A fundamental policy shift is required to widen responsibility for the prevention of diet, activity and weight-related ill health across the whole of Europe's population. Only such a comprehensive approach offers any realistic prospect of averting a public health catastrophe for Europe and indeed for the whole world.

A set of seven principles (the 'Sydney Principles') was developed by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children. The aim of the present communication is to present the Sydney Principles and report on feedback received from a global consultation (November 2006 to April 2007) on the Principles.The Principles state that actions to reduce marketing to children should: (i) support the rights of children; (ii) afford substantial protection to children; (iii) be statutory in nature; (iv) take a wide definition of commercial promotions; (v) guarantee commercial-free childhood settings; (vi) include cross-border media; and (vii) be evaluated, monitored and enforced.The draft principles were widely disseminated and 220 responses were received from professional and scientific associations, consumer bodies, industry bodies, health professionals and others. There was virtually universal agreement on the need to have a set of principles to guide action in this contentious area of marketing to children. Apart from industry opposition to the third principle calling for a statutory approach and several comments about the implementation challenges, there was strong support for each of the Sydney Principles. Feedback on two specific issues of contention related to the age range to which restrictions should apply (most nominating age 16 or 18 years) and the types of products to be included (31 % nominating all products, 24 % all food and beverages, and 45 % energy-dense, nutrient-poor foods and beverages).

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The problem of obesity was only accepted by the World Health Organization as of major public health importance in 1997 when the criteria for the specification of the metabolic syndrome were also being sought. Then the risk factor analyses of the determinants of global ill health at the start of the millennium showed that an excessive body mass index (BMI) above the optimum of 21 was one of the top 10 contributors. No analyses could be related to abdominal obesity because of the absence of systematic representative surveys of waist circumferences but the ill health attributable to excess weight included the risk factors specified in the metabolic syndrome and showed that the co-morbidities in Asia were far greater than those predicted from simply an excess weight. The recent proposed definition of the metabolic syndrome includes these different criteria specified on an ethnic basis but there is now a need to recognize that abdominal obesity is more common on the developing world and linked to childhood stunting and early deprivation. The importance of intrauterine and postnatal epigenetic and altered organ function needs to be recognized. Thus the co-morbidities associated with weight gain and the development of the metabolic syndrome dominate in the developing world where the majority of the population is proving more susceptible to the effects of weight gain than Caucasians now living in affluent societies. This therefore presents a major challenge in both research and public policy terms.