Childhood obesity: government’s plan targets energy drinks and junk food advertising

The commitments outlined in chapter 2 of the government’s childhood obesity plan are welcome, and represent a significant improvement on those in the first plan.(1) The ambition “to halve childhood obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030” are positive goals but further steps will be needed if they are to be achieved.(2)

We applaud the government for planning to increase walking and cycling to schools and are pleased that other physical activity is to be encouraged. However, we feel strongly that the “medicine must be matched to the patient”, and children should be encouraged to take part in a variety of activities that they enjoy so that they are more likely to carry on with them after school.

We agree with the statement in the plan that “Schools have a fundamental role to play in helping equip children with the knowledge they need to make healthy choices for themselves….” This will help them become health literate. In order to achieve health literacy children and young people need through their education and schooling to be able to assess and evaluate information, manage risk and make lifestyle choices that develop and maintain healthy lifestyles and ultimately good health.(3)

The choices are in relation to a number of current pressing public health issues including obesity; mental health; sexual health; and smoking. Therefore, we urge the government to make Personal Social and Health Education (PSHE) compulsory in all schools. In addition, training and support should be provided for teachers and school nurses, so that they will be competent and confident in carrying out this vital work.

A significant step that is missing from the updated plan is the promotion of breastfeeding. This we think is important in helping to reduce infant obesity as well as assisting mothers regain their pre-pregnancy weight.(4,5)

Many doctors and nurses on the frontline could potentially help to tackle the childhood obesity epidemic.(4,6) They could use their many contacts with parents and their children to encourage healthy eating habits, and act as advocates for change at a community level. These roles may not be easy to undertake in parts of the country with GP shortages. Capacity issues still need to be addressed.(7,8,9)

Of major concern to us are financial issues. There is a lack of investment at a local level.(10,11) Directors of Public Health must be given the power and resources to drive forward strategies to tackle the obesity epidemic. They and their multidisciplinary teams have key roles in training, coordination and galvanising others into action.

In conclusion, we believe that the government has still not created a long-term child healthy eating strategy that is matched to the scale of the problem.(2) There are still significant areas that have not been addressed and there appears to be a lack of urgency. Strong, robust and bold actions are needed now.

References
1) Department of Health and Social Care. Childhood obesity: a plan for action, chapter 2. 25 June 2018. https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-....

2) Watson M C, Theaker T. Re: Fight childhood obesity with multiple methods, not just more taxes, MPs hear. BMJ Rapid Response. 7th May 2018. https://www.bmj.com/content/361/bmj.k1963/rr

3) Lloyd J. Improving health outcomes and health literacy for children and young people through Personal, Social and Health Education in schools. Paper presented at the 17th EUSUHM Congress. 27th June 2013. Royal College of General Practitioners. London.

4) Academy of Medical Royal Colleges. Measuring Up: The Medical Profession’s Prescription for the Nations Obesity Crisis. London: Academy of Medical Royal Colleges 2013.

5) Institute of Health Promotion and Education. IHPE Position statement: Breastfeeding. Welwyn: IHPE. 2017 http://ihpe.org.uk/wp-content/uploads/2015/05/Postion-statement-Breastfe...

6) BMA Food for thought: promoting healthy diets among children and young people. London: BMA 2015.

7) Baker M, Ware J, Morgan K. Time to put patients first by investing in general practice. Br J Gen Pract 2014;64:268-9. doi:10.3399/bjgp14X679921. 24868041.

8) Watson M C and Forshaw M. Tackling the crisis in general practice. Prioritising prevention and health promotion BMJ 2016;352:i1333.

9) RCGP. New GPs entering 'incredibly pressurised' profession, says RCGP. 15 June 2018. http://www.rcgp.org.uk/about-us/news/2018/june/new-gps-entering-incredib...

10) Watson M C and Tilford S. Directors of public health are pivotal in tackling health inequalities. BMJ 2016;354:i5013.

11) Watson M C and Thompson S. Government must get serious about prevention. BMJ 2018;360:k1279.