World Leaders Challenged to Agree a Global Pact on Obesity and Healthy Nutrition 

18/02/08 Obesity must be tackled in the same way as climate change with world leaders agreeing to vital steps to transform the environment that is making us fat, a leading international nutritional scientist warned today. (Sunday Feb 17 2008)

Speaking to the annual meeting of the American Association for the Advancement of Science in Boston, Prof Philip James said that governments, industry and all sectors of society need to ‘buy in’ to the global strategies essential to combat the devastating health consequences of the obesity epidemic.

There was a tremendous synergy between the measures and urgency needed to tackle climate change – the focus of this year’s World Health Day on April 7 - and the pressing need to transform the environment for diet and physical activity.

“We need to prioritise world agricultural production to make the best use of our limited resources, to increase the supply of locally sourced fresh foods - particularly fruit and vegetables. Climate change will inevitably impact on agricultural production everywhere, affecting both water supply and the variety and quality of crops that can be grown in different parts of the world.

“Much of the present high calorie density food production has a massive carbon footprint and requires wasteful amounts of energy and water. If we are to feed the world – 8 billion people in just 20 years time – with a healthy diet, we need to deliver a rescue plan for the planet – not just to address global warming, but to ensure we have sufficient healthy food to feed everyone.”

Prof James, who chaired the UN Commission on the Nutritional Challenges of the 21st Century, said that ensuring the global population is properly nourished meant a real change in attitudes in the boardrooms of the major food companies and food chain suppliers.

“With food prices rising globally, we must ensure that the world works even harder to eliminate under-nutrition, which also leaves a legacy passed down through generations. The legacy is an acute susceptibility to central obesity and a 2-5 fold increased risk of diabetes and high blood pressure with all its dire consequences. Billions of people whose diet is being rapidly ‘westernised’ are at much greater risk. That is why it is vital that we move away from the relatively recent domination of foods high in fat, sugar and salt, - the junk foods - and restore a healthy balance to our diets.”

Similarly our need to be more physically active means we can get a double benefit from switching to walking, cycling and energy efficient public transport systems whilst reducing our dependence on the motor car, he added.

The strategic approaches needed involve rejecting the misplaced notion that the obesity problem is merely a matter of individual choice.

“Blaming individuals for their personal vulnerability to weight gain is no longer acceptable in a world where the majority is already overweight and obesity is rising everywhere. It is naïve of ill-informed politicians and food industry executives to place the onus on individuals making ‘healthier choices’ whilst the environment in which we live is the overwhelming factor amplifying the epidemic.

“It is even more naïve to tell people that they just need to make a little change in their eating habits or their daily activity and suddenly the obesity problem will be remarkably easily solved,” warned Prof James, chair of the International Obesity TaskForce, the policy arm of the International Association for the Study of Obesity. Prof James also chairs an Alliance of five major international NGOs dedicated to combating obesity, diabetes and heart disease.

He said wide-ranging improvements needed to be implemented urgently in order to promote the global strategies to improve diet, activity and health and to prevent non-communicable diseases that have already been mandated by health ministers at the World Health Assembly, but have still to be put into practice by most governments and businesses.

One of the top priorities is to challenge the world’s biggest industry - the food sector - to go much further in transforming its products and to reduce the heavy promotion and abundant array of high energy dense foods. He challenged the food industry leaders to be more socially responsible by not overpricing healthy foods and make them affordable for all consumers.

Prof James warned: “For half a century, food technology has refined the techniques of producing the precise combinations of flavours – largely artificial – that can hook us on particular types of foods. Combinations of fats, sugar and salt appeal to the most innate instincts to consume.

“Along with that precision targeting of taste, finely honed techniques of marketing have been used to mould consumer preferences in ways which were unthinkable for earlier generations. In particular the way in which children have been targeted in recent decades has shown that the ruthless drive to increase sales and consumption figures has over-ridden common sense and the need for social responsibility.

“We need the leaders of the food industry now to create a level playing field for consumers, to take the pressure off children by taking a responsible approach which recognizes the major contribution this sector can make in helping to resolve the childhood obesity crisis."

Prof James said it was important that food was universally signposted with traffic lights labelling so that it was transparent to consumers when they are confronted with high fat, sugar and salt content in products.

“Consumers should no longer have to put up with clever marketing manipulations to confuse them even further with guideline daily amounts that are largely inappropriate. The traffic lights approach seems to be the one many parts of the food industry fear most – and perhaps for good reason because it warns consumers when what they are getting is mostly a junk food combination of fattening ingredients of little nutritional value.”

Governments should support and enforce a global gold standard on marketing to children to ensure that they are no longer subliminally programmed to demand the heavily promoted junk-foods and sugary drinks that are adding to the problems of childhood obesity.

Children in the developing world, programmed by a poor environment with inadequate maternal nutrition, are especially vulnerable to Western high fat and sugar diets, bearing up to five times the risk of children born in advantageous environments. With childhood obesity escalating in Latin America, the Caribbean, the Middle East and even Africa, obesity related chronic diseases is already overwhelming their health services.

The substantial number of US immigrants of Asian, Hispanic, Caribbean and African descent are also at heightened risk, as shown in the higher levels of obesity prevalence in most ethnic minority groups and their greater vulnerability to the complications of weight gain.

“I am throwing out a challenge: we need to see far stronger determination by boardroom decision makers as well as government leaders to not just talk about tackling this issue, but to take real and rapid actions. Just as the threat of climate change has begun to be taken seriously when it may be almost too late, the threat of an obesity-related health disaster around the world needs urgent action because like climate change its effects are exceptionally difficult to reverse,” he added.

Already 2.3 billion adults are forecast to be overweight, including 700 million obese by 2015, but the problem will be exacerbated for Asian populations who have a far greater vulnerability to abdominal obesity, and adverse metabolic risks for related chronic diseases. The childhood obesity epidemic will increase these problems even further.

Globally the number of people with diabetes is likely to double to 366 million by 2030, a figure which will include more than 30 million Americans. Already it is accepted in US government forecasts that one in three children born in the USA during the 21st century will develop type 2 diabetes.

In addition to working towards achieving healthy diets, a transformation is also needed in the way towns and cities are designed to counteract the sedentary nature of modern living and create places where people have a greater opportunity to be active.

“Rather than designing places where it is unpleasant or impossible to move around, whilst pouring billions into continuing to create car filled town centres and expensive motorway networks, we must now concentrate on improving public transport and curtailing the use of motor cars. We must also rethink how we build and provide real alternatives that encourage everyone to walk and incorporate activity into their routine every day life.

“The alternative of simply advocating more leisure activity is increasingly seen not to work without sustained additional changes to town planning and transport. Thus there is also a great synergy with the environment challenges of climate change,” Prof James noted.

The challenge of obesity, like climate change, is so great that action needs to be taken now even without having clear evidence of all the best options. “We can no longer afford to wait. If we fail to act until we have the perfect solution, then it will be too late,” he added.

The projected economic health and social burdens from type 2 diabetes, high blood pressure, cancers, arthritis, and other major health problems are already immense and are already beginning to cripple health systems. In the USA obesity costs exceed $120 billion a year, while the latest government forecasts predict that Britain is following the USA’s path towards a massive prevalence of obesity, which could affect half the adult population by 2050 and cost the UK health system almost $100 billion a year.