The lat­est pan­demic fac­ing world health? Obe­sity and Scot­land is at cen­tre of fight

The Herald on Sunday - - NEWS - Pho­to­graph: Getty BY VICKY AL­LAN

THE ma­jor pan­demic the world is fac­ing right now is not an in­fec­tious dis­ease, but obe­sity and Scot­land, which has some of the high­est rates in Europe, needs ur­gently to tackle it. Pro­fes­sor Peter Piot, a renowned mi­cro­bi­ol­o­gist and part of the team that dis­cov­ered Ebola, ar­gues that it must be a “top pri­or­ity” for the UK or the re­sult will be “health­care costs get­ting out of con­trol”.

Piot, who is in Ed­in­burgh to­day to re­ceive the Ed­in­burgh Medal for his con­tri­bu­tion to science and hu­man­ity, spells out his for­mula for tack­ling the prob­lem.

“You need to in­volve in­dus­try,” he said, “you need to have a real strat­egy, and when it comes to obe­sity we will need very strong lead­er­ship to re­verse that trend be­cause it’s go­ing to be a ma­jor hand­i­cap for Scot­land, and for other parts of Europe, if we can’t bring it un­der con­trol.”

There are lessons to be learned, he ex­plained, not only from the leg­is­la­tion cre­ated around smok­ing but also from the bat­tle against Aids, in which he played a ma­jor sci­en­tific role.

Al­ready in the United States, Piot ob­served, life ex­pectancy at birth for white men and women has gone down in the last few years. “That’s due to obe­sity, di­a­betes, al­co­hol and drugs. His­tor­i­cally that has never hap­pened out­side wartime.”

He de­scribed how, ear­lier this year, at the Davos World Eco­nomic Fo­rum, he pre­sented a lec­ture which he ended by say­ing he was “now go­ing to speak about an epi­demic not caused by a mi­crobe”. He then showed a map of the world that demon­strated how obe­sity was spread­ing like an epi­demic, or con­ta­gious dis­ease. This is not only a prob­lem for West­ern de­vel­oped coun­tries. With ur­ban­i­sa­tion and the spread of West­ern di­ets, obe­sity and di­a­betes are now ris­ing faster in low-in­come coun­tries than de­vel­oped na­tions.

To­day, Piot will present a lec­ture at the Ed­in­burgh In­ter­na­tional Science Fes­ti­val look­ing at epi­demics and a global con­text, and whether the world is ready for the “Big One” – a Span­ish Flu-type of pan­demic caused by a new in­fluenza virus.

Much of what he presents is a pos­i­tive story. “There has been great progress in im­prov­ing health,” he ex­plained. “We’ve never lived this long, never had it so good health-wise. The life ex­pectancy in Scot­land has im­proved even in the last 15 years, although the coun­try does have the low­est life ex­pectancy in West­ern Europe and the widest mor­tal­ity.”

How­ever, his con­cern is that we “en­sure that this new epi­demic of obe­sity and di­a­betes is not go­ing to wipe out all the gains that we’ve made”. To do that, Piot said, will re­quire “an all-en­com­pass­ing, so­ci­etal pro­gramme that not ev­ery­body will like be­cause it means do­ing cer­tain things less that we all like.”

A for­mer di­rec­tor of Unaids, the United Na­tions pro- gramme on Aids, Piot said things could be learned from the bat­tle with the vi­ral dis­ease. “Both prob­lems re­volve around some­thing that is plea­sur­able. In the case of HIV, it’s sex, and with obe­sity, it’s partly eat­ing. What we’ve learned is that it’s not just by pro­vid­ing in­for­ma­tion that you have an im­pact. With obe­sity, we also need to think about why are peo­ple obese. And some of it has to do with the fact that the af­ford­able food is not nec­es­sar­ily the healthy food.”

He said what was needed was “smarter re­search” in ev­ery­thing from science, pol­icy-mak­ing and mar­ket­ing. Among those strate­gies Piot ad­vo­cated was reg­u­la­tion on sugar con­tent of foods, re­stric­tions on ad­ver­tis­ing, and new rules around food sold in schools and hos­pi­tals.

Piot also pointed out the “two suc­cess sto­ries” of the smok­ing ban and leg­is­la­tion around seat­belts in cars and hel­mets for mo­tor­bikes. “These have re­ally re­duced mor­tal­ity in a big way.”

Peo­ple ob­jected at first, he con­tin­ued, “But then it be­comes nor­mal. You change the norms. When I was a stu­dent it was to­tally nor­mal, ev­ery­body was smok­ing and if you didn’t smoke, you were just not cool. To­day with many young­sters it’s just not cool to smoke.” One of the things that obe­sity has in com­mon with in­fec­tious dis­ease, he ob­served, is that it is linked to de­pri­va­tion. “Health prob­lems in Scot­land have a lot to do with de­pri­va­tion and so­cial con­di­tions. The same is true for epi­demics – again it’s the poor that are af­fected more, the ones that live in slums and have less ac­cess to health­care.” Piot cited New York as an ex­am­ple of a city that man­aged to turn around its health pro­file through the ag­gres­sive mea­sures put in place by Michael Bloomberg dur­ing his time as mayor. “He re­ally turned it into quite a healthy city. Twenty years ago it had some of the short­est life ex­pectancy in the US. Un­der Bloomberg the Aids epi­demic was un­der con­trol, trans fats were banned from restau­rants, and for ev­ery dish they were re­quired to say how many calo­ries.” The rate of obe­sity in chil­dren fell by 5.6 per cent be­tween 2006 and 2011. “It sounds like the nanny state,” he said, “but New York­ers are now among the health­i­est in the US. It shows what can be done. There’s an ur­gent need for ac­tion now. But there’s no magic for­mula. There’s no vac­cine. That’s the big dif­fer­ence be­tween it and in­fec­tious dis­eases.”

Fast food and our seden­tary lifestyle are part of prob­lem

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