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Scottish Cancer Prevention Network | Putting Prevention First

Changing our Culture of Excess

by Louise Codling, Head of Policy and Public Affairs at World Cancer Research Fund.

Our analysis of global research shows strong evidence that being overweight or obese is linked to an increased risk of several cancers. These findings come at a time when there is a growing trend of overweight and obesity around the world. Globally there are around 1.9 billion people who are overweight or obese, and this number is increasing in both higher and lower income countries. It is clear that more needs to be done to tackle overweight and obesity by reducing the amount of unhealthy food that people eat. However this is incredibly complex and requires action at every possible level, from government right down to the individual.

Governments and policy makers

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A huge hurdle in tackling overweight and obesity is that we live in an obesogenic world. Everywhere we look we are encouraged to make unhealthy decisions that make it easy to eat large amounts of high-calorie food and put on weight. These encouragements come under the guise of price promotions on unhealthy foods, sweets at supermarket checkout counters, junk food advertising to children, unhealthy food in hospital vending machines – the list goes on. The incentives to eat junk food in excess has a huge impact on health systems, which are struggling to deal with an increase in nutrition-related non-communicable diseases, such as various cancers, heart disease and type 2 diabetes.

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Governments play a vital role in making it easier to be healthy and ensuring that the healthy choice is the preferred choice. This starts with implementing policies that create an environment in which unhealthy behaviours are discouraged. Good examples of policies that have been implemented to encourage healthier behaviours include nutrition guidelines for schools, restrictions on junk food marketing to children and taxes on sugary drinks, but much more needs to be done. Our NOURISHING database describes policies that have been implemented around the world to tackle unhealthy diets and highlights gaps in policy action that need to be filled.

The individual

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Changing the amount of unhealthy food a person eats can be very difficult. One of the reasons for this is that physiologically, the human body has maintained an evolutionary craving for high calorie foods, which during prehistoric times helped humans to survive. It is because we are hard-wired to crave fat and sugar that we can find it hard to resist high calorie foods. Unfortunately, the food industry use this to their advantage by engineering high calorie foods which play to our evolutionary cravings. Personal responsibility for health is important, but in a world that is so obesogenic, it can be a hard battle to fight.

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To increase the chances of living a long and healthy life a good place to start is being aware of how industry is manipulating our eating habits. Other steps could include tracking BMI status and cooking healthy meals from scratch whenever possible.

Although a complex battle, it is essential that we take action at every level to change our culture of excess – only then can we stop the overweight and obesity crisis spiralling out of control.

Our obesogenic, carcinogenic environment – a legacy for our children

The relationship between obesity and cancer has been well described…and well ignored! Exposure to excess body fat will contribute to increased risk of some of the most common cancers including bowel and breast. Yet, few agencies working in the cancer settings (including the NHS) bring this to the attention of the millions of people who are in contact with healthcare every day. Many think it is a duty of care for people to be given advice on how to “stack the odds” against cancer occurrence (and recurrence) and that we deny people the opportunity to be supported to reduce cancer risk.

 

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Support for obesity reduction isn’t just about giving advice and guidance on diet and physical activity from health professionals. The reality is that “individual choices are highly influenced by the combined effect of retail marketing, price and promotions”. The Scottish Food Leadership report (prepared to guide the National Food and Drink Policy) highlighted that “the influence of Scotland’s well-crafted health education programmes …are competing with media and commercial messages which lead to confusion and poor comprehension of basic messages. This, in turn can lead to inaction.”

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Whilst many advocacy groups acknowledge that marketing of high energy foods and drinks should be restricted to children (e.g. on television) we need to remember that adults too are influenced by bright bargain offers. A focus on childhood obesity may be politically acceptable, but it will have minimal effect on the two thirds of adults who have excess body weight and the many women who experience weight gain throughout adult life and are thus at risk of increasing post–menopausal breast cancer.

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The new Childhood Obesity Action plan for England provides a good example of how to shirk the problem of adult obesity. Yes we will see a soft drinks levy, yes we will see some modest reduction in sugar which may impact a little on adult sugar intake (and calories if fat intake does not increase) but to take no action on promotions and marketing is a major omission.

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In Scotland, we look forward to more action on marketing and promotions across all sectors. The Healthcare Retail Standard for use in NHS settings limits promotions of energy dense foods and drinks. Food Standards Scotland newly published 5 year strategy highlights that adjustments to marketing, promotions (as well as reformulation) is needed in order to minimise consumption of  ‘discretionary’ foods (unnecessary, less healthier foods e.g. crisps, sugary drinks, cakes and pastries) and drinks. In January, the FSS Board recommended a package of measures to Scottish Ministers with proposals including fiscal measures and regulation around food and drink promotions. If the food industry cannot achieve effective change by voluntary means- hope of serious approach at last! Of course if Scotland’s food commission still believes in the effect of retail marketing described in their food leadership report we should also see a strong steer here too.

Clearly time for Scotland to lead the way for obesity reduction… yes please!

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Attention to Action

Every day the evidence grows. Every day we learn more about how obesity affects our health. Every day the media give this issue attention. But is this translating into action?

The recent report from IARC reaffirms the significant health consequences associated with excess weight.  We need to take action now to reduce future cancer incidence.

Continue reading “Attention to Action”

Losing Weight Feels Good

The association between body fatness and cancer risk varies by cancer site and by body size. What is clear however, is that aiming to achieve a Body Mass Index at the lower end of the healthy weight range is desirable (see WCRF recommendations on body fatness). The European Code Against Cancer guides us to “take action to be a healthy body weight.

Continue reading “Losing Weight Feels Good”

Avoiding excess body fatness makes sense!

The recent IARC report on cancer prevention concludes that the absence of body fatness lowers cancer risk, and that intentional weight loss (based largely on research from animal studies) has a causal cancer preventive effect. Never too late to start weight management strategies…or indeed too early. Continue reading “Avoiding excess body fatness makes sense!”

Recognising and overcoming an alcohol addiction

We are very grateful to an SCPN member, now an independent researcher, for sharing this very personal but hopeful account of her struggle to overcome her problem drinking.

I am now in control of my drinking. It feels good to say that, yet somewhat uneasy, as it’s never a ‘done deal’. I started drinking at 18, and it has taken me 16 years to get to a place where I can say that without an inkling of guilt, without wincing at the odd indiscretion or blow out.

I started drinking heavily at University. I went to the University of Sussex, near Brighton, which is an amazing place to be a student! There were several on-campus bars, and there was one literally 30 paces from my shared accommodation. It was great to get to know new people, and the cheap snakebites were a great conversation facilitator. It was acceptable to go every evening after dinner; there was no judgement. It helped us bond at a time when that felt so monumentally important for all that lay ahead of us.

Continue reading “Recognising and overcoming an alcohol addiction”

Life skills for adult physical activity: The basics first…then Wimbledon!

The current recommendations for health, wellbeing and cancer risk reduction highlight the importance of physical activity. Sometimes people mistakenly refer to exercise when they mean physical activity, and therein lies the potential for a whole load of biased views, often stemming from negative experiences of sports and exercise in schooldays.

Continue reading “Life skills for adult physical activity: The basics first…then Wimbledon!”

Improving Referral for Colonoscopy

On the 7th June 2016, the Westminster Government approved the recommendation of the UK National Screening Committee (UK NSC) to replace the current test used in the NHS Bowel Cancer Screening Programme (BSCP) in England with a newer test, the Faecal Immunochemical Test for haemoglobin (FIT). The Scottish Government had already announced the change from the traditional guaiac-based faecal occult blood test (gFOBT) to FIT on 18th February 2015. The rationale for these advances have been very well documented, as have the many advantages of FIT over gFOBT.

Continue reading “Improving Referral for Colonoscopy”

Confessions of a Converted Pedestrian: When Worlds Collide

Spring has sprung and very welcome it is too. Nights are lighter, the weather’s a little better…and every single member of the human race has made their individual way to precisely the same outdoor places as me!

Continue reading “Confessions of a Converted Pedestrian: When Worlds Collide”

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