Paul French, author of the Fat China: How Expanding Waistlines are Changing a Nation (China in the 21st Century) summarizes for The Guardian what the government has done over the past decade to fight obesity. He is underwhelmed.
Chinese healthcare planners are now far more aware of obesity, and the medical problems associated with it, than they were even just five years ago when Ji Chengye, of the Child and Adolescent Health Section of the China Preventive Medicine Association, declared that “China has entered the era of obesity”. It is now a subject of many studies, media speculation and greater educational awareness. In large part the government has blamed inactivity and sedentary lifestyles as the major culprit. Tian Ye, director of the China Institute of Sports Science, has said the issue of weight and physical decline can be attributed partially to the lack of sports activities among young people but funding for more mass-participation programmes was never forthcoming.
Across the board – from exercise to diet – specific funding for obesity awareness programmes remains low to non-existent. In China’s system of rigid central planning of budgetary allocations awareness of a problem can grow, but funding and new approaches are far slower to emerge, due to five year planning cycles. In 2009, as part of China’s $586bn (£384bn) fiscal stimulus package, the central government budgeted for billions more to go into the healthcare system, in the countryside and cities. However, none of this went to obesity prevention. While the number of researchers in the field has increased ground level activity remains small. According to China’s National Institute of Nutrition and Food Hygiene in Beijing, the country has just over 10,000 qualified nutritionists nationwide, but needs at least four million, based on international standards of one nutritionist for every 300 people.
China still remains legislation-lite when it comes to obesity. In 2007 when new obesity stats made headline news some initiatives were launched – the central government ordered the building of more playgrounds and passed a law requiring students to exercise or play sports for an hour a day at school. While more playgrounds were built they were often not well thought out and did not encourage more active play, while many schools have disregarded the exercise regulations (often due to parental criticisms of wasted time away from academic studies) or circumvented them by using the time for drilling or simple mass playground exercises.
Similarly, a government initiative to institute mass exercises in workplaces was largely ignored by employers as inappropriate when staff have customers to deal with. At the same time the Chinese Nutrition Society launched a campaign – Eat Smart at School – aimed at cultivating healthy eating practices in schools. This emphasis on school meals followed research in Hong Kong where staple lunchtime dishes such as fried rice and noodles were found to be high in fat, cholesterol and sodium. In 2006 Hong Kong launched a campaign entitled EatSmart@school.hk to promote territory-wide healthy eating. The campaign included issuing new nutritional guidelines on school lunch for primary school students to guide caterers to provide balanced diets to 300,000 students in some 600 whole-day primary schools. China followed suit, though only schools in wealthier urban areas have realistically been able to afford the new lunches.
However, despite debate, there has been no adoption of any formal legislation regarding TV advertising of fast food or requirements to introduce additional warning labeling to products in the HFSS category.
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