Children and Young People: Obesity

Baroness Jenkin of Kennington Excerpts

Tuesday 17th April 2018 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I thank the noble Baroness, Lady Walmsley, for initiating this important debate. I do not need to repeat all the figures that she has so ably put forward. However, I shall ask a question: how on earth did we get into this mess in the first place? It is the worst epidemic for 100 years.

Now, many of us have managed to stay the same weight for 100 years—

[Baroness Jenkin of Kennington (Con)]

Not that many!

[Lord McColl of Dulwich]

I will not say “Speak for yourself”, but there are a lot of people who have managed to stay the same weight.

The question is: how did they do it? They simply respected the various mechanisms that exist in the body for keeping the weight constant. What are they? They are very intriguing. One is to eat food that you have to chew. When you chew, the chewing muscles produce impulses that go to the brain telling it that you have had enough to eat. If that does not work and there is fat in the meal, when the fat goes through the stomach into the duodenum it releases a hormone that stops the stomach moving any further. We get a feeling of being full, so we stop eating. It is a very nice mechanism. Then, when the fat has been emulsified by the bile, the whole thing moves on and the stomach starts to move again.

At the end of food rationing the food industry was presented with a problem. It wanted to increase the amount of food that people ate, because we were all eating just the right amount—food rationing had sorted that one out. How was it to persuade people to eat more? The simple solution is to sabotage these beautiful mechanisms for keeping the weight constant. How did the industry do that? It demonised fat and got some unscrupulous members of the academic world to produce research that just happened to confirm its view that fat was the wrong thing. Then President Eisenhower had a heart attack and they found that what blocked his arteries was atheroma. As noble Lords will know from their Greek studies, atheroma is a Greek word meaning porridge. It might be Greek porridge, but it is not Scottish porridge, that is for sure. In fact it is not porridge at all: it is a cholesterol, fatty material. So they blamed that. Fat was demonised, so we had a low-fat diet.

The problem then was where to get the calories from, so they filled the diet up with carbohydrates. A low-fat, high-carbohydrate diet is tasteless because fat gives us a nice flavour. The food industry then faced the problem of how to get people to eat this terrible stuff. The answer is to pour in sugar. That makes it palatable. So was born the obesity epidemic: a low-fat, high-carbohydrate, high-sugar diet.

Then, just to make things worse, NICE said that all the calories we eat are expended on exercise. That was not true either: only a fraction of the calories we eat go on exercise. In fact, it is about a quarter. This idea that exercise is the answer to obesity led to hundreds of thousands of people pounding the pavements and roads wearing out their joints, so you had more and more joint replacements for the hip and knee. So the nonsense continued. Of course exercise is very important to general well-being and health, but not in terms of controlling weight. Then we insulted the children by calling them couch potatoes. Inactivity does not lead to obesity. Obesity leads to inactivity, but that is a different matter.

What is the answer? It is that we need an all-out campaign involving every man, woman and child, every institution, school, university and government department to try to reduce the obesity epidemic. When we were taking evidence from the experts in a recent Select Committee, we were told that all-out campaigns do not work. I pointed out that the AIDS campaign did. One of these experts said, “No it didn’t”, which surprised the Lord Speaker, Norman Fowler, because it was his campaign. It worked because he was absolutely honest and did not bother with anything politically correct. He said it as it was: “Don’t die of AIDS”; AIDS is lethal. So the campaign was successful. That is what we now need, because we owe it to our children. The obesity epidemic is killing millions and costing billions. The cure is free: eat less.

--- Later in debate ---

[Baroness Jenkin of Kennington]

My Lords, some 18 months ago I was asked by the Centre for Social Justice to chair its working group, which last December produced a report entitled Off the Scales: Tackling England’s Childhood Obesity Crisis. I urge noble Lords who are interested to take a look at that report, or at least its summary and recommendations. I for one would have liked to go further but the stresses between representatives of the food industry and food campaigners on the committee proved challenging, to say the least.

The topic might not seem a natural fit for the Centre for Social Justice but, as other noble Lords have mentioned, it is clearly a matter of social justice. By the age of five, children in poverty are twice as likely to be obese as their least deprived peers and by the age of 11 they are three times as likely. Children living in poverty are more likely not only to be obese but to experience a combination of acute social problems over their lifetime. Other identified barriers to families in deprived areas living a healthy life—in practice, healthy behaviours—include being more likely to live in an area with more takeaway and fast-food outlets, more likely to live in poor, unsuitable or overcrowded housing, and more likely to experience a combination of family breakdown, stress, mental health issues and financial problems. They are more likely to be judged and negatively influenced by social disapproval of their deprivation and obesity. These conditions make it challenging for families in poverty to practise healthy behaviours and difficult for policymakers to know where to begin, especially when education and awareness are not enough.

Since we started working on the report, further evidence and a plethora of similar reports have emerged on a regular basis. This includes one reported today from the University of Warwick about lack of sleep leading to obesity, as my noble friend Lady Neville-Rolfe mentioned. Not only is our children’s health at serious risk but our health service and our country is, too.

No child wants to be fat. I was a chubby child and a plump adult until I lost 28 pounds around seven years ago—and having put half of that back on again, I know just how difficult it is to lose weight and keep it off. I came to this subject and report not as an expert, but as a lay person who simply could not stand by and let things get any worse. We all know that living in an obesogenic society means that it is hard for most of us to resist temptation and maintain a healthy weight but it is especially hard for those living in poverty, whose choices are limited by circumstance.

During the process of writing our report, we came to understand how it is that no country around the world has been able to reverse its obesity trend on a national scale, although I urge the Government to look carefully at the work being done in Amsterdam through a city-wide, whole-systems programme that has kids weighed regularly and tested for balance and agility. I have visited the programme, and I think the Health Select Committee in the other place is going in the next few weeks. It is early days but, thanks to the deputy mayor’s political commitment, the city’s numbers are improving, showing a 12% drop in obesity over a three-year period and even more in the poorer areas. The case study of the Amsterdam healthy weight programme demonstrates the power that political leadership can have in bringing people together, seeking change and driving it through.

I do not underestimate the political courage needed to make that change and to take on many vested interests, but although childhood obesity is a complex and contentious issue, it is not impossible to address. Many key steps have already been taken. The childhood obesity plan is a welcome start to the conversation, and much good work is already being done across England by local authorities, charities, NGOs and universities among others. However, the system is fragmented. Without a joined-up approach, these efforts are at risk of being eclipsed by the growing scale of the epidemic. It requires robust and persuasive political leadership, cross-party and cross-sector commitment, a long-term vision, a whole-systems and targeted approach and consistent monitoring and evaluation.

I am lucky enough to spend many of my weekends with two great-nephews aged two and four. They run everywhere. Children are designed to run. You do not see small children walking. I would like to have the opportunity to talk about the daily mile, which fits in with what the noble Baroness, Lady Grey-Thompson, and the noble Lord, Lord Addington, were talking about, but time is short. Today you are sadly more likely to see children strapped into buggies for hours on end, in front of a tablet with a bottle of sugary, teeth-rotting juice and a sausage roll—sometimes called a Greggs dummy—to keep them quiet. The average child eats its own weight in sugar every year. Those kids simply do not stand a chance.

People think that being overweight is an abnormal response to a normal environment. That is not true at all. It is a normal response to an abnormal environment. Political will is needed to effect the change we so desperately need. I urge the Government to be bold, and I look forward to the Minister saying, “We can, and we must, end childhood obesity”. We really have no other choice.