Obesity hasn’t gone away, you know – however you draw it

Obesity hasn’t been in the news much lately but the problem hasn’t gone away. Most Irish people still need to eat more healthily. The Healthy Ireland Survey 2016 found that nearly two-thirds of the population aged 15 and over, eat snack foods, such as crisps and biscuits, every day, and many eat six or more portions daily.

Almost three-quarters of the population do not consume the recommended minimum five or more portions of fruit and vegetables every day. Men, and those over 75 years of age, are less likely than others to eat enough fruit and vegetables. Only 14 per cent of unemployed people eat five or more portions of fruit and vegetables each day. These findings show that Irish diets have serious shortcomings. To help address the problem the Department of Health recently launched a new food pyramid.

There are several differences between the old (2011) pyramid and the new one. The new pyramid recommends that top shelf ‘treat’ foods, such as biscuits, crisps, cupcakes, and sugary drinks, be consumed no more than once or twice a week, whereas the old pyramid advised a maximum of one per day. This top shelf is cut off from the rest of the pyramid to stress the point that snack foods are unnecessary for good health.

Seven portions

Fruit and vegetables are now on the bottom shelf which contains foods that should be central to everyday diets. The new pyramid recommends that we consume between five and seven portions of these every day. Breads, cereals, pasta, rice, and potatoes are now on the second shelf and wholegrain versions are preferable. Portion sizes are smaller in the new pyramid.

For example, the 2011 version recommended a meat portion size of between two to three ounces and this is now 50 to 75gms (1.8-2.6oz). Six servings of pasta, potatoes, bread, rice, and cereals were recommended by the old pyramid and the new version recommends three to five servings per day. The pyramid is easy to read and useful to have on the kitchen notice board.

Although the new food pyramid is a step in the right direction in terms of dealing with obesity, it will not change eating habits.

According to a recent article in the Milbank Quarterly "Big Food" – agribusiness, food processors, restaurants, and marketers – has created the obesity problem. Big Food is more powerful than the tobacco industry in the way it buys influence with policy makers. All over the world the food industry co-opts food regulators and legislators, finances industry-friendly scientists, and litigates against food regulations.

“The power of Big Food to shape consumer preferences through slick marketing and to undermine strong government action is literally making people sick.”

Healthier environments

Ireland’s new obesity strategy, A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025 aims to reduce obesity in adults and children by an average of 0.5 per cent per year. The strategy consists of 10 steps including “whole school” approaches to health and creating healthier environments.

However, it is not strong on controlling the food industry. Step three – “Secure appropriate support from the commercial sector to play its part in obesity prevention” – is not aggressive enough.

Actions in relation to food reformulation (for example, less salt and sugar in processed food), marketing codes of practice, and smaller portion sizes, are to be pursued in agreement with the food industry and mostly on a “voluntary basis”. This will not work. To date, the food industry has successfully staved off evidence-based regulation and taxation.

When the food industry agrees to rein itself in, the rules are usually highly permissive and deter governments from acting more forcefully. The Milbank Quarterly article points out that "health advocates should be wary of self-regulation, which often appears generous, socially responsible, and potentially effective".

Self-regulatory initiatives such as product reformulation and calorie-posting on menus “are particularly unhelpful for the poor and less educated.”

So Big Food must be told what to do by government. Policy makers in Ireland need to be be as aggressive towards the food industry as they were, and are, towards the tobacco industry. Portion sizes in ready-to-eat, ready-to-heat foods, and restaurants, must be regulated by law. Advertising and marketing of all processed foods have to be strictly controlled or outlawed altogether.

We haven’t a hope of solving the obesity problem until this happens, new food pyramid or not.