Guidelines fail to target real problem, says Iain Broom
Here we go again. As obesity figures loom large on the Scottish Government’s health agenda, what have we actually achieved since the national and international “epidemic” was first mooted more than ten years ago?
I would suggest very little. The obesity statistics continue to rise, especially amongst schoolchildren, and younger. But what is the government’s answer to this? More of the same.
This is despite the evidence that existing measures have had little or no effect in stemming the tide of the increasing weight of the population. Indeed the current advice in relation to the national diet, or “healthy eating” may, in fact, have been the trigger to the obesity explosion.
Forty years ago we had an increasing problem with deaths and severe illness from coronary heart disease and despite any sustainable evidence, the consumption of saturated fat and animal and dairy produce were targeted as the root cause of this problem.
Advice to drastically reduce the intake of such products was given to curb the increasing prevalence and incidence of cardiovascular disease in the population.
There was, however, no real evidence for this decision and the amount of carbohydrate, such as bread, rice and pasta, in our diet was hugely increased to more than 55 per cent of our energy intake. Surprise, surprise, we then started to get fatter.
Increasing carbohydrate intake increases the demand for insulin and increasing levels of this hormone promote fat deposition, especially around our waists.
Insulin promotes narrowing of the arteries and high levels of the hormone lead to raised blood pressure and inappropriate distribution of cholesterol in the blood stream. This leads to the formation of particles which promote narrowing of arteries in vessels which supply blood to the heart and brain.
A shaft of light has, however, recently appeared from the east, with the Swedish government carrying out a complete U-turn on its healthy eating advice after a committee of experts reviewed more than 16,000 scientific papers.
They have recommended a drastic reduction in the intake of carbohydrate as a percentage of energy intake from more than 50 per cent to between 20 and 40 per cent and increased the amount of fat and protein in the national diet.
Moreover, they have added that dairy produce such as milk, cheese and butter are actually good for you, as are meat and bacon.
A revival of common sense
Having destroyed our dairy industry and gone a long way to destroying the meat industry in the West, maybe we are seeing the beginnings of a revival of common sense.
But this is only half of the problem relating to obesity. What about the role of activity?
Since the 1980s, we have systematically driven down activity in the population with increasing automation and the design of where we food shop.
More importantly for children, by invoking the National Curriculum, at the expense of destroying our physical education and games afternoons in schools, but maintaining expenditure and time on computer skills, we have contributed to the current explosion in childhood obesity.
The safest place for children to play freely is in parks and recreational areas away from traffic.
Parents are, however, frightened to allow their children this type of free play which perhaps they, and certainly their grandparents had. This is because of their fear of sexual predators, a fear that is without any supportive evidence.
Again the “nanny state” interferes in children’s play with free play almost abolished in schools and pre-school nurseries under inappropriate ‘health and safety’ measures.
The use of structured play, designed to prevent so-called accidents – really the fear of litigation by parents – drives down activity and exercise, creates a climate of protectionism and reduces overall energy expenditure. This in turn fosters inactivity and failure to participate in healthy activities such as sports and other forms of exercise.
I would suggest it is time to review what we are doing to the population in this country and review our guidelines and cut back on the nanny state.
• Professor Iain Broom is director of Centre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen. www.rgu.ac.uk