By Professor Annie Anderson
At the SCPN we take obesity as a risk factor for cancer seriously. Last year I worked with the (WHO) International Agency for Research on Cancer (IARC) on a new analysis for a forthcoming handbook on body fatness and cancer.
The key findings were summarised by a paper in the New England Journal of Medicine. Amongst the key points made were that the absence of excess body fatness lowers the risk of most cancers. Thirteen cancers were identified as having sufficient evidence to show a significant relationship with excess body fat. The data is not just interesting but highlights opportunities for significant cancer risk reduction through weight management. In Scotland, we need to take this evidence seriously. Two-thirds of our population are overweight or obese and as Obesity Action Scotland highlight ”Scotland can’t stomach it any longer”. We have seen some brave ambitions set out by Food Standards Scotland. Can Scottish government really take effective action?
At the end of last year, the Health and Sports Committee of the Scottish Government held a focused inquiry into obesity on Tues 6th December inviting a few organisations for insights. The session looked at the obesity strategy in terms of what was and was not achieved, what might be the new obesity strategy exploring diet and physical activity dimensions.
What is agreed is that Scotland needs a bold and brave strategy for tackling obesity. There will be no “one size fits all”. In our blog published on January 1st, we reflected on what has happened in 10 years and where we might progress. This week we are continuing this theme and have asked SCPN members who have many years experience in the obesity field to give us their top 5 aspirations for the forthcoming obesity strategy?
First off, Joyce Thompson, Chair of the Scottish Board of the British Dietetic Association shares her thoughts:
1. Scottish Government formally recognises as an inclusive human right, the right to food (i.e. all the nutrients that a person needs to live a healthy and active life, and to the means to access them). Rationale – everybody in Scotland should have the resources, abilities and facilities to purchase, prepare and cook fresh, healthy and affordable food, no matter where they live.
2. Scottish Government evaluates the concept of initiatives aimed at improving access to high quality low cost foods such as ‘community shops’ and ‘social supermarkets’ (these are specifically for people on low incomes and are like conventional supermarkets but utilise surplus products and apply different retail strategies e.g. some products are sold at a significantly lower consumer price). Rationale – there is a rise in demand for food assistance and we need to address food poverty.
3. Increase the power and requirement for local authorities to regulate the establishment of fast food outlets including mobile food vans. Rationale – we live in an increasingly toxic food environment whereby the fast food industry successfully influences eating patterns in the opposite way needed for health.
4. All public sector organisations should be made to apply strong and affordable nutrition standards and healthy food policies for food and drink served in public facilities and local/central government buildings, as well as food and drink purchased with government funds. These standards also require being regulated. Rationale – public sector should be exemplary advocates.
5. Bring together colleagues from across NHS and commercial and third sector weight management services and others to review the current arrangements for managing/supporting overweight/obese people across Scotland so as to identify opportunities to manage demand/need in both NHS (primary and secondary care) and wider community (commercial, third sector) settings. Rationale – obesity and obesity-related disease are crippling the NHS and; Scotland needs to develop a more joined up and cooperative approach to support the 30% children and 65% of adults are already overweight/obese as it is neither appropriate nor affordable for the NHS to take sole responsibility for the provision of weight management services.
6. The Scottish Government should apply a regulatory framework to phase out price promotions of foods and drinks high in fat and sugar. Rationale – promotions encourage people to buy more of a product. The balance of promotions in Scotland is in favour of high sugar and fat food and drinks (50% vs 30%) and so most promotions involve junk food and sugary drinks.