Abstract
BackgroundChildhood obesity is a global public health problem as a result of poor eating and activity behaviours. Periodically, taxation has been proposed as a strategy to modify food purchasing behaviour, and once again, there is growing interest in the feasibility of this approach towards obesity prevention. This article examines the outcomes of an expert panel that was convened to obtain consensus on 1) which foods are most problematic in terms of obesity if consumed during early childhood and 2) which foods would be amenable to taxation as a strategy to reduce consumption. A nominal group technique was facilitated with a panel of 12 Australian experts including nutrition professionals, academics and clinicians with an interest in childhood obesity. In addition to routine ranking analysis, transcripts were explored using thematic analysis to reveal the collective beliefs of the experts.ResultsThe panel reached consensus about the types of foods that were problematic in terms of their consumption and contribution to early childhood obesity which included prepared foods consumed outside the home, high protein infant formula products and sugar-sweetened beverages. However of these food and beverage items, the panel only deemed sugar-sweetened beverages and infant formula to be potentially amenable to taxation. They also highlighted the importance of subsidizing fresh fruit and vegetables, whole and unprocessed foods and hence topic complexities resulted in panel discussion being extended beyond the central notion of taxation.ConclusionsThe panel identified several food groups that contributed to early childhood obesity but noted that these foods were not equally amenable to taxation. Results of this research should be considered during decision making and planning regarding population policy and regulation to reduce childhood obesity in the very early years.
Highlights
Childhood obesity is a global public health problem as a result of poor eating and activity behaviours
The most recent data from the 2011–2012 Australian Health Survey indicates that 25.1% of children aged 2 to 17 years were overweight or obese, including 18.2% overweight and 6.9% obese based on Body Mass Index (BMI) [4]
This paper reports on the use of a systematic consensus-building method - the nominal group technique, as a tool for identifying priority foods with the potential to respond to taxation
Summary
Identifying and prioritising key foods “What is it that causes obesity? Well, any drink, which contains calories, any food, which contains calories.”. The overall task of identifying foods potentially amenable to taxation was not an easy decision for the experts, given the contribution of discussion to a significant number of barriers and issues, which subsequently played a central part in reaching consensus Barriers such as lack of definitions for food items, portion sizes and the nutrient density of foods were deemed to hinder support for taxation methods to reduce unhealthy food consumption in the early childhood years. The complexity of the topic along with undertaking specific, sequential tasks meant that panel members needed to seek clarification on the process and activities on several occasions to ensure clarity and understanding Another limitation is that lack of definitions of food groups or items was continually identified by the panel as a significant barrier to food taxation, it was out of the scope and purpose of this research to define some of the problematic categories. We know energy-dense nutrient-poor food choices comprise a significant proportion of early childhood energy intake, it is suggested to investigate particular dietary patterns and trends of children to identify the bigger picture of diet consumption, rather than just the contribution of individual foods
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