tag:theconversation.com,2011:/uk/topics/obesity-crisis-52026/articlesObesity crisis – The Conversation2020-07-17T13:32:54Ztag:theconversation.com,2011:article/1423452020-07-17T13:32:54Z2020-07-17T13:32:54ZPoorest Americans drink a lot more sugary drinks than the richest – which is why soda taxes could help reduce gaping health inequalities<figure><img src="https://images.theconversation.com/files/348142/original/file-20200717-37-tjdn6g.jpg?ixlib=rb-1.1.0&rect=219%2C78%2C5628%2C3410&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Soda contributes to obesity and other diseases. </span> </figcaption></figure><p>Many countries such as the <a href="https://www.lshtm.ac.uk/research/research-action/features/uk-sugar-tax-will-it-work">U.K.</a> and <a href="https://www.latimes.com/science/sciencenow/la-sci-sn-soda-tax-mexico-20161102-story.html">Mexico</a> and a handful of U.S. cities such as <a href="https://drexel.edu/now/archive/2020/February/Soda-Tax-and-Beverage-Consumption/">Philadelphia</a> and <a href="https://sftreasurer.org/business/taxes-fees/sugary-drinks-tax">San Francisco</a> have imposed soda taxes in an effort to fight rising obesity. </p>
<p>Lots of research shows a link between drinking sugary substances and a <a href="https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html#:%7E:text=Frequently%20drinking%20sugar%2Dsweetened%20beverages,gout%2C%20a%20type%20of%20arthritis">whole host of negative health outcomes</a>, including type 2 diabetes, heart disease, liver disease, tooth decay and gout. </p>
<p>As economists who study <a href="https://www.researchgate.net/profile/Jay_Zagorsky">economic status</a> and <a href="http://www-personal.umd.umich.edu/%7Epksmith/research.htm">health</a>, we wanted to look at this from another perspective: Does how wealthy you are affect how much soda you consume? And could reducing sugary beverage consumption narrow the <a href="https://www.nationalacademies.org/news/2017/01/new-report-identifies-root-causes-of-health-inequity-in-the-us-outlines-solutions-for-communities-to-advance-health-equity">double-digit life expectancy gap</a> between the richest and poorest Americans? </p>
<h2>Wealth and soda</h2>
<p><a href="https://www.doi.org/10.1016/j.ehb.2020.100888">We analyzed data</a> for over 24,000 U.S. adults in two nationally representative random samples from the <a href="http://www.nlsinfo.org/">National Longitudinal Surveys</a>, which follow groups of people over a period of time, asking them hundreds of questions each year on a variety of topics like employment, health and attitudes. Some questions are asked every year, while others are included less frequently. </p>
<p>We looked at two groups of people. The first is referred to as the <a href="https://www.nlsinfo.org/content/cohorts/nlsy79">NLS 1979 cohort</a> and includes people born from 1957 to 1964. They were asked how often they consumed sugary drinks in the previous week every other year from 2008 to 2016, meaning the respondents were in their 40s and 50s when asked the question. </p>
<p>The second group is known as the <a href="https://www.nlsinfo.org/content/cohorts/nlsy97">NLS 1997 cohort</a> and includes people born from 1980 to 1984. They were asked the sugary drink question four times from 2009 to 2015, putting them in their 20s and 30s. </p>
<p><a href="https://www.cdc.gov/nchs/products/databriefs/db122.htm">Prior studies</a> <a href="http://www.doi.org/10.3945/ajcn.111.018366">have found</a> that consumption of sugary drinks <a href="http://www.doi.org/10.1016/j.jand.2012.09.016">tend to rise</a> as income falls. But few of them controlled for the range of other factors that could also matter, such as gender, race and ethnicity, education, cognitive skills and interest in health and nutrition. Moreover, none of them focused on wealth, which can offer unique insights on the issue. </p>
<p>Wealth represents an accumulation of resources rather than a regular flow of income. Newly graduated doctors have high income and low wealth, while retirees may have high wealth, but little income. The difference between income and wealth means they could affect consumption patterns differently. Wealth is distributed much more unequally. In addition, individuals may signal their membership in the upper economic echelons through the foods they consume.</p>
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<p>We first looked at the share of respondents who reported drinking any sugar-sweetened beverages in the survey week by income and wealth deciles, which divides them into 10 equal groups depending on their income or wealth. </p>
<p>The number of sugar-sweetened beverages consumed generally falls as income rises. We found the same pattern when we looked at wealth, but the differences by wealth are more pronounced. Our analysis suggests that adults living in the richest 10% of families drink about 2.5 fewer sugary drinks a week than those in the poorest 10%. </p>
<p>This decline in sugary drink consumption as income and wealth rise holds up even after taking into account things like education, race, gender, cognitive abilities and interest in nutrition. </p>
<p>What’s the impact of 2.5 more sugar drinks a week? Rough calculations based on the typical sugar amounts in these drinks – <a href="https://sphhp.buffalo.edu/content/dam/sphhp/emergency-responder-human-performance/understanding-nutrition-labels.pdf">about 9.5 teaspoons</a> per 12-ounce can – suggest that it could result in <a href="https://www.livestrong.com/article/532975-how-to-calculate-how-many-calories-comes-from-sugar/">about 5.6 pounds of weight gain</a> over a year, assuming no increase in physical activity or decrease in consumption of calories from other sources.</p>
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<h2>For richer or poorer</h2>
<p>We also wondered whether soda consumption might change as people gain or lose wealth or make more or less money. Would increases in economic status correlate with decreases in sugary drink consumption?</p>
<p>Over the four-year periods we could observe, changes in income and wealth, even large ones, were not correlated to changes in sugary drink intake. We did not observe that adults who had gotten richer tended to report a drop in the number of sugary drinks consumed.</p>
<p>One possible explanation is that while economic status shapes our early drinking habits, those habits don’t much change in adulthood. Another possible explanation is that four years is not enough time for noticeable changes in sugar-sweetened beverage consumption to happen.</p>
<p>Our finding that people who are wealthier or make more money consume fewer sugary drinks supports the idea that soda consumption contributes to <a href="https://www.nationalacademies.org/news/2017/01/new-report-identifies-root-causes-of-health-inequity-in-the-us-outlines-solutions-for-communities-to-advance-health-equity">health inequities</a> along the economic distribution.</p>
<p>However, that doesn’t mean soda taxes are the best way to reduce these inequities. Since we find that sugary beverage consumption is higher for poorer Americans, these taxes can be regressive – meaning they fall more heavily on those with less income. On the other hand, if people with lower incomes respond to the higher prices caused by “soda taxes” by cutting consumption substantially, they can avoid the tax and improve their health. </p>
<p>A <a href="http://doi.org/10.1161/CIRCULATIONAHA.119.042956">just-published study</a> suggests that some soda taxes may be more effective than others at changing drinking habits. Specifically, it found that taxes based on the quantity of sugar in a drink are more successful than those simply based on volume, which <a href="https://www.cnn.com/2020/06/22/health/soda-tax-sugar-content-wellness/index.html">are more common in the U.S.</a></p>
<p>So well-designed soda taxes can help reduce rich-poor health disparities, but we’ll need a range of strategies to achieve that goal.</p><img src="https://counter.theconversation.com/content/142345/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>But the taxes have to be well-designed to avoid being overly regressive and targeting the poor.Patricia Smith, Professor of Economics, University of MichiganJay L. Zagorsky, Senior Lecturer, Questrom School of Business, Boston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1251752019-10-16T18:15:12Z2019-10-16T18:15:12ZSome countries have introduced mandatory nutritional labelling on menus – here’s why the UK should follow suit<figure><img src="https://images.theconversation.com/files/296942/original/file-20191014-135529-18ezzhz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/769150114?src=48d5DhNuMQDjhA7Vdsodrg-1-59&size=medium_jpg">Olga_Moroz/Shutterstock</a></span></figcaption></figure><p>Would you eat a burger if you knew it contained almost <a href="https://www.dailymail.co.uk/femail/food/article-3219456/Chef-s-6-000-calorie-creation-contains-nearly-three-pounds-meat-10-rashers-bacon-12-onion-rings-comes-salad.html">6,000 calories</a>? Some would gladly tuck in while others would recoil in horror. But if you have calories on the menu, at least you know what you’re biting into. And as our latest research shows, menu labelling, as it is called, may be a powerful way to change the nation’s eating habits.</p>
<p><a href="https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-015-0210-8">Research shows</a> that the British public is increasingly eating out and ordering takeaways, rather than preparing food at home. Our earlier research estimates that a quarter of UK adults and a fifth of children eat at a restaurant or order a takeaway at least once a week. Food that isn’t prepared at home <a href="https://academic.oup.com/nutritionreviews/article/71/5/310/2460221">tends to be</a> less healthy, more calorific and higher in fat, sugar and salt than food prepared at home. While eating out is a triumph for a large and important commercial sector, it is also contributing to the obesity crisis and the increase in diseases such as type 2 diabetes and cancer. </p>
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Read more:
<a href="https://theconversation.com/local-takeaways-create-a-double-burden-for-obesity-59102">Local takeaways create a double burden for obesity</a>
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<h2>Still not mandatory</h2>
<p>Unlike nutrition labelling on pre-packaged food, which has been around for years and mandated under <a href="https://www.gov.uk/guidance/food-standards-labelling-durability-and-composition">EU law since 2016</a>, menu labelling is still not mandated in the UK. The government included voluntary menu labelling in its <a href="https://webarchive.nationalarchives.gov.uk/20180201181346/https://responsibilitydeal.dh.gov.uk/pledges/pledge/?pl=8">Public Health Responsibility Deal in 2011</a>, and several establishments have since introduced menu labelling. </p>
<p>Of the <a href="https://www.technomic.com/available-studies/industry-reports">top 100 chain restaurants</a> in the UK, we recently found that 42 publish nutritional information on their websites, and of these, 14 voluntarily provide menu labelling in their establishments. A proposal for mandated menu labelling was included in the UK government’s <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/718903/childhood-obesity-a-plan-for-action-chapter-2.pdf">Childhood Obesity Plan</a>, and a public consultation closed last December, but no announcement on a final policy has been made so far.</p>
<p>Mandatory menu labelling has been introduced in other countries, including the <a href="https://www.sciencedirect.com/science/article/pii/S0022435917300775">US</a> in 2019 and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/monitoring-the-changes-to-the-nutrient-composition-of-fast-foods-following-the-introduction-of-menu-labelling-in-new-south-wales-australia-an-observational-study/D4205EA998E45B0FC3303065E186035E">parts of Australia</a>. </p>
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<figcaption><span class="caption">Calories explained.</span></figcaption>
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<h2>Labelled menus mean healthier food</h2>
<p>We found that food and drink sold at the top largest UK chain restaurants whose menus display energy information are lower in fat and salt than those of their competitors. </p>
<p>Menu labelling has often been touted as a way to provide information that helps people choose healthier dishes, but several reviews, including a recent <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009315.pub2/full">Cochrane review</a>, found only modest, poor quality evidence of an effect of menu labelling on purchasing and consumption. Our evidence suggests that the benefit of menu labelling may not necessarily be in helping consumers make healthier choices, but in incentivising restaurants to serve healthier food and drink. Without nutritional information, it is difficult to know where improvements are needed.</p>
<p>Nutritional information is only helpful if it is accurate. A <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/an-evaluation-and-exploration-of-irish-foodservice-businesses-uptake-of-and-attitudes-towards-a-voluntary-governmentled-menu-energy-calorie-labelling-initiative/644FD0D51460DF6578FFE3E0E371059F">2018 study</a> on the views of Irish food-service businesses towards voluntary menu labelling found that key barriers to implementing it included concerns about potential inaccuracies in calorie information and the lack of training on how best to provide quality calorie information. </p>
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Read more:
<a href="https://theconversation.com/can-food-have-negative-calories-nutritionist-debunks-the-idea-100986">Can food have negative calories? Nutritionist debunks the idea</a>
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<p>If food outlets are mandated to provide menu labelling, they will need greater support and training to do so. But it may also increase the demand for more accurate, efficient and accessible methods of data collection (<a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/an-evaluation-and-exploration-of-irish-foodservice-businesses-uptake-of-and-attitudes-towards-a-voluntary-governmentled-menu-energy-calorie-labelling-initiative/644FD0D51460DF6578FFE3E0E371059F">typically laboratory or electronic database analysis</a>), promising easier ways to account for the nutritional quality of what’s on restaurant menus.</p>
<h2>Should nanny stay at home?</h2>
<p>Mandatory labelling will not be popular in all corners. After all, who doesn’t enjoy blowing out at the occasional all-you-can-eat buffet? The challenge is that eating out is not occasional anymore. It is has become habitual. </p>
<p>Fortunately, as we increasingly ditch the kitchen for the restaurant and takeaway, government has found that there is <a href="https://www.diabetes.org.uk/about_us/news/poll-food-labels-influence-spending">strong public support for menu labelling</a>. Through the <a href="https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action">Childhood Obesity Plan</a>, the government is exploring many ways to help make it easier for us all to make healthier choices and menu labelling should be considered as one of many policies, not as a silver bullet. </p>
<p>The 6,000-calorie burger is an extreme example. But think about it, when you last ate out, did you know how many calories you were consuming?</p><img src="https://counter.theconversation.com/content/125175/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dolly Theis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>British people are increasingly eating out. Menu labelleling is a way to ensure they make healthy choices.Dolly Theis, PhD Candidate, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1208112019-07-29T11:34:40Z2019-07-29T11:34:40ZWhy are school lunches still so unhealthy?<figure><img src="https://images.theconversation.com/files/285510/original/file-20190724-110154-1gn9a2b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Do you know what your child is eating at school?</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>There are more than <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ijpo.12185">91m school children</a>
worldwide now defined as living with obesity – and the UK is in the top 20 countries for obesity levels. In the UK, the obesity rate for children doubles <a href="http://www.gov.uk/government/publications/national-child-measurement-programme-ncmp-trends-in-child-bmi">during primary school</a> years – and then <a href="https://theconversation.com/physical-activity-programmes-in-schools-arent-working-heres-why-109684">increases again in secondary school</a>.</p>
<p>This is in part because teenagers in the UK <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf">consume poor quality diets</a>, low in nutrients and high in processed foods. Indeed, girls in England do not get essential nutrients required for <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf">reproductive and overall good health</a> (vitamin A, folate, iron). And young people are also generally low in at least five micro-nutrients needed for development, immunity, mood and energy levels. </p>
<p>Teenagers in the UK also consume the <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf">highest amount of added sugars and sugary drinks</a> compared to all other age groups. Teenagers also consume the highest amount of breakfast cereal products (that are also known to be filled with sugar), and confectionery. And only <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf">4% of UK teens meet daily fibre recommendations</a>. This is concerning given that dietary fibre is associated with a decreased risk of heart disease, <a href="https://www.diabetes.co.uk/news/2018/mar/high-fibre-diet-has-benefits-for-type-2-diabetes,-study-claims-96054636.html">type 2 diabetes</a> and cancer. Young people are also <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf">only eating around two and half portions</a>of their recommended five a day of fruit and vegetables. </p>
<p><a href="http://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action">Research</a> also shows that teenagers from disadvantaged backgrounds have <a href="http://www.gov.uk/government/publications/national-child-measurement-programme-ncmp-trends-in-child-bmi">lower micro-nutrient and fibre intake</a> than their more well-off peers. And findings from the <a href="https://foodfoundation.org.uk/">Food Foundation</a> think-tank show that almost 4m children in the UK live in households that <a href="https://foodfoundation.org.uk/publications/">struggle to afford to buy</a> enough fruit, vegetables, fish and other healthy foods to meet the official nutrition guidelines.</p>
<p>These types of dietary patterns can not only have negative consequences on the physical health of teenagers, but they can also impact their mental health. Research shows malnourished teens are <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0024805">less likely to fulfil their potential</a> at school, and more likely to suffer with poor mental health.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-best-way-for-children-to-lose-weight-heres-what-the-research-says-79714">What's the best way for children to lose weight? Here's what the research says</a>
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<h2>Why the poor choices?</h2>
<p>But brain changes that occur with puberty coincide with the transition to secondary school and these changes can influence attitudes and behaviours in all areas – <a href="https://psycnet.apa.org/record/2016-34828-010">including healthy eating</a>. The desire to fit in is strong, and liking healthy food can be seen as “uncool” by teens. Young people also <a href="https://academic.oup.com/her/article/20/4/458/632655">place great importance</a> on social time within the school day. And many teenagers describe the school dining hall as an <a href="https://www.tandfonline.com/doi/abs/10.1080/0305764X.2019.1630367">intimidating place</a> with poor food choices and teachers roaming – making it somewhere they would rather avoid. There’s also often long queues and a lack of perceived privacy in school canteens – which can lead to teenagers skipping lunch and getting most of their energy intake at morning break or at the end of the school day from local food outlets.</p>
<p>There’s also the wider issue that school food policy has failed to sustain quality nutrition – particularly in secondary schools. <a href="http://www.akofoundation.org/wp-content/uploads/2017/11/2_0_fell-report-final.pdf">Researchers from the Jamie Oliver Foundation</a> were alarmed to find many schools are still serving high fat and sugary foods at break and lunch – including pasties, pizza, doughnuts, muffins and cookies, often in large portion sizes. This is despite Oliver campaigning tirelessly over the last decade to change the nation’s eating habits after <a href="https://www.imdb.com/title/tt0464070/">Jamie’s School Dinners</a> aired in 2005 to reveal the terrible standards of school food in the UK. <a href="https://www.telegraph.co.uk/news/celebritynews/11821747/Jamie-Oliver-admits-school-dinners-campaign-failed-because-eating-well-is-a-middle-class-preserve.html">Oliver has since said</a> that his push to improve nutrition for children didn’t work because eating well is still seen as a “posh and middle-class” concern.</p>
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<img alt="" src="https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/285511/original/file-20190724-110158-12p6itv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Processed foods that are high in fat, sugar, and salt have become a mainstay of lunches in schools across the UK.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<p>A lack of continuity between successive governments and poor consistency in the evaluation of school food standards may also be to blame. Indeed, the current <a href="https://www.schoolfoodplan.com">school food plan</a> that provides practical and specific guidance on the types of food and drinks schools should and shouldn’t offer – <a href="http://www.schoolfoodplan.com/wp-content/uploads/2016/03/SFP-governance-and-funding.pdf">has not been evaluated since 2013</a>. And while <a href="http://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action-chapter-2">it’s a requirement for schools to follow this plan</a>, in reality there can be a great deal of difference in how schools feed their children.</p>
<h2>Time to act</h2>
<p><a href="https://theconversation.com/mind-the-doughnut-emotional-eating-is-a-habit-that-can-start-in-childhood-58602">Research shows</a> that eating habits people pick up in their youth <a href="https://academic.oup.com/jpubhealth/article/28/1/10/1553731">tend to track into adulthood</a>, which makes the teenage years an important stage to start forming healthy habits. So rather than placing the full responsibility of food choice onto teens, more needs to be done to enable young people to make healthier choices. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/285513/original/file-20190724-110170-kx5nt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">School lunches should be nutritious and delicious.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>This can include consulting with pupils to engage them in making decisions about the dining room environment and better food education. Reducing choices and streamlining menus has also been shown to improve <a href="http://www.researchgate.net/profile/Michael_Nelson12/publication/265755030_First_annual_survey_of_take_up_of_school_meals_in_England/links/5630bd2d08ae1bdcebcf2383.pdf">healthier food choices</a>. Though to improve teenager health in a sustained way, wider issues <a href="https://theconversation.com/advertising-has-the-power-to-make-children-fat-and-this-needs-to-stop-58899">such as food advertising</a> and food development also need to be looked at. </p>
<p>But of course it <a href="https://theconversation.com/obesity-crisis-cant-be-solved-by-schools-major-new-study-91265">isn’t just all down to schools</a>, parents can also help massively by creating a home environment that supports healthy eating. Here, patience is a must and convenience is key – offer carrots or chopped fruit when they are hungry coming through the door after school. And <a href="https://theconversation.com/why-parents-and-pupils-are-finding-healthy-packed-lunches-hard-to-stomach-65419">be the example</a> – have fun trying new fruits or vegetables – and help kids to recognise that fuelling with nourishing foods impacts how we all feel, think, look and perform.</p><img src="https://counter.theconversation.com/content/120811/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelly Rose does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Obesity crisis: pizza, pastries, chips, donuts, cookies, hot dogs, and burgers – just your average school lunch.Kelly Rose, PhD Researcher in the School of Science, Engineering and Design, Teesside UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1098212019-01-21T13:30:42Z2019-01-21T13:30:42ZHalf of employers say they are less inclined to recruit obese candidates – it’s not OK<figure><img src="https://images.theconversation.com/files/254125/original/file-20190116-163268-mcmhpn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women in customer facing roles often suffer most.
</span> <span class="attribution"><a class="source" href="https://www.worldobesity.org/resources/image-bank">World Obesity Image Bank</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Obesity is one of the most pressing and controversial public health challenges. It has the distinction of being a crisis about which most people have an opinion – often based on a simple diagnosis – but for which nobody has found a correspondingly neat solution. </p>
<p>It’s still very common to hear even clinically trained experts, as well as ordinary folk, trot out tired old certainties about a <a href="https://www.womenshealth.northwestern.edu/blog/obesity-it-disease-or-choice">lack of willpower</a>, or that it is a lifestyle choice for which people should take more responsibility. Even in some modern businesses, it seems that it’s still OK to target discriminatory practices against those living with obesity. </p>
<p>Only recently, Pakistan International Airlines was reported to have told <a href="https://www.independent.co.uk/travel/news-and-advice/pakistan-international-airlines-cabin-crew-weight-loss-flight-fat-weight-limit-a8715166.html">overweight cabin crew</a> that they must lose weight or be grounded. “No one would like to have shabby crew in the aircraft,” <a href="https://edition.cnn.com/travel/article/pakistan-international-airlines-cabin-crew-weight-memo-intl/index.html">a spokesperson reportedly said</a> in mitigation. </p>
<p>So is it time to get tougher on obese or overweight workers and the “burden” they have become, or would a more empathetic and supportive approach work better?</p>
<h2>Obesity: the facts</h2>
<p>In England, <a href="https://www.gov.uk/government/news/dame-carol-black-publishes-review-on-links-between-work-and-addiction">60% of men and 50% women are overweight or obese</a>. A quarter of men and women are obese and this has been increasing over the last 30 years. For comparison, in 1980 only 7% of adults were obese. In 2014-2015 treating obesity and its consequences cost the NHS in England £5.1 billion. </p>
<p>Evidence shows the causes of obesity are devilishly complex. The 2007 UK government’s Foresight report on <a href="https://www.gov.uk/government/publications/reducing-obesity-future-choices">the science of obesity</a> remains one of the most comprehensive dismantling of the “lack of willpower” argument. It showed dozens of medical, psychological and societal contributors to the problem.</p>
<p><a href="https://www.gov.uk/government/news/dame-carol-black-publishes-review-on-links-between-work-and-addiction">Dame Carol Black’s review</a> into the impact on employment outcomes of drug or alcohol addiction, and obesity – to which I was an adviser – found there are many social determinants of obesity. <a href="http://www.euro.who.int/__data/assets/pdf_file/0003/247638/obesity-090514.pdf">A major review by the World Health Organisation</a> found that over 33% of those not in work, and those who are either obese or severely obese, were from the most deprived areas. </p>
<p>This means that obese people in lower socioeconomic groups are getting heavier at a faster rate than people in higher socioeconomic groups. This is illustrated in the graph below from France where, between 1997 and 2012, the lowest income group became obese more than three times faster than those in the two highest income groups.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=425&fit=crop&dpr=1 600w, https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=425&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=425&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=534&fit=crop&dpr=1 754w, https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=534&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/254118/original/file-20190116-163265-1kqkbn9.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=534&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
<span class="attribution"><span class="source">2014/ World Health Organisation.</span></span>
</figcaption>
</figure>
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Read more:
<a href="https://theconversation.com/your-parents-lifestyles-can-determine-your-health-even-as-an-adult-86879">Your parents’ lifestyles can determine your health – even as an adult</a>
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</em>
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<h2>Weight stigma</h2>
<p>Obesity in the workforce is something we still hear less about, but which is also increasing. <a href="https://publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/2309.htm">Public Health England estimates</a> that up to a third of working people are obese and that there are 16m days of sickness absence each year due to obesity. The cost of lost productivity in the US attributable to obesity has been <a href="https://bmjopen.bmj.com/content/7/10/e014632">estimated at $15.1 billion</a>. <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12621">Shift workers</a> also have an elevated risk of obesity too.</p>
<p>What is clear is that negative stereotypes about obese people at work persist. They are often seen as lazy, lacking in self-discipline, less competent, less conscientious and unmotivated. <a href="https://www.hrmagazine.co.uk/article-details/obesity-at-work-fighting-fat-or-fighting-stigma">Obese</a> workers often have lower starting pay and less hiring success – <a href="https://www.crosslandsolicitors.com/site/crossland_news/Employer_survey_obese_candidates_2015_html">45% of employers</a> say they are less inclined to recruit obese candidates. They are less likely to be regarded as able leaders or to have career potential, are more likely to experience bullying and harassment, and obese women are less likely to get customer-facing jobs. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/254126/original/file-20190116-163265-nlljbo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The workplace can be a difficult place for people with obesity.</span>
<span class="attribution"><span class="source">World Obesity Federation</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p><a href="https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2008.636">One study on employment discrimination</a> found the more overweight a person is, the more the likely they are to report discrimination in the workplace. Overweight workers were 12 times more likely, obese respondents were 37 times more likely, and severely obese respondents were 100 times more likely than normal weight respondents to report employment discrimination. </p>
<p>Women are also 16 times more likely to report weight related employment discrimination than men. This is because parts of our service sector have an “<a href="https://www.theguardian.com/society/2016/dec/02/dorchester-hotel-could-be-sued-over-grooming-rules-for-female-staff">aesthetic labour</a>” market where body image and grooming are at least as important as competence. </p>
<p>The relationship between obesity and mental health is also important. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21052">One study</a> found that discrimination on the basis of weight explains much of the link between obesity and psychological well-being and there is clear evidence that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561038/">anti-psychotic drugs</a> and obesity are linked. Despite all this complexity, for some it’s still easier to blame the obese. </p>
<h2>Supportive help</h2>
<p>In Europe, <a href="https://europeanlawblog.eu/tag/case-c-35413-kaltoft/">the law is catching up</a> with the need to make sure that employers understand that functional impairment – such as reduced mobility – resulting from extreme obesity can be considered as coming under the scope of equalities legislation as a “protected characteristic” and require workplace adjustments to be made. This at least points the way towards supportive rather than punitive approaches in workplaces. </p>
<p>Offering support is not about absolution but it is about helping people living and working with obesity and overweight to take more control and to make changes to their diets and lifestyles which gradually rebuild self-esteem and agency. </p>
<p>Workplaces can be great arenas within which this support can be offered without prejudice and where small successes can be built upon. I’m old-fashioned enough to believe that kindness and empathy are, in the end, more powerful forces than derision and contempt. Let’s give them a try.</p><img src="https://counter.theconversation.com/content/109821/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Bevan receives funding from bodies such as the Department of Work and Pensions, the Engineering Employer's Federation and the European Occupational Safety and Health Agency to conduct research on workforce health policy and practice.</span></em></p>People with obesity earn less and have a harder time finding work.Stephen Bevan, Head of HR Research Development, Institute for Employment Studies, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1096842019-01-17T10:28:22Z2019-01-17T10:28:22ZPhysical activity programmes in schools aren’t working – here’s why<figure><img src="https://images.theconversation.com/files/254173/original/file-20190116-163274-lgeb25.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>A third of children in the UK are <a href="https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/health-survey-for-england-2014">overweight or obese by the time they reach primary school</a>. Many other countries are facing the same issue, with a tenfold increase in the worldwide prevalence of childhood obesity <a href="https://www.sciencedirect.com/science/article/pii/S0140673617321293?via%3Dihub">over the past four decades</a>. </p>
<p><a href="http://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf?sequence=1">International guidelines</a> recommend that young people aged five to 18 should do at least an hour of moderate to vigorous physical activity every day. But globally, eight out of ten adolescents <a href="https://www.sciencedirect.com/science/article/pii/S0140673612606461?via%3Dihub">fail to meet these guidelines</a>. In particular, <a href="https://insights.ovid.com/crossref?an=00005768-200202000-00025">girls</a> and children from <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-10-214">disadvantaged socioeconomic backgrounds</a> are less likely to be physically active.</p>
<p>Governments worldwide are attempting to tackle the growing problem of obesity by increasing the amount of physical activity young people are doing on a daily basis. In the UK, for instance, the government’s <a href="https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action">Childhood Obesity Strategy</a> focuses on helping pupils in schools to move more. </p>
<p>A typical school-based intervention may introduce activity breaks into daily class lessons or add a new physical education lesson through a specialised teacher. It could also include building new playground equipment or assigning physically active homework. In the UK, funding for such initiatives, specifically to finance physical activity in primary schools, has recently <a href="https://researchbriefings.parliament.uk/ResearchBriefing/Summary/CDP-2017-0006">doubled to £320m</a>. This is thanks to additional revenue generated from the Soft Drinks Industry Levy. </p>
<p>But while this all sounds well and good, robust evidence for the effectiveness of existing school-based physical activity programmes is lacking. It is also unclear whether all children – irrespective of socioeconomic status – benefit equally. </p>
<h2>Moving more</h2>
<p>Our <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12823">recent research</a>, which examined 17 international trials, shows that current efforts are not working as intended. When the results of these interventions were combined, there was no effect in increasing the amount of physical activity school children engaged in across the full day. </p>
<p>We conducted a review examining previous research on school interventions that aim to improve physical activity. We looked at trials conducted in Europe, Australasia and North and South America. On average, 20 schools and over 450 children were included in each individual study. Physical activity was measured objectively using automatic electronic monitors to capture actual physical activity across the full day, instead of asking students or parents what they remembered doing, which can be highly inaccurate. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/254177/original/file-20190116-163277-g4bwek.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many children don’t get enough daily exercise.</span>
<span class="attribution"><span class="source">Pexels</span></span>
</figcaption>
</figure>
<p>What we found was not promising. Overall, the interventions were ineffective in changing the amount of physical activity school children did across the day – compared to children in control schools. Breaking down the data, we found no evidence of effectiveness among girls or boys, or for children from different socioeconomic backgrounds. </p>
<p>So despite the promise of schools being the ideal environment for influencing young people’s health behaviours, the available evidence suggests current efforts are failing.</p>
<h2>Beyond the school gate</h2>
<p>But this does not mean there should be an end to school-based interventions. But there does need to be a better understanding of what went wrong with these previous initiatives – along with work to improve them. </p>
<p>One reason for the lack of effectiveness, for example, could be that the programmes may not have been implemented as intended in schools. The programmes often include many components and depend on a range of (already busy) school staff implementing them in a particular way. But to what extent this happens is very often unclear. Similarly, we know little about what the main barriers are to implementing full programmes as intended. It could also be the case that school-based initiatives have a positive impact on children’s physical activity during school hours, but that this is not maintained outside school. </p>
<p>Having said that, it is unlikely that substantial changes to physical activity and obesity will be made by focusing only on schools. More work needs to be done to make sure the wider environments children spend time in are supportive for behaviour change – this includes their homes and local communities.</p>
<p>So given that childhood obesity increases the risk of diseases including type 2 diabetes, heart disease and cancer in adulthood, and that together these diseases are estimated to cause around <a href="https://www.who.int/nmh/publications/ncd-status-report-2014/en/">seven in ten deaths worldwide</a>, this is something that needs to happen sooner rather than later.</p><img src="https://counter.theconversation.com/content/109684/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebecca Love receives funding from the Gates Cambridge. </span></em></p><p class="fine-print"><em><span>Esther van Sluijs receives funding from MRC, NIHR, and DoH. </span></em></p><p class="fine-print"><em><span>Jean Adams receives funding from the National Institute for Health Research, the Health Foundation, the Medical Research Council, and the Department of Health & Social Care.</span></em></p>There has been a tenfold increase in the worldwide prevalence of childhood obesity over the past four decades.Rebecca Love, PhD Candidate in the Centre for Diet and Activity Research, University of CambridgeEsther van Sluijs, Programme lead – Behavioural Epidemiology, University of CambridgeJean Adams, Senior University Lecturer in Dietary Public Health Research, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1032772018-09-20T13:01:57Z2018-09-20T13:01:57ZHow to teach kids where food comes from – get them gardening<figure><img src="https://images.theconversation.com/files/237080/original/file-20180919-143281-1jqb58y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research shows children are five times more likely to eat salad when they have grown it themselves.</span> <span class="attribution"><span class="source">Rawpixel.com/Shutterstock</span></span></figcaption></figure><p>Survey the shelves of most supermarkets and you’ll no doubt be confronted with row upon row of food designed to appeal to children.
Be it chicken nuggets or turkey twizzlers – many foods now bear little resemblance to their original ingredients – “junk foods” now line the supermarket shelves to <a href="https://onlinelibrary.wiley.com/doi/full/10.1046/j.1470-6431.2003.00328.x">appeal to young consumers</a>. </p>
<p>The influence of supermarkets on UK children is not to be underestimated. These super-retailers generated just under £164 billion in 2011 with UK grocery sales predicted to rise to just below <a href="https://www.statista.com/statistics/330171/grocery-retail-market-value-in-the-united-kingdom-uk/">£197 billion by 2021</a>.</p>
<p>This makes the children’s food and beverage market a highly lucrative sector. In the US, for example, it has been worth over US$41 billion (£30 billion) <a href="https://www.statista.com/statistics/309772/us-retail-sales-of-children-s-food-and-beverages/">in the year to date</a>. Children tend to influence their parents’ buying decisions while shopping – and marketing tactics like <a href="https://www.tandfonline.com/doi/figure/10.1080/10454446.2015.1048026?scroll=top&needAccess=true%20and%20https://www.tandfonline.com/doi/full/10.1080/10454446.2012.65378?%E2%80%8B">free toys and media tie-ins</a> can play a big part. </p>
<p>It’s maybe not surprising then that a recent poll from the supermarket Asda, revealed that many children today lack basic knowledge of where their food comes from. The survey, which quizzed 1,000 children under the age of eight, found that 41% <a href="https://www.express.co.uk/life-style/food/712737/avocados-come-from-animals-Kids-shocking-lack-of-food-knowledge-exposed">didn’t know eggs come from chickens</a>. Similar polls have found that many children are <a href="https://www.farminguk.com/News/Survey-shows-a-third-of-British-children-don-t-know-where-milk-comes-from_46824.html">unaware that milk comes from cows</a>.</p>
<p>There have, of course, been many campaigns to rectify this lack of knowledge by raising awareness of the risks and problems of feeding processed food and ready meals to children, including the publicity raised a decade ago by chef Jamie Oliver’s campaign for <a href="https://www.theguardian.com/society/2005/mar/06/schoolmeals">real school dinners</a>. Unsurprisingly though, many children still appear to be unaware of the origins of their food. </p>
<h2>Food ignorance</h2>
<p>This all comes at a time when childhood obesity is a major problem in the UK – with many children becoming fatter as they go through school. Almost 60% more children are classified as “severely obese” in their last year of primary school than in their first year, according to the <a href="https://www.gov.uk/government/statistics/statistics-on-obesity-physical-activity-and-diet-england-2018">latest government figures</a>. </p>
<p>For a whole variety of reasons, many children now spend long periods of time indoors, engaged in sedentary screen-based hobbies – which is a large part of the problem. This is something that was highlighted only recently when TV star Kirstie Allsopp [smashed her son’s tablet] amid a <a href="https://www.theguardian.com/tv-and-radio/2018/sep/15/kirstie-allsopp-defends-decision-smash-childrens-ipads">riot of publicity on Twitter</a>. </p>
<p>Of course, most schools routinely <a href="https://www.gov.uk/government/publications/obesity-healthy-eating-and-physical-activity-in-primary-schools">teach healthy eating</a> and the importance of exercise as part of their curriculum. But this does not mean that children will act on the advice they receive from teachers in the classroom. </p>
<h2>Limited choices</h2>
<p>Nutrition is often an important component in food <a href="https://academic.oup.com/jcr/pages/food_decision_making">choices for adults</a>, but it is taste, texture (and pleasure) that are more likely to be of interest to the average child. So although schools routinely challenge children to think about nutrition, neither the curriculum nor school lunches provide a broad sensory experience of food. </p>
<p>This means that many children progress through school without trying a range of fresh and nutritious foods, and remain unaware of the source and value of such produce as they get older. This is significant, because <a href="http://journals.sagepub.com/doi/full/10.1177/0038038518789542">the research we have done</a> shows that the sensory experience of eating is what drives childhood learning about food and nutrition. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=319&fit=crop&dpr=1 600w, https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=319&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=319&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=401&fit=crop&dpr=1 754w, https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=401&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/237084/original/file-20180919-146148-1834f76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=401&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘Look what we grew!’</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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</figure>
<p>Observing children in two UK schools, our work reveals that gardening clubs provide new and exciting opportunities to connect production with consumption. These spaces have the potential to change the way schools think about the healthy eating curriculum by giving children the freedom to touch, taste, smell and – above all – understand the source and value of fresh food.</p>
<h2>Let children get muddy</h2>
<p>For children, this involves sensory engagement with “mess” and materials usually screened from the sanitised retail, marketing and service of food. Encouraging children to play with soil, discover animals and insects, and explore the garden is what gives them pleasure. Encouraging them to get their hands muddy is central to this playful experience. And, more importantly, when they are absorbed in these activities, feeling the soil, touching some worms, digging or even just running around, they learn about food at their own pace. </p>
<p><a href="https://www.gov.uk/government/news/kids-encouraged-to-veg-out-in-school">Research</a> shows that when children experience the growing of food in the outdoors in this way, they are much more likely to taste and enjoy it. And they even challenge their parents to try what they have grown.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/237086/original/file-20180919-158237-bb2df7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Gardening can help children to learn how the world works.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/small-african-girl-working-garden-watering-39032056?src=I10Qb9ul9QkMnawwxpz-qg-1-5">Lucian Coman/Shutterstock</a></span>
</figcaption>
</figure>
<p>The benefits of outdoor learning are <a href="https://www.bbc.co.uk/news/science-environment-36795912">well documented</a>. But gardens are vital if children are to grow up with a working knowledge of food cultivation and the pleasure it gives to harvest everyday crops like radishes, chives and peas. </p>
<p>Most schools could offer growing and gardening as part of the curriculum – even on a small scale. Sadly though, many do not – concerned about the practicalities it involves – and the time it takes away from “more important” classroom subjects. But if the government is serious about tackling obesity, anxiety and ignorance when it comes to eating, the school garden is the best place to start.</p><img src="https://counter.theconversation.com/content/103277/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma Surman has received funding from the ESRC, EPSRC and the Heseltine Institute for Public Policy, Practice and Place</span></em></p><p class="fine-print"><em><span>Emma Surman has received funding from the ESRC, EPSRC and the Heseltine Institute for Public Policy, Practice and Place.</span></em></p>Teaching children to grow their own fruit and vegetables could be key to tackling the obesity crisis.Lindsay Hamilton, Senior Lecturer in Organisational Ethnography, Keele UniversityEmma Surman, Senior Lecturer in Marketing, Keele UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/945202018-04-06T11:45:32Z2018-04-06T11:45:32ZSugar tax: what you need to know<figure><img src="https://images.theconversation.com/files/213406/original/file-20180405-189830-1rlytgw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?src=GG3uJv9gEpsmlHGEoz9sdA-1-8">shutterstock</a></span></figcaption></figure><p>If you like swigging sugary drinks, you might get a bit of a surprise next time you go to buy one, as a so-called <a href="http://www.bbc.co.uk/news/health-43414777">sugar tax</a> has now come into force in the UK. </p>
<p>From now on, drinks with a sugar content of more than 5g per 100ml will be taxed 18p per litre and 24p for drinks with 8g or more. It’s hoped the tax will help to reduce sugar intake, as scientists have shown that <a href="http://care.diabetesjournals.org/content/33/11/2477.long">sugary drinks lead to weight gain</a> and diabetes. <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/613532/obes-phys-acti-diet-eng-2017-rep.pdf">Figures show</a> that 58% of women, 68% of men and 34% of 10- to 11-year-olds in the UK are classed as overweight or obese. </p>
<p>Of course, a tax alone is not going to solve the obesity problem overnight. Sugary drinks may be a leading source of sugar in <a href="https://www.gov.uk/government/news/phe-publishes-latest-data-on-nations-diet">the UK diet</a>, but they are not the only contributor to obesity. So while we are not going to see obesity prevalence crashing down anytime soon, what taxes can do is contribute to change. </p>
<h2>How to reduce sugar</h2>
<p>The UK sugar tax aims to incentivise sugar reduction in drinks. Because it is imposed on drinks over a certain sugar threshold, manufacturers have the option of lowering sugar levels to avoid the tax. This way, the government is sending a clear message to the industry: get your act together and get sugar down. </p>
<p>On this measure of success, we don’t have to wait for the tax to be implemented to know that it has had an effect. According to the the UK Treasury, over 50% of soft drinks manufacturers (including retailer own-brands) <a href="https://www.gov.uk/government/news/soft-drinks-industry-levy-comes-into-effect">have already reduced sugar levels</a>, responding to the stick of legislation. So much so, in fact, that the Treasury has <a href="https://www.gov.uk/government/news/soft-drinks-industry-levy-comes-into-effect">downgraded its forecast</a> of how much money the levy will bring in – still standing at an impressive £240m. </p>
<p>The taxes will also make a contribution to the funding of programmes designed to reduce obesity. Such “earmarking” of taxes is relatively rare, but in the UK the tax was introduced in the <a href="https://www.gov.uk/government/publications/budget-2016-documents/budget-2016">March 2016 budget</a> with the explicit goal to “fund a doubling of the primary schools sports premium”.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=381&fit=crop&dpr=1 600w, https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=381&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=381&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=479&fit=crop&dpr=1 754w, https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=479&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/213408/original/file-20180405-189821-1pusfvs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=479&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Theoretically, a 1.75 litre bottle of cola bought from a supermarket could increase in price by about 25%.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?src=GG3uJv9gEpsmlHGEoz9sdA-1-16">Shutterstock</a></span>
</figcaption>
</figure>
<p>We know this approach is workable. In 2015, Jamie Oliver voluntarily imposed a 10p extra <a href="http://jech.bmj.com/content/71/11/1107">charge on the sugary drinks</a> served in his restaurants, encouraging others to do the same. The proceeds were donated to The <a href="http://www.childrenshealthfund.org.uk/about/">Children’s Health Fund</a>. In the two and a half years since, the fund has given away £162,000 in grants to improve child health. And <a href="https://www.sustainweb.org/news/mar18_school_fountains/">according to Sustain</a> – the NGO that manages the fund – 146,000 children have benefited from improved access to drinking water, as a result of the extra charge.</p>
<h2>Will it change what people buy?</h2>
<p>The UK government has not made changing people’s dietary habits an explicit aim of the tax. But evidence from elsewhere does suggest people buy less when a tax comes into force. For example, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442881/">in Mexico</a> – which introduced a one peso per litre excise tax on sugary drinks in 2014 – purchases of taxed drinks fell by almost 8% in the following two years. Larger decreases were seen in households at the lowest socioeconomic level. And people also bought more of the untaxed drinks – notably water. </p>
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Read more:
<a href="https://theconversation.com/what-the-world-can-learn-from-mexicos-tax-on-sugar-sweetened-drinks-56696">What the world can learn from Mexico's tax on sugar-sweetened drinks</a>
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<p>In the Mexico case, however, we don’t actually know if people started buying fewer sugary drinks because of the price hike, or because of another reason. This is because <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442881/">the data</a> simply measures the decline after the tax, not why the decline is happening. So while prices are likely to have a played a role, there could be <a href="https://www.sciencedirect.com/science/article/pii/S0306919217308837">another mechanism</a> at work. It could be, for example, that the tax started a conversation, raised awareness, got the industry talking about what it would do in response, and stimulated other actions to reduce consumption. </p>
<h2>The lasting measure of success</h2>
<p>Getting people talking, even arguing, about the tax is also an important part in all of this. Is it fair, as it affects people who are poor more than the rich? Why do we need what is essentially a punitive measure to get industry to act? If we are against the idea, then what else would work better and can we prove it?</p>
<p>These questions are important because it’s when these conversations percolate through society, that norms can change. Less so-called nanny statism and more people working it out for themselves. Working out, perhaps, that producing and consuming a lot of sugary drinks is not normal at all, but something weird that should be relegated to the past. </p>
<p>An important measure of the success of the <a href="https://www.gov.uk/guidance/check-if-your-drink-is-liable-for-the-soft-drinks-industry-levy">Soft Drinks Industry Levy</a>, then, will be if it contributes to changing these norms – in industry and society. And if it does, it will help to contribute towards a healthier society and healthier people.</p><img src="https://counter.theconversation.com/content/94520/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Corinna Hawkes receives funding from the UK Department of Health as co-investigator on the Obesity Policy Research Unit.
She is on the Future of Food Advisory panel convened by Dave Lewis, CEO of Tesco.</span></em></p>Why you might soon be paying more for your favourite sugary drink.Corinna Hawkes, Professor of Food Policy, City, University of LondonLicensed as Creative Commons – attribution, no derivatives.