I’m late in seeing this but the World Bank published this report linking food systems to obesity last year.
It’s got lots of charts and tables and ends with actions that can be taken in food production systems to improve food quality. It’s wonky, but useful.
Policy wonks, students, advocates: If you are looking for data on what countries are doing to promote healthier people and food systems, check out these resources:
Advocates: these are great sources of ideas.
Some new resources for food system advocates have just come my way. Use and enjoy!
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.
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
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.
As part of its series on obesity, the Lancet has produced this chart to illustrate why it is so important to create a food environment that makes healthy choices easy. Nice!
For tonight’s Grand Rounds at Columbia University, I did an interview with FPOP (Food Policy and Obesity Prevention).
March 31, 2014—Years before the Reagan Administration decreed that ketchup was a vegetable, Marion Nestle saw the connections between the dinner table and politics. Nestle, the nation’s leading advocate for good nutrition, will address the Mailman School in a Grand Rounds talk tomorrow and kick-off Public Health Fights Obesity, a month-long series of lectures and special events, including an April 16 symposium on preventing childhood obesity.
Nestle, a professor and founder of the department of Nutrition, Food Studies, and Public Health at New York University, is the author of acclaimed books, includingFood Politics: How the Food Industry Influences Nutrition and Health, and most recently, Why Calories Count: From Science to Politics.
In anticipation of her Grand Rounds talk, the student group Food Policy and Obesity Prevention interviewed Nestle about everything from attempts to regulate Big Soda, GMO labeling, to school lunches done right.
The federal Dietary Guideline Advisory Committee recently published recommendations that for the first time considered issues of food sustainability. There has been a lot of controversy.
The guidelines have always been controversial, but never anything like this. I think this is an example of how worried the food industry is about the pushback about diet and health in America. Sustainability is the “S word” in Washington. The guidelines committee is trying to do is what I’ve been advocating for a very long time, which is to bring agricultural policy in line with health policy. Right now the policies are completely divorced.
At the same time you have Heinz and Kraft joining forces.
The food industry is in a defensive position because food and health advocates have been enormously successful in changing the market and changing people’s views. The fastest growing segment of the food industry is organics. The makers of processed foods are in retreat. Warren Buffett must think there’s plenty of money to be made in selling junk foods. I hope he’s wrong.
Is Big Food increasingly eyeing opportunities overseas?
If you can’t sell it here, you sell it there. The best example of this is the soda industry, which is the subject of my next book. There has been a 10- to 15-year decline in sales of carbonated sweetened beverages in the United States. It’s one of the great successes of health advocacy. To compensate, Coke and Pepsi are increasingly focusing their efforts overseas. Expect obesity and its consequences to follow.
Speaking of global commerce, should we be concerned about trade agreements like the Transpacific Partnership?
Food and Water Watch called it “NAFTA on steroids.” It’s very hard to know what’s going on because the negotiations are being done in secret. People are worried that a lot of the protections we have against bad things in food will be taken away on the basis of violations of trade agreements.
Closer to home, here in New York we’ve heard a lot about attempts to legislate on soda with failed attempt to limit portion sizes. Other areas have had more luck—
Not luck—skill! The only place in the United States where a soda tax has been successful is Berkeley. They did everything about advocacy right. Instead of framing it as a health argument, they framed it as an argument against corporate power: Berkeley versus Big Soda. And there was an enormous grassroots effort to engage the entire community. Community organizing is classic public health. Nobody does it very often. But when it’s done, it works!
Another issue people have been talking about is GMO labeling.
I was on the FDA food advisory committee in 1994 when they were in the process of approving GMOs. Those of us who were consumer representatives told the FDA that it had to require labeling. I’m surprised it’s taken this long for there to be a major national uproar. From the beginning, the question was: if they don’t want labels, what are companies like Monsanto trying to hide?
Speaking of Monsanto, there was news this week that a chemical in their Round Up herbicide is a likely a carcinogen.
RoundUp also induces weed resistance, which has become an enormous problem for the industry. And most of it is used on GMOs. It’s a plant poison! Why would anyone think it would be good for health?
Are GMOs always bad?
The papaya that’s engineered to resist ring spot seems like a reasonable use of biotechnology to me. It saved the Hawaiian papaya industry. That’s the only example I can think of that’s beneficial. Most of the technology has been applied to commodity crops.
What about food insecurity? Can GMOs help?
If you want to help food-insecure nations, you need to empower them to do their own agriculture. That agriculture needs to be sustainable. GMO crops are not sustainable. They require seeds, fertilizer, and pesticides, every year.
According to a new Rudd Center study, more kids are eating fruit at school. At the same time, there’s a lot of pushback against healthy foods at school.
In 2010, Congress passed the Healthy Hunger-Free Kids Act. That was bipartisan. Today, bipartisan seems out of the question. The Republicans want to roll the Act back. There’s no question it’s working in most schools that have people committed to it. There are huge advances being made in school food that carry over to food outside school. Kids come home and they want different foods because they see that eating healthy foods is valued.
How much is this change tied to school leaders compared to funding?
More funding would help. But some of the poorest schools have cafeterias where you walk in and the food smells good. They’re making it happen by cooking onsite with USDA commodity foods, which are unprocessed and cheap. Someone who knows how to cook can turn USDA surpluses into good meals. But not every school does that. I’ve been in schools where the food was terrible, the kids weren’t eating it, and the plate-waste was astronomical. If the food service workers know the names of the kids, it’s a good sign the food will be good too.
For students interested in food and health, what sectors offer the most opportunity? Government? Nonprofit?
It depends on what you like. We need good people in government. It’s really important to have public health professionals work from within to make agencies like the FDA and Department of Agriculture do useful work. Everybody loves NGOs. It doesn’t matter which. Just do it!
Attend Marion Nestle’s Grand Rounds talk on April 1, 4:00-5:30 p.m., at Alumni Auditorium, 650 West 168th Street, or watch it on LiveStream.
The Times’ obituary for Dr. Albert J. (“Mickey”) Stunkard, who died last week at the age of 92, describes his work on the genetics of obesity and quotes Dr. Walter Willett’s comment that genetics accounts for only a small part of the “legions of the obese.”
Stunkard was writing about the lifestyle and environmental determinants of weight gain, long before most of us had a clue.
I learned this in 2000 when Michael Jacobson and I were writing a paper on public health policy approaches to obesity prevention.[i] We were arguing that policies aimed at preventing weight gain focused almost entirely on personal behavior but needed to focus on fixing the environment of food choice.
A peer reviewer scolded us for missing Stunkard’s work.
At last, we discovered Stunkard’s groundbreaking work. In the published paper, we wrote:
The most notable exception [to the focus on personal responsibility] was the report of a 1977 conference organized by the National Institutes of Health (NIH) to review research and develop recommendations for obesity prevention and management.
In one paper, A.J. Stunkard thoroughly reviewed social and environmental influences on obesity.[ii] As a result, the conference report included an extraordinarily broad list of proposals for federal, community, and private actions to foster dietary improvements and more active lifestyles.
These ranged from coordinated health education and model school programs to changes in regulations for grades of meat, advertising, taxes, and insurance premiums. Some of the proposals cut right to the core of the matter: “Propose that any national health insurance program…recognize obesity as a disease and include within its benefits coverage for the treatment of it.” “Make nutrition counseling reimbursable under Medicare.” And “Fund demonstration projects at the worksite.”[iii]
He was far ahead of his time and will be greatly missed.
References
[i] Nestle M, Jacobson MF. Halting the obesity epidemic: A public health policy approach. Public Health Reports 2000;115:12-24.
[ii] Stunkard AJ. Obesity and the social environment: current status, future
prospects. In: Bray GA, editor. Obesity in America. Washington:
Department of Health, Education, and Welfare (US); 1979. NIH Pub.
No.: 79-359.
[iii] Stunkard A. The social environment and the control of obesity. In:
Stunkard AJ, editor. Obesity. Philadelphia: WB Saunders; 1980. p. 438-
This session is on Practicing Food Studies. It will be at 5;00 p.m. Details to come.