Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 24
by examining why policy is important for obesity
prevention. Our analysis covers the food system
and physical activity environment but with more
emphasis on the former. A brief review of policy
instruments and how evidence is incorporated into
policy - making is presented. Then two case studies of
how evidence is, and is not, used in policy - making are
outlined to provide a practical perspective on evidence
- based policy development. Finally, we discuss
those features that are especially important for helping
to build the policy backbone for preventing childhood
obesity.
Why is policy important for
preventing childhood obesity?
There is a variety of competing views about the importance
and role of policy for preventing childhood
obesity. Certain stakeholders claim that there is little
need for government policy because the food marketplace
and physical activity environment is managed
democratically, with people being able to demand
the food and physical activity choices they want to
consume or adopt, and the market then efficiently
provides these for them. For instance, they point out
that food manufacturers now provide abundant, safe
and relatively cheap food — so what is the problem?
Conversely, others (including ourselves) argue that
government policy is very important because the
community has an expectation that the state has a role
in protecting and promoting the food system and
physical activity environments as community goods.
There are three particular reasons why policy is
important for preventing childhood obesity.
Food system failure
Despite the impressive efficiencies of the modern food
system in producing, processing and distributing
food, its operation ignores the ecological fundamentals
of the food and environment cyclic relationship
and functions in a non - sustainable linear fashion. 2
The modern food system does not have sufficient
checks and balances in place to ensure that detrimental
over - consumption and environmental impacts do
not happen. Indeed, the warning signs of food system
failure are amply illustrated by increasing environmental
damage, staple food shortages, rising food
prices and increasing obesity prevalence. This assessment
is consistent with Moodie et al ’ s observation that
obesity is a sign of commercial success (increasing
food sales) but a market failure because the market is
failing to deliver the best outcomes for people. 3 Policy
provides a statement and intentions regarding the
food system structure and operation that can help
avert and/or correct system failure.
People are not able to demand
unencumbered what they want
to consume
Generally it is an illusion that people have “ free
choice ” and are able to demand unencumbered what
food they want to consume or what physical activity
they wish to participate in. In other words, all our
choices are determined by individual free will. People
are rarely actively involved in how the food system
operates and what food products are made available
or marketed to them. For instance, it is estimated that
there are over 320,000 food products available in the
US marketplace, 4 many of which people would not
have dreamed of demanding before being persuaded
by marketers. By labeling people as “ consumers ” we
perpetuate a way of thinking about how the food
system operates in terms of three “Cs ” —consumption,
commercialization and commodification. 5 Policy can
be used to build a more engaged and informed citizenship
in relation to the food system and the way it
operates.
The vulnerable members of society need
to be protected
Nutrition and obesity prevalence data consistently
reveal that it is the most vulnerable in society and
those least able to engage with the food system that
are most at risk of food insecurity and obesity. 6
Engagement with the food system needs to be considered
against democratic principles and rights such as
participation and transparency in decision making. In
this regard, Lang has also coined the term “ food
democracy ” to refer to “ the demand for greater access
and collective benefit from the food system ” . 5 These
democratic principles and attainment of food democracy
can only be pursued within a food policy framework
and not left to market forces and consumer
demand.
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