Tackling inequality in obesity statistics
made more accessible to poorer families.
Dr Carolyn Summerbell, reader in Human Nutrition with the University of Teesside's School of Health & Social Care in the UK, says price and accessibility are restricting the effectiveness of health promotion campaigns to encourage healthier diets.
The World Health Organisation recently announced a new campaign to promote greater consumption of fruit and vegetables. Low fruit and vegetable intake is estimated to cause some 2.7 million deaths each year, and was among the top 10 risk factors contributing to mortality, according to last year's World Health Report. Sufficient daily intake of fruit and vegetables could not only help prevent obesity but also other major chronic disease such as cardiovascular disease, type 2 diabetes and certain cancers, stated the WHO.
But recent trials by the UK researchers found that many doctors are unwilling to devote the necessary time to obesity management and nutrition advice.
Writing in a recent issue of the BMJ (vol 327, 8 November), Dr Summerbell and colleagues report on a study on 44 general practices and 843 obese patients, splitting them into two groups. GPs and practice nurses in one of the groups were given three 90 minute training sessions covering information on reducing dietary energy intake, increasing physical activity and pharmaceutical intervention. The approach to obesity management entailed practitioners seeing patients regularly - about every two weeks until they had lost 10 per cent of their original body weight.
The second group of GPs and patients acted as a control group. After 12 months, there was little difference in weight between those patients attending trained practices and the control group. The training programme resulted in only limited implementation of the approach to obesity management and did not achieve improved patient weight loss, reported Summerbell.
"Although cases of obesity are shooting-up and reaching epidemic levels, it is not considered a medical priority at the moment. It doesn't attract the same amount of research as heart disease or diabetes."
"I think this is partly because some people feel it is their own fault if people are obese and it doesn't get taken as seriously as it should by health professionals," said Dr Summerbell.
She added that the media also had a major role to play and that a few hours advice from the family doctor on treating the problem has to be weighed against the mass of publicity about the numerous diets available.
One way to address this issue would be to encourage supermarkets and other shops to stock fruit and vegetables at prices everyone can afford.
"We already have the example of one of the Scandinavian discount supermarkets offering a third off all fresh fruit and vegetables; but people still need a car to get to most of their stores which are usually situated just outside main shopping centres," she said.
"The presence of obesity is more likely to be found in areas where people don't have access to a car and have to rely on a corner shop that probably only stocks a limited range of fruit and vegetables and at prices that many people simply can't afford. So whatever family GPs and newspaper articles say, they can't get hold of fruit and vegetables at prices they can afford. That's one of the major problems in tackling obesity."
A recent report from the International Obesity Task Force (IOTF) said that Britain could see obesity levels soar by 40 per cent within a single generation if no action was taken to halt the epidemic. Childhood obesity has increased so fast that it is already three times higher than it was 10 years ago, the think-tank warned.
