APPENDIX 51
Joint memorandum by the Coronary Prevention
Group and the International Obesity TaskForce, London (OB 114)
OB ESITY: TIME FOR ACTION
Recognising that
— Obesity is a disease which promotes
other diseases, including diabetes, cardiovascular disease and
cancers, disability and early death
— Excess bodyweight is pandemic, affecting
an increasing proportion of children and adults
— Vulnerable groups are affected disproportionately,
reflecting social and ethnic inequalities
— The costs of obesity are borne by
health services and also by families, individuals and society
— Prevention of obesity can only be
addressed effectively at a societal level
Believing that
— People of all ages have the right
to a high standard of physical and mental health
— Children have a right to protection
from environments that jeopardise their wellbeing
— Responsible adults have a duty to
ensure children are not exposed to such environments
We urge the government, relevant authorities
and responsible parties to consider the wide range of options
outlined in this document, based on a meeting convened by the
Coronary Prevention Group and the International Obesity TaskForce,
London, on 11 November 2003.
In particular, we recommend the government adopts
the following strategic measures urgently:
— Appoint a cabinet minister to oversee
a comprehensive cross-departmental obesity prevention strategy
engaging government, civil society and business as part of a new
public health programme.
— Establish an independent public health
agency directly responsible to parliament to monitor progress
on prevention of obesity, diabetes, cardiovascular disease and
cancers, with powers to ensure compliance with prevention policies
and to propose regulatory measures.
— Introduce public procurement, fiscal
and other measures to counteract the current subsidies of foods
with a high energy density or high content of fat/sugar/salt,
and to encourage an expanding market for local growers and food
suppliers to provide fresh and healthier foods.
— Legislate to restrict the marketing
to children of foods with high energy density or high content
of fat/sugar/salt on television and elsewhere.
— Introduce a simplified food labelling
scheme with clear symbols warning of high energy density or high
fat/sugar/salt content, in keeping with WHO and Department of
Health nutritional goals.
— Require all policies in urban planning,
transport and rural development to have a physical activity impact
statement, demonstrating how the policies incorporate safe and
secure opportunities for physical activity integrated into daily
life.
— Provide resources, in addition to
those defined in relevant National Service Frameworks, to develop
effective obesity management and prevention in primary health
care settings.
FURTHER MEASURES
(AND RELEVANT
LEAD DEPARTMENTS)
Government action:
— Require health and obesity impact
statements in all government policies (including agriculture,
trade, education, media, transport, town planning)—DoH
— Extend the formal monitoring of population
diet, activity and anthropometric measures, (height, weight, waist
circumference, BMI) including the annual sampling of child populations—DoH,
DfES
— Develop national nutritional targets
and food standards to help industry meet those targets—DoH,
FSA
— Conduct health audits of commercially
sponsored materials for schools, clinics etc—DoH, DfES
— Make public sector catering the `gold
standard' for healthy eating—All * Ensure public sector
employers offer incentives for cycle and walking to work and remove
incentives for car use—All
— Ensure that OFSTED inspection criteria
include an appraisal of school health programmes, including food
provision, physical activity provision, health and food education—DfES,
OFSTED
— Use children's media to promote healthier
dietary choices and physical activity, eg via computer games,
internet sites, comics and public service advertising on children's
TV—DoH, DCMS, Ofcom
— Engage TV programme makers and regulators
to ensure that family TV programming supports healthy diets and
active lifestyles—DCMS, Ofcom
— Invest in early years education of
parents and children about healthy lifestyles, increasing the
use of Sure Start programmes and promoting breastfeeding —DoH
— Introduce and enforce clear and simple
food labelling to identify foods (including those sold in catering
outlets) which meet nutritional criteria and should be consumed
in greater quantities—FSA
— Review the use of cosmetic food additives
(colourings, flavourings and flavour boosters) being used to promote
the sales of energy-dense, low nutrient foods—FSA
Fiscal controls and market regulation:
— Consider the application of small
taxes on foods high in fat, sugar or salt, and direct the revenue
towards the support of measures for the prevention of obesity—Treasury,
DoH, FSA, DTI
— Apply levies to recover the production
subsidies for oils, sugars and dairy fats supported under the
Common Agricultural Policy regime—Treasury, DEFRA
— Subsidise the distribution and marketing
of fruit and vegetables—DEFRA
— Reinstate the fuel tax escalator—Treasury,
DT
— Promote congestion charging in urban
areas across the country —Treasury, DT
— Provide subsidies for public sector
facilities that encourage physical activity, eg provide free school
usage of swimming pools, provide low-cost child passes to activity
centres—Treasury, DPM
— Offer tax incentives to employers
who provide physical activity opportunities—Treasury
— Develop food labelling standards
to identify those food products which fail to fit within agreed
nutritional standards, those that do comply, and those which should
be consumed freely and in greater quantity than at present—FSA
— Consider a logo scheme and vouchers
for foods and activities which enhance health—FSA, DoH
Industry and retail sector action:
— Food industry: develop a wide range
of reformulated foods which are beneficial to dietary health—FSA,
DTI
— Food industry: develop healthier
alternatives to confectionery, snacks and soft drinks for children—FSA,
DTI
— Food industry: restrict the use of
cosmetic additives in energy-dense, low nutrient foods—FSA
— Food industry: support rules to restrict
the promotion of foods high in fat, sugar and salt—FSA,
Ofcom
— Food industry: support simple and
clear labelling measures to identify foods which meet nutritional
criteria and should be consumed in greater quantities—FSA
— Food industry: develop health-promoting
ready-to-eat take-away and convenience foods—FSA
— Catering industry: offer child size
portions of restaurant main menu items, ready meals and convenience
foods—FSA
— Catering industry: offer all restaurant
customers smaller portion options with price incentives—FSA
— Retailers: improve distribution and
access to healthy food options, including fruit and vegetables—FSA
— Retailers: ensure households in low
income areas have full access to healthier food options with no
price disincentive—FSA, DPM
— All private sector employers: provide
free, secure cycle parking and charge full costs for car parking—DT,
Treasury
— All private sector employers: provide
changing rooms for cyclists and walkers—DT, Treasury
— All private sector employers: review
staff canteen policies, encourage smaller portions and healthier
options—FSA, Treasury
Research and training:
— Undertake research into obesity management
strategies and evaluation techniques—OST, DoH
— Develop the evidence base for effective
prevention and monitoring of planned initiatives, including reliable
and standardised base-line data on diet and physical activity—OST,
DoH
— Introduce training standards for
health professionals to cover nutrition, physical activity and
obesity management—DoH
— Provide in-service training for primary
care workers in obesity recognition and management—DoH
— Monitor and report on media balance
and accuracy regarding health promotion—DCMS, DoH
Local authorities and local health authorities:
— Assign to a chief officer in each
authority responsibility for integrating anti-obesity programmes
and related public health measures across departments
— Evaluate all local policies for their
obesity impact, including policies in health, education, transport,
economic development, planning, urban design and retail development—DPM
— Develop performance management measures
for the promotion of physical activity and nutrition standards—DPM
— Assess policies for children under
care in health, education and social service facilities to ensure
protection from environments and inducements prejudicial to the
children's health—DfES
— Promote more and safer walking and
cycling routes, pedestrian zoning and cycle parking provision
and discourage short-journey car use—DT
— Require planning authorities to ensure
that new or re-located public services are sited where their staff
and clients can reach them by walking, cycling and public transport—DPM
— Limit the numbers of fast food outlets
in urban areas—DEFRA
— Create opportunities for activity
in public areas, remove obstacles to free movement—DEFRA
— Ensure parks and recreation areas
are clean, secure, safe for and freely available for both children
and adults, especially near areas of deprivation and high-density
housing—DPM
— Ensure further play, sport, fitness
and recreation facilities are available at low cost, especially
near areas of deprivation and high-density housing—DPM
— Develop procurement policies to encourage
the purchase of locally produced, healthier foods
— Ensure freely available public drinking
water facilities—DEFRA
— Develop incentives for authority
employees to follow healthy lifestyles and diets
— Increase the number of dietitians
working with schools and community groups—DoH
— Make exercise facilities widely available
at low cost, and free on prescription
— Incorporate gyms and play areas into
health centres Schools:
— Identify schools as beacon community
facilities setting high standards for the promotion of health
and well-being—DfES, OFSTED
— Ensure the free-fruit-for-schools
scheme is made permanent and fully publicly funded—DoH,
DfES,
— Expand the free-fruit-for-schools
scheme to include vegetables, and make it available to all ages—DoH,
DfES
— Develop school food and health policies
to ensure adequate pastoral care for children, with a school food
and health programme developed with children, staff and parents—DfES,
OFSTED
— Review the materials and facilities
used by the school to ensure they encourage and promote the school's
food and health policies based on sound nutritional values—DfES,
OFSTED
— Develop reward schemes for choosing
healthy food and activity options at school
— Prohibit inappropriate food/drink
marketing in schools—DfES
— Encourage the purchase of healthier
products in vending machines
— Provide free, clean drinking water
fountains
— Increase media literacy training
in schools, and ensure its consistency with health messages
— Support measures to encourage safe
walking and cycling to and from school, including the provision
of secure cycle racks and discouraging traffic near schools
— Offer alternative physical activity
in schools, eg dance, aerobics and self-defence, especially for
girls; and improve changing room facilities
— Make school activity facilities available
for community use
— Encourage continued education on
practical food and cooking skills—DfES
— Encourage family sport and activity
opportunities
— Provide sports and play equipment
for schools, retain and increase play areas and sports fields—DfES
— Train teachers in social and emotional
competence and anti-bullying and anti-stigma techniques—DfES,
OFSTED
January 2004
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