What’s the Better Health UK campaign about, and why care?

What’s the main goal of this week’s “Better Health” UK government campaign announcement?

The main goal of the “Better Health” campaign is to help tackle the nation’s soaring obesity rates, alongside reducing COVID-19 symptom severity and the need for hospitalisation.

It is true that being obese makes us more prone to experience more severe COVID-19 symptoms. In a study involving 387,109 men and women in the UK, it’s been suggested that we’re twice as likely to be hospitalised with COVID-19 if we’re obese.

Why does obesity make us more prone to COVID-19 symptom severity?

There are many plausible explanations.

But it is suspected that one of the possible reasons why obesity makes us more prone to COVID-19 symptom severity involves something called “immune hyper-reactivity” – which means the immune system overreacts, going above what is needed to eliminate the virus and resulting in exacerbated tissue damage.

Obese patients are predisposed to more extreme COVID-19 symptoms and organ damage from this uncontrolled immune response and exacerbated inflammation.

Are people listening?

For sure, the campaign went out strong in the mass media.

And I believe people are listening and talking about this because the “Better Health” introductory message is very well articulated, as it starts by first reasserting what we as a nation have already been doing well (behaviour-change wise) over the past few months: In the context of COVID-19, we’ve been reflecting more about our health, and respecting lockdown needs and social distancing.

So, this initial reassertion of self-efficacy is very clever, as it gets us to listen and it empowers us from a behavioural change perspective.

Put simply, when we hear what we’re doing well already, we’re more likely to continue adopting new favourable health behaviours.

Will the campaign be successful?

The success of the “Better Health” campaign can be measured in various ways, but I believe that the most relevant statistics we could obtain, and follow are:

  • behaviour change measures (that is, are we indeed changing our health and eating behaviours positively as a direct result of this public health message?) AND
  • overweight and obesity rates (currently, 63% of us in England are either overweight or obese; might this percentage go down as a result of this campaign?)

If the campaign is successful and people do undertake to change their eating behaviours, it’d be interesting to see how obesity rates improve in the coming year or so.

But behaviour change is complex, and of course public health campaigns can only do so much. They may involve policies that impact our food choices, and in this case the campaign is aligned with policy changes such as restricting junk food advertising on TV and online as well as “buy one, get one free” deals.

However, it all still comes down to personal choices, how each of us view our own health from a self-determination perspective, and if we believe we need to make changes in the long run or not.

If the person isn’t invested, no one can force them to eat better and move more. We need to want to change for new choices to be made and for change to happen.

Do all of us need to cut out calories?

No. The campaign is targeted at those of us who are overweight or obese, and it recommends a daily caloric reduction to 1400 calories daily for women and 1900 for men.

While this is a blanket (same for all) caloric restriction with no personalisation and doesn’t focus too much on diet quality (difficult to do so in public health messages), it’s a great step forward.

What do the critics say?

Some critics of the campaign dismiss the concept of calories all together.

But I don’t think this is fair. Here’s why:

Although I agree that calorie counting doesn’t work for everyone when it comes to eating better, the laws of thermodynamics are inescapable.

Eating fewer calories than you expend does lead to weight loss. Full stop.

And it doesn’t matter if those calories come from carbs, fats or protein, from junk food or from whole fresh foods, from vegan choices or keto choices, or if they are eaten at different times of the day.

When we take in more calories than we use or excrete, we put on weight. When we take in fewer calories than we use or excrete, we lose weight.

But doesn’t the quality of the calories we eat matter when it comes to health?

Yes, it does. Even more so when it comes to immune health.

In those of us carrying excess body fat, caloric restriction without malnutrition yet with optimal nutritional quality is preferable as we’ve seen in numerous research studies, because this also helps to optimise metabolic markers that are connected to better immune functioning.

One of those markers that would improve from this includes serum C-reactive protein. Levels of this protein produced by the liver rise in response to systemic inflammation in overweight and obesity. The problem is that when levels of this serum C-reactive protein are chronically above normal ranges, that’s when we may also experience “immune hyper-reactivity” as the body tries to eliminate the COVID-19 virus, resulting in exacerbated tissue damage and more severe symptoms experienced.

Obese patients are predisposed to more extreme COVID-19 symptoms and organ damage from this uncontrolled immune response and exacerbated inflammation.

What additional awareness should the campaign include?

It is difficult for public health campaign to be all-encompassing. This is because their effectiveness depends on short, simple messages that all of us can easily hear and understand.

So, in defence of the campaign, too much information can backfire. And critics fail to ignore this.

However, I do believe there are aspects that could be taken into account besides cutting calories and moving more. And it all comes down to developing a personal interest in health and nutrition education, where the individual feels motivated to dive deeper into all the variables that may aid weight loss.

For example, lack of sleep or poor sleep quality are linked to increased appetite and more calories eaten. Stress load can also lead to reduced self-control around food and comfort food may act like a pacifier. So, sleep and stress are things we’d want to also pay attention to when trying to better manage our weight.

Gut health is another factor that can be computed when trying to optimise our diets: this is because the types and ratios of microbial colonies living in our gastrointestinal ecosystem can impact our hunger hormones as well as metabolism and weight loss rate.

And the list goes on.

Which aspect of the campaign are you not comfortable with?

Without naming names, I find it odd that the campaign directly lists 3 popular weight management services that not everyone finds motivating.

I personally believe there’s more power in working with a nutrition professional or with a weight loss coach on a one-to-one basis. Someone who can listen to your challenges and help you work out solutions that are more suitable for you, with a higher degree of both nutritional and behaviour-change personalisation.

But, of course, not everyone may be able to afford this, so solutions centred around eHealth, digital and weight loss groups are an “okay” second best option. Better than nothing.

And for the working population, the campaign could have also included corporate wellness sponsorship incentives, encouraging companies to adopt weight loss packages for employees who may benefit from this, either through digital routes or by way to sponsoring the services of weight loss coaches to work with employees one-to-one and in groups.

The introduction of weight loss coaches in the NHS is an initiative that didn’t get much press but that could work wonders, I believe.

On the other hand, the NHS Weight Loss Plan app being linked to in the official NHS Better Health site hasn’t had much uptake – barely over 100 total app downloads as of today (disappointingly very little given the noise this campaign has been making).

What are the opportunities for nutrition professionals?

Endless. Awareness is becoming a priority. People are now, more than ever, motivated to take charge of their health and seek the help they need.

Whether you want to grow a weight loss service, food product, or meal delivery business, or perhaps work as a nutrition professional or weight loss coach on a one-to-one basis, your opportunities for business growth are immense.  

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