170224_TSF_BlogHero_01How do we get a nation to eat well, with the aim to improve health and wellbeing, short and long term?

It is always going to be complex. And a recently released report from the Obesity Policy Coalition, involving Deakin University, The Australian Prevention Partnership Centre and Informas, have some suggestions for government on how to do so.1

The project team worked with government officials across local, state and federal levels to document current policy actions over 42 policy areas covering factors that can impact the diet of a population, as well as policy implementation infrastructure, as at June 2016.

Each policy was assessed by a group of over 100 experts from 53 organisations for the extent of policy implementation by each level of government, followed up by some recommendations.

Experts included senior representatives from health non-government organisations and community groups, nutritionists and academics, and the study authors are under no misconceptions to think that there is a single, simple policy approach, like a sugar tax or a ban on junk food in schools.

“There is no silver bullet to helping people eat more healthily,” says Dr Gary Sacks, lead author on the report. “We know from international evidence that we need coordination across federal, state and local government to implement a whole suite of different policies to tackle the problem.”

Some policy suggestions

At a national level, areas of priority include developing and implementing a plan for improving population nutrition; enforced regulations for marketing of unhealthy foods to children (as the current self-regulation set-up ain’t working); and taxes to increase the cost of unhealthy foods – like sugar-sweetened beverages. 1

Various policies currently implemented by states and territories are doing well. The report noted that each has a policy for healthy eating in schools, which is great, but such policies need to ensure increased awareness, compliance, and on-going support.

The report also made recommendations specific to the food industry.

At a federal level, clear guidelines need to be implemented for the various stakeholders in policy development. Where food industry and representatives have conflicts of interest with improving nutrition of the population, they should not be involved in setting policy objectives.

It is also recommended that food manufacturers (and associated entities) be added to the list of prohibited political donors.

Prohibiting food industry influence on nutrition policy and guidelines is important.

Food industry lobbying, funding and other influential tactics have been found to impart serious political sway, resulting in weakened policy response when addressing diet-related disease among the population.2

The U.S. government has been seen to be influenced by the food industry in this respect, including attempts to divert attention away from the detrimental health effects of nutritionally poor products like soft drink or heavily refined grains, to focus solely on exercise or influencing research outcomes, for example.

“Food products such as sugar-sweetened beverages were not primarily developed to cause harm, but when harm is demonstrated it is often denied or challenged by those with vested interests,” says Professor Stephen Colagiuri, Metabolic Health and Director of The Boden Institute at the University of Sydney.

Taxing unhealthy foods is another area proposed to the government, and (despite push-back from particular politicians who believe food choice, health and obesity are only about personal responsibility) warrants consideration.

By adding a tax to foods that offer little nutritional value – like sugary drinks – they are more expensive and less appealing to buy. The revenue from that tax can be redirected to subsidies for fresh produce, providing nutrient-dense food that is affordable and accessible to all.

“It can’t be that we are all inadequate human beings the problems is we live in an environment where junk food is everywhere, it’s heavily marketed and in a lot of cases it’s really cheap,” says Dr Sacks.

It has been projected a combined tax and subsidy package could save the Australian government $3.4 billion in healthcare over a person’s lifetime by improving health and quality of life.3

Yes, there isn’t a G.S.T. on fresh produce that is applied to many packaged and processed foods. Therefore, in theory, the fresh produce is affordable. But we are still not eating enough of the nutrient-dense whole food fresh produce like vegetables and fruit.4 So, somewhere along the line, there seems to be a disparity of what we think is affordable or accessible, and what actually is.

Another policy proposal is the reformulation of the Health Star Rating scheme, which, as long-time That Sugar followers know, is flawed, and once amended, should be made mandatory on all packaged food and drink.

There are plenty of other proposals – check out the full report: http://www.opc.org.au/downloads/food-policy-index/AUST-summary-food-epi-report.pdf

Why should the government consider addressing diet-related health policy?
When current research finds that 75% of Australians aged 9-18 exceed the limits for added sugar intake set by the World Health Organisation,5 a sugar tax or intervening the food industry’s influence over healthy policy mightn’t seem so crazy.

Incidence of non-communicable, chronic disease is on the rise, here and in around the world, influenced by factors such as what we eat, exercise, stress, our environment, and obesity. 6-7

In Australia, 63.4% of adults were recorded as overweight or obese.8 The concern is not aesthetics and “the problem is not excess weight per se, but the serious health consequences that stem from being overweight or obese,” says Professor Nicholas Talley, chair of the Council of Presidents of Medical Colleges.

Regularly overeating or drinking too much sugar-sweetened beverages can play a large part in weight gain for some. But obesity is complex – often it is not a simple matter of eat less move more.

“We don’t really control our food choices”, says Professor Colagiuri. “Over many years, food manufacturers have increased the size of a standard sugar-sweetened beverages portion by approximately three-fold in the knowledge that larger containers alter the norm of appropriate portion sizes and increase consumption.”

We must always consider the influence of clever marketing of highly palatable and moreish (a.k.a. somewhat addictive) foods, as well as their affordability. These foods not only provide a source of energy with little nutrition compared to the real, whole food counterparts, but they often come packed with all manner of additives, preservatives and flavours that each or in combination could affect body response.

It is recognised that schemes focusing on moving more or a sugary drink tax are not enough on its own. Everything we put into our mouths has the potential to heal or harm, and understanding the relationship between food and health, and implementing education and guidance on this is necessary, complex, and requires a multi-pronged approach.

Personal responsibility for one’s health is a part of the picture. And policy isn’t about the government dictating every morsel we eat. Instead, it can assist the individual or caretaker (i.e. parent) make better and informed choices.

To enable people to make health supportive food choices, the government can help by engaging appropriate stakeholders and discourage the food industry influence on health policy; intervening the influential unhealthy food marketing machine; and providing for all education, support, and access to affordable real, whole, nutrient-dense food.

By Angela Johnson (BHSc Nut. Med.)

 

References:

  1. Obesity Policy Coalition 2017, Policies for tackling obesity and creating healthier food environments, viewed 20 February 2017, <http://www.opc.org.au/downloads/food-policy-index/AUST-summary-food-epi-report.pdf>
  1. Mialon, M Swinburn, B Allender, S & Sacks, G 2017, “‘Maximising shareholder value’: a detailed insight into the corporate political activity of the Australian food industry”, Australian and New Zealand Journal of Public Health, [ePub ahead of print].
  2. Cobiac, LJ, Tam, K, Veerman, L, & Blakely, T 2017, ‘Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study’, PLoS Medicine, vol. 14, no. 2, pp. 1-18.
  3. ABS 2014, Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011-12, viewed 21 February 2017, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.007main+features12011-12>
  4. Colagiuri, S 2017, The obesity epidemic and sugar-sweetened beverages: a taxing time’, Medical Journal of Australia, vol. 206, no. 3, pp. 109-110.
  5. AIHW 2014, Leading types of ill health, viewed 20 February 2017, <http://www.aihw.gov.au/australias-health/2014/ill-health/>
  6. Talley, N 2017, ‘National Health Summit on Obesity calls for Australia to take action to stem the pandemic’, The Medical Journal of Australia, viewed 20 February 2017, <https://www.mja.com.au/journal/2017/206/3/national-health-summit-obesity-calls-australia-take-action-stem-pandemic>
  7. ABS 2015, Overweight and obesity, viewed 20 February 2017, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2014-15~Main%20Features~Overweight%20and%20obesity~22>