17 May 2019
Caroline Bovey BEM is Chair of the BDA
Last week saw the publication of the latest Obesity, Physical Activity and Diet statistics for England, and they make for fascinating reading. They also make it clear that there is a great deal to be done by dietitians, the BDA and others to improve the nations diet and manage obesity and related conditions. Although these figures are England only, we know similar stories are reflected across the UK.
Diets still need to improve
Although it won’t come as news to many dietitians, the stats show the nation’s eating habits continue, on average, to be far from ideal. Adult fruit and vegetable intakes remain well below recommendation at an average of 3.8 per day, although that has increased from 3.6 in 2016. Children’s intakes of fruit and veg remains flat, with only 18% in 2017 consuming the recommended five portions daily. All age groups continue to consume at least twice as much free sugar as recommended (5% of energy intake) although this is falling, and no age group reaches the recommended intakes for oily fish (20g per day or one portion a week), with children in particular consuming virtually none.
All this tells us we have a lot of work to do. Excellent initiatives run by dietitians that help children and adults to prepare and eat healthier meals at home, at school and at work need to been grown. Educations schemes to help people or better understand the nutritional content of the food they are eating are more important than ever. Programmes such as Let’s Get Cooking and Work Ready need to be expanded and supported by governments across the UK and embedded across communities and health and social care environments to ensure that they are accessible and delivery is sustainable.
You will know that my theme as chair is promoting the role of all dietitians in public health and prevention. I strongly believe that all dietitians, be they in an acute role or working for industry, have a role to play in public health. Making every contact count to reinforce health promoting messages is something we can all do, including on social media which offers multiple platforms which can be used to share information with a wide range of readers including otherwise hard to reach audiences.
Obesity rates keep rising
Obesity rates continue to rise steadily, with 64% of adults now having overweight or obesity, of which 29% have obesity, which represents an uptick since 2016. Childhood obesity has actually fallen very slightly in the last 11 years amongst reception age children from 9.9 to 9.5%, but remains too high, and this fall is not replicated at year six, where obesity has risen slightly from 20 to 20.1% over the same period.
These increases are starting to have a real impact on the health service, with 711,000 hospital admissions where obesity was recorded as the primary or secondary diagnosis, a 15% increase on 2016/17. This is no doubt partly due to better and more confident and sustained recording, but means we are beginning to see the true scale of obesity’s effect on the NHS and people’s health.
This is why our ongoing support of national efforts to manage obesity in England as well as Wales, Scotland and Northern Ireland is so important. Efforts to improve the nutrition composition of food as well as change the obesogenic environment are an important part of the wide-ranging approach that is needed. Dietetic obesity services have been shown to be effective in helping people to lose weight sustainably, but these multi-component services they are too few and far between. Too many providers have cut back funding for weight management services leaving us with a postcode lottery for access to effective support.
Food insecurity and poverty
The average household spend on food remains low, although it did increase slightly over the last year. Positively, the gap between what the richest and poorest spend on food as a percentage of their income is falling. However, food remains the biggest item of expenditure after housing, fuel and power for those in the lowest income households.
Obesity continues to be a disease of poverty, with children from the most deprived areas being more than twice as likely to have obesity in reception or year six than children from the least deprived areas. This gap continues to grow.
The BDA Trade Union continue to campaign on the issue of food insecurity, taking resolutions to the Trade Union Congress and through other avenues.
Not all bad news!
One could be forgiven for being demoralised about such a challenging set of figures, but there are some positives. Red and processed meat intakes are now below the recommended 70g per day (or less) for every age group except adult men 19-64, and even there the trend is a downward one. This is positive news when it comes to the environmental impact of the food we eat. As our One Blue Dot toolkit helps explain, reducing intakes of red and processed meat are good for us and good for the planet!
These numbers also show us that there is huge scope for dietitians to play a bigger role. Governments and health services in all countries of the UK now recognise poor diet and obesity as the biggest health challenge facing the population, so there’s never been a more important time. I hope you’ll use the forthcoming Dietitians Week as an opportunity to highlight what it is that you are doing, and will advocate for yourself and the profession at every opportunity year-round, as I will continue to do!