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5 July, 2018 Committee Secretary Dr Belinda Reeve Alexandra Jones Senior Lecturer, Sydney Law School PhD Candidate, Charles Perkins Centre Research Fellow (Food Law and Policy), The George Institute for Global Health 5 July, 2018 Committee Secretary Department of the Senate PO Box 6100 Parliament House Canberra ACT 2600 Phone: +61 2 6277 3228 Fax: +61 2 6277 5829 [email protected] Dear Committee Secretary, Submission to the Select Committee into the Obesity Epidemic in Australia from the Charles Perkins Centre’s Food Governance Node Thank you for the opportunity to make a submission to this inquiry into the obesity epidemic in Australia. More than a quarter of Australian children aged 5-17 years are overweight or living with obesity.1 Childhood obesity has increased by 50% since 1980,2 and while increases in the rate of obesity may have slowed, the prevalence remains high, particularly among children in lower socioeconomic groups,3 and among Aboriginal and Torres Strait Islander children.4 1 Australian Institute of Health and Welfare, ‘Australia’s Health 2018’ (Australia’s Health Series No 16 Cat No AUS 221, Australian Institute of Health and Welfare, 2018) <https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of- contents> 233. 2 Timothy P Gill et al, ‘Childhood Obesity in Australia Remains a Widespread Health Concern that Warrants Population-Wide Prevention Programs’ (2009) 190 Medical Journal of Australia 146 3 Jennifer A O’Dea, ‘Differences in Overweight and Obesity among Australian Schoolchildren of Low and Middle/High Socioeconomic Status’ (2003) 179 Medical Journal of Australia 63. 4 A Lee and K Ride, ‘Review of Nutrition Among Aboriginal and Torres Strait Islander People’ (2018) 18 Australian Indigenous Health Bulletin (online) Sydney Law School T +61 416 977 673 ABN 15 211 513 464 Room 533, New Law Building F +61 2 9351 0200 CRICOS 00026A The University of Sydney E [email protected] NSW 2006 Australia sydney.edu.au Obesity increases children’s risk of a range of health problems, including elevated blood pressure and insulin resistance, as well as the likelihood of psychosocial problems such as low self-esteem and bullying.5 As importantly, childhood obesity is linked to obesity and overweight in adulthood, and associated non-communicable diseases (‘NCDs’) such as diabetes, heart disease and musculoskeletal problems,6 which are leading, yet preventable causes of death and illness in Australia.7 It is critical to address the current burden of childhood obesity if we want to avoid the economic and personal costs of obesity to a future generation of Australian adults and their families, to Australia’s healthcare system, and to taxpayers. While this is self- evident, it cannot occur if governments insist on delegating responsibility for rising population weight gain to individuals and/or industry alone. Past government policies have failed to reverse or even stabilise weight gain in Australian adults and children. In some cases, governments have shown remarkable devotion to policy approaches that have not worked. This cannot go unchallenged. If we want to change population health outcomes, we need new approaches. Charles Perkins Centre, University of Sydney We are writing on behalf of the Food Governance Node, located in the Charles Perkins Centre at the University of Sydney. The Charles Perkins Centre was established in 2012 with the mandate of generating innovative and workable solutions to easing the global burden of diabetes, obesity, and cardiovascular disease. The Charles Perkins Centre is <http://healthbulletin.org.au/articles/review-of-nutrition-among-aboriginal-and-torres-strait- islander-people/>. 5 William H Dietz, ‘Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease’ (1998) 101 Pediatrics 518. 6 Ian D Caterson, ‘The Weight Debate: What Should We Do About Overweight and Obesity?’ (1999) 171 Medical Journal of Australia 599; World Health Organisation (‘WHO’), ‘Obesity: Preventing and Managing the Global Epidemic’ (WHO Technical Report Series No 894, WHO, 2000) 50 <http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/>; A M Magarey et al, ‘Predicting Obesity in Early Adulthood from Childhood and Parental Obesity’ (2003) 27 International Journal of Obesity 505. 7 Australian Institute of Health and Welfare, ‘Australian Burden of Disease Study: Impact and Causes of Illness and Deaths in Australia 2011’ (Australian Burden of Disease Study No 3 Can No BOD 4, Australian Institute of Health and Welfare, 2016) <https://www.aihw.gov.au/getmedia/d4df9251-c4b6-452f-a877- 8370b6124219/19663.pdf.aspx?inline=true> 16-27. 2 based on a collaborative approach, bringing together multidisciplinary teams of researchers to identify new solutions to the challenges of diabetes, obesity, and cardiovascular disease. One of the ways in which the Charles Perkins Centre facilitates collaboration is through the creation of Project Nodes, of which the Food Governance Node is one. The Food Governance Node was created by Dr Belinda Reeve from Sydney Law School and Alexandra Jones from the Charles Perkins Centre in 2016, with the aim of creating a cross-disciplinary platform for the development and evaluation of new legal, policy, and regulatory strategies for improving diet and nutrition in Australia. The Node includes researchers from faculties and research centres across the University, as well as from other academic and non-government organisations in Australia. It draws on members’ expertise in law, business, public health, and health policy in seeking solutions to NCDs that lie at the junction of law, regulation, and public health. While the Select Committee has called for submissions on range of matters related to childhood obesity, our submission will focus on two of the matters that are the subject of the inquiry: • the effectiveness of existing policies and programs introduced by Australian governments to improve diets and prevent childhood obesity (focusing on laws, policies, and regulations relevant to diet-related health); and • the role of the food industry in contributing to poor diets and childhood obesity in Australia. 1. Effectiveness of existing policies and programs introduced by Australian governments to improve diets and prevent childhood obesity While childhood obesity has been recognised as an issue of concern by all Australian governments, the response to the issue has varied significantly across the different jurisdictions. Some governments have acknowledged that a comprehensive, whole-of- government (and whole-of-community) approach must be taken to address this problem, leading to comprehensive programs of action. For example, the New South Wales Premier has set the target of reducing overweight and obesity rates of children by 5% over ten years and has created a delivery plan that includes education and information to 3 enable informed choices, as well as measures that aim to create environments supportive of healthy eating and active living.8 Overall, however, government action on childhood obesity in Australia has been neither comprehensive nor sustained. Research by the Global Obesity Centre at Deakin University (GLOBE) (supported by the Australian Prevention Partnership Centre) benchmarked each Australian governments’ performance against recommendations for action to address obesity and improve diet-related health, created by an international network of experts.9 It found that while there were some areas where Australian governments were progressing recommended actions, there were a number of areas where they were significantly lagging behind other countries in their efforts to address unhealthy diets and obesity. Key gaps in implementation a) Regulation of unhealthy food marketing to children One area in which the report identified a gap is regulation of unhealthy food marketing to children. Australia currently relies on two self-regulatory initiatives developed by the Australian food industry to regulate unhealthy food marketing to children: the Responsible Marketing Children’s Initiative (RCMI) and the Quick Service Industry Initiative for Responsible Marketing and Advertising to Children (QSRI).10 Companies that sign on to these initiatives agree to market only “healthier dietary choices” in media that is directed primarily to children, among other commitments. While the food industry claims that these initiatives have been effective in reducing the amount of unhealthy food marketing that directly targets children, independent scientific research shows that the initiatives have not reduced children’s total exposure to 8 NSW Government, Tackling Childhood Obesity <https://www.nsw.gov.au/improving- nsw/premiers-priorities/tackling-childhood-obesity/>. 9 The Australian Prevention Partnership, Deakin University and INFORMAS, Policies for Tackling Obesity and Creating Healthier Food Environments; Scorecard and Priority Recommendations for Australian Governments (February 2017) <https://www.heartfoundation.org.au/images/uploads/publications/OVERALL_Food_EPI_Report _v3.pdf>. 10 Australian Food and Grocery Council, Advertising to Children <https://www.afgc.org.au/our- expertise/health-nutrition-and-scientific-affairs/advertising-to-children/>. 4 unhealthy food marketing11 – the objective recommended by the World Health Organisation for policies and regulations that restrict unhealthy food marketing to children.12 Research has also demonstrated that there are a number of gaps and “escape clauses” in the substantive rules contained in the RCMI and
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