Changing Behaviour to Improve Population Health and Reduce Health Inequalities

Transcription

1 Changing Behaviour to Improve Population Health and Reduce Health Inequalities Professor Theresa Marteau Behaviour and Health Research Unit University All Party Parliamentary Food and Health Forum 14 th June 2016

2 Changing Behaviour to Improve I. The Problem II. Changing behaviour (a) Changing Minds (b) Changing Environments III. Changing Environments Size Availability & Proximity Labelling IV. Policy Options? Population Health

3 Overweight and obesity among adults Health Survey for England More than 6 out of 10 men are overweight or obese (66.2%) More than 5 out of 10 women are overweight or obese (57.6%) 3 Adult (aged 16+) overweight and obesity: BMI 25kg/m 2

4 Childhood Obesity and Socio- Economic Position

5 Changing Behaviour to Improve I. The Problem II. Changing behaviour (a) Changing Minds (b) Changing Environments III. Changing Environments Size Availability & Proximity Labelling IV. Policy Options? Population Health

6 Change people s minds to II Changing Behaviour Two Approaches Resist Environments Change Environments

7 II. Changing Behaviour (b) Changing environments Hollands, Shemilt, Marteau, Jebb, Kelly, Nakamura, Suhrcke, Ogilvie BMC Public Health 2013

8 Changing Behaviour to Improve I. The Problem II. Changing behaviour (a) Changing Minds (b) Changing Environments III. Changing Environments Size Availability & Proximity Labelling IV. Policy Options? Population Health

9 Changing Environments Size

10 Changing Environments Sizeand Food Consumption Intervention Outcome Comparisons Effect Larger size vs. smaller size Consumption 92 from 61 studies (6711 participants) Small to moderate increase SMD: 0.37 (95% CI: 0.29 to 0.45) Moderate quality evidence IFsustained across the whole diet (i.e. all foods on all occasions), size of effect suggests that making sizes smaller across the whole diet could reduce daily energy consumed from food by: 12% to 16% in UK adults = 279 kcal per day 22% to 29% in US adults = 527 kcal per day Hollands, Shemilt, Marteau, Jebb, Lewis, Wei, Higgins, Ogilvie Cochrane Library 2015

11 Changing Environments Availabilityand Food Purchasing Effective Interventions Increasing availability of healthier options Reducing price of healthier options Hollands et al Cochrane Review in progress

12 Changing Environments Labelling 25 studies n= 9 purchasing impact Too heterogeneous for synthesis n=16 consumption impact 12: meta-analysis 7: energy (calories) 4: low risk of bias Crockett et al Cochrane expected 2016

13 Changing Environments Labelling Energy (kcal) labelling at point of consumption IFsustained across the whole diet (i.e. all foods on all occasions), size of effect suggests that energy (kcal) labelling all foods and drinks could reduce daily energy consumed by: up to 8% in UK adults = 166 kcal per day Crockett et al Cochrane expected 2016

14 Changing Behaviour to Improve I. The Problem II. Changing behaviour (a) Changing Minds (b) Changing Environments III. Changing Environments Size Availability & Proximity Labelling IV. Policy Options? Population Health

15 IV Policy Options

16 IV Policy Options: Downsizing our Food Environments What? Physical Environments Smaller default serving and tableware sizes for energy dense foods and drinks Reduce availability of larger portions and packages Place smaller portion sizes in stores and cafes more accessibly than larger ones Demarcate single portion sizes in packaging through wrapping or visual cues Economic Environments Restrict pricing practices whereby larger sizes cost less in relative (and sometimes absolute) monetary terms than smaller sizes Restrict promotions to smaller sizes Where? Commercial AND Public Sector Environments How? Voluntary Agreements AND Regulation Who? Policy Makers AND Public Marteau et al. Downsizing BMJ 2015

17 Changing Behaviour to Improve I. The Problem II. Changing behaviour (a) Changing Minds (b) Changing Environments III. Changing Environments Size Availability & Proximity Labelling IV. Policy Options? Population Health

18 Thanks! Gareth Hollands Ian Shemilt Rachel Pechey Paul Fletcher Milica Vasiljevic David Ogilvie Hannah Lewis Yinhu Wei Eleni Mantzari Dominique L. Couturier Susan Jebb Julian Higgins Marcus Munafò Angela Attwood Andy Woods Nick Scott-Samuel Marc Suhrcke Ryota Nakamura Rachel Crockett