It’s time for national obesity strategy given that this is now the most prevalent disease in Ireland, writes Alison O’Connor
I have a particular dislike for supermarkets. By the time I’ve wheeled the trolley to the cash register I’m usually feeling nauseous, confused and slightly dazed by the awful lighting.
What, I often wonder, would a supermarket visit be like without all the tricks and fandangles employed to pull us from the nutritional straight and narrow, no matter how good our intentions are when we first wheel through the automated doors.
That trickery begins immediately – right there in front of you is the fruit and veg aisle – such a layout is nonsensical in terms of these being the items most likely to get squashed at the bottom of the trolley - but the research has shown that if we pick up some greens and other fresh stuff first, we’ll feel so virtuous we’re more likely to veer off course in the subsequent aisles with the highly processed foods.
These visits are all the harder if you are accompanied by children; cruising a cereal aisle with small people is a very particular form of pain as most parents will tell you. If you’re trying to be a diligent and responsible shopper for your household, and examining labels as you go, that vertigo-like feeling that hits you at the end will be even more intense. At times it seems as if a degree in nutrition, as well as a magnifying glass, is required to cut through the marketing hype and jargon.
After all, these retail chains have spent tens of millions on trying to get you to spend as much as possible during your visit, as have the food and beverage industry, who want you to pile their high calorific, low nutrition rubbish, as high as possible in your trolley. Then we hand over that little card the retail chain has so kindly given us with the promise of bonus points, but which tells them exactly, down to our toilet roll preferences, what we like to buy. That information gives them the basis for tricking us into buying even more in the future.
No wonder it can feel like a battleground, and that we could do with some good honest-broker help that we can trust. In Ireland we need it more than most as we remain on track to end up as the fatman of Europe, given our eating habits.
Our reputation for having a national sweet tooth is borne out by the World Health Organisation (WHO) prediction that by 2030 Ireland will be one of the most overweight countries in the EU. This figure has been described as an exaggeration by some, but either way our levels of heftiness are seriously high and in need of attention.
Clearly there is a balance between personal responsibility and Government responsibility in what we as citizens eat, or what we decide to allow our children to eat, but the truth is both approaches are needed to combat what is a massive problem. We need help, and fast, from our Government to counter the might of the wealthy manufacturers and retailers.
A recent international example illustrates beautifully how the food industry is so reluctant to assist the consumer in this area. Australia introduced a voluntary system where foods are rated from half a star, up to five stars for the healthiest products. How wonderfully consumer-friendly. However a number of major food manufacturers dragged their heels on signing up. After all there is nothing in it for them.
Force is the only thing that works. Therefore it was disappointing this week not to see the Government include a tax on sugar sweetened drinks in the Budget. It was encouraging though to see our Health Minister Leo Varadkar mooting it, and it is surely something that will happen soon. Perhaps it was naïve to expect it to be part of the Budget, given that we are in general election mode, but nor should we underestimate the persuasive lobbying powers of the food industry here and how they influence politicians. Mexico recently introduced a sugar tax and although it is set at only 10% it is reported to be having a positive effect, and a tax was also introduced in Berkeley, California.
There is strong evidence just this week of the sway the industry hold in the UK where accusations have been flying that a report on the merits of a sugar tax, contained in a childhood obesity strategy, is being suppressed.
Last year the Royal College of Physicians in Ireland called for the introduction of a 20% tax on sugar-sweetened drinks in this year’s Budget. Earlier this week the college’s group on obesity called for a national obesity strategy given that this is now the most prevalent disease in Ireland affecting one-in-four children and two out of three adults. Of all the stark figures supplied, perhaps the most frightening is the fact that 25% of our three-year-olds, 25% of our nine-year-olds and 26% of our 13-year-olds are overweight or obese.
The report called for an integrated approach so that adults and children who are overweight or obese can be treated and supported with weight management in the community, and in primary and secondary care settings. At the moment there is a shortage of treatment programmes across Ireland and healthcare professionals are insufficiently trained in detecting, treating and managing obesity.
Logic dictates that as our rates of obesity rise exponentially, we will see a parallel increase in healthcare costs. The cost of overweight and obesity in Ireland in 2009, including direct and indirect costs was estimated at €1.13 billion. Those direct costs represented 2.7% of total healthcare costs for that year. It is frightening to think that if the prevalence of overweight and obesity reaches the 90% predicted by 2030, direct healthcare costs alone will reach €5.4 billion.
Of course we should also remember that prevention is the key here, since evidence shows that obesity has a tipping point, once gained, weight is difficult to lose. But what causes us to gain it is not simply one factor, or a lack of willpower, indeed it is a complex number of factors, which the report states include a high calorie diet, lack of physical activity and psychological, emotional and genetic factors.
Up to now health policies and resources have targetted the consequences of obesity rather than addressing its prevention and treatment.
Society likes to over simplify the problem and has a propensity for “fat shaming” but the report makes the point that while some determinants are within the control of individuals “the majority are not”.
Another key recommendation is to train health professionals on how to raise and discuss the issue of overweight/obesity in a non-judgemental and empathetic manner and also give them training in how to help people change their behaviour.
There is strong evidence that the best way to approach this problem is to have strong public policy backing us all up up as we try to get healthier.
A simple visit to your local supermarket proves the need for it.
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