It's not either/or - fighting obesity must involve exercise and diet

Verity Comley discusses the Institute for Economic Affairs's The Fat Lie report and the impact of food and physical inactivity on obesity.

The ‘obesity epidemic’ in the UK is well documented.

In the past two decades, the number of obese adults has almost doubled. It is now estimated that around 10 per cent of deaths in England and Wales are the result of excess weight. Britain is the fattest nation in Europe.

Just last week it was reported that a study of more than five million Britons found that excess weight increases the risk of developing ten common cancers by up to 62 per cent.

The cause of the ‘epidemic’ – salty processed food and sugar filled pop. Right?

Wrong, according to a new report produced by the Institute of Economic Affairs – The Fat Lie.

Taking evidence from DEFRA, the National Diet and Nutrition Survey, the Office for National Statistics and the British Heart Foundation Christopher Snowdon found that all the evidence indicates that per capita consumption of sugar, fat and calories has been falling in the UK for decades.

Snowdon argues that the huge increase in obesity has primarily been caused by a decline in physical activity at home and in the workplace, rather than an increase in sugar, fat or calorie consumption as public health campaigners would have us believe.

It follows that campaigners calling for product reformulation, fat tax and other anti-market policies to reduce calorie consumption at population level energies are misplaced.

While the report does touch on the issues associated with the self-reported evidence used to support the conclusions, it down plays how underreporting may have changed with time.

Snowdon suggests that the virtually uninterrupted decline in calorie consumption is unlikely to be a result of misreporting. I would argue that this is somewhat naive.

It seems likely that thanks to increased media attention obesity receives, which is commented upon by Snowdon, people are more aware of the factors which contribute to obesity.

Rather than being ‘forgetful or dishonest’ as the report suggests, it is likely that individuals are simply ashamed of their consumption as a result of the social stigma attached to being obese.

We all do it. That visit to your doctor where they ask how many units of alcohol you drink a week, and you report that you drink one unit a night (that glass of wine with dinner) which you know in reality is more likely to be two, or three units depending on how big and full the glass is.

There is strong evidence that the reporting of ‘socially undesirable’ e.g., high fat and/or high sugary foods has changed as the prevalence of obesity has increased.

Levels of underreporting are greater for fat than for protein, providing additional support for the well-documented occurrence of the selective misreporting of specific macronutrients eg fat and sugars.

Consequently the ability to estimate population trends in caloric intake and generate empirically supported public policy relevant to diet-health relationships from nutritional data, especially self-reported data, is extremely limited.

Obviously diet has a role to play given that obesity is caused by a lack of energy balance – energy in does not equal energy out. Essentially eating too much and moving too little.

The subject of moving too little is where I can agree with Snowdon. An increase in sedentary behaviour has prevailed – generally speaking people are less active in their day to day lives.

Britons walk an average of 179 miles a year, down from 255 miles in 1976. Outside of work, 63 per cent report spending less than ten minutes a day walking and 53 per cent do no sports or exercise whatsoever.

However, obesity is not central to the physical inactivity agenda. Physical inactivity is a far larger issue given that physical inactivity causes a similar number of deaths (around 5.3 million worldwide) as smoking and that it is possible to be fit and fat.

The World Health Organisation and all four of our very own home countries Chief Medical Officers (CMO) rate physical inactivity as the fourth major risk factor for chronic diseases or preventable cause of death.

Public Health England is now engaging with a growing network of organisations whose main aim is to get people active and establishing a framework to encourage increased physical activity.

But now we, as a sector, need to press forward with solutions – collectively.

The Alliance Public Health Working Group, which will consult on the Public Health England draft Framework, aims to bring our members together to come up with solutions to the problem and help members engage with the public health agenda.

We have also recently created a Physical Activity in Schools Working Group to ensure that all children are active from a young age and afforded an equal opportunity to enjoy physical activity which makes them more likely to make physical activity a lifelong habit.

Take the conclusions within The Fat Lie with a pinch of salt – but just a small one, since too much of that’s not good for you either, but certainly more does need to be done to increase physical activity among large swathes of the population.

Read more blogs by Verity.

Read more Sport and Recreation Alliance blogs.

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