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The focus of World Obesity Day 2016 – observed today – is childhood obesity, in alignment with the World Health Organization’s (WHO) Report of the Commission of Ending Childhood Obesity (ECHO).

In an exclusive interview with Food Industry Asia (FIA) on the occasion of World Obesity Day, Dr Sania Nishtar, ECHO co-chair, founder and president of Heartfile, and a candidate for the role of WHO Director-General, talks about how obesity is a multi-factorial issue that requires a whole-of-society solution.

FIA: Over the past few years, we have seen an increase in incidence and rates of childhood obesity and overweight. What, in your opinion, is driving this growth? 

DSN: Obesity is a complex issue and evidence suggests that the increasing prevalence is driven by biological, behavioural and environmental factors. The health of mothers-to-be can influence how their infants grow and develop. Cultural norms and behaviours around food and physical activity will influence children’s exposure to and attitudes towards healthy lifestyles. Due in part to globalisation, children today are growing up in an increasingly obesogenic environment that predisposes them to weight gain in both high- and low- and middle-income countries, as well as socio-economic groups. Rapid urbanisation, lack of access to affordable healthy foods, and limited opportunities for outdoor play and physical activity have all resulted in an energy imbalance.

FIA: What are the roles government, industry and civil society should play in tackling childhood obesity?

DSN: The report of the Commission on Ending Childhood Obesity was clear: Governments hold the ultimate responsibility of ensuring their citizens have a healthy start in life. To achieve this, governments need to take ownership and provide leadership in addressing childhood obesity through long-term political commitment. Civil society has a vital role to play in increasing awareness of this critical issue and advocating for policies that support healthy lifestyles. It can also play an important role in holding both government and the private sector to account for commitments made. Industry or the private sector is not homogenous, and each sector should consider how best to contribute to ending childhood obesity within the scope of its core business. The report, however, specifically calls on the private sector to support the production of, and the facilitation of access to, foods and non-alcoholic beverages that contribute to a healthy diet, as well as to facilitate access to and participation in physical activity.

FIA: Regarding the marketing of unhealthy foods and children’s exposure to it – what are the opportunities for industry to self-regulate, in terms of tackling the issues of obesity and non-communicable diseases (NCDs)?

DSN: Children are increasingly exposed to powerful marketing, and are especially vulnerable to this. Voluntary efforts to date have not resulted in equitable protection of all children from the marketing of unhealthy foods and beverages through traditional and digital media, or in the places they gather. There are some examples of self-regulation yielding positive results in the area of reformulation, particularly for salt and sugar in Norway, for instance, but this has not been evident in regard to marketing. Multinational companies, in particular, must seize the opportunity to help reduce the impact of cross-border marketing.

FIA: Is there a place for public-private partnerships (PPPs) in working to end childhood obesity and finding solutions for NCDs, or should it be left to governments to come up with taxes and regulations? What should PPPs do to be more effective, and how should they operate?

DSN: Government needs to set policy and the necessary measures to ensure these are fully implemented. The private sector can play a role in addressing childhood obesity, as part of its core business, but additional accountability strategies are often necessary. Conflict of interest risks needs to be identified, assessed and managed in a transparent and appropriate manner when engaging with non-State actors. Codes of conduct and independently audited assessments of compliance with government oversight are therefore important.

FIA: What more can all stakeholders do with regard to education on food nutrition within the life-course approach?

DSN: Healthcare workers, caregivers, children and the whole of the community must have the benefit of clear guidance on appropriate nutrition, and particular attention should be given to disadvantaged and vulnerable communities. Nutrition education must be free of commercial interest, and the education sector, civil society and non-governmental organisations (NGOs) have an important role to play in contributing to the dissemination of nutrition education.

FIA: What do you believe the food industry can and should be doing to deal with the issue of childhood obesity?

DSN: The industry’s core business is food and within that realm, there are a number of initiatives to reduce sugar and fat content, and decrease portion sizes of processed of foods and beverages that could contribute to the prevention of childhood obesity and health gains. However, to be effective, healthy, nutritious options need to be accessible and affordable for all sectors of society, in order to reduce inequality and make the healthier choice the easy choice. Healthy, nutritious options are undermined by the continued marketing of unhealthy foods and non-alcoholic beverages. Only if this stops, will behaviour change in consumers be truly supported.

Dr Sania Nishtar is the founder and president of the NGO think tank, Heartfile, a powerful and respected health policy voice in Pakistan. She has served as Federal Minister in the Government of Pakistan, and is currently Chair of the UN Secretary General’s Independent Accountability Panel for the Global Strategy for Women’s, Children’s and Adolescents’ Health, and is Co-chair of the WHO’s Commission on Ending Childhood Obesity. A physician cardiologist by training, Dr Nishtar’s areas of interests are health systems, global health, broader issues of governance and public-private relationships.