Obesity – policy talk

Naveed SattarBHF Cardiovascular Research Centre

University of Glasgow

Lean, Gruer, Alberti, Sattar (2006) BMJ

Changing prevalence of obesity in the UK

Prevalence of obesity (BMI > 30) in UK women 1994 - 2002

Medical Complications of Obesity

Phlebitisvenous stasis

Coronary heart disease

Pulmonary diseaseabnormal functionobstructive sleep apneahypoventilation syndrome

Gall bladder disease

Gout

Diabetes

Osteoarthritis

Nonalcoholic fatty liver diseasesteatosissteatohepatitiscirrhosis

HypertensionDyslipidemia

Cataracts

Skin

Pancreatitis

Idiopathic intracranial hypertension

Cancerbreast, uterus, cervix, prostate, kidneycolon, esophagus, pancreas, liver

Gynecologic abnormalitiesabnormal menses/ infertilitypolycystic ovarian syndromeNumerous pregnancy comps.

Stroke

Primary driver for epidemicOvereating or under activity?

Jeffery RW, Harnack LJ. Evidence Implicating Eating as a Primary Driver

for the Obesity Epidemic. Diabetes 2007;56:2673-6

Yet lots of increased activity studies – largely negative

“What is provided is what is eaten”Lean...Sattar (2006) BMJ

• Fast foods: highly dense, fat and sugary

– MacDonald's Big mac with milk shake >1200 calories

• Taste buds develop liking for fatty and sugary food (e.g. Irn Bru with Crisps)

• Not accustomed to fruit, veg , healthier, less dense foods

Marketing?

BOREDPANDA.com

Where can we intervene

• Governmental engagement? Real or not?

– If real, what can they do?

– Sugar drinks tax – likely positive minor effect

– Other legislation?

• School - change food philosophy

– Activity programmes alone will not work

– More emphasis on nutritional education?

– Provide better quality lunches e.g. in France

Food, retail and catering Industry

• “Increase healthy options”

• “increase range of portion sizes”

• “promoting fruits and vegetables”

Food, retail and catering Industry-HALF A STORY!

• “Increase healthy options”

• “increase range of portion sizes”

• “promoting fruits and vegetables

• DECREASE LESS HEALTHY OPTIONS

• DECREASE LARGE PORTION SIZES

• DECREASE CONFECTIONERY OPTIONS

• At very least Level playing field…….

• Taxation? Cutting consumption in Mexico, Hungry

Other potential ideas?

• Calorie content of all foods in BIG writing

• Time for a snack

– Latte (250) and cream cake (350) = 600kcal

– Coke and crisps = 280 kcal

– Tea and banana = 90kcal

• Harder to solve than smoking – we have to eat!

– Food and drink Industry – huge money maker for government

50 mins discussion

• Anything goes

• What is realistic?

• Where can we make a difference?

• Collaborations?

• How to measure outcomes?