As one of the chairs of NICE Advisory panels she works with industry to obtain voluntary agreements to improve the nations health. Her talk, following just 1 day after her appearance on Radio 4, was entitled Knowledge, Nudge and Nanny – opportunities to improve the Nations Health.
Salient Points of Lecture
- No 1 attributable cause of poor health in Britain is DIET
- Implementing dietary recommendation could save 33,000lives/year
- High fat/high sugar Items
5 least intake items Fresh fruit, raw/boiled vegetables, High fibre breakfast cereals, High fibre bread
- Sustainability of NHS is dependant on rapid upgrade in prevention and public health
- Education is necessary but not sufficient. The influence of environmental factors plays a significant role in nations health
- Knowlege – Nudge – Nanny I.e. 7 Choice step plan - Do Nothing, Provide information, Enable Choice, Guide choice by changing default policy, Guide choices through incentives, guide choices through disincentives, Restrict Choice.
- Weight loss – the most cost effective means is via weight watcher groups – (more effective than State nurses) Loosing just a few pounds makes a significant difference to diabetes
- On individual level – need to encourage and enable people to develop practical coping strategies to withstand obesogenic environment.
- At Population Level – Change the environment to make the healthier choices, the easier choices.
- Public health approach to changing diet_
People – Make healthier choices easier - e.g food labelling
Products – Providing healthier products e.g. reformulation – less salt/sugar and smaller portions
Promotions – marketing restrictions
What could Possibly be done?
- Ban fast food outlets near schools?
- Require healthier food options in takeaways
- Provide Food standards for schools, hospitals, prisons.
- Provide incentives for employers to provide healthier food in workplaces
- Support Health Professions in advocating dietary change and provide support for patients
- Provide consistent messages for consumers
- May be necessary to impose additional taxes of items bad for health I.e. sugary drinks – mexico successfully adopted such a strategy
Population-level measures to promote a healthier diet are an essential complement to individual lifestyle interventions Education is useful, but rarely sufficient and not always necessary
Action from industry is crucial to transform the food environment
There is a subtle balance of power between policymakers, industry and the public which needs to be understood and managed if effective policies are to be successfully adopted.