Health Check

'Portion sizes have increased over the past 10 years, often slowly and imperceptibly, in the same way that people's weight has'
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Indy Lifestyle Online

Every Saturday, tens of thousands of people get into their cars and spend their morning sitting in a queue on the M25 to get to the Bluewater shopping centre in Kent, the largest of its kind in Europe. Hundreds of shops are crammed under one roof, so customers need not be in the open air or even walk very far to get from one store to another. When they do get tired, there is a vast food court, with every type of fast food imaginable, from burgers to burritos, pizzas to panini. If that is not enough, people can collapse into the multiscreen cinema complex, order a super-large box of popcorn, or even munch pizza throughout a two-hour film.

Every Saturday, tens of thousands of people get into their cars and spend their morning sitting in a queue on the M25 to get to the Bluewater shopping centre in Kent, the largest of its kind in Europe. Hundreds of shops are crammed under one roof, so customers need not be in the open air or even walk very far to get from one store to another. When they do get tired, there is a vast food court, with every type of fast food imaginable, from burgers to burritos, pizzas to panini. If that is not enough, people can collapse into the multiscreen cinema complex, order a super-large box of popcorn, or even munch pizza throughout a two-hour film.

Now, all this may seem like an average Briton's typical weekend leisure activity. But beneath Bluewater's gleaming glass domes lurk nearly all of the multiple causes of one of the biggest health problems gripping this country - obesity.

It is not often that the heads of our prestigious medical colleges bandy about words such as "terrifying" and "time bomb", but last week, three of them came together in an unprecedented move to issue a warning about the soaring numbers of overweight and obese people in Britain. Two thirds of men and women are now classed as overweight or obese. One in 10 children under four is obese, rising to one in six in the five-15 age group. Obesity has doubled among children, trebled among women, and nearly quadrupled among men over the last 20 years.

What terrifies the medical experts is that for the first time last year, doctors began to see Type 2 diabetes - a condition previously only found in middle-aged, often overweight adults - in children as young as six. Ten-year-olds are showing signs of heart disease, teenagers have breathing problems, and more than 30,000 people a year are dying prematurely because of obesity.

In the same way that many people claim that their weight "just crept up over the years", so, too, has the experts' realisation of the full extent of the obesity problem. Everyone - doctors, the food industry, the Government and the obese - agrees that the causes are complex and the solutions multi-factorial. It is not just about fat, greedy people eating more than they need to and being too lazy to do something about it. But a trip to Bluewater is a neat example of a lot of the causes - and solutions.

The rise of these huge, out-of-town shopping-centres has only added to the culture of the car. Bluewater is not within walking distance of anywhere - everyone drives to it. When they do get there, there are lifts from the car parks to the shops. Escalators take you from one level to another. The distance that anyone has to move under their own steam is minimal.

An interesting factor in the whole debate about obesity is that the average person actually eats fewer calories and less fat per day than 30 years ago - but does far less exercise. Parents drive their children 500 yards down the road to school, and then carry on to their place of work. People drive to the park to walk their dog, or to the newsagents to get a newspaper.

Children in particular suffer from this. They no longer cycle to the shops to get sweets, or run down the road - they are driven there. The loss of playing-fields, combined with a (perhaps irrational) public perception that paedophiles and murderers lurk at every corner, means that many youngsters don't even know how to ride a bike, let alone have the freedom to get on one and burn some energy.

But back to Bluewater. A glance around the food court highlights another problem - portion sizes. Order a McDonald's burger, and the first thing you will be asked is whether you want to "go large". Bags of crisps come in maxi-sizes, chicken meals in "bargain buckets".

When I bought a magazine last week, I was offered a "family-size" chocolate bar for half price. Forget the family bit, I munched my way through the whole thing - while lying on the sofa reading the magazine, of course.

Super-sizing started in America. Fast-food companies noticed that customers were ordering two meals and eating them both, but seemed embarrassed about admitting it.

So, they introduced extra-large meals, on the basis that simply offering that choice legitimised the customer's desire to eat more. Now, they have gone one step further - a lot of the advertising for extra-large meals focuses on the choice being manly, macho, a badge of honour. Portion sizes of everything from biscuits to lasagne have increased over the last 10 years - often slowly and imperceptibly - in the same way that people's weight has.

So, we can blame shopping centres, the food industry, car culture, even child abusers for the obesity epidemic. But what about personal responsibility? Food manufacturers argue that no one forces people to go large, and most people object to the idea of a nanny state telling people what to eat. Maybe we just need to start making sensible choices, for our own and our children's sake.

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