When obesity is not just a health problem; information is a citizen's right

08/10/2018
180813octagonoetiquetadoMONTEVIDEO (Uypress) - Obesity and overweight are a health problem in our country. The WHO considers childhood obesity one of the most serious public health problems of the 21st century, and Uruguay does not escape this epidemic.

The Executive Branch is considering a decree on the labeling of industrial foods, the result of a process that took many months of negotiation between different actors, which involves regulating industrial foods, processed and ultraprocessed, and provides for the incorporation of a front seal – a black octagon, as is already happening in Chile - with warnings on products that have excess sugar, saturated fats, sodium.

According to a study by the Honorary Commission for Cardiovascular Health, 40% of children of school age in Montevideo have some degree of overweight or obesity, and 15% already have hypertension.

This increase in childhood obesity is associated with an inadequate diet and a greater sedentary lifestyle. But it should be noted that very sugary products, or very salty, and trans fat foods are increasingly becoming part of children's diet. That is why experts indicate that the problem of obesity is not so linked to the abundance of food but to the poor quality of food, and disproportionately affects low-income sectors.

Other countries are also affected by this pandemic, and it is good to know how they have tried to change reality. For example, Chile, a country in our region, has been implementing a law on Nutritional Composition of Foods and its advertising for more than two years.

It is important to know how the population accepts this law, and for this we communicated with experts from the Institute of Nutrition and Food Technology (INTA) of the University of Chile, who have been conducting a comprehensive evaluation of this law, and the University of Carolina del Norte (Food Research Program)

We spoke with Marcela Reyes, doctor of nutrition, INTA academic from the University of Chile, who began by saying that this law arises because "Chile now has one of the highest prevalences worldwide for obesity, particularly in children and in people with low incomes. This not only makes us sick and kills prematurely, it also costs us 1.4 billion a year, resources that could be directed to other health problems or social issues such as childhood, education, pensions among so many others "

Other alarming data shared by Dr. Reyes: "according to the latest surveys, overweight affects more than 70% of those over 15. In this case, the alterations derived from obesity have an important impact on health of Chileans: 1 in 10 adults is diabetic, 1 in 4 is hypertensive and at least 1 in 2 has blood cholesterol problems, and more than 80% of deaths can be associated with obesity".

Speaking of food labeling it is also said: "the food industry has put pressure on politicians and health professionals", however progress is being made in the application of the law.

She tells us that in Chile the characters caricatured in packaging and television advertising aimed at children of those same products also disappeared; while in schools and kindergartens the sale and delivery of this type of food was restricted. These are the three main measures of the Law of Nutritional Food Composition and its Advertising.

According to our studies, Marcela Reyes adds, 95 percent of mothers of preschoolers and adolescents surveyed agree with what foods are not healthy.

And according to a study that was made nine months after the law was implemented, 23% of adolescents noticed the absence of labels to define if a food is healthy. The campaign developed by the Ministry of Public Health of Chile, is very simple: "Prefer foods with fewer seals and if they do not have any, the better."

We also spoke with Camila Corvalán, PhD, head of the CIAPEC (Center for Research in Promotion of Obesity and Chronic Diseases) of INTA and leader of this evaluation.

"What we hope to see is if the perceptions and attitudes of the people change," Corvalán said. But the team is also interested in analyzing the modification of food based on "if the nutritional content is modified, what groups were reformulated", in more than 15 product categories. In this regard, one of the emerging discussions has to do with the change of sugar by sweeteners. In response to this change, added the researcher, "we are coding particularly the sweeteners, we are going to see if it increases its use and see what effects they have on the human being".

The previous labeling - Corvalán says - includes the list of ingredients, the table of nutritional composition, as well as phrases such as "light", "diet", high in calcium, etc. All of them are regulated in the health regulation of food. "In my opinion, it is essential that information on ingredients and nutritional composition be mandatory on all packaged foods. However, I believe that it does not fulfill the function of informing the population. On the one hand few people read it and on the other hand, even reading it is difficult to interpret, how many milligrams of sodium are a lot ?. For the regular shopper, their greatest use is to compare, for example how much sodium is in 100 grams of this ham versus this other, but I think few people do that. "

And in my opinion the complementary information "light" is rather confusing, one tends to think that something "light" does not have sugars, fat or calories, there are even diabetics who eat it thinking it is right for them. In this context, I think that the label that is being applied by the new Food Law is a contribution. It is a stop sign, black with white, that must go on the front face of the container. It clearly says "excess sodium" or another nutrient. That way there is nothing to interpret or suppose. "

"People are clear that they have to eat more fish, more fruits and vegetables, that everyone knows, but that does not necessarily mean that we eat healthy, adds Dr. Corvalán. "Knowledge is only one of the factors that influences our diet. There are more structural things that influence in greater proportion, such as what foods are available for me to buy, at what price, what promotional strategies are used, how does my culture value them, etc. This is what has been called the food environment, all the physical, economic, political and cultural characteristics that determine our diet, beyond our preferences or knowledge ".

The problem of obesity and its associated pathologies is very complex. The Law does not only consider labeling foods with excessive critical nutrient content in a simpler way, it also includes the fact that these foods cannot be sold in kindergartens or schools; neither can they be given away or promoted to children under 14 years of age. In addition, no food can use commercial hooks as gifts. "

When asked if one can choose to live healthy, nowadays, Corvalan answers "that of" choosing "puts the emphasis on the individual, as saying" if someone is fat it is because they are stupid, they don't know how to choose well ", equivalent to that "the poor one is poor because he is lazy". It is not easy to choose healthy when everything around you urges you to choose unhealthy. As much as I know that I have to eat 5 servings of fruits and vegetables a day, if these are only sold at the supermarket or on fair days, they are expensive, they are not promoted, they are difficult to prepare, etc., it will be much easier eat a packaged snack that they sell anywhere, it's big, cheap, it comes with a gift, it doesn't spoil, I can eat it in front of the computer, etc. It is not impossible to "choose" to live healthy, but it is very difficult in our country. "

This Chilean experience is a good antecedent to predict a good process of application of food labeling in Uruguay, an issue that forces us to think not only about health issues, but also about the economic burden of treating a population with NCDs ( non-communicable chronic diseases) that could be prevented with a good diet and efforts to combat a sedentary lifestyle.