Childhood obesity is an echo of the much larger adult world (in fact 66 per cent of Scottish adults) where excess body fat is associated with the torment of stigma, lower employment and an abundance of ill health.
For virtually every child that is at risk of obesity there is also a parent who is struggling with excess availability of cheap, well marketed promotions of sugary and savoury snacks in paper shops, garages, work canteens, vending machines, coffee mornings and bake sales.
The adult world shapes what our children see and respond to. The best way to protect our children from obesity is to act upon societal actions that impact on vulnerable people at all ages. Is picking off a few token acts aimed at reducing childhood obesity the best way to tackle the problem?
Adults matter – most food eaten by children is paid for by adults. Food habits are learned in childhood largely from what parents are seen eating and drinking. Limiting promotions of foods high in sugar, salt and fat to children is worthy and to be applauded for many reasons including clearing space for some clever promotions of healthy foods. Limiting promotions ticks a very welcome box, but there are bigger boxes with bigger caloric impact starting with the availability and use of food (and drinks) in our everyday lives. This isn’t only about consumption of “energy drinks” or even sugary drinks (both of which we can live without) but the excess offerings in public spaces including vending in leisure centres, catering portions, coffee shops, and chocolate bars and sweeties in dress and charity shops.
Pester power is a force most parents have seen, but there are other challenges than the supermarket checkout – look at the offerings at the local cinemas. Many parents would welcome a major hammer on so called “childrens’ meals”, which offer poor nutritional value, and there are many more examples. There is work to be done and work that government must tackle on a bigger platform. The poor response by industry to voluntary changes in the sugar content of foods points towards the need for meaningful mandatory actions.
But at last the British government is making some moves in the trench warfare of public health versus the food industry – but the battle is a long one. Some of us will remember the NACNE report of 1983 and a decade on in 1993 when the Scottish Diet Report made it clear that much needed to change to improve the nation’s size, nutritional status and related diseases.
A Scottish food conference in 1996 heard that at least one major retailer would be removing confectionary from checkouts. Today, we hear that we may finally see “unhealthy foods” removed from checkouts. To wait almost a quarter of a century for one small step in the battle against obesity does not bode well.
In 2007, Ofcom introduced broadcasting restrictions to reduce the exposure of children to advertising of foods high in fat, sugar and salt. The consultation document that preceded this was clear that a 9pm watershed restriction would not be considered. Today, we find this topic will be explored in some more detail – only an 11-year wait this time. A wait that some might describe as too little too late.
In 2008 Scotland launched the national food and drink policy. Those of us involved in the Food Leadership report said a lot about health and the challenges of industry. One statement stands out.
“Consumer education can increase awareness about health and sustainability but this has not been demonstrated to change dietary behaviours. Indeed, there is now a significant evidence base to show that education alone will have minimal effect on consumer demand and dietary change. The right pricing, marketing and availability strategies need to accompany investments in educational programmes.”
Many of us are waiting to see how the Scottish Government will undertake that challenge of blending consumer education (including menu labelling) with pricing, marketing and availability strategies. Maybe we will see something meaningful for the whole population in the long awaited Good Food Nation Bill or indeed Scotland’s obesity strategy. There are many reasons why we need to gain ground on this battle with greater speed for ourselves, our children and grandchildren.
Annie Anderson is Professor of Public Health and Nutrition at University of Dundee. She works with the Scottish Government and is part of the Scottish Cancer Prevention Network