Government Policy and Obesity

The Overseas Development Institute (ODI), a UK think-tank, published a report this week entitled Future Diets. It explores the growth in obesity worldwide, and its clear link with the rise in diseases such as type 2 diabetes, some cancers, heart disease, and stroke. As a personal trainer in London I take a great interest in the causes of obesity, and this report is one of the most detailed I’ve ever read.

Steve Wiggins, ODI research fellow emphasised the “alarming” rise in overweight and obese people in the developing world, to around 900 million, four times the number in 1980. Some of the biggest increases are in countries like Egypt and Mexico, whose populations are spending more than ever on junk food. There are now more overweight and obese people in the developing nations than in the high-income nations of the world.

The rise in global obesity is putting “an enormous burden on public healthcare systems” says Steve Wiggins.

Obesogenic environments

The ODI report explored the phenomenon of ‘obesogenic environments’ ie the notion that the local urban environment is contributing to the rise in obesity. In London this is definitely the case. These are my observations:

High traffic levels (and our society’s obsession with the car) deter walking and cycling, high crime deters exercising outdoors after dark, the prevalence of fast-food outlets (particularly in the poorest parts of East London) encourages lazy and unhealthy eating particularly among the young. Supermarket alcohol, sweets, biscuits and cakes get cheaper and cheaper. At lunchtimes, city workers in the financial districts of EC2 and Canary Wharf E14 wolf down sandwiches high in fat and salt. And healthy food is getting more and more expensive: good quality red meat, fish, even fruit and veg.

The rise of refined carbohydrates

The ODI report rightly points to sugar as a major contributor to the world’s obesity epidemic, and all the refined carbohydrate junk-foods which are high in sugar and low in micro-nutrients. Some governments have taken a step in the right direction, for instance Canada’s Food Guide in 1992 had carbohydrates as the biggest part of it’s ‘food rainbow’, and in 2007 switched to fruit and veg as the biggest part, ie recommending its population to eat mostly fruit and veg. A notable exception to the rise in sugar consumption is China, which still consumes relatively little sugar, and it’s not surprising that there is less obesity in China than in other developing nations which have embraced junk-food.

South Korea’s success story

The report highlights that proactive government policy to improve the nation’s diet can work. South Korea has a policy of promoting the healthier aspects of its traditional diet, by training women nationwide to cook high-vegetable meals, to discourage the consumption of processed foods high in fat and refined carbs.

The rise of ‘Big Food’

Globalisation has brought junk-food to the developing world, whose populations see the likes of McDonalds and KFC as aspirational, but are largely clueless about the public health implications of junk food.

Public policy and diet

The ODI concludes that governments around the world have been timid in their public health policies to reduce obesity in their populations. There are a few exceptions, such as South Korea (see above), Denmark (forcing a reduction in trans fats in all processed foods in 2004). and Norway (using subsidies and taxes to encourage a healthier diet).

The report states that “there is considerable scope for public policy to have a real influence on diets” through a combination of subsidies, taxes, education and information, and tighter regulations on levels of salt, sugar, and trans fats in the manufacture of processed foods.

Malnourished in micro-nutrients

It’s ironic that as populations consume more calories, more salt, more sugar, and more saturated fat, there is also a rise in malnutrition when it comes to micro-nutrients ie- vitamins and minerals. Junk foods are largely deficient in vitamins and minerals. Sugar is an anti-nutrient, which leeches micro-nutrients from the body when it is metabolised, something the ODI report does not highlight sufficiently.

Rationing in World War 2

One of the boldest public health policies to transform the nation’s diet was Britain’s rationing during WW11. In London, the moat of the Tower of London was used to grow vegetables, as were gardens all over London, and some of London’s parks.

The report notes that populations today largely resent government intervention in their eating choices, and governments fear being branded ‘nanny state’, restricting individual freedom. The report points out that bold public health policy to restrict smoking in public places was highly successful and met with little public resistance, although the report admits that food policy is more complex.

Individual responsibility

The report makes little or no mention of individual responsibility in tackling obesity. As a personal trainer in London I encourage my clients to be proactive in changing their diets towards healthier food choices. I think it depends on how much you value your health and wellbeing, how disciplined you are to make the effort to cook healthy food for yourself rather than eat junk food and takeaways, and how much belief you have in your own power to change your eating habits.

Dominic Londesborough is a personal trainer in LondonĀ