“Many experts believe that the rapid expansion of ultra-processed foods, more so than any other sub-system within the agriculture and food system, is the major factor in the obesity epidemic,” the new report reads. “Preventing obesity and improving other forms of malnutrition can only be achieved by one common approach – the promotion of a high quality diversified diet rich in fruit and vegetables.”
But how? Over 61 pages the report – which has yet to appear on the World Bank’s website, but is available here – highlights the possible actions up and down the supply chain that could help tip the scales in favour of healthier foods and curb consumption of “ultra-processed foods”.
Processed foods panned
Processed foods are singled out as the big villain in the piece. Their hyper-palatability, high energy density, sale in large portions and the “aggressive and sophisticated” way in which processed foods are marketed all “undermine the normal processes of appetite control, cause overconsumption, and therefore obesity, and diseases associated with obesity”.
New laws to restrict advertising of junk foods would therefore be a good place to start tackling obesity, the World Bank suggested. “An area where government could play an important role, yet has not to date, except in the new law implemented in Chile in 2016, is on regulating marketing of unhealthy food to children,” the authors explained.
Industry can’t be trusted to self-regulate, the Bank suggested. Efforts already in place to limit access to unhealthy foods have focused on industry-led interventions and agreements, but the evidence to date shows this is a “highly risky approach and should be accompanied by other measures including regulatory actions by the government to enforce certain restrictions”, noted the authors Aira Htenas and Yurie Tanimichi Hoberg.
More collaboration between the food industry and campaigning groups would also help. These stakeholders are often at loggerheads when policymakers begin to mull over new approaches to tackle public health issues, but there are examples of how closer partnerships can foster change, such as the Marine Stewardship Council’s scheme for sustainable fish.
The introduction of taxes is more complicated and “could incur unintended consequences”, the authors noted. Still, WHO has recommended taxing sugar-sweetened drinks and many countries have a levy in place, or are pushing new regulations through.
Wider taxes on junks foods or other ingredients can be fraught with problems, though – what would a tax on fat do the price of peanuts, for example? Denmark’s fat tax was repealed within a year, the Bank noted, whilst constant reformulation by manufacturers would leave governments continually playing catch-up as fiscal measures were re-evaluated and altered.
Improvements to labelling could be less controversial. Firms including Nestlé, Mars and Unilever recently committed to nutrition logos modelled on the UK’s traffic light scheme. But these are not without their critics or problems: last week, campaigners highlighted that a number of cereal manufacturers in the UK are not using the red, green and amber coding in a move to “deliberately deceive” consumers.
Improvements to national dietary guidelines are also much-needed, said Hoberg and Htenas. Currently these “do not provide ample guidance on hoe to choose among the wide array of processed foods”. Guidelines therefore “need to reflect the reality of heightened consumption of ultra-processed foods,” they concluded, citing Brazil’s advice to “avoid ultra-processed foods”.
Further down the chain biofortified cereals should “become the norm rather than the exception”. Subsidies should be re-targeted towards fruit and vegetable production rather than “unhealthy ingredients for food processing” such as sugar, corn and palm oil, the economists said.
Lawrence Haddad, executive director at the Global Alliance for Improved Nutrition Gain said the report “is an important signal to those inside and outside the World Bank that obesity is not off the table, and that some of the Bank’s investments in agriculture and food systems could be doing more to mitigate it and may even be inadvertently contributing to it”.