Tackling Childhood Obesity: Physical Activity More Effective Than Advertising Bans  

A ground-breaking study published in the American Journal of Preventive Medicine has established that the US’s ban on child-directed fast food TV advertising has been the least impactful measure to reduce childhood obesity. Research indicates that physical activity programmes were the most effective approach.

The study, undertaken by 10 researchers from various institutions in the US, focused on three long-term U.S. federal policies adopted since 2002 to tackle childhood obesity: after-school physical activity programmes, sugar-sweetened beverage (SSB) excise tax and bans on fast food television advertising which is targeted towards children.

Researchers found that bans on fast food advertising were the least effective measure, reducing obesity by less than one percent among children. This has been attributed to the substitution effect and the US policy’s narrow focus on fast food. The most effect was an increase in after-school physical activity programmes, which reduced obesity by 1.8 percent.

According to Dr Jeremy Lim, Partner & Head of Asia Pacific Region at Oliver Wyman, “This study has important implications on the directions that public sector and industry stakeholders take in addressing the critical global issue of childhood obesity. Physical activity is well known as a key component of balanced lifestyles, and this study demonstrates its effectiveness and value in policy measures to promote this. Targeted taxes may not be as effective as physical activity promotion depending on the assumptions made about what SSBs are substituted with. It is critical that resources to address childhood obesity are allocated in the most efficient way, and this study will be a useful reference for governments.”

Methodology of the study

The purpose of the study was to estimate the likely impact of these three federal policies on childhood obesity prevalence in 2032, after 20 years of implementation beginning in 2002. In 2012, researchers utilised a micro-simulation model – a highly-detailed, computerised analytical tool - to examine how these policies affect obesity-related behaviours in US children.

The model estimated yearly changes in physical activity, diet and BMI using equations with multiple variables, which were developed from the results of the 2001-2010 National Health and Nutrition Examination Survey (NHANES).

The study is significant as it provides the first quantitative estimate of the potential impact of after-school physical activity programs and other policies on US childhood obesity prevalence. Furthermore, use of this analytical model to understand behavioural change will contribute to ongoing and improved research in childhood obesity.

The researchers did find that sugar-sweetened beverage excise tax has characteristics which suggest it could be the best option to reduce childhood obesity, however, there are little effectiveness data for the sugar-sweetened beverages and advertising policies, particularly in children, and existing data often come from observational studies. In addition, the estimated policy impact is sensitive to the model assumptions. For instance, substituting a caloric beverage, rather than a zero-calorie beverage can reduce the sugar-sweetened beverage policy’s estimated impact by more than 60%. In the absence of data on substitution effects in food consumption resulting from an advertising ban, it was assumed that a lower-calorie meal would be available and consumed instead. In this analysis, policies were assessed independently, but to reverse the childhood obesity epidemic, a comprehensive set of national policies would need to be implemented.

Implications for informing policy

Childhood obesity is recognised as an urgent global issue. A study published by researchers at Duke-NUS Graduate Medical School in Singapore and at the Duke Global Health Institute estimated that the lifetime medical costs for a child with obesity could be US$19,000 more than that for a child with normal weight.

Given the urgency of addressing this issue, it is crucial that policies and programmes (particularly those initiated at the global level) are supported by research such as this study. Facilitating active lifestyles for children and striving to reduce the proportion of sedentary behaviour have been a cornerstone of The World Health Organization’s (WHO) efforts on obesity.

After-school programmes have the potential to provide opportunities for enhanced physical activity and the development of healthy habits in children, especially those from socioeconomically disadvantaged families who may have limited access to nutritional foods and environments conducive to physical activity outside of school.

Industry efforts to tackle obesity

In the health and nutrition space, FIA advocates a multi-stakeholder approach to address the dual burden of over-consumption and under-nutrition. FIA recognises that in Asia, the food industry and governments have been working together to address the issue of childhood obesity through various programmes such as promoting balanced lifestyles, improving nutrition literacy, and supporting public-private partnerships to offer a whole-of-society solution.

FIA supports measures that are science-based and have been proven to be effective, such as those put forth by the International Food and Beverage Alliance (IFBA) and The Consumer Goods Forum (TCGF). FIA has long demonstrated its commitment to working on multi-sector platforms to ensure the adoption of a responsible approach to advertising and marketing of food and beverage products to children throughout Asia and continues to stress the importance of reducing physical inactivity.

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