Australia slips on number one cause of ill health – poor diet

Australians are being failed by national efforts to make foods healthier, Australian researchers have found. Foods continue to be laden with fat, sugar and salt with few controls on food manufacturers.

Professor Bruce Neal, at The George Institute and The University of Sydney, led a team that evaluated the Federal Government’s Food and Health Dialogue, and found it wanting. “It has fantastic aims but a very weak implementation plan,” he said.

The evaluation was published today in the Medical Journal of Australia.

The Food and Health Dialogue was launched by the government in mid-2009 to improve the nutritional profile of foods and help educate consumers about their diets.

But the new research shows that in the first four years, targets were set for just 11 out of a possible 124 action areas (8.9%) and none had been delivered. There was also no evidence that any of the proposed educational programs had been implemented.

“Poor diet is now an even bigger cause of ill health for Australia than smoking,” said Professor Neal. “Unfortunately, while the government has been doing a stellar job on tobacco control, it’s not doing quite so well in the food space.”

“If we are to get on top of health problems like obesity, diabetes and heart disease we have to fully implement the Dialogue objectives. The huge quantities of salt, sugar and fat added to the food supply by industry are now the main cause of ill health in the country, and the Dialogue is the only serious attempt to get on top of this.”

“Clearly this is a complex and ongoing process. Some companies have been making a real effort, but if you look at the big picture progress has been depressingly slow,” Professor Neal said.

Professor Rob Moodie, a co-author from the University of Melbourne, reinforced the urgent need for action. “We need the Government to make this a priority. And we have to find a way to strengthen a process that relies upon the voluntary engagement of industry. Powerful industry lobby groups like the Australian Food and Grocery Council are stifling action.”

The authors compared the Dialogue to successful programmes in the US and the UK and highlight the need for stronger leadership, transparency and regular reporting.

Jane Martin from the Obesity Policy Coalition said: “The UK experience has shown that these types of initiatives can be effective but action in Australia is occurring at a glacial pace. If we don’t want to be the first generation to outlive our children, then we need to get serious about improving diets, particularly in children. We need meaningful targets, with sanctions for non-compliance and we need the government to take a strong stance and lead the way on this.”

The evaluation is calling for more effective implementation, Professor Neal says, with three key groups of recommendations around:

1. Rationalising of stakeholder roles - Government and public health groups must set the policies. The food industry must deliver them. Government needs to take a stronger leadership role.
2. Clear targets and timelines, with consequences for non-achievement - That is, enforcement if voluntary measures fail to deliver. Currently, business incentives all push for the addition of more salt, fat and sugar in order to maximise profit.
3. Better transparency and reporting - The successes and failures of individual industry players need to be highlighted, with easy community access to information that will empower consumer choices.

Research paper recommendations

Agreed objectives

• Leadership from ministerial level of government
• Substantial new investment in Dialogue activities
• Broader engagement to include all relevant stakeholder groups from government, industry, public health, academia and other organisations
• New process for target-setting that removes major conflicts, adopts applicable overseas targets in interim and sets maximum acceptable levels
• Industry roundtables focus on implementation activities

Taking account (monitoring and evaluation)

• Clear and meaningful objectives to be defined with timelines
• Process, intermediate and definitive health outcomes to be specified
• Objective third party delegated to report upon achievement of objectives
• Economic evaluation to be done

Reporting and transparency

• Enhanced transparency of Dialogue processes (with open meetings of Executive, Reformulation Working Group and Roundtables)
• Six-monthly scorecards reported for all outcomes

Holding to account (enforcing)

• Agreed Dialogue targets enshrined as Codes of Practice by Food Standards Australia New Zealand
• Develop strategy to reward corporate participation and discourage non-compliance
• Explore options for responsive regulation to support Dialogue activities
• Documented plan to move from voluntary to regulatory mechanism if objectives not achieved

Responsiveness

• Rolling review of each target every five years, with re-setting as required
• Annual review of Dialogue aims and objectives against performance
• Mechanism for review and upgrading of Dialogue approach as required

Leads

• Professor Bruce Neal

  Executive Director, The George Institute, Australia