I’m writing these blogs as part of a conversation with Londoners that’s happening across London … a London Great Weight Debate! Along with many other Directors of Public Health, I’m planning to get a Great Weight Debate going with my residents. We recently launched an online survey on sugar reduction, and received replies from every ward in Lewisham, 2,600 in total. 88% of those who responded felt that action should be taken to help people in Lewisham cut down their sugar intake. 87% of respondents supported NOT allowing supermarkets to give price promotions on sugary drinks and snacks. Most encouraging of all for me, only 16% of respondents disagreed with a sugar tax of 7p on a can of sugary drink, with the money raised going to support work in schools to tackle obesity.
Despite the government’s cuts to public health spending and local authority funding, many London councils are still doing lots of innovative things to raise their residents’ awareness and ability to change their lifestyles. Actions range from community cookery classes, to cycle training, to training and supporting an army of volunteer diet and physical activity champions in local communities.
What can London do?
Many London boroughs are already leading the way in applying a whole system approach to obesity. At a local level, councils and their partners are taking action across four broad, overlapping areas all at the same time:
- Actions that affect children and young people
- Increasing residents’ awareness of what needs to be done and engaging their support
- Actions taken by health and other public services
- Actions that change the food, drink and physical environment
Actions that affect children and young people
The changes in our bodies that can determine how easily we gain excess weight start whilst we are still in our mother’s womb. An obese pregnant mum is not only more likely to have a premature baby and a difficult delivery, but her baby’s metabolism may be set for excess weight gain for the rest of its life. Helping a mum lose weight when planning for a baby, and offering antenatal care that helps to a mum to manage her weight, tackles mum’s weight and the future weight of her unborn child. From the moment the baby’s born, what goes in its mouth can determine its chances of becoming an obese child or adult. Breastfeeding reduces childhood and adult obesity in later life, and several local authorities have worked closely with their local maternity units, health visiting services and voluntary groups to make their boroughs comply with the United Nations Children’s Emergency Fund (UNICEF) Baby Friendly standards.
Schools are the next battle front in a whole system approach. Many London primary schools have started getting their pupils to run a mile a day (www.thedailymile.co.uk) with amazing results. Many more primaries and secondaries have signed up to the Healthy Schools award scheme run by the GLA, often with help from their local council. School Meals are nearly always healthier than packed lunches, and eating a school meal makes young people less likely to buy a high fat, high sugar take-away with a can of sugar rich drink. Schools that see school meals as important for the wellbeing of their students have higher school meal uptake – particularly secondary schools.
Actions taken by health and other public services
Many councils continue to fund weight management programmes to help adults and children lose weight, but with reduced funding, the only way to meet the sheer scale of the obesity challenge is to make every single contact with a health professional count. That means making sure all front line staff are trained to raise the sensitive subject of their patient’s weight (especially when the staff member may be overweight themselves), and that they don’t miss any opportunity to offer brief advice and signpost their patients to the services that are on offer. Hospitals in London are starting to put their own houses in order with the food and drink that they supply to patients, staff and visitors. All London councils are working with GP practices, pharmacies and community outreach providers to invite patients aged 40-74 with no obvious cardiovascular disease for a health check. Identifying obesity and offering advice and support to lose weight is key to preventing future heart attacks and type 2 diabetes.
Actions that change the food, drink and physical environment
I’ve already mentioned many actions that councils, schools and the NHS are taking to ‘increase the good’ and ‘reduce the bad’ food and drink that surrounds us. Some are going much further, influencing the food that is grown in their borough, using planning policies to stop new fast food take aways opening near schools, and because they can’t close the 8,600 chicken shops already open in London, working with them to make their food healthier, for example by using healthier cooking oil.
Over the next year, several councils are planning to join Jamie Oliver and Sustain’s SUGAR SMART campaign. They will be asking thousands of organisations and businesses in London, from restaurants to schools to leisure centres, to football clubs and museums to sign a Sugar Smart declaration and make three commitments around drinks, food and advertising/promotions.
The final, and literally the biggest battle ground in a whole system approach to tackling obesity, is the physical environment itself. Town planners and council transport departments have been working with public health professionals, and with the Greater London Authority and Transport for London, to make sure that new developments encourage more journeys by foot and bicycle. Cycle trails, superhighways and quietways are spreading across the city. Parks and open spaces are being made safer and more attractive to use, with outdoor gyms and trim trails.
What can you do?
As I mentioned in my previous blog, making even small changes to our lives can shift even large amounts of excess weight over time. Every local council website has lots of information and advice that can help you, and Public Health England has recently launched ONE YOU, a website designed to help you improve your health (www.nhs.uk/oneyou). You can even download a SUGAR SMART app from the Appstore and Google Play that allows you to point your phone at a barcode to tell you how many cubes of sugar there are in thousands of different products.
But perhaps the most important thing you can do, is to make your voice heard alongside millions of other Londoners and campaign to bring the environment that has made London an obesity capital back to normal. Join the London Great Weight Debate and have your say in your borough. 8.7 million voices supporting radical action on obesity sends a very powerful message to the Mayor of London, and to the government.