Some Food is killing us!

Well the food industry is, which along with three other industries, is responsible for at least one third of all global preventative deaths – 19 million around the world every year; 34% of the 56 million total death. The others are: fossil fuels, alcohol and tobacco. The 19-million number does not include deaths caused by commercial practices (as opposed to products – 1.2 million), unhealthy diets overall (11 million), air pollution from fossil fuels (10 million) and alcohol (three million).

These numbers, and the mechanisms employed by the related industries to play down their adverse impacts, are presented in a compelling series of reports published in the Lancet under the title; Commercial determinants of health.[i]

The commercial practices that lead to these impacts range from legal to illegal, evident to subtle. They often overlap. At the same time, several types of practices used by commercial players harm us. The most obvious are marketing, reputation management, questioning scientific evidence, and financial manipulation.

Human health and wellbeing does not begin in clinics or hospitals any more than justice begins in law courts or peace starts on the battlefield. Rather, health starts with the conditions in which we are born and raised, and in schools, streets, workplaces, homes, markets, water sources, kitchens, the foods we eat and in the very air we breathe.

The area over which most of us have some sort of control is in what we choose to consume, whilst the food industry designs products with the bliss point that establishes their constant desire, and the drift from real food is underscored by societal, political and financial pressures. Industry pressurises government to dilute efforts to reduce harm and sustain profit, rather than coalescing around a paradigm of generating health as well as wealth.

Micro Policy Intervention

As individuals we hold limited power. As people with an educated voice we have capability to influence peoples’ choices, engage in positive health generational behaviour and ultimately choose to elect decision makers that reflect the need for change.

Do not feel impotent about the pervasive influence of the industries highlighted – change does happen, it can begin in clinic and at home. Recall that in the past century, social movements of workers, environmentalists, women, indigenous people, and others, have played a crucial role in limiting the harmful commercial determinants of health.

Dissecting the influence of industry on food availability and consumption ultimately boils down to human desire and choice – but these have consequential impacts. In the UK life expectancy is now falling, more so in economically and socially deprived areas, but also in the US and other developed countries.

Data from the Office for National Statistics show that men born in the poorest areas of the country are now expected to live almost 10 years less (73.5 years in the period 2018 to 2020) than those in the richest areas (83.2 years), and women eight years less (78.3 versus 86.3).

The figures also show that in the most deprived areas people are living more of their life in ill health. Girls born in the poorest areas of England live 19 years less in good health than those born in the wealthiest.[ii]

Ill health costs the country loss of income, diminished productivity and a declining tax base – yet despite the obvious impact on economics there is still little emphasis in the UK on state led limitations on adverse food choices, especially sugar. Imagine healthier communities; more productive working populations; less financial drag on individual, corporate and government budgets; stronger economic growth at a global scale being enhanced by changing behaviour on sugar consumption alone.

Macro Policy Intervention

Diabesity does damage in two ways: raising health-related spending, while lowering worker productivity due to illness. Diabetes, obesity and their complications result in long-term care costs, often including hospitalisation, a doubling down on high-cost medical care and lost work hours. Governments, employers and patients end up sharing the burden as detailed in a 2015 Morgan Stanley report (The Bitter Aftertaste of Sugar) – which like so many has been long forgotten.

Reflected by Henry Dimbleby in his post resignation essays and recent book ‘Ravenous’, he correctly identifies the impotence of the government and states – “The so-called Government Food Strategy is not a strategy at all. It is merely a handful of disparate policy ideas, many of them chosen because they are unlikely to raise much of a media storm”.

During his time at DEFRA he was commissioned to conduct an independent review of the food system, which resulted in recommendations to expand free school meals, impose a long-campaigned for salt and sugar tax, limit junk food advertising and introduce GP prescriptions for fruit and veg.

None of which have materialised because of the ‘free market ideology’ and concerns that the ‘nanny state’ will be seen to be restricting people’s choice to eat poorly.

In 1954 the tobacco industry paid to publish the “Frank Statement to Cigarette Smokers” in hundreds of U.S. newspapers. It stated that the public’s health was the industry’s concern above all others and promised a variety of good-faith changes. What followed were decades of deceit and actions that cost millions of lives.

Food is obviously different from tobacco, and the food industry differs from tobacco companies in important ways, but there are also significant similarities in the actions that these industries have taken in response to concern that their products cause harm. Because obesity is now a major global problem, the world cannot afford a repeat of the tobacco history, in which industry talks about the moral high ground but does not occupy it.[iii] It is following the same playbook of emphasising personal responsibility and paying scientists to deride the evidence of harm, paying millions in lobbying fees and using their power to propose that they are the bringers of joy, rather than long term loss of health.

Where does that leave us?

Decisions on what we eat seem simple, as Michael Pollen once stated ‘Eat Food Not Too Much. Mostly Plants’. Yet this message has a hard time competing against fast-food advertising where billions are spent targeting young people, and by extension, parents and caregivers.

The problem that arises from the industry targeting children is that, parents who are often short on money, time, the ability to make an effort, need somehow, to ensure that their children are eating healthily – including at school – are as susceptible perhaps as children are to the effects of advertising and marketing of unhealthy food.

This is further complicated by the availability of healthy food choices, requisite skills to cook and lack of understanding of the long term impacts of bad food choices.

Presenting facts to many people engaged in self destructive lifestyles has only limited impact – the change has to be government led, and not just in the UK. Politicians are loathe to engage in any changes that threaten their grip on power, but as the Morgan Stanley Report emphasises, diabetes alone will bankrupt all major economies unless it is brought under control.

References

[i] Commercial Determinants of Health March 23^rd 2023 The Lancet

[ii] Wise J. Life expectancy: Parts of England and Wales see “shocking” fall BMJ 2022; 377 :o1056

[iii] Brownell KD, Warner KE. The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q. 2009 Mar;87(1):259-94.