A Cabinet overlord should be put in charge of tackling Britain’s growing obesity crisis, according to new proposals from a coalition of concerned health organizations and experts published today. (Thursday)
The government should also establish an independent agency with regulatory powers to ensure that a wide range of civil service departments deliver on policies to prevent obesity and reduce levels of diabetes, heart disease and cancer.
The recommendations were
submitted in a memorandum to the House of Commons Select Committee on Health,
which took evidence at its final hearing from three ministers – Melanie
Johnson, minister for public health, Margaret Hodge, children’s minister and
Tessa Jowell, secretary of state for culture, media and sport.
A comprehensive set of proposals, which cover
more than 80 separate recommendations, was developed by NGOs and experts who
attended a one-day conference in London on November 11 last year arranged by
the Coronary Prevention Group and the International Obesity TaskForce.
Additional measures proposed include:
·
Using government purchasing power to expand the market
for fresh healthy foods while counteracting the current subsidies supporting
the ingredients in high fat/sugar/salt products
·
Restrictions on the marketing of “junk” food to
children
· Clear food labelling, with warnings on foods which breach WHO and Department of Health nutritional guidelines.
· An emphasis on encouraging physical activity in planning, transport and rural development policies
Prof Philip James, chairman of the International Obesity TaskForce and an adviser to the Commons select committee’s inquiry, said that a powerful Cabinet post was essential to allow a minister to “knock heads together” between various government departments.
“We need coherent government strategies to be implemented rapidly and effectively if we are to have a remote chance of turning back the tide on obesity. The crucial thing now is to address the rapid epidemic of childhood obesity and defuse the time bomb of type 2 diabetes and other chronic diseases which is ticking away.”
“We also need a government that is prepared to stand up to commercial pressure. Food and drink companies need to face up to their responsibilities to curb the high-pressure marketing of the products we know are contributing to the problem and to deliver on promises to be part of the solution by providing better products that people can enjoy while improving their dietary health,” added Prof James.
The inquiry into obesity is
one of the longest parliamentary investigations undertaken into a health issue.
The committee’s report will be delivered to the House of Commons later in the
year.
[End]
For
further information please contact
Neville Rigby,
Director of Policy and Public Affairs,
International Obesity TaskForce
231 North Gower Street
London NW1 2NS
Tel 0207 691 1902
Mobile 07939250347
Email: obesity@iotf.org
Website : www.iotf.org
Joint
memorandum to the Parliamentary Select Commmittee for Health from concerned
not-for-profit organisations and obesity and public health specialists arising
from a meeting convened by the Coronary Prevention Group and the International
Obesity TaskForce in London on November 11, 2003, to propose strategies for
action to address the issue of obesity and its prevention.
Obesity:
Time for Action
Recognising that
· Obesity is a disease which
promotes other diseases, including diabetes, cardiovascular disease and
cancers, disability and early death
· Excess bodyweight is
pandemic, affecting an increasing proportion of children and adults
· Vulnerable groups are
affected disproportionately, reflecting social and ethnic inequalities
· The costs of obesity are borne
by health services and also by families, individuals and society
· Prevention of obesity can
only be addressed effectively at a societal level
Believing that
· People of all ages have the
right to a high standard of physical and mental health
· Children have a right to
protection from environments that jeopardise their wellbeing
· Responsible adults have a
duty to ensure children are not exposed to such
environments
We urge the government, relevant authorities and
responsible parties to consider the wide range of options outlined in this
document, based on a meeting convened by the Coronary Prevention Group and the
International Obesity TaskForce, London, on 11 November 2003.
In particular, we recommend the government adopts
the following strategic measures urgently:
·
Appoint
a cabinet minister to oversee a comprehensive cross-departmental obesity
prevention strategy engaging government, civil society and business as part of
a new public health programme.
·
Establish
an independent public health agency directly responsible to parliament to
monitor progress on prevention of obesity, diabetes, cardiovascular disease and
cancers, with powers to ensure compliance with prevention policies and to
propose regulatory measures.
·
Introduce
public procurement, fiscal and other measures to counteract the current
subsidies of foods with a high energy density or high content of
fat/sugar/salt, and to encourage an expanding market for local growers and food
suppliers to provide fresh and healthier foods.
·
Legislate
to restrict the marketing to children of foods with high energy density or high
content of fat/sugar/salt on television and elsewhere.
·
Introduce
a simplified food labelling scheme with clear symbols warning of high energy
density or high fat/sugar/salt content, in keeping with WHO and Department of
Health nutritional goals.
·
Require
all policies in urban planning, transport and rural development to have a
physical activity impact statement, demonstrating how the policies incorporate
safe and secure opportunities for physical activity integrated into daily life.
·
Provide
resources, in addition to those defined in relevant National Service
Frameworks, to develop effective obesity management and prevention in primary
health care settings.
SIGNATORIES
NGOs
Association
for the Study of Obesity
British
Heart Foundation Health Promotion Research Group
Child
Growth Foundation
Coronary
Prevention Group
Diabetes
UK
Dietitians
in Obesity Management
Food
Commission
International
Obesity TaskForce
Move4Health
National
Children’s Bureau
National
Federation of Women’s Institutes
National
Heart Forum
National
Obesity Forum
Parents
Jury
Sustain:
the alliance for better food and farming
Sustrans
The
Obesity Awareness and Solutions Trust
World
Cancer Research Fund
YMCA
(Central)
YMCA
(England)
Obesity,
public health specialists and others concerned
E
Brunner, Department of Epidemiology and Public Health, University College
London
L
Edmunds, Avon Longitudinal Study of Parents and Children, Bristol University
K Fox,
Department of Exercise and Health Sciences, University of Bristol
P
Gibson, Royal College of Paediatrics and Child Health
G
Hastings, Centre for Social Marketing, Strathclyde University
S
Jebb, MRC Human Nutrition Research, University of Cambridge
T
Lang, Institute of Health Sciences, City University
E
Poskitt, London School of Hygiene and Tropical Medicine
A
Sandford, Action on Smoking and Health
C
Summerbell, School of Health, University of Teesside
J Wilding, Clinical Sciences Centre, University of
Liverpool
L Carpenter,
Education and Equal Opportunities Department, National Union of Teachers
Further
measures (and relevant lead departments)
Government
action:
·
Require
health and obesity impact statements in all government policies (including
agriculture, trade, education, media, transport, town planning) – DoH
·
Extend
the formal monitoring of population diet, activity and anthropometric measures,
(height, weight, waist circumference, BMI) including the annual sampling of
child populations – DoH, DfES
·
Develop national nutritional targets and food standards to help
industry meet those targets – DoH, FSA
·
Conduct
health audits of commercially sponsored materials for schools, clinics etc – DoH, DfES
·
Make
public sector catering the ‘gold standard’ for
healthy eating – All
·
Ensure
public sector employers offer incentives for cycle
and walking to work and remove incentives for
car use – All
·
Ensure
that OFSTED inspection criteria include an appraisal of school health
programmes, including food provision, physical activity provision, health and
food education – DfES, OFSTED
·
Use children’s media to promote healthier dietary choices and
physical activity, e.g. via computer games, internet sites, comics and public
service advertising on children’s TV – DoH, DCMS,
Ofcom
·
Engage TV programme makers and regulators to ensure that family TV
programming supports healthy diets and active lifestyles – DCMS, Ofcom
·
Invest in early years education of parents and children about
healthy lifestyles, increasing the use of Sure Start programmes and promoting
breastfeeding – DoH
·
Introduce
and enforce clear and simple food labelling to identify foods (including those
sold in catering outlets) which meet nutritional criteria and should be
consumed in greater quantities – FSA
·
Review the use of cosmetic food additives (colourings, flavourings
and flavour boosters) being used to promote the sales of energy-dense, low
nutrient foods
– FSA
Fiscal
controls and market regulation:
·
Consider
the application of small taxes on foods high in fat, sugar or salt, and direct
the revenue towards the support of measures for the prevention of obesity – Treasury, DoH, FSA, DTI
·
Apply
levies to recover the production subsidies for oils, sugars and dairy fats
supported under the Common Agricultural Policy regime – Treasury, DEFRA
·
Subsidise the distribution and marketing of fruit and vegetables – DEFRA
·
Reinstate the fuel tax escalator – Treasury,
DT
·
Promote congestion charging in urban areas across the country – Treasury, DT
·
Provide subsidies for public sector facilities that encourage
physical activity, e.g. provide free school usage of swimming pools, provide
low-cost child passes to activity centres – Treasury,
DPM
·
Offer tax incentives to employers who provide physical activity
opportunities –
Treasury
·
Develop
food labelling standards to identify those food products which fail to fit
within agreed nutritional standards, those that do comply, and those which
should be consumed freely and in greater quantity than at present – FSA
·
Consider a logo scheme and vouchers for foods and activities which
enhance health
– FSA, DoH
Industry and
retail sector action:
·
Food
industry: develop a wide range of reformulated foods which are beneficial to
dietary health – FSA, DTI
·
Food
industry: develop healthier alternatives to confectionery, snacks and soft
drinks for children – FSA, DTI
·
Food industry: restrict the use of cosmetic additives in
energy-dense, low nutrient foods – FSA
·
Food
industry: support rules to restrict the promotion of foods high in fat, sugar
and salt – FSA, Ofcom
·
Food
industry: support simple and clear labelling measures to identify foods which
meet nutritional criteria and should be consumed in greater quantities – FSA
·
Food
industry: develop health-promoting ready-to-eat take-away and convenience foods
– FSA
·
Catering industry: offer child size portions of restaurant main
menu items, ready meals and convenience foods – FSA
·
Catering industry: offer all restaurant customers smaller portion
options with price incentives – FSA
·
Retailers: improve distribution and access to healthy food
options, including fruit and vegetables – FSA
·
Retailers: ensure households in low income areas have full access
to healthier food options with no price disincentive – FSA, DPM
·
All private sector employers: provide free, secure cycle parking and
charge full costs for car parking – DT,
Treasury
·
All private sector employers: provide changing rooms for cyclists
and walkers – DT, Treasury
·
All private sector employers: review staff canteen policies,
encourage smaller portions and healthier options – FSA,
Treasury
Research and training:
·
Undertake research into obesity management strategies and
evaluation techniques – OST, DoH
·
Develop the evidence base for effective prevention and monitoring
of planned initiatives, including reliable and standardised base-line data on
diet and physical activity – OST, DoH
·
Introduce training standards for health professionals to cover
nutrition, physical activity and obesity management – DoH
·
Provide in-service training for primary care workers in obesity
recognition and management – DoH
·
Monitor and report on media balance and accuracy regarding health
promotion – DCMS, DoH
Local
authorities and local health authorities:
·
Assign
to a chief officer in each authority responsibility for integrating
anti-obesity programmes and related public health measures across departments
·
Evaluate
all local policies for their obesity impact, including policies in health,
education, transport, economic development, planning, urban design and retail
development – DPM
·
Develop
performance management measures for the promotion of physical activity and
nutrition standards – DPM
·
Assess
policies for children under care in health, education and social service
facilities to ensure protection from environments and inducements prejudicial
to the children’s health – DfES
·
Promote
more and safer walking and cycling routes, pedestrian zoning and cycle parking
provision and discourage short-journey car use – DT
·
Require
planning authorities to ensure that new or re-located public services are sited
where their staff and clients can reach them by walking, cycling and public
transport – DPM
·
Limit the numbers of fast food outlets in urban areas – DEFRA
·
Create
opportunities for activity in public areas, remove obstacles to free movement –
DEFRA
·
Ensure
parks and recreation areas are clean, secure, safe for and freely available for
both children and adults, especially near areas of deprivation and high-density
housing – DPM
·
Ensure
further play, sport, fitness and recreation facilities are available at low
cost, especially near areas of deprivation and high-density housing – DPM
·
Develop procurement policies to encourage the purchase of locally
produced, healthier foods
·
Ensure
freely available public drinking water facilities – DEFRA
·
Develop
incentives for authority employees to follow healthy lifestyles and diets
·
Increase the number of dietitians working with schools and
community groups
– DoH
·
Make exercise facilities widely available at low cost, and free on
prescription
·
Incorporate gyms and play areas into health centres
Schools:
·
Identify
schools as beacon community facilities setting high standards for the promotion
of health and well-being – DfES, OFSTED
·
Ensure
the free-fruit-for-schools scheme is made permanent and fully publicly funded –
DoH, DfES,
·
Expand the free-fruit-for-schools scheme to include vegetables,
and make it available to all ages – DoH, DfES
·
Develop
school food and health policies to ensure adequate pastoral care for children,
with a school food and health programme developed with children, staff and
parents – DfES, OFSTED
·
Review
the materials and facilities used by the school to ensure they encourage and
promote the school’s food and health policies based on sound nutritional values
– DfES, OFSTED
·
Develop reward schemes for choosing healthy food and activity
options at school
·
Prohibit
inappropriate food/drink marketing in schools – DfES
·
Encourage
the purchase of healthier products in vending machines
·
Provide free, clean drinking water fountains
·
Increase media literacy training in schools, and ensure its
consistency with health messages
·
Support
measures to encourage safe walking and cycling to and from school, including
the provision of secure cycle racks and discouraging traffic near schools
·
Offer alternative physical activity in schools, e.g. dance,
aerobics and self-defence, especially for girls; and improve changing room
facilities
·
Make
school activity facilities available for community use
·
Encourage continued education on practical food and cooking skills – DfES
·
Encourage family sport and activity opportunities
·
Provide sports and play equipment for schools, retain and increase
play areas and sports fields – DfES
·
Train teachers in social and emotional competence and
anti-bullying and anti-stigma techniques – DfES,
OFSTED
Neville Rigby/Dr Tim Lobstein/Prof Philip James,
International Obesity TaskForce, London.
231 North Gower Street, London NW1 2NS Tel: 0207 691
1900
January 2004