The sugar-filled elephant in the room

Power Play - The government wants to tackle New Zealand's climbing rate of childhood obesity, so why is it ignoring the sugary elephant in the room?

As with many other wealthy countries, the rate of obesity in this country is on the rise.

The latest figures held by the Ministry of Health show that a third of adult New Zealanders are obese, and a further third are overweight.

When it comes to children, 10 percent are obese and almost a quarter are overweight.

The Health Minister, Jonathan Coleman, says being overweight or obese is expected to overtake tobacco as the leading preventable risk to health in New Zealand within the next year.

His plan for tackling childhood obesity, unveiled on Monday, includes 22 initiatives which are a mix of new and expanded existing services.

They include targeted interventions for those who are obese, more support for those at risk of becoming obese and broad strategies to make healthier choices easier.

But at the centre of the plan is a new childhood obesity health target - this will become part of the B4 School Check on four-year olds.

What this means, in practice, is that 95 percent of those kids identified as obese at age four will be sent for a clinical assessment and get family-based interventions.

This is a difficult line to tread. Yes, the nation's expanding waistlines will put pressure on the health system in future but is there a social stigma in labelling a four-year-old as obese?

Children's Commissioner Russell Wills says there is a risk of stigmatising people.

Dr Wills says authorities can do harm by setting people up to fail, and he argues that intervention works far better if it also involves "parent training".

He also says the government missed some glaringly obvious solutions - like making it mandatory for schools to only sell healthy foods.

Sound familiar? That's because it is. In mid-2008, the Labour-led government introduced a regulation forcing school tuck shops to make only healthy options available to students.

The rules were slated by the National Party as being an example of the nanny state at its worst and, less than a year later, the new Education Minister Anne Tolley scrapped the unhealthy food ban.

At the time she said for students who had been running around, there was nothing wrong with the odd pie.

When Dr Coleman announced his plans this week to tackle childhood obesity, he said he would not be reintroducing the ban as, he argued, it didn't work.

Is a year enough time to assess the effectiveness of such a plan? More likely, it would have been a tough sell politically to support something that Labour had championed.

Dr Coleman is also not entertaining any suggestion of a sugar tax, as he says sugar is in so many foods that it would be totally unworkable to put a tax on it.

What about sugary drinks?

Asked about taxing sugar-sweetened drinks alone, Dr Coleman said the evidence on whether it worked was inconclusive.

Mexico introduced a 10 percent sales tax on sugary drinks at the beginning of last year.

An assessment of the law change by the University of North Carolina showed a 6 percent drop in purchases of soft drinks over 2014.

Dr Coleman argues that there is no correlating decline in obesity so the government will not be considering such a tax in New Zealand.

The Children's Commissioner, however, says that is not good enough.

He says childhood obesity is reaching crisis point and price is a powerful signal - noting that a litre of fizzy drink is vastly cheaper than a litre of milk.

Dr Wills says the government has not gone far enough and that voluntary guidelines simply do not work.

But National has painted itself into a corner with the rhetoric it used when Labour tried to make regulatory changes to tackle obesity.

It would be hard for National to put in place tough rules for healthy food in schools, when in opposition it had slated the previous government as nanny-state for trying to do just that.