Chairman: Lord Rea
Joint Vice-Chairmen: Tony Baldry MP
& Dr Ian Gibson MP
Secretary: The Earl Baldwin of
Bewdley Treasurer: Rev Martin Smyth MP
SPEAKERS:
Dr Susan Jebb, MRC Human Nutrition Research
Dr
Susan Jebb is head of Nutrition and Health Research at MRC Human Nutrition
Research in Cambridge. She originally trained as a dietician before studying
for her PhD at the University of Cambridge. She now leads a research group
considering the role of dietary factors in the aetiology of obesity and the
dietary management of obese patients. Dr Jebb is Deputy Chair of the UK Association
for the Study of Obesity and has a strong personal commitment to the
development of more effective multidisciplinary strategies for the prevention
and treatment of obesity.
Professor Kenneth R. Fox, Professor of Exercise and Health Sciences at Bristol University
Kenneth
Fox is Professor of Exercise and Health Sciences at the University of Bristol,
as well as a Fellow of the Physical Education Association, an International
Fellow of the American Academy of Kinesiology and Physical Education, and a
Fellow of the British Association of Sport and Exercise Sciences. He serves or
has served on several national committees including the National Audit Office
Scientific Advisory Panel for the Obesity Report, the Executive Committee of
the association for the Study of Obesity, and the British Nutrition Task Force
for Obesity. He has been on advisory panels for the Food and Drink Federation,
the Sugar Bureau and the Meat and Livestock Commission on Obesity. He is the
author of The Physical Self: From Motivation to Well-Being, and
developed the widely-used Physical Self-Perception Profile. Professor Fox is
also the author of over 130 publications in academic and professional journals.
Introduction
Most fast food options are very energy dense, but Dr Jebb said that the American sandwich company ‘Subway’ provided a fast food low energy density alternative, which is achieving a considerable commercial success in the USA.
On the subject of portion sizes, Dr Jebb said that food intake and portion sizes were on the increase at a time when our energy needs are lower than before. She stated that the average chocolate bar provided around 10% of our daily energy requirement and a ‘king size’ bar could provide up to 20% of our energy needs.
10. Prof Fox went on to analyse some of the more scientific reasons for the recent rise in obesity. He said that western society had created a biological and cultural mismatch, which in its simplest form resulted in an increase in food availability and a fall in levels of activity thus contributing to an increase in obesity levels. An increase in the levels of food consumption could be attributed to stronger signals to eat, weaker signals to stop eating, the increased availability of food, the concept that eating could be rewarding and the high status attributed to eating well. The reduction in activity levels were a result of lower signals simulating activity, stronger signals to stop activity, the notion that inactivity can be rewarding and is a high status viable alternative.
Television
11. Studies into television habits had also been shown to have an effect on obesity levels: 25% of 11-16 year olds watch in excess of 4 hours per day, resulting in a seven-fold increase of those becoming obese. However, it is worth noting that some studies have also concluded that there is a low correlation between the time spent watching television and participation in physical activities.
Ways of tackling obesity
12. Having considered various causes of obesity, Prof Fox then identified the ways in which it could be tackled, putting these [ways of addressing it] into two categories:
· People need to eat less, thereby reducing their nutrient intake
· People should take more physical exercise because increased activity results in weight loss and also improves the body’s composition by maintaining muscle and increasing fat loss. Professor Fox also highlighted the Health Education Authority’s physical activity recommendations, which included thirty minutes of ‘moderate intensity physical activity’ (such as a brisk walk) at least 5 times per week
13. As his talk drew to a close, Prof Fox outlined his recommendations at a political level for dealing with the problem of obesity, essentially by calling for a national strategy for physical activity. He said that at present there was no national agency for physical activity and that a ‘co-ordinated effort across sectors’ was required. He acknowledged, however, that there were already ‘seeds of development that could be given impetus,’ and that strategies already existed in Scotland and Northern Ireland. Prof Fox also recognised that there had to be a closer link between food and activity policy; ‘eating and activity are two key elements of lifestyle associated with health and both combine to produce positive energy balance that causes obesity.’
Questions and Discussion
14. Sandra Holdsworth, Institute of Consumer Sciences: asked Dr Jebb how much the general public really knew about issues like the glycaemic index. Dr Jebb said that such issues presented something of a ‘communications challenge. It was difficult to be precise about mechanisms that were not fully understood and so it was therefore difficult to give information to the general public about how such mechanisms could be introduced into diets. It was likely that there would be more research into the glycaemic index and she hoped that explicit dietary requirements would eventually be available more widely.
15.
Behavioural changes: In response to Ian Gibson’s
question as to how one might counteract the propensity [for example] of
grandparents to reward their grandchildren with inappropriate foods (including
in terms of quantities), Dr Jebb said that it would be necessary to get
families to recognise other ways of ‘rewarding’ their children. Prof Fox said that it was also worth looking
at the cultures of countries such as the Netherlands to see how they addressed
such issues; obesity was not nearly so prevalent in the Netherlands.
16.
Responding
to a question from Jane Landon of the National Heart Forum, Dr
Jebb highlighted the importance of food marketing saying that it helped put
food in its 'cultural context.' She added that the concept of schools with
overstretched resources accepting offers of sponsorship from the likes of
Walkers Crisps of 'free books for schools' was at odds with policies to promote
healthy eating.
17. Dr Jebb agreed with Richard Cottrell of the Sugar Bureau that it was worth looking at the ‘lost opportunity’ of low calorie meals, many of which were large and low density, as a means of promoting healthier eating. This option could be looked at amongst a range of other ways.
18. Andree Dean of the Fitness Industry Association expressed interest in Prof Fox’s idea of a national strategy for physical activity. (She explained the difficulties she had encountered with primary care trusts when making referrals with primary care trusts). Prof Fox said that up until now there had been a lack of support for a national strategy but more people were now listening to concerns about obesity and general fitness. He was optimistic that there would be more support for such strategies and thus would be more support for the kind of valuable work undertaken by the FIA.
19. Dr Jebb told Ian Gibson that it was getting increasingly difficult to ignore the need for some kind of integrated national strategy that encouraged the various aspects of health protection that were thought important. She added that a point had been reached [within her organisation / industry] where there was now sufficiently good evidence for her and others to be able to provide dietary information that would benefit the population.
20. Dr Penny Gibson of the Royal College of Paediatrics and Child Health said that, in the past, too much had been left to the willpower of individuals in tackling the causes of obesity. It was incumbent on all to do as much as possible to make it easier for people to deal with obesity. Prof Fox agreed and added that it was easy to point the finger of blame on the individual. The problem of obesity had been around for 20 years and so he felt it was necessary to treat it on a par with disablements such as partial sight.
21. Jill Eisberg of the Dairy Council expressed concern about the differential subsidies available for full fat versus reduced fat milk in schools. Dr Jebb said that this was a good example of poor integration of policies and said that she hoped others, perhaps the Department of Health, would look into this anomalous situation.
22. Baroness Masham of Ilton referred to previous work she had done with an institute for young offenders. She said that she had noticed a distinct improvement in their behaviour and performance when they had had a healthy diet. Prof Fox agreed; he had spent the past 10 years working with young people and had noticed similar tendencies.
23. Ian Gibson asked how one reconciled the problem of eating disorders with the kind of aims and information Dr Jebb and Prof Fox had just been communicating. Dr Jebb said that she saw no real conflict between the issue of obesity and eating disorders. In both cases, it was however necessary to give the general public better access to information that would give them a better understanding of what constituted healthy food and a healthy weight.