Saturday, October 15, 2005

Better Suburban Planning Needed To Curb Obesity

From the Globe and Mail, Toronto:

It's time to shift the focus from blaming individuals for being fat to understanding how the environment we live in discourages healthy living, a scientific think tank has concluded.

"We need to look well beyond getting more gym classes for kids and better food in school cafeterias," said Diane Finegood, scientific director of the Institute of Nutrition, Metabolism and Diabetes, part of the Canadian Institutes of Health Research, a federal funding agency.

"We need to understand how we can fundamentally alter the environment so the healthy choice is the easy choice."

Dr. Finegood said that means rethinking the way public policy is created and implemented in a broad range of areas, including urban planning, transportation, education, agriculture and taxation.

But the immediate focus needs to be on infrastructure, including urban design and planning, she said.

"At a time when we're about to embark on major investments in infrastructure, we need to make sure we do things differently," Dr. Finegood said.

"We can't allow ourselves to repeat the mistakes of the past."

Stephen Samis, director of health policy at the Heart and Stroke Foundation of Canada, agreed.

He noted that when governments began establishing zoning bylaws, they had three main goals: to ensure the health, the safety and the welfare of citizens.

"Unfortunately, the focus today is almost exclusively on safety. We need to get back to those other basic tenets, health and welfare, in the way we regulate our built environment."

He said there are several factors that should come in to play when there is development, including building sidewalks, ensuring roads are interconnected to facilitate walking and public transport, building walking and cycling paths, ensuring mixed-use development so people are not forced to drive to stores, and even financing for new housing.

"Suburbs are a proven thing, so financing is easy, but financing smart, healthy development is a lot more difficult," Dr. Samis said. "That's not smart if you look at the impact of suburbs."

Canadian researcher Larry Frank has shown that suburbanites are about 35 per cent more likely to be obese than their urban counterparts, in large part because they spend so much time in their cars.

Dr. Finegood and Dr. Samis led a think tank that met last week in Toronto to establish research priorities for tackling the obesity epidemic. The meeting involved more than 100 experts from a wide array of specialties, including medicine, public health, the environment, urban planning, economics, agriculture, the food industry and consumer groups.

While there was broad consensus on the need to address suburban sprawl as a health issue, the expert group was not able to agree on how to deal with the obesity problem through economic incentives and disincentives.

While some public-health officials tout a "fat tax" as the way to discourage consumption of unhealthy foods, others believe healthy foods should be subsidized to make them more accessible.

"Clearly this is a sensitive issue, and politically charged," Dr. Finegood said. "But the reality for us as scientists is that the evidence is poor: We don't know what works and doesn't work because economic incentives haven't been properly evaluated."

The main goal of the think tank is to help focus research priorities and eventually develop better public policies.

"Bringing a diverse group together to look at what we know and what we need to know about tackling obesity is a Canadian first," Dr. Samis said. "But it's just a first step. We're keen to start kicking some of this research out the door."

According to Statistics Canada, more than 59 per cent of Canadian adults are of unhealthy weight. The total includes 23 per cent who are obese (meaning more than 30 per cent or more of their body weight is fat) and 36 per cent who are overweight (25 per cent or more fat).

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