The global obesity epidemic needs to be reconsidered in terms of regulatory controls to make it easier for people to choose healthier foods, according to a new medical journal series.
In Wednesday's issue of The Lancet, researchers note that no country out of 187 has reversed its obesity epidemic, but child obesity rates have started to level off in some cities and countries with "patchy progress."
For children, the focus needs to shift to prevention given the enormous threat, said one of the lead authors, Christina Roberto of the nutrition department at Harvard T.H. Chan School of Public Health in Boston.
"There are a number of factors that work against us when we try to avoid unhealthy food," Roberto said.
"We are really programmed to like high fat, high sugar, high salt foods and there are plenty of them available. We have psychological vulnerabilities. The way foods are marketed, the portion sizes we're given, being inundated with food messages all the time, that makes us want to overeat."
Convenience foods also tend to be less healthy, while healthier options can cost more, Roberto said.
Countries around the world have successfully tested ideas such as:
- Quebec’s ban on commercial advertising directed at children under the age of 13, which the Supreme Court of Canada upheld because of the vulnerability of children.
- Mandatory nutrition standards for foods sold in schools.
- Overhaul food labels to make them easier to understand.
- Government planning to encourage nutritious purchases from farmers markets, facilitate physical activity through bike lanes and green spaces and speed limits along school routes.
- Brazil’s program that favours fresh, local, non-processed foods for children to eat in school meals.
- Michelle Obama’s efforts to engage the food industry to improve nutritional quality of school menu items.
Other examples of policy solutions included:
- Tax "health-related" foods less than junk foods.
- Limit price promotions at point of sale, such as candy displays at the checkout.
- Give nutrition education such as cooking classes in school.
There’s no shortage of ideas, but governments need the courage to implement them, Roberto said.
In countries such as India and Mexico, children’s heights are consistently below the World Health Organization’s reference values. "Tackling of overweight and underheight simultaneously will need a coherent nutrition policy to promote children’s health and prevent poor nutrition in all of its forms," Tim Lobstein of the World Obesity Federation and his team said in another research paper.
Lobstein is also concerned with how highly processed foods and sweetened beverages contain ingredients to condition the taste buds of children to a lifetime of energy-rich, nutrient-poor foods.
Internationally, there are now more industry-led pledges on food advertising to children than government regulations, but the scope needs to be broader, with more nutritious criteria and better enforcement, the researchers said.
Voluntary measures 'ineffective'
In Canada, Bill Jeffrey, national co-ordinator for the Centre for Science in the Public Interest, said the federal government or other provinces could expand Quebec’s advertising ban or change how higher taxes are applied to fresh fruit salad compared with sugar-loaded cereals.
"There’s a large appetite for doing voluntary measures with the food industry which demonstrably are ineffective," Jeffrey said, commenting on the findings.
"The food industry is a formidable force in Canada. When you try to apply regulatory controls to them, they fight back. I think that’s a big part of the problem. People are not fully aware of the extent to which large companies really do try to resist good public health policy."
At a grocery store in Toronto, Yasmine Halfnight said she'd welcome more regulations and education. Her daughter Grace is not yet two and already has food preferences based on appearance.
"She'll see something with a Sesame Street character and she wants that," Halfnight said.
Opposite ideas, such as individual responsibility versus environmental factors often shape the debate and stall progress, Roberto said, but increased efforts could make serious strides toward halting the obesity epidemic.