Biting back against childhood obesity

Advertising, environment and affluence all have an impact on the health of young people, and it’s a problem that’s growing, says Xanthe Clay

What with working from home, schooling at the kitchen table, sports facilities closed and even meeting friends in the park rationed, the past 15 months have been a challenge for parents and children alike. Is it any wonder that the kids have spent more time than ever watching screens of one kind or another, while exhausted parents reach for a bag of crisps come lunchtime? “Anything to get through” has been our mantra.

But for most of us, whether we’re parents, concerned friends or relatives, there’s a niggling awareness that the health of our kids is taking a serious battering. It’s not a new issue, of course. Lord Coe, speaking on the BBC Today programme on Thursday, admitted that “between the ages of 10 and 14, children become 50 per cent less active”.

Child obesity is a growing problem worldwide, with the World Health Organisation estimating that while in 1975 less than one per cent of children and adolescents were obese, the latest figures (compiled before the pandemic) stand at around seven per cent. In the UK, one in five British children leaving primary school are obese. Add in the children who are “just” overweight and the numbers grow to one in three. Not only are these children at higher risk of health problems, but they’re more likely to be victims of bullying and suffer mental health issues as a result. As obese children move to adulthood, they are twice as likely as their less weighty pals to become obese adults – and complications from obesity currently cost the NHS over £6billion a year.

Despite the fanfare over the Government’s Obesity Strategy announced last summer, with kids’ activity seriously down during lockdown (according to Sport England) and data published in the UK’s National Food Strategy review indicating that children ate more junk food and snacks but less fruit and vegetables during that time, it’s likely these figures will get substantially worse.

Junk food just keeps jutting in. Brace yourself for Dr Chris van Tulleken’s new BBC programme, What Are We Feeding Our Kids? which airs on May 27 and shows how a diet of ultra-processed food caused his body to age by 10 years. And yet children are exposed to 15 billion adverts for “High Fat Sugar or Salt” foods a year online alone. The recent breakthrough that advertising of HFSS foods will be outlawed online as well as before 9pm on TV is encouraging, and comes after pressure from a raft of organisations, including Public Health England and the Royal College of Paediatrics and Child Health – and from Bite Back 2030, a youth-led group founded by Jamie Oliver and Norwegian philanthropist Nicolai Tangen in 2019, which campaigns for fairer, healthier food for young people. Whether it was that which focused the Government’s mind, or Boris’s brush with death while fighting Covid-19 a year ago, is not clear. Certainly the Prime Minister blames the severity of his bout with the virus on his obesity: he was reported to have a BMI of over 36 when he was admitted to St Thomas’s Hospital in April 2020. He’s right, as Public Health England estimated that having a BMI of 35 to 40 could increase a person’s chances of dying from Covid-19 by 40 per cent.

So will a clampdown on advertising be enough to reverse the trend? The industry argues that there is no conclusive evidence that advertising and obesity are related. The Internet Advertising Bureau released a statement in response, urging the Government “to reconsider the smarter, evidence-led solutions that can be delivered more quickly and effectively by the existing regulatory system”.

Health campaigners disagree. The Obesity Health Alliance – an alliance of 44 health charities, medical colleges and campaign groups – has long campaigned for an end to junk food advertising to children. And it’s hard not to believe that a constant bombardment of enticing ads makes a difference. A recent experiment by Bite Back exposed eight teenagers to advertising for fried chicken, before taking each one separately to a restaurant and asking them to order from a menu of 50 items. They all chose fried chicken – even when they had no particular memory of seeing the advertisements.

Just how flooded your environment is with junk-food options depends on how affluent your area is. Data from Public Health England shows that more deprived areas of the country have as many as nine times more fast-food outlets per person as the most affluent areas, and there is a growing body of evidence linking exposure to fast-food outlets with obesity. According to Dr Max Davie, officer for health improvement at the Royal College of Paediatrics, childhood obesity “is becoming a disease of poverty, linked to the conditions people on low incomes live in: more insecurity, longer working hours, less access to healthy food because of price” – all issues highlighted in Marcus Rashford’s Feeding Britain’s Children campaign. Which doesn’t mean that more well-off kids are immune to the problem, just that it is easier to avoid. The solution will involve all of us rethinking our attitudes to food, says Davie. “It isn’t something that a single magic bullet is going to solve.” First off? “The first priority is for the plan to be implemented,” Davie says. It’s time to stop talking, and start walking.

FIGHTING OBESITY – AND THE STIGMA THAT SURROUNDS IT While campaigner Christina Adane (see below left) applauds the new advertising measures, she and Bite Back don’t support some of Johnson’s rhetoric that has gone alongside the Obesity Strategy, in particular his line that tackling weight issues is a matter of “personal responsibility”. Adane stresses that “no one chooses to be obese.” This is echoed by Professor Chris Whitty, who, speaking at a lecture in March, warned against stigmatising obesity. “There is no reason why people should feel shame or embarrassment about obesity,” he said. “It is purely something to be concerned about from a medical point of view.”

Davie argues that it’s important to be mindful of cost. “Asking, ‘Have you tried eating apples rather than crisps?’ when five apples are going to cost more than five bags of crisps it isn’t helpful.”

Judy More, a leading children’s dietician, points out that there may be other factors. “A lot of parents worry about children not eating enough rather than eating too much,” and this may stop them from noticing that “some children don’t have the feeling of satiety that others do”.