News and Opinion
There are stories relating to obesity breaking around the world every day. The stories below are those where journalists haver sought NOF opnion/quotes or summaries of research on which NOF may have a view. Where possible the source of the stories are identified by the newspaper banner or a URL in red.
NOF Opinion will always be identified in italics.
Europe lacks integrated approach to tackle obesity crisis, new EIU report finds
- In most European countries around half of the population is now overweight or obese, and the percentage is set to rise further over the next decade. In the UK this could reach 71% by 2025
- Associated healthcare costs are rising, with direct costs ranging from 1.5-4.6% of health expenditure in France to around 7% of healthcare spending in Spain
- Lifestyle and behavioural education programmes are crucial—but obesity is also a medical condition that is hard to treat and is directly linked to other serious conditions
- No European country has a comprehensive strategy for dealing with obesity. Experts say that only an integrated, multi-sectoral strategy is likely to cap the growth of obesity rates
Europe is facing an obesity crisis of epidemic proportions that threatens to place a tremendous burden on its healthcare systems. But policymakers appear divided over how to deal with the issue, according to Confronting obesity in Europe: Taking action to change the default setting, a new white paper published today (November 25th) by The Economist Intelligence Unit (EIU) and sponsored by Ethicon.
Projections from the World Health Organisation (WHO) indicate that the proportion of those who are overweight or obese is expected to rise further in most of western Europe over the next decade, reaching 71% in the UK, 76% in Iceland and 82% in Ireland, although the projections remain cautious owing to limitations in available data and reporting. Obesity puts strains on healthcare systems: the European Organisation for the Study of Obesity (EASO) found direct costs ranging from 1.5-4.6% of health expenditure in France to around 7% of healthcare spending in Spain.
Several of those interviewed for the report agree that European obesity policy on the national level has suffered from being fragmented among a number of government agencies, creating the need for better integration. "An effective strategy has to integrate a number of different sectors and different tools", said Roberto Bertollini, chief scientist and WHO representative to the EU.
Most policies looking to address obesity focus on lifestyle changes, including an emphasis on healthy diets and exercise. The majority of pan-European and even national obesity campaigns have been focused on healthy eating in schools and homes, better food labelling and incentives associated with healthy eating and exhortations for work-outs or “active kids” campaigns.
While lifestyle and behavioural education programmes have a crucial role to play in preventing obesity in healthy people, experts (including the American Medical Association) define obesity as a disease that is hard to treat. In order to rise to the challenge of obesity, policymakers need to acknowledge that those who are already obese are suffering from a medical condition for which lifestyle-based programmes are insufficient.
Zoe Griffith, head of programme and public health at Weight Watchers, highlighted the limitations of programmes aimed at lifestyle and behavioural change: "Education in schools, availability of healthy eating and restriction on marketing to children will go some way towards resetting our society, but what they are completely ignoring is the majority of the population who are overweight and obese and need treatment. It’s a very complex political and policymaking environment."
Martin Koehring, the editor of the report, summarised the report findings as follows: “Our report has highlighted that creating an environment that prevents obesity and discourages an unhealthy lifestyle is crucial. National approaches to obesity need to take into account two very different target populations. On the one side are healthy people, for whom prevention programmes are largely designed. On the other side are those who are already severely overweight and obese, for whom the traditional emphasis on behavioural change is generally ineffective. Only an integrated, multi-sectoral strategy is likely to cap the growth of obesity rates.”
The Faculty of General Dental Practice (UK) says that a newly-published study underlines the need for stronger action to reduce the consumption of sugar from fizzy drinks.
The analysis of the sugar and calories in sugar-sweetened carbonated drinks, conducted by the Action on Sugar campaign group and published in the BMJ Open, reveals that the average 330ml can contains more sugar than an adult's recommended daily maximum intake of 30g (equivalent to 7.5 teaspoons), with some containing over 52g (12 teaspoons).
FGDP(UK) is supporting the authors' calls for further steps to be taken to cut the amount of sugar consumed from fizzy drinks in order to reduce the incidence of obesity, type 2 diabetes and dental caries.
The Faculty's Dean, Dr Mick Horton, said:
“The recent news that some manufacturers and supermarkets are reformulating their soft drinks ranges is welcome, and shows that the Sugar Tax is working even before its implementation. However the fact that the average fizzy drink contains more sugar than an adult should consume in an entire day, and three-quarters of them contain more than a child's recommended maximum, proves they simply cannot form part of a healthy and balanced diet, and stronger action is needed.
“Further restrictions on advertising of high sugar drinks, and a ban on price promotions, would help stop tens of thousands of children having to be hospitalised to have their teeth extracted, and if the government makes reformulation to under 5g of sugar per 100ml mandatory, the savings to the NHS will far outstrip the tax foregone, and more importantly the nation’s health will be improved.”
Notes to editors
1. The Faculty of General Dental Practice (UK) is based at the Royal College of Surgeons of England. It provides services to help those in general dental practice raise standards of patient care. It does this through standards setting, providing education courses and assessments, CPD, policy development, research and publications. Membership of FGDP(UK) is open to dentists and other registered dental professionals.
2. The study, Cross-sectional survey of the amount of free sugars and calories in carbonated sugar-sweetened beverages on sale in the UK, is available at http://bmjopen.bmj.com/content/6/11/e010874.full.
3. Action on Sugar’s public policy recommendations are at http://www.actiononsugar.org/News%20Centre/Surveys%20/2016/189696.html.
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Podium.me is a new national platform for the voices of the under 20s across the UK. We broadcast a daily podcast on our site www.podium.me.uk and cover a huge range of subjects.This week, our army of student and teenage journalists have been asking young people about their attitudes to school dinners, fast food, and the right to be fat.It makes interesting listening, and we welcome feedback and debate via twitter podiumme and facebook podium.me
Listen to our 3 minute podcast of UK teens discussing food issues
A week later than intended the Department of Health [DH] has published the calorie reduction pledges that it has secured from the food industry as part of its Responsibility Deal plan. The announcement was to have been made on March 14th to celebrate the 1st Anniversary of the idea of pledges being agreed and the script for the day called for a fanfare tp herald a number of " momentum building " exemplars to showcase the commitment of industry to health. Unfortunately, key industry players such as McDonalds, KFC and Burger King didn't read the script and the announcement has had to be made without them pledging anything. The fact that the DH Press Release publicising the pledges was embargoed to midnight last night also gives the impression that someone thought that a Saturday would be a better day to bury " not such good news ".
The Deal is, however, a beginning with a lot more work to be done - and DH has admitted as much. In the end, the National Obesity Forum believes that regulation/legislation will be required to bring everybody into line: the majority of the 75% of brands who signed the pledge have only " promised " to do things: they have not specified how many calories they will take out and by when. Coca Cola - acknowledged by NOF for its commitment to swap sugar for sweeteners in many of its soft drinks brands - is an exception. It will take 30% of calories out by 2014 by its use of stevia. Tesco should be also be complimented on its decision to make shopping for low-calorie products easier by adding a " Green Ping " label to the packaging - a " traffic lights " system if there ever was one! One day the UK will see the end to the impossibly complicated GDA food labelling system.
The Department of Health's [DH] battle to beat obesity is now being undermined by food and drink industry giants declining to sign a pledge to reduce the calorific content of their foodstuffs. Following the recent report from Which?, which listed High St food outlets that had declined simply to list calorie counts on processed foods [see below], this second setback in DH's drive to beat obesity is seen by nutrition experts as a catastrophe for public health.
The Forum would agree and is reminded of the many times the DH has been told not to expect industry voluntarilly to do what is necessary. The " Which? " report demanded that moves to introduce a robust pledge to lower the fat, salt and sugar content of food must be made within six months - and the Forum would support the watchdog 100%.
Major High St food outlets such as Costa Coffee, Pizza Express and Garfunkels have shunned the government initiative to reduce obesity by not displaying calorie counts with their products. The watchdog Which? has marked the 1st Anniversary of the launch of the Department of Health's [DH] " Responsibility Deal " with the food and drink industry by naming and shaming the companies that have declined to play ball. " If food companies don't agree to help people eat more healthily, " Which? insists, " then we must see legislation to force them to do so ". In reply, the DH has challenged the Which? list by stating that it had secured pledges that more than 70% of fast food and takeaway meals had calorie values attached - thanks to McDonalds, Pret a Manger, Yo! Sushi and Subway.
The Forum, listed by the GUARDIAN as a group which believes that legislation or regulation is long overdue, is particularly dismayed that the 1st Anniversary has not witnessed the DH naming the food giants who it lobbied to sign a calorie reduction pledge. Momentum-building exemplars were " promised " - but not delivered. If the DH wants to see 5bn calories less eaten daily across the nation, this will not be achieved by bits of calorie information here and there - but it might be with serious calorie reduction of food stuffed with high levels of fat, salt and sugar.
The Healthy Survey for England figures for 2010/11 show a 30-fold increase in 2010's bariatric surgery when compared to 2000. The 2000's 8,087 operations, even though they include 1,444 for band adjustments, dwarfs the 261 that were "headline news " 12 years ago. There was also a significant regional variation in the number of operations carried out and hospital admissions were also increasing - and increasingly varied across the country - and three times more women than men were being given a primary diagnosis of obesity. Tim Straughan,CEO of the NHS Information Centre which publishes the Survey, confirmed the growing impact of obesity on both people's health and NHS resources and suggested that health professionals working in the field might want to examine the regional discrepanicies.
Regional variations are very concerning to the National Obesity Forum [NOF] and, having examined them, it believes that they illustrate a postcode lottery which still exists in England. It is deplorable. Some Primary Care Trusts [PCTs] abide by the NICE [National Institute for Health and Clinical Excellence] in offering bariatric operations to obese patients but others flout it by making it virtually impossible even for the morbidly obese to qualify for the surgery. Hospital admissions vary similarly from region to region due to the disinclination of a significant number of surgeries referring needy patients. The premise is that obesity is the patients' own fault and that the NHS shouldn't be expected to pay for treatment.
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?
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.
Although they have been available for some time as treatments for diabetes, drug 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.
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.
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! ".
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.
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.
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, ailment 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, price 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.
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  bowls of chips for £1.39 in the belief that it was value for money!
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 ".
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.
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.
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.
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.
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!
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.
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, medicine which carried out the analysis, viagra buy 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.
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.
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]
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 not only among older women but also among adolescent girls [source: BMC Public Health]
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.
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.
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.
The use of weight-loss drugs has risen by 65% and sales of other slimming products by 20% in this last year according to a survey by the The Co-operative Pharmacy. Chemists record that they have concerns that the rise could be the result of discrimination. 20% of people surveyed stated they had been victimised over their weight with women most likely to to say that they had been ridiculed about their bodies. Depression and stress were also cited as the greatest influence on weight gain. The survey urged people to consult their GP or pharmacist about ways of shedding weight.
Discriminating against the obese is deplorable with the psychological aspects of obesity often overlooked. Unfortunately GPs can still be very hesitant in talking about weight issues and be dismissive. They will be prescribing lifestyle advice before prescribing drugs - but increasingly it appears that their patients demand the latter or even bypass their GP to buy their pills over the counter.
Tom Condliffe, pill a morbidly obese man [BMI 43], rx whose primary care trust [PCT] refused to fund his bariatric surgery, for sale has lost his Appeal to take his case to the Supreme Court though he may ask the court itself to consider his case on the basis that it raises issues of general public importance. His QC argued that the PCT disregarded the benefits of surgery but the PCT responded by stating that health authority bosses were entitled to make such decisions without taking into account non-clinical and social factors.
The NOF is bound to inquire what is the purpose of NICE [the National Institute of Clinical Execellence] if the courts are going to run a coach and horses through its guidance? Mr Condliffe, who has several co-mobidities brought about by his weight, qualified for surgery when he had a BMI 35.
Bristol researchers have found that the majority of families receiving letters offering them the chance to discuss their children’s significant overweight with a GP, failed to take it up. Only 47% consulted their GP and barely 15% who did ended up with any record of their child's weight in the GP’s notes. As well as parents finding it difficult to seek help from a health professional GPs also seemed reluctant to deal with an often embarrassing issue. [British Journal of General Practice]
Professor David Haslam, NOF chairman, believes that the research showed that better ways were necessary to motivate children and adults with weight problems into shedding the pounds. Sending letters to parents is a waste of time. It’s the duty of the healthcare professional, doctor or nurse, when they see a patient whose weight is putting their health at risk to seize the moment – the children’s lives could be at stake.
[see also 20th July 2011]
Several national supermarket chains have teamed up in Edinburgh to promote fruit & vegetables, doctor reformulate some of their own brand fruit & vegetable produce and swap fruit for chocolate at check-out. This could well be a “ feasibility study “ for a wider roll-out throughout the United Kingdom.
It sounds too good to be true – and hopefully it will become contagious across the country. The Scots would like to think that it’s a dramatic illustration of supply and demand and shows a seismic “ behaviour change “ shift in the nation: truth is, it may be more to do with falling in line with the coalition government’s “ responsibility deal **. But as they say in the trade, “ every little helps! “
** The “ responsibility deal “, aka nudging, won’t work by itself, according to the House of Lords Science and Technology Committee. The government has really to be prepared to use legislation to tackle obesity. NOF is very comforted to know that it’s not alone in sharing this view.
RADIO Edinburgh/Forth radio
A US study has found that children whose parents were told that they were overweight were no more likely to lose weight than parents who were not told. The study’s conclusion is that perhaps school should concentrate efforts on making sure that lunches were healthier and increased use of physical activity.
[Archives of Pediatric Adolescent Medicine: Aug 2001]
The biggest flaw in the study is that the schools did not tell the parents that their child was “ overweight “ or “ obese “ but simply gave them its BMI. Since parents in general have little concept of BMI, case is it any surprise if they gave the letters scant attention? To compound the issue, erectile the authors also state that, since the letters were sent home c/o child, they may never have been delivered in the first place!