It would have been such a simple fact check…
If you hope that food professionals are getting better quality information about child obesity than the general public, the current issue of the trade publication, Food Navigator, will unfortunately dispel that idea. The popular belief that kids are becoming “obese” because they eat ‘unhealthy’ food — as defined by calories, fat, salt and sugar — gulp down uncontrolled portions, and don’t get enough exercise was sadly evident. So, too, were beliefs that the most costly chronic diseases — the “Big Three:” heart disease, cancer and stroke — are caused by improper eating and can be prevented by eating right.
The focus of the article in the current issue of Food Navigator was on proposed public health strategies to combat obesity. According to the article, the American Dietetic Association is calling for reform of the U.S. healthcare system to focus on the prevention of obesity.
A quick fact check confirms that the ADA did issue a press release, also quoting Evelyn Crayton, a registered dietitian and member of the ADA Board of Directors. In it, the ADA called for a reform of the U.S. healthcare system to redirect health strategies towards prevention. Bad diets are associated with 70% of deaths in the United States, it stated, including the “Big Three — heart disease, cancer and stroke.” Ms Crayton was quoted saying that obesity is the most significant nutrition problem facing the country and, speaking on behalf of the ADA, said that national health strategies to prevent obesity were needed. She said “the focal point should be children, to prevent childhood obesity.”
On their own, parents often don’t know how to help their children grow up to be healthy, said Ms. Clayton, and too few parents have a registered dietitian paid for through insurance to assess their nutrition and to intervene. “If we don’t act to stop current trends, the current generation of children will have shorter life expectancy that their parents,” she said, adding: “Registered dietitians are the nutrition experts who provide intensive nutrition assessment, personalized intervention and ongoing counseling.”
Of course, the preponderance of research fails to support these statements. [New readers will find a Google search tool in the right hand column to search for background posts.] But what may be most disturbing to regular JFS readers is what the Food Navigator used as an example of a successful government health policy that should be considered for our children: the child obesity program that had been adopted in Singapore in 1992.
The article reported that “during the 1990s, Singapore reduced child obesity through a combination of changes in school diets and increased fitness and physical activity programming.” Nutrition education of children, it said, is also likely to be the key to influencing their dietary habits. Despite the support of dietetic professionals, the Singapore program would hardly be the nutritional interventions most parents would want it for their children.
Fact check. In reality, Singapore’s “Trim and Fit” program proved far from effective or beneficial for young people. In fact, the adverse consequences for the children were so serious and the negative reaction of parents so vehement, the Health Ministers finally shut the program down after 15 years. As was covered in-depth here, the Minister of Health had described the program in the British Medical Journal. It had included every initiative in popular childhood obesity programs here: ‘healthy eating’ nutrition curriculums, strict control over “unhealthy” foods and drinks available in schools, encouragement to drink more water, intensive physical exercise, rewarded healthy lifestyle practices, promoted healthy lifestyle habits in families’ homes, etc. Fat children were given special attention, separated from their classmates and made to do more exercise until they lost weight. They were also referred to public health services for more intensive follow-up with doctors and dietitians.
The program’s failures were compounded by the fact that fat children were found to be suffering intense ridicule and bullying. And dangerous weight loss behaviors soared, with use of appetite suppressants, anorectics, among the highest in the world, even though Singapore’s obesity rate was only 1.6%. According to the deputy and assistant deputy directors of the Minister of Health, Singapore’s “Trim and Fit” program had been patterned after the school-based Active Programme Promoting Lifestyle Education in School interventions which had been tested in ten schools in Leeds, England. That program had also failed to reduce obesity and resulted in no difference in BMIs among the young people.
The Food Navigator article also described proposals to tax bad foods and for government subsidies for ‘healthy’ foods, claiming these strategies could combat obesity. ADA spokesperson Tara Gidus*, said that “food manufacturers should be providing healthy options to consumers but consumers also need to take personal responsibility.” According to the article, Ms. Gidus "said some companies are taking the initiative offering solutions to controlling portions and reducing calories, fat, sodium, and sugar in their foods. Others are ignoring the problem and continued to develop new foods void of nutritional value and rich in calories, excess fat, sugar, and sodium.” Ms. Gidus noted that food companies lose money when they develop “healthy foods that taste good” because people don’t buy them, but government subsidies might motivate food companies to try again. Federal attention to public nutrition is essential, Ms. Clayton added.
Citing a USDA Economic Research Service obesity policy publication, the Food Navigator described a program in Scandinavian countries as an example of a successful government subsidy program for the purchase of healthy food items to address obesity. This program was reported as reducing adult coronary heart disease between 1976 and 1980s.
A simple fact check finds that mortality rates from heart disease had indeed dropped during that period. In Sweden, for example, they had dropped dramatically throughout 1969 to 1993, just as they had in most industrialized countries, unrelated to the subsidy program. Nor could that trend be attributed to reductions in obesity. Obesity rates didn’t drop during the 1970s and 1980s. Just the opposite. Government data shows they rose, about five-fold among Swedish men between 1969 and 2005; and about 20% among Swedish women during the 1980s alone. Clearly, government subsidies for 'healthy eating' hadn’t proven effective in addressing obesity.
Why does the accuracy of information from dietitians matter?
One of the largest health professional political action committees in the country is that of the American Dietetic Association. Its motto is “If dietetics is your profession, politics is your business.” Besides reforming the healthcare system to preventive health, its key government policy lobbying issues are obesity, and promoting ‘healthy weights’ for children, and school-based food and wellness programs. Sound science-based information matters because it may affect not only how our limited public health resources are spent, as on policies that are ineffective or without demonstrated benefits that outweigh risks. But it also affects the programs directed towards our children, and the information they hear about their food and bodies.
© 2008 Sandy Szwarc
* Ms. Gidus, known as the Diet Diva, has a morning television diet show and owns a nutrition consulting company in Orlando, Florida. According to her website, she motivates groups on “achieving a healthy weight, preventing disease, maximizing energy, aging well, enhancing sports performance and creating a positive body image.”