Viewpoint: Dr Kailash Chand: Better diet and more exercise could save 50% of NHS costs

About 40 to 50% of all consultations in GP practices are as a direct consequence of diet-related illness like a new diagnosis of type 2 diabetes or its complications - heart disease, stroke, certain type of cancers and kidney failure writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'Most significant health advances have been made by population-based public health approaches.' Pic: Michele Jones
Dr Chand: 'Most significant health advances have been made by population-based public health approaches.' Pic: Michele Jones

More than one third of children in the UK are either obese or overweight. Obese children are more likely to experience bullying, low self-esteem, anxiety, depression and have a higher risk of developing type 2 diabetes and heart disease in later life.

In 2004, the WHO declared obesity a global epidemic. Eleven years later the statistics tell us that not only are we failing to tackle the issue but it's getting worse. There are now 1m morbidly obese people in Britain. Trends suggest that without effective intervention nine out of 10 adults, and six out of 10 children, will be overweight or obese by 2050. The association between diet and heart disease and cancer is irrefutable. Indeed, it could be argued that diet-related ill health is set to cripple the NHS.It is estimated that the cost of obesity to the NHS in England in 2007 was £4.2bn and has risen to over £6 bn in 2015. I fear this kind of spending cannot be sustained and could go on to paralyse the NHS.

Significant health advances have been made by population-based public health approaches

The government, schools, parents and children are equally to blame for this sorry state of affairs. The government has never woken up to the harsh reality that there just are not enough resources and funding for nutritional food or physical activities for the country's growing population. Schools think their responsibility begins and ends with giving lessons in various subjects to their students. Development of the overall personality is none of their concern. As a result, taking care of adequate physical fitness is rather frowned upon. I would love to see eating a balanced diet become the social norm for children. School is the best place to help families do this. Parents should support schools when they are trying to improve the food our children eat.

Supermarkets hardly help – placing snacks such as crisps and chocolates in prominent positions. Fast-food restaurants not only proliferate, but big food corporations are the main sponsor of the sports events. Food corporations often focus on personal responsibility as the cause of the nation's unhealthy diet and raise fears that government action challenges freedoms. But this obscures the reality that some of the most significant health advances have been made by population-based public health approaches in which the overall welfare of the population trumps certain individual or industry freedoms. The public smoking ban is a prime example. It has already had an impact on reducing cardiovascular mortality.

What we need is to recognise the lifelong burden of physical inactivity and poor diets on children and young people by curbing the promotion and availability of unhealthy foods, and providing sufficient opportunities for sport and exercise. We could do this by making the following mandatory:

* Delivery of ‘an appropriate physical education curriculum’ in schools .

* The expansion of safe cycle paths and networks .

* A halt to school playing field sales .

* A reduction in salt, sugar and hydrogenated fats added to pre-prepared foods.

* A ban on advertising unhealthy food and drink to children.

* Mandatory ‘traffic light’ labelling on food packaging.

That is not only a question of aesthetics. But in my view will help sustain the NHS and will have favorable workload implications! I would estimate that something like 50% of our patients' medical costs would not just be reduced but be eliminated if their diets were healthier and they exercised more. But we, as a nation, seem to be working on the other end of the problem.

What will be the use of a good education if the person who got it is in bad health – physical and mental as well as emotional?

* Dr Chand is BMA deputy chairman

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