by Marion Nestle

Currently browsing posts about: Obesity-in-kids

Sep 7 2016

The well deserved fuss over the UK’s childhood obesity plan

The much delayed UK government’s plan for dealing with childhood obesity has finally been released to virtually universal dismay over the missed opportunity.

The strategy is now a Plan, and says it is “the start of a conversation.” It reconfirms the government’s intentions to implement a soft drink tax, subject to consultation, but does not include a range of measures recommended by its own Public Health England and by last year’s House of Commons Health Committee, such as reduce food marketing and controls on retail promotions. It relies on voluntary sugar reduction by the food industry and encouraging parents to help increase children’s physical activity to meet the recommended 1 hour per day.

It’s fun to read the criticisms: nobody minces words.

An editorial in The Lancet

The UK Government’s long-anticipated response to the childhood obesity crisis disappointed everyone. From doctors, health charities, and celebrities to the very industry it seeks to propitiate, the Childhood Obesity Plan, published with as little noise as possible in the summer recess, has met with resounding criticism. As a Comment in today’s Lancet highlights, the strategy has been delayed for a year, and in that time it has been watered down to a vague Plan with no teeth.  Reading the report from start to finish gives the impression that its authors haven’t.

The Lancet editorial continues

The absence of curbs on industry practices that contribute to childhood obesity—promotions of unhealthy food in supermarkets and restaurants; advertising of junk food through family TV programmes and social media—seems like a gift to industry.

The Lancet is especially miffed because it ran a series on obesity last year that made it clear what kinds of policies needed to be enacted.

Also in The Lancet, World Obesity’s Tim Lobstein and Klim McPherson say

What we read in the government’s Plan is nothing particularly new, nothing bold, and very little that can actually be measured to assess the Plan’s success. It is a document that is not only a disappointment to public health professionals, but also evidence of a government walking away from its moral duty to protect the health of children, and its fiscal duty to protect the NHS from the consequent costs.

The Association for the Study of Obesity (ASO) issued a statement:

the plan is a lost opportunity to provide leadership and commitment in tackling childhood obesity as part of a whole systems approach. It lacks bold actions that are needed to reverse the current high levels of child obesity such as: a ban on junk food advertising before the 9pm watershed; reduction in portion sizes; reformulation targets for industry that address high energy density foods; curbing the promotion of unhealthy foods in supermarket; investment to increase and extend evidence-based child weight management services. All of these would be robust, evidence-based actions and would start to tackle the root causes of obesity in this country.

Again in The Lancet, Yoni Freedhoff and Kevin Hall point out the need for more sensible weight loss studies:

Over the past several decades, dozens of randomised controlled trials have compared various diets for the treatment of obesity. Ideally, such studies should have provided strong evidence for clear clinical recommendations and also put a stop to society’s endless parade of fad diets. Unfortunately, the evidence base remains contested and the “diet wars” continue unabated…What is especially striking is the similarity of the long-term pattern of mean bodyweight change, irrespective of diet prescription.5 …Fewer resources should be invested in studying whether or not a low-carbohydrate diet is marginally better than a low-fat diet, or whether intermittent fasting provides marginally better short-term outcomes than a so-called Paleo diet.

Their study provides further evidence why we need stronger policies for preventing obesity.  It’s too bad the UK couldn’t do better.

And if you think things are any better in New Zealand

The food industry has hit out at claims in a leading journal that New Zealand’s childhood obesity plan was flawed and that the government valued corporate profit over public good. The Food and Grocery Council said that an editorial in the New Zealand Medical Journal, which claimed that the government’s strategy did not address excess sugar intake, was “flawed on many fronts.  Moreover, the FGC complained that its response to the article, solicited by Fairfax Media, was not run.

Addition, September 14

Nov 10 2015

Two reports: Who is Obese? How to Curb Global Sugar?

The first report is from the UK.   Fat Chance? Exploring the Evidence on Who Becomes Obese is a curious example of what happens when a sugar company (AB Sugar) partners with a health organization (2020 Health) to produce a policy document.

The report examines the role of age, gender, socioeconomic factors, the built environment, mental health and disability, sleep, bullying and child abuse, smoking, ethnicity, and religion as factors in obesity—everything except diet and activity levels.

The press release for the report gives key findings, among them:

  • Obesity rates are rising rapidly among the poor as well as other groups who experience social instability.
  • Uncertainty seems to be a significant factor for weight gain.
  • Fast food outlets near working environments have a significant impact on the BMI of men; the lack of green space has an impact on obesity rates particularly among girls.
  • Half of all people suffering with psychosis are obese.
  • Parental obesity, especially in mothers, is a far more predictive factor in childhood obesity than is ethnicity.

Its authors write:

What is particularly highlighted in recent research, though rarely explicitly stated, is that obesity rates seem to be deeply influenced by social change (not just influences within static social categories). The studies we have compiled for this review show a subtle trend that has become increasingly evident over the last decade. It is highlighted in economic mobility, rising rates of mental illness, technological habits and engagements, and rapidly shifting urban ground. Argued here, broadly speaking, is that many of these categories strongly hint to a meta-structure that remains profoundly under-researched and largely ignored. This is the structure of uncertainty, a type of habitus that influences the terms of emotional engagement between an individual and their daily life. Insidiously, it undermines health seeking behaviour by making daily decision processes cognitively intolerable and emotionally taxing.

They conclude:

…approaches to obesity that recognise and incorporate complexity might impact a host of rising health problems that affect communities across Britain. The same interventions that encourage healthy BMI may improve energy levels through metabolic process and sleeping habits, while reducing risk of mental health problems, diabetes and a range of other comorbidities not discussed in this report.

But they don’t say what those interventions might be.

Could they possibly have something to do with removing sugary drinks and foods from local environments?

For doing just that, the World Cancer Research Fund International has produced Curbing Global Sugar Consumption: Effective Food Policy Actions to Help Promote Healthy Diets & Tackle Obesity.

Examples of actions which have had these effects include school nutrition standards in Queensland, Australia; a vending machine ban in France; a front-of-package symbol that led to product reformulation in the Netherlands; soda taxes in France and Mexico; a programme targeting retail environments in New York City, USA; a programme promoting increased water consumption in schools in Hungary; school fruit and vegetable programmes in Netherlands and Norway; a healthy marketing campaign in Los Angeles County, USA and a comprehensive nutrition and health programme in France.

The first report asks us to solve problems of poverty, instability, and mental health before taking action to prevent obesity, even when actions are known to be effective.  The second calls for such actions now.

Could AB Sugar’s sponsorship possibly have something to do with this difference?

Jun 9 2015

The Lancet series on obesity policy (in case you missed it)

Some time ago, I posted the terrific Lancet infographic on obesity policy.

Here are the series articles (or at least the abstracts) that go with it.

Oct 8 2014

Some thoughts on military might: obesity, candy, and the USDA’s arms race

Mission: Readiness versus obesity

As I noted in an earlier post, Mission: Readiness, an organization of former high-ranking military officials concerned about obesity and other health problems in military recruits and personnel, has issued a hard-hitting defense of USDA’s school nutrition standards.

New Picture (1)

But the military loves giving candy to kids

Dr. Karen Sokal-Gutierrez, who is engaged in international programs to reduce sugar-induced tooth decay among children, sends the results of her Google search for “US Military give children candy.”

Halloween candy buy back: To prevent tooth decay in US children, this program is having us send our candy to servicemen. Do they eat it themselves, or do they give it to local children where they serve?

A historical perspective on generations of military candy practices

US troops endanger Afghan children by giving them with candy

Images for US soldiers giving children candy

Dr. Sokal-Gutierrez notes that it’s not just the military that give children in developing countries candy—it’s also tourists and aid workers in developing countries and refugee camps.

She understands why it feels good to do this, but points out that the children might not have toothbrushes or dental treatment.  Candy, she emphasizes, contributes to severe tooth decay, mouth pain, malnutrition, problems in school, etc.

Why is the USDA Buying Submachine Guns?

Another reader, Kris Gilbertson, asks this question based on an article in Modern Farmer.

According to a USDA press rep, the guns are necessary for self-protection.

“OIG [USDA’s Office of the Inspector General] Special Agents regularly conduct undercover operations and surveillance. The types of investigations conducted by OIG Special Agents include criminal activities such as fraud in farm programs; significant thefts of Government property or funds; bribery and extortion; smuggling; and assaults and threats of violence against USDA employees engaged in their official duties,” wrote a USDA spokesperson.

One can only resort to cliche: food for thought.

May 9 2014

Opening today: Fed Up! See it!

This ad was in last Sunday’s New York Times.  It appears again today with blurbs added.

Full disclosure: I’m one of the many people interviewed for the film and appear in three 10-second clips.

Fed Up! is a stunningly hard-hitting exposé of the food industry’s role in promoting unhealthy diets and childhood obesity.  It spares nothing in showing the devastating effects of obesity on kids (I found those parts painful to watch).

The film’s main message is that the food industry, in collaboration with government, is responsible for creating a food environment that promotes poor health.

It is especially tough on food company marketing and industry-sponsored research.

It is also—I think, unfortunately—tough on Michelle Obama and her Let’s Move! campaign.

Mrs. Obama is not the problem.  The food industry’s marketing and co-opting practices are the problem.

We can debate whether it was wise or useful for Let’s Move! to partner with the food industry, but the campaign has done much to bring issues of childhood obesity to public attention.

It’s ironic that the accomplishments of Let’s Move!—the White House garden, the Healthy Hunger-Free Act of 2010, the new school food nutrition standards, the new nutrition standards for WIC, and the new food label, for example—are at this very moment under fierce attack by food companies, their trade associations, and their friends in Congress.

With that said, the film is well worth seeing.  Don’t miss it.  Get your friends to see it.  Let the debates begin.

How to see Fed Up!

  • Watch the trailer here.
  • Find out where it’s playing here.
  • Share it on social media here.
  • See Katie Couric’s excellent ABC News interview here.
  • Read the New York Times review here.

As for the debate, please enjoy:

Additions

Mar 31 2014

New book: Childhood Obesity

Kristin Voigt, Stuart G. Nicholls, Garrath Williams.  Childhood Obesity: Ethical and Policy Issues.  Oxford University Press, 2014.

 

 

I gave this one a blurb:

A well-researched, highly critical, but carefully balanced examination of everyday assumptions about childhood obesity and its prevention from an intensely moral perspective.  Although the authors demonstrate that no intervention is without ethical complications or effective entirely on its own, they call for immediate actions to reduce the stigma of childhood obesity, support parents, and create food environments healthier for children, adults, and the environment.    

Dec 13 2012

Good news: cities report declines in childhood obesity

I don’t get many fan letters (as you can tell from reading the comments to posts).  When I do, they mean a lot.  Here’s an especially lovely one from a reader this week:

I cannot help but think of you and the work that you do having a great impact on the first signs of child/youth obesity declining.  Although the “researchers” indicate they are not sure of the reasons for the decline, I think many within the food / food politics community know that the work you do, the awareness you spread and the advertising you expose, greatly affects the way we feed our children.  As a real food advocate and parent, thank you for the work you do.

Thanks but I can take no credit (much as I would love to).

The writer is referring to a front-page, right-hand column story—the most important of the day—in the December 11 New York Times.   The article said that several cities are reporting drops in childhood obesity rates.

The drops may be small, just 3% to 5%, but any reversal in obesity trends is excellent news.

Last September, the Robert Wood Johnson Foundation first reported such drops.

It noted that the declines were occurring in places that had taken comprehensive action to address childhood obesity.

New York City, for example, has engaged in major efforts to make healthy dietary choices the easy choices.  Health Commissioner Tom Farley recently reported a 5.5% decline in childhood obesity.

The Foundation says that Philadelphia:

has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Broad policies like these are exactly what the Institute of Medicine recommends (me too).

And now, it seems, these actions are actually having the intended effect.

That’s the best news ever.

And I don’t care who gets credit for it.

 

Nov 12 2012

Kids don’t need kids’ food

I did an interview for Childhood Obesity with Jamie Devereaux, its features editor.

Here are the first and last questions.  For the entire interview, click here:

The issue of access to healthy food is a major topic in the overall childhood obesity discussion in America. How important do you think it is to focus on solving the problems of food access as an objective in addressing childhood obesity?

I was impressed with Michelle Obama’s choice of targets for reducing childhood obesity—improving access to food in inner cities and improving school food. Both are excellent targets and, in a rational world, should attract widespread bipartisan support. It’s self-evident that it is more difficult to make healthier food choices  when no healthy food choices are available or when healthier foods are relatively expensive.

Some years ago I lived in a low-income Washington, D.C., neighborhood and was appalled at the poor quality of the supposedly fresh foods offered in the single grocery store within walking distance. I wouldn’t buy it and wouldn’t expect anyone else to want it either. Some studies report that inadequate access is a huge problem in inner cities and rural areas; others say the opposite. Without getting into arcane details about how the studies differ, the access problem just seems obvious and obviously needs to be fixed.

Finally, if you could shape the discussion of healthy food access for children in America—how would you frame it and what would you focus on?

Kids don’t need kids’ food. If adults are eating healthfully, kids should be eating the same foods that adults eat. Babies don’t need commercial baby food. Older kids don’t need kids’ products. Families can all eat the same foods, and that should make life easier for all concerned. If you don’t want your kids drinking sodas, don’t bring them home from the supermarket. Teach kids to eat real foods early on, and they will be great eaters throughout life.

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