Stephen Leeder: Food folly

ONE of at least 11 patron saints of food, St Anthony the Abbott, a fourth century ascetic, is the patron saint of pig butchers and the saint to turn to if you need your bacon blessed. A hermit for 20 years, he healed people with a mixture of miracles and pig fat.

With so close a connection between food and saints, it is no surprise that the celebration of All Saints Day and the preceding All Hallows Eve, or Halloween, involves feasting.

This year, marauding bands of youngsters, like extras from a Harry Potter movie, will go door-to-door extorting treats lest they inflict a trick (or threat, as the word once meant). Although an astonishing array of healthy and unhealthy foods were traditionally associated with Halloween, it is now all about lollies, as the authors of a Perspectives article lament in the latest issue of the MJA.

The relentless transition from unprocessed basic foods to refined and processed products has occurred through a massive and highly articulated industry connecting paddock and plate. Mechanised farming and the impressive gains of agricultural husbandry have brought huge global benefits.

Wastage has fallen dramatically — in comparison, up to 50% of produce in India is still wasted because the supply chain is primitive, unrefrigerated and chaotic (Institution of Mechanical Engineers, Global food: waste not, want not, 2013 ).

Yet in the midst of this progress there are problems, obesity being the most obvious and important. It is impossible for food consumers to make healthy choices if they are not informed about the content of food, and labelling of products is crucial.

A review of food labelling in Australia and New Zealand, chaired by former federal health minister Neal Blewett, released its report, Labelling logic in 2011. The response from the Legislative and Governance Forum on Food Regulation, an intergovernmental committee, acknowledged the problem of obesity, noting that “the chronic disease burden caused by poor diet is the largest cause of ill health in the community. It has a greater impact than smoking, physical inactivity and alcohol misuse … The annual economic costs of obesity in Australia are estimated to be $58.2 billion, comprising $8.3 billion in financial costs and $49.9 billion in net costs of lost wellbeing.”

It saw food labelling as one among many small changes that might, cumulatively, achieve health benefits.

Besides food labelling, taxes on bad foods and incentives to consume good foods have attracted attention. A research letter using theoretical modelling shows that the consequences of a consumption tax on fruit and vegetables appear grim.

Such imposts, as The Economist has pointed out for years, frequently prove not to be regressive in practice because they cannot be as easily minimised by the rich as income tax. Nevertheless, a review of what might be achieved by taxes and subsidies shows that taxes are most likely to be effective when applied to foods with close, untaxed, healthier alternatives available.

Subsidies are most effective when applied to fruit and vegetables. Both become stronger measures at higher rates (20%–40%). Also, if they are designed well (such that healthier foods avoid the tax), taxes can create upstream incentives for food industry reformulation.

If we as health professionals want more treat and less trick from our food supply, new skills and strategies and strong political leadership will be needed to bring the food and health industries together in fruitful relationships. The agenda should include banning the use of industrial trans fats, progressive lowering of added salt and intelligible food labelling.

These things may not be blockbusters but, as shown with the control of tobacco, progress is achieved in these complex environments by many small efforts.

The necessary policy work is tough — intellectually and politically — and the muscle power and spiritual clout of a patron saint of public health diplomacy would be warmly appreciated.
 

Professor Stephen Leeder is the editor-in-chief of the MJA and professor of public health and community medicine at the University of Sydney.

This article is reproduced from the MJA