Food policies for healthy populations and healthy economiesBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2801 (Published 15 May 2012) Cite this as: BMJ 2012;344:e2801
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This article presents healthy diet as a dogmatic concept although it really isn't. While taken to the extreme diets rich in sugars, animal and saturated fats (notably trans-fats) are linked to cardiovascular disease there is also evidence of more mitigated conclusions in the literature and these are not presented here. The UN stated that policies to promote consumption of fruits, vegetables, wholegrain, nuts and fish and reduce intake of animal fats, trans-fats and sodium 'could' prevent millions of premature deaths; a degree of uncertainty is allowed for. Current policies however do not allow for this uncertainty and seem to reach binary conclusions to problems which very complex and difficult to study in isolation.
Whilst the state intervention in the food sector was indeed partly removed to allow private, open and competitive markets to flourish, it was also removed because of many perceived inherent failings to the system as well as cost. The results were that of an open market: competitiveness and increase in availability quality and choice of food (Please note that quality does not necessarily make a food item healthy. A quality trifle is still a trifle). The fact that ‘consumers were placed in the driving seat of the modern food system’ ought to be seen as a positive development. Consumers hence had greater choice not only of ‘unhealthy’ foods but also of a constant supply of foods now deemed as healthy, this freedom ought to be lauded. The reasons accounting for people tending to choose ‘unhealthy foods’ is brushed to the side (such as palatability, self-gratification, enjoyment, stress relief, time constraints etc); and the explanation provided by the article is lacking at best and patronizing at worse. Whilst food education and provision of consistent information (by means of labelling for example) is very much desirable, the assumption that people (children apart) consistently make the wrong food choices through sheer ignorance is supercilious. The same train of thought can lead down a dangerous path towards more regulation and taxation of food. We already apply a 20% tax on most of these ‘unhealthy’ foods already as compared to ‘healthy’ foods – it is called VAT. Fruit, vegetables, meat and so on are zero-rated in the UK. If taxation was that effective, why hasn’t it worked already? A recent paper from Oxford seems to collude with this.
The Brazilian example of schools favouring foods from family farms has less to do with nutrition than state intervention and political beliefs.
Food is an intimate experience which can hardly be broken down into good versus bad (cf. cheese, fruit juice etc.) Whilst excesses and overindulgence may be linked to health problems, this is not only restricted to food intake. Exploration of the reasons for such behaviour rather than assuming it is secondary to ignorance may be more instructive, albeit at the expense of increased complexity. Whilst guidance, education and provision of information should always be praised, interventions in such matters pose serious ethical questions about one’s freedom of choice and the society’s ability to accept the ‘burden’ of free choice.
Competing interests: none