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BMJ 2004;329:54 (3 July), doi:10.1136/bmj.329.7456.54
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EditorManaging risk is concerned with a hierarchy of control in which controlling a dangerous environment is the best strategy for limiting riskfor example, taking people off operating machinery by automating processes. The study by James et al on preventing childhood obesity by reducing the consumption of carbonated drinks seeks to limit the risk of obesity but its method, using health promotion, is analogous to walking around a factory with a megaphone shouting: "Watch yourselves on those dangerous machines!"1
Life is not that complex despite our attempts in medicine to pretend that it is. My generation ate more junk food than this poor generation could ever dream of. In the 1970s we ate pork pies, scotch pies, Spam, corned beef, cake, biscuits washed down with dilute orange squash. I was, however, fit and slim. How can this be so?
Childhood obesity is not caused by diet but by a lack of
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Des Spence, general practitioner
Maryhill, Glasgow G20 9DR destwo@yahoo.co.uk
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