Childhood Obesity and Advertisement
For the past ten years the issue of obesity has been on the UK public and governmental agendas. With the largest percentage of obese people in Europe the United Kingdom officially considers obesity as one of the major public health problems, which has to be approached on different levels – from personal to governmental (Hill et. al. 2003). This paper focuses not as much on the general analysis of obesity and the UK legislation on the issue, but rather on childhood obesity. This has become a major problem in the country and thus requires rapid measures to decrease the childhood obesity levels. Along with the analysis of the factors that lead to childhood obesity and the existing legislation on the issue, this study inquires into one particular legislation – the HFSS advertising restrictions introduced in 2007, their efficiency, as well as the role of advertisement in the development of childhood obesity.
The problem of childhood obesity. Introduction. Facts and statistics.
Currently, as well as for the past decade obesity is still considered to be the biggest healthcare problem in the UK (Cole et. al. 2000). It is so significant, that many people are already calling it a crisis (Borland 2013, Wright et. al. 2001). Obesity in children has reached such numbers that some researchers are already calling it an epidemic, which started back in 1980s (Reilly et.al. 2005).
While in the 1980s less than 10 percent of European kids were obese, in the beginning of the 21st century already more than 20 percent of the younger population was obese (Urquhart 2013, Knai, Lobstein & McKee 2005). Great Britain is one of the countries with the highest levels of obesity among children. The percentage of children with this health problem continues to rise in the UK. For example, for the school year 2009-2010 obesity among 10 and 11-year-olds has increased by 0.8 percent (Haigh 2010). Over almost 10 years the obesity levels among children have grown from 9.6% in 1995 to almost 14% in 2003 (Tackling childhood obesity 2005). All in all 1/3 of the UK children is overweight or obese even before they leave primary school (Brimelow, 2013). Obesity in childhood is a great problem, which results in a number of complicated diseases, such as hart disease, cancer, respiratory disease and diabetes (Must & Strauss 1999, Guillaume 1999). There are various biological reasons causing obesity, which can be grouped into genetic, idiopathic, or endocrinal (James et. al. 2004).
It is essential to define what obesity is. According to Reilly et. al. (2005), obesity can be defined as body mass index equal or even bigger than 95th centile with “equivalent to a standard deviation score of 1.64 or more” (p. 1357). Borland (2013) gives another definition of obesity: it begins when the measure of the weight compared to the height is 30 or more.
There are two main factors that lead to childhood obesity: lack of physical exercises and overconsumption of calories (Reilly et. al. 2003). The changed lifestyle and new food patterns have together created a strong ground for the new overweight generation (Hill & Peters 1998, Reilly et. al. 2002). TV and Internet became the new form of activity for children, which is as exciting as any other, but requires much less energy waste (Ashton 2004). At the same time fast foods and sugar drinks have formed the basis for the diet of a modern child.
Currently the issue of childhood obesity is being tackled on different levels. It starts with school and family programmes that promote healthy lifestyle, proper foods, and physical activity. For example, there is an APPLES programme – the nationwide active programme promoting lifestyle in schools (James et. al. 2004). Studies state that obesity prevention is easier and more efficient than fighting with the already existing disease (Dehkhan, Akhar-Danesh & Merchant 2005).
The problem of childhood obesity is so significant because it leads to very complicated health issues in the adulthood. Although some researches show that overweight children usually don’t grow up as obese adults (Wright et. al. 2001), obese children usually grow up as adults with health problems caused by additional weight. Therefore, currently the UK is growing an unhealthy generation.
Socio-economic factors
The issue of childhood obesity in the United Kingdom is very complex. First of all there is the complexity of legislation that is based on two notions: firstly the UK is a federal state with different legislation in each of the countries; secondly, it is a part of the European Union, which makes it follow some common EU regulations, as well as gives the citizens of the UK access to information from other states within the union. Moreover, one has to take into consideration some other factors related to the issue, such as financial burden of obesity-related diseases on tax payers, various eating habits of the UK population, the appearance of ‘children foods’ etc.
United Kingdom consists of four countries, which not only have different histories and cultural background, but also different legal systems and governmental powers. Legislation is usually unique to each of the countries within the federation, which means that healthcare as a governmental responsibility in England and Northern Ireland is different. At the same time, some of services and activities are provided nationally. One of those nation-wide spheres is media.
While the UK is a federal state, it is also a member of a larger union – the European Union. Therefore, many of the UK legislations are influenced by the EU laws, which means that governments of Wales, England, Scotland and the Northern Ireland are not always able to make their own laws. For example, the legislation regulating the TV content is much lighter in the European Union, which means that people living, for example, in Scotland are able to access information that is not regulated by British laws.
The UK health system is a national one, which means that it’s free for people accessing medical assistance. But, at the same time, it is not free for the state and thus – for taxpayers. With the constantly increasing obesity rates the money spent on treating obesity-related diseases grows each year. As a result, taxpayers have to contribute to the national budget more each year. This financial factor is an important element of the obesity debate in the UK, because the population has to pay for treatment of people that simply did not take care of their health.
Although Britain became much more liberal and egalitarian, there is still a huge difference between representatives of different social classes, which is seen not only in income levels, but also in lifestyles. Moreover, representatives of different social classes live in separate areas, which have strong influence on their lifestyles. As Martin (2008) describes it: “the area where people live will have consequences for availability of fresh fruit and vegetables, opportunities for sport and exercise, access to medical care and health advice, quality of schooling, and street safety to enable walking to work, school and shops.” This means that a person living in a poor district initially has fewer chances for healthy food and lifestyle (Wang 2001). Therefore, obesity in the UK is a common disease for the poor population.
The eating habits of adults in a family have strong influence on children (Ruskin 2003). Obese parents with unhealthy lifestyle are not able to teach their children to live and eat healthy. This turns into some form of an “obesity chain”, where parents pass to the younger population undesirable habits (MacVean 2012). Moreover, English families have developed an unhealthy trend of separate dinners. Instead of having a dinner altogether, parents and children have meals at different times of the day. As children are not interested in preparing healthy complicated meals, they prefer fast processed foods, which only increase obesity risks.
Another tendency of the past decades is the appearance of the whole new food industry – ‘children’s food’ (Martin 2008). While in the majority of other countries children switch from food for infants to the family diet, in England they rather move to children’s food, which includes various types of unhealthy fast foods: chicken nuggets, fish fingers etc. Having a whole segment of the food market for themselves children have not only became more independent in choosing types of food they consume, but they’ve also become a target for advertisement. Children food has become a whole new market, which is currently developing and easy-prepared food that still has poor nutrition levels is constantly advertised as food for the younger generation.
Except meals that children have at home, there are meals they consume at schools on the daily basis. And a school meal is the type of food of the lowest nutrition value with fast foods dominating in the sphere. Although some time ago school food in England had to follow some nutritional standards, this rule was canceled in 1980s. This led to the popularization of fast foods as the main form of food for schoolchildren. Moreover, state schools get financing from the government, which until recently was only 37p (Martin 2008), which meant that instead of healthy products children get in schools only foods high in fat, salt and sugar.
In the UK breast feeding rates are very low according to the general European standards (Armstrong & Reilly 20902). Although more than 70 percent of women breast-feed their babies right after the childbirth, this number drops twice only six weeks later (Breastfeeding statistics 2000). At the same time research shows that breastfeeding and childhood (obesity are definitely linked.
Evolution of the issue
The issue of obesity has entered the UK national agenda in the end of the 20th century. The growing percentage of obese adults and children, as well as the dramatic statistics and predictions made the problem of obesity become the center of not only public, but also the governmental attention. Along with the introduction of various types of legislation on obesity, the UK government has changed its’ attitude to obesity with time. From being considered a medical problem it has evolved into personal problem throughout time. Each type of approach towards obesity has called upon different types of legislation. The following timeline presents not only the development of the UK legislation targeted at tackling obesity, but also the evolution of the perception of the disease.
The first official document focusing on obesity problem in England was issued in 2001 by the National Audit Office and named Tackling Obesity in England (Tackling Obesity in England 2001). As it was the first approach to the problem, it just highlighted the issue, but did not offer any solutions to it. In this study obesity was seen as a medical problem, thus all the responsibility of tackling it was on the National Health Service.
In 2002 and 2003 the Wanless Reports have changed the focus of obesity from health to economy. Attention was paid to the financial consequences of health problems caused by obesity. According to these reports, obesity in the nearest future would have become a significant burden for the National Health Service budget. Already in 2005 obesity cost the NHS more than one billion pounds, while further indirect costs were more than two million (Tackling Child Obesity 2005). The number got even more significant with the rapid growth of obese population in the UK, and by the year 2013 more than five billion is spent on treating obesity-related diseases in a year (Borland 2013). Therefore, from being a medical problem it has turned into an economic one.
The next state document on the issue was published in 2004. It was The House of Commons Select Committee Report on Obesity. It did not focus on one issue, but rather highlighted health problems, as well as economical and social background of the issue. Notably, the report took into consideration the new societal norms (Choosing Health 2004), which made obesity a social issue.
Shortly afterwards obesity was identified as one of the governmental sic heath priorities in the Choosing Health: Making Healthy Choices Easier paper (Choosing Health 2004). It focused on the role of government in the creation of a healthy nation and defined healthy lifestyle as a national priority. As the state is responsible for provision of health services, obesity as a common health issue becomes the governmental responsibility. At the same time, the state is not the only one responsible for tackling with obesity, because it is also a problem for the UK population. Therefore, obesity became a public health problem.
The last step in the development of perception of obesity on the state level was its’ turn into a personal problem. Although some critics say that it led to the oversimplification of the issue, it is clear that without individual attention to one’s health, no state regulations can significantly influence the current state of affairs. In case of children it rather involves parents who are responsible for the lifestyle of their kids (Brimelow 2013).
Existing legislation
With growing attention to healthcare issues and obesity being one of the top priorities of the government, there are currently various ways in which the government already influences the food industry, as well as some measures, which haven’t yet been implemented (Consider tougher regulation in obesity fight 2013). Currently there are still many critics stating that the policies that are related to obesity should be stricter. Martin (2008) names six different ways in which government can change the society and improve the healthcare situation that was presented earlier:
Impose enforceable duties on bodies which are in a position to improve the health environment; provide powers (such as powers of licensing, taxation, inspection) which give some leverage in ensuring that stakeholders recognise their responsibilities; provide tools such as judicial review and actions in tort to enable private bodies and individuals to protect health; provide protections against public health interventions which go too far and which impinge on the human rights of individuals; set norms to influence public opinion on what is and what is not acceptable health behavior.
Not all of the steps proposed in Martin’s research are currently implemented in the United Kingdom, although some significant steps have already been made in order to improve healthcare situation on different levels. This includes Jamie Oliver’s initiative to improve meals in schools; breastfeeding legislations; HFSS advertising restrictions; nutrition labeling on products, etc.
Back in 2000 the UK government introduced nation-wide standards for school means, as well as regulations controlling it (Reilly et. al. 2000). At the same time fast foods remained in the school menu. Therefore, it was up to children to decide what they want to eat. Currently, tanks to the nation-wide attention that was attracted to the issue by Jamie Oliver, the regulations of school meals became stricter. Currently schools have to ensure that each child has to have at least two portions of fruits and vegetables per day. Moreover, later the food regulations were extended to vending machines located in schools.
According to the Food Safety Act 1990 selling of foods that are dangerous for health is a criminal offence. Unfortunately, it is almost impossible to prove that fast foods or foods high in fat, salt and sugar can actually kill a person. Moreover, all the food safety laws do not focus on the nutritional component of products, thus they cannot be used in the process of controlling obesity levels and decreasing the amounts of HFSS.
The Food Labeling Regulations of 1996 stated the need to mark foods in terms of nutrition. These regulations did not cover all the products and food labeling was rather a voluntary act of a manufacturer (Reilly &Wilson 2006). At the same time the information on packages cannot always be fully trusted. Moreover, it was required only when the manufacturer made specific nutritional claim. Therefore, it is essential to make these regulations stricter and force all the manufacturers to put the true nutrition value on their products.
The support of breastfeeding all over the EU is guaranteed by the Protection, promotion and support of breastfeeding in Europe: a blueprint for action issued by the European Commission (European Commission 2004). As a result of this recommendation provided by the EU national governments had to ensure the security of breastfeeding women. In England this includes the issues of breastfeeding in public, which is often criticized, but has to be supported by the government in order to secure the protection of women.
It is essential to remember that obesity and especially childhood obesity is a problem for the whole Western World. Therefore, back in 2010 the World Health Organization (WHO)has published in 2010 a set of essential recommendations on tackling childhood obesity (Cutting children’s exposure to unhealthy food 2011). The WHO outlined definite measures to decrease the influence of unhealthy foods on the younger generation. Therefore, the regulations that were introduced in the UK back in 2007 have foreseen the global tendencies in advertisement control.
HFSS foods advertising restrictions
Children are the main target for food advertisement in the UK. It became especially true with the development of the ‘children’s food’ segment on the market. As children are much easily influenced by the media and various marketing strategies, they are more vulnerable to the influence of advertisement. Therefore, the protection of children from the adds of unhealthy products and foods high in fat, salt and sugar (HFSS foods) is currently one of the top priorities in fighting childhood obesity in the United Kingdom.
For the first time the UK government has risen the question of control over advertisement of junk foods ten years ago, back in 2003 (HFSS advertising restrictions 2010). It was the first desire to change both nature and balance of advertisement of food and drinks to kids. The Office of Communications (Ofcom) is responsible for controlling the advertisement of HFSS foods. In 2006 the Ofcom issued a document describing the importance of regulations in the advertisement of unhealthy foods for children. At first it offered the guidelines for the voluntary actions of manufacturers. In 2007 the Ofcom has officially banned the advertisement of unhealthy foods during and around programmes for children, as well as those programmes that could be considered appealing for kids aged 4-9, and all the children’s channels (Walker et. al. 2007). In 2008 the Ofcom has extended its’ regulations to programmes for children aged up to 15. Along with the Ofcom, there is another body involved in the advertisement control – the Advertising Standards Authority (ASA). It has introduced restrictions for techniques that can be used for the advertisement of food and drinks (HFSS advertising restrictions 2010).
As time passed after the implementation of the program, the Ofcom spokesperson stated that in 2009, after the introduction of the last legislation, the children’s exposure to ads of HFSS products has reduced by no less than 37% (Children 'watch same level' of junk food ads 2012). With the introduction of new regulations by the Ofcom the UK became a country with the strictest advertisement control in the world.
Policy analysis
It seems like the Ofcom has made significant progress in the development of HFSS foods advertisement. Almost all the TV channels abided the rules introduced by the Office of Communications (Smith 2011). At the same time, many still stay that the legislation was not efficient enough and demand even stronger measurements applied to TV advertisement for children.
Statistical information and recent researches show that the Ofcom actions did not influence the amount of information about unhealthy foods that children get on TV. Moreover, some studies have shown truly dramatic results: if before the legislation the unhealthy food advertisement was less than half of the overall amount of TV adds, but after the implementation of legislation it has significantly risen to more than 60 percent of all TV advertisement (Children 'watch same level' of junk food 2012). Moreover, before the ban of all the adverts seen by children only 6.1 were about junk food, while after the ban this percentage has risen by almost 1% (Children 'watch same level' of junk food ads 2012).
There are some future steps proposed by the National Institute for Health and Clinical Excellence and other specialists. They believe that the Ofcom can use these steps as an outline for further actions. Firstly, their main mistake is considered only on the advertisement in programs aimed directly for children. But, in fact, children watch much more TV content than is commonly considered “youth” information. Therefore, they are still exposed to the HFSS advertisement throughout the day. As a solution, the National Institute for Health and Clinical Excellence advises to ban all the HFSS adds before 9 PM. They believe, on the basis of evidence that such regulation will decrease the exposure of children to HFSS advertisement by no less than 80 percent (Cutting children’s exposure to unhealthy food 2011).
Conclusion
Obesity has become a great problem for the Western civilization in the 21st century. Not only more and more adults become overweight, but also children are constantly gaining additional weight. The United Kingdom has one of the highest childhood obesity rates in Europe, and the percentage of overweight children is constantly growing. In the future these children will turn into very unhealthy adults with high chances of coronary diseases, diabetes, and a number of other obesity-related illnesses (Freedman et. al. 2003). As a result, the United Kingdom is currently growing and unhealthy generation.
There is no simple explanation why the population is getting more and more overweight. Two main factors are defined for childhood obesity: fast foods that form a major part of the diet of modern children and TV and Internet, which have become the new form of immobile recreation. Thus all the energy gained from food is not spent^ which and leads to obesity. But there are many more factors that influence childhood obesity: social status of the family, parents’ eating habits, the creation of ‘children’s food’, meals consumed in school, etc. Put together these factors form a basis for the rapid development of childhood obesity.
The legislation of the United Kingdom is very complex, as on one hand it is a federation that consists of different countries with their own legislation, but on the other hand it is a part of the larger European Union. Therefore, the UK legislation consists on multiple levels, although some of the issues can be covered nation-wide.
This paper focused on the legislation in the sphere of media, which is one of the nation-wide spheres. The advertisement of fast foods and HFSS foods has been limited in the UK back in 2007. Currently these advertisements are not allowed during the programs for youth aged up to 15, they are also prohibited on channels for children. Despite the fact that it is the most strict advertisement legislation in the Western World, studies show that it does not have significant results. In order to decrease the consumption of fast food and thus – obesity levels, HFSS advertisement requires stricter regulations.
