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Tackling the obesity epidemic – suggest a luxury chocolate, not a walk?

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Nurses have been asked this week to promote a new digital app that will encourage people to walk more.

 The main aim is to try and get people in the age group of 40 to 60 to walk briskly for at least 10 minutes every day - which seemed a surprisingly low target to me.

But unfortunately, the facts speak for themselves. Research has indicated that 41% of adults in this age range in England walk less than 10 minutes continuously at a brisk pace – and that is in one month, let alone a week! 

Getting more people to exercise is obviously going to benefit the population’s health, but is the goal set out this week by officials at Public Health England going to contribute towards tackling obesity?

“The average body mass index for adults in the UK is 28 – when a healthy range should be 20 to 25… anything over 30 is clinically obese.”

This isn’t one of the stated objectives of PHE’s One You physical activity campaign – which talks mainly about preventing heart disease, protecting your mind, and staving off age-related illnesses – but you would think it would help.

Especially as we are in the middle of an obesity epidemic at the moment, as one eminent professor made abundantly clear at a conference for school nurses yesterday.

The average body mass index for adults in the UK is 28 – when a healthy range should be 20 to 25, 25- 30 is overweight and anything over 30 is clinically obese – noted Colin Dayan, a professor of clinical diabetes and metabolism at Cardiff University.

This epidemic in the UK is a “product of affluence,” Professor Dayan told the audience at the Royal College of Nursing’s conference in London.

“Our ability to buy calories has increased because our country is becoming richer. But to add to that we have made the calories cheaper,” he said, pointing to supermarket deals that offer bigger packets of junk food for the same price.

But, his more controversial point was about tackling the obesity epidemic. Exercise, perhaps surprisingly, plays a fairly insignificant part in helping people to lose weight, he said.

“Our ability to buy calories has increased because our country is becoming richer. But to add to that we have made the calories cheaper,” - Professor Dayan

He pointed to a study colleagues had carried out which showed people who dieted lost a fairly equal amount of weight to people who both dieted and exercised.

He also noted how it was actually really difficult to burn calories, especially considering our modern lifestyle (a one-hour walk is equivalent to losing two biscuits’ worth). Plus there is the temptation after exercise to reward yourself with food, potentially undoing all the hard work.

While keeping fit has other benefits (mainly cardio vascular), maintaining a healthy BMI is really all about the food people eat, said Professor Dayan.

What were his solutions for nurses offering advice? Well conventional diets for quick weight loss don’t work, in his opinion. We need a more sustainable approach, he said.

This will involve re-engineering people’s food intake by both changing our expectations within society about eating more healthily, and also helping people to understand how they feel full, he said.

“In France people “don’t eat Cadbury’s Dairy Milk” but in local supermarkets you can buy just one, small luxury chocolate for about double the price.”

He pointed to France – where obesity prevalence is far lower than the UK, but it is a similarly wealthy country – where meals generally are eaten more slowly, which allows your body the time to produce the “feeling full” hormone, cholecystokinin.

In addition, in France people “don’t eat Cadbury’s Dairy Milk” but in local supermarkets you can buy just one, small luxury chocolate for about double the price, Professor Dayan noted.

The French option is far better for your health because the small chocolate will stimulate the hormone that makes you feel full more quickly because of its rich taste, he said. This is the kind of thinking we need to tap into, he was at pains to point out.

So how to sum up this new approach needed by specialist public health nurses, and all those in their day-to-day work on tackling and preventing obesity? “Can you have your cake and eat it? Yes you can if it fills you up,” according to Professor Dayan.

It seems counter-intuitive, but maybe suggesting a luxury chocolate, not a walk, might be the first step.

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