Auckland University. New-Zealand: Global progress towards tackling obesity has been “unacceptably
slow”, with only one in four countries implementing a policy on healthy
eating by 2010, according to a new six-part series on obesity, just
published in The Lancet.
In less than a generation, rates of child obesity have risen
dramatically worldwide. For example, in the USA children weigh on
average five kilograms more than they did 30 years ago, and one in three
children is now overweight or obese.
Although child obesity rates have started to level off in some cities
and countries, no country to date has experienced declining rates of
obesity across its population.
“The key to meeting the World Health Organisation’s target to achieve
no further increase in obesity rates by 2025 will be strengthening
accountability systems to support government leadership, constraining
the role of the food industry in the formation of public policy, and
encouraging civil society to create a demand for healthy food
environments says Obesity Series lead author, Professor Boyd Swinburn
from the University of Auckland.
The Series consists of six papers and was published to coincide with
the Healthy Eating Research meeting in Baltimore (USA) where Professor
Swinburn launched the Series.
New estimates produced for the Series suggest that cutting calorie
consumption by just 200 kcal per day (equivalent to one 500ml bottle of
cola) could reduce the bodyweight of children and adolescents in the
general population to late 1970s levels.
In low- and middle-income countries, although stunting still affects
over a fifth of children under five years of age, obesity has become the
most common form of undernutrition.
This double burden that can affect the same population and the same
individual, (characterised by undernourished infants who do not develop
their full height but also have increased body mass index (BMI),
highlights the importance of ensuring a supply of healthy food that is
not jeopardised by the aggressive marketing of cheap, less nutritious
products by multinational food companies, says Professor Swinburn.
“Undernutrition and overnutrition have many common drivers and
solutions, so we now need to see an integrated nutrition policy that
tackles both these issues together”, says Dr Tim Lobstein from the World
Obesity Federation and co-author of the Series.
The food industry has a special interest in targeting children.
Repeated exposure to highly processed foods and sweetened drinks during
infancy builds taste preferences, brand loyalty, and high profits.
This year the global market for processed infant foods is expected to
be worth a staggering $19 billion, up from $13.7 billion in 2007. Yet,
few countries have taken regulatory steps to protect children from the
negative health effects of obesity or implemented widely-recommended
healthy food policies. Most have relied solely on voluntary moves by the
food industry, with no evidence of their effectiveness.
“Our understanding of obesity must be completely reframed if we are
to halt and reverse the global obesity epidemic. On one hand, we need to
acknowledge that individuals bear some responsibility for their health,
and on the other hand recognise that today’s food environments exploit
people’s biological (eg innate preference for sweetened foods),
psychological (eg marketing techniques), and social and economic (eg
convenience and cost) vulnerabilities, making it easier for them to eat
unhealthy foods”, says Dr Christina Roberto, from Harvard School of
Public Health in the USA.
“It’s time to realise that this vicious cycle of supply and demand
for unhealthy foods can be broken with ‘smart food policies’ by
governments alongside joint efforts from industry and civil society to
create healthier food systems.”
The Series authors call for food policies that change the nature of
the food and consumer environment including the availability, price, and
nutrition standards of food products, and the marketing practices that
influence food choices and preferences.
Examples include: tighter supervision and international regulation of
the food supply; an international code of food marketing to protect
children’s health; regulating food nutritional quality in schools along
with programmes to encourage healthy food preferences; taxes on
unhealthy products such as sweetened drinks and subsidies on healthier
foods for low-income families such as vouchers for fruit and vegetable
boxes; and mandatory food labelling as an incentive for industry to
produce more nutritional products.
The responsibility for reducing the prevalence of obesity goes far beyond governments, say the Series authors.
They make a number of hard-hitting recommendations for public health
professionals and society, including the proposal that civil action is
key to combating obesity. The authors point out that it was pressure
from the public that saw smoking banned in public places in the UK, and
access to health care granted to all people living with HIV/AIDs in
South Africa.
Finally, say the authors, health professionals are poorly prepared to
treat obesity. More must be done to improve health-care training,
particularly to address biases about patients with obesity, and to
improve care-delivery strategies, specifically for children with obesity
for whom there are currently few treatment options.
For media enquiries email s.phillips@auckland.ac.nz