Obesity - Fat chance

Published on Friday 9 July 2010 16:40

AS A busy mother of two, Aygul Etienne's shopping trolley was once full of the frozen pizzas and fizzy drinks she bought to get her family through the week.

But struggling to lose her baby weight she felt exhausted all the time and her son was hyperactive. "I had done celebrity fitness videos and diets, but after losing the weight I just piled it all back on again," she admits. "My family was cooped up and not getting out and my son wouldn't go to bed at night. I was so tired and eating lots of carbs."

Now, after following lifestyle changes recommended in the UK government's 75 million Change4Life campaign she is a stone-and-a-half lighter and her son's healthy diet and active lifestyle have cured his hyperactivity. Simple things like cycling, walking and swapping ready meals for fresh chicken and veg have made all the difference.

The 32-year-old is one of more than half a million people who have signed up to the scheme to make small but crucial changes for weight loss and fitness.

Although it is too early to say whether the campaign has had any wider impact, public health experts have hailed the fact that simplicity has been the key to its adoption by the public consciousness. Ideas like healthier recipes, free swimming classes, smaller portions and encouraging children to play outside have captured the public's attention and chime with our more frugal approach to the weekly shop.

But now the future of the TV ad campaign - which is broadcast in Scotland despite being primarily an English initiative - is up in the air. Last week Conservative Health Secretary Andrew Lansley announced dramatic public funding cuts to Change4Life, saying he wants the food industry to foot the bill for its advertising. The hope, he said, was that it would become "a social movement".

With intense pressure on budgets, Lansley believes the food and drinks industry and other private firms such as insurance companies and gyms should be footing the bill for promoting healthy lifestyles. Supermarkets, with their ability to bankroll cut-price promotions, could play a key role, he says.

Tens of millions of pounds of public money have been poured into tackling obesity by the governments north and south of the Border, encouraged by public health experts alarmed at the nation's growing girth.

Yet so far there is little evidence to show whether such schemes have been successful.

So is it time to hand over the reins and accept that public money alone cannot head off the obesity crisis? Amid stubbornly high rates of inactivity and weight gain, soaring NHS bills for diabetes, heart disease and cancer, can food and drinks manufacturers be trusted to promote a healthy lifestyle? Or is the apparent conflict of interest just a recipe for disaster?

Tam Fry, honorary chairman of the anti-obesity campaign the Child Growth Foundation, is appalled at the government's about-turn. "At the moment we are at a terrible crossroads," he says. "People have benefited from Change4Life. It was the first concept that had a real chance of working, so all the good things that may have happened will no longer be there. This sort of campaign needs a lot of funding and a long-term view. If we are trying to change behaviours, that does not happen overnight, only after years and years of constant reminders."

The kind of benefits Fry means are small but significant. As well as the hundreds of thousands signed up for Change4Life, 20,000 community projects have sprung up such as cookery classes, yoga and gardening. Over 85 per cent of the public recognise the brand and understand what it is about. Families can stick branded menu planners to their kitchen walls and download holiday activities.

The glue holding the brand together is the Change4Life logo, an animated family of characters used as a social marketing tool on TV and websites such as YouTube and Mumsnet, offering easy ways to make healthy lifestyle changes.

But Dr Vivienne Nathanson, the British Medical Association's head of professional activities, is worried that having industry at the helm of a potentially lifesaving strategy could damage what has so far proved an effective message.

"We think the campaign has been fantastic, really simple and impressive and has engaged the public," she says. "And some of the families in its target groups are quite difficult to reach. We need to not just educate people but get them to commit to long-term changes. It might be expensive, but it could cut the cost to the NHS in the long term.

"The question is: will there be money and will industry interfere? The worry is that they could scrap something which could be powerful. I am not a purist and I don't think that public health has to be completely separate from industry - for example, supermarkets have a powerful role to play - but I see that as being supportive and I don't want them to control the message because that could corrupt the message. We just want to make sure that the arrangements are clear that industry funds it but does not control it."

But the success of the campaign so far is not down to public money alone. A sponsorship deal using the Change4Life family, by Wallace And Gromit creators Aardman Animations, is in place with Channel 4 show The Simpsons.

A number of commercial interests are already linked with the scheme including Huggies swim nappies, private medical insurance providers Aviva, Mars Petcare which supports its walking campaign, and Pepsico, owner of Pepsi who are using its sports ambassadors to promote a healthy lifestyle.

Children's television network Nickelodeon launched "active lifestyle" messages on its channels and Wii creator Nintendo joined forces with the Change4Life brand in a campaign to encourage 60 minutes of activity a day. Flora handed over much of its sponsorship of the London marathon to the Change4Life logo last year. And food and drinks industry insiders believe there is an even bigger role to play, denying a conflict of interest will corrupt the message.

Julian Hunt, director of communications for the Food and Drink Federation, said: "Government and industry should work together. It's a strength of industry that it has an instant connection with consumers, that's one of the things people talk about, it's the brands that people relate to and if they complement the government's message that can be a good thing.

"There's a lot in it for companies. It's clearly the right thing to be doing. There's a broader societal concern about health issues that no business is going to ignore and there is a commercial advantage to be responding to this debate. Over the last ten years food manufacturers have been removing salt and calories and our members are no longer using trans fats. It's not in our interests to make people unhealthy and ill. Despite the premature outrage I don't think anyone knows how this is going to turn out. All the government has done is signal it's going to be hard to justify."

It may sound like a utopian view, but retailers are already promoting healthy food and reaping the financial rewards. The Scottish Grocer's Federation has a Healthy Living Programme advising convenience stores in deprived areas how best to sell fruit and veg. In 680 targeted shops across the country long gone are the sad displays of wizened carrots and rotting turnips we are all familiar with. Instead shiny, good quality fruit is placed in point-of-sales displays. In the last three years 56 per cent of customers say they now buy more fruit and veg. The 200,000 Scottish Government-funded scheme was adopted by Change4Life last year.

How the move will affect Scots is still unclear. The scheme is Westminster-funded, but reaches north of the Border via websites and TV.

So while grassroots projects in Scotland such as free swimming classes for children and local healthy eating schemes won't be directly affected - at least, until the scale of Scottish Government public spending cuts becomes clear - we are likely to see changes in UK national advertising campaigns and marketing, on TV and websites.

Scotland's health department has launched a number of high-profile and expensive healthy living campaigns over the past few years, from recipe hotlines to weighing primary children, yet still the number of overweight adults and children is worrying.

The proportions of men and women getting at least half an hour of exercise each day has increased in recent years, but is still worryingly low at 44 per cent of men and 33 per cent of women. And almost half of Scots still fail to eat five portions of fruit and vegetables a day. Around 66 per cent of men and 60 per cent of women are overweight or obese.

Agyul Etienne is open to the idea of private industry funding healthy living initiatives, but with caution. Embarrassed now at the very thought of piling frozen pizzas into her shopping trolley, she does not want a healthy lifestyle promoted by junk food manufacturers, but accepts that her local supermarket and other retailers might have a role to play.

"If the government's not going to fund it any more they must pick the companies who will act responsibly," she says. "Rather than coke manufacturers it might be orange juice so that people won't be bombarded with positive messages about cola. It should be something that will support the health of people. People know the right foods from the wrong ones, they just have to be made more aware."

Slim pickings…

The Scottish Government has invested hundreds of millions of pounds in healthy living campaigns over the years, with varying results. It is currently investing 56 million over three years on tackling obesity, healthy eating and physical activity.

Take Life On - One Step at a Time

This promotes good diet, exercise, body mass index awareness and family health. Using the same kind of simplicity as Change4Life, the 500,000 campaign was launched in 2008 and incorporates TV, radio and billboard advertising, alongside a dedicated website.

Preventing Overweight and Obesity

This is the SNP's flagship plan to tackle Scotland's obesity timebomb, prepared jointly with local authorities. Launched in February 2010 the so-called "route map" includes working with the food industry and retailers to improve portion sizes, promotions and healthy choices in shops. Within the plan are community projects such as free weight-loss classes and gym memberships, linked to national targets to improve obesity rates.

Healthy Eating Hotline

Launched in 2003, the hotline was set up to advise on low-fat meals and promoted by celebrities including chef Nick Nairn. It was criticised as a waste of taxpayers' money when the number of monthly calls fell to 279 - or 17 a call for the public purse, although 74 per cent of the public said they were aware of the TV adverts.

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