/ Health

The government’s obesity strategy is long overdue

The end of July saw the government launch an obesity strategy that contains some bold ideas – but does it address the root causes?

COVID-19 has affected those with excess weight more severely. Public Health England research showed obese people were twice as likely to be admitted to hospital, and more likely to be admitted to intensive care compared with those of healthy weight.

The end of July saw the government launch an obesity strategy that contains some bold ideas.

These include the end of ‘buy one, get one free’ and other promotions on foods high in fat, salt and sugar (HFSS). It also proposes banning these products from prominent positions, such as shop entrances and checkouts.

Unhealthy special offers

Our research in 2016 and 2019 showed special offers were mostly on confectionery, sugary drinks and other products.

Instead, retailers will be encouraged to offer promotions on healthier choices like fruit and veg – although it’s not clear how this will be done.

Another new measure, and one we’ve long supported, is a ban on advertising HFSS foods and drinks online and on TV before 9pm.

Current rules don’t cover programmes most watched by children such as Britain’s Got Talent.

There will also be a consultation on a blanket ban on advertising HFSS foods online and on social media.

Other measures include calorie labelling in cafés and restaurants that employ more than 250 people, calorie labelling on alcohol packaging, plus a consultation on front of pack labelling that could lead to traffic light labelling being mandatory rather than voluntary.

Will the latest strategy fix the problem?

Of course, we’ve had obesity strategies before and these steps alone won’t fix the problem.

As a former NHS nutritionist, I can see key elements missing from the plans. There’s no mention of early childhood years– even though 23% of children start school overweight or obese.

Also missing is any attempt to address our food environment at large, including the impact of socioeconomic inequalities and so-called food deserts where people have limited access to nutritious food.

What do you think of the government’s latest obesity strategy? How far do you think it will go towards fixing the issues?

Comments

Do kids even watch traditional live TV that much? Will the ban on ads having any impact on ads served online?

We need, I suggest, to see obesity from choice – by simply eating incorrectly – as something to be deprecated to try to change complacency towards it, and most particularly where children are involved. Helping your child to become fat should be seen as a dereliction of parental duty. Quite how you distinguish between diet neglect and an inherent condition is a problem, I would agree, but I think we need to change attitudes.

I do not believe the cost of food is an issue; eating healthily is not inherently more expensive than choosing unhealthy foods; it should be cheaper but may involve the effort of preparing healthy meals and avoiding snacks and convenience foods.

This is a very, very tricky topic. One thing which nutrition scientists seem agreed on is that there’s no ‘right’ diet and certainly no diet that suits everyone. And weight gain can be ascribed in no little part to the efficiency of the metabolism.

The different efficiencies of metabolism of individuals is indeed a major factor, coupled with the amount of physical activity. The proportion of people with inefficient metabolism, who can eat as much as they want, declines with age. Sadly, some have died after taking ‘uncoupler’ drugs such as 2,4 DNP to reduce the efficiency of their metabolism and promote weight loss.

Those who have to take long-term corticosteroid treatment often struggle with weight gain, even if they are able to discontinue treatment.

Diet is only half the issue. Exercise is equally important.

Too many people seem to rely on ready meals which are unhealthy and expensive. Perhaps these need to be targeted with limits on fat, sugar and other nasty ingredients.

Here are statistics showing how smoking has declined over the past 40 years: https://www.statista.com/statistics/423001/cigarette-smoking-in-great-britain-by-gender/

This has been achieved in various ways, including better understanding of the health risks, education, and bans on advertising and of smoking in public places.

We understand the risks of obesity, so it’s time to take real action.

There seems little doubt that food has now replaced the smoking habit. Unfortunately one adversarial habit has replaced the other,

The physical damage caused by ingesting more than ones system can metabolically burn is probably equally as bad, if not worse than inhaling tobacco smoke, characterised by a long list of health problems such as diabetes, weight gain, high cholesterol, heart disease and gallstones – all of which have a detrimental effect on a persons psyche and self esteem.

The psychological effects are perhaps even more disconcerting as the link between sugar and addictive eating can lead to mental health problems.

Sugar induces a short term rush of dopamine followed by a sugar crash when the body tries to compensate and return your blood glucose levels back to normal by triggering more insulin. This in turn can bring about in some a craving for more sugar, leading to a vicious cycle of binge eating which, once established is very hard to overcome.

Food is also used as a coping mechanism in times of stress when the adrenal glands are triggered to work overtime pumping out cortisol and adrenaline at an alarming rate. Some individuals are better able to cope in the short term with this, but again an adrenal ‘high’ can induce an addiction.

The advent of the supermarket, constant TV food programmes and media advertising all add to the country’s obsession with food, a great comforter in times of trauma or any other deeply disturbing experience, often relating to a difficult social, physical emotional and intellectual development as a child.

As Ian makes a valid point, it is a tricky subject and there is no ‘right diet’. Evading the ‘naughty but nice’ food that tastes so good is hard to avoid during stressful times. The only universal solution, as far as I can make out, is to eat smaller portions, cut down (not out) on your consumption of sugar, salt and fatty foods, eat raw foods such as salads and fresh fruit, which retain their nutritional vitamins and minerals, but go easy on the fresh fruit due to its sugar content.

The modern trend towards an overindulgent lifestyle unfortunately is a luxury enjoyed by the fortunate few these days, but as old age approaches and the impending health problems associated with it start to show, either you take stock and change your eating and drinking habits or face up to the inevitable consequences.

From New Scientist, today:

“It turns out that the way we respond to food varies so much from person to person that there is no such thing as a one-size-fits-all healthy diet.

That may explain why science has failed to tackle the obesity epidemic. Consider a recent test of the efficacy of low-fat versus low-carb diets for weight loss. The DIETFITS study put more than 600 overweight people on one of the diets for a year. At the end, the average weight loss was the same in both groups, about 5.5 kilograms, but there was huge individual variation, ranging from much larger losses to significant weight gain.

This fits the conclusion of cutting-edge nutrition research: that a customised diet based on an individual’s metabolism and microbiome is required. Devising such diets isn’t beyond us and should be at the forefront of anti-obesity strategies. The US has already committed to this. But in the UK, we get reheated scraps of earlier anti-obesity plans. Ironically, to tackle this issue, we must think bigger.”

This seems logical. Individual metabolisms work differently when converting food and extracting the nutrients. The better converters get more value from their food which is both an advantage and a disadvantage. Age is also significant in all of this, as, of course, is society and diet within it. It is a subject that should be compulsory in school so that students begin adult life with thoughts about why fast food should be moderated and proper meal times are important for health.

The proportion of obese people has increased significantly over the last 60 years which suggests strongly there are factors at work that we could control rather than something inherent and uncontrollable in the make up of the general population.
https://www.kingsfund.org.uk/projects/time-think-differently/trends-healthy-behaviours-obesity

I wonder if, apart from normal diet, the doubling in alcohol intake is significant?

Ben Cardwell says:
16 September 2020

So how do we get a customised diet plan?

https://academic.oup.com/advances/article/8/3/412/4558122

Whilst no doubt obesity is complex that is no reason to avoid recognising some major factors. Trying to help those affected by these is a good start. “Sugar” seems a major factor, as does lack of exercise. Perhaps we should be more forceful in limiting the way sweet products are made available if we want to protect our children? The powerful lobbies work against this as they did with smoking.

So is the only way to somehow work on changing people’s attitudes by focusing on the dangers to their children’s future health and labelling such products as dangerous to health? A substantial part of the population should have the common sense to react responsibly. I’m not sure politicians have the guts to do this, so many guts will just get bigger.

We could at least influence that part of the population who are prepared to do something to help their children’s wellbeing?

ali O'Neale says:
14 September 2020

Very interesting views. However, to put it quite simply , we just eat too much. If we put breakfast back to 1pm we cut calories immediately and allow the body to repair itself. Blood sugar will drop and our bodies will burn fat instead (very efficiently) However children and people with eating disorders cannot be included in this approach.

My grandfather, who was quite small in stature and always very slim seemed to have cracked the obesity code by saying you should always get up from the table feeling you could eat the meal all over again. It definitely worked for him, but he was quite a strong character.

Peter J Woodward says:
18 September 2020

Agreed I am in advanced years but cannot help but recalling that in past years
the instance of overweight children (note I say ‘children’ not ‘kids’ – might I remind
people (especially BBC and media in general that ‘kids’ are baby ‘goats’ !!!) were
relatively in the minority due to no small part to the inclusion of at least two PT
periods each and every week. Worked effectively for our generation when during
the war years comfort eating and pacifying of unruly children was impossible
anyway.