Currently browsing posts about: Obesity-policy

The Mexican state of Oaxaca became the first to ban the sales of junk foods to children under the age of 18.

The state of Tabasco did the same.

A dozen other Mexican states are considering similar actions.  The rationale is clear: the health consequences of obesity in general and with Covid-19 in particular.

One-third of Mexicans aged 6 to 19 are overweight or obese, according to UNICEF. They may not be disproportionately affected by COVID-19 now, but they can suffer myriad health issues, especially in adulthood.

And Mexico’s new warning labels are now in effect and will be required for all packaged foods by the end of the year.

Mexico has been able to implement these measures despite overwhelming food industry opposition.

How?  I credit the outstanding advocacy work of the Mexico’s National Institute of Public Health and the consumer coalition, Alianza por la Salud Alimentaria.

Boris Johnson, the UK’s admittedly overweight prime minister, has suddenly become a champion of anti-obesity policy, following his bout with Covid-19.

As the Washington Post puts it, “Boris Johnson says ‘I was too fat’ as he launches anti-obesity campaign.”

The campaign is based on two reports, one detailing the high and growing prevalence of obesity in Great Britain and its links to Covid-19 susceptibility.

The second is a government policy report, which says it is

• introducing a new campaign – a call to action for everyone who is overweight to take steps to move towards a healthier weight, with evidence-based tools and apps with advice on how to lose weight and keep it off
• working to expand weight management services available through the NHS [National Health Service], so more people get the support they need to lose weight
• publishing a 4-nation public consultation to gather views and evidence on our current ‘traffic light’ label to help people make healthy food choices
• introducing legislation to require large out-of-home food businesses, including restaurants, cafes and takeaways with more than 250 employees, to add calorie labels to the food they sell
• consulting on our intention to make companies provide calorie labelling on alcohol
• legislating to end the promotion of foods high in fat, sugar or salt (HFSS) by restricting volume promotions such as buy one get one free, and the placement of these foods in prominent locations intended to encourage purchasing, both online and in physical stores in England
• banning the advertising of HFSS products being shown on TV and online before 9pm and holding a short consultation as soon as possible on how we introduce a total HFSS advertising restriction online

The UK food industry does not like this.  It insists that this campaign is “a terrible missed opportunity.”

I was interested to see Hank Cardello’s comment on this (Cardello is with the conservative Hudson Institute in the US): “How A Libertarian Is Tackling Obesity And Why Big Food Should Worry.”  Cardello thinks that Johnson’s efforts are the wave of the future.  The food industry should stop fighting public health measures, he says.  Instead, it should:

• Get ahead of imposed regulations instead of resisting change. Instead of fighting public health initiatives, they can lead the way with research that defines workable steps to reverse the obesity crisis.
• Educate with public service ads. It’s time that food and restaurant corporations air public service announcements (PSAs) about healthy eating and the impact of high sugar, salt and fat on health and obesity.
• Commit to a BHAG (”Big Hairy Audacious Goal”). They can decide, for instance, that at least 50% of the products they sell will be healthier versions or in smaller portions.

Wouldn’t that be terrific, and it’s great that he’s saying so (I keep telling him that he sounds more like me every day).

But can food companies follow his advice?  Not as long as they put profits to shareholders, first, alas.

That’s what really needs to change.

I learned about this from a tweet.

I recognized the clip.  It was from an interview I did in January in Toronto: TVO’s The Agenda: Battling bias in nutrition research (slso on YouTube, and in transcript).  Nam was the terrific interviewer.

But do not miss Minhaj’s last Patriot Act episode of 2019, “How America is Causing Global Obesity.”  This is a brilliantly researched account of obesity politics, from food industry influence to trade policy.

I couldn’t have done better myself and dearly wish I had his production team (and his performance ability).

On World Obesity Day, I posted links to three recent reports.

An editorial in The Lancet made me realize that I had not read this one nearly carefully enough.  It deserves careful reading.

It comes from Sallie Davies, who just stepped down as Britain’s Chief Medical Officer.  In another Lancet piece, she and her colleagues insist that children have a right to live in a healthy environment:

Today, government legislation is necessary not simply because we have an obligation to protect vulnerable children, but because children have rights. The UN Convention on the Rights of the Child (UNCRC), the most widely ratified international human rights treaty, sets out children’s rights to protection, education, health and health care, shelter, and good nutrition…a child rights approach requires us to recognise childhood obesity as the responsibility of the state and as an issue that must be addressed across society…It is time to address childhood obesity as a rights issue.

In her report, she insists that government should enact legislation to ensure a healthy food environment; Annex A lists recommendations:

• Increase taxes on sugary drinks
• Require product reformulation to reduce sugar and calories
• Tax unhealthy foods
• Label calories
• Provide free drinking water
• Remove tax exemptions for advertising
• Phase out marketing of unhealthy products
• Ban eating and drinking on public transport
• Only permit healthy options at sports facilities
• Promote smaller portion sizes

Her report also suggests ways to promote physical activity.

Worth a try?  I think so.

Friday October 11 was World Obesity Day, which explains why so many groups are issuing reports on obesity prevalence, risks, costs, and prevention strategies.

I wrote about the one from the Trust for America’s Health, The State of Obesity, a few weeks ago.

Here are three more, just in.

1.  The Heavy Burden of Obesity: The Economics of Prevention.

This one was produced by the OECD (Organisation for Economic Co-operation and Development).  It finds: “Almost one in four people in OECD countries is currently obese. This epidemic has far-reaching consequences for individuals, society and the economy. Using microsimulation modelling, this book analyses the burden of obesity and overweight in 52 countries (including OECD, European Union and G20 countries), showing how overweight reduces life expectancy, increases healthcare costs, decreases workers’ productivity and lowers GDP.”

2.  Time to Solve Childhood Obesity   This is “An Independent Report by the Chief Medical Officer, 2019, Professor Dame Sally Davies in the U.K.  The cover deals with both cause and effect:

3.  State of Childhood Obesity: Helping All Children Grow Up Healthy.  The Robert Wood Johnson produced this one.

Its key findings:

• Obesity rates for youth ages 10 to 17 did not change much from 2016 (15%-16%).
• Racial and ethnic disparities persist as do disparities by income.
• Mississippi had the highest overall youth obesity rate (25.4%); Utah had the lowest (8.7%).

Comment:  Obesity is a global problem, not just one for the U.S.  Plenty of policies exist that could help make healthier food choices easier and less expensive.  But as the Lancet Global Syndemic report so clearly explained, doing something about obesity is hampered by weak (corporate-captured) government, food industry opposition, and weak civil society.  The first two are difficult to do anything about without attention to the third.  The clear need: strengthen civil society.  Let’s get to work on that.

Trust for America’s Health has just published its annual report on obesity, state by state.

As the home page puts it, “U.S. Obesity Rates Reach Historic Highs – Racial, Ethnic, Gender and Geographic Discrepancies Continue to Persist.”

The press release has an even more pointed headline: “U.S. Obesity Rates at Historic Highs – Nine States Reach Adult Obesity Rates of 35 Percent or More.”

The report highlights that obesity levels are closely tied to social and economic conditions and that individuals with lower incomes are more at risk. People of color, who are more likely to live in neighborhoods with few options for healthy foods and physical activity, and, are the target of widespread marketing of unhealthy foods, are at elevated risk.

What to do?

The report calls for sugary drink taxes, expanded SNAP and WIC Nutrition support programs and a built environment that encourages physical activity.

Buried in the report are suggestions for curbing food-industry marketing and other efforts to undermine public health initiatives.

• Keep industry out of dietary guidelines.
• Consider regulating food-industry marketing.
• Stop industry from preempting state public health laws.
• Reduce unhealthy food marketing to children.

Lots of good stuff here and well worth a read.

The endlessly repeating process of defining health goals for the next ten years continues and the Department of Health and Human Services is now (or will be when the shutdown ends) collecting comments on draft objectives.

You can see the list of categories here.

That site also has links to the history of the objectives (which dates to 1979) and how the whole process works.

The point of the objectives is to set highly specific, measurable goals for health improvement, so that progress toward attaining the goals (or the lack thereof) can be tracked.

Here, for example, are the first two in the Nutrition section:

If you want an overview of the current status of nutrition problems in the world, what is being done about them, and what needs to be done about them, this report is required reading (to get to the download button for the entire report, scroll to the end of the page).

The report is chock full of useful facts, figures, case studies, and recommendations.  A massive undertaking, it

was produced by the Independent Expert Group of the Global Nutrition Report, supported by the Global Nutrition Report Stakeholder Group and the Secretariat at Development Initiatives. The writing was led by the co-chairs Jessica Fanzo and Corinna Hawkes, supported by group members and supplemented by additional analysts and contributors.

For a quick overview, go right to the slide deck and then to the graphics in the executive summary.

The report deals both with problems of malnutrition (undernutrition) and obesity (overnutrition), especially in children.

It also deals with adult obesity:

It identifies measurable nutrition indicators that can be used to track progress:

It recommends actions to reduce the prevalence of malnutrition and obesity.

What stands in the way of implementing these steps?  Political will, alas.

These reports have come out annually since 2014.  Let’s hope this one gets the attention it deserves.