Progression of obesity | A tax is good, prevention is better

Obesity continues to grow in the country. This is indicated by an analysis of Statistics Canada data by The Press last week. These conclusions, which have not yet been scientifically validated, confirm, however, unsurprisingly, that the trend has increased during the pandemic.

We write “unsurprisingly” because our habits have been disrupted by the pandemic: teleworking, gym closures, curfews and generalized anxiety have had an impact on physical activity, sleep and diet. of a very large number of Quebecers and Canadians. An impact whose extent we have not finished measuring.

But what exactly are we talking about when we talk about obesity? From a scientific point of view, obesity is defined by several criteria, starting with the body mass index (BMI) which must be greater than 30. As this is an imperfect indicator, because it is misleading ( you can have a high BMI by being very tall without being considered obese), the BMI must be accompanied by other criteria such as the fat level and the waist circumference.

All of these indicators allow scientists to monitor the progression of obesity in a given population in order to better predict and prevent the incidence of certain diseases such as cancers, type 2 diabetes and cardiovascular diseases. According to Statistics Canada, 27.6% of Quebecers and 29% of Canadians were obese in 2021 (the proportions were 23.9% and 26% in 2015).

Over the years, we have managed to better identify the causes of obesity: genetics, lifestyle, diet… We have also amply documented the role of the environment on the incidence of obesity: urban planning that does not always promote active transportation, the omnipresence of screens in our lives and its result, a sedentary lifestyle. And above all, access, in a neighborhood, to healthy food at an affordable price. In times of inflation and recession, this last factor is more crucial than ever.

The World Health Organization has called on all countries to adopt a game plan to prevent the obesity that now kills more people on the planet than malnutrition. We can’t escape it, it goes above all through education.

Everyone benefits from adopting healthy lifestyle habits, but by targeting children through prevention and education, we ensure that good habits take root early and firmly. In California, for example, a federal program has been set up to distribute healthy breakfasts and lunches in schools.

Next, we have to work on the food supply, which is deficient in many towns and regions that are then called “food deserts”. In Quebec, an ongoing pilot project could, if it yields good results, give birth to a program on a larger scale. This is to subsidize the purchase of fruit and vegetables for less privileged families. An INSPQ study has shown that distributing coupons or prepaid cards is less stigmatizing than forcing people to line up for a basket of food, for example, and that it helps to involve retailers in promoting healthy eating.

In addition to increasing the supply of healthy products, the purchase of nutritionally poor products can be discouraged. How ? By taxing products that are harmful to health, such as sugary drinks, for example. We are not talking about a symbolic tax, but rather a tax of 10% or more that would make a difference in the wallet. This is not the first time that such a tax has been mentioned, we have been talking about it for years. Newfoundland and Labrador, where 42.2% of the population was obese in 2021, is the first province in the country to adopt it last fall. We hope that this 20-cent tax on sugary drinks will help change habits, a consequence that several studies tend to confirm. But a tax alone has a limited impact. It must be accompanied by other measures. The Newfoundland government has therefore undertaken to invest the sums collected, estimated at approximately $9 million, in prevention.

Governments could work with sugar-sweetened beverage producers to be part of the solution by developing products that are less harmful to health.

Municipalities can also be part of the solution by using their zoning regulations.

Last year, the Quebec Court of Appeal ruled in favor of the borough of Côtes-des-Neiges–Notre-Dame-de-Grâce by confirming the validity of the municipal by-law which prohibited, in specific sectors, the establishment of new fast-food establishments near schools. The studies are clear: the proximity of these establishments has a negative impact on the food choices of young people.

Municipalities could very well define a healthy food zone around schools by encouraging businesses to promote fruits and vegetables and healthy meals. A special permit could also be given to food trucks offering a healthy menu around educational establishments.

The truth is that there is no shortage of ideas for promoting healthy lifestyles. It is, too often, the will to implant them.

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