Tackling the Weight of the Nation

The Role of Carbohydrates in Preventing Obesity

The prevalence of obesity in Britain has trebled in the last 20 years.  In 2001 21% of men and 23.5% of women were clinically obese  (BMI >30kg/m2) and a further 47% of men and 33% of women were overweight (BMI 25-30 kg/m2). If these trends continue, 30% of the adult population will be obese by 2010. Obesity is associated with a reduction in life expectancy of between 3 and 14 years primarily due to increases in risk of cardiovascular disease and certain cancers. It also contributes to a substantial burden of ill health, especially type 2 diabetes. As the nation struggles to keep its weight down the flour and bread industry has responded by actively promoting the proven weight loss benefits of a diet low in fat and high in carbohydrates, coupled with exercise.

Over the last 20 years the energy that we use in physical activity has decreased markedly. Cars and buses have replaced walking and cycling, manual occupations have been phased out in favour of sit down office jobs and TV has become the most popular pastime. As a result of our sedentary lifestyle coupled with the increasing availability of energy dense palatable foods, the nation continues to grow fat.  The causes of obesity are multi-factorial but obesity occurs when energy intake exceeds energy expenditure over a period of time. It only takes a 2 per cent persistent discrepancy between daily intake and energy output for progressive and substantial weight gain to occur. A 100 kcals per day above energy requirements can lead to a weight gain of 10 pounds (5Kg) per year.

In response to the obesity epidemic and to counter the faddy diet approach the Flour Advisory Bureau (FAB) and the Grain Information Service (GIS) launched a new literature review in September 2003 called Tackling the Weight of the Nation. It is a follow-up to a report produced for the Flour Advisory Bureau in 1999 entitled The Weight of the Nation.

The report pulls together the very extensive research in relation to low-fat, high carbohydrate diets and shows conclusively that an effective, realistic and achievable strategy for long-term weight management with clear health benefits does exist. Produced by Dr Susan Jebb and Dr Toni Steer of the Medical Research Council (MRC) Human Nutrition Research in Cambridge, the peer reviewed report includes evidence from lifestyle intervention studies in Europe and North America that show that overweight individuals who become active, reduce the fat in their diet and include unrefined carbohydrates can significantly reduce their weight over several years.  Modest weight losses of 5-10% of initial weight over a 4-year period have been shown to more than halve the new cases of diabetes. 
The report says that there is now good evidence from lifestyle intervention studies in Europe and North America that overweight individuals who become active, reduce the fat in their diet and include unrefined carbohydrates can significantly reduce their weight over several years.  Modest weight losses of 5-10% of initial weight over a 4-year period have been shown to more than halve the new cases of diabetes.

The health strategies that can achieve this require people to:

• Be more active, reducing sedentary activities and increasing programmed exercise
• Eat less fat
• Eat proportionally more wholegrain and high-fibre carbohydrate foods
• Reduce added sugars, especially soft drinks
• Reduce portions of energy-dense foods
• Plan regular meals, including breakfast

Dr Susan Jebb said, "Many health professionals and consumers are confused by the plethora of alternative dietary approaches that are promoted by individuals and the media. Unsubstantiated claims about the dietary treatment of obesity contribute to a climate of confusion and public distrust, which undermines credible treatments for obesity that have proven health benefits."

The Flour Advisory Bureau hopes that its initiative in commissioning "Tackling the Weight of the Nation" will play a role in reasserting the consensus view on how to manage the growing problem of overweight and obesity and so play a useful part in combating the growing incidence of associated diseases. 

The message remains simple and clear.. Exercise more; cut down on the intake of energy dense foods such as fat and proportionally increase intake of carbohydrate rich foods.  In fact these key messages have been supported by Government and research since the 1940's. The resulting weight loss may be slow and steady but these dietary guidelines are the very foundations on which to reverse the trends of obesity in the UK. We just have to find ways of making them more appealing.

With Tackling the Weight of the Nation, the FAB has the research in place and the experts on board. The task in hand now is to convert these solid research findings into clear public health recommendations, advice and guidance.

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