Health Promotion

I’m sceptical….what are you?
Published on Thursday, July 15th, 2010
New Scientist ran an interesting series of articles about denial in May this year.

It got me thinking that scepticism vs denialism is another way of describing a theme often addressed in this blog. I consider myself a sceptic – meaning that I take an objective approach to the evaluation of claims - but I also find that a bit of commonsense goes a long way. Deniers, on the other hand, have a position (or end goal) staked out in advance, and sort through the data employing “confirmation bias”. This is defined by New Scientist as “the tendency to look for and find confirmatory evidence for pre-existing beliefs and ignore or dismiss the rest”. Whether sceptics agree or disagree, we can debate the issues like grown ups. Dealing with denialism feels more like trying to rationalise with a toddler having a tantrum.

It’s easy to think of denialism as an old fashioned notion, driven by zealots such as anti-evolutionary theorists or those who believed the Earth was flat. But no – denialism is alive and well in our modern world. We’ve all heard of climate change and vaccination deniers. New Scientist provides useful perspectives on these examples, as well as deniers of the ill health effects of tobacco, the existence of AIDs and those who believe pandemics such as swine ‘flu are developed and released by pharmaceutical companies. I can add more examples to this list based on personal experience in the food and health area. Those who are convinced that:
- obesity is caused by single foods or beverages (and that this is a conspiracy of global food companies).
- anti-tobacco tactics directed to certain foods are the best option to combat obesity.
- specific approved food additives or ingredients cause illnesses ranging from autism to cancer (and that this is a conspiracy of both food companies and food safety organisations).
- there are no adverse health effects of high salt diets at a population level.
- it’s acceptable to deliberately design research studies to prove a point or handpick research results to suits their means, rather than taking a more objective view.
Your typical denier often has the public’s sympathy because they’re the “underdogs, fighting the corrupt elite”. They often occupy the moral high ground for this reason. And the media love the extreme viewpoint they offer so they have a natural public stage. Regulators, businesses and governmental organisations do not have the luxury of being able to handpick evidence to suit. They have to be objective, so they often come off looking non-committal, or at worst, defensive, when facing denialists in public.

In my digging around for material on this subject I also found this delightful quote by Richard Asher, published in The Lancet in 1959.

“It is important to realise that ideas are much easier to believe if they are comforting and that many clinical notions are accepted because they are comforting rather than because there is any evidence to support them. Just as we swallow food because we like it, not because of its nutritional content, so do we swallow ideas because we like them and not because of their rational content.”

I believe this rings especially true today and I’d love to hear some more examples of denialism that you’ve come across.
All hail the cheese roll
Published on Thursday, June 17th, 2010

They’re celebrating and exploring the science of the cheese roll in Dunedin this month. I love cheese rolls, and reading about this makes me want to rush home and cook up a batch of these warming winter treats.

Winter food is all about comfort, warmth and sustenance. Soup is a great example of this (and a perfect food match to those cheese rolls!). All those great staple classics like lasagna, shepherds pie, macaroni cheese and casseroles come into their own at this time of the year.

For those from the southern end of New Zealand, the humble cheese roll is so much more than a tasty snack. It’s part of our heritage. It’s about memories of Grandma and family times. It’s about sharing with friends and social occasions. And for those north of the cheese roll divide, there are other food favourites which fulfill this role in life.

The powerful social role of food cannot be underestimated. Recently I read some consumer research showing that the majority of people prioritise good nutrition when choosing what to eat at home or in routine situations. But unsurprisingly when asked the same question in relation to times when they’re socialising or eating with friends, good nutrition became less of a priority.

When communicating about food and nutrition the power of food’s traditional social role in our lives cannot be underestimated. These messages mean very little if they fail to acknowledge people’s behaviour and feelings around food, especially in social settings. Excellent nutrition communication needs to provide ways and means of achieving the same warm fuzzy feelings around healthy eating.

And for those of you who’re dying to experience the magic of the Southland Cheese Roll to warm you up this winter, here’s a great recipe.
Has the world already reached Peak Health? If so, who’s to blame?
Published on Monday, May 10th, 2010

The concept of peak oil has spread into the health sector, with public health professionals now talking about peak health in the same vein. This draws important parallels between our health as humans and the health of our planet – the two, as we have known for some time, being inextricably linked.

So have we already reached peak health? Are we therefore now heading down the slippery slope away from it? If, as experts predict, today’s children will not live as long as their parents (due to increasing obesity and its ensuing chronic diseases), perhaps we are.

And if we have surpassed peak health, who or what is to blame? Having recently returned from a largely finger-pointing and teeth gnashing Public Health Association of Australia (PHAA) conference in Canberra where there was much discussion on peak health, I know that many believe the blame lies with food manufacturers and marketers.

“How can they truly have the health of consumers as their main objective, when their main objective is to make a profit for their shareholders?”

That old chestnut.

In fact all organisations are constrained by financial realities, whether this involves making a profit, breaking even or maximising value for money. The ever present clamour for public sector funding to undertake health research is but one example of how money makes the world go around in the public as well as the private sector. We all need to make a living to feed and house our families, but most of us feel better in our work if we know our employer genuinely cares about us and others.

Actually what motivates businesses is far more basic than money. It’s survival.

At the NZ Food and Grocery Council’s half yearly meeting last week I was heartened by what John Doumani, General Manager for the Fonterra business in Australia and New Zealand said about how to build immortality into brands. He suggested that unless companies prioritise their objectives in order of customers first, employees second and shareholders third, they will not survive.

Looking after your customers means looking after their interests, in particular their health. Same for employees; after all, no one enjoys work for a company which puts shareholders first above all else. Ensuring customers are happy and healthy, and employees feel great about the company they work for will satisfy shareholders in the long term. Any wise and sustainable food manufacturer knows this.

Still, it seems that food manufacturers struggle to do anything right in the eyes of public health critics. Even affordable foods, developed (at great expense) by food companies to provide high levels of the nutrients commonly missing from diets in developing countries, were criticised at the PHAA conference. It left me questioning what food companies could possibly ever do right for such critics.

What do you think food manufacturers, and others can do to help us regain peak health?
Go First Lady!
Published on Thursday, February 11th, 2010

Well done Michelle Obama. I commend her “Let’s Move” public awareness campaign to help stem the tide of childhood obesity in the US, launched on February 9th and outlined in the NZ Herald.

A critical success factor is that this campaign appears to stem from Michelle’s own personal family learnings and experience prior to entering the White House. And now that she’s mother of the nation it makes sense to bring these learnings to her new, wider family. It’s a PR dream.

The four campaign pillars are: helping parents make better food choices, serving healthier food in school vending machines and lunch lines, making healthy food more available and affordable, and encouraging children to exercise more.

Yes, it is ambitious – but what I like is that it’s multifaceted - like obesity itself. The true causes of obesity in a population are highly complex, because they vary so much from person to person, so no single approach will ever be successful. What’s needed for prevention is a multifaceted approach across the population, to allow for this individual variation.

Within “Let’s Move” there are specific plans to work with the food industry on developing easily understood food labels, encouraging doctors to better identify and work with those children at risk, serving healthier food in schools, offering tax breaks to improve access to healthier food in specific areas, consumer education programmes providing tips and resources, and encouraging at least 60 minutes of exercise daily.

All really good common sense stuff, that’s pulled together as one campaign with one clear goal, by a powerful, talented and nurturing figurehead. As discussed on Rebecca Scritchfield’s US healthcare blog, recognition of the fact that governments alone will not solve the challenge of obesity is another critical success factor of Let’s Move. Surely it’s the sort of approach our own government should be taking? Why then abolish the progress made on making school food here healthier? Why take the view that education on its own doesn’t work, so stop marketing and producing healthy eating education and resources? Why stop programmes already working to improve access to healthier foods in communities? Why not commend food companies for the progress they’ve already voluntarily made (for example labelling foods with %DI information to help consumers plan their food and beverage intake)?

Our government seems to be focusing on exercise as a silver bullet. What do you think? Who would our Let’s Move figurehead be? Would people believe this of Bronagh?

(PS – these questions aren’t rhetorical. I’d really like to hear your views!)