Unhealthy food and the way we choose and consume our food are fundamental factors affecting the growing problem of our expanding waistlines.
While most people ascribe personal willpower to lose weight as the solution to this problem, the fact is that there are many subconscious environmental and biological influences undermining our desire and determination to trim the fat.
The obesity problem has become so worrisome that some governments have been looking at methods to help their citizens cut off those kilos for a number of years now.
However, solutions are neither easy to come by, nor easy to implement when thought of.
Your choice, in context
Says University of Cambridge, United Kingdom, Centre for Diet and Physical Activity Research (Cedar) Dietary Behaviours and Public Health Interventions lead Prof Dr Martin White: “The food industry tends to always take the view that it is entirely up to individual choice.
“I think there is reasonably good evidence that yes, people choose, but people make their choices in a context.
“And obviously, context varies from place to place, household to household, family to family, country to country and so on.”
Cedar and UK Medical Research Council Epidemiology Unit director Prof Dr Nick Wareham agrees, saying: “I think there is a political ideology that likes to portray these things as lifestyle choices, as if people have total volition and they make choices to be active or inactive, and I’m not sure it is quite that simple.”
He gives the example of someone living in a dangerous neighbourhood where they might not be able to exercise outside their home without fearing for their safety.
“You’re affected by the environment, and therefore, changing that environment is the key, rather than just providing more and more guilt to individuals to be more physically active, saying it’s up to them and that it’s a personal choice.”
Prof White adds: “Our argument would be that yes, you can – if you have the knowledge, skills, resources and motivation – get a healthy diet and feed yourself that diet.
“But people are subjected a lot to pressures, and apart from the advertising in the media, which tends to push people to buy things that are less healthy, I think the economic constraints are really important. These foods that are high in fats, salt and sugar tend to be cheaper.”
Supermarket promotions also tend to be more for less healthy foods, he says, which adds to the attraction of buying such foods.
“There’s another thing that the industry says often, which is that they just satisfy consumer demand.
“I personally do believe that, but I think that’s not the whole story; I think that industry also generates consumer demand.
“I think that it’s quite clear, looking back over history, that the food industry has helped create the demand for processed food over a long period of time,” he says.
Managing the unhealthy food problem is a tricky area for a number of reasons, according to Prof White.
“One is the political dimension. Food industries are important for governments because they help generate GDP (gross domestic product) and profits, which sustain economies, and they employ a lot of people.
“From a political perspective, whatever the public health goal of the government, they generally don’t want to seem to be criticising important bits of their economy like the food industry.
“There’s a kind of conflict of interest there, if you like, between the goals of public health and the goals of a healthy economy.”
He adds: “There is the dilemma. Obviously, when you stop to think about it, one of the key ways you can change what people eat is by regulating food, but governments won’t regulate because it would damage their economies.”
However, Prof White also acknowledges that a healthy economy is good for public health as the richer a country is, the better the health of its population tends to be.
Cedar assistant director Prof Dr Simon Griffin agrees that governments seem reluctant to take on the challenge of protecting us against unhealthy food intake.
“For communicable diseases, the government has a very interventionist policy; for non-communicable diseases, rather less.
“And the problem is, at the moment, many administrations are more concerned about free choice and lack of interference, but that lack of interference doesn’t apply to invading other people’s country (for example), which seems to be a rather strong interventionist approach.
“So I think it is interesting where administrations choose to intervene and where they don’t.”
He notes that another reason governments are reluctant to intervene in our food choices is the powerful influence of the food industry, which usually has lobbyists close to governments.
“But I think it is possible for administrations to intervene to alter choices; that doesn’t mean that you ban people from eating things, it means that you alter the weighting.
“And when administrations are brave and do things, it’s remarkable how there is then a lack of adverse data,” he says, referring to the compulsory wearing of seatbelts in cars and the banning of smoking in public places.
Comparing with tobacco
While there have been comparisons made between the war against obesity and the war against tobacco, there are also important differences to consider.
Says Prof White: “It’s different from tobacco and alcohol. For starters, the behaviour is more complicated.
“Tobacco is pretty much a single product. Alcohol is a mix of products, but one agent within that product that is the problem – the alcohol.
“Whereas food is more complicated with so much variety. You can take one food and say this is very good because it is high in vitamins, but at the same time, you can say this is very bad because it is high in saturated fat or whatever.
“An individual food can be both good and bad for different reasons, which makes it extremely complicated.”
The question, he says, is how to ensure that the population, on average, eats a diet that is good for their health, and at the same time, not bad for their health.
Prof Wareham agrees, saying: “There are discussions about taxing specific foodstuffs, but the problem is that there are few examples of bad foods – there are bad diets.
“Taxing cigarettes is easy because it is one thing and it is uniformly bad, but the analogy with foodstuff is quite tricky and taxing fat or sugar is quite difficult.
“I think the example that has been talked about is sugar-sweetened beverages, and that may or may not work; and I don’t mean work in terms of altering consumption, I mean work in terms of being politically acceptable.
“That may be a more realistic proposition because you don’t need to drink sugar-sweetened beverages, they have no nutritional value, so the likelihood for adverse outcomes (by not drinking them) are limited.
“So I think that is an area that should be explored.”
He notes, however, that this type of measure will require a certain period of time to first, promote and get the public used to the idea, then, to gain both political and public acceptance.
Prof White is also wary about public health stakeholders developing an adversarial relationship with the food industry, as has happened with the tobacco industry.
“You can see that all the evidence is beginning to stack up to suggest that there are some quite significant problems with the food industry. This kind of adversarial relationship may start to emerge and develop.
“And I think that’s problematic because we can’t say, let’s get rid of food, as we said with tobacco. We all have to eat.
“Therefore, we have to have a situation where we can work out a way to discuss, agree and find a way forward with healthier food and health for the future. And that has to be done together with the food industry, not in a kind of adversarial way,” he says.
“I think our overall conclusion at the moment – and there’s plenty of evidence we still need to collect – is that the way the food industry is set up at the moment, it seems to be putting profit before public health.
“I would not in any way argue the reasons for that – they have a job to do, which is to satisfy their shareholders; if the shareholders say the only thing we are interested in is the bottomline, then of course managers at every level will do their utmost to maximise profit.
“So, it does raise an interesting conundrum: what can you do to change the business model, to persuade the 10 or so big corporations that own most of the food industry?
“How can you persuade them that they need to change their business model such that health and the environment, which are the two kind of moral, philosophical, political things that people seem to be concerned about, have an equal weight to profit?
“And I don’t think we have an answer to that.”
Tan Shiow Chin was a 2015 Khazanah-Wolfson Press Fellow at Wolfson College, University of Cambridge. This is the last article of a series from her fellowship project on the subconscious cues that influence us to eat more and unhealthily.