Childhood Obesity: Is sugar the bitterest pill?

At a time when the NHS dominates the news columns of our beloved media, Her Majesty’s Government has just announced a sugar tax in a bid to address the growing (no pun intended) problem of childhood obesity. They have also indicated their support for measures to promote exercise. On the face of it, the intended outcome of this latest approach might be viewed with optimism. As ever though, greater scrutiny would seem to urge caution.

The debate relating to the effect of sugar on obesity has now largely been resolved. To be clear though, the sugars referred to in this context are those with a high glycaemic index. This just means that they will give sudden spikes to blood sugar levels as opposed to the more favourable low glycaemic index sugars which will tend to keep blood sugar levels at a more stable level. A diet rich in high glycaemic sugars is now thought to predispose an individual to obesity, diabetes, heart disease and a whole host of other undesirable health outcomes. Essentially, this is what all the fuss is about.

If we take the evidence on high glycaemic sugars as accepted knowledge, it follows that we have an NHS which is about to literally collapse under a tsunami of very ill patients. In short, this will merely confirm the demise of the NHS which is already being privatised quietly behind the scenes. This latest Government initiative seeks to address this scenario. But does it?

In several previous pieces, I have alluded to the need for greater education of our children in terms of what constitutes healthy food and what doesn’t. The advantage of a healthy body and mind needs to be underlined. The reduced strain on the NHS should just be seen as a secondary outcome. The prime focus needs to be the health of the individual. But although primary schools undoubtedly have a major role to play in this area, it is ultimately the children’s parents who usually buy and cook their food. Ergo, how do Governments educate parents?    

This will undoubtedly be the biggest challenge of this and subsequent governments as the NHS continues to face the life support button being permanently switched off. Relatively speaking, educating children is the easier of the two challenges. Children are generally more receptive to advice and guidance. Their adult parents though will often have already established life patterns of eating behaviour and attitudes to exercise. A strategy to re-educate them will cost a lot of money but will ultimately save a lot of money. It might even play a significant role in the salvation of the NHS.

But back to exercise. The last two generations have seen local councils selling off school playing fields to build more houses. The extra houses give shelter to yet more families whose children attend the school with less space to play. And so the insanity goes on. It is fashionable to talk of “a lack of joined up thinking” or even “a lack of forward planning” or, to use the dreadful jargon of local government “a lack of an impact assessment”. But the truth is that all three of these statements have merit because children now have the least space within which to exercise. My county and many like it nationally are in the process of a house building marathon although it is not always obvious why. It is frequently stated that we have a lack of affordable housing and yet a quick glance at the number of empty properties in provincial towns outside of our capital cities suggests a somewhat different picture.

This latest Government initiative seems set to allow adverts on children’s television programmes to continue just as they are. The problem is that many of these adverts focus on the very foods which boast the high glycaemic sugars which the Government pertains to be concerned about. Accusations of an all-powerful food manufacturing lobby will only intensify in the absence of a coherent explanation. During my time as a senior sales manager in the wholesale food industry, I saw more than enough evidence of this. The strategies employed are both pre-meditated and cynical.

As I completed my medical degree, I was spending a couple of months on my elective in ophthalmology at St. Paul’s Eye Hospital in Liverpool. It was located in the Royal Liverpool Hospital. Entering the hospital was an object lesson in most of what is right and wrong in this area of Government policy.

To begin with, it was very difficult to get through the front doors of the hospital without being subjected to the fumes of an army of smokers in various states of undress who colonized the entrance. A prominent sign next to them proudly claimed the hospital to be a smoke-free zone. Indeed.

Having negotiated nicotine alley, any visitor to the hospital was then subjected to an unexpected sight. Instead of the vending machines laden with chocolate, crisps, sweets and fizzy drinks, a local trader had a prominent display of fresh fruit and vegetables for people to buy. It was presented in very simple boxes as with a greengrocer of yore and was of a very high quality. This left an indelible impression on me. It reminded me that with a change in attitude and a bit of imagination, real change can always be achieved and very often without the assistance of Government.

But is a sugar tax the answer? Frankly, no. I listened intently to a Government minister assuring us that such a tax would yield big results and make advertisers rethink their strategies. It is often thought that if people want anything badly enough, they will invariably find the money for it irrespective of cost. The statistics for the rates of smoking would appear to bear this argument out. Rates of young girls smoking are actually rising, not falling and yet the cost of smoking has never been more prohibitive.

I am disappointed by this Government initiative as I think it is a huge missed opportunity. Not just for the future survival of the NHS but also for our wider society. When people enjoy better health, the knock on effects are enormous. I can recall a Government White Paper from 1990 entitled “The health of the nation”. That paper alluded to the need to take drastic action to address rapidly deteriorating health outcomes. That was a quarter of a century ago and now we have this. This will go down as one of the great let downs of post-war Government policy. David Cameron at least will doubtless absolve himself of any responsibility. Oh to be able to pick and choose on such serious national matters.

But paradoxically, that is exactly what faces every man, woman and child in Britain today. The NHS amazingly continues to provide free care at the point of access to every, man, woman and child. I point this out because for the vast majority of countries around the world, such an arrangement would be wildly fanciful. So consider this; if the NHS really is free at the point of access with no expectations placed on it’s 65 million consumers, the counter argument would question why the Government is even seeking to address childhood obesity in the first place. Haven’t people got the right to smoke, drink and laze around as they see fit? The liberal view would be just that. What right has the state to demand how people lead their lives?

As things stand, something has to give. It is no longer possible to run the NHS with no strings attached. People have to take some sort of responsibility for their health choices if we really want it to remain free at the point of access. Such an argument though is arguably pointless when we stop to consider the insidious and progressive privatization programme. As I draw to the end of this piece, I watch news footage of a 5 year old blood stained Syrian boy being pulled from a heap of rubble to the safety of an ambulance. Compared to his plight, there is a certain obscenity in writing about an entire generation of British children whose consumption of food grossly exceeds their levels of activity. For that poor traumatized wretch in the Syrian rubble, the chance of any meal would be a fine thing.