"The benefit of restricting advertising of unhealthy food has been well demonstrated"

The data on childhood obesity in Europe place Spain in an embarrassing caboose. It is the fourth with the worst figures in boys (42% overweight and 19% obese) and the second in girls (41% and 17%). If you scratch a little, it is found that the determining factor for this is not gastronomic culture or social customs, but inequality. The poorest households have more than double the rate of childhood obesity than the richest. As Santiago Felipe Gómez, head of Research and Programs at the Gasol Foundation, explains, the latter have more opportunities to play sports, safer neighborhoods in which to walk, more attention from parents, more resources to buy fresh products, they are less vulnerable to marketing of ultra-processed foods and rest better.

Gómez (Cornellà de Llobregat, 39 years old) has participated in the strategy of the High Commissioner against Child Poverty against childhood obesity, which aims to turn these figures around in eight years. Responds to EL PAÍS via videoconference.

Ask. What is the reason for the bad data from Spain?

Response. Childhood obesity is a multifactorial problem that depends on both biological, psychological and social issues. The answer is complex: there has been a change in our society in recent decades that has caused the social, family, educational environment, in which children and adolescents grow up, to be obesogenic.

P. These are levels that have remained stable in the last two decades. When did it start to be a problem?

R. The studies that go from the year 2000 to 2019 show that obesity remains stable in the general population. But there is significant gender inequality. In girls there is growth: in them the number of obesity has doubled in recent years. We started from a level in the year 2000 of very high data. But every time it is moving towards more serious conditions, towards what we call severe obesity, which is going to have worse repercussions both physically and psychologically, as well as socially.

P. And why are we worse off than most European countries?

R. Interestingly, it is the countries of the Mediterranean arch that lead that top five. We are at similar levels of Italy, Cyprus, Malta or Greece. The countries with the best figures are those with the least social inequalities, although it can be considered that there is an epidemic in practically the entire world.

P. Does inequality have more weight than the cultural or gastronomic habits of a given country?

R. It is that inequality entails a cascade of events in life, in the way people live and in the adversities that a family has to face on a daily basis. Childhood obesity figures have remained stable among those boys and girls whose mothers have university studies; in the rest they have worsened. In fact, in cross-sectional studies we see that the probability of presenting overweight and obesity, severe obesity and abdominal obesity in boys and girls of lower socioeconomic status is much higher. There is a very robust association between social inequalities and childhood obesity.

P. Probably, they have an environment with less possibility of doing sports, the diet is less balanced, they rest less. Play everything against him.

R. Exact. And they inhabit environments where it is more difficult to live and have a healthy lifestyle. There is a factor that is little talked about, which is sleep, which is very important in childhood obesity. These families live in homes where it is more difficult to sleep and stay asleep at night. They are smaller apartments, less acoustically insulated, with thinner walls, where you can hear the neighbors. Maybe you have someone with mental health problems who screams at night, or you’re on a street where there’s tremendous traffic, or you live in front of a highway, or the neighborhood teenagers have decided to have a big drink and throw the bottles into the streets. four in the morning. They are environments where it is more difficult to sleep, eat healthy, practice physical activity. It also influences psychological well-being, emotional balance, both in fathers and mothers who surely have jobs that involve a lot of effort, a lot of physical fatigue, who come home exhausted at odd hours. Perhaps they are jobs that do not fulfill them intellectually and that causes them to be more irritable and dissatisfied with their lives. And all this combined ends up transferring to the well-being and development of children.

P. What is wrong with what Spanish children eat?

R. There are multitudes of questions. For example, we have evidence that shows us that it is in the most vulnerable environments that there is less access to fresh, healthy products such as fruits and vegetables, such as fish, etc. And if there is, they are usually of a quality that perhaps the population does not want much. We also know that families are more vulnerable to strategies of marketing of the food industry. That ends up leading to a lower consumption of fruits and vegetables and more ultra-processed ones, because they are the ones that are sold perhaps in the store downstairs, because they are products that are well preserved, they are laminated… And, often, in those families also the source of satisfaction that they can give their boys and girls is often associated with it: “I give you a euro and you buy an ice cream”. Or: “This weekend we are going to eat at a fast food restaurant.” Because the child has a great time there and it doesn’t cost me too much money. It is an accessible type of reward, but of course, it does not end up benefiting that child, that family, that community, rather the opposite happens.

P. The initiative of the Ministry of Consumption to restrict the advertising of unhealthy food during children’s hours aroused much controversy. Would removing it help?

R. Of course. That at a scientific level is already well proven. It has a beneficial effect. And it’s obvious, if it didn’t make a profit, the industry wouldn’t invest. What happens is that there are also many issues of economic interest that must be managed. If this regulation ends up being promoted in Spain, it would place us at the forefront of policies in Europe.

P. Do children not do enough sport?

R. And beyond sports. It is about the population being physically active, beyond playing a competitive sport. Obviously, it is in the most vulnerable environments that there are fewer sports facilities. The fact that a boy or a girl can practice a sport has an economic cost. It is also important that parents have the feeling that the neighborhood where they go to school is a safe neighborhood so that they can let the child go by bike, walk, run or whatever, but with an active means of transport. Or that after school you can stay playing the square in the park, in the basket or in the goal or wherever.

P. The strategy wants to implement school canteens at all educational levels.

R. Canteens are important: more than 30% of children in Spain eat in one every day. But it is one more measure, it is not the definitive one. If the dining rooms were healthier, the health of children would benefit, but also that of the planet, reducing animal protein and increasing vegetable protein. Everything is very connected and it is a measure that we obviously support and recommend.

P. The plan has very specific goals, such as lowering childhood overweight to 20%-25%; reduce the social gap of obesity by 40%; increase physical activity by 10%; reduce sedentary lifestyle by 25%; increase the hours of sleep by 10%. Are they realistic in eight years?

R. We are aware that these are ambitious goals, but ambition is where things like this are achieved. They are achievable, but we need a political, social, economic and institutional consensus for this to be possible.

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