School of Population Health, University of Auckland, Auckland, New Zealand; WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia.
Obes Rev. 2013 Nov;14 Suppl 2:60-8. doi: 10.1111/obr.12103.
The lessons learned from over 20 years of obesity prevention efforts in Australia and New Zealand are presented. The obesity epidemic started in the 1980s but poor monitoring systems meant the rise in obesity prevalence initially went undetected. In the 1990 s, experts started advocating for government action; however, it was the rapid increase in media reports on obesity in the early 2000s which created the pressure for action. Several, comprehensive reports produced some programme investment but no regulatory policies were implemented. The powerful food industry lobby ensured this lack of policies on front-of-pack food labelling, restrictions on unhealthy food marketing to children, or taxes on unhealthy foods. The New Zealand government even backpedalled by rescinding healthy school food guidelines and withdrawing funding for the comprehensive national obesity strategy. In 2007, Australian Governments started a major long term-investment in preventive health in order to improve economic productivity. Other positive initiatives, especially in Australia, were: the establishment of several advocacy organizations; successful, long-term, whole-of-community projects reducing childhood obesity; a national knowledge exchange system for practitioners; and some innovative programmes and social marketing. However, despite multiple reports and strong advocacy, key recommended regulatory policies remain unimplemented, largely due to the private sector interests dominating public policy development.
本文介绍了澳大利亚和新西兰在过去 20 多年的肥胖预防工作中吸取的经验教训。肥胖症始于 20 世纪 80 年代,但由于监测系统不完善,肥胖症发病率的上升最初并未被发现。20 世纪 90 年代,专家开始倡导政府采取行动;然而,正是 21 世纪初媒体对肥胖问题的大量报道,给政府带来了行动的压力。一些综合性报告促成了一些项目投资,但没有实施任何监管政策。强大的食品行业游说团体确保了在食品标签、限制向儿童推销不健康食品或对不健康食品征税等方面缺乏政策。新西兰政府甚至撤销了健康学校食品指南,并撤回了国家肥胖战略的资金。2007 年,澳大利亚政府开始对预防保健进行重大的长期投资,以提高经济生产力。其他积极的举措,特别是在澳大利亚,包括:成立了几个倡导组织;成功实施了长期的、全社区范围的减少儿童肥胖的项目;建立了一个为从业者提供知识交流的全国系统;以及一些创新的方案和社会营销。然而,尽管有多项报告和强烈的倡导,关键的推荐监管政策仍未得到实施,主要原因是私营部门利益主导了公共政策的制定。