Nudging towards health?

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The 2010 “Health at a glance” report [1] jointly produced by the OECD and the European Commission has revealed that half the adult population of the EU is overweight or obese. In the UK, 24.5% of adults are classed as obese.

The report explains that while life expectancy in the EU has continued to rise, up from 72 years in 1980 to 78 years in 2007, healthy life years (the years of life spent in good health) still lag far behind. For the period of 2005-2007, average expected healthy life years were 61.3 for women and 60.1 for men. A difference between life expectancy and health life expectancy is undesirable for individuals and puts pressure on healthcare systems. It is also likely to have an impact on pension systems and many people may not be healthy enough to work until they reach pension age if current rises in obesity rates continue unchecked.
 
Poor health for many people means suffering from a chronic disease. Obesity and being overweight are risk factors for many chronic diseases such as coronary heart disease, diabetes, and also for some cancers, for example breast cancer. In addition, an unhealthy diet, for example eating insufficient amounts of fruit and vegetables, is linked to the development of other cancers such as bowel cancer (World Cancer Research Forum, 1997 [2]). The World Health Organisation [3] states that:
 
“While inadequate or bad nutrition is a risk factor in the development and progression of many chronic diseases, good nutrition is not a guarantee of prevention or cure, but can significantly reduce the likelihood of developing a number of common chronic diseases and/or slow down their progression”
 
Currently, the health problems associated with obesity and being overweight, such as major chronic diseases tend to emerge as people reach their mid 50s. But with increasing number of younger adults and children becoming overweight or obese, will the age of onset of chronic diseases decrease? This is already being seen in relation to type II diabetes, where there has been a noticeable increase in children developing the disease [4].
 
It is not that we are unaware of how to eat healthily – very few people in the UK are unfamiliar with the “five a day” message – but many of us do not always follow this advice. In addition, maintaining a healthy weight is not only about diet; physical activity is important as well. This does not mean joining a gym; often simple measures such as taking the stairs at work or walking instead of driving can make a difference.
 
The coalition government’s public health white paper [5], released last week, names obesity as a key public health issue and seeks to “nudge” people to make healthier life choices. In this context, nudging [6] is about facilitating healthy choices and making them easier and more attractive, while keeping unhealthy choices available and making them less attractive. It seems a concerted effort to stem the tide of obesity is clearly needed, but will nudging towards a healthier lifestyle be sufficient?
 
Rebecca Taylor
 
[1] http://ec.europa.eu/health/reports/docs/health_glance_en.pdf 

[2] World Health Organisation (2003) “Diet, nutrition and the prevention of chronic diseases”, technical report no 916
 
[3] World Cancer Research Forum (1997) “Food, Nutrition, physical activity and the prevention of cancer”
 
[4] “Children and diabetes”, Diabetes UK website, http://www.diabetes.co.uk/children-and-diabetes.html, accessed on 8 December 2010
 
[5] http://www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm 

[6] http://nudges.org/

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