The Citizen's Guide to Healthy Living
Introduction
Reading this guide will not make you healthier, so you can stop reading now if your quest is the elixir of life. The purpose of this small essay is to inform you about the State's plans to persuade you to live more healthy lives and to consider some of the cunning plans coming from a troupe of Baldricks, that Cameron keeps in a cupboard under the stairs at No.10 - to entertain us all. And as a Bonus, you will also be provided with a review of the new ConDem White Paper, Healthy lives, Healthy people - Bon Appétit.
Change 4 Life - you know it makes sense?
'Change4Life' is all part of a campaign, started under New Labour two years ago and continued by the Con-Dems, to persuade citizens to eat properly. It is all part of a bigger campaige to encourage a state-approved healthy lifestyle.
Visit the Change4Life website and this is how you will be greeted....
"Well done! Visiting this site is your first step in making a Change4Life, and you’re not alone."
Well Done! A nice big dollop of patronage there and the piece at the end about you not being alone is designed by the Baldricks in the Nudge Unit to provide you with a warm glow of being part of a much wider movement for change.
The message continues...
"The way we live nowadays means a lot of us, including our kids, have fallen into unhelpful habits. This means all of us need to make small changes to eat well, move more, and live longer."
Suffice it to say, the three senstences taken from the Change4Life website tell you all you need to know about the State's intentions in relation to its citizens.
Straightforwardly, citizens can't be trusted to eat properly, they've become unhealthy and have fallen into unhelpful habits; now they need help to get back to the correct path again.
I can't think of anything worse than a plate of carrots, except two plates of carrots.
We have been told for some time now that eating five portions of fruit and vegetables is supposed to guarantee a heathly lifestyle. Recently, a new study suggests that we should all be eating '8 a day'. What the commissars of health forget to mention is that there is no evidence that sticking to 5 or 8 portions a day does any good at all.
Five Scottish brothers, average age 85 years, have rejected vegetables all their lives and lived to tell the tale. The Artic Inuit and Kenyan Masai do not consume five vegetables a year, let alone a day and they manage to thrive, curious that. Let's hope these people never discover the Change4Life website.
Health secretary, Alan Johnson, back in October 2007, commenting on the launch of a report by the UK government’s Foresight project said:
‘We cannot afford not to act on obesity. For the first time we are clear about the magnitude of the problem. We are facing a potential crisis on the scale of climate change and it is in everybody’s interest to turn things round. We will succeed only if the problem is recognised, owned and addressed at every level in every part of society.’
The report declared:
‘By 2050, Foresight modelling indicates that 60 per cent of adult men, 50 per cent of adult women and about 25 per cent of all children under 16 could be obese. Obesity increases the risk of a range of chronic diseases, particularly type-2 diabetes, stroke and coronary heart disease and also cancer and arthritis. The financial impact to society attributable to obesity, at current prices, is estimated to become an additional £45.5 billion per year by 2050 with a seven-fold increase in NHS [National Health Service] costs alone.’
All very worrying then, half of the UK population will be like beeched whales,
morooned on their sofas, half dead couch potatos in 40 years from now. Clearly, based on this evidence we must act. But wait, this is not evidence, this is a projection from a computer model. And the report definitely has not factored in the important contribution that will be made to healthy living by the mass consumption of games consoles like the Wii and XBox Kinect. True these house bound Olypians might suffer from vitamin D deficiency but they can take tablets for that.
The Health Survey for England tells us that obesity across all sections of the population has been falling for the past few years, so why the panic? Could it be that the State, having been spooked by zealots in the health business, now feel obliged to tilt at large fat windbags even though it doesn't make much sense.
A Tax on Fat - apply salt liberally
Where subtle 'nudging' fails it has been suggested by some spook elements that taxes might be applied. Ah, now what you need is a rigorous argument, backed by good research, that applying tax to fatty foods will achieve some stated aim, e.g. reduce ill-health associated with fat ladened food.
Enter the Journal of Epidemiology and Community Health (2007, 61, 689-694) who reported that various studies into cardiovascular disease in the past have concluded that an optimum application of VAT on fatty foodstuffs could avert ‘up to 3,200 cardiovascular deaths’ per year.
You can take that rather impressive claim with a pinch of salt due to the large numbers of citizens who succumb to cardovascular disease. In percentage terms 3,200 is 1.7 percent of all death caused by heart disease, rather less impressive.
More seriously, those in Government and the media, who have a vested interest in blowing up headline information, don't always worry about the fine details of the research that wont persuade or sell.
It's not fat people that are the problem, it's fat cats.
The issues surrounding eating, health, and State invention in citizens lives is complicated. The Government is telling people that their eating habits are unhealthy, it further presumes to tell us that this disorderly eating is storing up big trouble for the future.
It might just be that the Government is coming at the problem of obesity from the wrong direction, i.e. by focussing on fat people when it should be focussing on the fat cats who drive the food industry.
Most of the food sold to poor people is junk!, recycled, reconstituted, reclaimed and fucking revolting. The poor get served up the left-overs, after the prime cuts have to been sent off to Waitrose. Add sugar to shit, place in a deep freeze for ten years and then put it on the supermarket shelf and call it fish fingers. The poor should eat the packaging, that has more nutritional benefit than the contents, then they wouldn't get fat. Ah, but soon some eco-warrior will want to take the packaging away from the poor because its destroying the planet.
The Ministry of this that and the other tinkers around with information supplied on the packets, E numbers, fat content, salt ect., and then congratulates itself for getting one over on the profit gorging food industry. It's as if they are saying, well, read the back of the packet, it tells you that the contents in that fish finger was once almost a fish - what more do you want?
If the State was serious about improving citizens health, artificial trans-fats would be banned and the food industry would be told to stop putting wall paper paste in our food, stop using bulking agents, stop reconstituting meat and fish and stop modifying every thing we eat.
In 2003, the Food Standards Agency issued new guidelines for butchers on the amount of connective tissue that could be classed as meat, for beef, lamb and pork, 25% was allowed - why wasn't it zero? Connective tissue is inedible garbage.
Citizens don't need more labelling information, what they need is a Government prepared to police food production for the benefit of citizens, then everyone would be far healthier.
Healthy lives, healthy people (White Paper Nov. 2010)
The White Paper tells us that government intervention will be based ‘on a rigorous assessment of the evidence’. Good, that's reassuring, given that we live in contradictory times. ‘People in England are healthier and are living longer than ever’ and '‘life expectancy is expected to continue to rise for both men and women’ but we are also told about the big concern over the nation's unhealthy habits. For instance, there's the concern about people who consume too much fat, people who drink to excess, people who don't excercise and so on. However, put the worry to one side, the vast majority of citizens are moderate in their behaviour in all regards; it's just the way people are. And interestingly, moderate drinking, for instance, is associated with the lowest mortality rates in alcohol studies. There is evidence that tee-totallers will depart the planet before the drinkers do (evidence from the journal Alcoholism).Unfortunately, the White Paper is not based on a rigorous assessment of the evidence, it also contains a fair few unsupported assumptions about health.
For example, regular physical activity keeps you healthy or gets you healthy. Recently, a TV programme told the story of a super fit fell runner who found it impossible to reduce his cholestral below 7, by conventional wisdom he should have died long before now. Why isn't the man dead, no one knows, he's a statistical anomaly. But no one has proved a causal link between an active lifestyle and improved health. It might just be the case that you just feel better following phyical activity, due to the release of chemicals in the brain; you might not be fitter at all, you might just think you are.
The White Paper proposes an expansion of the Change4Life programme, this proposal takes no account of evidence that doesn't support the use of community wide behaviour control experiments. Beyond beating up poor people with vouchers, Change4Life is unlikely to impinge on the lives of the moderate majority.
Central to the White Paper is the notion that eating 5 a day is crucial to securing improved health outcomes but no clinical link has been established. Indeed, the Women’s Health Initiative Dietary Modification Trial, found no statistically significant differences in the risk of breast cancer, colon cancer, coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) between the intervention and control groups.
Obese people, the Paper assumes, are more at risk of premature death. A seminal study reported no relationship between overweight and excess mortality for cardiovascular disease or coronary heart disease (Flegal et al). Other studies have found negligible differences in risk of death among people with body mass index (BMI) values from 20 to 35 (that is, from ‘normal’ right through to ‘mildly obese’).
And finally, most political sound bites, never leave out the expected savings to the health service from citizens choosing the healthy option. Unfornately, it costs the health service more to care for healthy people who live long lives than it does to care for those requiring treatment due to supposed poor lifestyle choices.