Category: Food and Drinks

Our policies and strategies for public health are not enough to control the global obesity epidemic. A radical policy shift could be the best way for governments to combat the global obesity epidemic. They should regulate food consumption and control the food sector in the same manner as the tobacco industry.

By providing frequent opportunities to consume excessive food and by encouraging sedentary habits, our environment promotes obesity. The portion sizes are larger, and ready-to-eat, “king-size” snacks in pre-packaged form are available. You’ve probably seen chocolate bars attached to soft drink bottles and foot-long sandwiches.

Often, smaller portions are not offered. Coca-Cola bottles were approximately 200 ml in size at the beginning of the 20th century. It’s now sold in bottles of 600 ml – 1000 ml for individual consumption. The larger chocolate bars and crisp packets encourage overconsumption while giving us the impression of better value.

Obesity results from a maladaptation of the body to its environment. Aside from a small group of people who have metabolic disorders or genetic predispositions, the main cause of obesity is eating too much food compared to energy expenditure.

A positive energy balance is the result when energy intake exceeds overall expenditure. Combine this with the body’s capacity to store large quantities of energy in fat, and you get the cause of the obesity epidemic. Weight gain can be caused by any factor that increases or decreases energy consumption, even if it is a small amount per day.

Our society and our environment must undergo radical change to solve the fundamental problem of a positive energy balance. These changes must empower people to alter their eating habits. We’re joking ourselves if we think that this is just about personal choice and we aren’t influenced by constant mass marketing.

Consider these measures:

Higher taxes on fast food. The local government could use the tax revenue from fat- and sugary-rich foods to subsidize fruits and vegetables.

Pricing strategies to encourage healthier food purchases

Foods that are lower in fat and energy density will be more readily available and cheaper.

The ban on fast food advertising in mass media, radio, and television is also applicable to sports.

Social marketing for healthy food

Manufacturers must use health warnings and traffic light labels on certain foods and beverages.

Providing financial incentives to food manufacturers and retailers to sell smaller portions.

Rationing of certain foods.

Consider the most controversial suggestion: rationing. The British government implemented rationing of food in all households during the Second World War (1939-1945). Each family was given a certain number of points per month, and certain foods, like meat, fish, and biscuits, as well as sugar, fats, and tea, were rationed.

Each adult received 16 points per month, and they could decide how to use them. There were special supplements for pregnant women, young children, and those with certain illnesses. Food shortages during World War II and government directives forced the people to change their eating habits. They ate significantly less sugar, meat, and eggs than we do today.

After the end of World War II, Britain continued to ration food for another 14 years. In June 1954, meat was de-rationed. People stopped using and buying cars and used public transport. Food supply and travel were limited. People ate less and did more walking.

In the United Kingdom, obesity rates were negligible during the years of rationing. Waste was minimized as individuals and government agencies worked to reduce food waste (sustainable consumption) to a minimum.

Could a form of food rationing or portion control help address the dramatic increase in obesity and ensure the sustainability of the foods we consume? We may have no choice if we continue to consume food in ways that are unsustainable for our health and the planet.

Vegetarians have a higher water content in their stools. Those who consume less fiber and more protein have lower water content. Fibre has a high water-carrying ability and makes our stools bulkier, increases the frequency of bowel movements, and makes the process of passing bowel motions easier.

Read more: Health Check: what your pee and poo color says about your health.

The other 25% of feces is made up of solids, which are mainly organic (relating to living matter) materials. A small proportion of solids is made up of inorganic materials such as calcium and iron phosphate, as well as dried constituents of digestive juices.

Around 25-54% of the organic material is made up of microbes (dead and living), such as bacteria and viruses.

Our poo is teeming with microbes, most of them alive. www.shutterstock.com

Microbes

Bacteria in feces have been extensively studied. It’s estimated there are nearly 100 billion bacteria per gram of wet stool.

One study that looked at a collection of fresh stools in oxygen-free conditions (as oxygen can damage certain types of bacteria) found almost 50% of the bacteria were alive.

The different types of bacteria present in feces can influence how hard or loose stool samples can be. For example, Prevotella bacteria, which can be found in the mouth, vagina, and gut, are more commonly seen in those with soft stools. In fact, a high-fiber diet is strongly associated with these bacteria.

Ruminococcaceae bacteria, which are common gut microbes that break down complex carbohydrates, favor harder stools.

Viruses have been less studied than bacteria as components of the gut microbiota – the population of bacteria and viruses that live in our gut. It is estimated there are 100 million to 1 billion viruses per gram of wet feces in most of us.

This number can change considerably when people become sick with viral gastroenteritis, such as in norovirus infections, where levels of more than a trillion viruses per gram of stool can be found.

What is the human microbiome?

Certain types of viruses that infect bacteria, called bacteriophages, have been linked to diseases of the gut like Crohn’s disease and ulcerative colitis.

Read more: So you think you have IBS, coeliac disease, or Crohn’s? Here’s what it might mean for you.

Archaea are bacteria-like microbes that can inhabit some of the most extreme environments on Earth, such as hot springs, deep sea vents, or extremely acidic waters. Archaea that produce methane are known to live in the human gut and account for around 10% of non-oxygen-dependent microbes.

Such methane-producing archaea like Methanobrevibacter are associated with harder stools and constipation, as methane can slow down intestinal movement. It is believed there are around 100 million archaea per gram of wet feces.

Single-celled fungi (yeasts) are present in the gut of about 70% of healthy adults. They occur in estimated concentrations of up to a million microorganisms per gram of wet feces but comprise only a small proportion (0.03%) of all microbes.

Other organic material

Some of the organic material includes carbohydrates or any other undigested plant matter, protein, and undigested fats. Feces do not contain large quantities of carbohydrates, as the majority of what we eat is absorbed. However, unprocessed amounts remain as dietary fiber.

Our feces don’t contain a large proportion of carbohydrates, as most are absorbed in the body. from shutterstock.com

Some 2-25% of organic matter in feces is due to nitrogen-containing substances such as undigested dietary protein and protein from bacteria and cells lining the colon that have been shed.

Fats contribute 2-15% of the organic material in our feces. The amount of fat excreted into our stools is highly dependent on dietary intake. Even with no fat intake, though, we do get some excretion of fat into our feces. Fat in feces can come from bacteria in the form of short-chain fatty acids when they ferment foods, in addition to undigested dietary fat.

Plastic particles

A recent study has found that microscopic plastic particles can appear in our feces when we drink from plastic bottles or eat foods that have been wrapped in plastic.

This small study of eight participants who were exposed to plastics in their food and drink identified up to nine different types of plastics in their stools. However, we need larger studies and additional analytical research to understand the clinical significance of this.

Poo is different in disease.

Not everyone’s poo is going to be the same. Diseases such as inflammatory bowel disease can lead to changes in the type of bacteria in our gut and result in raised inflammatory proteins that can be detected in our stool.

The presence of blood in the stool could signal bowel cancer, though this isn’t always the case. Fortunately, there is a good screening test that can pick up the presence of trace blood in the stools and lead to further investigations, such as a colonoscopy.

Junk food can mean many different things to different individuals.

The official dietary guidelines use more appealing terms, such as “discretionary food,” “sometimes food,” and “foods that are high in salt, sugar, and fat.” These labels are not always helpful in identifying healthy foods. Even though some fresh fruits and vegetables are low in nutrients, they are still healthy. Food products like soft drinks that have “no additional sugar” or muesli bars with added nutrients are not necessarily healthy.

In 2009, experts suggested using industrial food processing to determine nutrition issues.

It was acknowledged that some food processing makes foods more convenient, safe, and tasty. It also deemed a group of foods, called “ultra-processed foods,” as unhealthy based on factors other than salt, sugar, and fat content.

There is a growing body of evidence that shows the consumption of ultra-processed foods is linked to poorer health, including heart disease, diabetes, and obesity, and health, including plastic pollution, excessive land use, and biodiversity loss.

How can you identify these foods when planning to purchase or eat them?

Read more: Ultra-processed foods are trashing our health – and the planet.

What counts as an ultra-processed food?

Ultra-processed foods have been made with industrial processing techniques and may contain ingredients that you would not normally find in your pantry.

Processes that are used include extrusion, molding, chemical modification, and hydrogenation. (Hydrogenation can transform liquid unsaturated fatty acids into solid forms). It cannot be easy to distinguish ultra-processed food because manufacturers are not required to list the processing methods on the labels. Start with the list of ingredients.

Food substances are classified as ultra-processed food, and so are cosmetic additives. Food substances are processed versions of proteins and fibers (such as inulin or whey), maltodextrin, a carbohydrate that is highly processed, fructose and glucose syrups, and hydrogenated oil.

Cosmetic additives can be used to enhance the taste, texture, or color of food. They make ultra-processed food more appealing and irresistible (contributing to their overconsumption). Colors and flavors, including those that are listed as “natural,” non-caloric sugars (including stevia), flavor enhancers such as yeast extract or MSG, and thickeners/emulsifiers that modify the texture of a food can all be examples.

Read more: Ultra-processed foods – like cookies, chips, frozen meals, and fast food – may contribute to cognitive decline.

Eight foods you might not realize are ultra-processed

It is important to understand that ultra-processed does not mean junk food. Foods like chips, soft drinks, and confectionery are all ultra-processed. Many packaged foods that we would normally consider healthy are ultra-processed.

1. Breakfast cereals

Most cereals and breakfast beverages marketed as healthy, however, are highly processed. These products can include maltodextrins and processed proteins, fibers, and colors. Oats contain only one ingredient: oats.

2. Bars and balls of protein and muesli

In spite of the health hype, most are ultra-processed and contain processed fibers, proteins, inverted sugars (sugars that an industrial process has modified), and non-caloric sweetness.

3. Plant-based ‘milks’

Some dairy alternatives are made with emulsifiers or vegetable gums. Check the list of ingredients to see if all brands are ultra-processed. Some soymilks contain only water, soybeans, and oil.

Some foods that are highly processed can be easily identified. Some foods are healthy. Shutterstock

Read more: Food and drinks are getting sweeter. Even if it’s not all sugar, it’s bad for our health

4. Breads

Packaged breads often contain emulsifiers and modified starches, which are starches that industrial methods have altered. These breads tend to be cheaper, plastic-wrapped, and sliced. Fresh bakery breads are not as processed.

5. Yogurts

Flavored yogurts may contain additives such as thickeners and sweeteners without calories or flavors. Instead, choose plain yogurts.

6. Meal bases, sauces, and other ingredients

Pre-prepared sauces for pasta and stir-fries are often made with thickeners, flavor enhancers, and colors. Simple sauces that you can make yourself at home using ingredients such as canned tomatoes, vegetables, and garlic are minimally processed.

7. Processed meat

Cold meats packaged in plastic may contain emulsifiers and thickeners, as well as modified starches. They are ultra-processed. Instead of packaged processed meats, opt for alternatives like cold roast meats and chicken.

8. Margarine

Margarines, non-dairy spreads, and margarine-like products are ultra-processed foods. They contain additives, like emulsifiers, colors, and emulsifiers, unlike butter which is basically cream and salt.

 

The UK’s new tax is aimed at reducing obesity in children. Too much sugar can cause obesity in children and adults, but it also increases the risk for many other serious diseases. These range from heart disease to cancer. Sugar’s calories are only part of what is causing the problem.

Insulin is equally important. Insulin is produced by the pancreas when glucose levels in the blood increase. This insulin opens the cells’ doors to let glucose in. Too many sugary foods can raise blood glucose levels, which causes the pancreas to produce more insulin. As a result of the constant bombardment of insulin, the cells alter their locks to make the insulin key ineffective. As the cells become desensitized, blood sugar levels increase and the pancreas produces more insulin. The dangerous condition of high blood sugar and insulin can go undiagnosed and cause many diseases, even in people with normal weight.

Why is elevated insulin and glucose so dangerous? High blood sugar is a risk factor for type 2 diabetes. Free radicals are also produced, which can damage blood vessels. Three meals per day is a tradition that allows antioxidants time to repair damage. Snacking on sugary food may lead to less respite. This increases the risk of heart attacks.

No reprieve. www.shutterstock.com

Insulin, glucose’s partner, is also a “fertilizer,” promoting cell growth and increasing the likelihood that a normal cellular will become cancerous. Raised insulin levels have been linked to a variety of cancers and could be a risk factor for postmenopausal breast cancer. The double whammy that is high in insulin and high in glucose can be a major driver of disease.

Prediabetes

Prediabetes is a medical term that has been coined because of the health implications of elevated blood sugar. One report claims that has tripled in the UK since 2003. Most people don’t know that they have this condition and take no action to correct it. Prediabetes is more common in obese people, but 25% of prediabetic individuals are of normal body weight.

About one in twenty people with prediabetes will develop type 2 diabetes each year. A recent review of many studies found that prediabetes was also associated with a small but significant increase in the risk of several different cancers. The public’s health is greatly affected by detecting and treating prediabetes. The NHS Health Check, an NHS prevention program for people aged 40-74, detects prediabetes and allows patients to reverse the condition by adopting healthier lifestyles. It is better to adopt a healthy lifestyle and prevent diabetes from occurring.

Sugary foods and drinks are a great way to prevent high blood sugar and insulin. Sugar added to processed food is especially harmful. Fruits are high in sugar, but they also contain fiber. Fiber reduces blood glucose levels by slowing stomach emptying. Sugary drinks do not provide this feeling of fullness. Sugary drinks are void of nutrition and vitamins, but fruit is a good source of vitamins. Fruit (but not juice) has been linked to a reduced risk of type 2 diabetes.

You can also reduce blood sugar spikes by eating sweets only after consuming foods high in fiber, such as cereals, vegetables, or beans. Other plant foods contain natural chemicals that block glucose absorption in the gut. The best example is apples. My research has shown that onions contain chemicals that can lower spikes in blood sugar. The ability of plant foods to lower blood sugar may be one of the reasons why the Mediterranean diet is so effective in managing and preventing diabetes, despite its sweet foods.

The makers of sugary drinks are now complaining that the new tax is a victim to their products. Many other sources of sugar contribute to the epidemic. Food manufacturers should not reduce their sugary products but rather reformulate them.

These foods are also known as discretionary foods and include biscuits, sausages, sweetened drinks, alcohol, and cakes.

Diets that are unhealthy are the main reason for almost 1 in 3 adults in Australia being obese. Weight gain increases the risk of heart disease and type 2 diabetes, as well as some cancers.

The new research published in the International Journal of Behavioral Nutrition and Physical Activity today found that personalized nutrition advice helped adults eat fewer junk foods compared to conventional dietary advice.

What is personalized Nutrition?

Personalized Nutrition is the process of tailoring diet advice to improve the health of an individual based on their characteristics. Dietary advice can be tailored to a person’s weight, eating habits, cholesterol level, and genetics.

Dietitians have given personalized advice for centuries. The rise of wearables, apps, and new technologies that allow detailed monitoring of health is what is new. Can use the information for personalized advice.

New technologies fuel the rise of personalized nutritional products. Shutterstock

We conducted the Food4Me Study to determine whether personalized nutrition advice improved dietary habits.

Research on the topic

We recruited 1,607 adults from seven European countries to participate in a six-month diet study.

Adults were initially assigned to either a control or one of the three nutrition-specific groups.

Dietary advice

Adults in the control group received normal dietary advice. For example, I am “eating at least five servings of fruit and vegetables every day.” In Australia, the recommendation is to eat at least seven servings daily.

Read more: Supermarkets claim to have our health at heart. But their marketing tactics push junk foods.

Personalized dietary advice

The three groups of personalized Nutrition received tailored advice based on different characteristics. All advice was based on behavior change strategies, such as substituting discretionary foods with healthier alternatives.

The advice given to Group 1 was based on the food they consumed.

We told someone who ate a lot of salty meat to cut back on processed meats, pies, and salami and switch them for beef or turkey.

Group 2 was given advice based on the diet and measurements of their bodies.

We might tell someone who has a high cholesterol level and a high waist circumference to stop snacking on chocolate and biscuits. They would be better off eating fruit and healthy fats like nuts instead.

The advice given to Group 3 was based on the group’s diet, measurements of their body, and genetic information.

We told someone who had a high risk of cholesterol and was eating a lot of salty meat that they were genetically predisposed to this condition and should maintain a normal cholesterol level and a healthy intake. We recommended that they switch from processed meats such as burgers and sausages to lean meats like skinless chicken breast or lean meats.

Read more: These four diets are trending. We looked at the science (or lack of it) behind each one.

So, does personalized nutrition work?

At the beginning and the end of the study, we asked our volunteers to fill out an online survey, asking them how frequently they consume various foods and drinks.

Participants who received personalized dietary advice decreased their intake of discretionary food more than those who received normal nutritional advice.

This improvement was observed across all nutrition groups that were personalized, regardless of whether the advice was personalized on the basis of the diet, body measurements, genetics, or a combination thereof.

We did find some evidence to suggest that adults who were given advice solely based on body measurements and diet (group 2) reduced their discretionary intake of food more than those receiving advice based only on their body measurements and diet (group 3).

We found that personalized nutrition advice is associated with healthier eating. Shutterstock

Our findings are in line with other research on personalized Nutrition.

In a recent systemic review, we examined the results of 11 personalized nutritional studies conducted in Europe and North America. Overall, we found that customized nutrition advice was more effective than standard dietary advice in improving healthy habits.

The obesity epidemic is not just a problem for the individual but also has a huge impact on society. It costs more to live and work in obese communities, and it results in lost tax revenue.

Our new Grattan Institute Report, A Sugary Drink Tax: Recovering the Community Costs of Obesity, estimates community or “third-party” costs to be about A$5.3 Billion in 2014/15.

We suggest that the government tax sugar-sweetened drinks to recover some of the costs incurred by third parties and reduce obesity. A tax on sugar-sweetened beverages would make producers and consumers pay a greater share of the costs associated with their consumption, including those costs that have so far been passed onto other taxpayers. The added benefit is that the revenue raised could be used to fund obesity prevention programs.

Our proposed tax will only apply to non-alcoholic water-based drinks with sugar added. Soft drinks, fruit juices, flavored water, energy drinks, and flavored waters are included.

A sugary drink tax would be helpful, even though it isn’t a panacea to obesity (which requires numerous policies as well as behavioral changes on an individual level and in the population at large).

Why concentrate on sugary beverages?

Contrary to other processed foods like chocolate, sugar-sweetened drinks are often high in sugar. The majority of Australians, particularly younger people, already consume far too much sugar.

Sugary drinks are often consumed in excess because liquid calories do not trigger the “fullness” signal. Soft drinks and sugar-sweetened beverages may cause hunger and can lead to a lifetime preference for sweet food and drink.

Based on US evidence, we estimate that about 10% of Australia’s obesity problem can be attributed to these drinks.

Many countries, including the United Kingdom, France, South Africa, and some parts of the United States, have announced or implemented a tax on sugar-sweetened drinks. Taxes on sugar-sweetened beverages have been implemented or reported in many countries, including the United Kingdom (https://www.gov.uk/government/news/soft-drinks industry levy-12 things you should know), France (http://www.lemonde.fr/economie/article/2011/12/29/la taxe sur les boissons-sucrees will enter into force at 1er January 2016) and parts of the United States.

There is strong support for a tax on sugar-sweetened drinks in Australia if the money raised goes towards obesity prevention programs such as making healthier foods cheaper. The World Health Organisation, the Australian Medical Association, and advocates like the Obesity Policy Coalition support the introduction of a tax on sugar-sweetened drinks.

The tax will look like

We support taxing sugar in sugar-sweetened drinks rather than taxing them based on their price. This is because a sugar tax encourages manufacturers and consumers to purchase beverages that contain less sugar.

It is suggested that the tax be levied against manufacturers or importers who produce sugar-sweetened drinks. Evidence from overseas suggests that it will be passed directly on to consumers.

A tax of A$0.40 on 100 grams of sugar found in sugary drinks (about A$0.80 on a 2-litre soft drink) will generate about A$400 to $500 million annually. It will cut the consumption of sugary drinks by 15% or 10 liters on average per person. According to recent Australian modeling, a tax on sugar-sweetened beverages could reduce obesity by about 2%.

Author provided/The Conversation, CC BY-ND

Low-income earners consume more sugar-sweetened beverages than the rest of the population, so they will, on average, pay slightly more tax. But the tax burden per person is small – and consumers can also easily avoid the tax by switching to drinks such as water or artificially sweetened beverages.

Low-income people are more sensitive to price increases and, therefore, more likely than others to switch to healthier (non-taxed) beverages. The tax may not be as regressive as predicted. A tax on sugar-sweetened drinks may be regressive if measured in money. Still, the health benefits are greater for low-income individuals due to their higher rates of obesity and lower consumption.

The tax revenue could be used to fund obesity programs for people with low incomes, thus reducing its regressivity.

The sugar and beverage industries oppose any tax on sugar, but their fears are exaggerated. The major beverage companies own the majority of artificially sweetened beverages and waters that will not be taxed.

A tax on sugar-sweetened drinks will reduce the domestic demand for Australian Sugar by about 50,000 tonnes. This is just 1% of all sugar produced in Australia. While there might be some costs associated with the transition, this sugar can be sold abroad (as 80 percent of Australia’s production is already exported).

This recently published study shows that a greater number of genes are involved than previously thought. These genes may work in conjunction with your brain to affect your sugar addiction.

Read more: Fact or fiction – is sugar addictive?

What we know

Taste receptors are activated when food is in contact with our taste buds. The signal travels up the taste nerves and into our brain. This creates a flavor sensation and helps us decide whether we like the food.

In the last decade, genetic research has focused primarily on genes that affect sweetness. It also examined whether variations in these genes influence how we perceive sweetness and how much we consume.

In a previous study, we found that genetics accounted for 30% of the sweetness we perceive in sugars and artificial sweeteners. At the time, we did not know which genes were involved.

Read more: Curious Kids: how do tongues taste food?

What our latest study found

The new study analyzed data from 176,867 people of European ancestry from Australia, the US, and the UK.

We also measured the sweetness of artificial sweeteners, such as neohesperidin Dihydrochalcone and Aspartame. Also, we asked 686 Americans if they thought sucrose tasted sweet and if so.

The UK Biobank also contained data on the intake of sweets, such as chocolates and lollipops, and dietary sugars.

How many lollipops do you consume per day? Researchers combined genome analysis with these questions to discover links between sugar consumption and genes. from Shutterstock.com

We then looked at associations between the millions of genetic markers spread across the entire genome and perceptions of sweetness and sugar intake using a technique called genome-wide association analysis.

We found that after a 15-year research, several genes (others than those associated with sweet taste receptors) have a greater impact on our perception of sweetness and the amount of sugar we consume and drink.

There was a link between the gene FTO and sugar consumption. This gene was previously associated with obesity and health risks. The effect may be driven not by FTO but by nearby genes. These proteins act in the brain and regulate appetite as well as how much energy is used.

Genes near the FTO gene could be regulating how much sugar is consumed in our brains.

This study shows that the brain is a major factor in determining how sweet something tastes to us and how much we consume. This is in addition to the knowledge we have about taste receptors.

Sweet foods are a favorite of many people.

Our natural love of sweet food could be a legacy from evolution. Scientists think that being able to taste sweetness helped our ancestors to identify food rich in energy, which was crucial for their survival.

Read more: Our ancient obsession with food: humans as evolutionary Master Chefs.

However, being able to taste sweetness doesn’t always mean you prefer to eat lots of sweet-tasting food.

There are genes linked to the consumption of sweet food, but not our perception of how lovely they are. For example, FTO. There is the influence that perceives sweetness, but not whether or not we eat sweet foods.

Regional Differences

Our study of large populations of European descent found that genes for sweet taste receptors did not affect either the ability to taste sweetness or the amount of sugar consumed.

We found that by comparing individuals of different ancestries from the UK Biobank, we could see some differences between populations, which variations in genes for sweet-taste receptors may explain. We found that people of African descent tend to consume more sugar than those of European or Asian descent.

How can we make use of this?

Our latest study provides a genetic explanation for why some people prefer sweet foods. This could lead to the development of personalized diets that improve eating habits.

Genetics is not the only thing that influences your desire for sweet foods or how much you consume. You can’t blame your genes for a failed attempt to stop drinking or eating sugary drinks and snacks.

In spite of this, people do not consume enough fruit and vegetables. Over 75% of adults in low- and middle-income countries consume below the minimum recommended amount. In Tanzania mor, more than 95% of people consume less than the minimum requirements.

Our study shows that in the Nairobi slums, less than half the adult population meets their daily vegetable and fruit requirements. As global fast food outlets flood Kenya’s market, Kenyans prefer junk food, which they view as a status sign.

It could be because of this that there is a high level of diabetes in these slums, where one out of five people suffers from one of the conditions. We also found that less than a quarter (25%) of people with diabetes were aware of it. Fewer than 5% had their blood glucose under control.

Africa’s Fat Map

Increased non-communicable disease rates, such as diabetes, in countries with low and medium incomes, are largely due to rapid urbanization.

The World Health Organisation projects that people living with diabetes in sub-Saharan Africa will double, from 12 million to 24 million over the next 20 years. The World Health Organisation has provided evidence that type 2 diabetes is the main contributor to the rise.

Numerous studies on the continent indicate that obesity and excessive weight are risk factors for developing diabetes.

A review of the Demographic and Health Survey Data from seven African Countries over ten years shows there is a rising trend in overweight and obese women living in urban areas. The increase in overweight and obese urban women is seven times greater among the poorest women than the richest women.

The price is not the issue.

Nairobi’s slums have thriving vegetable markets. Why are slum dwellers not eating enough fruit and vegetables?

We initially thought the cost of fruit and vegetables would be prohibitive to slum dwellers, given that most of them are living on less than two dollars a day.

The price isn’t the only thing that makes people hesitate. Although imported fruit like pomegranates can be pricey, local products such as bananas and the trendy superfood kale are more affordable.

We found that slum dwellers wanted junk food to reflect a higher socioeconomic status.

They are motivated by a combination of clever marketing, celebrity culture, and social media frenzy surrounding the opening of global fast food outlets in Kenya.

In recent years, a number of fast food outlets opened in Nairobi. This has encouraged people to consume highly processed foods. Noor Khamis/Reuters

Who could blame them? In Kenya, many major fast-food chains from around the world have opened up in recent years. These include KFC Chicken and Pizza Hut. More are reportedly eyeing an entry into East Africa’s biggest economy.

Why it is difficult to change eating habits

It’s not easy to encourage fruit and vegetable consumption in slums. One of Kenya’s leading dailies published an article that slammed fruit and vegetables.

Scientists in Nairobi conducted laboratory tests on fruit and vegetable samples from the article. They found that they contained toxic levels of different substances.

The company argued that samples from Sukuma were high in lead. This was most likely due to contaminated riverbeds, where this vegetable is usually grown. Pieces of oranges and bananas showed high levels of calcium carbide, which is illegally used to accelerate the ripening process of fruit.

The article has caused widespread criticism and has made it more difficult for those who live in urban slums to eat vegetables.

The World Health Organization’s recommendation to improve fruit and vegetable consumption is pitched at the highest policy level. One suggestion is to restrict the marketing of foods and beverages for children.

These suggestions may not be practical for the health professionals on the ground.

What message should we send to residents of Nairobi’s Slums, asking the challenge for health professionals? Were we to tell them that they should eat more fruits and vegetables in light of the revelations made in the article? Do we ask them to eat junk food until authorities stop the illegal practices that affect the fruit and vegetable industry?

Industry self-regulation has failed to change the amount of fast food advertising targeting Australian children, according to new research from the Prevention Research Collaboration and NSW Cancer Council.

Researchers looked at fast food advertising during children’s peak television viewing times. They assessed whether companies were signed to the Quick Service Restaurant Industry Initiative (QSRII) for Responsible Advertising and Marketing to Children, introduced in 2009.

This Initiative, which had seven signatory companies at the time of the study, specifies that only food and beverages that represent healthier choices are to be promoted to children.

Researchers also compared the energy content of the advertised food to the daily energy needs of girls and boys aged four, eight, and 12 years.

Current regulations

In Australia, food and drink advertising aimed at children is regulated through statutory guidelines and industry self-regulation.

The Children’s Television Standards are statutory guidelines that cover the use of promotions, popular characters, unsuitable material, and clarity of messaging.

These do not regulate the types of foods that may be advertised to children, except alcohol, and only apply to a limited broadcast period (around one hour a day).

Unfortunately, this is usually not during children’s most popular programs or viewing times.

In terms of industry self-regulation, QSRII is one of two current programs. The other is the Australian Food and Grocery Council’s (AGFC) Responsible Marketing to Children Initiative.

These name specific types of foods and marketing techniques they consider appropriate for advertising to children and for defining child audiences.

However, these specifications are poorly defined, highly permissive, and voluntary for food manufacturers and services.

For example, company-developed nutrient criteria were found to consistently stipulate higher thresholds for negative nutrients compared with existing professional standards.

Another example involves rules for television advertising AFGC’s Responsible Marketing to Children Initiative. The threshold for applying advertising restrictions is rarely if ever, reached since many of them stipulate that they only use when children comprise half of the viewing audience.

There has also been low participation in Australian industry self-regulatory initiatives by food companies.

The failure of self-regulation

The study authors found there were as many advertisements for unhealthy fast foods in 2010 as there were before the Initiative was introduced.

One reason for this is that the Quick Service Restaurants’ self-regulation only applies to a very narrow range of advertised foods.

For example, the regulations don’t cover packages sold by fast food outlets as “family meals,” despite the fact that they are designed to be consumed by children and parents.

The analysis showed a child’s share of all but one of these family meal packages contained energy far in excess of children’s requirements.

The results indicate that in its current form, industry self-regulation is not reducing children’s exposure to unhealthy fast food advertising.

This is consistent with the results of previous research, which showed the Australian Food and Grocery Council’s (AFGC) Responsible Marketing to Children Initiative had not reduced children’s exposure to advertising for a range of unhealthy foods on Sydney television.

That research found children still watched the same amount of television advertising for unhealthy foods as they did before self-regulation was introduced.

Findings from both studies suggest a clear need for governments to set standards for limiting food advertising to children.

Why reduce children’s exposure to junk food marketing

There is consistent scientific evidence showing food marketing influences what foods children want, ask their parents for, and ultimately eat and drink.

The vast majority of food marketing targeted to children is for unhealthy foods, and food marketing to children is extensive across the internet, magazines, outdoor locations, and in stores.

Despite marketing being widespread across different media, television remains a major source of children’s exposure to advertising.

Australian and international studies indicate that a meaningful reduction in advertising of unhealthy foods and beverages is likely to be a cost-effective (and probably cost-saving) strategy for obesity and chronic disease prevention.

Necessities, not luxuries

The National Preventative Health Taskforce set up by the Australian Government has recommended children’s exposure to unhealthy food advertising should be reduced.

The Government responded that it would monitor the impact of self-regulation before taking any further action.

To be convincing, industry self-regulation needs to redress the numerous limitations in its current commitments and comprehensively and genuinely implement reductions in food and beverage marketing to children across all media, at all times, and for a broad set of energy-dense, nutrient-poor food products.

It is particularly important for any policy limiting unhealthy food advertising to use a standardized, independent nutrient profiling tool based on 100g/100mL to determine the appropriateness of foods and beverages for marketing to children.

The World Health Organization has recently called for global action to reduce the impact of marketing foods high in saturated fats, trans-fatty acids, sugars, and salt on children and recommends governments introduce policies to reduce children’s exposure to marketing of these products.

The limitations and failure of Australian industry self-regulation to date indicate that it’s time for the government to take action and set regulatory standards.

This piece is based on an article published in the Medical Journal of Australia today.

Through pricing, marketing, and availability, our food environment has been, for many decades, encouraging to make unhealthy choices. The rise of advertising has led to an increase in obesity and nutrition deficiencies as more people choose to consume unhealthy food.

Each of us has the right to purchase whatever we can afford. Commercial forces may limit our freedom of choice more than we realize. A new study published in The Lancet indicates that commercial entities, with their deep pockets and power to influence people’s choices, are responsible for many of the key causes of poor health. The commercial entities affect the political, economic, and regulatory systems and policies.

Industry Tactics

Commercial determinants are the ways in which commercial entities influence our food environment to maximize their profits. They create an atmosphere that encourages us to make unhealthy choices.

Three main methods are used to do this.

We have been socialized to believe our adult food choices are the direct result of our free will and freedom of choice. For people with limited money, this “freedom” can be limited by the food and beverage manufacturers and retailers who choose what to sell, market, and produce.

Marketing creates demand. The supermarkets are full of ultra-processed food with added sugars, unhealthy oils, and harmful additives. These products are made to make you want more. The marketing of food and beverages is done in an unethical manner. The companies target children using manipulative images and parents who are stressed with “easy” ways to feed and satisfy their family.

Profits of food and beverage companies increase their political influence. This is particularly true for markets that are underregulated in countries with low and middle incomes. They use their economic strength (employment, taxes) to support corporate lobbying, which weakens government policies.

What can you do?

The Lancet series outlines four ways that governments, businesses, and citizens can curb the power and harm caused by commercial entities.

1. Rethinking the political and economic system

Bhutan, Ecuador, Brazil and other developing countries are paving the way for new frameworks which put people first. Scotland and Wales in the UK have taken important steps.

These frameworks are designed to measure the commercial impact on health and environment and to encourage practices that promote good health. To achieve this, commercial entities must pay their fair share in taxes and be held accountable for all the harm that their products cause to health, the environment, and social welfare.

2. Create an international convention on commercial health determinants.

In practice, that would mean replicating global regulatory frameworks that work and expanding them. The World Health Organization (WHO) Framework Convention on Tobacco Control shows that public health policies are not at the mercy of commercial interests. The convention, which was adopted in 2003, has had a significant impact on public policy changes around the world. The way has provided countries with a framework to develop and implement evidence-based measures that reduce tobacco use and associated harms. Examples include:

Smoking-free laws.

Graphic health warnings for tobacco products.

Prohibitions of tobacco advertising and promotion, as well as sponsorship and tax increases.

The Lancet proposes that an “international convention” should be created on commercial determinants to health, with the support of WHO and its members states. The Lancet suggests that leaders in public health and politicians should replicate the tobacco-control convention by requiring countries to adhere to a set or principles. The framework must be sufficiently broad to include all commercial influences on the health. They include gambling, mining, automobiles, pharmaceuticals and technology (as well as the more familiar alcohol and food industries).

3. Comprehensive policies on food and the environment

Public procurement, i.e. how government purchases goods and services, is one type of policy that has been proven to protect and improve the health. The government can influence the food industry through its purchasing power by encouraging healthy food production and distribution and limiting unhealthy food products.

In 2008, the mayor of New York City directed city agencies to adhere to public food procurement standards in order for them to serve over 260,000,000 meals and snacks annually. The standards are applicable to over 3,000 programs at 12 agencies, including schools, shelters, and hospitals. The nutritional requirements include dairy, cereals and meat as well as fruit, vegetables and fruits.

The Brazilian School Food Programme provides another example of an effective national procurement policy that has direct benefits for health. The program provides healthy meals for millions of children in public schools throughout Brazil.

The company is required to buy 30% of its food from family farmers. The program has improved students’ health and well-being as it promotes sustainable and ethical food production. The programme has been successful in regulating the sale and marketing food both inside and outside of school grounds.

This model could be adopted by countries around the world, including South Africa. Despite industry promises not to sell unhealthy food and beverages to schools, these products are still easily available and readily available.

Read more: South Africa must ban sugary drinks sales in schools. Self regulation is failing

4. Social mobilisation.

Citizens, civil societies, activists, public-health practitioners, and academics are able to demand their right of health by requesting government action regarding commercial determinants. You can use a number of different strategies to achieve this. They can use their collective voice to support evidence-based measures of health, expose and oppose harmful effects of commercial factors on health and equity, and insist that governments and commercial actors are held accountable.