Background
According to available statistics, 1.8 billion adults Worldwide are overweight. Nearly half of them suffer from obesity. Every year, 2.8 million people suffer from premature death as a result of being obese/overweight. 4.2 million deaths occur due to the exposure to outdoors air pollution, and another 3.8 million due to indoor air pollution (coming from fuels and dirty cookstoves). Around 7.2 million people die due to tobacco use, 1.6 million deaths are linked to insufficient physical activity, 3.3 million deaths linked to alcohol use, and 4.1 million deaths are connected to excess intake of salt.
Importance of wellbeing during (and beyond) the pandemic
Preliminary studies on the severity of the coronavirus in different patients show that (besides age) certain factors could exacerbate the effect of the virus in our bodies. Some of these factors are: exposure to poor air quality, smoking, insufficient physical exercise, obesity-related conditions or micro-nutrient deficiency (such as vitamin D). In essence, these are all determinants that have an impact on immune systems.
It will still take some time before vaccines are available to all. Meanwhile, government guidelines on mask-use and social distancing should be followed as precautions to protect ourselves and (specially) the most vulnerable. Yet, strengthening our immune systems should also be a priority. Following a healthy diet, exercising, ensuring sufficient sleep, avoiding harmful habits (i.e smoking and over-drinking), or trying to minimise stress are ways to improve our bodies’ capacity to fight off disease. Indeed, good habits such as healthy eating boost our immune systems. What’s more, increasing attention is being directed towards the idea of food as medicine.
The below figure provides an example of the differences in nutritional value of two snack choices. The nutritional content of coke can be summarised as 39g of added sugar and 45mg of sodium (equivalent to around 135mg of salt). Not only this is an unbalanced choice from the macronutrient point-of-view; take a look at the dramatic difference in terms of micro-nutrients. So, why would coke ever get picked over a fruit or a glass of water?
When it comes to deciding what to eat for a healthy lifestyle, consumers can face an intimidating task. Paleo, Keto or Vegan are currently some of the trendiest diet options out there. Each of these diets has pieces of scientific evidence backing its benefits. However, it is debatable whether a single dietary option can be the right for every single individual. Genetics, age or environmental background are some of the factors that could determine an individual’s dietary requirements. On the other hand, experts seem to be coming to an agreement with regards to a number of ingredients in ultra-processed foods that we should definitely steer clear of to avoid illness: Added sugar, added salt or unhealthy fats. In addition, ultra-processed foods often contain additives that may harm our guts.
Although some might argue that diet is just an individual’s choice, when it comes to public health, both businesses and policy makers play an important role. In fact, in a joint commentary between WHO’s DG and the former president of Uruguay (Tabaré Vázquez), the authors stated:
“No longer can we say that (…) regulating business is too hard, and that responsibility lies in the hands of individuals to make the healthy choice. Instead, we must expect—and help—governments to make the healthy choice the norm for their citizens.”
This article presents a brief explanation on the implications of both policy and markets in wellbeing and provides a few examples of good practices, with a focus on diets.
Role of businesses and governments in diets
A 2017 studyshowed that, just in the UK, junk food producers spend 27 times more in advertising than the government’s healthy eating campaigns. What’s more, every year, the most watched events Worldwide are supported by multi-million junk food ads featuring the most influential personalities in sports, acting or music. The US president has often promoted junk food brands in public. More recently, during the pandemic, the government of the Spanish Autonomous Region of Madrid was shamed as a result of its decision to provide children from low income families with meals from local fast-food outlets. These are just a bunch of examples of questionable public-health practices by policy makers.
On the other side, manufacturers of traditional ultra-processed foods employ teams of scientists to design meals that appeal to us. Sensory (taste and texture) contrasts, fast meltdown in the mouth, memories’ evoking flavours, unusual levels of addictive ingredients (sugar, fat, salt and monosodium glutamate), including saliva stimulants (i.e. lactic/citric acid), digestion-slowing ingredients (casomorphins) or overly large portions, are some of the ways these unhealthy foods become so attractive. These foods are literally designed to trick our brains into eating more of them.
How can we then turn the tide?
Good practices - Policy
Some of the strategies that governments can follow to improve the quality of diets are: Education programmes, labelling standards, financial dis/incentives, conditional food vouchers, school meals, quality standards (i.e. limitations to sugar content), private/public procurement guidelines, integrated and holistic health system, food marketing regulations, regulations on the built environment (i.e. investment in food-deserts), investment in nutrition research or policy coordination from the local to the international level. A few examples of good food policy initiatives are provided below.
- Oman: With support from WHO, the country implemented a cross-stakeholder programme to develop local initiatives. Within a few years, the project managed to achieve a 10% reduction in salt content in breads produced in participating bakeries.
- Chile: The country has imposed one of the strictest legislations over unhealthy foods and drinks. With a solid regulation on labelling, a restriction on ads targeting children and a ban on junk foods sales at schools; Chile has already achieved over a 20% drop in sugary drink sales and is expecting to see a decrease in NCDs within the next few years.
- Milan Urban Food Policy Pact: In 2015, mayors and representatives of local governments, signed a document by which they commit (among other things) to “develop sustainable food systems that are inclusive, resilient, safe and diverse, that provide healthy and affordable food to all people”. To date, the Pact has been signed by 210 cities, with a total of more than 450 million inhabitants.
If you would like to dive deeper into the challenges and opportunities of nutrition policy, please check this article from D. Mozaffarian and colleagues, published on TheBMJ.
Good practices - Business
As per policy makers, businesses can also follow a few guidelines to contribute to healthy diets: Paying employees living wages to allow them to afford a healthy diet, avoiding placing junk foods at checkouts to avoid impulse buying (applicable to both online/physical supermarkets and convenience stores), promoting healthy choices, offering more plant-based meals and grass-fed/organic meats, or promoting clear labelling (avoid benefiting from loopholes). A few examples of good business practices are presented below.
- Online platforms promoting the consumption of local foods: La Ruche Qui Di Oui, a French-based platform, is one of the first and most successful projects at the European level that connects consumers with local food producers.
- Rude Health: Besides offering organic dairy-free drinks, some of their products, despite being processed (note that there are differences between processed and ultra-processed foods), have no additives.
- Jamie Oliver: This British celebrity chef and food entrepreneur has actively campaigned against junk food ads, specially those targeted to children.
A few aspects on the importance of healthy diets, such as the environmental or socio-economic impact of the food we eat, have not been considered in this piece. I will address these and other topics in future posts.
Get in touch!
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Figure sources: https://www.coca-colaproductfacts.com/en/products/coca-cola/original/16-oz/, https://www.medicalnewstoday.com/articles/271157#nutrition, https://unsplash.com/photos/z8PEoNIlGlg, https://unsplash.com/photos/s9Yc_FqP2q0.
