The worldwide increase in obesity has been driven by global trade liberalization, economic growth and rapid urbanization. Owing to the scope and complexity of the obesity epidemic, prevention strategies and policies across multiple levels are needed in order to have a measurable effect. Although many putative causes of the obesity epidemic exist, in this Review the effect of globalization on global trends in obesity prevalence is discussed and population-based interventions from several countries are reviewed. The authors make broad policy recommendations for obesity and chronic disease prevention at the global population level.

Global obesity: trends, risk factors and policy implications

Much of the global burden of disease is associated with behaviors—overeating, smoking, excessive alcohol consumption, and physical inactivity—that people recognize as health-harming and yet continue to engage in, even when undesired consequences emerge. To date, interventions aimed at changing such behaviors have largely encouraged people to reflect on their behaviors. These approaches are often ineffectual, which is in keeping with the observation that much human behavior is automatic, cued by environmental stimuli, resulting in actions that are largely unaccompanied by conscious reflection. We propose that interventions targeting these automatic bases of behaviors may be more effective. We discuss specific interventions and suggest ways to determine whether and how interventions that target automatic processes can enhance global efforts to prevent disease.

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Changing human behavior to prevent disease: The importance of targeting automatic processes.

One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress. Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention.The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention.

Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation

We examined the influence of menu calorie labels on fast food choices in the wake of New York City’s labeling mandate. Receipts and survey responses were collected from 1,156 adults at fast-food restaurants in low-income, minority New York communities. These were compared to a sample in Newark, New Jersey, a city that had not introduced menu labeling. We found that 27.7 percent who saw calorie labeling in New York said the information influenced their choices. However, we did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.

/pdf/calorie-labeling-and-food-choices-a-first-look-at-the-26pni7uq5d.pdf

Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City

Objective The US Food and Drug Administration and Institute of Medicine are currently investigating front-of-package (FOP) food labelling systems to provide science-based guidance to the food industry. The present paper reviews the literature on FOP labelling and supermarket shelf-labelling systems published or under review by February 2011 to inform current investigations and identify areas of future research. Design A structured search was undertaken of research studies on consumer use, understanding of, preference for, perception of and behaviours relating to FOP/shelf labelling published between January 2004 and February 2011. Results Twenty-eight studies from a structured search met inclusion criteria. Reviewed studies examined consumer preferences, understanding and use of different labelling systems as well as label impact on purchasing patterns and industry product reformulation. Conclusions The findings indicate that the Multiple Traffic Light system has most consistently helped consumers identify healthier products; however, additional research on different labelling systems’ abilities to influence consumer behaviour is needed.

/pdf/the-science-on-front-of-package-food-labels-4z6og0bsgk.pdf

The science on front-of-package food labels

Objectives. We assessed the impact of restaurant menu calorie labels on food choices and intake.Methods. Participants in a study dinner (n = 303) were randomly assigned to either (1) a menu without calorie labels (no calorie labels), (2) a menu with calorie labels (calorie labels), or (3) a menu with calorie labels and a label stating the recommended daily caloric intake for an average adult (calorie labels plus information). Food choices and intake during and after the study dinner were measured.Results. Participants in both calorie label conditions ordered fewer calories than those in the no calorie labels condition. When calorie label conditions were combined, that group consumed 14% fewer calories than the no calorie labels group. Individuals in the calorie labels condition consumed more calories after the study dinner than those in both other conditions. When calories consumed during and after the study dinner were combined, participants in the calorie labels plus information group consumed an averag...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2009.160226

Evaluating the impact of menu labeling on food choices and intake

OBJECTIVE: The goal was to study how popular licensed cartoon characters appearing on food packaging affect young children9s taste and snack preferences. METHODS: Forty 4- to 6-year-old children tasted 3 pairs of identical foods (graham crackers, gummy fruit snacks, and carrots) presented in packages either with or without a popular cartoon character. Children tasted both food items in each pair and indicated whether the 2 foods tasted the same or one tasted better. Children then selected which of the food items they would prefer to eat for a snack. RESULTS: Children significantly preferred the taste of foods that had popular cartoon characters on the packaging, compared with the same foods without characters. The majority of children selected the food sample with a licensed character on it for their snack, but the effects were weaker for carrots than for gummy fruit snacks and graham crackers. CONCLUSIONS: Branding food packages with licensed characters substantially influences young children9s taste preferences and snack selection and does so most strongly for energy-dense, nutrient-poor foods. These findings suggest that the use of licensed characters to advertise junk food to children should be restricted.

https://pediatrics.aappublications.org/content/pediatrics/126/1/88.full.pdf

Jenny Baik

Papers

Evaluating the impact of menu labeling on food choices and intake

Influence of Licensed Characters on Children's Taste and Snack Preferences