On July 3, 2012, the American Cancer Society (ACS) Cancer Action Network asked the US Surgeon General to initiate a comprehensive review of the consumption of sugar-sweetened beverages and their effects on health—with the aim of raising public consciousness and changing behaviours in choices of food and beverages. The ACS request aims to shed light on the link between excessive consumption of sugar-sweetened beverages and obesity. By promoting obesity, a high sugar intake may indirectly increase cancer risk. A third of all cancer deaths have been linked to poor diet and inadequate physical activity—important modifiable determinants of cancer risk. The ACS's request is in line with its recent guidelines on nutrition and physical activity for cancer prevention, which proposed recommendations for individuals (eg, “limit consumption of high-calorie foods and beverages”) and for community action (eg, “decrease access to and marketing of food and beverages of low nutritional value, particularly to youth”). Current trends towards increasing portion sizes, sugar-sweetened drinks, additives, high-calorie convenience foods, and ready meals, compounded by decreased physical activity, have contributed to the obesity epidemic in the USA, and similar trends are now being seen in many other countries worldwide. Childhood obesity is one of the most serious health challenges of this decade, because patterns of behaviour established in childhood are likely to be lifelong. Healthy choices are made by individuals, but they can be either facilitated or impeded by social, physical, and economic factors, and by the regulatory environment. Access to, and affordability of healthy foods, compared with the availability of inexpensive, extensively marketed high-calorie foods and beverages of low nutritional value, and barriers to physical activity, all contribute to obesity. It is difficult to alter behaviour when so many forces—many outside an individual's direct control—conspire against such change. Efforts are therefore essential to create an environment that encourages healthy choices, promoting physical activity and increasing access to affordable, healthy food while decreasing access to—and exposure to marketing of—food and beverages of low nutritional value. As part of the problem, the food and drink industry should also be part of the solution. Aggressive lobbying of regulators and government, and tactical targeting of children, minorities, and emerging economies should be tackled. Cynical marketing and brand alignment often culminate in the junk food and drink giants—eg, McDonald's, Coca Cola, and Cadbury's at the 2012 Olympics Games in London—acting as major sponsors of sporting and social events. Corporate responsibility campaigns that deftly shift responsibility for overconsumption from corporations to individuals to forestall regulation and promote brand—tactics similar to those employed by the tobacco industry—are also worrying and should be strongly discouraged. The obesity crisis is made worse by the way in which industries formulate and market their products. Governments should work with the food and drink industry to make healthier products and market them more responsibly. Taxation of individual components—eg, sugar—will not work in isolation, and needs to be part of a broader long-term plan. For instance, companies could be incentivised to decrease additive content over longer periods of time to gradually acclimatise consumers to the difference while not having a major effect on the viability of their business. Interventions and strategies should aim to make healthy choices the easiest choices. At both the individual and community level, health policies should aim to: improve awareness and information about benefits of a healthy lifestyle; introduce appropriate fiscal measures to make healthy food more affordable; and enhance regulatory mechanisms and measures that increase nutritional information or restrict marketing of unhealthy food. The 2004 WHO global strategy on diet, physical activity, and health, and the 2011 UN High-level Summit Political Declaration on the prevention of non-communicable diseases—in response to the rapid changes in nutrition and physical activity all over the globe—provide a framework that should be implemented and strengthened. Population-based prevention policies are expected to generate much needed health gains, and will largely pay for themselves through reductions in future health-care expenditure. It took nearly five decades from the US Surgeon General's report on tobacco and cancer for effective public health policies to be put in place; we cannot wait that long this time.
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Aug 1, 2015
Marize Melo Dos Santos + 5
Open Access