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Obesity – an AMA Priority

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Obesity is one of the key priorities for the AMA and its Public Health and Child and Youth Health Committee.

It is an increasing problem for our health at all ages, from childhood to old age, as Australia relentlessly climbs international league tables for the overweight and obese.

Essentially, Australia’s nutrition policy has failed.

A combination of a Federal system that requires a broad consensus across jurisdictions, governments averse to regulating industry, fear of ‘nanny state’ accusations, and a food and grocery supply chain and retail industry that seems to view even a voluntary food labelling system with suspicion, makes changing this difficult.

The all-pervasive subtle, and not so subtle, marketing of food is successful. The result is that we buy more, and are surrounded by plenty.  Many of the most promoted foods and beverages are energy dense. 

Human beings are poorly designed to cope with excessive amounts of these foods in our regular diet. The consequences include weight gain, type 2 diabetes, and an increase in the frequency of certain cancers.

The year 2013 marks 10 years since the World Health Organisation warned that “added sugars should make up no more than 10 per cent of target energy intake”.

 A can of soft drink contains nine teaspoons or more of added sugar. This is highlighted by the ‘Rethink Sugary Drinks’ campaign, which AMA supports, which is based on a similar US campaign that has increased awareness of the sugar content of these drinks. New York City Mayor Michael Bloomberg has also played a major role in drawing attention to the contribution of excess energy intake to the United States obesity epidemic.

Less obvious is the added sugar in products such as tomato sauce, salad dressings, and even bread.

Getting information on the amount of sugar, fat, salt and energy in our processed foods generally requires a magnifying glass, so consumers can honestly say their choices are based on taste and cost, in ignorance of nutritional value.

The AMA has been a strong supporter of clear, simple, front-of-packet labelling of processed foods and beverages to inform consumers about the nutritional value of what they consume.  This is not a magic bullet in the fight against obesity, but it is one plank in a platform.

The AMA’s preference had been for a traffic light system of food labelling but, after this was rejected by Australian governments, we participated in a successful two-year process that has led to the adoption of a five-star rating system – the more stars the better the nutritional content – for front of packet food labelling.  The stars will be accompanied by a large font information panel regarding the presence of key ingredients.

In June of this year the Legislative and Governance Forum on Food Regulation, bringing together Australian and New Zealand Ministers responsible for food regulation, formally adopted the star system, and marked packets will begin appearing on shop shelves around mid-2014.

Introduction of food stars is to be accompanied by a program of public education to improve nutritional literacy.  Ministers hope that the food and grocery industry will voluntarily adopt the front of package labelling system, but will review the extent of uptake two years after its introduction.

The food star system is not a panacea in the battle against obesity, and it is unrealistic to expect that its first iteration will be perfect. No doubt further refinement will occur over time.

Nevertheless, it is extremely disappointing to hear of some push back against the food star system from some sections of the food and grocery industry. Perhaps they believe a change of Commonwealth government will see less support for the introduction of the food star system. The AMA will oppose any indication from the industry that they are stepping back from the system they were a part of developing.

Even if governments ignore the personal cost of obesity, they cannot ignore the costs to the health budget – and these are so great as to convince governments of all complexions of the need to support all measures that hold the promise of reversing the rising tide of the obesity epidemic in Australia.

Energy intake is just one side of the equation that can lead to overweight and obesity, and the AMA also recognises the benefits of regular exercise. These benefits go beyond energy consumption and extend to many other positive effects on our health, as detailed in our Position Statement on Physical Activity (position-statement/physical-activity-2006).

We are also examining potential tools that could assist doctors in providing advice to their patients on maintaining a healthy weight.

Obesity and, particularly, childhood obesity, will remain an AMA priority.