SPECIAL REPORT: Ending Childhood Obesity – Demand for High Level Action

01 Feb 2016 --- According to the World Health Organization (WHO) 70 million young children will be overweight or obese by 2025 if current trends continue. Following the release of the Commission on Ending Childhood Obesity (ECHO) report to the WHO last week (25 January), NutritionInsight is investigating what high-level action is necessary to address this major health challenge.

Childhood obesity is a “complex, multi-factorial issue” as stated by the WHO. Apart from the physical consequences, children with obesity can also be effected behaviorally and emotionally. This explains the importance of the ECHO report, which took two years’ worth of global research in over a 100 countries to complete.

Scale of the problem
The World Obesity Federation, which represents over 50 regional and national obesity organizations, responded favorably to the report release, as it highlights the child obesity challenges: “This report is of particular importance because, in less than a generation, rates of child obesity have risen dramatically worldwide.” Research has shown that in the USA children weigh on average 5kg more now than they did in the 1980s. Today, one in three children is now overweight or obese, due to growing up in environments that encourage excess calorie intake and sedentary behaviors. Furthermore, the number of overweight children aged under five years in Africa has nearly doubled since 1990 (5.4 million to 10.3 million), which is similarly alarming. Globally, at least 41 million children in this age group are obese or overweight, with the greatest rise in the number of children coming from low- and middle-income countries.

“Childhood is a time when food preferences and physical activity habits are formed and so an opportunity to encourage the development of healthy behaviors" the WHO told NutritionInsight. “Undernutrition in early life places a child at particular risk of becoming overweight or obese in later life, when food and physical activity patterns change.” Children with obesity are very likely to remain obese as adults, and are at danger of chronic illness. Benefits in society, economy as well as health could therefore be achieved with eradication of obesity in childhood.

Government action and policy
In order to put an end to childhood obesity, the ECHO report recommends coordination of all government sector contributors and institutions responsible for policies. This includes, but is not limited to: education; food; agriculture; commerce and industry; development; finance and revenue; sport and recreation; communication, and trade. 

The report also proposes actions for key stakeholders. The WHO confirmed the importance of collaborative ownership to NutritionInsight: "Without joint ownership and shared responsibility, well-meaning and cost-effective interventions will have limited reach and impact.”

Governments and their multiple agencies need to lead in the prevention and treatment of childhood obesity. On 21 January, members of parliament (MPs) debated the upcoming Childhood Obesity Strategy in the United Kingdom, including how school meals can effect children’s health were discussed. 

Keith Taylor MEP previously urged fellow MEPs to support his call to lower the amount of sugar allowed in baby foods under EU law earlier this month. He also recognizes the importance of the report, and told NutritionInsight: “We are now awaiting the European Commission to come forward with a new proposal on the permitted levels of sugar, which the Parliament called for to be in line with scientific evidence and WHO recommendations. The ECHO report should provide a useful reference for this process.”

The World Obesity Federation suggest that interventions could prevent national dietary guidelines “being undermined by commercial interests.” They advocate development of a “framework convention” similar to the Framework Convention for Tobacco Control which has successfully reduced tobacco use, in order to protect and promote healthy, equitable and sustainable food systems: “Such a convention would need to be developed by the WHO and governments without the influence of commercial interests,” they state. 

The role of food marketing
The ECHO report notes that in wealthier countries, poorer children are more likely to be obese, partly due to the relative affordability and abundance of fatty fast foods and high-sugar snacks. Marketing of unhealthy foods and non-alcoholic beverages is identified as a major factor in the increase in numbers of children being overweight and obese, particularly in the developing world. 

MEP Keith Taylor told NutritionInsight about the recommendation for policy makers to develop regulations on the marketing of complementary foods: “In line with WHO recommendations that infants should be breastfed exclusively for the first 6 months of life, the Parliament also voted to stop baby foods being promoted before 6 months, which is another positive step forward” he concluded. 

Working with the "private sector"
One of the actions the report suggests to prevent childhood obesity is for countries to “engage constructively with the private sector to encourage implementation of policies and interventions.” However, the ECHO report notes that this sector includes a number of areas, including agricultural food production, food and non-alcoholic beverage industry, retailers, catering companies, sporting-goods manufacturers, advertising and recreation businesses, and the media.

Initiatives by the food manufacturing industry to increase production of innovative, healthy and nutritious choices could accelerate health gains worldwide. Nevertheless, the ECHO report also observes: “Despite the increasing number of voluntary efforts by industry, exposure to the marketing of unhealthy foods remains a major issue demanding change that will protect all children equally.”

A spokesperson for the Food and Drink Federation (FDF) told NutritionInsight: "With their nutrition, product innovation and communications expertise, UK food and drink brands stand ready and willing to do more to tackle this issue in partnership with others, faster and with more impact. We will, without question, achieve more by working together.”

The FDF described to how the food industry is taking action against childhood obesity in the UK: “We strongly believe that only a coherent, structured and evidenced-based plan will crack obesity in this country. Everyone needs to up their game and support wide-ranging actions to help families, whether that’s supporting pregnant women, making it easier for children to play outside or helping people improve their food choices." 

Their statement continues: "Responsible food and drink producers are focusing their efforts where they can have the maximum impact. Under the Department of Health’s Responsibility Deal, this has meant companies taking action to help improve diets across the piece, lowering salt and calories, adding fruit and vegetables into their products, capping portion sizes, and supporting better public education.”

Time will tell whether this collaborative attack is successful in stopping childhood obesity for good.

by Kerina Tull