Junk food and drink have no place in our hospitals

IF you are one of the few Australians who still smoke, you would not expect to be able to buy cigarettes in a hospital or health clinic. It is counter-intuitive for tobacco to be sold in the very places that treat smoking-related diseases.

In the same vein, the centres that treat chronic diseases, such as type 2 diabetes, heart disease and cancer, should not sell junk food and drinks. Sugary drinks, fried foods, potato chips, pies and pastries are fuelling an obesity epidemic that is leading to increased incidence of these diseases, so selling these products in the hospital canteen is the wrong approach.

This is why NSW Health’s recent move to remove sugary drinks from sale in that state’s hospitals and health services, and improve the nutritional quality of food on offer, is such a welcome step. It reflects the burden of disease that poor diet and overweight and obesity are having in our society, and acknowledges the role that health professionals play in making healthy changes happen.

The change is in line with the consensus reached at the National Health Summit on Obesity convened by the Council of Presidents of Medical Colleges late in 2016. The summit concluded that the medical profession had a responsibility to lead by example by having healthier food and drink available in hospitals and health services, universities and medical college and association facilities. The goal was to make the healthy choice the easy choice in the places where health professionals live, work and learn.

More and more, we are seeing councils and health services make changes to improve the healthiness of food and drinks in community, sport and health settings – particularly focusing on sugary drinks.

The Alfred Hospital in Melbourne has increased the price of high sugar drinks as well as putting them out of sight in the cafe. This has resulted in a reduction of sugary drink sales by 36 500 units a year. It has also had wide acceptability by people who frequent the cafe with few even noticing the changes.

A number of regional health services, including Murrumbidgee Local Health District in NSW and Victoria’s Western Districts Health Service and Barwon Health, have also removed sugary drinks from sale. The YMCA has also shown strong leadership with a phase-out of sugary drinks in their sports facilities Australia-wide, and this is now being considered at a global scale.

With around 64% of Australian adults and 27% of children now overweight or obese, we have a serious problem on our hands. It is well understood that junk food and sugary drinks are major contributors to the problem, with the Australian Dietary Guidelines indicating that these foods should only be eaten occasionally and in small amounts.

The high levels of kilojoules, saturated fat, added sugars and added salt in highly processed foods are associated with increased risk of obesity and chronic disease, such as heart disease, stroke, type 2 diabetes and some forms of cancer. Surveys show that the average Australian adult gets around 35% of their total energy intake from these foods, and for children the amount is higher, reaching up to 40% for teenagers.

These unhealthy processed food products are displacing healthier foods from the diet – 95% of both adults and children fail to meet the guidelines for fruit and vegetables. A mere 7% of adults and 5% of children meet the recommended amount of vegetables, with half of adults meeting the guidelines for fruit and 68% of children.

Poor diet and being above a healthy weight are leading risk factors for the burden of disease in Australia. In 2011, overweight and obesity was estimated to have cost our nation $3.8 billion in direct health care costs.

Obesity alone has increased by nearly 50% between 1995 and 2011–12, with the proportion of people with a body mass index of 35 and above doubling in that time.

What’s most concerning is that this is a problem that is largely preventable. But it’s being driven by our “obesogenic” environment.

Not enough is being done to restrict the saturation of persuasive unhealthy food promotions and the availability of cheap, highly processed junk food and drinks.

This move by NSW Health is a progressive one. It sends a clear message that these foods and drinks are unhealthy and, as a consequence, are not endorsed by our hospitals and health services. It also creates an opportunity in the marketplace by providing an incentive for companies to reformulate or develop new, healthier products for stocking in hospital vending machines and for sale in cafeterias. This is part of a larger movement in schools and workplaces to improve the nutritional quality of the food made available in these settings, and helps to increase demand and grow the market for healthier products.

Accelerating change in these health-promoting settings helps to influence the social norm, so that a consistent message around the importance of a healthy diet is sent not just to patients, but to visitors and staff as well.

Making the healthy choice the easy choice is an important and positive step for everyone.

Jane Martin is executive manager of the Obesity Policy Coalition and of Alcohol and Obesity Policy at Cancer Council Victoria.

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