Our food habits reflect our self-respect

A bought breakfast on the way to school. Photo by VnExpress/Quynh Tran.

That food manufacturers sell products that seriously affect the health of consumers is a scandal that demands attention.

An article by a senior journalist, with plenty of experience in dealing with agricultural issues and food safety, hit home to me how processed food has become the plaything of businesses in the same way that the tobacco industry has been pursuing profit while determinedly playing down the serious health consequences of the use of its products. 

With food we are seeing another case of private interests gaining profit while society is left to bear the cost of health care and family upheaval. 

"Diet-related diseases pose a major risk for Covid-19. But the U.S. overlooks them." is the title of the article on this issue that Politico (US Edition) ran last month. The writer is Helena Bottemiller Evich. She uses as examples of countries making efforts to encourage public health, from the British prime minister pushing steps to foster among the public a healthier diet, to Mexico:

Some states in Mexico recently went as far as banning junk food sales to children — on top of the country’s existing taxes on sugary drinks and fast food. Chile was already deep in its own crackdown on unhealthy products, having imposed the first mandatory, national warning labels for foods with high levels of salt, sugar and fat along with a ban on marketing such foods to kids.

In the US, apart from Michelle Obama's campaign, there has been no sustained effort to block the trend of the mounting toll of obesity:

[This is so] even as researchers increasingly recognize that obesity is a disease that is driven not by lack of willpower, but a modern society and food system that’s almost perfectly designed to encourage the overeating of empty calories, along with more stress, less sleep and less daily exercise, setting millions on a path to poor health outcomes that is extremely difficult to break from. 

Marion Nestle, a New York University professor and author of  books on food policy, told Evich:

How do we stop it? With great difficulty and political will. If you’re going to do anything about it, you have to take on the food industry, which no one wants to do.

Evich points out that the narrative cultivated by the food industry is another of the viewpoints propogated by elite groups for their own self-interested purposes, whether to sell newspapers, advertising, or political party. This time it goes like this:

There’s also a deep-seated belief in America that obesity and other diet-related diseases are the result of personal choices and anything the government does to meddle with our diets is an assault on American liberty. That narrative is increasingly being challenged by science. 

Research shows that once someone has obesity, there are almost no dietary or exercise interventions that are successful at reversing the disease over the long term and many people lack access to more aggressive treatments like drugs and bariatric surgery. Humans, it turns out, are largely hardwired to keep weight on once they gain it. 

 The severity of the matter is made clear by these statistics:

More than 42 percent of American adults — about 100 million people — had obesity before the pandemic began, according to the Centers for Disease Control and Prevention. Nearly three-fourths of American adults are overweight or have obesity. Roughly one in five children now have obesity.

The costs associated with this epidemic, along with diabetes, hypertension, cardiovascular disease and cancer, all related to diet, are among the greatest threats to the fiscal future of the United States, not to mention the health, well-being and productivity of millions of people. 

Where America goes, the rest of the world follows. Vietnam, where I live, has seen its the rate of overweight and obese children more than double in the past 10 years. From VnExpress:

By 2020, for every 100 children between the ages of five and 19, 19 are either overweight or obese, a sharp increase compared to the figure of 8.5 in 2010, according to National Institute of Nutrition figures released in April.

The rate of overweight and obese children was 26.8 percent in urban areas, 18.3 percent in rural districts and 6.9 percent in mountainous regions.

The health ministry has set a target of controlling obesity and overweight rates among children under five years at 5 percent in rural areas and 10 percent in urban areas.

Rana Flowers, a representative of the United Nations Children's Fund (Unicef) in Vietnam, said the nation is facing an overweight and obesity burden. She warned of an increase in the consumption of soft drinks and fast food in schools across urban cities. 

In Vietnam, an increase in spending power has meant parents, often unaware of the likely result, give snacks of processed foods and soda drinks to their children because they are too busy to provide healthy meals. Also, it is true that "fat and healthy" is a pairing that is firmly in the traditional mindset of Vietnamese. 

In the US, says Evich,  Agriculture Secretary Tom Vilsack is the only political leader who expresses concern. She adds:

There’s a bipartisan bill to require Medicare to cover medications and more types of specialists to help treat obesity. The legislation has been introduced repeatedly since 2013, the year the American Medical Association formally recognized obesity as a disease, but has not gotten much traction even as major Covid aid bills have moved through Congress.

Fatima Cody Stanford, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School who is a key advocate for the bill, said the pandemic has sparked much more interest among lawmakers and staff, but it hasn’t yet translated into legislative action.

One of the biggest challenges, she said, is that most people still do not understand obesity is a complex disease, not something that can be blamed on or fixed by personal choices, and it often requires multidisciplinary treatment that many people do not have access to.

“We aren’t taught about obesity,” Stanford said, referring to a lack of education in medical schools. “If doctors don’t understand obesity, why would the general public? Why would policymakers?” 

The minimal action within the government bureaucracy is of this type, as per Evich:

The Food and Drug Administration has been working to update what foods can be labeled as “healthy” since 2018 and has yet to unveil a proposed rule, let alone finalize or enforce one. The agency this month released long-delayed voluntary sodium reduction goals for food-makers to try to nudge them to use less salt in their products over the next two years. The policy, which is voluntary, took the better part of a decade to develop amid some pushback from the food industry. 

The goal is to slowly dial down the sodium used across the American food supply so consumers' palates can adjust to eating less salt over time.

As well as the use of added salt and sugar in processed food, there is the matter of foods becoming less nutritious even as their bulk grows. Crops, too, have higher yields, but the gain is according to weight, not nutrional value.

The Rothamsted Research centre, a leading British non-profit agricultural institute, has used statistics that go back 175 years to show that here has been a profound change in nutritional value of  wheat in particular since the 1960s.

With soil conditions being a stable element, the outcome is major for a world trying to feed itself in a healthy fashion, as well as preventing basic hunger. Scientists at Rothamsted report this:

Wheat is an important source of minerals such as iron, zinc, copper and magnesium in the UK diet. If you look at the data, their concentrations remained stable between 1845 and the mid-1960s, but since then have decreased significantly - which coincided with the introduction of semi-dwarf, high-yielding wheat cultivars. The overall decrease in mineral content of between 20 and 30% is considerable.

One effect which may contribute to the decreased mineral contents of semi-dwarf wheats, and other high yielding modern crops is ‘yield dilution’. During the ‘green revolution’ of the 1960s, these newer wheat varieties were bred that had higher yields – the driver for this was to combat hunger across the rapidly expanding populations in the developing world. These varieties produce bigger and more grains, but that means an increased amount of starch - which dilutes other grain components including minerals.  We have shown that semi-dwarf wheats also contain less minerals even when grown under the same conditions side by side with the old varieties. This demonstrates that is clearly a genetic effect and not due to environmental factors.  

The genetic effect cited here has dramatic implications for the effort to feed the world in a healthy way, given that genetically modified crops of all kinds are grabbing market share all around the world. 

News from Reuters out today:

Brazil Thursday became the first country to allow imports of flour made with genetically modified wheat, though shipments of the new variety developed in Argentina are unlikely anytime soon due to opposition from Brazilian millers and global consumers.

The story gives insight into what is happening in GM agriculture:

The decision may spur a broader global discussion about genetically modified wheat as prices rise and concerns grow that more severe weather could threaten food security. Genetically modified soybeans and corn have long been accepted on global markets, but are primarily fed to livestock rather than humans.

To conclude, Evich points out that the obesity crisis already apparent in many countries is a complex matter:

The problem is driven by so many factors, including poverty and systemic inequality, lack of access to healthy foods, lack of time to cook, overall stress levels, trauma, poor sleep, a lack of access to safe walking paths and parks, to name just a few. 

However, care over our food is important to personal health and it is something we have control over to a large extent. Care in this direction is also important as to the non-wasteful use of a nation's resources through having to increase the public health budget. The population as a whole needs to get busy in demanding political action to push manufacturers to be proactive in  food safety and public health to sustain the common good.

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