Should Europe follow in UK footsteps with childhood obesity strategy?

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As the UK’s childhood obesity strategy turned one last week, health campaigners lined up their critiques of the first 365 days. However, the government managed to sidestep any bad press by announcing an expansion of the plan’s focus (from sugar content to calorie counts) and funding for a new €5.4m (£5m) obesity research policy unit.

The news was welcomed by manufacturers (warmly) and by health groups (tentatively). But look more closely at what the government has said and there is very little detail. What’s more, a number of the commitments made in the plan – published on August 18, 2016 – have yet to see the light of day. And the less action the government takes, the more the plan becomes reliant on its one flagship policy – the tax on sugar-sweetened drinks. That is a dangerous game to play.

“Complex problems like obesity require a multi-sectoral, 'all-of-government' approach,” explained Alexandra Wright, an expert in social policy at the University of Edinburgh. “To ensure that one type of intervention, such as a public health tax, isn't 'blamed' politically for wider, systemic failures to address complex problems like obesity, it's important to be very clear about the particular goals of the tax and then measure it against those specific criteria.”

The principal aim of the obesity plan is to “significantly reduce England’s rate of childhood obesity within the next 10 years”. Vague as that may be, it’s unlikely that a levy on sweet beverages will be enough to keep that promise. This puts the onus on the rest of the package, which currently offers “thin gruel” in terms of effective policies, according to Malcolm Clark at campaign group the Children’s Food Trust (CFC).

"The government may have the cheek to call it a 'world-leading' obesity plan, but only a couple of elements come anywhere close, and on tackling marketing and promotions the UK is still way behind,” he said.

Mad about marketing

Indeed, the new calorie reduction programme targeting categories like pizzas, burgers and snacks sounds ominously similar to one of the pledges in the public health responsibility deal that was scrapped in 2015. And despite efforts this year to expand the rules on the marketing of foods high in fat, salt and sugar (HFSS) to non-broadcast media (including social media), the industry-led regulations are far from perfect.

“We can’t ignore the fact that the food industry continues to get away with bombarding children with adverts that we know encourage unhealthy food choices,” said Caroline Cerny, lead at the Obesity Health Alliance, a coalition of 40 health charities, medical royal colleges and campaign groups.

“The [Committee of Advertising Practice] regulations are full of loopholes and don’t reflect the way children watch TV or online content. Failing to tackle this area is significantly undermining the impact of the childhood obesity plan,” she added.

It’s not just campaigners that have raised concerns about marketing. In November, the World Health Organisation claimed that poor regulation of powerful digital adverts is undermining other actions taken to tackle rising levels of childhood obesity. More recently, the World Bank highlighted the “aggressive and sophisticated way” in which processed foods are promoted and advertised, and recommended that governments should step in. Europe’s health ministers have also suggested that self-regulation might not be working.

If the ongoing review of the audio visual media services directive is anything to go by, there appears little hope of intervention. But the UK does want to assess the evidence again: the new policy unit will “look to develop a deeper understanding on the causes of childhood obesity, including marketing to children and families”.

But is this a tactic to delay any hard decisions? Some would argue that the evidence compiled by WHO, the World Bank and Europe’s health campaigners is enough. “The evidence is overwhelming,” argued Laura Bauld, professor of health policy at the University of Stirling, citing examples of countries in which children are “better protected from junk food marketing”, like Finland, Norway and Sweden.

Who dares wins

Indeed, across Europe there are policies in place to tackle obesity but little sign of these being brought together in a truly world-leading strategy. The UK has tried, but only time will tell if the strategy is as “severely limited” as some suspect. None of these interventions will curb obesity overnight, of course.

So, where does this leave other member states that might be toying with the idea of obesity plans of their own? Will they be inspired to go further than the UK, or reticent to face the wrath of campaigners and industry?

“Without wanting to pass judgment on whether the UK strategy is up to the challenge of fighting child obesity or not, I think the principle of introducing a strategy should act as inspiration for other European countries,” said Nikolai Pushkarev, policy coordinator for food, drink and agriculture at the European Public Health Alliance.

“I think more national strategies on childhood obesity will be introduced in the coming period. Our hope and expectation is that they will be designed and implemented to deliver,” he added.

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