By Tiffany Hoy

According to the World Health Organization, obesity has reached epidemic proportions worldwide, with at least 2.8 million people dying each year as a result of being overweight or obese.

Globalization has brought fast food culture to Chinese cities, contributing to major obesity problems — a 2006 study found that over one-fifth of the one billion obese or overweight people in the world are Chinese.

One of the fattest nations in the developed world, Australia also shares this obesity problem. If Australians' weight gain continues at current levels, almost 80 percent of adults will be overweight or obese by 2025, according to Monash University.

To discuss the problem of obesity and evaluate a packaging solution being developed by the Public Health Association of Australia, international nutrition experts met at an obesity and nutrition conference in Sydney on Wednesday.

The rise of multinational fast food outlets has been a key change in our environment leading to fatter foods and fatter people, Bruce Neal, a professor at the George Institute for Global Health in Sydney, told the conference.

"As fast as we get rid of all our traditional vectors of disease — infections, little microbes, bugs — we are replacing them with the new vectors of disease, which are massive transnational, national, multinational corporations selling vast amounts of salt, fat and sugar," Neal said. "This isn't a problem of individual behaviors; this is a problem of massive environmental change over the last few decades — of corporate success on a massive scale by the food industry. Their success is a public health disaster on a scale that is almost unprecedented."

Over time, consumers in developed countries have become acculturated to larger serving sizes that are well above what's necessary for an enjoyable, sensible and nutritious meal, said Tim Gill, associate professor at the University of Sydney's Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders.

"Upsizing (in fast food outlets) was clearly used as a marketing tool in previous decades, but I'm pleased to say there' s been a general agreement to move away from that. But in the intervening years, we've now become acculturated to what is now a recognized serving size," said Gill.

"The clear indications are that people will consume a portion that's put in front of them. People will seek value by purchasing the largest portion size, because it's relatively cheap compared to the smaller size. We've just had a disconnect in terms of what we need to eat and what we can purchase," he added.

A 2005 study by American scientists found that diners who ate from a bowl of soup that kept refilling would not only eat far more than normal, but they didn't notice that they had eaten more, and didn't feel more sated.

Furthermore, most shoppers base their food choices on price rather than nutritional value, with lower socio-economic status consumers more likely to eat high energy-dense foods such as sugary drinks, said Marion Hetherington, a professor of biopsychology at the University of Leeds.

Australia is attempting to combat these issues with a star rating labeling system to be used on food packaging, to rate and clearly show the nutritional value of foods.

"The obsession that industry has with what it prints on labels and what will not be printed on labels about the composition of foods I think is a very good indicator of the impact that labels can have in one form or another on people's purchases," commented Neal.

Approved by health ministers in June, the Australian Health Star Rating system will be made mandatory, if a review after two years finds that voluntary implementation has not been successful.

However, the experts do not necessarily think the labels alone will change peoples' behavior. The real test will be if it drives food producers to reformulate their products to make them more healthy and achieve a better rating.

"If we had a red traffic light for salt, and that was 10 percent above the cutoff, they might try and reformulate it to take 10 percent of the salt out and get down to an amber. They might do the same thing to get from an amber to a green," said Neal.

"If we could progressively shift those points down a little each year over the next few decades, I think we could fundamentally change the food supply.

"I think that's where the real potential of food labels is. We can use them as a vehicle not to try to get people to make better choices, but as a vehicle to actually change the average composition of the food supply, so we don't have to go out there and make better choices, we can't help but make those better choices," Neal added.

However, nutritional scientists are concerned that the algorithms underpinning the star ratings will not reflect the most up-to-date scientific research about what's good for us.

Jennie Brand-Miller, a professor at the University of Sydney's School of Molecular Bioscience, said low-fat diets may not in fact be best for our health, and nutritional schools-of-thought may need to take a dramatic shift towards protein-rich diets, with higher fat and low GI carbohydrates.

"Low-fat dietary advice has not been helpful on a population level. It is consistently associated with weight regain. It does not reduce the risk of chronic disease," said Brand-Miller.

"We need to pay more importance to protein. Protein is satiating, and we've undervalued it. We need to pay more attention to the sources of carbohydrate — we need to switch from high GI to low GI carbohydrates.

"There is a range of macronutrient ratios that are healthy. And this offers flexibility, moderation. It means we can accommodate cultural differences and ethnic differences — so important in Australia. And it's behaviorally more sustainable," she added.

CEO of the Public Health Association of Australia Michael Moore, who is helping to develop the star rating system, said the algorithm behind the ratings would ideally be flexible, and ever- changing according to the latest science.

"Whilst we work extraordinarily hard to make sure the algorithm is right, that it is working, that it's consistent with the dietary guidelines and the guide to healthy eating, I'm not married to that particular algorithm," Moore said.

"I can see a time in which more research will come out and the algorithm will be modified, and I would think the algorithm will actually be modified fairly regularly," he added.

At the heart of the obesity issue is the question of responsibility, and whether it's up to consumer to look after their own needs, or industry to provide more healthy foods.

"In Britain, the public health responsibility has been an important initiative in the sense that companies will sign up, they will pledge to reduce the amount of calories in their food, to reduce the amount of salt," said Hetherington.

"Some industry will want to be part of that, because of public relations, but for whatever reason they'll sign up to responsibility deal and in doing so, lowering calories, salt and sugar in food, they are taking responsibility in the obesity epidemic," she added.

By lowering the salt, sugar and calorie content of their foods independently — a so-called "health by stealth" approach — industry will not face competitive pressure caused by only some producers providing more healthy foods in the marketplace, said Hetherington.

For example, "tomato juice manufacturers all agreed to have a consensus on lowering salt content. So there wasn't one manufacturer who had a regular salt version, all of them as it were by stealth reduced the salt content of the tomato juice. And consumers will eat and buy what's given to them," she said.

And for consumers switched-on to nutrition and interested in weight loss, manufacturers can use images, odours and tastes to help health-conscious people to resist tempting foods and make more healthy choices, Hetherington added. But finding the motivation is largely up to you.

This article was originally published at Xinhua