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K E Y P O I N T S

World Health Organisation (WHO) and Food and Agriculture Organisation (FAO) commissioned an independent report into obesity and chronic disease - the result is called the Expert Report.

Several chronic diseases are associated with obesity: heart disease, diabetes and some cancers.

In 2001, chronic diseases, such as heart disease, diabetes and cancer, contributed to approximately 59 per cent of the 56.5 million total reported deaths in the world and 46 per cent of the global burden of disease.

To combat obesity, and its associated chronic diseases, the Expert Report recommends that people eat: fewer foods high in saturated fat and sugar, less salt, more fresh fruit and vegetables and carry out at least one hour of moderate-intensity activity each day.

The report also details exact quantities of carbohydrates, sugar, protein, salt, fat and fruit and vegetables that should be eaten - see article below.

Health experts agree that changes in lifestyle have contributed to the problems of chronic disease, but believe it's possible to make positive improvements by altering what we eat and how much we exercise.

How to combat obesity

Bupa investigative news - 7 March 2003
written by Rachel Newcombe, Bupa health news reporter

Over a billion people worldwide are now overweight and 300 million are clinically obese. As weight soars, so too does the risk of chronic diseases, such as heart disease, diabetes and stroke, yet simple diet and exercise changes could save lives. In a bid to combat the growing obesity epidemic, a new report from the World Health Organisation (WHO) has produced comprehensive guidelines for living. But what are the recommendations, how easy is it to put them into practice and are obesity and chronic disease really such threats?

What were the headlines?

News relating to the World Health Organisation (WHO) report was picked up by many publications in the UK and worldwide. Unlike coverage on other topics, the angle and slant of the articles varied considerably, reflecting the many points and issues raised in the Expert Report.

Among the headlines, examples included "1 billion people are overweight", "Junk food timebomb", "Eat less processed food, say experts", "Cut sugar to battle obesity, says report", and "Obesity epidemic blamed on food firms".

What is the bigger picture?

The report was commissioned by the World Health Organisation (WHO) and the Food and Agriculture Organisation (FAO) and compiled by an independent team of 30 global experts. They looked at the existing evidence concerning chronic diseases and used their own expertise to suggest ways of reducing obesity and improving people's health.

In particular, the report suggests ways of adapting nutritional intake and increasing energy expenditure, such as:

Reducing energy-rich foods high in saturated fat and sugar
Cutting the amount of salt in the diet
Increasing the amount of fresh fruit and vegetables eaten
Undertaking moderate-intensity physical activity for at least an hour a day

For a daily diet, they recommend consuming:

Between 15 and 30 per cent fat, of which saturated fat should account for less than 10 per cent of this total
Between 55 and 75 per cent of carbohydrates
Less than 10 per cent of sugar
Between 10 and 15 per cent of protein
400g of fruit and vegetables

Physical activity is recognised as critical, and the authors say: "There is convincing evidence that regular activity is protective against unhealthy weight gain, whereas sedentary lifestyles, particularly sedentary occupations and inactive recreation, such as watching television, promote it."

The experts laid some of the blame on processed foods, which are high in fat, sugar and salt. In addition, they noted that children's weight problems may be related to watching junk food adverts on television, which whets their appetite for such foods.

Dr. Ricardo Uauy, Head of the University of Chile's Institute of Nutrition and Food Technology, and Professor of Public Health Nutrition at the London School of Hygiene and Tropical Medicine, who chaired the expert group, said, "This Expert Report is highly significant because it contains the best currently available scientific evidence on the relationship of diet, nutrition and physical activity to chronic diseases, based on the collective judgement of a group of experts with a global perspective."

He added that, "The report provides goals for dietary components and physical activity levels consistent with good health and the prevention of the major nutrition-related chronic diseases: coronary heart disease and hypertension, cancer, diabetes, obesity, osteoporotic fractures and dental diseases."

“There are a number of factors involved in the rise in obesity and chronic disease, but it's predominantly due to the way we live our lives. Our lifestyles have fundamentally changed - we don't take time to prepare or enjoy food in the way we used to, plus we're not as active as we were in the past. The key factor in obtaining the correct weight for your height is your daily activity level. If you walk 20 minutes every day, it's much better for you than going to the gym once a week and it will have a much greater effect on your weight.”

Dr Paula Franklin,
managing director
Bupa Lighten Up

What does this mean?

Professor Philip James, chair of the International Obesity Task Force (IOTF), said, "We now know that the biggest global health burden for the world is dietary in origin and is compounded by association with low physical activity levels."

"It is clear the severity of the global obesity epidemic is the result of changes in diet and activity in recent decades. Obesity has rocketed in the UK over the past 20 years and has risen dramatically in the USA. This burden is here to stay and is sure to get worse, unless we act now and treat this with a real sense of urgency," he added.

Dr. Paula Franklin, managing director of Bupa Lighten Up, agrees that lifestyle changes, too little exercise and processed foods are partly to blame. "We eat a lot more fast food and pre-prepared foods now," she said, "and inevitably by doing that we tend to eat more fat and more sugar than we would if we'd prepared it ourselves from scratch."

Belinda Linden, head of medical information at the British Heart Foundation (BHF), said, "An unhealthy diet and lack of physical activity are two major risk factors for coronary heart disease - the single biggest killer in the UK. We support the WHO's new Expert Report, which brings together the best available current evidence and expert opinion and aims to tackle current lifestyles which increase the burden of chronic disease."

A C T I O N P O I N T S

Cut back on takeaways and pre-prepared foods.

Prepare meals at home from scratch, with fresh ingredients.

Keep your body moving as much as possible - all activity contributes.

Don't be overwhelmed by trying to do everything at once. Cut back slowly on sugar and fat, and build up exercise gradually.

Involve the whole family in healthy eating and exercise.

Enjoy food and enjoy being active!

What does this mean to me?

Recognising the risks is one thing, but actually putting them into action can seem daunting.

According to Dr. Franklin, the key to being more active is "to not think of it as exercise." She says, "Daily activities make a difference. For example, if you have the opportunity to walk to the train instead of taking the car, then do it. The way to lose weight and keep it off successfully is to make small changes that can become habits in your life, so you don't have to think about it and it doesn't take too much effort." As far as diet goes, she recommends taking things a step at a time, gradually cutting down, for example, on sugar in tea, until you can stop completely.

Belinda Linden, from the BHF, advises that, "A closer look at food labelling will help you to avoid high-calorie, fatty and salty products and take a positive step towards better health."

Jeanne Barczewska, childcare manager for Bupa Teddies Nurseries, stresses the importance of ensuring children adopt healthy habits. "Children need to get a balanced diet with the right combinations of food and be physically active. At our nurseries, all children go out to play or on walks at least twice a day, and the menus and activities are planned on a weekly and monthly basis," she said.

Although it's not always easy to plan ahead at home, thinking about meals in advance and buying accordingly can aid healthy eating.

Summary

The threat of obesity and the many health problems related to it shouldn't be ignored. On the positive side, it can be prevented by adopting healthier ways and, although it may seem like hard work, it will be beneficial in the long run.