Yes Doctor,huge U.S. multi-nationals are difficult to say "no" to. We certainly have it coming at us from all angles, technology, junk food, lack of advice from dieticians. It seems as though it will become a self fulfilling phrophicy.

Let's face it, the almighty dollar rules our world, those who have a concerntration of dollars, sell junk, which the public health systems must deal with at a later date, no wonder our hospitals are struggling to cope, inadequetely resourced from Costello, trying to deal with the after effects of big mac's.

We need more these days than to be shown the pyramid by dietaticians, we need them to ask what food do you enjoy, then design a recipe regieme around the healty food we enjoy. If this does not happen, the eventuallity of consuming ever increasing amounts of junk, because we cannot afford "real food" such as fruit and vegetables, will certainly explode.

It is correct to say that we need to get people to change their lifestyles in order to expend more energy and to eat less. However, it is more a case of working out how to do this within the context of today’s world than a funding issue.

It is no good complaining that primary school children no longer walk to school. This is difficult if not impossible for most. Young children need to be accompanied when crossing roads. Only the few who live very close to school, do not have siblings who need to go to different schools or preschool or childcare or swimming lessons etc., don’t have to push heavy strollers laden with school bags up steep hills or along busy roads breathing in toxic fumes and who have a parent or nanny who has an hour or so to spare in the morning and does not need to get to work. A better solution would be to require all schools to start the day with some sort of exercise such as aerobics or running around the oval. This would also have the effect of improving behaviour in class especially among boys. There should also be provision for children who need afterschool care to attend sports or dance classes.

A walking school bus system would be good but is reliant on volunteers – maybe this is where funding could come in. Pedestrian crossings are also needed – I see nine-year olds having to take chances across busy roads on a daily basis – usually someone stops for them but one day they won’t. Why do we have 40-zones along busy streets with pedestrian crossings that serve only to annoy drivers then no crossings along residential streets that are used as rat-runs.

I would also like to see a bicycle proficiency program in late primary school (as happens in the UK) so that children can be encouraged to cycle once they reach high school. Then we need safe cycleways or shared footpaths so they can avoid busy roads

cont'd.

It is also useless telling people that they should not eat fast food and should be preparing fresh food everyday. This is often impractical and neglects to mention that it is quite possible to take inexpensive shortcuts that are quite healthy. For example, using frozen vegetables or lean mince with shop bought pasta sauces. My children are allowed the occasional Macca’s but without the French fries and definitely no promotional toy. I would like to see a system where the healthier alternatives can be quickly identified in the supermarket – not just low fat which usually means lots of sugar.

Junk food advertising has rightly received attention. However my children’s school, and I imagine many others, has a ‘healthy canteen’ and spent weeks teaching the merits of good nutrition and exercise then the following week sent the children home with a large box of Mars chocolates to sell for a fundraiser with a promise of a prize for any child who sells them all. They were surprised when parents complained. Schools need to practice what they preach. They made a great deal of money which is no doubt why schools readily give up their principles for the mightier dollar. Perhaps some other companies can come up with some healthier fundraising alternatives?

While the Coca Cola mentality pervades this country (blindly following the example of the USA), this government will continue to rake in the big bucks from the Corporates like softdrink manufacturers, legislating to allow the addition of caffeine in softdrinks, as they have done. If you have adults and children craving your product that's better than spending advertising $'s and risking that they miss the adverts.

While Coca Cola and other major corporates continue to inject massive amounts of political donations into the coffers of all of the major parties, we will continue to see political decisions like this one that has been designed against the interests of the health and welfare of the general public but in favour of the corporates.

He who pays the piper clearly calls the tune in Australia's parliaments.

You alluded to another problem Dr Moodie, that has crept into our schools over the past 20-30 years or so. At lunch breaks school playgrounds would erupt into life, with children rushing out to play cricket, football, basketball or whatever was going. Today, with schools concerned about litigation through accidents, etc. children are encouraged or required to limit their involvement in such activities unless teachers are directly supervising during sports periods.

Handball is often the most arduous activity in the playground today, with Tamagotchi the next in line. Any wonder the obesity levels are rising.

Dr Moodie, your commentary seems to fly in the face of the recent studies by the NSW government which argue that children are LESS sedentary than they were 10 years ago. Questionable research on that reporting process aside, I'd be interested in a research project that surveyed how much of an impact the use of caffeine in softdrinks has had on the population generally. With the amounts of such drinks consumed by children each day, I imagine the effects on their calorie intake would be significant.

Considering the other stimulant and addictive effects it would have on children, it can hardly be considered as anything other than a breach of care by government on a growing health issue.

This appears to be a class problem. My son has been to two large private primary schools in the past seven years, in which I have seen nothing to suggest to me that these children are any fatter than the children were at the state schools I attended 40 years ago. Maybe we need to ask what these parents and children are doing right that their less-well-off counterparts are not. It's not just a matter of the cost of food either: junk food is expensive.

The problem of obesity has many faces. The key issues of nutrition and exercise are often correctly identified but most of the population have a basic knowledge of these yet do not apply them to their lifestyles. Clearly a behavioural element to obesity is critical but often neglected.

Our health system is not designed to address obesity. We prefer to wait until patients develop chronic disease and then ameliorate the long term complications than to address at risk patients. GPs get higher payments when their patients fall ill. They are, for the most part, not allowed to claim on the Medical Benefits Scheme unless their patients have a medical problem.

Lets turn this around. Pay general practices (lets call them Wellness Centres) when their patients are well (not when they are sick). Enable Wellness Centres to employ nutritionists, exercise physiologists, nurse educators, psychologists and lifestyle coaches to tackle obesity (and smoking, stress, depression, anxiety, falls, and other preventable diseases) in the early stages not waiting until they get ill.

Let every Australian citizen have a Wellness Plan outlining a healthy lifestyle and how to prevent illnesses. And give the Wellness Centres the ability to follow-up patients. Lets use e-mail, phone, SMS and other technologies to continually reinforce healthy lifestyles. Lets free up very scarce GPs from dealing with preventable illnesses and use their talents and skills far more wisely. Lets have walking groups leaving from Wellness Centres and yoga, tai chi and Pilates classes based in them.

And lastly lets find some politicians and bureaucrats with some real vision about health and not illness.