Education, legislation and allegations of the nanny state

As we emerged bleary eyed from the cocoon of Christmas, desperately trying to fit back into our jeans, we were met with a flurry of health-related headlines that made for dismal reading.

One in four UK adults will be obese by 2035, according to Cancer Research UK, and sugar consumption leads to 28% of children having tooth decay by their fifth birthday, said NHS England.

Our love affair with alcohol means liver disease is the only cause of death still increasing year-on-year, and diabetes type 2 diagnoses have increased by almost 60% in the last 10 years as a result of expanding waistlines.

It’s a stark picture: we are eating and drinking ourselves into early graves. But must of us had all spent the last few weeks eating our way through family-sized packs of Maltesers and drinking our own bodyweight in Baileys.

At the same time, there is a burgeoning market in so-called super foods, fad diets and miracle cures. Expensive belts that give you a six-pack while you watch the telly and pricy pills that melt the fat while you chow down on your chips.

But what can we really do to make a difference to our lives? Who can we believe and what should we invest our time, and money, in?


Alcohol and liver disease

Last week’s change to recommended drinking limits said there was no “safe” level of alcohol consumption and knocked seven units off the recommended weekly maximum for men.

They were, predictably, met with cries of “nanny state”. The attack on civil liberties being described by some commentators made it sound as though we were all to be fitted with a personal bomb that would explode if we happened to drink one too many glasses of Rioja at any given time.

Nigel Farage even called for us all to “protest” the advice. I was confused – what were we supposed to be protesting against? What should I write on my banner? “Down with science”?

Guidelines based on a thorough examination of all the available evidence, are exactly that: guidelines. They give us all the opportunity to educate ourselves on the risks and make informed decisions about our own health.

And it’s an approach we could all benefit from employing more, not less, as fact-based advice gets lost in the twin vortex of fads and ads – particularly when we remember that public health marketing budgets are minuscule when compared to the funds and resources the food and drinks industry have at their disposal.


Sugar and obesity

NHS England’s latest Change4Life campaign, #SugarSmart includes an app that tells you how much sugar is “lurking” in your favourite foods. A decades-long obsession with cutting fat has simply led to companies replacing it with sugar and marketing the resulting products as healthy.

Evidence on the dangers of sugar has been mounting for years, and this new campaign tells us the average five-year-old consumes their own body weight in sugar over a year. This is scary stuff.

Studies have suggested the white stuff is addictive, with MRI scans showing sugar consumption lights up the same pleasure-receiving regions of the brain as cocaine and heroin.


Big business

In November, an inquiry by the Parliamentary Health Select Committee resulted in it backing calls for a “sugar tax” but the British Soft Drinks Association (BSDA) rejected the proposal out of hand.

In a press statement, Gavin Partingtion, BSDA director general, said there was “no evidence” that such a move would have an impact on obesity and called the inquiry a “PR campaign by the health lobby”.

Until there is a public demand for it, it’s hard to see how industry can be persuaded to accept such a measure.

Following the launch of #SugarSmart, Gorkana, a respected PR website that bills itself as an “indispensible resource for media intelligence”, published a piece advising food and drink brands to move with public opinion.

“The zeitgeist at the moment is the commentary around sugar intake and its potential negative effect, so obviously this has to have a bearing on food and drink brands and the worst thing you could do is ignore the context in your media campaign,” said Liam Keogh, the director of Palm PR.

Does this insight into the marketing mind show it’s down to us to demand better? Does education take us to a tipping point at which we are more

willing to accept legislative change?

But who is responsible for making sure we know the difference between evidence-based health advice and pie in the sky fads and rip-offs; that there is no replacement for a balanced diet and exercise?

A sugar tax is one of a raft of measures set out in Tipping the Scales: Why Preventing Obesity Makes Economic Sense, a new report from Cancer Research UK, which says obesity could lead to around 700,000 new cases of cancer over the next two decades.

Other recommendations include restricting the marketing of junk food to children and clear and consistent food labelling, but we can’t rely on big business to look after the nation’s health.

The industry only exists to make profits. As the Gorkana article shows, consumers need to demand change and we will only do that if we know our stuff.


Education vs. legislation

Report after report has shown that a minimum unit pricing (MUP) on alcohol sales would reduce deaths from liver disease yet the policy has been fiercely resisted.

Research from the University of Sheffield estimated a MUP of 50p would result in alcohol-related deaths falling by about 60 cases in the first year and 318 by year ten. It would see hospital admissions drop by 1,600 in year one, rising to 6,500 by year 10, and save the UK £942m in a decade by reducing crime and health spending.

The Government dropped its commitment to instating MUP in England in 2014, and in Scotland, where a bill to set the 50p minimum was passed in 2012, it is still yet to be implemented thanks to a protracted legal challenge by the Scottish Whiskey Association.

Over the Christmas holidays, while we were nursing our festive tipples, it emerged the European Court had concluded MUP would be illegal if the same effect could be achieved via taxation.

We can weigh up the relative benefits of policy vs. public health education all we like, but the truth is the two must be used together.

Banning smoking in public places, for example, has been credited with record numbers of people quitting – but would that have happened without the proceeding years of education on the catastrophic consequences of the habit?

Education that leads the consumer to demand change, and become more willing to accept legislation changes.



Before I started working in this industry, I didn’t think about this stuff. I smoked, I drank far too much and I ate whatever I felt like. Exercise was a dirty word.

As I mark three years in this world of, evidence and medical conferences it’s a different story. I gave up cigarettes two years ago, I go the gym three or four times a week and I look at what is in the food I eat. I am still overweight and, in all honesty, I still drink too much. But I am a third of the way into my second annual Dry January, and I am eating my five a day.

I am in a very privileged position: my job means I have daily access to the experts, studies and papers that make up our collective body of knowledge. I am only a sample size of one, and there was no control group, but in my opinion, education works.

I would argue that organisations like NHS England have a duty to present us with the facts and it’s up to us to decide what we will do with them. We all deserve the opportunity to know enough to make our own decisions: that is not the same as being told what to do.

Published on: January 15, 2016