Katharine Jenner of Action on Salt and Sugar objects to the political argument that 'cheap food'; will solve the twin problems of food poverty and ill health.
As a nutritionist, it’s not often I get to quote the late Terry Pratchett, but at a time when public health nutrition is high on the political agenda, I couldn’t miss the opportunity. So here he is on Captain Vimes, who earned just 38 dollars a month:
"A really good pair of leather boots cost fifty dollars. But an affordable pair of boots, which were sort of OK for a season or two and then leaked like hell when the cardboard gave out, cost about ten dollars. Those were the kind of boots Vimes always bought, and wore until the soles were so thin that he could tell where he was in Ankh-Morpork on a foggy night by the feel of the cobbles. But the thing was that good boots lasted for years and years. A man who could afford fifty dollars had a pair of boots that'd still be keeping his feet dry in ten years' time, while the poor man who could only afford cheap boots would have spent a hundred dollars on boots in the same time and would still have wet feet. This was the Captain Samuel Vimes 'Boots' theory of socioeconomic unfairness."
Author Terry Pratchett, Men at Arms: The Play
Now, what has this to do with nutrition? Well, try replacing ‘boots’ with ‘food’ and ‘wet feet’ with 'bad diet’. (In fact, try it with anything – housing, transport, culture and education – and it holds up.) My point is: eating well is an investment, and those who can’t afford it pay the price with their health.
Cheap foods tend to be satisfying but unhealthy, think chips, chocolate, cola, fried chicken and chow mein. An unhealthy diet of salty, sugar, fatty processed foods leads to obesity, high blood pressure and high cholesterol, and these are now known to lead to more problems than we could ever have imagined: type 2 diabetes, which can and does lead to eye problems and even amputation because it destroys your nerves; myriad diseases of the heart and blood vessels including heart attacks and strokes with devastating consequences; a variety of musculoskeletal problems including painful knees and lower back which can make just walking to shops misery, broken bones, and damaged cartilage; fatty liver; and tooth decay, the most common reason for a child to be admitted to hospital.
All this before you even consider the invisible damage to a person’s mental health. Children who are overweight or obese have lower self-esteem, sometimes withdraw socially, and may even be bullied because of their weight. And don’t even get me started on the environmental costs of packaging, intensive food production and use of antibiotics, poor animal welfare and the tremendous waste in the food production lifecycle.
Years of austerity and disregard of food quality as a high-priority public health and political issue has seen higher living and housing costs, increased unemployment, long working hours and zero-hour contracts. Together these are having terrible consequences for the diets of those on low incomes, both for adults and children. Many breakfast clubs that provided free breakfasts have closed or are under-funded, and far too many children are facing holiday hunger – where they’re not receiving free school meals during the holidays and their parents don’t have the money to buy the extra food needed. The difficulties are apparent in the increase in food banks, and these meet only the most basic nutritional needs for a temporary period of crisis and cannot be a long-term solution.
The Outgoing Chief Medical Officer, Dame Sally Davies, reminded us that to meet official recommendations for a healthy and disease-busting diet, those on the lowest incomes would have to spend 50–60% of their disposable income on food alone [footnote 1].
After that, who would be able to afford decent boots?
Poorer families are affected disproportionately by austerity measures, and the health gap between rich and poor has widened in the last ten years. Projections suggest that if current trends continue, one in three children in the most deprived areas will be obese by 2030 [footnote 2]. Parents living without food security want their meals to be as filling as possible, this means sacrificing fresh fruit and vegetables for processed foods such as ready meals and takeaways (deprived communities have a higher density of fast food outlets), even if it risks malnourishment and long-term health problems. These costs have knock-on consequences for everyone’s pockets: the management consultancy firm McKinsey [footnote 3] estimated that obesity costs the UK 3% of GDP, this was around £60 billion in 2018, with large costs (around £5 billion) being borne by business in terms of sickness absence and reduced productivity.
The decisions made by policy-makers, investors and food businesses affect health prospects for all of us, but for people on a low income in particular. Over recent weeks, Sustain has published a roundup of the promises being made by the leading political parties on a range of the themes relevant to food, farming and fishing. I took special interest in those on ending hunger and promoting children’s health through good food. I was therefore alarmed to read Sustain’s summary of the situation:
"There are some startling gaps, both in the detail and ambition. For example, four leading parties (Labour, Lib Dems, the Green Party and the SNP) acknowledge the shocking rise in referrals to emergency food banks. These parties have committed to establishing everyone's right to food in UK law. Yet worryingly, the Conservative Party makes no mention either of the scandal of food banks or the food poverty that affects millions of our fellow citizens; beyond confirming the party's existing commitment to some children receiving free school meals."
I was also concerned to read the Conservative manifesto saying:
“We will tackle the underlying causes of increases in NHS demand, for example via a long-term strategy for empowering people with lifestyle-related conditions such as obesity to live healthier lives, as well as tackling childhood obesity, heart disease and diabetes.”
Problems start before a person has become obese or developed heart disease, caused by the choices that are available to them. This has been a central tenet of public health nutrition for many years. Obesity is not a ‘lifestyle condition’ as this message suggests and becoming obese is not a lifestyle choice. Half the population has not chosen to become overweight or obese, and we do not need to be ‘empowered’ to live healthier lives, as if half the population just don’t have the confidence to choose quinoa over Quavers in Tesco.
The problem is not with the individuals, the problem is the unhealthy nature of the food that’s affordable and that we’re constantly surrounded by and coerced into buying. The Conservative manifesto seems to address interventions only for the individuals who are already unwell. Labour and the Lib Dems mention the need for public health policies that affect everyone such as restrictions on marketing and extending the soft drinks industry levy to sugary, milky drinks (noting that the sugary drinks tax was introduced under the Conservative party as a tax to manufacturers on drinks that contain a lot of sugar, encouraging them to make their products healthier). This is what we need more of and what we are campaigning for.
This is a matter that politicians must take more seriously. To truly address the underlying causes of obesity and poor health, the next Government must step up and regulate the environment we live in, not just encourage the people who are already suffering the consequences to make better choices. This means looking at a lot of uncomfortable truths. It means tackling Big Food and Drink – the big business who make a profit from selling cheap, poor quality food and drink, full of salt, fat and sugar. It means looking at the millions and millions these businesses spend on educating us into adopting the unhealthiest behaviors through clever advertising and irresistible promotions. It means ensuring that everyone has the means to buy healthy food, or be provided healthy food by the institutions that serve them. It means taking on the rise of the cheap takeaway, convenience food, and endless special offers and discounts on processed foods. It means helping shift our culture back to the enjoyment of cooking and sharing fresh, delicious and healthy meals.
It means making 50 dollar boots available to everyone, so we can all have dry feet.
Find out more...
Read what the main political parties have said about food, farming and fishing in their 2019 election manifestos: and Sustain’s commentary
Find out more about the commitment by several UK political parties to the Right to Food, and the current National Food Strategy process
Read Sustain’s opinion on ‘cheap’ food imports
Take a look at Sustain’s guide for Councils on Hot Food Takeaways: Planning a route to healthier communities
Find out more about Sustain’s work on Sugar Smart and the Children’s Food Campaign
- Scarborough P, Kaur A, Cobiac L, Owens P, Parlesak A, Sweeney K, et al. Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines. BMJ Open. 2016;6: e013182. doi:10.1136/bmjopen-2016-013182
- The Broken Plate, Food Foundation
- McKinsey Global Institute. Overcoming obesity: An initial economic analysis. McKinsey & Company, 2014
5 Dec 2019
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Children's Food Campaign: Better food and food teaching for children in schools, and protection of children from junk food marketing are the aims of Sustain's high-profile Children's Food Campaign. We also want clear food labelling that can be understood by everyone, including children.
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Katharine Jenner is Campaign Director of Action on Salt and Sugar. She is a Registered Public Health Nutritionist and the Campaign Director of the award-winning salt reduction charity Action on Salt (CASH), its international arm World Action on Salt and Health (WASH) and Action on Sugar, which aims to reduce unnecessary sugars in the population's diet. She also runs the only charity dedicated to lowering the nation's blood pressure, Blood Pressure UK and is a Visiting Lecturer in Public Health Nutrition at several UK Universities. Katharine worked as a media strategist for several years and as such is very interested in developing innovative approaches to communicating public health. Katharine is a Sustain Trustee and chairs the Sugar Smart working party.
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