Failings of our new government’s childhood obesity strategy
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3 reasons why the Government’s children’s obesity plan will fail children
Today, many young people are receiving their A-Level results.
But today also marks the long-awaited publication of the Government’s plan of action to reduce the staggeringly high levels of children’s obesity across the UK.
And after more than a year of waiting, it’s fair to say we’re extremely disappointed with the results.
Unfortunately, the 13 page plan lacks substance. You might even expect better quality from some A-Level essays.
In truth, it feels like many anticipated pages of the plan have been torn out and ditched in recent weeks.
But putting the marking to one side for a moment, there are some clear and worrying gaps in this plan. And the simple fact is that, as it stands, the nation’s children are being let down.
Children’s obesity matters
One in three children are overweight or obese by the time they leave primary school. And an obese child is five times more likely to be an obese adult, putting them at risk of the biggest preventable cause of cancer after smoking.
Our research has shown that if nothing is done, obesity could cause 670,000 cases of cancer over the next 20 years, plus millions more cases of other diseases.
The children’s obesity strategy was first promised as a manifesto commitment from the Conservative Party before the 2015 General Election. The Prime Minister and Health Secretary talked of a “game-changing” strategy and recognised children’s obesity as “a national emergency”.
First to Christmas 2015, and then past January and into the New Year. In the meantime, we made the case for concerted action on obesity and cancer. But the Government’s delays on publishing the strategy followed through into this summer.
Now the plan has finally been published, and we can see three crucial reasons why it falls short of the ‘game-changing’ strategy that was promised.
And worse still, there are some areas that aren’t acknowledged at all.
1. Despite the evidence, junk food marketing has been ignored
Junk food marketing is an absolutely critical influence on children’s weight. It affects what food children choose to eat and pester their parents to buy. It also increases their total energy intake and affects which brands they prefer.
Public Health England’s independent review of the evidence – which the Government said would inform its plans to tackle children’s obesity – backs this up, stating: “Available research evidence shows that all forms of marketing consistently influence food preference, choice and purchasing in children.”
Thousands of our campaigners are worried about junk food marketing – which is why they’ve put so much time and effort into pushing the Government to tackle it as part of our Junk Free TV campaign.
There is also widespread public support – with three-quarters of adults supporting a ban on junk food advertising before the 9pm watershed.
If the Government wants to make a difference, it needs to deal with how kids are bombarded with junk food ads.
Yet, this plan makes no mention of any marketing restrictions. As recently as last month, the Government said a strategy would look at “everything that contributes to a child becoming overweight and obese“.
So neglecting junk food marketing – one of the biggest factors in children’s obesity – is inexcusable.
We’ve been making this case loud and clear. And our recent research on the perceptions of junk food among primary school pupils brings home why this matters. It shows that junk food marketing:
- Makes children hungry and want to eat junk food,
- Creates adverts that children can remember in the supermarket
- Pushes them to pester their parents for it
What does this mean in reality? These two quotes are particularly poignant:
The plan cites “economic realities” as a reason for not going further. But with obesity costing the UK almost a billion pounds a week, and with a warning from the Chief Executive of NHS England that, if unabated, obesity could ‘bankrupt the NHS’, this reasoning is short-sighted.
2. The soft drinks industry levy is not enough
The strategy re-affirms a commitment to the soft drinks industry levy – often referred to as the ‘sugar tax’. This measure is very important to reduce rates of children’s obesity – as our research has previously found – and it must be kept. Children in the UK consume up to three times the maximum amount of sugar they should, and fizzy drinks are their number one source.
But a levy is one measure and that doesn’t make a strategy, particularly when it’s so clear the best way to reduce children’s obesity is to tackle it from all sides. As Sir Harpal Kumar, our chief executive, puts it:
Since the last General Election, the Government has championed the need for a comprehensive and robust strategy to tackle the growing obesity crisis, particularly for children. Today is a missed opportunity in that fight. The sugar levy alone isn’t enough to ensure children live long and healthy lives.
The plan also makes a commitment to “aim to significantly reduce England’s rate of childhood obesity within the next ten years”. But with no clear definition of what this means, or how such an ambition will be funded, it’s hard to see how the plan can be evaluated.
3. Physical activity is not the key to tackling obesity
The plan also seems to imply that the answer to children’s obesity is simply making children more active. Of course, exercise has an important role to play, but Professor Linda Bauld, Cancer Research UK’s Cancer Prevention Expert, explains why it’s not the only solution:
Children taking part in sport is unquestionably a good thing – but physical activity isn’t the silver bullet that solves children’s obesity. A plan which doesn’t address junk food marketing will not go far enough to protect our children from a lifetime of poor health outcomes.
And the Behavioural Insights Team – an organisation owned by the Government – has shown exactly that, finding obesity is down to consuming too many calories and that: “Only an implausibly large reduction in physical activity could explain our weight gain” while falling levels of activity “do not provide the answer”.
Today’s announcement is full of warm words with no plans for enforcement. The plan contains many policies, including improving food in academies and reducing sugar by 20% in foods eaten by children. It even includes a ‘recommitment’ to an initiative that already exists. But nobody seems to be responsible for delivering them.
We need what was promised – our children’s health depends on it
The new Prime Minister is clear that we need to fight the burning injustice that, if you’re born poor, you will die on average nine years earlier than others. And the most deprived children are most likely to be obese. Tackling health inequalities starts with our children and reversing the rising tide of ill-health caused by obesity.
This strategy is a missed opportunity to protect the next generation from diseases like cancer, and reduce the crippling burden of obesity on the NHS.
We need the ‘game-changing’ strategy the Government promised a year ago.
Childhood obesity: UK's 'inexcusable' strategy is wasted opportunity, say experts
Medical experts and campaigners have criticised the government’s childhood obesity strategy as weak and embarrassing, and accused policymakers of throwing away the best chance to tackle the culture of unhealthy eating that is crippling the NHS.
The government’s measures, centred on the sugar tax announced by George Osborne in March, rely on voluntary action by the food and drink industry and are shorn of any restrictions on junk food marketing and advertising.
The industry, which has lobbied hard against regulation for months, has undertaken to reduce by 20% the amount of sugar in products such as cereals, desserts, yoghurts and sweets. The strategy document makes clear that manufacturers that reduce sugar in their products will escape the sugar tax, which is not due to come in for two years.
The money accrued by the levy on sugary drinks will go to fund breakfast clubs and sport. Schools will be asked to give pupils an extra 30 minutes a day of physical activity, and parents and carers will be encouraged to get their children moving for a further 30 minutes.
Citing the triumphs of Team GB at the Olympics and the example of St Ninians primary school in Stirling where children walk or run a mile every morning, the public health minister, Nicola Blackwood, said: “Initiatives like this will make a huge difference to children’s health and fitness and we hope our new measures on school sport will help to create future Team GB Olympians.”
But the strategy contains neither of the two measures that Public Health England (PHE) said would have the most impact on the childhood obesity epidemic.
A third of children leaving primary school are overweight or obese and at risk of a lifetime of health problems including diabetes, heart disease and cancer. Asked to investigate the issue and make recommendations on what should be done, PHE backed a sugar tax and reductions in sugar content of foods but prioritised two other measures:
- Banning price-cutting promotions of junk food in supermarkets, such as multipacks and buy one get one free, as well as promotion of unhealthy food to children in restaurants, cafes and takeaways.
- Restricting advertising of unhealthy food high in salt, fat and sugar to children through family TV programmes such as Britain’s Got Talent and The X Factor, as well as on social media and websites.
Neither appears in the strategy.
Campaigners likened the strategy to the responsibility deal brought in by Labour and continued throughout David Cameron’s premiership, which was widely condemned as a failure. Food and drink companies were encouraged to pledge to make their food healthier by cutting salt, fat and sugar. There has been little in the way of monitoring, but health groups believe the deal has not significantly contributed to improving the nation’s diet.
“After the farce of the responsibility deal where Andrew Lansley made the food industry responsible for policing themselves, it is sad to see that this is just another imitation of the same responsibility deal take two,” said Prof Graham MacGregor, chairman of Action on Sugar and Consensus Action on Salt and Health.
“It is an insulting response to the UK crisis in type-2 diabetes, both in children and adults. This will bankrupt the NHS unless something radical is done.”
Action on Sugar called on the prime minister to rescue the childhood obesity strategy. “Theresa May launched her prime minister campaign by saying that she wanted to tackle health inequalities, obesity being a major factor in this,” said Jenny Rosborough, the group’s campaign manager and a registered nutritionist. “The UK should lead the world in tackling obesity and type-2 diabetes and this is an embarrassing and inexcusable waste of a fantastic opportunity to put the nation’s health first.”
Although the childhood obesity strategy was a flagship initiative of Cameron’s and originally the work of staff in Downing Street, May has chosen not to launch it. It has been published by the Department of Health while she is on holiday in Switzerland.
The Children’s Food Campaign, a member of the Obesity Health Alliance, which includes charities and health organisations such as the royal colleges, fought hard for tough action on cut-price junk food and a ban on TV adverts for unhealthy food before 9pm, when viewing by children tends to drop off.
“Price promotions were one of the big issues that Public Health England majored on,” said Malcolm Clark of the campaign. “It looks like the government is failing to listen to its own public health experts.
“Industry likes to paint us as nanny-statists, but PHE is not a campaigning organisation. They have done a very thorough literature review of peer-reviewed evidence and come up with a recommendation on that.”
Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “While encouraging more exercise in schools is to be welcomed, the evidence is compelling that we also need restrictions on the marketing and promotion of unhealthy foods. We need stronger action to protect children from junk food advertising if we want to make a difference. So for the government to ignore these aspects is inexcusable.
“The government had a chance to protect the next generation from diseases like cancer and reduce the crippling burden of obesity on the NHS. We need the game-changing strategy it promised a year ago. As it stands, our children will witness a rising tide of ill-health from obesity well into the future.”
The strategy document nods to the thinking underlying the focus on voluntary measures and physical activity. It aims to “significantly reduce” childhood obesity within 10 years, it says. “We are confident that our approach will reduce childhood obesity while respecting consumer choice, economic realities and, ultimately, our need to eat.”
The president of the Royal College of Physicians, Prof Jane Dacre, said: “I am disappointed that after such a long wait for the childhood obesity strategy, the government has published a downgraded plan.”
The British Medical Association described the strategy as weak. “Given the UK has the highest level of obesity in western Europe, with one in three children overweight or obese by the time they leave primary school, the government should be doing everything in its power to tackle this problem. Instead it has rowed back on its promises by announcing what looks like a weak plan rather than the robust strategy it promised,” said Prof Parveen Kumar, the BMA board of science chair.
“Although the government proposes targets for food companies to reduce the level of sugar in their products, the fact that these are voluntary and not backed up by regulation, renders them pointless. Targets are also needed to reduce levels of saturated fat and salt in products – these must be backed up by regulation.
“Poor diet has become a feature of our children’s lives, with junk food more readily available, and food manufacturers bombarding children with their marketing every day for food and drinks that are extremely bad for their health. It is incredibly disappointing that the government appears to have failed to include plans for tighter controls on marketing and promotion.”
The British Soft Drinks Association, meanwhile, said it was unhappy that the sugary drinks levy was going ahead. “Given the economic uncertainty our country now faces, we’re disappointed the government wishes to proceed with a measure which analysis suggests will cause thousands of job losses and yet fail to have a meaningful impact on levels of obesity,” said Gavin Partington, its director general.
He said manufacturers were already cutting the sugar content of their drinks.
Ian Wright, director general of industry body the Food and Drink Federation, said:
“The proposed tax on soft drinks is a disappointing diversion from effective measures to tackle obesity. Soft drink companies are already making great progress to reduce sugars from their products, having achieved a 16% reduction between 2012 and 2016.
“However the target set for sugars reduction in the plan is flawed. It focuses too strongly on the role of this single nutrient, when obesity is caused by excess calories from any nutrient. Moreover the target is unlikely to be technically practical across all the selected food categories.
Reformulation is difficult and costly: there are different challenges for each product recipe change can only proceed at a pace dictated by consumers. We will of course do everything we can in the next six months to work towards a practicable reformulation solution while continuing to urge the government to adopt a ‘whole diet’ approach.”
Childhood obesity strategy delayed further, government admits
“It is a very complex issue and there is a lot of work going on to get it right,” said a Department of Health spokesperson. “There are a lot of different issues that need considering and we want to make sure it is right when we put it out. David Cameron and Jeremy Hunt have said they want it to be a game-changing moment.”
The news from the ministry will anger health charities and campaigners, who say there is an urgent need for action on obesity, including introducing a tax on sugared foods. Cancer Research UK accused the government of failing children, saying that every day counted.
“David Cameron has called children’s obesity a crisis and yet the government has failed the next generation by stalling on one of its own health priorities,” said Alison Cox, the charity’s director of prevention. “While the government delays, more children will become obese.
“Our survey shows people want the government to act to fight children’s obesity – eight out of 10 think it’s a problem. To help prevent thousands of cancer cases we want a ban on junk food ads during family viewing times, a sugary drinks tax and more sugar taken out of food. The future health of our children depends on strong action right now.”
The childhood obesity strategy was expected in December, but delayed amid speculation that the campaign for a sugary drinks tax – supported by the restaurateur Jamie Oliver, medical charities and the House of Commons health select committee – had become embarrassingly popular for a government disinclined to interfere with the market by imposing new taxes.
The launch of the strategy was then said to have been scheduled for January, which slipped to February or even March. Now the department says publication will be in the summer.
Ben Reynolds, of the Children’s Food Campaign, which has been working with Jamie Oliver to press for a sugary drinks tax, said: “It would be disappointing if a sugary drinks tax is not included.”
He said they understood that the government might instead intend to put pressure on the food and drinks industry to act by cutting sugar and making products healthier, with the threat of fiscal action if they do not comply.
If so, said Reynolds, “we would like to see a timescale and some metrics on how they judge that industry has responded. A vague threat is nothing without that.”
It appears increasingly unlikely that the measures in the obesity strategy will include a sugar tax, although both David Cameron and Jeremy Hunt – in a recent interview with the Guardian – have said that is not off the table.
The prime minister was said earlier this month to have scrapped the idea in favour of the threat of a levy on drinks companies if they did not reduce the sugar content themselves. Sources within the Department of Health said they did not expect a sugar tax, although they insisted they did not know the content of the strategy, which has not yet been finalised.
The delay in the strategy will cause great concern among health campaigners. Shirley Cramer, chief executive of the Royal Society for Public Health, said: “Childhood obesity is a time bomb on which the clock is ticking, set to wreck the future health of our children and the sustainability of our NHS. There can be no excuse for delay or prevarication when we know – and the government knows – what must be done, especially if those delays are for political reasons.”
Jane Landon, deputy chief executive of the UK Health Forum, said: “The government has pledged its firm commitment to tackling child obesity, but we simply cannot afford a delay in taking action. As the clock ticks, the prevalence of obesity continues to rise, adding to already unsustainable demands on health and social care services.”
Prof John Wass, the Royal College of Physicians’ special adviser on obesity, said: “The delay in publishing the strategy is extremely disappointing, and a hugely missed opportunity to save lives, improve patient care and save NHS funds.”
Prof Russell Viner, of the Royal College of Paediatrics and Child Health, said: “With every day that passes, more children are at risk of developing serious conditions associated with obesity. These include type 2 diabetes, high blood pressure and asthma. So yet another delay in the publication of the government’s childhood obesity strategy gives great cause for concern.”
The dental health of children was also highlighted on Friday night by an analysis from the Press Association which showed that thousands of young children have had decayed teeth removed in England’s hospitals over the last four years.
Overall, there have been 128,558 episodes of care for children aged 10 and under needing one or more teeth out since 2011.
Andrew Gwynne, the shadow public health minister, said: “It’s utterly unacceptable that at a time when the country is facing an obesity epidemic David Cameron is kicking his obesity strategy into the long grass.
“Unfortunately, it appears ministers are far more interested in listening to big business than to the health experts. The government needs to urgently rethink this delay and publish its strategy as soon as possible. Ministers should stop putting their political interests over those of the nation’s health.”
A voluntary levy on sugary drinks in Jamie Oliver and Leon restaurants has raised £50,000 so far, which will be distributed to health and educational causes.
Tam Fry, of the Child Growth Foundation, said: “This constant delay in publishing the childhood obesity strategy is unforgivable and the statement that they ‘want to get it right’ is the most ridiculous and lame excuse.
“The Department of Health, and No 10 who is pulling its strings, have had literally months to get it right and it is a fair bet that its essential elements have been finalised for some time.
“In the words of the England’s chief medical officer, Dame Sally Davies, the current epidemic is a national emergency, which should be tackled by immediate action at Cobra level and not put off at the whim of any politician. Health secretary Jeremy Hunt regards childhood obesity as a great scandal and has promised draconian and robust action to address it. But what have we got? Total inaction.”
Childhood obesity is of increasing concern to health experts. In 2013, 29% of children aged two to 15 in England and Scotland and 34% in Wales were either overweight or obese. In year six, just before children leave primary school, 20% of boys and 17% of girls were obese, according to figures collected by the child measurement programme.
Obesity is a risk factor for long-term health problems that are becoming an increasing burden on the NHS, such as type 2 diabetes, which now accounts for nearly 10% of the entire NHS budget.
This article was amended on 26 February 2016. It originally quoted a Department of Health spokesperson as saying a sugar tax was unlikely. The department has subsequently said this was not the case.
To reverse the obesity epidemic, community efforts should focus on supporting healthy eating and active living in a variety of settings. Learn about different efforts that can be used in early childhood care, hospitals, schools, and food service venues.
The key to achieving and maintaining a healthy weight isn&rsquot short-term dietary changes it&rsquos about a lifestyle that includes healthy eating and regular physical activity.
BMI and waist circumference are two screening tools to estimate weight status and potential disease risk.
A high BMI can be an indicator of high body fatness. Visit the Healthy Weight Website learn about balancing calories, losing weight, and maintaining a healthy weight.
Healthy eating habits are a key factor for a healthy weight. Visit the ChooseMyPlate Website look up nutritional information of foods, track your calorie intake, plan meals, and find healthy recipes.
Physical activity is important for health and a healthy weight. Learn about different kinds of physical activity and the guidelines for the amount needed each day.
Learn about the seriousness of childhood obesity and how to help your child establish healthy behaviors.
What's in the new strategy?
- Voluntary targets for manufacturers to cut the amount of sugar in food and drink products by 5% in the first year, moving towards a 20% reduction by 2020.
- Schools being called on to deliver at least 30 minutes of physical education each day, and parents and carers to ensure children get the same amount of exercise at home.
- The new sugar tax will come into force in 2018, and the money raised will be used to fund more school sports and school breakfast clubs.
- Public Health England (PHE) will set targets for sugar content in food and drinks per 100g, and calorie caps for certain products.
- PHE will monitor and report on whether the industry is reducing sugar content through the voluntary scheme. If insufficient progress is made, the government will consider 'whether alternative levers need to be used'.
- A new voluntary 'healthy schools rating scheme' will be taken into account during school inspections.
This Is Why The U.S. Is Failing To Tackle Childhood Obesity
Childhood obesity has been called an epidemic, but in some ways, that’s wishful thinking. Because with an epidemic, you can usually pinpoint a cause and potential solutions. Childhood obesity is more like fighting a hundred infections at once and trying every medication you’ve got, hoping something sticks.
Worldwide, obesity among kids is 10 times higher than it was in 1975, and many experts believe it’s going to get much worse. The U.S. has some of the highest rates: According to the Centers for Disease Control, 1 in 5 school-aged children and adolescents in the United States are affected by obesity. The issue impacts kids as young as two years old.
Obesity rates among American children continue to rise despite widespread awareness of the associated health dangers — such as an increased risk of certain cancers, diabetes and heart disease, and obesity’s effects on hormones involved in controlling blood sugar and puberty .
To some degree, there has been modest progress toward healthier eating for kids in the U.S. — mainly through efforts to improve school lunches and tax sugary beverages — but this country is struggling just as much as everyplace else in the world, says Erica Kenney, a researcher in the department of nutrition at the Harvard T.H. Chan School of Public Health.
“Addressing childhood obesity is absolutely like playing whack-a-mole,” she said. “There are so many pieces to this, so many factors that are cultural, environmental, political and systemic. You target one or two pieces of it and then 10 more take its place. Obviously, everyone wants healthier kids. But no one has yet come up with the best strategy to make that happen.”
This issue is due to a mess of factors, from ineffective policymaking to socioeconomic inequality to a pervasive tendency to blame the individual . But small steps of progress — both in the U.S. and in other countries setting meaningful new precedents — offer some degree of hope that the right combination of strategies can add up to lasting, healthy change.
Why children gain weight beyond levels that are considered healthy — and then maintain or increase that weight into their teens and beyond — can be attributed to a wide range of confounding variables, Kenney noted. Those include genetics, the ubiquity of fast food, the broadly accepted value of sugar as a “reward,” parental eating habits, metabolism changes, sleep problems, childhood trauma, race, neighborhood design and safety, mental health concerns, chronic health conditions, economic disparity, school nutrition policies, stigma and bullying, social and cultural cues that determine food choices, and legislation at the federal, state and local levels.
Even malnutrition could be in play. When most people think of that word, severely underweight children come to mind, and that’s an accurate image, but it’s not the only one. The World Health Organization considers obesity a form of malnutrition as well, which can happen when people are consuming calorie-dense foods that have scanty vitamins and minerals.
And those are just the major factors.
Many kids are facing not just one or two of these challenges, but a bunch of them at once. Take a kid of color in an economically disadvantaged neighborhood, for example — already at disproportionate risk for eventual obesity, according to recent research . Not only will that child have genetic factors at play if their parents are overweight or obese, but they may not have access to healthy foods , they may be disproportionately targeted by unrelenting junk food marketing , and they may be affected by weak school nutrition efforts and a lack of safe places to play and walk for exercise.
But what if a kid is in a wealthy white suburb, born to parents who don’t carry a genetic push toward obesity, and has plenty of access to fruits and vegetables? Since socioeconomic factors play a huge role in childhood obesity, they would have a better chance of avoiding weight gain, but it isn’t a given. They could still be subject to stress, emotional issues, high sugar consumption and metabolism changes.
Once being overweight tips into being obese, the issue gets even tougher, because getting obese children back to a healthier body composition is significantly more difficult than trying to prevent weight gain in the first place.
“It’s like any chronic disease,” says Kenney. “Prevention is much easier than treatment. In the case of childhood obesity, that’s true at the highest possible level. There is a great deal of evidence that once obesity takes hold in the body, it’s hard to reverse. Once you’re a certain size, the body doesn’t like to let go of that.”
That’s one of the reasons obese children are significantly more likely to become obese adults. Another reason? Just take a look around.
“We are living in the most difficult food environment in history when it comes to nutrition,” Kenney states, referring to the overwhelming amount of cheap, energy-dense foods available pretty much everywhere. “I go to the hardware store to buy a hammer and at checkout, I have 50 different candy options. It is like that everywhere, as we all know, and it never used to be like that. The availability, and the cheapness, of the options is staggering.”
Yet, she adds, our culture tends to put emphasis on the individual, shaming them for not having enough willpower. “That’s not true,” Kenney says, “and it makes obesity prevention and treatment even tougher to roll out.”
And keep in mind that kids’ eating habits are strongly influenced by factors outside their control. They don’t buy and cook their own food, but rather are expected to eat what they’re given — at home, school, social events — and are highly susceptible to predatory junk food advertising . It’s not likely you’re going to see a middle schooler, alone, examining food labels in the supermarket to make sure she’s choosing a product without trans fats.
In reality, the problem is not personal, it’s systemic, and it’s becoming increasingly clear that effective solutions need to be comprehensive and have to come from the top. Some of the strongest (and, indeed, only) examples of programs that have actually lowered rates of childhood obesity among a broad population demonstrate this.
As part of a citywide program in Amsterdam, children are regularly weighed and fitness-tested. If they are determined to be overweight, they are referred to a child health nurse, who helps the child and her family learn to, for instance, shop and cook more healthfully or find physical activities to replace TV watching and video games. Between 2012 and 2015, the number of overweight children in Amsterdam dropped 12%, the BBC reports , bucking a global rising trend.
A program focused on helping parents set boundaries for their kids helped make Leeds the first city in the U.K. to lower its childhood obesity rate .
Chile has seen strides forward through regulations enacted in 2016 mandating warning labels on packaged foods high in sugar, saturated fats and sodium — similar to what you’d see on a pack of cigarettes — and prohibiting the marketing of these foods to children under 14 years old. The moves are already showing promising results , with Chilean parents reporting more awareness of the relationship between nutrition and obesity and an interest in changing to healthier eating habits.
“No country has reversed its obesity epidemic,” said Christina Roberto, assistant professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania. “But we can learn from each other and watch the effects of these specific efforts.”
That said, what works overseas may not always be viable in the States.
The sheer size of the U.S., the political wrangling that prevents more comprehensive policies, and the heterogeneous makeup of the population mean that efforts that work elsewhere may work only in small pockets of the U.S. — and only if they have a legislator, school superintendent or other advocate willing to stand up for big changes. But such changes are unlikely to be rolled out on a wide scale.
Policy changes at a local or state level can be met with resistance and cries of “nanny-state interference,” said Kenney. Parents may feel attacked for their choices, especially if education and programs are perceived as shaming them into compliance.
At the national level, you see the outsized influence of the food industry stymieing progressive health policies. That’s probably not surprising, given the high-profile role of former food industry lobbyists. The Project on Government Oversight has noted that snack food and corn syrup industry lobbyists have been appointed by the Trump administration to set food policy at the U.S. Department of Agriculture. Under Secretary of Agriculture George “Sonny” Purdue, the USDA has not been particularly supportive of stronger nutrition standards in public schools, Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at the University of Connecticut, told HuffPost. She pointed to recent pushback on changes that could bring more whole grains and vegetables into school lunches.
Another potentially big step forward — that’s facing huge hurdles from corporate lobbying — is taxing sugary beverages, says Roberto. Drinking soda and other sugary drinks is a contributor to obesity , and research published this month suggests taxing sugar-sweetened drinks can cut down consumption and thereby reduce obesity rates and the number of new Type 2 diabetes cases.
Roberto and her colleagues found that after Philadelphia put a tax in place on sweetened beverages at the beginning of 2017, there was a 38% drop in sales. The tax has not been in place long enough to show a significant effect on obesity, Roberto said, but it’s likely that data collection over the next few years could be promising.
“Showing an association between something like sugar reduction and obesity takes time,” she said. “We would also have to connect that reduction to the beverage tax, so right now we don’t have the data, but it’s likely we will in the future.”
Sara Bleich, a professor of public health policy at the Harvard T.H. Chan School of Public Health, believes that a national soda tax is one of the best chances we have to lower childhood obesity. But the beverage industry has done a very good job of quashing state soda taxes , making a comprehensive national policy seem like a pipe dream.
Bleich also recommends restricting recipients of federally funded Supplemental Nutrition Assistance Program, or SNAP, benefits from using those dollars to buy sugary drinks and candy. She cites evidence that strengthening the nutritional requirements for foods that can be purchased by participants in WIC – the special assistance program for women, infants and children – lowered obesity risk for 2-to-4-year-olds .
Tightening control on how people spend their benefits is a contentious idea, with some arguing it’s overreaching and paternalistic. States that have tried to apply for waivers to institute such restrictions have failed to get them approved by the USDA, which runs SNAP. But Bleich argues that the potential health benefits outweigh the cons and that “SNAP is a critically important place to target legislation.”
Even the most notable childhood-obesity campaign, Michelle Obama’s Let’s Move effort, is seen as more of a win for awareness than as impetus for significant decrease in childhood obesity numbers. In fact, in the nearly 10 years since the program was first announced, the childhood obesity rate has ticked slightly upward, from 17% in 2010 to 18.5% in 2016 .
That’s not a knock, though, because getting the issue to be so prevalent in the national conversation actually did begin to create some much-needed momentum, says Bleich, a senior policy adviser for the initiative.
“The program’s biggest effect is that it served as a lightning rod for state and local policymakers,” she says. “It also showcased activity and nutrition as positive aspects for children, rather than telling them what not to do. That put the focus on the benefits, and that’s an important distinction.”
Let’s Move, announced in 2010, also got some power from another huge initiative enacted that year that was less publicized but equally important: the Healthy Hunger-Free Kids Act, legislation that aimed to increase access to healthy food in public schools, particularly for children from low-income families.
“People may not realize it, but there’s been a massive amount of improvement in schools in the past couple years,” says Schwartz. “That is because that legislation was rolled out in phases and we’re seeing the benefit of that now.”
The act set maximum calorie amounts, mandated strong nutrition standards like having more whole grains, and set saturated fat limits for protein sources.
“Changes in policy like this act are useful not just because kids are eating healthier, but because they drive food producers to meet certain nutrition standards,” says Schwartz.
Case in point: Because of the act, Doritos sold in schools are formulated differently — baked instead of fried, and made with more whole grains than those you’ll find in stores. And yes, you might be wondering why there are Doritos in schools at all, but Schwartz says this is a good example of “baby steps” moves, because, until the past few years, schools were awash in chips, candy and soda, in part because it brought more funding to cash-strapped districts .
To be sure, addressing childhood obesity in the United States will likely feel like a whack-a-mole game for quite some time to come. You might get a whole public school district following stricter lunch nutrition guidelines, while the private school down the street serves whatever it wants. (And in either case, children are tempted by cheap candy, sugary beverages and junk food sold by the counter of every store on the walk home from school.) You could get state legislation passed that raises the accessibility of healthy food in poorer areas, only to see those laws get scuttled after the next election.
“To say this is a huge system to change is an understatement,” says Schwartz. “I really don’t think any country has this figured out. All we can do is keep trying, and keep hoping we make more progress.”
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Supermarkets targeted in the battle against obesity
Britain is fatter than ever. New government measures to combat obesity in Britain have been welcomed, broadly, by health experts. Yet some are dismayed that action on TV advertising will consist of consultation rather than legislation. Photograph: Jill Mead/The Guardian
Britain is fatter than ever. New government measures to combat obesity in Britain have been welcomed, broadly, by health experts. Yet some are dismayed that action on TV advertising will consist of consultation rather than legislation. Photograph: Jill Mead/The Guardian
Last modified on Mon 2 Jul 2018 13.50 BST
New laws to ban shops from offering special “two for the price of one” deals near supermarket checkouts for food high in sugar, fat or salt are to be introduced in an attempt to ease an obesity crisis that has made the UK the most overweight nation in western Europe.
Ministers will also announce today that they are to consult on introducing a 9pm watershed on television advertising for unhealthy foods after intense pressure from health experts. According to official figures, one in three children in the UK are now obese by the time they leave primary school.
After years of being criticised by health experts for failing to match its pledges to cut child obesity with action, the government will unveil a strategy that will also include:
Forcing restaurants and takeaways to show the number of calories clearly on their menus.
Consulting on a ban on the sale of energy drinks to children. Two in three children aged 10 to 17 use high energy drinks linked to numerous health issues in young people.
Encouraging schools to adopt “active mile” initiatives, such as the Daily Mile scheme – which encourages nursery and primary school pupils to jog or run, at their own pace, for 15 minutes every day.
Updating rules on the standard of food in schools so they reflect the most up-to-date sugar and fibre intake recommendations made by the Scientific Advisory Committee on Nutrition.
The measures were broadly welcomed by health organisations and experts, though some were privately disappointed that ministers had not committed to action on the television advertising watershed.
But industry leaders expressed “deep disquiet” at the prospect of further regulation from government. Tim Rycroft, director of corporate affairs at the Food and Drink Federation, said: “The government has come forward with proposals centred around further industry regulation. While the commitment to full consultation on these measures is welcome, there will be deep disquiet in the food and drink manufacturing sector today. Advertising and promotions underpin the healthy, vibrant and innovative market for food and drink that UK shoppers love.”
Experts also signalled that any backtracking or stalling would be disastrous for the nation’s health and the NHS’s finances.
Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “More than 60 cancers are diagnosed daily in the UK due to excess weight, and our research has shown that young people are more than twice as likely to be obese if they remember seeing a junk food advert every day.
“Children who carry too much weight are five times more likely to be obese adults, putting them at risk of many diseases, including several types of cancer. The government now needs to be steadfast in taking forward these measures with urgency and determination.”
Government sources conceded that after years in which ministers had been preoccupied with structural changes to the NHS – most of which failed to deliver real savings – it was now widely accepted within Whitehall that effective campaigns to improve public health, notably by tackling obesity, were a far more effective way to control NHS costs.
Health secretary Jeremy Hunt said: “It is near impossible to shield children from exposure to unhealthy foods. Parents are asking for help – we know that over three quarters of parents find offers for sugary sweets and snacks at checkouts annoying. It’s our job to give power to parents to make healthier choices, and to make their life easier in doing so.”
The government will also call on industry to recognise the harm that constant adverts for foods high in fat, sugar and salt can cause, and look at introducing incentives to those that reduce the sugar and calories in the products they sell.
Last November the Organisation for Economic Co-operation and Development (OECD) found that 26.9% of the UK population had a body mass index of 30 and above, the official definition of obese in 2015. Only five other OECD member states had higher obesity rates, four outside Europe and the other in eastern Europe. The OECD pointed out that obesity had increased by 92% in the UK since the 1990s.
Caroline Cerny of the Obesity Health Alliance representing groups concerned about obesity,said that the plans had “the real potential to ensure that children in the UK will face the healthy future they deserve. For too long our environment has continually steered us towards high fat and sugar options with relentless advertising and promotions.”
She said the plans did address the issue of children “being continually exposed to junk food adverts when they watch their favourite TV shows and when they go online. These proposed measures, along with action on the promotion and placement of unhealthy food and improved labelling, demonstrate that the Government is stepping up to create a more balanced environment that will make it easier for everyone to make healthier choices.”
The Local Government Association, whose members are responsible for public health, welcomed the plan but said more needed to be done, including giving councils powers to ban junk food advertising near schools and the need for specialised support for obese and seriously obese children.
“Councils need to be properly resourced if they are to carry out their public health responsibilities effectively and this needs to be balanced against their already over-stretched budgets, otherwise the ill health consequences of obesity in our younger generation risks causing NHS costs to snowball.”
Professor Graham MacGregor, chairman of Action on Sugar and of Action on Salt said: “What’s missing is a fully joined-up campaign which includes: uniform traffic light labels on food, rather than just calorie labelling, mandatory reformulation on sugar and calories, a tax on confectionery or unhealthy food with the opportunity to reformulate, and only healthy products (not high in fat, salt and sugar)should be marketed across all platforms, including TV, digital and print marketing. Simply consulting about the nation’s biggest public health crisis is not going to save lives.”
War on sugar failing as puddings get sweeter
Across the board, sugar content has fallen by just two per cent against a target of five per cent in the first year Credit: Anthony Devlin/PA
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G overnment targets to cut the sugar in common foods have failed spectacularly – with puddings getting sweeter and no change at all in chocolates or biscuits, new figures show.
Ministers pledged to slash levels in a vast range of products by 20 per cent by 2020, under the Government’s 2016 childhood obesity strategy.
But the first official assessment of progress shows that almost seven in 10 of the most popular brands have shown no change in their sugar content – or have even seen it increase.
Across the board, sugar content has fallen by just two per cent against a target of five per cent in the first year.
And the least change has been made in some of the most sugary products, the figures from Public Health England (PHE) show.
Manufacturers were told to shrink their products, change their recipe or boost sales of healthier options to meet the key pledge.
Instead, the majority have either done nothing or made their offerings even sweeter.
Of the top 20 brands responsible for the most sugar sales, 56 per cent saw no change in their content and 12 per cent added more.
Just 33 per cent cut the amount in their products.
D uncan Selbie, PHE chief executive said on Monday the food industry needed to “step up,” highlighting the fact some companies had “as yet taken little or no action”.
The findings, which examine the amount of sugar per 100g, show that the content in biscuits and chocolate confectionary has remained stubbornly unchanged, in the first year since the targets were set. And puddings have become one per cent sweeter, despite repeated pledges to crack down on sugar content, the data from shopping baskets shows.
5 Responses to “Systematic Failures in Dealing with Obesity”
July 28, 2020 at 8:21 am, Allen Browne said:
I prefer a sanitary bombaliff myself.
July 28, 2020 at 12:47 pm, Ted said:
I like it! Thanks for helping me learn something new.
July 28, 2020 at 1:46 pm, Angela Golden said:
This is so disheartening. I had such high hopes that the UK would move the world forward in obesity treatment, not backwards.
July 28, 2020 at 1:54 pm, Ted said:
I wouldn’t call this a backward move exactly, but I agree that it’s disappointing.
July 29, 2020 at 1:58 am, Chester Draws said:
We face a huge and growing epidemic,
Not really — it’s leveling off. (What very slight growth there is occurs because we are getting taller, and BMI exaggerates for the tall, and older.)
What we are now being told is that it isn’t a lack of willpower, but in order to stop us eating so much we will be forced to change diets and other habits. To me that is a worse outcome — I don’t want to live in a society where what I eat, when I eat and where I eat is decided by the government.
We know exactly what will happen. HFSS foods are banned from child watching hours. Since children don’t buy their own food, it will have no effect. The result won’t be to say “it had no effect, it was useless” but will be to double down. HFSS will be banned at all hours.
Of course that won’t have any effect either — because advertising doesn’t change habits, it only changes brands bought. So the ratchet will be moved up another notch.
Advertising bans are the worst possible policies. They don’t work and they are costly (as the TV channels who pushed them are finding to their horror). Bad policies are not “moving in the right direction” because they seem virtuous. They are just bad policies.
The UK introduced a tax on drinks that were high in sugar in April 2018. Companies have to pay:
- 24p per litre of drink if it contains more than 8g of sugar per 100ml
- 18p per litre of drink if it contains between 5 and 8g of sugar per 100ml
The policy was declared a success before it was even launched as manufacturers changed the recipes of their drinks to avoid paying the tax.
Between 2015 and 2018 the total quantity of soft drinks sold containing at least 5g of sugar per 100ml fell 50% while sales of drinks containing less than 5g per 100ml rose by 40%.
The amount of tax paid in each quarter since the levy was launched has been higher than it was in the first, suggesting the reductions in sugary drinks being sold have not continued.