August 18, 2016

expert reaction to childhood obesity strategy

The government has released its plan to tackle childhood obesity.

Prof. Tom Sanders, Professor emeritus of Nutrition and Dietetics, King’s College London, said:

“I support the increase in exercise. However, the strategy does not focus on how to restrict overconsumption of food energy. Both fat and carbohydrate consumption need to be cut. As most of the food energy comes from carbohydrate, the focus should be on reducing portion sizes of carbohydrate rich foods being careful not to replace it with fat. Swapping added sugar for starch won’t help because they provide the same number of calories per gram.

“In my opinion, thinking that technical innovation can dig us out of the problems caused by the mass production of cheap high calorie food is an easy trap to fall  into! Previous technical innovations such as low fat/fat free or artificial sweeteners have had no impact on obesity. Arguably, these innovations may have fanned the fire because obese individuals are more likely to use such foods(e.g. artificial sweeteners)  but not change the dietary habits which are making them fat A recent study showed that weight loss was better in obese patients advised to drink water instead of artificially sweetened drinks. Furthermore, The evidence suggest that people who select whole foods are less likely to be obese than those who select highly processes foods.

“Cutting sugar from drinks and confectionery will help reduce the intake of empty calories but probably more empty calories come from crisps and other deep fried foods which are high in fat.

“In terms of sugar reduction in complex foods, the potential benefit is more complex. Replacing sugar with starch in food will have no impact on calorie reduction and if sugar reduction results in an increased  proportion of fat in the product then the calorie content per 100g will increase

“It is good to encourage healthy eating but it is the quantity of food consumed rather than the quality that affects weight gain. The strategy does not explain how  the intake of foods consumed on the school fringe or at home will be reduced.

“The current nutritional signposting is probably not fit for purpose because it was designed to reduce intakes of saturated fat, salt and sugar not calorie intake.

“Lacking are any controls on the marketing of obesogenic foods e.g. no controls on pick and mix sales of confectionery in shopping centres or the placement of high calorie snacks at checkouts and marketing of junk food in cinemas. I think tougher action is needed if there is to be any meaningful impact on obesity.”

Professor Mark Hanson, Director Institute of Developmental Sciences at the University of Southampton:

“The long-awaited Plan for Action on childhood obesity is now published. It rightly highlights the scale of the problem which we face in the UK and the medium- and longer-term health, societal and economic costs which the epidemic of childhood obesity will inevitably bring if it is not addressed as a matter of urgency.

“The government’s plan contains several good components, but I know that many experts in the field, many health care professionals and probably many parents will feel disappointed that it does not go far enough.

“It is very surprising that the plan makes no reference  to the report of the Commission on Ending Childhood Obesity (ECHO) published by the World Health Organisation in January of this year, and endorsed at the World Health Assembly in May, by the UK government among others. The Commission took account of a wide range of contemporary research from many countries and consulted widely, producing a series of clear recommendations. Some of these are mirrored in the government’s plan, but several very important ones are not.

“The government’s plan continues to place much responsibility on parents and children, as well as busy health care professionals and teachers. It completely ignores the importance of the life course nature of childhood obesity, a path along which many children have already started by the time they are born birth and in infancy. Even young children who are not obviously overweight or obese may be at risk in this respect.

“Urgent action is needed to engage the parents of tomorrow in having a healthy lifestyle before conception, in preventing obesity and diabetes before and during pregnancy and in promoting breast feeding.

“There is a real danger that the government’s plan will deliver too little, too late, and that major opportunities will have been missed.

“It is good to see that the plan recognises that this is the start of a conversation on how to tackle this problem. To this end, it is important to engage all the relevant people in that conversation. As emphasised in the Chief Medical Officer’s report of last year, the health and behaviour of young people in the period before they conceive a baby is critical to a range of health issues, including childhood obesity. We urgently need this group of the population to join us in preventing the problem, rather than just focussing action on treating it once it has developed in their children. Their health is their future – for them and their children – and we owe them a chance to make it better.”

Declared interests

Prof. Tom Sanders: “Prof Tom Sanders is a Scientific Governor of the charity British Nutrition Foundation, member of the scientific advisory committee of the Natural Hydration Council (which promotes the drinking of water), and honorary Nutritional Director of the charity HEART UK. Prof. Tom Sanders is now emeritus but when he was doing research at King’s College London, the following applied: Tom does not hold any grants or have any consultancies with companies involved in the production or marketing of sugar-sweetened drinks. In reference to previous funding to Tom’s institution: £4.5 million was donated to King’s College London by Tate & Lyle in 2006; this funding finished in 2011. This money was given to the College and was in recognition of the discovery of the artificial sweetener sucralose by Prof. Hough at the Queen Elizabeth College (QEC), which merged with King’s College London. The Tate & Lyle grant paid for the Clinical Research Centre at St Thomas’ that is run by the Guy’s & St Thomas’ Trust, it was not used to fund research on sugar. Tate & Lyle sold their sugar interests to American Sugar so the brand Tate & Lyle still exists but it is no longer linked to the company Tate & Lyle PLC, which gave the money to King’s College London in 2006. Tom also used to work for Ajinomoto on aspartame about 8 years ago.  Tom was a member of the FAO/WHO Joint Expert Committee that recommended that trans fatty acids be removed from the human food chain. Tom has previously acted as a member of the Global Dairy Platform Scientific Advisory Panel and Tom is a member of the Programme Advisory Committee of the Malaysian Palm Oil Board. In the past Tom has acted as a consultant to Archer Daniel Midland Company and received honoraria for meetings sponsored by Unilever PLC. Tom’s research on fats was funded by Public Health England/Food Standards Agency.”