University of the Witwatersrand: Obesity and industry – it’s not what it looks like

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A recently published study by researchers from Wits University has found that voluntary actions from the food and beverage industry aim to protect industry interests instead of improving public health outcomes.

The Priority Cost Effective Lessons for System Strengthening South Africa (PRICELESS SA), a research unit from the Wits School of Public Health led the study which was published in the Nature Food Journal, performed a review of 25 peer-reviewed papers and 20 voluntary actions by the food and beverage industry in Low- and Middle Income Countries (LMICs) across the globe, and analysed the implications of these actions for public health and policy.

The review was part of several collaborations that Wits together with the Global Diet and Activity Research (GDAR) Network at Cambridge University have worked on. GDAR is funded through the UK National Institute of Health Research (NIHR) and aims to contribute to the field of diet and activity research in African and Caribbean countries and to inform policies for NCD prevention.

Lead researcher of this first of its kind review from PRICELESS, Agnes Erzse said that one of the problems identified in the study was that international organisations like the United Nations (UN) had previously acknowledged public/private partnerships and self-regulation, where industry was seen to have a role to play in addressing Non-Communicable Diseases (NCDs) and their risk factors.

Because of this, industry had been able to avoid government regulation by convincing policy makers that their actions to self-regulate are adequate. This was also a more convenient approach for resource strained countries whose focus was economic growth.

“It was important for us to know that if these voluntary actions replaced evidence-based policies in low- and middle-income countries, are they effective or not? What this study shows is that these actions are not effective when it comes to public health, in fact our study also showed that they negatively affect policy making because they replace, dilute and delay effective measures,” said Erzse.

Strict monitoring
Voluntary actions by industry were found to negatively influence the food and beverage environments in LMICs by failing to reduce exposure to unhealthy foods and beverages, particularly across four NCD prevention areas.

Product reformulation
Simplified nutrition labelling
Restricting marketing to children
Limiting sales of Sugar Sweetened Beverages (SSB) in schools
In instances where industry put in place self-regulatory measures, there was a lack of monitoring and evaluation from LMICs, which made it difficult to hold industry accountable.

“They [industry] do not provide targets and benchmarks to what they are doing, do not use appropriate nutrition standards when they are setting their criteria, their language is vague, and it is impossible to hold them accountable because it is written in a way that gives them leeway to get away with whatever they wish to do,” added Erzse.

No room for industry in policy
Professor Karen Hofman, director of PRICELESS said that governments should start relying on evidence when making public health policies.

Hofman believes that the study proves why industry should not be involved in policy formulation processes because industry’s main priority is to make profit instead of safeguarding public health.

“The fact is that there is no room for industry to be involved in the designing of regulations that have anything to do with public health,” she said.

“Policy makers can listen to industry but their views and their evidence should not be taken into account because we now have more than enough evidence that shows that voluntary actions do not make a difference,” added Hofman.

She further said that the true cost of NCDs and obesity-related conditions like high blood pressure, diabetes and cancer was far too high as they affected the Gross Domestic Product (GDP) where ill-health affected people’s ability to participate in the economy.

According to Hofman, governments needed to make policies that would make it easier for the public to access healthy food and beverage while also limiting the marketing that people are exposed to.

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