Just six months ago the Healthy Living Social Marketing Programme was launched with a seven-point plan to halt the rise in obesity among children under 11 by 2010. It detailed a range of eye-catching initiatives, from increasing the provision of supervised play at home and in schools to reducing the amount of time children spend in front of the TV and computers.

However, the decision by public health minister Caroline Flint to roll out the now five-year-old 5-a day programme and add some Top Tips for Mums has raised further concern among those urging swift and comprehensive action.

"5-a day is a great initiative, but it can't stand alone in the fight against obesity," says David Haslam, the clinical director of the National Obesity Forum. "The government says it is committed to doing something about obesity but it is too slow."

Paul Sacher, a dietician at Great Ormond Street Hospital for Children, is even more critical and believes the government has missed the point. "There is no real evidence that 5-a-day prevents obesity, whereas other initiatives do. What about encouraging exercise?"

Earlier this year MPs on the Commons Public Accounts Committee called for the appointment of an obesity tsar to galvanise a public health drive and said parents must be given clearer guidelines. The committee said that even simple messages to those with a problem are not being put across nearly three years after the government set a target to halt obesity among children under 11.

"It is lamentable that, long after the target was set, there is still so much dithering and confusion and still so little coordination," says Edward Leigh MP, PAC chairman.

The slow response could be down to the fact that tackling childhood obesity is the responsibility of three separate government departments - health; culture, media and sport; and education. This approach has been criticised by shadow health secretary Andrew Lansley, who describes it as a lack of joined-up thinking. "We run serious risks for our future," he says.

It is a situation which Annette Brooke, Lib Dem spokeswoman for children and families, says has to end before obesity can be tackled effectively. She is calling for a named government minister to co-ordinate urgent action. "The longer it goes on without a coherent approach the more difficult it will be to resolve," she says.

The DoH's latest response saw the publication last week of a 30-page report reviewing the evidence of the causes of obesity. It will have done little to pacify its critics. The report reiterates existing targets on reducing salt consumption to 6g a day and returns to statistics published in its 2004 White Paper Choosing Health, but the only new initiative it mentioned was that list of Top Tips for Mums.

The DoH promises that Top Tips for Mums is just one of a range of initiatives from its Small Change, Big Difference campaign which is being rolled out this year and next alongside partners in the public, food manufacturing and retail sectors. But details of further initiatives are not yet available.

"Increasing children's consumption of fruit and veg is a priority for government and most families," says a spokesman. "Healthy Living is about providing support when and where it is required and in a way people will respond to."

But, with the target to halt the rise in obesity just three years away, simply giving advice on food consumption is not enough, say critics, and it is time the government got serious with its seven-point plan. n

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