With 2024 being an Olympics and Paralympics year – the latter having just finished – it’s a good time to consider sports policy and independence.
Sport has long been one of the most important pillars of Wales’ cultural identity. As one of the main vehicles by which Wales acts independently abroad, sport also has some importance when it comes to “soft power”, “brand awareness” and low-level diplomacy (Part III).
That’s all well and good for athletes, governing bodies, sponsors and politicians – but what about the rest of us?
Part one (of three) will concentrate on sport and exercise as a public health matter.
According to Public Health Wales1, in 2017, 23.6% of people in Wales aged 16+ were obese (defined as having a Body Mass Index of 30 or above). The proportion of those aged 16+ who were either overweight or obese was 60%.
Although Scotland has a far higher obesity rate than Wales (around 35% of those aged 16+), Wales would still rank towards the top of the list of “fattest countries in Europe”.
When the report was published, its projection for future years was that 62% of those aged 16+ would be overweight or obese by 2024 (a target Wales hit for once). This would rise further to 64% by 2030.
Additionally, figures from Senedd Research2 show that some local authorities – such as Carmarthenshire, Bridgend, Merthyr Tydfil and Blaenau Gwent – already have combined obesity and overweight rates that are near or exceed 70%.
Too much focus on diet; not enough focus on exercise?
Deprivation plays a big role in determining whether or not someone will become overweight or obese – we all know that.
Other reasons listed in the Public Health Wales report include:
- Poor nutrition during early years, including lack of breastfeeding and early weaning.
- Alcohol and sugary soft drinks – though since the report’s publication, the UK government introduced the sugary drinks levy.
- Eating too few fruits and vegetables.
- Eating too much hot food out-of-home, particularly processed fast food; countries with a culture of eating non-processed food (i.e. Italy, Greece, France) have lower obesity rates.
That’s the ingoings, but what about the outgoings?
The general guidance is for the youngest children (under-5s) to be physically active for three hours a day; older children (5-18-year-olds) to be active for an hour a day; working-age adults to be active for at least 2 and a half hours a week (ideally in 30-minute bursts per day); and older adults to be active for between 75-150 minutes a week.
“Physically active” can mean anything from below:
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The proportion of people meeting these guidelines in Wales is low, particularly older children (11-16-year-olds) – where only a fifth meet recommended guidelines. Most young to middle-aged adults do hit physical activity guidelines, but rates drop off after age 55.
Exercise (not just sport) is important because there are health benefits to exercising regularly even if you don’t necessarily lose weight.
Exercise is important for maintaining a person’s weight, but equally so to strengthen and protect the parts of a person’s body that would be put under strain by being obese or overweight – such as the heart, lungs, blood vessels, muscles, bones and joints.
The Policy Challenge
By 2050, Public Health Wales3 expects obesity (which covers illnesses related to obesity such as Type II diabetes) to cost the Welsh NHS £465million-per-year – up from £73million in 2011.
Public health and sport are devolved. Apart from some specific measures (such as elements of the tax system), the Welsh Government and Senedd have most of the tools at their disposal to address the issue.
This presents challenges though. While public authorities can take action to regulate and restrict access to unhealthy foods – or make them a less convenient option – all they can do is nudge us in the right direction. They can’t force us to eat or drink a certain way. They can’t force us to do more exercise.
The Welsh Government’s five-year plan, “Healthy Weight, Health Wales”, runs until 2029.
There’s a more detailed summary at Senedd Home, but the core tenets include:
- Promoting healthier foods, and restricting advertising on high-salt, fat and sugar foods.
- Restrictions on energy drink sales to young people and takeaways near schools.
- Encouraging everyday exercise (making walking and cycling safer/more attractive).
- Stricter nutritional guidelines in the NHS and education.
- A diet-based approach to treating Type 2 diabetes.
One possible measure with the strategy – ending free sugary soft drink refills and multi-buys for high sugar, fat and salt products – prompted a recent backlash, as did one of the measures introduced to support regular walking and cycling (20mph default speed limit).
While there have been calls to introduce planning restrictions on hot food takeaways, you can already predict the “anti-business, anti-choice, nanny state” arguments which will arise from it.
Taking all of this together, the biggest obstacle to tackling obesity isn’t the Welsh Government. It’s us.
So where do you even begin to address it?
Probably at school.
1. Public Health Wales (2018). “The case for action on obesity in Wales”. Available at: https://phw.nhs.wales/topics/overweight-and-obesity/the-case-for-action-on-obesity-in-wales/
2. Senedd Research (7th March 2024). “The rise in obesity: some food for thought”. Available at: https://research.senedd.wales/research-articles/the-rise-in-obesity-some-food-for-thought/
3. Public Health Wales (2018). “The case for action on obesity in Wales” (p31-34). Available at: https://phw.nhs.wales/topics/overweight-and-obesity/the-case-for-action-on-obesity-in-wales/
