Welsh inquiry into childhood obesity
Submissions were invited for an inquiry into childhood obesity in Wales. The deadline was Friday 3rd May 2013.
I submitted a response – it can be seen in full here - CO 15.
The last I heard was on 14th May 2013 when I received a letter from the chair, Ann Jones, saying that the inquiry had been put on hold. So it was out-of-the-blue that I today received an email with a copy of the report following the review.
As of the time of writing (26th March 2014), the web site lists the report as “in preparation”. I will share the recommendations from this 38 page report. Hopefully you’ll be able to view the whole document on line soon.
The all Wales obesity pathway
Before we look at the recommendations – we need to bring everyone up to speed with what is known as the all Wales obesity pathway. This is the current Welsh ‘strategy’ for dealing with obesity:
Level 1: Community-based prevention and early intervention focused on lifestyle advice and information (e.g. Change4Life)
Level 2: Community and primary care weight management services (e.g. MEND).
Level 3, Specialist multi-disciplinary team weight management services (e.g. Dr Haboubi’s clinic)
Level 4: Specialist medical and surgical services (i.e. bariatric surgery).
So, the current Wales obesity ‘strategy’ is Level 1 – industry sponsored fake food swap dietary advice; Level 2 – the cola/cake/biscuit/bagel/cornflakes adorned eatbadly plate dietary advice; Level 3 – attend a clinic to receive eatbadly plate advice in person; Level 4 – barbaric surgery so that you can’t eat properly. I jest, but not much.
You’d think that anything would be better than this. Here are the six recommendations that the committee came up with:
“Recommendation 1:Welsh Government should conduct a review of the progress of Local Health Boards in meeting the minimum service requirements for each level of the All Wales Obesity Pathway. Welsh Government should publish the results of that review in a timely fashion, including a timetabled action plan to address any gaps that are identified.
Recommendation 2: Welsh Government should ensure that level 3 services for children are put in place across Wales. The Minister should report back to the Committee on progress in a timely fashion.
Recommendation 3: Welsh Government should develop and publish an evaluation framework for its strategies relating to childhood obesity to ensure the performance of strategies can be reliably monitored against outcomes.
Recommendation 4: Welsh Government should continue with, and extend, the Child Measurement Programme, and indicate clearly how the data will be used to monitor and evaluate childhood overweight and obesity programmes.
Recommendation 5: Welsh Government should publish in a timely fashion a report on the actions taken by the new Welsh Government Cabinet sub-Committee looking at encouraging children and young people to participate in more physical activity, with reference in particular to: the impact of budgetary constraints on the provision of local authority leisure facilities; and the actions being taken to ensure that Welsh Government is working across departments to increase participation levels.
Recommendation 6: Welsh Government should explore how forthcoming legislation, such as the Future Generations, Planning and Public Health Bills, can be used to address childhood obesity. Ministers should report back to this Committee on his conclusions at the earliest opportunity.
This Committee will ask the Minister to provide an update on progress against these recommendations in September 2014.”
The committee didn’t re-look at the crisis and ask – what could and should we do to solve obesity in Wales? They didn’t take a fresh look at the epidemic. They didn’t challenge whether or not current advice is working. They didn’t look at proposals for new advice. They merely recommended lots of reviewing and lots of publishing and lots of demands for government/ministers/the minister to report back.
My submission was ignored. How do I know this? Because the report lists evidence taken into account at the bottom of each page and the following submissions are referenced:
CO 05 – Sustrans Cymru;
CO 16 – Royal College of Paediatrics and Child Health (4 references)
CO 21 – City and County of Swansea;
CO 22 – Public Health Wales (3 references);
CO 24 – Aneurin Bevan Health Board (3 references);
CO 25 – Royal College of Physicians (Wales) (4 references);
CO 27 – Betsi Cadwaladr University Health Board (2 references);
CO 30 – Cardiff and Vale University Health Board (2 references);
CO 31 – Wales Dietetic Leadership Advisory Group and Public Health Dieticians in Wales;
CO 38 – Academy of Royal Colleges Wales;
CO 42 – Public Health Wales;
CO 47 – Cwm Taf Health Board;
CO 48 – Sport Wales (3 references).
And the oral evidence from the minister and Chief Medical Officer (15.1.14) was referenced 14 times.
Notice that every body referenced is a public body. Current providers of public health dietary advice – from the minister and public health Wales to dieticians and council workers – have provided the reference base for this report. When the current advice isn’t working – you need to go beyond the current advisors for a solution.
You can read my advice in full from page 14 in my submission. The headlines are:
“These are the three urgent steps that we need to take to reverse the obesity epidemic in Wales. These will address adult obesity in Wales, as well as childhood obesity.
1) Reverse current dietary advice.
Tear down the eatbadly plate from every school and medical centre in Wales. Stop telling people to base their meals on fattening (starchy foods). Go back to knowing that starchy foods make us fat and sugary stuff even more so. All dieticians and dietary advisors need to be re-educated and re-trained. With relationships with soft drinks manufacturers and sugary cereal companies, telling the public to favour fake over real food (cereal, not eggs; margarine, not butter; low calorie drinks, not milk), dieticians are a merchandising force for the fake food industry.
2) Deliver one clear government message – Eat Real Food!
Real food is: meat, eggs and dairy from grass living animals; fish; vegetables; fruits in season; nuts and seeds. Whole grains are debatable as a real food. They have been introduced into the food chain in the blink of an eye in terms of evolution. They may be consumable in moderation, but most definitely should not be the foundation for childhood or adult diets. As real food is promoted, so processed food should be demonised concomitantly.
I use the following as an analogy: “If we have been eating real food for 24 hours, agriculture gave us large scale access to carbohydrates four minutes ago and sugar consumption has increased twenty fold in the past five seconds. I wonder which food is more likely to be responsible for the obesity epidemic or any modern disease…”
3) Eliminate conflicts of interest.
England naively believes that the obesity epidemic can be solved by working with the ‘food’ industry. The ‘food’ industry is part of the problem – never will it be part of the solution. Wales is in a unique position in this respect, as we have no economic allegiance to the fake food industry. We need not fear for withdrawal of government funding or ‘food’ industry jobs lost in our discrete nation.
We do however need to eliminate conflict of which governments may not be currently aware. Change4Life has been shown to be one such example. The British Dietetic Association should be kept at arm’s length, not given a monopoly on dietary advice, given their corporate relationships (past and/or current) with Danone, Abbott Nutrition, Birds Eye, Kellogg’s and The Sugar Bureau and likely more (they are far more secretive about their ‘food’ industry relationships than their American or Australian counterparts – likely ashamed of them).
The British Nutrition Foundation (BNF) was founded in 1967 and its web site says that this organisation “…exists to deliver authoritative, evidence-based information on food and nutrition in the context of health and lifestyle. Accurate interpretation of nutrition science is at the heart of all we do.” Here are their sustaining members and members. ”
Which set of advice do you think would more likely have an impact on the obesity epidemic?
Review, publish and report? Or
“EAT REAL FOOD!”