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How governments can tackle obesity in their country | Aetna International

The world’s growing problem

According to the World Health Organization (WHO), obesity rates have more than doubled since 1980. Today, 13% of adults and 6.3% of children are obese. And that’s globally. Without intervention, overweight and obese children are likely to struggle with weight into adulthood.

Read our introduction to ‘globesity’ here, and access Aetna International’s 2017 white paper on the subject here.

So what can be done? And who should do it?

Many decry the interference of the ‘nanny state’, but governments play an essential role in helping consumers improve their diets and lifestyles. Through a thoughtful combination of education programmes, taxes and incentives, governments can nudge consumers and food producers in the right direction.

Research shows that when governments act, they can have a positive effect. 

In 2005, the Japanese government unveiled the Japanese Food Guide Spinning Top. This model illustrates the proper balance and quantity of different foods — milk and fruit are at the bottom, grain and vegetable dishes are at the top — while emphasising the importance of physical activity. (That's the spinning part.)

To gauge the model’s effectiveness, researchers surveyed nearly 80,000 patients at 11 public health centres across the country to determine their adherence to the dietary guidelines.

Those who followed the guide the most closely had a 15% lower mortality rate than those who followed it the least.[1]

Comparable results have been documented in China, whose Chinese Food Pagoda model offers similar guidance as the Japanese Food Guide Spinning Top. Unfortunately, most consumers don’t have time to seek out dietary guidelines. Instead, harried shoppers rely on food labels to determine what to buy and what to leave on the supermarket shelf. Here too governments can play a role by mandating labelling that offers clear, simple nutritional information.

Food labelling

In 2011, the European Commission implemented mandatory labelling of:

  • calories
  • total fat
  • saturated fat
  • carbohydrates
  • sugars
  • protein
  • salt

Unfortunately, research to date has not shown a clear impact.

Consumers seem to be influenced more by brand, taste, convenience and family preference than by a calorie label they spend just 25–100 milliseconds scanning.

What does it all mean?

One challenge is that people have a hard time connecting data on a label with the actual health impacts. In fact, more than a third of Europeans mistakenly think that a child needs more calories than an adult male.

More explicit labels are clearly needed.

Recently, researchers in the United States tested the relative effectiveness of warning labels versus calorie labels on sugar-sweetened beverages (SSBs).

Parents who saw a label reading “Safety Warning: Drinking beverages with added sugar contributes to obesity, diabetes and tooth decay” were significantly less likely to purchase SSBs than 

  • those who saw a simple calorie label.
  • Most said a warning label would change their belief about a beverage’s healthfulness and would encourage them to purchase fewer such beverages for their children.
  • And nearly three in four were in favour of adding warning labels to SSBs.

Money, money, money

Governments have an even more powerful tool they can use: fiscal policy.

In March 2016, the UK government announced a new levy on sugary drinks after campaigns by the British Medical Association and the celebrity chef Jamie Oliver. When implemented the levy will raise the cost of a can of Coca-Cola by 11%, while leaving the cost of pure fruit juices and milk-based drinks untouched. It is also expected to generate £520m, which will go toward boosting primary school sports programmes.

Will the new levy make a difference? According to the World Health Organization’s Global Action Plan for the Prevention and Control of Noncommunicable Diseases, the right mix of taxes and incentives can have a demonstrable effect on nutrition.

The role of tax

In a recent review, the WHO found strong evidence for taxing sugary drinks 20-50% and providing subsidies for the purchase of fruit and veg of 10-30%.

The report also advocated taxes on foods that are high in:

  • saturated fats
  • trans fatty acids
  • free sugars
  • salt

In November 2014, the city of Berkeley, California imposed a $0.01-per-ounce tax on the distribution of soda, energy and sports drinks, fruit-flavoured drinks and sweetened water, coffee and tea.

One year later, researchers found that SSB consumption in Berkeley had decreased by 21%, while consumption in nearby cities that had failed to pass tax measures increased by 4%.

The tax generated $1.5 million in just eight months, money earmarked for programmes to address obesity.

Protecting the economy

Governments also need to protect their economies from the impact of obesity and associated diseases, because these problems can have a profound effect on commercial productivity, medical costs, social services and even culture.

By reforming approaches to nutrition, exercise and health in schools, by promoting development and infrastructure projects that support healthy lifestyles and by influencing the food and beverage industry, governments can reduce the impact of globesity in measurable ways.

HA case study for cultural change

On New Year’s Eve 2007, Oklahoma City Mayor Cornett stood in front of the elephant enclosure at his local zoo and announced that his city was going on a diet to lose a million pounds. Less than five years later, the city had accomplished that goal and moved from the list of America’s fattest cities to the list of its fittest cities.

In a 2013 TED Talk, Mayor Cornett outlined a series of actions the city had taken, including making streets pedestrian friendly, building a new urban park, creating Olympic-calibre venues for water sports and launching fitness programs for inner-city children. Perhaps most importantly, however, the mayor’s program fostered grassroots involvement.

“People were signing up, and so the pounds started to add up, and the conversation that I thought was so important to have, was starting to take place,” he said. “It was taking place inside the homes, mothers and fathers talking about it with their kids. It was taking place in churches. Churches were starting their own running groups and their own support groups for people who were dealing with obesity. Suddenly, it was a topic worth discussing at schools and in the workplace.”

Playing our part

At Aetna International, we believe that only a new holistic approach can slow and stop the spread of obesity. This is an approach that involves food manufacturers, retailers, governments, employers and, yes, insurance companies.

While individuals must ultimately make the decision to become healthier, not everyone can come to this realisation, alter their behaviour and implement safe, informed changes to their diets and lifestyle without support.

Read our introduction to ‘globesity’ here, and access Aetna International’s 2017 white paper on the subject here

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