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Friday 10 July 2015 12:26pm

Dr Rachael McLean, public health physician and EDOR member, was invited to speak about ways to tackle obesity at the Public Health Association (PHA) of New Zealand annual conference, held in Dunedin, 6-9 September, 2015.

Dr McLean, a senior lecturer in the Departments of Human Nutrition, and Preventive and Social Medicine, at the University of Otago, told the PHA conference attendees that we know what to do about obesity in New Zealand.  The challenge is being able to create the appropriate public health policy and environment changes to enable the solutions to become a reality.

Further information

Read a summary of Dr McLean's presentation

Fad diets and mung beans: a call to action and a way forward on tackling obesity
Public Health Association media release, 8 September 2015

We know what to do about the growing obesity problem in New Zealand. We just seem to lack the courage and foresight to implement the changes that will make a difference, the Public Health Association Conference was told today in Dunedin.

Conference keynote speaker Dr Rachael McLean, Senior Lecturer in Public Health and Nutrition at Dunedin School of Medicine, said that Māori, Pacific and those in socioeconomic hardship are more likely to be obese than others in New Zealand. This suggests the causes of the obesity epidemic have a lot more to do with the systems and structures we have in place than with personal responsibility. Dr McLean quoted the UK's Foresight Report of 2007 which highlights major societal changes in work patterns, transport, and food production and distribution which “have exposed an underlying biological tendency, possessed by many people, to put on weight and retain it.”

She said one popular response to burgeoning waistlines has been the emergence of fad weight-loss programmes like the Paleo and low carb diets. “Each one is vigorously self-promoted to the exclusion of all others, is usually based on cherry-picked and anecdotal evidence, excludes whole food groups and focuses on weight-loss rather than overall health. There's usually a book involved stressing your personal responsibility and telling you that you can do it if you just work hard enough!”

The food industry loves all this, she said, because it can design and market tailored products, making money in line with the latest trend. However, she said, if we look closely at the range of fad diets around, there are a number of attributes many share which are probably beneficial such as: avoiding highly processed foods; limiting sugar; eating mostly plants and some lean meats, poultry and seafood.

“The problem is it's really hard for people to eat like this because the food industry dominates the marketplace. It is hardly regulated in what it can produce or say, so we're inundated with conflicting messages about what's good for us. Meanwhile, mass-produced, unwholesome food choices are often cheaper than nutritious food.”

Dr McLean said there is a way forward, one that was recommended by the New Zealand Medical Association in a 2014 policy briefing. Its recommendations included more stringent restrictions around food marketing; taxes to reduce consumption of certain foods (such as sweetened drinks); a simple food labelling system; nutrition guidelines in schools; reducing the number of fast food outlets; and health impact assessments so we can develop social settings that support physical activity.

“The truth is that a narrow focus on 'personal responsibility' does not work, and we will not get anywhere by simply saying people should exercise more and eat less. We will only succeed by building healthy public policy, and creating supportive environments for people to live, be active and eat well every day".

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