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Tackling the obesity epidemic and its associated adverse health consequences is one of today's important public health challenges. Obesity directly costs the National Health Service (NHS) about £6 billion per year. Direct and indirect costs of diabetes are estimated to be £24 billion and are likely to double over the next 20 years.1 Some fundamental misunderstandings among the medical and healthcare community and lay public inhibit the implementation of effective interventions. Our decisions about the food we buy and what we eat are often automatic and made without full conscious awareness.2 For example, despite wanting to lose weight, we're still tempted to buy the brightly packaged chocolate bar at the checkout till.
The lifestyle hierarchy places diet as a powerful common determinant of cardiovascular disease, obesity, type 2 diabetes and several cancers.3 The Lancet Global Burden of Disease Study reports that poor diet contributes to more disease than physical inactivity, smoking and alcohol combined.4 Recent scientific advances support a number of specific dietary targets to be prioritised for the prevention of cardiovascular disease. Several are aimed at increasing consumption of healthy foods, with a number to reduce the consumption of harmful ones. The α-linoleic acid, polyphenols and omega-3 fatty acids found in abundance in nuts, fruit, vegetables, olive oil and oily fish rapidly exert positive health effects by attenuating thrombosis and inflammation,5 and it is estimated that increasing population consumption of fruit and vegetables by one portion per day and nut consumption by two servings a week would prevent 5.2 million deaths from cardiovascular disease globally within just 1 year.6 Conversely, the consumption of trans-fats commonly found in fast food can rapidly increase C-reactive protein and other inflammatory markers within weeks.7 Reducing consumption of sugary drinks by 15% would prevent 180 000 people from becoming obese …
Contributors AM wrote the initial draft, with further addition/editing by MM and TS.
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.