One of the most important issues facing public health today is obesity. Worldwide, approximately 30% of adults are obese, and costs around $2 trillion annually. A health concern with complex determinants and many intertwined causes, there’s no single magic bullet solution to the rising prevalence of obesity. A new report by the McKinsey Global Institute studied 74 interventions to see what was effective. They studied 74 interventions that target obesity, which range from subsidizing school meals, adding calorie and nutrition labels, as well as restrictions on advertising high-calorie food and drinks.
The report covers areas one would expect, such as energy balance and changing dietary and physical activity behaviours. While these issues are important and do require study, the authors also looked at the environment and how that impacts obesity. There’s a lot of literature that shows that your environment plays a large role in obesity, and simply telling someone to “eat less and move more” is an ineffective strategy at best, and one that further stigmatizes at worst. It’s something we’ve discussed in relation to poverty, and illustrated with the retailer IKEA.
The main findings of the discussion paper were:
- While they did find that personal responsibility is important, interventions also need to change the environment and tackle societal norms. Decreasing portion sizes, tackling how products are marketed, and changing the physical environment are all avenues that can and should be explored as a way to improve health.
- There’s no single solution. We need to have prolonged action, driven by evidence, in order to see changes.
- While some may be skeptical of how these will be funded, they found that almost all the interventions ended up saving money through decreased healthcare costs and higher productivity. They hypothesize that such an intervention could save the National Health Service in the UK about $1.2 billion a year.
- We can’t tackle obesity by going at it alone. We need to get everyone on board, pulling in the same direction to reverse these trends. In particular, we need partnerships between public and private businesses, as well as the communities they serve, in order to change public health outcomes (for more on this, see this post by Jenn Lau)
They then set four important issues that any intervention aimed at tackling obesity should consider:
- Interventions should bring as many sectors as possible together, in order to ensure success
- The interests of government and business will need to be aligned, and this requires specific attention
- Interventions shouldn’t be unduly prioritized as this could prevent action from occuring
- Doing something is better than doing nothing.
To combat the rising prevalence of obesity, we need to do something. Reports such as these can amalgamate what everyone is doing, look for what is working and what isn’t, and this can be used to to inform future interventions on what should be done.
For more on the report, you can read the Executive Summary, or the full report (Note: both are PDFs)
If one looks back on the twentieth century wars, one feature of that period was that given the mobilization of nations and their citizens to participate in those wars, a huge amount of food (as well as all else) had to be delivered to all those moving masses. The processed food manufacturing industries that had to “up scale” all their resources to process and transport all that food to the “fronts” and was epic on its scale. The kinds of food required / packaged / shipped, had to have the protein, carbs, fats and sugars to fuel the fighting forces and had to be condensed into the smallest possible packages (canned pork and beans…yuck). These forces came back from conflict with altered tastes for foods that they may not have been exposed to “back home” before going to war.
Look at all the Giant corporations (I am speaking about North American companies) that roared to prominence in the marketplace, post war. As a post war boomer I remember the how our family diet changed during the early fifties from the cooking style sourced from my grand parents to the “can”. Just about everything started to have sugar in it, if it was in a can. If it was not in a can, you put sugar on it anyway. Prepared sauces to sweeten lower grades of meat (our family was not poor but frugality was a the root of Mother’s buying habits until the sixties) meant that one could not have eat meat without sugar on it. Poof, obesity… Everywhere.
I was heard the BEST concept to take to the supermarket, when shopping. Eat The Walls. In most supermarkets all the food a person needs to eat reasonably healthy is “on the walls” (excluding the innovation of adding a Delicatessen section in recent times). Bakery, Vegetables, Dairy and Meat are generally on the outside walls of the space. Careful forays down the aisles for flour, pasta, rice, oils and spices (and a few treats) and there is no way a person can get and stay fat.
Access to these kinds of choices is a Big problem in North America, as in many places there is limited (there is certain corporate culpability in this) availability of reasonable quality food.
Cooking? A generation have not forgotten how to cook food from “scratch”… They never learned it or have even tasted it, Ever. Spices are foreign. Salt, pepper, corn syrup and sugar, maybe some ketchup, that’s about it. If people can learn how to cook again, then perhaps, obesity can fade away. Schools are the only place that can introduce the possibility and only with quality cooking programs that deliver good food to the plates of students and show them the recipes that got that good food to the plate. The high school my children went to had a cooking program that had an Amazing chef. He “educated” the pallets of hundreds of young people during the time he was there. Only a dedicated effort to educate the populace, starting with young people, to cook and eat “real” food, can there be any change into a lifetime of good eating habits.
Food from the walls, spiced simply and well, eaten with good company.
That’s all it takes.