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Preventing obesity

Prevention starts in infancy



Crawford in his editorial on population strategies to prevent obesity has not mentioned an important factor in the aetiology of obesity: the method by which infants are fed.1

Von Kries et al found that a history of three to five months of exclusive breast feeding was associated with a 35% reduction in obesity at the age of 5 to 6 years, which was not accounted for by social factors, lifestyle, etc.2 They discuss the evidence for a programming effect of breast feeding in preventing obesity and being overweight in later life. Gilman et al found that infants who were fed breast milk more than infant formula milk, or who were breast fed for longer periods, had a lower risk of being overweight during older childhood and adolescence.3

Hidden sugars in foods undermine strategies to reduce obesity and diabetes

In tackling the increasing obesity and diabetes problem described by Crawford in his editorial,1 the focus needs to be on getting to the root of the problem, not on weight reduction programmes when the damage is already done. We need fundamental changes to food production, not just in labelling.

Trying to find sugar-free foods in shops and supermarkets is like running an obstacle course. It is easy to identify sweets as culprits, but what about the hidden danger of sugar in savoury foods and foods thought to be healthy, such as breakfast cereals, fruit juices, salad dressings, and yoghurts? I make my own fruit yoghurts as it is impossible to buy them unsweetened.

Doctors underestimate obesity

The hazards of excess body weight have been clearly established by epidemiological and clinical studies as reviewed by Hitchcock Noël and Pugh.1 We agree that obesity can be easily identified and that patients who are mildly or moderately overweight may be overlooked. A recent study has shown that about a quarter of overweight patients were thought to be of normal weight by their primary care doctors.2

Despite its high prevalence,3 obesity is documented by doctors only in a small proportion of patients, indicating that this life threatening condition is considerably under-reported in medical records.4


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