Dr Corinna Hawkes is Head of Policy & Public Affairs at World Cancer Research Fund International. She is part of the Implementation, Monitoring and Accountability Working Group of the World Health Organization’s high-level Commission on Ending Childhood Obesity.
Worldwide obesity has more than doubled since 1980, and the latest figures from the World Health Organization show that more than 1.9 billion adults and 42 million children under the age of 5 are obese. Despite these staggering statistics, however, The Lancet’s major six-part series on obesity published today, finds that there’s been a global failure to tackle the global obesity epidemic.
At World Cancer Research Fund International we’re particularly concerned about the global obesity epidemic because our analysis of worldwide research shows that there are 10 cancers linked to being overweight or obese. This is why we developed our NOURISHING policy framework to help governments and policymakers worldwide to promote healthier diets, reduce obesity and non-communicable diseases such as cancer.
Food policies need to be effective
From our work compiling and assessing policies for our NOURISHING framework, we know the core areas where policy can make a real difference. But we also know from the evidence we’ve accumulated, that just pulling a policy action from the shelf and applying it willy nilly is not going to have the impact we need. That’s why we don't just advocate for food polices – but effective food polices, or, in the words of the paper I authored for The Lancet’s series on obesity, smart food policies. What do smart food policies look like? I underline the principles of smart food policies in my paper. One of the most important principles is that they need to be designed based on an understanding of how they work. At the moment, many policymakers assume that policies work by making healthier choices the easier choices. That makes a lot of sense, and it can be effective. But not always, and not necessarily beyond the specific setting or over time. This is because people still don’t want to eat the healthy diet on offer and remain entrenched in their habits.
Policies shouldn’t just focus on individual behavior change
There is clear evidence from behavioral psychology that this is because people have learned to like the foods they do as a result of the environment they grew up in. And so they are resistant to change. In other words, we are largely creatures of habit – and habits are difficult to change. That’s why we need smarter food policies, food policies which accept that people have a legacy of learned preference. We need to do more than make healthy choices the easier choices, and make healthier choices the preferred choices.
Early intervention needed to develop healthy habits
How do we do that? Well, first we have to target infant and young children. Preference formation starts in the womb and continues throughout life. If we can help kids learn to enjoy healthy eating when they are young, they have a better chance of eating healthily into adolescence and adulthood.
Create a supportive environment
Second, we have to make sure the food, social and information environment remains supportive as we grow up. And for the parents, peers and caregivers – the many of us who have already learned unhealthy preferences – there are actions we can take to help us help ourselves through the way food is priced and presented.
Make healthy food affordable for the most disadvantaged
Third, we need to make sure that people who want to eat well have the opportunity to do so. This is particularly important for people in disadvantaged communities who would like to eat healthily but cannot afford or access such diets. This is not rocket science, but it does require far greater understanding of the existing preferences of our populations, and how they are formed. Marketing? Peers? Parents? Evidence suggests it's a combination of all of these things. It also requires patience: creating a generation of unhealthy eaters took time. With smart food policies we can turn that around – but we need to be patient.
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