Like Big Tobacco, Big Food is a cunning manipulator of public opinion. Without intervention, virtually all Americans will be overweight by 2030, and half will be obese. Other industrialised nations are not far behind. We can no longer afford to be embarrassed, or to avert our eyes from the forces underlying this tragic pandemic. Science has taught us that the obesity pandemic is less a matter of individual preferences than of societal pressures, and of the power of the institutions that impose them. We can and should resist
Childhood obesity in the US jumped from 5% in 1964 to 14% in 1999. In Australia, one out of every five children is overweight. Obesity-linked "adult onset" diabetes mellitus is for the first time being reported in children and adolescents in the UK and many other countries. In 1985 Steven Gortmaker, a psychologist at Harvard Medical School, and William Dietz, a paediatrician who now heads the nutrition and physical activity division of the Centres for Disease Control and Prevention, collaborated on a landmark study of obesity and television viewing. They found a clear association between the number of hours of television a child watched and the risk of that child becoming obese or overweight. In 12- to 17-year-olds, the prevalence of obesity increased by 2% for every hour of weekly television time. A more recent study found that, while 8% of children watching one hour or less of television a day were obese, 18% of children watching four or more hours were obese. The more television children watch, the more they eat. (By comparison, even reading is a workout, at least in studies that have been done with obese children, perhaps because it engages their minds a bit more emphatically.) Television viewing prompts children to consume more food while they consume less energy, an ideal recipe for adiposity.
When children dictate family food choices, as is increasingly the case in the US, entire households are immersed in a miasma of one-dimensional sweet taste that reinforces juvenile preferences. Marketing soft, sweet and salty foods is good business, and children are the most vulnerable targets. Childhood obesity rates are highest in countries where advertising on children's television programmes is least regulated - in Australia, the US and England.
Sweden and Norway maintain a virtual ban on advertising to children, and have consistently low levels of childhood obesity. Ireland, Belgium, Italy and Denmark pose restrictions on children's advertising, and are pressing the other states of the European Union to do the same. The US and other countries can afford to do no less. Public nutrition campaigns should go beyond vague recommendations to exercise and eat a balanced diet: the link between inactivity, junk food consumption and obesity should be made explicit. The food industry will lobby against these efforts, of course, claiming that they constitute "legislation of food choices".
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