Joining Forces to Tackle Obesity, 21-22 January 2002

 

Transcript : Preventing Obesity Through Dietary Strategies

 

Speakers

Prof. Tim Lang
Professor of Food Policy, Thames Valley University

 

DR WILLIAM DIETZ: Our next speaker is Professor Tim Lang, who is Professor of Food Policy at Thames Valley University. Tim.

PROF TIM LANG: Thank you. Lots of shuffling so we’ve all got the handout. I’m going to whiz through this very fast, but firstly I want to thank the organisers and you, and I’m going to follow on exactly from Susan’s ending there. I too think there’s a great opportunity. I think we have the evidence, the issues, what action are we going to take and I want to, as it were, put some circles round her last figure or graphic and say I think we’ve got to address culture, history and what sort of society we are. I’m pressing a button and nothing’s happening. I’m obviously pressing the wrong one. You can read that.

 

Now basically what’s wrong with current policies? They’re fragmented. They’re historically loaded. To understand the British diet you’ve got to understand industrialisation, why we were separated from the land. You’ve got to understand where immigrant populations coming in from real food cultures are giving counter forces, all of that. That’s what I mean by history and culture. We’ve basically got inappropriate food supply delivering inappropriate and undesirable health outcomes. We’ve got an industry, a structure, a food supply chain, which is delivering ill health. Not wilfully, but it is objectively.

 

Now I’m going to give you a very instant run through, the last 50 years basically of food policy has looked something like that. The previous 150 years or arguably 100 years have been an experiment. Built on the backs of colonialism. Britain produced goods, sold them and got fed by its colonies, broadly. Second World War, First World War, Boer War, blew that apart, all of the great thinkers in the 1930s and 1940s, gave us that. Said if we invest capital with good science we’ll increase production, because the main problem was underproduction, because it’d all come from the colonies. As long as we distribute it right, because they had major evidence of poverty, we’ll deliver health. Now there were some problems with that. It assumed that the problems of health were basically to do with under consumption, it assumed the main problems was underproduction at supply level, it assumed contamination, adulteration and so on could be dealt with. And the evidence started piling up it wasn’t working - we had the same boxes with a new box added. By about the 1960s and 1970s the build-up of what probably brings most of us here, health education, which was essentially saying to people, sort yourself out, eat properly. It’s not worked. Or we wouldn’t be there.

 

What actually we’re in now is the end of a 50-year attempt to have some sort of sane food policy. It’s not worked in the past. We’ve got to go back to the beginning. The old model is in ruins.

 

Some of us think a new model - it doesn’t matter how you draw it, this is just one version - is going to look something like this. If you want to build a building under which we shelter and have health, health is at the top, you’re going to have to deal with so many variables, those are the columns, and take for granted certain things that are actually fundamental - air, water, climate, soil, energy. Crucial ecological factors transformed by societies. It’s what we’re calling the ecological public health model. The new model basically is assuming we’ve got to alter an immense amount. We’ve got to think whole food supply systems. We’ve got to think complexity, multi-factorial. We’ve got to think life cycle analysis. I’m not just meaning "humans". I’m meaning our waste - not just our excrement but the packaging that comes around our food, where’s it going? It’s a waste.

 

In other words we’re arguing a much more complex vision of what public health is, which requires new science and new visions for public health. So in that sense, the food crisis that we in Britain particularly have had, but other countries too, all the intensive Western models of food supply chains are in not dissimilar messes to us. They have not dissimilar patterns of disease emerging. This is not a British phenomenon but Britain as ever is astonishingly interesting because we were the first industrial nation, because we owned one third of the world, because we had the arrogance to treat our culture and our soil in the way that we did. So this is a big picture we’re addressing, it’s not just the tweak of a lever here and a lever there that’s got to be addressed, it’s a whole food culture. I think we have opportunities at lots of different levels and the good news is all of these are emerging.

 

At European level there are initiatives going on, the Common Agricultural Policy’s in crisis. Take it from me it’s always been in crisis, there’s nothing new about that, it’s not set in concrete, it’s always been moving. But there are some very interesting initiatives emerging, new institutions. The World Health Organisation, the European region working with the European Union, things that haven’t happened in the past. At the national level, I, like everyone here, think the NAL report is a landmark report. Fantastic, it really is thoroughly good. But where’s its featuring in the NHS plan, we’ve still basically got a sickness ministry and plan with a bit of bolt-on public health. Good, but actually we need the ecological public health vision emerging. It’s going to take a long time to do it, it’s taken us 50, arguably 200 years to get in the mess, it’s probably going to take us 20 or at least 30 years to get out of it.

 

At the local level there are all sorts of exciting and interesting things going on. Now all of this we know and I can’t believe, and I do apologise, I’ve not been here until today, I cannot believe you haven’t covered these things, the cost of diet related ill health. It’s immense. At the European level 1.5 million deaths, premature due to cardiovascular disease. The huge direct cost, not indirect costs in suffering, I speak as someone whose father dropped dead of a heart attack, it was a very good death actually - he just keeled over dead. But that’s not what always happens. There’s an immense investment in care that goes in, years of working lives lost and so on, the psychological suffering of caring, there are six million carers, people, I’m one, I’m looking after an 89 year old mother. These are all sorts of extraordinary complicated issues that we’ve got to include in our audit of what we mean by the costs of obesity.

The one particularly important issue for me is the environmental dimension of that. Consumers basically have got cheaper food and are not paying the full costs of it. We don’t pay for the waste that goes from the packaging in our food or from the distortions to the market. We don’t pay for the grossly energy wasteful systems of transportation. We’re not paying for climate change, that’s going to alter how we grow our food. We’re not paying for the methods of production. There’s been a revolution in the last 50 years, arguably 70 years, new products, new processes, new distributions, new globalisation. Will Hutton was talking about that this morning. The food, basically we started globalising 1,000 years ago. The so-called Columbian exchange of 500 years ago around Europe, the old world annexed the new world, began a food exchange. Tomatoes, potatoes, all sorts of things that we eat routinely. There’s nothing new, but the last 50 years had intensified that in an astonishing manner. Obesity from this perspective is merely a by-product of this food revolution and inappropriate use of the physiological legacy that we have from evolution, our capacity to store fat. The fact that we’re changing our transport, we use non-renewable resources instead of food to go and get our food - it’s negative equity in financial terms. The mass psychology of it, the supply, trades aren’t meeting demands, and the culture is being shaped by branding. The whole drivers of the contemporary food soup are frankly not taking health seriously. Now anyone from the food industry would immediately go hysterical and say, "That’s complete nonsense, health is our number one priority" but what they mean by health is safety. The manufacturer of well-known Mars Bars doesn’t want you or I to die with one in our mouths while we’re eating it. That’s what they’re bothered about and if I was Mars Bars, and I used to work for Mars Bars, sweeping the floors when I was 18, I too would have that concern.

 

But the problem of the subject that we’re talking about today is long term. It doesn’t work like that. You don’t die with that fat object in your mouth. It doesn’t work like that. So we’ve got the wrong drivers in the food, this highly efficient, stunningly brilliant, stunningly creative food system, it’s giving the wrong drivers, and here is just one. I’ve been looking through a report that we’re launching on Thursday at the figures on advertising. Here they are. Nearly, well over one half of a billion pounds on food - another nearly third of a billion on drink. It’s a very big bill. Now when we look at where it’s going, it’s going on this: dairy products, £55 million, fruit and vegetables, £3.5 million. This is a distortion of market methods. We’re said to live in a market, I’m asking you to say, "What sort of market do we want to have?" I don’t want this. Do you?

 

Children’s attitudes, approaches, whole behaviour has been warped, I completely agree with what Susan has said. We’ve had these sort of figures. Susan referred to cooking. It’s ludicrous - it’s completely ludicrous. I mean I can’t work a video machine, I don’t even have a telly, we threw ours away 20 years ago when the kids left home. It was marvellous. So we get the grandchildren to work the video for us. But actually if this is our notion of a skill, God help us. This is a deskilled dependent food culture, being created before our eyes - it’s your children. Look at it.

 

If we look at retailing, Wendy’s going to be talking about this I’m sure, I’ll give a slightly different angle. Over the last 100 years, these are the figures. I’d like a big historic sweep. Over the last 100 years you’ve seen the collapse of small shops. You’ll be saying, "Who cares? I love Sainsbury’s, I love the co-op, I love Tesco’s". Marvellous. Actually what’s happening is you’re all going to the warehouse, so you’re using a car driven on non-renewable resources to get there instead of food as your fuel. That’s what’s happening. And we’re all doing it. That collapse of the blue there is the collapse of local shopping. It’s also 60,000 shops - that’s general shops - close every week. Look at that collapse in independent grocers. Why do I pick out grocers? Because it’s fruit and vegetables. When I moved to London from the sublimely wonderful north of England, I moved back 30 years. There were three greengrocers within 500 yards of our house where my Mum had gone.

 

Hyper-marketisation is the name of the game. It’s dragging us out of our towns, it’s dragging us into our cars - it’s hiking in inequalities. The excellent Joseph Rowntree Foundation-funded Michael Carley study, I was on the advisory board of it, but he did it, they did it, just look at these figures. The whole structure of retailing is built around the car. Where’s the ecological sense in that? Think obesity and we’ve got a very powerful argument to start pressurising government ministers. We stop them talking platitudes because in 30 years time this will not add up. I don’t think it adds up now. I can’t believe you do either. Look at how we get to the shops. Look at the rapidity of the change. The collapse of walking. You can say, "Great, 30% are still walking". But it’s gone down from over 40% in 12 years. I now, actually, I’m sounding like a real po-faced purist idiot, which I’m not. I may be an idiot, but I’m not po-faced. But we got rid of our car. And the reason we got rid of our car in our household, well the kids had gone so that was easy, was because one of my 500 sisters-in-law who had young kids got rid of her car and she lives in a hilly town and bikes seven miles to work. She’s like a sylph and she’s 51 and last year she and her partner biked all the way from their house in Brighton to Croatia. And then the thought of me doing that fills me with total gloom but the astonishing thing is you can do it even if you’re my age in the middle fifties. So we gave away our car so we now bike to shop and it’s ludicrous, you see me as my boss said to me, not a pretty sight, looking like a bag lady every Saturday with sort of baskets hanging from my little folding bike. We look complete fruitcakes. I don’t care any more.

 

Look at the change in the mode of shopping. Just look at it. You’ve got these figures so I’m whizzing through them. Look at the class inequalities. It’s structured. This is a society and yet some of the rationalisations we use, and say, "Oh, Hyper Mart is so marvellous, marvellous darling, I can go and do my shopping in one shop, it’s fantastic’. Actually the evidence is you’re spending more time shopping, because you’re having to go so far to get to the shop and you’re having to take your kids and the roads aren’t safe to let your kids out so they’re not playing, so they’re in front of so many Playstations. It’s a privatisation atomisation of a society. I sound like a radical critic, I am.

 

Look at the food miles. Look at the distance that the food is going on, look at the energy costs. It’s ludicrous; our food doesn’t give us the energy that we spend on getting the food to us. This is not a sustainable society that we live in. We live in this beautiful climate for fruit growing. You think it’s awful and all want to go to the Mediterranean, so do I. But it’s fabulous for fruit growing, for soft fruit, for top fruit. Four out of five pears are being imported. These figures are awesome. Just look at them.

 

And here’s the hard economics. This is what I’d like the National Audit Office legacy to really get to grips with. If we all eat double or 50% increase our fruit and vegetable consumption, all it means is more imports. Because of the negative food trade gap that we’ve got, which is over £9 million a year, fruit and vegetables account for 40% of it. So when we say, eat more fruit and vegetables, you’re adding an ecological burden because it’s coming long distance. Asparagus from Spain, where they’re draining their aquifers so we’ve got three months a year of asparagus for our dinner parties when we can grow it in Worcestershire and God wees on it. It’s called rain. I mean this is loopy. The hard business is this, this trade business.

 

Just look at the figures on energy use. What a ludicrous society we live in. The energy auditing has to come in to the new public health perspective. It’s not just a matter of individual choice. This is a cultural shift that we’re having to make. Now what are the policy options? We can carry on with this individualised model of saying I, Tim Lang, can choose, Caroline Mulvihill can choose. Phil James can choose, Wendy can choose, Susan can choose. But we know what’s happening - our society’s fragmenting and almost all of the health indicators. Not entirely, there’s some good news as well. But obesity is the bad news.

 

We can go for this policy package, what I call option one. Allow the food industry to carry on investing in branding like it’s going out of fashion. We’re now branding an apple for God’s sake, putting little stickers on to say this is ‘x’ brand of an apple. You can have that lot. The ultimate that we’re going towards now, very fast indeed, is the bottom one, genetic screening. That’s policy option package one.

Or we can have the population in health approach, which is what I prefer and I would suspect many of you would prefer. In which case unless we tackle all those columns, remember that figure I put up, the columns, the multiplicity of columns, if we don’t tackle them all, in a co-ordinated way, the roof under which we shelter - health - starts listing, tilting, crumbling. All the columns are needed or the roof falls down. We have to build exercise into daily life. Ken will be talking about that later. We’ve got to reclaim civic space. We’ve got to make it safe for people to play outside, that means getting rid of cars, chaining cars up because they’re chaining us up. We’ve got to teach kids to cook, we’ve got to re-localise shopping. It’s not going to happen overnight, but we’ve got to do it. Not just the little niche market of Sainsbury’s local, or a token one by the petrol station. That’s what’s happening in my area now. The petrol station is becoming something where the busy, frustrated consumer commuter can stop off, get their high fat snacks to eat while they’re motoring at four miles an hour in the BMW, and pick up the shopping for that night ready to make. And this is a cultural phenomenon. I’m parodying it, as you can tell. But it’s not far off.

 

The truth of the matter is the current trends in the wrong direction. Neither the food is going to the people nor are the people going to the food using food as fuel, but both the food and the people are travelling further in unsustainable ways. Food is using more energy than it gives, our lifestyles are structured so that we’re privatised - we’re making individual choices. One of the crazy things I do and my partner does by shopping on our bikes is we take our lives into our own hands. Struggling with all the BMWs and four-wheel-drives. Struggling to crush us out of the way. Go to Copenhagen and you see a different vision for transport and they’re not satisfied with it, as people will tell you.

 

The current patterns took so long to develop but we do now I think have a glimmer of an alternative policy package and frankly this is what I want to end on. That will not happen however much evidence we have, and I think we have a lot of evidence, for the second vision, the population, the ecological public health approach. I think the evidence is there in bucket loads. What we don’t have is a political will. Now why haven’t we got that? Because there isn’t a co-ordinated organised movement arguing for it and that actually is what this conference ought to be about and I think is about. Thank you.