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Britain's obesity epidemic will get worse - particularly amongst the poor - unless radical steps are taken to tackle social inequality, food subsidies and advertising, warn experts.
Multi-national food companies have flooded the world market with cheap, unhealthy foods rich in saturated fats, sugars and salt, according to an international team of experts.
Supersized fast-food portions and supermarket ready meals have have had a disproportionate impact on the less well-off because of the cost of healthy alternatives.
And because of the global nature of the food market the problem of obesity is also increasing in the developed world.
Writing in the British Medical Journal, the researchers say the conditions within which people trade, live, and work affect health, influence behaviour and weight and call for food subsidies, advertising, urban planning, employment, and social structure to be addressed.
Epidemiologist Dr Sharon Friel, of University College London, and colleagues, said: "Food subsidies have arguably distorted the food supply in favour of less healthy foodstuffs such as those high in saturated fat, and transnational food companies have flooded the global market with cheap to produce, energy dense, nutrient empty foods.
"Supermarkets and food service chains have displaced small, family run stores or stalls, encouraging bulk purchases, convenience foods, and supersized portions.
"Although global food prices have dropped, on average, in rich countries, the foods recommended in healthy eating guidelines are often more expensive than the less healthy options.
"Targeting community and personal norms and preferences, food advertising through television, which is omnipresent in rich countries and ever increasing in developing economies, aims to persuade individuals — particularly children — that they desire foods high in saturated fats, sugars, and salt."
Dr Becky Lang, of the Association for the Study of Obesity, backed the researchers' claims and said they underlined what the Foresight report was saying a month ago.
Dr Lang said: "Making unhealthy food more expensive will not be as effective as making healthy food cheaper, but we need a lot of people to get their heads together to see how that can be achieved. There is a perception that healthy food is too expensive for many families, and we need to change that.
"Obesity is a very complex problem, and is not going to be solved by one Government department. It needs a joined up approach across health, education, transport, planning - the whole 'shebang'."
The researchers point out the World Health Organisation's global strategy on diet, physical activity, and health has identified the social determinants of the obesity epidemic, and in Europe ministers have committed to balancing responsibility between individuals and society.
Building on this, further collaboration with other UN agencies is needed to create a more extensive evidence base for understanding issues related to governance and healthy behaviours.
Dr Friel, who was in Australia yesterday, and colleagues went on: "Ensuring that global food marketing does not target vulnerable societies requires binding international codes of practice related to production and marketing of healthy food, supported at the national level by policy and regulation.
"Regulating television advertising of foods high in fat or sugar to children is a highly cost effective upstream intervention.
"However, reliance on voluntary guidelines may result in differential uptake by better-off individuals or institutions and provides little opportunity for public and private sector accountability.
"Such global or national regulations must be developed by a consortium of public-private institutions and adhere to criteria for good governance."
The recent Foresight Report in the UK also highlights that most drivers of obesity are societal issues and therefore require societal responses.
The researchers added: "Unless this is addressed, the obesity epidemic and its inequalities will persist and possibly increase.
"The need for wider policy action is being recognised. But, despite these efforts, the global obesity epidemic continues and its social gradient persists.
"Tackling it requires concerted action at global, national and local levels to promote a more equal distribution of affordable nutritious food, and improved more equitable living and working conditions. The health professions are key to spearheading such an effort."
Dr Lang added: "Obesity is different across various social groups and just telling people to eat healthily and take more exercise is not going to solve the problem. It goes much deeper than that. Attitudes have to change in society as a whole, and healthy foods could be made cheaper, although it will take some work."
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