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Fight childhood obesity with multiple methods, not just more taxes, MPs hear

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1963 (Published 02 May 2018) Cite this as: BMJ 2018;361:k1963

Re: Fight childhood obesity with multiple methods, not just more taxes, MPs hear

The Institute of Health Promotion and Education strongly agrees with nutrition experts - “the ongoing battle to reduce childhood obesity must be fought on several fronts”.(1) For this epidemic there are no “silver bullets” or quick fixes. A multifaceted campaign is needed supporting children and their families and at the same time, tackling obesogenic environments.(2,3)

Many healthcare professionals could help promote healthy eating, and doctors, especially GPs, could play crucial roles.(3,4) Importantly, as community leaders they could advocate for change. They could also use their many contacts with parents and their children to encourage healthy eating habits. However, these roles may not be easy to undertake in parts of the country with GP shortages. Capacity issues will need to be addressed.(5,6)

In schools, school nurses, teachers and catering staff could all help to establish healthy dietary habits. Health promoting schools need to be established: but it is essential that staff are trained and supported.(7,8)

We urge the Government to take the following 10 important steps to tackle the childhood obesity epidemic:
I. Create a long term child healthy eating strategy that is matched to the scale of the problem.(9)
II. Continue with reformulation of food including adjusting portion sizes.(9)
III. Apply subsidies for healthier options and taxes on less healthy products.(3,9)
IV. Improve food labelling. The traffic-light system should be compulsory.(3,10)
V. Regulate marketing and promotion.(3)
VI. Promote healthy food in key settings including hospitals and schools.(3,4,11)
VII. Increase the promotion of breastfeeding.(4,12)
VIII. Make PSHE compulsory in all schools.(8)
IX. Ensure that doctors and nurses are trained and have sufficient time to act on this issue.(4,5)
X. Give adequate resources to Directors of Public Health so that they can coordinate, train and galvanise key professional groups.(13,14)

Reductions in obesity will take a long time to achieve, however, we believe if these actions were to be undertaken, we would begin to tackle the obesity epidemic. As a society we should be promoting children’s health and not allowing them to be prone to preventable diseases such as certain cancers, heart disease, type 2 diabetes and mental health issues.(4) Bold and powerful actions are needed to protect children from future ill health.

References
1) O’Dowd A. Fight childhood obesity with multiple methods, not just more taxes, MPs hear. BMJ 2018;361:k1963.

2) Watson M and Lloyd J, 2015. Taxing sugar should be just one element of a multifaceted campaign BMJ 2015;351:h4388

3) BMA Food for thought: promoting healthy diets among children and young people. London: BMA 2015.

4) Academy of Medical Royal Colleges. Measuring Up: The Medical Profession’s Prescription for the Nations Obesity Crisis. London: Academy of Medical Royal Colleges 2013.

5) Baker M, Ware J, Morgan K. Time to put patients first by investing in general practice. Br J Gen Pract 2014;64:268-9. doi:10.3399/bjgp14X679921. 24868041.

6) Watson M C and Forshaw M, 2016. Tackling the crisis in general practice. Prioritising prevention and health promotion BMJ 2016;352:i1333.

7) Thompson S R, Watson M C, and Tilford S. The Ottawa Charter 30 years on: still an important standard for health promotion. International Journal of Health Promotion and Education. 2018,56(2), 73-84.

8) Institute of Health Promotion and Education. 2015. IHPE Position statement: PSHE in Schools. Welwyn: IHPE. http://ihpe.org.uk/wp-content/uploads/2017/11/IHPE-Position-Statement-PS...

9) Watson M and Lloyd J, 2016. Re: Taxing sugar. British Medical Journal Rapid Response 21st March 2016. http://www.bmj.com/content/352/bmj.h6904/rr-0

10) Watson M 2013 Consistent food labelling system is rolled out across UK. BMJ Rapid Response 23rd June 2013.
http://www.bmj.com/content/346/bmj.f4010/rr/651049

11) Watson M and Lloyd J, 2013 It’s time to ban junk food on hospital premises. BMJ Rapid Response 1st July 2013. http://www.bmj.com/content/346/bmj.f3932/rr/652126

12) Institute of Health Promotion and Education. 2017. IHPE Position statement: Breastfeeding. Welwyn: IHPE. http://ihpe.org.uk/wp-content/uploads/2017/11/Postion-statement-Breastfe...

13) Watson M C and Lloyd J, 2016. Need for increased investment in public health BMJ 2016;352:i761.

14) Watson M and Tilford S, 2016. Directors of public health are pivotal in tackling health inequalities. BMJ 2016;354:i5013.

Competing interests: No competing interests

07 May 2018
Michael Craig Watson
Associate Professor of Public Health.
Tim Theaker, Trustee, Institute of Health Promotion and Education, Welwyn AL6 0UD, UK. http://ihpe.org.uk/
University of Nottingham, Faculty of Medicine and Health Sciences, Queen's Medical Centre, Nottingham. NG7 2HA.