Smoking causes Cancer, Food causes Obesity - Why not Act on Food?
Obesity is the highest and theoretically most preventable cause of death and disease after smoking throughout the world. Global prevalence of obesity has increased more than twofold since 1980. WHO refers to a world-wide obesity epidemic with about 1.5 billion adults overweight or obese, and 500 million people obese.(15% of the world’s population is overweight; 5% is obese).
The problem is getting worse with WHO predicting that about more than 700 million will be obese and 2.3 billion adults will be overweight by 2015 (just 5 years from now). By the year 2025, obesity levels could be as high as 50% in the US and Polynesia, 40% in Britain, Europe and Australia and more than 20% in Brazil. In 50 years time almost half of the world's population could be obese - that's staggering!
Something Has to be done!
Excess weight will cause millions of extra cases of diabetes, stroke, heart disease and cancer inflating medical costs in the US by an estimated $48-66 billion per year. Obesity already consumes about 12 % of the US health care budget, more than double the $47 billion attributable to smoking. Why is nothing being done? Anti-smoking campaigns have been very effective. There is a lot of similarity between smoking and obesity in terms of cause and effect, health consequences and costs and control mechanisms. This article proposes the need for a campaign to tackle obesity similar to the very successful Quit Smoking campaigns.
US and worldwide policies and strategies to curb tobacco smoking are probably a good model for efforts to tackle the obesity epidemic. As for smoking, bans won't work and won't be introduced - you can hardly ban food! But taxes on undesirable foods with very high levels of calories, fat and sugar could work. Denmark recently introduced the world's first fat food tax by applying a surcharge on all foods that contained more than 2.3 % saturated fats. Similar taxes could be imposed on sugar, and high-calorie foods or meals. See Fat Tax on Unhealthy Foods - Tax Fat, Soda, Calories, Sugar, Fast Foods?
Effective warning labels on packages could also work if they were the 'traffic lights' system or other systems designed to put a warning on 'dangerous foods' (foods with high fat, sugar or calories and high calorie density foods). However these 'Good, Bad and Ugly' labels have been blocked by food industry. Highly processed foods are major sellers in the market place.
Properly designed advertising and education campaigns should be devised that work - not the current mumbo jumbo that is served up. They need to be hard hitting like the anti-smoking advertisements.
There is also a need for hotlines and education facilities like the various 'Help to Quit' services that are offered by many governments throughout the world.
Will these make obese people feel bad like the smokers who huddle outside offices to smoke? Probably but 'Fat-stigma' already exists. Remember that smoking and nicotine are highly addictive making the job much harder for anti-smoking campaigns. Anti-obesity campaigns should be a 'piece of cake' in comparison.
Anti-Smoking Campaigns Have been shown to be Cost-Effective
Australia's famous 'Every cigarette is doing you damage' ad has been shown to be very effective with smoking rates dropping by 1.4 per cent, (190,000 fewer smokers) after the first six months of the mass media campaign .The campaign was also shown to be very cost-effective with significant savings to the health system. Research showed that this campaign was particularly effective for the young teen group, aged from 12 to 13, with a 50% reduction in likelihood of taking up smoking. The campaign was less effective for older kids.
Childhood obesity rates are alarming with WHO estimating that 42 million children under the age of 5 years, were overweight in 2010. Twenty percent of American kids are now classified as overweight. The important issues is that overweight and obese children are likely to stay obese into adulthood and will remain a burden on the health systems throughout their lives. There is a similar need to focus obesity advertising campaigns on the younger age groups.
Cause and Effect - Smoking versus Obesity
Just as the tobacco companies fought long and hard against the notion that smoking causes lung cancer and many other diseases, the food industry has mounted a very strong campaign against the notion that highly processed foods rich in fat, sugar and calories are the cause of excess weight and obesity. It is hardly rocket science to claim that people put on weight and become obese because that eat too much. The argument is that it is lack of will power and the type of food that people eat that is the problem rather than the food itself.
However reviews of recent research have shown that the cause of excess weight is FOOD - the highly processed convenience foods that were developed in about 1975. These rich foods with high calorie densities are the cause of the problem. The obesity epidemic in developing countries is largely the result of the importing of these western- style highly processed foods and western lifestyles. See: At Last - Cause of Global Obesity Identified - We Passively Eat Too Many Calories
The conclusions from a major British Study - Tackling Obesities - Future Choices identified the cause of obesity.
- People worldwide are getting fatter simply through a process where normal people are making a passive (normal) responses in a fat promoting environment. Most people eat 'normally' - that is three meals a day. The problem is the food they eat is too rich. The problem is Passive Over consumption - people eat normal meals, which are too rich and so over-consume calories without being aware if it.
- Modern supermarket food is rich in fat and calorie dense. So people who eat 'normally' as they have always done (3 meals a day) passively overeat and consume too many calories. Modern processed, 'convenience' foods, are marketed very effectively. Over the last forty years the food processing and delivery systems have developed to provide palatable, cheap, highly processed and energy-dense foods that are pushed through effective advertising campaigns 'Good on you're Mum'. Better food distribution systems mean that these foods are more accessible and convenient, and can be bought in supermarkets which have effectively eliminated the small, local fresh whole food suppliers.
- Research has confirmed that these change in food processing and supply are the dominant cause increases in average weight in the UK from the 1980s and USA from the 1970s.
- The export of processed foods and western lifestyles to the more affluent people in developing countries is the cause of obesity in these countries as well. Western processed foods, 'fast foods' and western diets, soft drinks and western lifestyles have led to the increasing rates of obesity. Most of the people getting fat in these countries as those who can afford the western foods and lifestyles. Even the Indian Government is concerned about the rising rate of obesity in India! See: The West Exports Fat Stigma while its Diets, Food and Lifestyles make the World Fat
- People are responding normally to the 'fat-promoting' environment in which we live that includes food, eating patterns and lifestyle. To put it in other words, obesity is the result of people throughout the world responding passively in a perfectly normal way - not being gluttons - but eating the way they have normally done all their lives - but the food has changed. The problem is the food is TOO RICH and the serving sizes are TOO LARGE.
In summary genetics and body form loads the gun for obesity, but what pulls the trigger is the 'fat-promoting' environment in modern society and modern processed foods.
Adding to the problem is that meal and portion sizes have increased. Meal portion sizes, even at home today are far larger than in the past. Larger plates, burgers, muffin tins, cup holders, and pizza pans are becoming the standard. Fast Food servings are huge. The 'Upsize Me' deals make meals much bigger. On average, the larger portions eaten today amount to an additional 50-150 calories per meal.
Similarly meal frequencies (though snacks and calorie laden drinks) have increased dramatically. Research has shown that between the mid 1970s and mid 1990s the average number of snacks per day increased by 60 percent over this period. The contribution of snacks to total calories more than doubled, mostly due to eating more snacks including drinks.
People are Over-consuming Calories and get Fatter each Year
Figures from the USDA show that the average American consumed 2,234 calories in 1970 and that this rose to 2,757 calories in 2003. This is an increase of 523 calories per day, which is equivalent to almost and extra meal a day for an average person.
Research has shown that there is a consistent trend for people to get heavier each year. The average weight gain is about 400 g in men and women. People get heavier and heavier each year. Research has shown that this trend is very hard to stop with only 20% of people who try to lose weight being successful and only 10% showing long-term permanent weight reduction.
To stop the trend and to restore the average American to weights that applied in 1978, would require an average person to reduce their daily intake by at least 250 Calories a day. The reduction required for the average obese adult would be double this, at about 500 Calories per day. This is a major reduction in calorie intake.
So we eat more, we eat more often, and what we eat is full of fat and calories. Is it any wonder that most of use are getting fat and there is a world wide obesity epidemic
Conclusion - Anti-Smoking Style Campaigns and Policies are required to Address the Global Obesity Epidemic.
- Government intervention through various advertising campaigns and various interventions are urgently required to change the 'fat-promoting' environment (food and lifestyle) if the obesity epidemic is to be controlled. see At Last - Cause of Global Obesity Identified - We Passively Eat Too Many Calories
- People need to be able to eat normally and not get fat - this will only happen if they change what they eat, and how often they eat. This will require a major advertising campaign and lower accessibility to the high fat, calorie dense foods that they are eating now.
- The intervention required is beyond personal choice and self-regulation in the food industry. The food processors are the cause of the problem in many ways and they are hardly going to voluntarily promote the idea that the foods they produce are bad.
- These finding largely counteract the blame-game - Many people claim that "Fat people overeat and so its their choice and its up to them up to them to cut back". This is similar to the blame game for smoking. "People who Smoke know it Causes Lung Cancer - Why Don't they stop"? Why should governments waste billion of dollars trying to get obese people to reduce their weight or people who smoke to stop? The answer is that these campaigns can be it is cost-effective and they do work. Nothing that is being done now is working. Every person who pays tax has to share the high cost of health problems caused by obesity. Fat stigma hasn't worked and its unlikely to be effective when more than 50% of people are obese in 15 years time!
- Highly Processed food that are Rich in Calories, Fat and Sugar are the Cause of Obesity and Excess Weight Problems. People eat normally, eat these foods and get fat. These foods are like cigarettes and something must be done to make them less available, more expensive and have labels on them to warm consumers of the dangers in eating these foods.
- Research has shown that most people don't understand calories, especially the concept of a daily calorie target, allowance or limit. Similarly it has been shown that most people don't read or take any notice of calories on menus - quote. Much stronger intervention is required. See: Q&A Calorie Counts on Menus: Are they Accurate, Understood, Effective, Worthwhile?
- Meals sizes at fast food restaurants are ridiculously large. A single meal may be equivalent to the total daily allowance for a man, woman or child. This is a major part of the problem.
Many Meals, especially those at fast food outlets are simply too large.The average daily calorie allowances depend on body weight and activity level but the average values are:
- Men = 2,500 kcal (Calories)
- Women = 2,000 kcal (Calories)
- Children aged 5-10 = 1,800 kcal (Calories)
The summary below highlights the problem as many of the meal choices are 70-120% of the daily allowance for the average person. A fuel gauge labelling system (see: Food Labels - New Guide Using a Fuel Gauge for Daily Calorie Allowances) has been used to illustrate the calories in the meals compared with the daily allowance. The food 'fills' up the images of a man. woman and child. The summary table shows healthy choices from the same outlet.
A tax on high calorie meals or better labelling using the one shown is the only way to stop people overeating.
© 2011 Dr. John Anderson
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