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Experts push for concrete action on obesity in Australia

With one in four children overweight, a public health crisis is looming

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A man crosses a road in central Sydney.   © Reuters

MELBOURNE -- Calls are mounting in Australia for government action against growing rates of obesity and poor diets, which experts warn are fueling serious health problems and could lead to a public health crisis.

The statistics are damning. In 2014-15, over 63% of Australian adults were overweight or obese, according to official data. The figure for children aged 5-17 years was one in four, or 27.4%.

Studies show obese or overweight people are more prone to chronic conditions including heart disease, cancer and diabetes. The first national audit of children and adolescents with type 1 diabetes, published in the Medical Journal of Australia in February, found that 33% of this population was overweight or obese.

Beyond the risks to individuals' health and quality of life, there is also a significant economic cost. The Melbourne-based Grattan Institute estimates that adult obesity costs Australian taxpayers $5.3 billion Australian dollars ($4 billion) a year.

Yet, while the health, social and economic impacts of obesity and excess weight are increasingly well-documented, the official response in Australia is lacking, say health advocates.

"When I was practicing as a GP, every day I saw children coming in with preventable health issues related to obesity -- and that was 10 years ago," said Richard Di Natale, leader of the Australian Greens, a minor political party with 10 members currently elected to the federal parliament.

"Successive Australian governments have been short-sighted about health -- and I fear that this will come back to haunt us. Elected representatives need to do what we're paid to do -- legislate to put people's well-being first."

A comprehensive new report entitled "Policies for tackling obesity and creating healthier food environments," led by researchers at the Global Obesity Centre at Deakin University, reviews current federal and state government policies to address unhealthy diets and obesity in Australia and outlines concrete proposals.

Key recommendations for the federal government include: implementing a tax on unhealthy foods, including sugar-sweetened drinks; introducing regulations to restrict the advertising of unhealthy foods on broadcast media; and developing a national strategy for improving population nutrition.

In some areas, researchers found that Australia was meeting best practice, including with food pricing (the country's goods and services tax, or GST, is not applied to basic foods such as fresh fruit and vegetables); food labeling; and regular monitoring of population body weight. But such initiatives alone were deemed insufficient to tackle the country's widening waistlines.

"What this report is showing is that even though it's clearly a massive public health problem, the response so far from the government has been mediocre," said Gary Sacks, senior research fellow at Deakin University and a lead author of the report, which was supported by over 100 researchers from over 50 organizations.

"There are pockets of good practice but there's no national strategy; this isn't highlighted as a priority for action and Australia's slipping behind international best practice. Definitely the government response isn't in proportion to the size of the problem."

A global 'epidemic'

Obesity levels have risen dramatically around the world over recent decades, with the problem now also taking a toll in low- and middle-income countries. In 2014, more than 1.9 billion adults were overweight, including 600 million who were obese, according to the World Health Organization. In addition, 41 million children under the age of five were overweight or obese -- over half of them living in Asia.

WHO, which defines individuals with a body mass index of 30 or more as obese, has labelled the problem an international "epidemic," warning that it can "paradoxically [coexist] with undernutrition in developing countries."

In the Asia-Pacific region, researchers have warned that the consumption of ultra-processed food and drinks is increasing in tandem with liberalized trade and investment, with a resultant spike in diet-related illnesses.

A study by Australian National University researchers published in the Globalization and Health journal in December found that per capita sales transactions at chain food outlets such as KFC and McDonalds approximately doubled in Australia and Singapore and tripled in South Korea between 1999 and 2013. In China, expenditure for the same period increased 18-fold, from $1.90 per person in 1999 to $34.80 per person in 2013.

"The key thing is our food supply. We're surrounded by unhealthy food," said Sacks, explaining rising obesity levels in the Australian context.

"Unhealthy food is available everywhere, it's heavily marketed, it's often really cheap and I guess the whole environment pushes us to consume and to consume junk food."

Sugar tax debate

One policy measure which is gaining support from a growing number of health experts, in Australia and elsewhere, is the introduction of a tax on sugar-sweetened beverages. Over 10 countries currently have the tax in place, including France, Chile, Mexico and several Pacific island nations.

"More and more organizations are coming out in support of such a proposal," said Stephen Duckett, health program director at the Grattan Institute. Duckett co-authored a November 2016 report urging the Australian government to introduce the tax, which is also backed by the WHO.

The report argues that the tax would raise more than A$500 million a year and generate an estimated 15% drop in consumption of sugar-sweetened beverages. Advocates of the proposal point to the example of Mexico, where studies suggest soft drink consumption went down after the tax was introduced in 2014.

Di Natale said the Greens would introduce a bill into the Australian senate by the end of 2017 on a sugar-sweetened beverages tax.

"It is high time the government stepped up and listened to the chorus of experts from Australia and around the world about the role of a sugar tax -- as part of a package of policy responses -- on driving down obesity," he told the Nikkei Asian Review.

But the tax is not backed by either the ruling Liberal-National Coalition or the opposition Labor Party in Australia. In a recent statement, federal Health Minister Greg Hunt argued that fresh fruit and vegetables "were already effectively discounted," as they were exempt from GST, and pointed to various government initiatives already in place, including programs encouraging physical activity in schools.

The country's Deputy Prime Minister Barnaby Joyce was even more blunt in his opposition to the proposed tax, telling reporters in November last year that people should simply "stop eating so much and do a bit of exercise."

The domestic food and beverage industry has also voiced resistance. Geoffrey Annison, director of health, nutrition and scientific affairs at the Australian Food and Grocery Council, an influential lobby group, told the Nikkei Asian Review that the body opposed a sugar tax as there was "no data" to confirm improvements in health outcomes.

Duckett said it was important to persuade sectors such as the sugar industry that they would not take a serious hit. "The sugar that goes into sugar-sweetened beverages is a very small percentage of Australian production and that can be exported overseas," he said.

If talkback radio is an accurate gauge of the public pulse, then community awareness of diet, obesity and related health complications may be building, according to Sacks, who recently took to the airwaves following the release of the Global Obesity Centre report. In the past, he was commonly accused of advocating a "nanny state" style of government intervention that was widely criticized.

"But actually this time, I've had less of that. The people phoning in were concerned parents saying that they want some help making healthy choices for their kids and the [callers were] just a little friendlier; more aware of the problem and the recognition that there is some action needed," he said. "Maybe community expectations are changing."

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