Obesity 'equal to terror threat'

Obesity is predicted to continue rising

The threat to Britain and the NHS from rising obesity is as grave as that posed by terrorism, a top expert says.

Durham University public health expert Professor David Hunter, who also acts as a government adviser, said ministers should be taking "bold action" now.

He said this could include compelling manufacturers to improve the salt, fat and sugar content of their products.

The Department of Health said it was making progress in disease prevention in a number of areas.

Professor Hunter said that governments since the 1970s, including the present Labour government, had "tinkered around the edges" of the rising problem of obesity.

The threat to our future health is just as significant as the current security threat Professor David Hunter Durham University

He said

it was possible that the disease it caused could overwhelm the NHS, with some predicting a doubling of the number of people with type II diabetes by 2025.

The solution, he said, was a more direct approach, with less public consultation.

"They have been talking about it for four decades, but that never seems to be enough," he said.

"The government was quick to move for things like ID cards or 42-day detention without trial - now it needs to show similar leadership in public health.

"The threat to our future health is just as significant as the current security threat."

While many disease prevention initiatives were having some impact, he said, this was on a "piddling" scale.

He said that current work between the Food Standards Agency and food manufacturers and suppliers could go further.

"Lots of the initiatives are under a voluntary agreement - but it has just come to the point where things like these are simply not working."

He said that bigger warning labels, changes in the taxation of "unhealthy" foods, and even the use of compulsory regulations to force manufacturers to cut levels of salt, sugar and fat in their foods could be employed.

'Terror by targets'

Professor Hunter, who has written a book called "The Health Debate" about the challenges facing the NHS as it hits its 60th anniversary, also criticised targets as a tool for NHS reform, describing it as a "terror-by-targets" culture which damaged staff morale.

The recent review by Lord Darzi placed emphasis on the prevention of disease as a priority for the NHS, as did the Public Health White Paper in 2004.

A spokesman for the Department of Health pointed to the decision to fluoridate drinking water to improve oral health, and the introduction of smoking bans, as signs that it was serious about this.

"Lord Darzi's recent review envisioned an NHS that is as good at preventing ill health as it is at treating the sick," he said.

"We are tackling obesity through awareness campaigns and action in schools. Our alcohol and sexual health campaigns encourage responsible drinking and safer sex."

A spokesman for the Food Standards Agency said that the voluntary approach currently used with the food industry had been successful.

She said: "We set voluntary targets for salt and have seen considerable reductions in a range of food.

"Legislation is one option if industry doesn't respond to our voluntary approach, but so far it has proven unnecessary."

Fat friends 'can boost your size'

Being overweight can run in the family

People are subconsciously influenced by the weight of those around them - so fat friends can cause someone to put on weight too, researchers suggest.

An international team, including University of Warwick experts, dubbed it

"imitative obesity" - or "keeping up with the Joneses" on calories.

Their study, presented to a conference in the US, looked at data on 27,000 people from across Europe.

But one expert said the causes for the rise in obesity were much more complex.

Consumption of calories has gone up but that does not tell us why people are eating more Professor Andrew Oswald, University of Warwick

The work, by scientists at the University of Warwick, Dartmouth College, and the University of Leuven, is being presented to an economics conference in Cambridge Massachusetts.

They suggest

choices about appearance, on which decisions such as job offers or being deemed attractive are based, are determined by the choices others around you make.

So, if people around you are fat, it is permissible for you to be fat too.

It found

nearly half of European women feel overweight, while just under a third of men felt the same.

'Cheeky'

Professor Andrew Oswald at the University of Warwick, who worked on the study, said: "Consumption of calories has gone up but that does not tell us why people are eating more.

"Some have argued that obesity has been produced by cheaper food, but if fatness is a response to greater purchasing power, why do we routinely observe that rich people are thinner than poor people?"

He said: "A lot of research into obesity, which has emphasised sedentary lifestyles or human biology or fast-food, has missed the key point.

"Rising obesity needs to be thought of as a sociological phenomenon not a physiological one.

"People are influenced by relative comparisons, and norms have changed and are still changing."

But Dr David Haslam, clinical director of the National Obesity Forum, said: "It's a bit cheeky to pin it on sociological influences - there's more to it than that.

"If you are surrounded by people, whether that's friends or within the family home, who are overweight, you are sharing the same environment where there is likely to be an abundance of the wrong kind of foods."

Fat versus fiction by Vivienne Parry

Fat versus fiction

The moral panic about the obesity epidemic was always hard to swallow, says Vivienne Parry. Now, a new study says we may have been wrong all along

• Vivienne Parry
• The Guardian,
• Thursday June 16 2005
• Article history

There is an epidemic of obesity. We are all going prematurely to hell in a heavily reinforced handcart, the victims of our own self-indulgence and laziness. And a tsunami of diabetes, osteoarthritis, heart disease and cancers is about to hit us. Bring on the lettuce leaves and five-mile runs.

That's the orthodoxy, but a number of scholars are now accusing obesity researchers, the media and public health officials of exaggeration.

This week sees the publication of yet another of these dissenting views. The Obesity Epidemic: science, morality and ideology (Routledge 2005) is the work of two Australian academics, Michael Gard and Jan Wright, experts in physical education and education respectively. I can hear the sniffs of disapproval already.

They are outside the medical community, but that doesn't mean they have nothing of value to say.

Scientists talk about fat as if it had a clear cause. Too much energy in and not enough out. The reality, these authors claim, is that there are many aspects of both the causes and the consequences of being overweight or obese which are not explained by this simplistic model.

The authors do not dispute that the proportion of those who are obese in the population has roughly doubled in the US and many parts of Europe since 1980. Nor do they dispute the increase in cases of Type 2 diabetes.

In the US, 55% of adults with diabetes are obese, compared with 31% in the general population, which surely links obesity and diabetes.

It is said that 365,000 Americans die prematurely each year because of obesity. This figure became written in stone almost as soon as it appeared in 1999. But it was derived from 10-year- old data, taken in part from self- reported weights and heights.

In April, research published in the Journal of the American Medical Association by Katherine Flegal, a scientist at the Centres for Disease Control, which used newer data, showed that

it is far from certain that there is measurable excess mortality among obese or moderately overweight Americans.

Many will say that this is because of better drug treatments. But 30-50% of prescription drugs are not taken as directed, and many lower income Americans don't have health insurance and can't afford drugs, so this doesn't ring true. If it was, one would think the pharmaceutical industry would have been shouting it from the rooftops, yet Flegal's findings did not make the front pages like the 1999 study. But given the $46bn weight loss industry dependent on scaring stouter citizens, that is hardly surprising.

You could regard all this in the same vein as global warming dissent - to be trashed either because you think it wrong, or think there is truth to the argument but it shouldn't be made because it encourages complacency.

But Gard and Wright have some points on the ideology surrounding obesity and also the way body mass index (weight divided by the square of height) is used as a measure.

In the past, only those whose BMI was in excess of 30 were deemed overweight or obese. That value has now been changed to 25 and above, instantly exploding the number of obese people, labelling them as "abnormal" and in need of medical treatment.

This arbitrary definition of fatties vs thinnies has meant constant exhortation to get to your "ideal weight", within the magic 20-24 BMI band. Since there are naturally a range of weights within a population, many are trying to achieve the impossible. When they fail, they are told they are "weak-willed".

Obesity is one of those areas where science meets culture full on. Science has always been used by some as a church to which they retreat for factual underpinning of their moral beliefs. Fat people are bad, fat people are lazy, fat people are symptomatic of our moral decline.

To be overweight is said to be the product of a breakdown in family values and of slothful kids. Low-income groups are more likely to be obese, and so it is assumed that children living in poverty must watch more TV than rich children. But telling parents to restrict TV viewing is easier than dealing with health inequalities caused by poverty, a more likely cause of obesity than daytime TV, no matter how damaging that might seem.

We are right to be concerned about the rising levels of Type 2 diabetes but should we be worrying about the health futures of people with a BMI of 26 or 28 who are taking regular exercise? Probably not, but we will continue to tell these people that they are porky slobs who ought to try harder.

In doing so, it is likely that we are condemning them to the sort of yo-yo dieting that results in weight gain, not weight loss.

Obesity 'as bad as climate risk'

reposted from: http://news.bbc.co.uk/1/hi/health/7043639.stm

Obesity 'as bad as climate risk'

Alan Johnson said a "cultural and societal shift" was needed

The public health threat posed by obesity in the UK is a "potential crisis on the scale of climate change", the health secretary has warned.

Alan Johnson said the magnitude of the problem was becoming clear for the first time and "it is in everybody's interest to turn things round".

Details have emerged of a government study which says half the population could be obese within 25 years.

Ministers are drawing up a long-term action plan to tackle obesity.

Greater efforts

The government-commissioned Foresight report is expected to report on Wednesday.

It suggests the cost of the epidemic, in terms of health care provision and lost work hours, could reach £45bn a year by 2050, according to the Observer.

Professor Klim McPherson, of Oxford University, and Tim Marsh, of the National Heart Foundation, predict that

within 15 years 86% of men will be overweight - but not necessarily obese -
(currently 73% - see figure 1 at top)
and within 20 years, 70% of women.

The study showed there had to be "further and faster" efforts beyond existing anti-obesity measures to encourage exercise and healthy eating, Mr Johnson said.

We will only succeed if the problem is recognised, owned and addressed at every level and every part of society Alan Johnson, health secretary

Prime Minister Gordon Brown has backed a long-term action plan to fight obesity, funded by money earmarked in Tuesday's Comprehensive Spending Review.

The government is also due to ask the Food Standards Agency to probe the use of unhealthy "trans-fats", which have been linked to coronary heart disease, in fast food.

But Mr Johnson said individuals also had to take responsibility for their own health as part of a "cultural and societal shift".

He said: "There is no single solution to tackle obesity and it cannot be tackled by government action alone.

"We will only succeed if the problem is recognised, owned and addressed at every level and every part of society."

Life expectancy

Public Health Minister Dawn Primarolo told the BBC that a longer term view needed to be taken of the obesity issue.

She said: "The government has been doing a lot already in terms of healthy foods in schools, sports activity in schools, labelling of food, working with young people.

"This report was part of the development of our strategies.

"But... if we don't act, what will happen in health terms for individuals and for our communities in 10, 20 years' time is really something we that we need to face up to, and that means looking at everything."

Dr Colin Waine - who chairs the National Obesity Forum - said that

in terms of its impact on society, the health threat posed by obesity "will hit us much earlier than climate change".

He added:

"We are now in a situation where levels of childhood obesity will lead to the first cut in life expectancy for 200 years. These children are likely to die before their parents."

reposted from: http://ap.google.com/article/ALeqM5gn5vhYdfDa9UWNdAxIGAh80YFp6QD8SB6G800

An overweight person eats in London, Wednesday, Oct. 17, 2007. Britain's health secretary called Wednesday for a fundamental shift in the way the nation tackles obesity after a study said dramatic action was required to stop the majority of the population from becoming obese by 2050. (AP Photo/Kirsty Wigglesworth)

Report Warns UK of Burgeoning Obesity

By TARIQ PANJA – Oct 17, 2007

LONDON (AP) — Most British citizens could be obese by 2050, a new government report warns, http://www.foresight.gov.uk/Obesity/Obesity_final/14.pdf

and the nation's health secretary called Wednesday for a fundamental shift in the way the nation tackles obesity.

Health Secretary Alan Johnson didn't blame British eating habits, calling obesity "a consequence of abundance, convenience and underlying biology."

"As this report starkly demonstrates, people in the U.K. are not more gluttonous than previous generations and individual action alone will not be sufficient," he said in a speech to Parliament.

The obesity analysis by the Foresight program, run by the Office for Science, concludes that excess weight has become the norm and described Britain as an "obesogenic" society.

Obesity costs Britain the equivalent of $90 million a year already. Obese people have a greater risk for life-threatening conditions, including diabetes, heart disease, and cancer.

The number of overweight and obese people has tripled in the last 25 years. One in four adults are now obese, according to the most recent Health Study for England.

By comparison, about one-third of adults in the United States are obese; two-thirds are overweight.

The Foresight report projects that by 2050, 60 percent of British men, 50 percent of women and a quarter of children and young people will be obese unless drastic action is taken.

The study's authors, who based their findings on research from 250 experts over two years, said there was scant proof that current anti-obesity policies worked. The government pledged to draw up new plans to combat bulging waistlines.

Solutions to the problem will not be found "in exhortations to greater individual responsibility or in the futility of isolated initiatives," the health secretary said.

The report made a series of proposals:

_Earlier action when young children start gaining too much weight.

_Targeting people who are at increased risk.

_Controlling high-calorie foods.

_Changing the design of towns to make them more physically demanding.

_Increasing employer responsibility.

"There is a danger that the moment to act radically and dramatically will be missed," said Sir David King, the government's chief scientific adviser and head of the Foresight report. "It is a problem that is getting worse every year."

King and his fellow authors said obesity was inevitable in developed societies like Britain, where convenience foods, labor-saving devices, cars and sedentary work are part of daily life.

"We are facing a far worse scenario than even our gloomiest predictions," said Philip James, chairman of the International Obesity TaskForce, in a statement. "We need to respond rapidly and decisively."

On the Net:

• http://www.foresight.gov.uk/Obesity/Obesity_final/14.pdf

Obesity 'epidemic' turns global

reposted from: http://news.bbc.co.uk/1/hi/health/7057951.stm

Obesity 'epidemic' turns global

Obesity increases heart disease risk

People are getting fatter in all parts of the world, with the possible exception of south and east Asia, a one-day global snapshot shows.

Between half and two-thirds of men and women in 63 countries across five continents - not including the US - were overweight or obese in 2006.

The Circulation journal study included over 168,000 people evaluated by a primary care doctor.

Experts said the findings were deeply worrying.

Excess body weight is pandemic Lead researcher Beverley Balkau

People who are overweight have a higher risk of heart disease, Type II diabetes and other diseases including some cancers.

The International Day for the Evaluation of Obesity (IDEA) study looked at two measures of fatness - waist circumference and a calculation called body mass index or BMI.

A BMI (weight in kg divided by square of height in meters) of 18.5 to 25 is considered healthy.

A BMI over 25 is deemed overweight and greater than 30 is obese.

Pandemic

Just 7% of people in eastern Asia were obese, compared to 36% of people seeing their doctors in Canada, 38% of women in Middle Eastern countries and 40% in South Africa.

Canada and South Africa led in the percentage of overweight people, with an average BMI of 29 among both men and women in Canada and 29 among South African women.

168,000 people were evaluated by a doctor on a single day. The US was not included in the report. A BMI over 25 is deemed overweight and greater than 30 is obese.

In Northern Europe men had an average BMI of 27 and women 26 - just into the overweight category. In southern Europe, the average BMI was 28. In Australia BMI was 28 for men and 27.5 for women while in Latin America the average BMI was just under 28.

Waist circumference was also high - 56% of men and 71% of women carried too much weight around their middle.

"The study results show that excess body weight is pandemic, with one-half to two-thirds of the overall study population being overweight or obese," said Beverley Balkau, director of research at the French National health research institute INSERM in Villejuif, who led the study.

That puts the rest of the world close to par with the US, long considered the country with the worst weight problem.

168,000 people were evaluated by a doctor on a single day. The US was not included in the report. A BMI over 25 is deemed overweight and greater than 30 is obese.

An estimated two-thirds of Americans are overweight and a third of these are obese. In the US, the lifetime risk of developing diabetes, is also high - 33% for men and 38% for women.

In the study, the overall frequency of heart disease was 16% in men and 13% in women. There was a high frequency of heart disease in Eastern European men, 27%, and women, 24%, in contrast to Canada where the frequency in women was 8%, and in men 16%.

The frequency of diabetes varied across regions. Overall, 13% of men and 11% of women were diagnosed with diabetes.

Ellen Mason of the British Heart Foundation said: "It is tragic irony that whilst much of the world is starving, many developed countries across the world are in the grips of an obesity crisis.

"Whilst it is vital not to stigmatise people in our society for being overweight, it is important we all know the health risks from being obese. The worrying increase of diabetes in the UK is clearly linked to rising obesity levels and plummeting physical activity levels. Being obese or diabetic, or worse, both, increases your chance of getting heart disease.

"Whilst the UK may not be the worst offender in this global study, we are aware that it's a major health issue in our country. After seeing the heart attack death rate reduce in the UK in the last few years, there is a real risk that this figure could go back up if diabetes and obesity continue to rise as they currently are."

A BMI over 25 is deemed overweight and greater than 30 is obese.

Child obesity alert plan pondered

reposted from: http://news.bbc.co.uk/1/hi/uk/7055735.stm

Child obesity alert plan pondered

Obesity is linked to a number of health problems

Parents may be warned if their children are found to be overweight, under Department of Health (DoH) proposals.

Children in England and Wales are currently measured at the ages of five and 10 but parents are informed of the results only if they request them.

But the figures may be given to parents automatically under the new plans.

The DoH said ministers were prepared to go further and faster in the fight against childhood obesity, although no firm decisions had been made.

Between a quarter and a third of children are thought to be overweight and doctors fear there will be an epidemic of poor health related to obesity in coming decades.

An obese person dies on average nine years earlier than somebody of normal weight, while a very obese person's life is cut short by an average of 13 years.

Under the proposals being considered, information obtained under the national measurement programme could be given to parents automatically.

And involvement in the measurement scheme may become compulsory unless people choose to opt out of the scheme.

Early education

Tam Fry, from the National Obesity Forum, said child obesity was a "huge problem to overcome".

He said: "It's a good thing in the sense that if the government expects parents to [have] prime responsibility for the raising of their children, it is absolutely essential that they should know what the healthy range of weight is.

"We would think, in fact, this whole thing has got to start earlier.

"If you start earlier, around the age of two and three from nursery, then you've got the time to start to implant the healthy eating, healthy exercise education, which will then carry them through school."

Mr Fry added that the Forum would even like to start to promote this mode of lifestyle "from conception".

A recent report by the Foresight Programme argued that dramatic and comprehensive action was required to stop the majority of us becoming obese by 2050.

Its authors predicted that if current trends continue, in that year, 60% of men and half of women will be obese and cases of type 2 diabetes will rise by 70%.

The report also suggested that cases of stroke will rise by 30% by the middle of the century and cases of coronary heart disease will rise by 20%.

reposted from: guardian

Fat chance

The window of opportunity to tackle the obesity crisis is rapidly closing and the present token measures will be totally ineffectual.

Neville Rigby

Another Wanless review warns of dire consequences unless radical action is taken to aid the recuperation of an ailing health service and its clientele. Yet it should surprise no one that

obesity continues its remorseless upward trend and that this will impose an extraordinary burden - even greater than it already does - on the already stretched health system, the economy and, implicitly, on people's lives and wellbeing.

The latest report from Derek Wanless and his team refers to key determinants that have worsened since his 2002 review, "particularly the unforeseen rise in adult and childhood obesity". Unforeseen? This would depend upon which direction one is looking.

Evidence of the decline in healthy weight and the across-the-board increase in the average weight of the entire population and, with it, the continuing growth in obesity, has been monitored annually and headlined in government statistics ever since the Health of the Nation white paper

in 1992 established the improbable target to return adult obesity rates to the 6-8% level they were a quarter of a century ago.

The target was abandoned, but the alarm bells have continued to ring.

Sir John Bourn, comptroller and auditor general, presenting the National Audit Office's first report on obesity told parliament in 2001:

"Nearly two thirds of men and over half of women in England are now overweight or obese.

And the problem here is increasing faster than in most other European countries. If prevalence continues to rise at the current rate,

more than one in four adults will be obese by 2010

. This would significantly increase the incidence of associated diseases, such as coronary heart disease, and would cost the economy over £3.5bn a year by that date."

As a deliberately conservative prediction, this underestimated the scale and cost of the problem. Wanless notes higher levels of obesity predicted by 2010, when some 33% of men, 28% of women, and one in five boys and girls will be obese.

Even if the Department of Health's Public Service Agreement (PSA) target to halt the year on year increase in obesity in children under 11 is reached by then - and it won't be - it would mean accepting as some sort of achievement that only 20% of our children will be obese.

The consequences of failure to tackle obesity was made clear in the government's 2004 white paper Choosing Health, which forecast an 18% increase in heart attacks, 28% increase in hypertension, and a 54% increase in type 2 diabetes by 2023. Yet there seems to be little real political appetite to take more effective preventive measures that might avert this costly scenario and permit the next generation to grow up at a healthier weight than their parents.

The nod towards a healthier diet is little more than that - with the focus on lifestyle choices leaving individuals to take the initiative. We make do with small gestures such as free fruit for a few infants but not for all children, or an allowance - the equivalent to the price of a weekly cappuccino - for pregnant women to improve their diet, but not given until it is too late to make any difference to those in real need.

The fundamental need to make comprehensive improvements across the entire spectrum of the food on offer, and to protect children effectively from the promotion and availability of junk food has still to be properly addressed.

To halt the obesity trend requires more realistic and comprehensive approaches to improve the quality of the nation's diet - and activity.

We should recognise, as we did with smoking, that the external costs of continuing the unbridled promotion of a vast range of poor nutritional value products will be borne by all of us, not just in the enormous burden on health services, but in many other aspects of daily life.

The cost of obesity in the US already exceeds $125bn a year - and is rising. The UK is following the same downward spiral. The trends and consequences can no longer be called "unforeseen".

It is time to take much bolder steps in a different, healthier direction.