4 Apr 2014

Health of the nation

Recently, chief medical officer Dame Sally Davies has drawn attention to both rising obesity rates in adults and children, coupled with decreasing awareness in individuals of weight problems. More on details are on the BBC website http://www.bbc.co.uk/news/health-26765078 which is typical of how the report has been discussed in the media.

The actual report is here - https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/298297/cmo-report-2012.pdf and a lot of important points in it seem to have been ignored in favour of the obesity story.

Obeisty wasn’t the only issue Sally Davies comments on “A substantial portion of the burden of sickness absence is attributable to mental health” she notes ‘stress’ as a big issue. “38% of work-related illness is due to work-related mental health problems.” She says “the health status of the prison population is such that it has been suggested that, on average, prisoners aged over 50 have the same health status as those who are 10 years older in the general population.”

Unlike media responses, the original report is clear that “Increasingly sedentary lifestyles also play a part in the obesity picture.” “Adults watched an average of 1,648 minutes (27.5 hours) of television per week in 2013.” And, very importantly, she says, “Obesity is a complex multi-factorial problem which is not completely understood.” She does highlight the need for public education around sugar consumption.
We’ve taken food skills and cookery out of schools, and there’s nothing like the educational opportunities there could be around learning good nutrition, growing food, and learning to make our own food. Consequently we eat things out of packets with no real understanding of what we’re consuming, which makes it harder to manage a healthy balance. Without nutrition education, any other intervention is meaningless.

“People living in more deprived areas are, on average, disproportionately more exposed to avoidable risk factors for cancer.” We really need to be taking that onboard. “cigarette smoking, obesity, poor diet, and excessive alcohol consumption all are all significant risk factors for cancer, and are all more common in deprived areas”. We need to look at underlying factors here – education, resources, and poverty of opportunity all play a role. Again, the sedentary lifestyle dominated by screen-based entertainment is not helping.

There is a wider debate here which needs to happen, and isn’t. None of these health issues exist in a vacuum. Poverty diets can readily cause obesity with cheap carb and sugar based food being far more affordable than fresh fruit and vegetables. We need to be talking about access to affordable leisure and exercise opportunities, access to outdoor spaces being a critical part of this for those on low incomes who could never afford a gym membership. Mental health is also improved by access to green spaces. Stress is known to be alleviated through physical activity as well. We need to be talking about how current work culture is making people ill.

There is a known relationship between sleep deprivation and weight gain. http://www.hsph.harvard.edu/nutritionsource/sleep/ Our noise polluted, stressful living environments, and the pressure to work long hours coupled with a lack of exercise makes for poor sleep, which in turn does not improve mental health. Visit a doctor when stressed and you’ll be told to get more exercise, more rest and more sleep (at least, that was my experience!).

There is a relationship between sedentary lifestyle and lack of exercise – two sides of the same issue that are not being properly connected in discussions. We should be talking about car and commuter culture, about our increasing dependence on screen-based entertainment, our depleted social interactions, our lack of safe access to green spaces. We should be talking about the work-life imbalance that leaves people sick with stress but also too tired to get out and about. We should be talking about real food, and knowing how to source and prepare it. Issues of poor mental health, and obesity are connected within our culture, and the same issues underpin both. Until we start tackling those core issues, by creating a healthier and more sustainable society, we’ll be left with the empty noise, empty calorie solution of a ‘sugar tax’ and nothing at all will change.

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