Abstract

The UK has seen an impressive reduction in the prevalence of cancer in the last three decades. But we have seen this decrease is matched by an increase in incidence - we have developed some excellent tools for saving lives and treating the disease, but poor at preventing it. The rise in cancer incidence is matched by a rise in obesity prevalence, and there is good reason to suggest the two are related: low levels of physical activity, high levels of sedentary behaviour and high intakes of fatty and sugary foods and insufficient fruits and vegetables and all major contributors to the risk of cancer obesity and to the risk of cancer. We have a common agenda in prevention.

Let me focus on food and nutrition. It is the leading cause of death and ill-health in the World Health Organisation's analyses of the Global Burden of Disease. Diet-related NCDs are rapidly becoming the leading causes of early death in lower-income countries. Traditional diets, rich in plant-based foods, vegetables, pulses, grains, are being replaced by foods rich in fats and sugars and salt: tasty and attractive but less protective from ill-health.  

There are interested parties in these changes in dietary patterns. Globally, a significant proportion of advertising is devoted to promoting food, fast food outlets, alcohol and tobacco. Further advertising promotes sedentary behaviours. These are large, powerful industries. It can even be argued that the food industry has an embedded investment in fatty tissue: an overweight person needs to consume more just to maintain their core temperature, move around, repair and service their organs. It is perhaps not surprising that food companies are spending it advertising their products globally, and also extending their marketing into remote rural areas of the world.

How do we tackle these big forces? I believe that health professionals have a unique voice and are credited with being relatively free from vested interests. Doctors are taken seriously and given an audience where many others are not, so it is important that researchers, clinicians, practitioners, join with your associations and groups to speak out.

However, there is one caveat. The narrative of blame for obesity is very much a narrative of individual responsibility, of poor choices and stupidity. The media reinforce the message with images and headlines implying blame. More important to us, there are surveys of health practitioners showing that many also have this view of obesity being a result of irresponsibility, and it is important to challenge yourself before speaking out. It is very hard to lose weight once gained, as many of us in this room will acknowledge. We need to be fully on the side of our patients in the wider struggle to prevent poor health.