News and Opinion

966 calories - and counting?

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Published on Tuesday, 24 January 2012

Now here's a fast-food meal that will make YOU a whopper, runs the Daily Mail's headline. The paper states that Burger King's latest - a 966 calorie Smoked Bacon and Cheddar double Angus burger - has been blasted by health critics.  Too right it has.

At a stroke, as they say in Westminster, the high street chain has run a coach and horses through the government's promise, made 24 hrs earlier, that people on the high street can be reassured that its Responsibility Deal with the food industry is working.  Further proof that responsibility appears not to be in the forefront of  the food industry's mind is Tesco's decision to sell £1 bars of Kitkat for 20p in order to lure customers back into their stores after Christmas! The chain also decided to put Easter Eggs on its shelves on Boxing Day [although it upset one customer who criticised her store for forgetting that chocolates for Valentine's Day should have been its priority!].  Finally, another Responsibility Deal backer, McDonalds has proudly added to the calorie count by declaring that 100 million additional customer visits darkened its doors in 2011. Big Macs are now available in 384 round-the-clock franchises that operate seven days a week. Enjoy.  

But take heart if you are reading this in the UK.  USA media are amazed that the National Obesity Forum is carping at a 966 calorie item. They suggest that we might be quite lost for words when presented with the 1,000+ calorie burgers that ring the tills across the Atlantic.  How long will it be, one wonders, before these gut-busting meals pop up here because our government has lost any stomach to take on Big Food? 

Department of Health - "people will weigh less "

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Published on Monday, 23 January 2012

The Department of Health [DH] has announced 66 health measures which it expects local authorities to focus on when the " new " NHS ge ts up and running.  In a Public Health Outcomes Framework scheme to cost a ring-fenced £5.2bn, they will additionally receive cash bonuses - a " health premium " - when they report progress.  " People will weigh less " is the confident prediction made in the DH Press Release. Oh, if only life was so simple. 

It isn't.  Though for children it might be simple to establish progress towards weight loss courtesy of the already successful " universal " primary school-based National Child Measurement Programme how will councils reliably measure excess weight loss in its adults?  GPs do get QOF payments for taking the BMI of obese patients of 16yrs and over but that is by no means universal.  Data collection nationally by demographic surveys has a good track record but local surveys will be a different kettle of fish - and costly. Word on the street says that if the cost is greater than the premium it attracts, why spend the money?  This Public Health Outcome may not be even be attempted.  What a pity!. 

Nursery guidelines - missed opportunity

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Published on Monday, 16 January 2012

After years of indecision the Department of Education [DoE] has finally produced nutritional guidelines for early years settings. Excellent though the 3 part document may be, particularly because it makes the point that the guidance has been produced to " ensure " that the requirements of children aged 1 - 5yrs are met, the DoE does not insist that it be followed,  How strange is that?  Even when its Introduction reminds the reader that nearly 25% of UK children are either overweight or obese by the time they join reception class in primary school - and that cases of rickets, iron deficiency and dental decay are becoming more commonplace - the DoE makes following its healthy advice " voluntary ".  The Department states that it does not have the evidence required to make it's advice mandatory causing the National Obesity Forum to wonder what more evidence it needs with hundreds of thousands of children so unhealthily overweight pre-school. 

Byetta/Victoza get a shot in the arm

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Published on Wednesday, 11 January 2012

Although they have been available for some time as treatments for diabetes, Byetta and Victoza - drugs that mimic a gut hormone suppressing appetite - looks as if they might be a simple once-a-day injection that takes care of obesity, too.  National Obesity Forum chairman, Professor David Haslam, says tha they really have the potential for revolutionising treatment.  " Safety wise they are pretty good. I am using them on my patients and have had a lot of success. For some they have helped lose four stone and have brought blood sugar under control for the first time ". The have also helped patients blood pressure and reduced cholesterol and enzyme levels.

It is not all good news of course. Common side effects include nausea, vomiting and diarrhoea but trails reported in the BMJ [Jan 14th] suggest that overall patient satisfaction with the treatment is relatively high.   Thankfully a drug for obesity may be no longer limited to Alli or the XLS Fat Binder pills available over-the-counter at pharmacies. 

Big mothers, fatter daughters

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Published on Monday, 09 January 2012

If you want to know what your girlfriend's going to look like in middle age, look at her mother.  Researchers at the Glasgow University confirm that bigger families are having bigger children and that daughters seem to inherit more from their mother.  The Glasgow study found that, of its female cohort, 17% were obese mothers but  20% of daughters were obese,  a far higher proportion than among fathers and sons or mothers and sons. 

The Scotsman's Sunday edition headlined its coverage " Children who shall inherit the girth " - a laudable title for a newspaper produced on the sabbath. Its take home message is, again, commendable.  The message?  All children with overweight/obese parents and at risk of becoming so themselves, should be monitored for unhealthy weight gain from birth.

25% children on diet before 10yrs

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Published on Friday, 06 January 2012

In a poll of children aged 7-18yrs, 40% under-10 yr olds considered themselves overweight, had been bullied because of it or had dieted in the past year.  The survery suggested that many children were turning to extreme measures to tackle their weight rather than eat healthily and take regular exercise.  Of all age groups, one in seven said that they were on a constant  "diet " whilst more than a quarter had visited anorexia websites.  The work was commissioned for ITV's " Dying to be Thin ".

On Dec 31st THE GUARDIAN " leaked " a NHS Future Forum report advising the Department of Health to require health professionals to discuss issues such as diet   with " patients " at every contact.  This survey should be a wake-up call to school nurses - who clearly appear not to have done so with thousands of children in their care.   

Keep slim - get a better " bac "

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Published on Friday, 06 January 2012

If you follow French diet guru Pierre Dukan you just might support his call to award better marks to " baccalaureat " students " if they stay slim.  However, if you don't, you would be correct in thinking that his educational advice is as flawed as his fad Dukan Diet.  The Western Mail reports that the controversial exams suggestion should be avoided in Wales - and states that France's obesity umbrella gropup, CBNO, is none too enamoured of it either.  The Daily Telegraph, which also covers the story, quotes the groups's president, Anne-Sophiel Joly, as anticipating  playground taunts such as " Fatso!, you'll never get your bac! ".

A New Year: a New Obesity Plan

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Published on Monday, 02 January 2012

Like daffoldils in Spring, you can tell it's January when a state-sponsored celebrity chef arrives to publicise the government's current attempt to rein in the nation's expanding waistlines.  Ainsley Harriott has joined Jamie Oliver and Lloyd Grossman by producing a cookbook of healthy " supermeals ", none costing more that £5 to make, to prove that it is possible to eat both well and cheaply. 3 supermarket chains - Asda, Aldi and the Co-op - have agreed to sell the ingredients at a discount and 4 million recipe cards are to be posted to families.

Not unduly surprisingly a number of people, including the National Obesity Forum and British Dietetic Association, are not impressed at Round 3 of the CHANGE4LIFE initiative.  THE INDEPENDENT invited Professor Tim Lang, Professor of Food Policy at City University, to post a comment on its double spread critique of the DH's latest foray into obesity prevention, cosiness with the food industry and public health " successes ".  Entitled " Will this new wheeze work? Fat Chance. " Lang described the DH's 2012 resolution as a soft option which, whilst looking good on the surface, is hopeless when confronted with the enormity of the change required.   

NHS to tackle risky lifestyles

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Published on Saturday, 31 December 2011

Patients should be asked about their diet every time they see a health professional according to radical proposals by NHS advisers to tackle soaring rates of obesity.  The NHS Future Forum, lead by a former Chair of the Royal College of General Practitioners, Professor Steve Field, wants health staff routinely to talk to patients about their lifestyle, even when they are suffering an unrelated illness, and offer them advice and help to become healthier.

Though some organisations have voiced fears that such interventions might stop patients seeking medical help in case they are asked questions they found uncomfortable, the National Obesity Forum [NOF] welcomes the proposal - particularly when the prevention of childhood obesity is concerned.  Though THE GUARDIAN did not print a summary of an interview with NOF in its paper edition, it did include it on its online coverage.  NOF described Field's initiative as a welcome start to 2012 and wanted to make the point that young children have routine GP/health professional check-ups.  They should be used sensibly to assess weight gain and, when concerning, interventions offered. The Child Growth Foundation has ready a protocol in place which health professionals should follow.  

Obese Britains think they're healthy!

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Published on Wednesday, 28 December 2011

40% of obese Britains think they are healthy according to a Bupa Health Pulse poll and are " blissfully unaware " of the dangers of eating too much and not taking enough exerise.  The survey also disclosed that British people are among the most overweight in the world.  Of the 12 countries surveyed, only the USA, Saudi Arabia and Australia had comparable levels.

There is considerable literature suggesting that not only the general public but also health professionals don't recognise unhealthy weight.  It is essential that schools begin to shoulder a responsibility to educate everyone in maintaining a healthy weight and avoiding the non-communicable diseases that may result from beging dangerously overweight - type 2 diabetes, cardiovascular issues and some cancers.  GPs are also key to this: if they fail to be honest with their patients asnd tell them that tbey are fat, the probably consequence may be that will become fatter.

Tell your partner he/she's fat?

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Published on Wednesday, 21 December 2011

Men are three times more likely than women to struggle to tell their partner that they need to lose weight research suggests.  The ICCR [International Chairion Cardiometabolic Risk] and the National Obesity Forum are calling for the British public to be more upfront with their loved ones about losing weight. Hinting to a loved one that he/she should consider reducing their waistine could play a considerable role in reducing critical health issues. It may not be a comfortable conversation buit as long as it is done sensitively it could even save their life!  Start by some encouragement to make r simple lifestyle changes such as becoming more active, making small alteration to their eating habits and replacing sugary drinks for water.  This is about health not vanity.

There may be no better time that now - Christmas and the New Year to broach the subject.  Nearly 60% of people worry about friends or family who have large waistlines but feel prevented from talking to them about their size.  Tell them that carrying too much fat around the waistline puts a person at risk of such conditions as type 2 diabetes, coronary heart disease and stroke.  Focus on health and well-being, not aesthetics - " You are important to me, and I want you around for a long time!.  Make suggestions about what you could do together  to get healthy.

UK women " fattest in Europe "

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Published on Saturday, 26 November 2011

Eurostat. the official EU statistics agency, reports that 23.9% of UK women are now classed as obese compared to only 15.6% in Germany, 12.7 in France and just under 9.3% in Italy.  A disturbing 16.7% of UK 18 - 24 yr old females are severely overweight - nearly four times as many as in gallic countries.  The report states that the share of obese persons increases with age and also varies according mto the educational level. 

The UK shouldn't be surprised at the figures.  The recent announcement that only only 1 in 4 meals are cooked in this country shows how much significant numbers of the population rely on ready made food and the microwave.  Until the school system begins to put back domestic science and cookery lessons onto the curriculum, obesity figures will be ever so.  Unfortunately, the latest fad some restaurants - to offer a " bottomless " menu - may not help either.  One restaurant owner reported that a customer finished off fifteen [15] bowls of chips for £1.39 in the belief that it was value for money!   

Caesarians and obesity

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Published on Sunday, 20 November 2011

Babies born by planned Caesarian Section [CS] are more likely to become obese than those born naturally according to Imperial College, London, researchers.  Taking their cue from previously published literature they believe that the process of natural labour and passing through the birth canal programmes infants to metabolise fats properly.  They are pursuing the hypothesis that if babies are not exposed to normal labour the normal metabolic development is distorted with significant overweight being a result.

Even with this literature in the public domain, NICE [The National Instute for Health and Clinical Excellence] announced on Wednesday November 23rd that all women should have the right to elect a CS delivery!   One has to wonder whether NICE researchers had done their background reading or thought their guidance through.  There are some 740,000 babies born in the UK every year and. if every mother-to-be took the NICE option, it could lead to the collapse of the NHS surgical services.  NICE should reconsider.  CS operations have, of course,  their rightful role but placing itself open to all comers is not it.  

DH " sacks " obesity advisory group

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Published on Tuesday, 15 November 2011

The Department of Health has disbanded its Expert Advisory Group on Obesity and is replacing it with a new National Ambition Review Group - whatever that may mean.  It states that it has a new approach to public health and, therefore, new advisory arrangements for obesity are required.  It will bring together key partners and experts from the academic and scientific field. 

If the old expert group was responsibible for the recent abysmal strategy, " Call to Action " [see October 20th 2011], it is probably better that it be disbanded.  It allowed vested interests, particularly in the food industry, to take a strangehold on public health and render ineffectual any strategy to beat the current epidemic. What the Department of Health should be seeking out now is independent thinking to overcome, arguably, the UK's most pressing health problem.   It would be nice to know who are the key partners with " ambition ". 
 

BST to beat child obesity?

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Published on Thursday, 10 November 2011

Researchers from the London School of Hygiene & Tropical Medicine [LSHTM]have suggested that keeping BST year-long could help in preventing childhood obesity.  In the November issue of Journal of Physical Activity and Heath they state that children spend 11% more of their time outdoors on days before the clocks are put back from October-April.  The paper happens to coincide with the passage of the Daylight Saving Bill currently going through the House of Commons - but it may not be enough in itself to convince Scots MP to vote for it.  In the far North it would mean some children cycling to school in the dark and a proper harm-benefits risk assessment of this needs to be carried out.   

The NOF clearly advocates physical activity as being crucial to a healthy lifestyle but is less certain that this alone prevents obesity.  In a seminal paper in 2010 Terry Wilkin's Plymouth group published work that indicated that attempts to tackle childhood obesity by promoting physical activity have been largely unsuccessful.  Judging by the press coverage accorded to the LSHTM  paper, the notion of 365 days Summer Time in the future could lighten up what might be a very bleak 2011 Winter.

" We're no obe-city! "

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Published on Tuesday, 08 November 2011

The SUN is never short of a snappy headline - and the Rotherham Institute for Obesity [RIO]'s claim that its patients have lost more that 10 tonnes over the last two years gave the tabloid another chance to shine.  Rotherham's message in particular is that not enough children are being referred to its weight-loss service. Matt Capehorn, RIO's clinical manager and clinical director of NOF, emphasised that tackling childhood obesity now would save generations of overweight adults in the future. 

Capehorn's statement is yet another reminder that the coalition government's  recent " Call to Action " on obesity [see below] is still not focussed enough on children and that we will continually be seeing overweight/obeses children until it is.  Rotherham primary schools' 2010-2011 National Child Measurement Programme weight figures will be published in December. Will they be as dramatic as RIO's success?  Watch this space!

MPs deride HMG obesity strategy

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Published on Wednesday, 02 November 2011

The House of Commons' cross-party Health Select Committee considers that the government's Responsibility Deal with food and drink firms to improve public health will not solve the huge problems of obesity and chronic drinking.  The Committee's report, examining Government reforms proposed for Public Health, echoes concerns expressed by the British Medical Association, campaigneers and celebrity chef, Jamie Oliver.  The government must be ready to use legislation if industry fails voluntarily to reformulate its unhealthier products and " nudging " the population into heahier lifestyles also fails.  For it's part, the Department of Health refutes this approach and is adament that working with industry will provide the solution.  It insists that it is the Department and not industry that is setting the health agenda.

The National Obesity Forum [NOF] simply repeats it condemnation of the Department's strategy to tackle obesity and has broadened its demand for a comprehensive Inquiry into the epidemic [see below].  NOF understands that the National Audit Offioce and Commons' Public Affairs Committee's have also identified obesity for further reports: it is NOF's opinion that a joint Inquiry by all three bodies should be timetabled for early 2012. 

This demand takes into consideration that the House of Lords Science and Technology Committee has already inquired into " nudging " and was told by a senior Conservative that it was " an open question whether nugging will have any effect on behaviour change whatsoever ".

Obesity - " Call to Action "

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Published on Thursday, 20 October 2011

The National Obesity Forum, together with the Child Growth Foundation - the UK charity focussed on the prevention of chidhood obesity - has called for a second House of Commons Inquiry into Obesity following the publication of " Call to Action ", the Department of Health's strategy to accomplish a downward trend in obesity by 2020.  It is seven years since the Select Committee published its seminal report on obesity - and comparatively little has been achieved to stem the epidemic since.

The NOF calls the government's strategy " hopeless ".  Chairman Professor David Haslam told GP, the general practice weekly, that " Call to Action wouldn't make a single person thinner.  It is meaningless to primary care and I almost completely object to it ".  He also had some choice words for the " Dietary Recommendations for Energy " document released simultaneously with " Call to Action ".  Commenting on the new recommendations - which increased the calorie count -he castigated the increase for being " really unhelpful ". " It gives out entirely the wrong message." he said. " People are going to think that they can eat that little bit more. If anything, that will add to the obesity problem!"

" Call to Action " whose chief message is that the UK should strive for a collective daily reduction of 5 billion calories as a " new national ambition ", has received flak from all quarters except, of course, the food and drink industry. Jamie Oliver's view that the document was " worthless, regurgitated, patronsing rubbish " was the opinion most quoted.

The Cameron fat tax diet

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Published on Sunday, 09 October 2011

A full page in the SUNDAY TIMES summarises the first week of reaction since the Prime Minister announced that the UK might consider following the Danes by slapping a tax on foods that contain more that 2.3% of saturated fat [see below].  The page identifies a number of other countries who are already imposing, or considering the imposition, of similar taxes.  It reports the " popular " views of Oldham where the Council wants to put a £1000 surcharge on fast food restaurants and, finally, summarises the views of a number of obesity specialists. 

The newspaper states that the National Obesity Forum is " surprisingly uneasy " about the prospect of a fat tax.  It shouldn't be.  The Forum has been frequently  quoted in favour of a tax but would certainly be " uneasy " if the junk food that is to be taxed disadvantages the millions of poorer households who depend on it.

Fat Tax - UK may follow Denmark

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Published on Tuesday, 04 October 2011

In an interview during the afternoon with CHANNEL 5 NEWS at the Manchester Conservative Party Conference, Prime Minister David Cameron hinted that the UK would consider a " fat tax " [see GUARDIAN Oct 3rd below].  The interview was first run in the 5 NEWS AT 5 bulletin complete with an endorsement from the National Obesity Forum.

In a longer quote to the Press Association the Forum made it clear that the devil might still be in the detail but it was a move in the right direction.  The UK should seriously consider such a tax, implementing the first of 20 measures that the recent UK/WHO Assembly High-Level meeting in New York had fudged addressing.  Taking a word out of the coalition's own play book, the Forum opined that yesterday's Danish decision may have " nudged " the Prime Minister into making his statement. 

Danish tax saturated fat

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Published on Monday, 03 October 2011

As of this morning Danes will pay an extra 25p for a pack of butter and 8p extra for a packet of crisps as a new tax on foods which contain more than 2.3% saturated fat comes into effect.  The move has parallels elsewhere in Europe with Hungary also introducing taxes on foods with unhealthy levels of sugar, salt, carbohydrates and caffeine.  Denmark, Switzerland and Austria have already banned trans fats whilst Finland and Romania are considering also considering fat taxes.

Faced by this turning tide in Europe David Cameron had little alternative but to take the oppportunity to annouce that Whitehall will also consider a fat tax [Tuesday, Oct 4th 2011].  Cameron knows that if the UK does nothing it faces a prediction that 60% of its population could be obese by 2050.  This may not only result in the downfall of the NHS but also of severely damage the nation's workforce.  Will the tax work?  Only time will tell of course but Danish Health Minister, Jacob Neilsen, is quoted by Associated Press as being convinced that " the tax is a step in the right direction ". 

Unhealthy food - name and shame

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Published on Saturday, 01 October 2011

An Australian consumer group has launched the " Shame the Claim " campaign to encourage people to reveal those food products that present healthy claims but are far from good for you. The group states that parents in particular have signed up having had enough of the persistently deceptive marketing of unhealthy foods to children from food companies that should know better given the global rise in childhood obesity.

Brilliant! 

Babies who are already " obese "

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Published on Monday, 26 September 2011

New scanning techniques have allowed Imperial College, London, scientists to examine fat in babies whilst still in the womb.  They show, for the first time, a direct link between the overweight/obese BMI rating of a mother-to-be and her child.  Some 50% of foetuses studied had more adipose, or fat, tissue around their abdomen than would have been expected.  Newborn babies typically have about 700g of adipose tissue but for each unit increase in maternal BMI, this increased by some 7g with a huge build up of fat in the babies livers. Normally a newborn baby has minimal or no detectable liver fat.

The Department of Health has announced that it will tackle obesity from pregnancy.  The above research confirms that this is too late.  Measures should now be considered to nip obesity in the bud - at school.  With 50% of conceptions unplanned, it is of paramount importance that all women of child bearing age - nowadays from the earliest years of secondary school - should know the possible outcome of not being in good physical shape.   

    

UN cops out on obesity

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Published on Monday, 26 September 2011

On Sept 19th a High-Level Meeting of the United Nations General Assembly signed a Declaration recognizing the economic and social burdens of Non-Communicable Disease [NCD], also known as chronic disease.  However, despite being told by Secretary-General Ban ki-moon that " collaboration is more than a public health necessity " and that "NCDs are a threat to development ", the Assembly failed to set any specific goals to reduce their impact.

If you want an opinion of the UN kop out, read the scathing editorial published on THE LANCET 's Online First.  The declaration, it says, has clearly come under multiple pressures from governments and lobbyists resulting in a watered down document reflective of national and industry interests.  " It lacks ambition and is more a politically correct document that a political declartion of war.  Individual countries must now take bold steps to accelerate their responses below the slow timetable the UN proposes if real progress is to be made ".

What the UK will do is anybody's guess.  Andrew Lansley addressed the UN  and called for " tough " action on obesity.  However, the fine words he used in New York need to be replicated at home in his forthcoming document [possible  publication date October 13th] setting out how obesity will be tackled in the new public health and NHS systems.  Given that one of its central themes - the Responsibility Deal - has been declared a non-starter by a number of obeservers, the document might be as bland as the UN's Declaration. 

Why your child should be like Scooby

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Published on Thursday, 15 September 2011

The Department of Health is partnering with the TV children's programme
LazyTown in an initiative to help 2-5 yr olds ditch junk food and take up more healthy exercise.  In a poll of 20 children's TV shows Scooby Doo was voted the best programme but it was the LazyTown acrobatic Sporatcus that was named the Healthiest Character.  In the initative, activity packs will be distributed from the UK's 3,600 Sure Start Children's centres. 

As part of its coverage, THE SUN contacted the NOF to come up with six bullet points to encourage kids to adopt a fitter lifestyle.  Top of the was the list was the tip to ditch the buggy whenever possible followed closely by a prompt to get children back into the habit of the simple, enjoyable activities that used to be standard - playing hopscotch, skipping, and going on swings in the park.  Sportacus, played by Marcus Scheving and the inspiration behind the creation of " LazyTown ", once began a presentation at an NOF national conference by walking to the podium - on his hands!  

Brush your hair too much - get obese!

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Published on Monday, 12 September 2011

US Surgeon General, Regina Benjamin - the American equivalent of the UK's Chief Medical Officers - has put forward the idea that women who spend hours at the hairdressers or in front of their bedroom mirror might be getting obese as a result. 

Indeed - and the DAILY MAIL's US correspondent telephoned the NOF all the way from New York to check her theory out.  We said that Benjamin had a point: daily exercise to keep in shape should come before the daily comb.  People who turn out of bed and head straight for the gym at 6am - or before - seem not to care if they don't look like a Vogue model.  Come 7am, however, they find quality time to get their hair and faces fixed - if not at home, then on the bus.  Certainly, they feel better for both physical activities!      

McDonald's post calorie counts

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Published on Sunday, 04 September 2011

McDonald's are to post " calorie counts " for their products in all 1200 UK outlets from September 7th.  Along with other " fast food " retailers such as KFC, Pizza Hut, Pret a Manager and J D Wetherspoon, they are fulfilling their Responsibility Pledge to the Department of Health [DH] to help combat opbesity.  With 3m McDonald's meals being served daily, the DH hopes that this will have a huge effect on the high street and will help people make healthier choices when they eat " out-of-home ".

Though this is a welcome move and a step in the right direction, it is little more than window dressing when compared with the measures that need to be taken to reduce the ingredients of high-dense food to acceptable levels.  Even DH and McDonald's agree that only 20% Big Mac customers are likely to take heed of the counts - but those that do, if New York research is anything to go by, consume 100 calories less per meal.

Towns where children are fatter than their parents

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Published on Saturday, 03 September 2011

Analysis of statistics comparing the most recent government adult obesity estimates and the 2008/9 National Child Measurement Programme figures has found that 20 of the 22 areas that children were fatter than adults are in London. The DAILY MAIL, which carried out the analysis, maps out the other English hotspots.

The figures belie Department of Health assurances that the obesity epidemic is  levelling off ".  It may well be in affluent area - such as towns in the countryside and afluent areas surrounding big cities - but in inner cities the picture is not the same.  For example, in Westminster, the " seat " of government, childhood obesity is 28.6%, 10% above the national English average.

Obese spend 50% more time in hospital

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Published on Tuesday, 30 August 2011

The Glasgow Herald is reporting research* showing that obese Scots spend an average of 26 days in hospital compared to 17 for someone within the healthy weight range.  The researchers from Edinburgh University trawled through medical records of some 16,000 men and women to examine the link between BMI and hospital stays.  In response to the finding, a Scottish Assembly spokeswoman stated that " the environment we live in means that weight gain becomes almost inevitable " [* Scottish Medical Journal 28th August].  

What an admission!  Perhaps this statement will stop governments blaming obesity on the failure of individuals to make healthy lifestyle choices and start to ensure that their politicians focus on strategies to change the obesogenic environment in which their populations live.  This week's THE LANCET spells out the measures that only governments can take.

26 million UK adults will be obese by 2030

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Published on Monday, 29 August 2011

The obesity crisis is being driven by a food industry bent on maximiising profits - but governments are failing to intervene to protect the health of their populations, leading scientists state.  In the UK, the fattest nation in Europe, the number of obese adults is now forecast to rise by 78% over the next two decades resulting in more than a million extra cases of diabetes, heart disease and cancer.  A series of research papers published in The Lancet* ahead of the United Nations/World Health Organisation [UN/WHO] High-Level Meeting on non-communicable diseases [New York  Sept 19th/20th], lists 20 proven interventions for curbing obesity which show that eight would save costs as well as improving health.  The researchers state that no country in the world is successfully tackling the threat as leaders fear the wrath of electors if they slap extra taxes on healthy foods. [* www.thelancet.com/series/obesity] 

The INDEPENDENT is unique in both its coverage of The Lancet series but also for a Leader stating the case for a " fat tax ".  This was echoed in interviews with  Forum spokespeople by the BBC's News Channel, Radio 5 Live and 20 of the BBC's local radio stations that highlighted some of the 20 measures that The Lancet believes the UN/WHO should implement as soon as possible.  The series of the Lancet papers should be required reading for anyone interested in tackling to-day's pandemic and preventing it taking further hold in the future. 

THE LANCET is not alone in looking forward to the UN/WHO meeting.  The BMJ chooses to ask whether or not vested interest will bring the meeting to its knees.  In a paper " Will industry unfluence derail UN summit? ", it raises serious concerns about the " powerful sway " of tobacco, alcohol, food and drug industries.  This concern is then supported by a Commentary declaring that the meeting will be a " battleground, pitting public interests against powerful private ones ".  The two days may witness the emergence of a global social movement for change shaping the future of our health for years to come - or see it scuppered. [BMJ August 24th 2011]

Parents give kids junk for " easier life "

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Published on Sunday, 21 August 2011

Eight out of ten parents are still packing lunchboxes with unhealthy food such as crisps and chocolate according to Annabel Karmel research even though fruit is one of children's most most popular snacks.  According to Ms Karmel " parents start out with good intentions, but at busy times of the day opt for an easier life and give in to children even though they know that the food may not be healthy ".  They make up for it, however, with nearly 50% admitting that they tried to trick their children into eating healthy vegetables by hiding them in pasta dishes.

The survey shows that pester power is alive and well but the parents should get brownie points for cunning.  Other tricks employed were offering finger food portions of vegetables and the least favourite - mushrooms, spinach and broccoli -even being pureed.  The last trick - resorting to a bribe of a sweet treat - should always remain, what it is, " treat ".

A second survery, The Kids Brand Index 2011, also reported recently in the MAIL, emphasised just what parents still have to face up to. Walkers Crisps, McDonalds and Coca Cola are three of the favourite brands of UK children.  The news may not be all bad however: the survey does not record whether the favourites are the traditional items or the newer, healthier reformulated products.

The " fat and jolly " hypothesis for adolescent girls

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Published on Wednesday, 17 August 2011

French clinicians, aiming to describe the association between BMI [Body Mass Index] and depression in teenage children, report that overweight adolescent girls are more likely to be depressed than obese adolescent girls, giving support for
the  " fat and jolly " hypothesis not only among older women but also among adolescent girls [source: BMC Public Health]  

Smoking " pack years " concept for obesity?

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Published on Wednesday, 17 August 2011

A team of researchers from Australia, Denmark and Indonesia have come up with the suggestion that obesity should be measured in "obese years" or "BMI years", analogous to the " pack years " concept used for smoking.  Up to now obesity has been measured internationally only by the severity of the problem and not its duration.  To do the latter would be much more meaningful because examining the association between obesity and the risk of mortality, by considering only its severity and ignoring its duration, may have underestimated the adverse effects of the current epidemic [source: International Journal of Epidemiology]  

Obesity tops list of kids' health concerns

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Published on Wednesday, 17 August 2011

The Director of the US National Poll on Children's Health has confirmed that obesity heads the list of children's health concerns for the fourth straight year.  He added the warning, however, that the level of adult concern has declined over the past few year.  The Director, a paediatrician, considers that this should be a warning to public health officials because it indicates how the public is hearing national messages that previolus increases in children's obesity have recently levelled off. [source: LiveScience.com]

The UK Department of Health should take heed.  It is keen to state that UK childhood obesity is " levelling off ", too, and may be is risking a similar apathy. 

Fat and fit live as long as slim

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Published on Tuesday, 16 August 2011

Toronto researchers are challenging the idea that all obese individuals need to lose weight.  They say that trying - and faiiling - to lose weight may be more detrimental than simply staying at an elevated body weight.  Healthier obese people were generally heavier in early childhood and were happier carrying extra weight. [ source: Journal of Applied Physiology, Nutrition and Metabolism]

Fortunately, the researchers stress that all these individuals were also more likely to be physically active and consume a healthy diet.  Their research co-incides with this week's timely reminder that physical activity is key: even as little as 15 minutes burst per day can add 3yrs to your lifespan and reduce the risk of an early death by 14%.  It confirms that the more you do [particularly 100 minutes if you can manage it brings even bigger health gains [source The Lancet]

Another reason for being physcally active is that watching TV could lead to a premature death.  Australian researchers conclude that every hour watching takes 22 minutes off your life and, they say, the stats would be the same across the world.  Viewing for an average of six hours a day can cut short your life by 5 years.  Now that you've read this, consider a walk round the block before settling down to to-day's telly [source: British Journal of Sports Medicine].

Junk food still stars in TV ads

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Published on Wednesday, 10 August 2011

Although US children are viewing fewer " unhealthy " sugary, fatty foods advertised on TV, University of Illinois researchers have found that advertisers have increased advertisements for " fast foods "!  They cite recent research showing that children watching cartoons consumed 45% more snacks when they were exposed to food ads.  The food industry has, expectedly, repudiated the findings whilst noting that parents need to be aware that junk foods still feature heavily in TV ads.  However, it took the opportunity to announce that it had developed new uniform nutrition criteria for foods that can be advertised to children. 

Since the criteria will not go into effect until 2014, US parents concerned for their children's health still must await years for proof that " self-regulation" by commercial interests works.  Unfortunately it would appear that the UK government is still adopting a similar non-regulation/legislative approach.  

Predicting babies' risk of obesity

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Published on Wednesday, 10 August 2011

In a leading article for the peer review journal The Archive of Disease in Childhood, a leading UK paediatrcian, Professor Mary Rudolf  from Leeds, questions whether enough is being done to identify babies most at risk of becoming obese.  She proposes an Obesity Risk Tool [ORT].  Quite apart from the logical reversal of traditional criteria for weight faltering [namely to identify infants rising through 2 centiles/being above the 98th centile] further clear indications such as parental BMI, mother's gestational weight gain and the child's birthweight should be taken account of.  She advocates that  the ORT becomes an indispensible item in a primary healthcare workers armoury. 

Producing a dependable ORT is arguably the most important innovation in reducing/preventing childhood obesity. The only long-term strategy in the country's fight against obesity is to fix it at source - focussing on the year[s] before/during pregnancy, birth and the child's very early years.  Hopefully, the UK Department of Health will fully recognise this when publishing its obesity strategy later this year.

Coping with " high risk " pregnancies

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Published on Wednesday, 10 August 2011

An Editorial in the British Medical Journal [BMJ] calls for better GP training to reduce the " worring number of high risk pregnancies - such as obesity and maternal deaths. A number of obstetric medicine professors signed the editorial conrfirm that older women are more likely to be obese, have hypertension or be predisposed to gestational diabetes and thromboembolism.. The team proposes increasing the number of obsteric physicians and insists that GPs and other doctors shold be trained in obstetrics [source BMJ]

Stall in new anti-obesity drugs

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Published on Tuesday, 09 August 2011

The failure of new obesity drugs to meet USA Federal Drug Administration [FDA] safety demands is preventing new approvals in obesity therapies.  This has left Orlistat - and its over-the-counter version, Alli - as the only long-term therapy approved in Europe and the US .  The FDA states that more safety evidence must be provided and both Lorquess and Qnexa have challenging paths to approval.  It is not all bad news however.  Novo Nordisk is now attempting to establish a higher dose of Victoza diabetes drug as a viable weight-loss drug for non-diabetics.  Victoza's mechanisim avoids centrally acting side-effects that have been the cause of recent drugs withdrawals.  Pivotal trials are scheduled to begin in the Autumn. [source Datamonitor]

Welsh Assembly missing trick

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Published on Tuesday, 09 August 2011

Conservative members of the Welsh Assembly have criticised the Assembly for not using pharmacies to ease GP burden.  With 20% of the population obese only 2% offer weight management services and none offer cholesterol testing.  According to the Conservative health spokesman, Darren Millar AM, it would also make economic sense to spread the burden, too, with £1bn budget cits facing NHS Wales.  The Assembly has responded by stating that it is committed to increasing pharmacy services and is trialling two vascular screening projects in Porthcawl and Merthyr Tydfil.  The studies include the provision of advice on healthy eating. [source:  BBC WALES]