- Obesity is a global crisis ... and at its heart is our
love of sugary food. The World Health Organisation wants us to eat less,
but big business wants us to eat more. Today the battle begins in earnest.
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- When William Steiger looked in the mirror at his Geneva
hotel and pulled his tie into place, he knew that a battle lay ahead. Glancing
through his private papers that morning ñ Tuesday, January 20 ñ
the Yale graduate and assistant to US health secretary Tommy G Thompson
made his final preparations for a meeting many considered to be one of
the most important of our time.
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- In a few hours, inside a wood-panelled room in the Swiss
capital's heart, 32 officials and diplomats would gather to consider a
blueprint for combating obesity, one of the greatest health problems sweeping
the globe.
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- But while the majority at the World Health Organisation
(WHO) board was behind the plan, Steiger ñ backed by the powerful
food and drinks lobby ñ was preparing to pull apart the best opportunity
to date to avert a public health crisis that is threatening to bring the
human race to its knees.
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- The focus of Steiger's attack was a report entitled the
Global Strategy On Diet, Nutrition and Physical Activity ñ also
known by its technical number, 916. For the first time the WHO had produced
a global blueprint that examined how to prevent and control the major diet-related
diseases, including diabetes, obesity, some cancers and cardiovascular
and dental diseases.
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- The need for a global strategy was clear, said WHO's
scientists. Already in the developed world the US and UK were suffering
epidemics of obesity fuelled by sedentary lifestyles and processed foods,
but now so too was the developing world.
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- The report ñ put together by 36 of the world's
leading nutrition and activity experts ñ warned that poorer countries,
even more than Western nations, were at risk from junk food because their
populations carry more "thrifty genes", which predisposes people
to putting on weight quickly after centuries of living through glut and
famine. By 2025, it added, India would have one of the highest rates of
Type II diabetes, which correlates with the rising incidence of obesity.
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- Among the raft of proposals contained in the report were
plans for national guidelines on diet and physical activity, a ban on food
marketing that exploits children, and a better food labelling system.
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- However, one part more than any other has transformed
the report into a global battlefield ñ a clause that suggests only
10% of the average energy intake for an adult should come from added sugar.
Currently, 13% of calories in the British diet come from added sugar, or
around 70 grams each day per adult. In the US, where public health guidelines
are more lax, added sugar can provide as much as 25% of the population's
intake.
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- Under Steiger's pressure, the only real agreement reached
at the January meeting was to give member states until today to submit
further comments for revisions of the draft document. Then, in mid-March,
the final draft strategy would be made available to members of the World
Health Assembly and in May WHO's full 192-country membership would vote
to adopt it.
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- However, with billions of pounds at stake for the food
and drinks industry, one of the most intensive lobbying campaigns is being
redoubled in an attempt to change the minds of member countries. Already
details about the extent of the lobbying activities surrounding the report
has been remarkable. Led by the sugar manufacturers groups, lobbyists have
been hired and US senators used to threaten WHO funding.
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- In the US ñ where the majority of the population
(more than two-thirds) are now overweight or obese ñ the financial
interests in sugar are enormous. The industry has strong connections to
the highest levels of the US government through its lobbying firms, which
have aggressively targeted politicians and government officials. One of
the strongest factors in its favour is that much of US sugar production
is based in Florida, a state run by governor Jeb Bush, President George
W Bush's brother.
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- Jose "Pepe" Fanjul, president of sugar giant
Florida Crystals Corp, is close to George Bush and officials with access
to the White House. He is one of Bush's top fundraisers. Other sugar firms
have feted the Republicans. In 2000, J Nelson Fairbanks, chief executive
of US Sugar Corp, became a "Pioneer", an honour for fundraisers
who bring in at least $100,000 for Bush's campaign. Warren Stanley, chief
executive of Cargill, a sugar trader, is a Pioneer this year.
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- The International Sugar Organisation (ISO) has also been
vigorously lobbying sugar-exporting countries such as Mauritius, Brazil
and French Guyana. They in turn have expressed reservations about the WHO
strategy, fearing that a curb on consumption would mean a decline in their
sugar exports. Earlier this month an ISO memo revealed that it believed
the WHO report was "scientifically deficient and cannot be a basis
for a global strategy on diet and physical health".
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- On the back of ISO lobbying, many of the "Group
77" countries ñ the world's poorest ñ are now supporting
its position.
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- Under siege from the food and drinks companies, the WHO
experts have come out fighting, saying the ability of the world to adopt
workable initiatives to tackle its health crisis is in danger of slipping
out of reach. Professor Kaare Norum, the most senior scientist involved
in the WHO report, wrote last month to US health secretary Thompson accusing
the administration of putting the interests of sugar barons ahead of the
fight against obesity.
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- Norum accused the US of making the health of millions
of young Americans a "hostage to fortune" by failing to act over
its obesity epidemic to protect business. Since 1990 successive US governments
have blocked WHO calls for action, he claimed.
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- "It is significant that resistance from business
interests, which included the sugar industry and soft drinks manufacturers
with US government support, was also demonstrated when a previous WHO expert
report, based on a scientific consultation in 1990, made similar recommendations
intended to prevent diet-related chronic diseases," he wrote. "What
has happened to Americans since then? Obesity rates have risen so that
now one in three bears the burden of the very high health risks associated
with this condition, with the poorest and most vulnerable sectors of society
worst affected."
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- This weekend, Norum told the Sunday Herald he would be
"mobilising scientists from all over the world" to lobby on WHO's
behalf. "The sugar industry has been playing behind the scenes. We
are now trying to convince the developing countries that it's not like
the sugar industry is saying. You have to place health before business.
The sugar industry is being used as a weapon against this global strategy.
They say that the science of the report is not good. That is just bullshit.
It's robust ."
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- Concern that the strategy may be diluted or scrapped
has fuelled letters to Bush from the Senate. Democratic Senator Edward
Kennedy expressed concern about the perception that the US is "beholden
to outside industry influences" and that its comments about the strategy
"were formulated primarily to satisfy trade groups rather than out
of concern about public health, chronic disease and obesity."
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- Kennedy added: "Indeed, the objections raised in
the administration's comments in the report did largely mirror those raised
by food industry trade groups."
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- UK-based Consumers' International said the WHO strategy
must succeed. "Obesity isn't just an issue for developed countries,
it's one for developing countries. This is a global crisis," said
a spokeswoman. "The strategy has set out action for governments but
has also called for them to take action in relation to the private sector.
That is what the US has had problems with. It has been trying to shift
responsibility back towards personal responsibility."
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- For Bush, the issue of fighting the fat lies with the
individual, not governments. Many campaigners fear he will appease industry
at the expense of world health. Bruce Silverglade, of the US health campaign
group Centre for Science in the Public Interest, said: ""We all
have a personal responsibility to improve our diets, but doing so, especially
for children, is extremely difficult in the current food environment where
large portions of high calorie foods are pitched to the public via massive
advertising that dwarf government nutrition education programmes."
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- He added: "It is certainly ironic that the nation
that inve nted Coca-Cola, fast food, and Twinkies is now trying to tell
the world how to combat obesity."
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- Sir Liam Donaldson, the UK's chief medical officer and
head of the delegation at the WHO meetings, is said to favour the strategy.
This weekend, a department of health spokesman said of the WHO obesity
plan: "The UK is supportive of the central thrust of the strategy,
and would support its consideration at the World Health Assembly. We welcome
the emphasis on promoting activity and diet, with better labelling of foods,
which are high in fat, sugar and salt to deliver a more healthy lifestyle."
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- Last week, the Consumers' Association announced it was
threatening a boycott of top branded foods unless the government and food
industry take action to improve the nation's diet and tackle obesity. According
to Sue Davies, senior policy adviser at the Consumers' Association, real
power lies with individuals to force change at food and drinks firms and
in government. "We believe the major companies and government are
not accepting responsibility to make sure food is labelled properly and
make it easier for people to choose a healthy diet. Through voicing their
concerns customers can make changes. Big business and governments react
when they see there is clear consumer demand for change."
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- Obesity: What The Experts Say
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- Dr Riaz Khan, director-general of the World Sugar Research
Organisation: "The concept of 'good food and bad food' displayed throughout
Report 916 lacks scientific validity. It singles out single elements of
the diet, such as sugar, meat, edible oils and dairy products as being
unhealthy. It is the most basic of nutritional principles that there are
'good and bad diets', not 'good foods or bad foods'.
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- "Every food can make a valuable contribution to
the diet and diet variety; it is getting the balance right that is the
key. In the report, sugar has been specifically targeted with the recommendation
to limit dietary energy from free sugars to less than 10% of daily energy.
WHO Technical Report Series 916 is scientifically flawed and its recommendations
to limit consumption of certain foods and increase consumption of others
pose serious negative economic implications to a host of food commodities,
including sugar."
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- Professor Kaare Norum, chair of the WHO report's working
group: "I regard the need for a global strategy on diet to be of paramount
importance . There is an extensive body of sound scientific research now
available which supports the case for immediate action to improve dietary
health through the reduction in the consumption of foods containing high
levels of fats, added sugars and salt and soft drinks containing high volumes
of calorific sweeteners.
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- "It is significant that resistance from business
interests, which included the sugar industry and soft drinks manufacturers
with US government support, was also demonstrated when a previous WHO expert
report, based on a scientific consultation in 1990, made similar recommendations
intended to prevent diet-related chronic diseases.
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- "You have demonstrated admirable leadership in your
support for the WHO framework convention on tobacco control, which shows
that the US is capable of being a force for good in public health. I urge
you to show equal courage and determination to support global efforts to
address another of the biggest public health challenges facing us all in
the 21st century."
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- Ralph Vance, president of the American Cancer Society:
"The tobacco control experience has taught us that policy and environmental
changes at national, state and local levels are critical to achieving changes
in individual behaviour. Measures such as Clean Air laws and increases
in the excise tax on cigarettes are highly effective in deterring tobacco
use. To avert an epidemic of obesity-related disease similar purposeful
changes in public policy and in the community environment will be required.
Without effective policies, the current global trends toward increasing
obesity, poor nutrition and physical inactivity will continue unabated.
ACS fully supports WHO's efforts to address this important health issue."
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