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OVER the past decade, Australia’s weight problem has worsened. Since the Obesity Policy Coalition (OPC) launched in June 2006, we’ve seen a rise in obesity rates among many demographics, while the burden of disease for poor diets and obesity has increased.
It’s costing us financially, physically and socially at a national, community and individual level.
As explained in the MJA recently, Australia lacks a sustained, comprehensive and strategic approach to prevention, together with adequate funding, coordination and monitoring.
In 2011, Australia’s spending on prevention and public health as a share of total recurrent health spending was 2.0% (versus New Zealand’s 6.4%, Finland’s 6.1% and Canada’s 5.9%).
When you consider the large proportion of preventable disease related to diet and obesity, as well as the direct economic costs of $3.8 billion a year, it is extremely concerning that Australia still does not have a national obesity strategy.
Public health experts have been advocating for a variety of different actions and strategies to address this very serious health problem for a number of years. Many of these are cost-effective and some would go further, providing funds to bolster prevention spending.
While there is a well recognised suite of actions to address Australia’s weight problem, a lack of a clear and consistent call to action by health organisations means that this has not been well communicated to the policy makers who can bring about these changes.
This lack of consistency is one element hindering progress at a national level.
Health organisations are starting to align their obesity policy advocacy efforts – proposing a clear suite of actions that will ensure that governments develop and implement an effective strategy to tackle this urgent health problem.
- Related: MJA InSight — Put tax on sugared drinks on table
- Related: MJA InSight — Prevention policy “flapping in the wind”
- Related: MJA InSIght — Obesity measures missing
- Related: MJA — Obesity management in general practice: does current practice match guideline recommendations?
As we head into the federal election and the start of the OPC’s second decade, let’s reflect on what policies must be introduced or strengthened to reduce the impact of overweight and obesity.
Action required: 20% levy on sugary drinks
We know that price is an important lever which can be highly effective in influencing sugary drink consumption. We know from the experience in Mexico and from our research that increasing the price of sugary drinks in Australia has the potential to reduce consumption and improve population weight and health outcomes, if the tax is set at a sufficiently high level. Meanwhile, a 20% price hike can raise at least $400 million per year for much-needed obesity prevention initiatives.
The OPC and other health bodies were relieved to see that the goods and services tax was not extended to fresh fruit and vegetables as previously considered. Such a tax would have been a disincentive for eating a healthy diet.
The revenue raised from a tax on sugary drinks, meanwhile, has the potential to have the opposite effect and can be used to subsidise healthy food for low-income families.
Action required: Interpretive food labelling
The new interpretive front-of-pack labelling system, the Health Star Rating System, is an important policy development. However, its effectiveness has been hampered by the watering down from a mandatory to a self-regulatory arrangement.
It also continues to co-exist with the industry Daily Intake Guide which it was meant to replace to reduce consumer confusion.
Food companies can choose whether to use the scheme or not, so many products do not carry the stars. Widespread adoption of the stars is necessary for shoppers to compare products and use the rating system as it was intended.
It also appears that some companies are using it selectively on products. Self-regulation can create a very uneven playing field, putting those companies who have adopted the scheme across all product lines at a potential commercial disadvantage.
Action required: Reduce children’s exposure to junk food marketing
We need to consider if business as usual is going to support families, schools and communities to raise healthy, happy children.
With few children eating a healthy diet and up to 40% of their energy coming from junk food, we must consider why we allow junk food and drink companies to self-regulate and to:
- continue to sponsor children’s sport;
- make their own rules about what can be marketed to children, with sugary breakfast cereals and chicken nuggets considered healthier choices; and
- target children through digital platforms such as Facebook.
This constant bombardment of food and drink advertising means unhealthy products have become the wallpaper for a generation where more than a quarter are overweight or obese. Not placing meaningful controls on promotion, and justifying this by saying that parents are responsible, takes the focus off those who manufacture and promote highly processed food.
In conclusion, the need for action on diet and weight is being increasingly understood and acted on in communities that are hit hardest by this problem.
In some places, the leadership is coming from local government, in others it is groups like the YMCA or local community health services. State and territory governments are also playing an important role, such as funding education campaigns like LiveLighter and establishing policy frameworks for a range of settings.
These activities are very important, but alone they are not enough.
It should be a priority for the federal government to establish a national obesity prevention strategy to tackle the drivers of our obesogenic environment, some of which are outlined above.
Until we see national leadership tackle the problem, we will continue to fail to improve diets and slow obesity, making no impact on its growing burden of preventable disease on the hospital system, the economy and families.
Jane Martin is Executive Manager of the Obesity Policy Coalition.
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Metabollic centres in every public hospital please. Bariatric surgery readily available in the public system? These are not mentioned, its depressing. Marketing campaigns about junk food labelling…. paaaalllllease.
These articles always seem to attract the anti-fructose zealots. The reality is that both fats and sugars are energy-dense, and individual dietary intake needs to be matched with individual requirements for both nutrition and energy. This varies widely with age, gender, activity and genetics. Dietary advice to reduce fat consumption – especially saturated fats, is still supported by good evidence (see the methodologically strong systematic reviews from Mozaffarian’s team, linking saturated fat intake to coronary risk). This work showed that the benefits of lowering saturated fat intake hold if they are replaced with polyunsaturated fats, but not if the energy gap is replaced with carbohydrates.
So, the dietary profession has never advised us to increase sugar intake. Eating less fat means just that – less fat consumption. That should be done within a diet of mainly unprocessed or minimially processed whole foods, with lots of plant-based foods. This needs to be matched to individual needs, but there is no single ‘recipe’ – there are multitudes of healthy dietary patterns around the world, fructose included.
There is no black/white battle between sugar and fat – both need to be moderated according to needs and lifestyle. The dietary world is replete with simplistic messages and pseudoscience. No wonder consumers are confused.
While I agree with Dr Joe, there needs to be more done by the government.
Tax on sugar IS imperative. Regulation on how much sugar can legally be added per weight of product should also be made law. A total ban of trans fats is also key.
I also would like to see better treatment of thyroid conditions.
As a person who has multiple auto-immune diseases, I have watched my body destroy itself, including late onset type 1 diabetes, hashimoto’s & fibromyalgia, causing me to gain weight despite consuming a healthy diet. I’ve lost count of the many GP’s & specialists who have said ‘change your diet, you need to lose weight’ & yet 3 dieticians have all said I don’t eat enough to warrant my weight & my diet is better than they can design!
Anyone with hashimoto’s will tell you they suddenly & inexplicably put on alot of weight. Hashimoto’s is on the increase – why? I personally think it’s an increase in soy being added to everything. It’s a well known goitrogen & cheap ingredient to bulk up foods. Instead a diet that is anti-inflammatory (lactose, gluten & processed sugar free), containing no goitregenous foods would be very beneficial.
You will then see many people, especially women lose alot of weight & have better chances of fighting the progression of autoimmune diseases.
Moderation with self control – as with most things – is the best answer – if things have so worsened since the opc arose, it should be disbanded, not given more taxpayer funds! Statistics are selectively used to demonstrate anything!
Would love the government to actually look at it being a mental health issue instead of wasting money on ‘patches’ to fix the problem.
As an obese person, I CAN tell u it is a mental health issue, anorexia is is it not? No different with the triggers for obesity too. We keep having these amazing apithany’s about sugar, fats blah blah. STOP !
Educate the children but in doing that there are soooo many people with so many different ideas. Go back 30 years for example we all ate fresh food, stuff all genetically modified food, Life was a lot easier.
We have a higher rate of Autisim, behavioural issues etc etc. arent’ these under mental health issues too?
ACKNOWLDEGE it is mental health and you may find changes happen.
Totally agree with Dr Joe. The sooner we unlearn the low fat falsehood the better! The evidence is in. It was a big fat lie. Fructose is the culprit. We do need clear food labelling, but especially highlighting sugar content, not low fat. But while it is those with a BMI over 40 that are the real drain on health resources, we do need to get the whole population to understand the need to cut carbs. BIM 30-40 are the over 40’s of the future. We DO need to tax sugar, INCLUDING sugar added to milk and fruit juices. And that needs to be extended to how advertising to kids is restricted.
Interesting article.
If there was any doubt about the effects of advertising and availability on children, we need to look no further than refugee children. Arriving from places of scarcity and traditional diet, when exposed to a new culture they quickly become accustomed to changing to a new range of food and drink based on what they see around them. The children put pressure on their parents to buy them food and drink which other “Australians” consume.
Not surprisingly a significant number gain excess weight very quickly. What is more heartening is that once given proper dietary advice and recommendations to return to their traditional foodstuffs they lose weight just as quickly.
Changing perception of what is normal is the answer, by whatever means.
David
Blah blah blah. The Public health collaboration in the UK is way ahead of us. To genuinely tackle wieght issues we need to promote a low carb higher fat diet. In other words we need changed dietary advice. Not the public health 101 approach of ban and tax. And dont forget that the BMI is not an indicator of health. Those who are “overwight” do not sufffer problems from the few extra kg. In fact people with a BMI of 27 live the longest.