Young People Welsh Assembly Government, 2005 and Maternity Services

NSF for Older People Welsh Assembly Government, 2005 (Consultation Document)

Diabetes NSF for Wales Welsh Assembly Government, 2002

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 33 Appendix 4 Ward, Score and WIMD Rank Appendix 5 Newport Wards and Sub-wards (2005)

Newport Ward Score WIMD Rank Communities First areas Pillgwenlly 63.71 5 1 Pillgwenlly Tredegar Park 58.79 23 2 Tredegar Park Bettws 49.31 51 3 Bettws Ringland 42.06 82 4 Ringland Alway 31.19 181 Victoria 29.13 218 Sub-wards Stow Hill 27.10 246 1 Alway / Somerton Gaer 25.67 269 2 Victoria Shaftesbury 22.47 335 3 Stow Hill Lliswerry 20.64 383 4 Gaer / Maesglas Beechwood 14.65 551 5 Lliswerry Llanwern 13.92 576 6 Beechwood / St Julians St Julians 12.51 621 Allt Yr Yn 8.55 727 Malpas 8.48 732 Marshfield 7.21 771 Rogerstone 5.86 800 Langstone 4.58 830 Graig 3.34 846 Caerleon 3.29 849

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 34 Appendix 6 Recommendations for Health Benefits

Department of Health (1991) recommendations for foods, nutrients, vitamins and minerals, and proportions of five different food groups in the diet (Balance of Good Health, 2001)

Fat 35% of food energy; Saturated Fat: 10% of total dietary intake

Fruit and Vegetables at least five portions of a variety a day

Salt reduce average intake to 6g/day

Sugar average intake of non-milk extrinsic sugars to not exceed 60g/day

Iron 14.8 mg/day for females aged 19 to 50

Calcium 700 mg/day for 19 to 50 year olds, 800 mg/day (Female), 100 mg/day (Male)

Folate 200 µg/day

Vitamin D 10 µg/day for over 65 year olds

Balance of Good Health Applies to adults and children over 5 years old. Gives recommended proportions of five food groups: bread, cereals and potatoes; fruit and vegetables; milk and dairy; meat, fish and alternatives; foods containing fat and foods containing sugar.

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | APPENDICES | PAGE 35 NOTES

NEWPORT NUTRITION ACTION PLAN | 2005 – 2007 | NOTES | PAGE 36 National Public Health Service/Newport Local Health Board Victoria House 2nd Floor 136/140 Corporation Road Newport NP19 0BH

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