The junk science behind the war on junk food

About a mile up the road from spiked‘s offices in central London, an office block formerly owned by BT, the telecoms giant, is getting a major facelift. Developers Derwent London are creating nearly 25,000 square metres of prime office and retail space in the bustling area around Angel underground station. But you won’t find fast-food outlets or tobacconists there, because the major tenant of the new building, Cancer Research UK (CRUK), seems to have put a block on them.

Sarah Lyness, executive director of communications and information at CRUK, told spiked that the charity had provided ‘guidance on the use of retail space at the base of the building’, adding: ‘Half of all cancers could be prevented by changes to lifestyle. A key element of Cancer Research UK’s work is to help people understand how they can reduce their risk of cancer. Factors such as stopping smoking, eating a balanced diet, maintaining a healthy body weight and avoiding sunburn all have an important role to play.’

Actually, it is far from clear that lifestyle changes, other than not smoking cigarettes, could have such a dramatic impact on health. For example, it is hard to believe that ‘junk’ food like burgers, fried chicken and pizza are fundamentally any worse for you than posh foods with similar make-up, like Kobe beef, foie gras or smelly French cheese such as Roquefort. Even if we accept the need for a balanced diet, whatever that might be, the offerings at McDonald’s or KFC could just as easily be part of that as any other kind of food. Along with the fragrant odour of the Colonel’s secret recipe of herbs and spices, there is a distinct whiff of snobbery in this demonisation of certain ‘junk’ food products.

More practically for CRUK’s new home, nearby Upper Street in Islington is jam-packed with fast-food outlets, restaurant chains and bars, and there are numerous shops where you can satisfy a craving for Lucky Strikes or Marlboros. Banning such outlets from the CRUK building is akin to urinating in the ocean, done more for show than effect.

But the block on undesirable fellow tenants is in keeping with the outlook of health professionals, charities and campaigners more generally: ‘we know what’s good for you’ is their message. They would like us to make ‘healthy choices’, which increasingly seems to mean not having any choice at all or being nudged (aka shoved) into doing what they think is best for us.

Another example of this ‘we know what’s good for you’ outlook runs through a report published yesterday by the US Institute of Medicine (IoM) and the National Research Council (NRC). Local Government Actions to Prevent Childhood Obesity provides a list of different policies that could be taken to resist the expanding waistlines of America’s children. According to the report, ‘In the United States, 16.3 per cent of children and adolescents between the ages of two and 19 are obese. This epidemic has exploded over just three decades. Among children two to five years old, obesity prevalence increased from five per cent to 12.4 per cent; among children six to 11, it increased from 6.5 per cent to 17 per cent; and among adolescents 12 to 19 years old, it increased from five per cent to 17.6 per cent.’

The case for action sounds dramatic, but a little bit of scepticism is required. While children have been getting fatter, the figures quoted are really a matter of definition. If you create an arbitrary dividing line between ‘healthy weight’ and ‘unhealthy weight’, then quite small average changes in weight could lead to quite scary-looking changes in obesity rates. The real question is whether children generally are ballooning in weight – and even on the basis of these new figures, the overwhelming majority of children are clearly not obese. Nor does it follow that obese children will turn into obese adults and go on to suffer serious ill-health as a result. While being very fat (much fatter than most of the children labelled as obese in these figures) is associated with an increased risk of various diseases, being fat itself is not a disease and it is inappropriate to talk about an ‘epidemic’ of obesity.

The US report leaps from these questionable conclusions to a lengthy menu of policy options. While accepting that parents, not the authorities, play the major role in children’s diets, the report says ‘those positive efforts can be undermined by local environments that are poorly suited to supporting healthy behaviours – and may even promote unhealthy behaviours. For example, many communities lack ready sources of healthy food choices, such as supermarkets and grocery stores. Or they may not provide safe places for children to walk or play. In such communities, even the most motivated child or adolescent may find it difficult to act in healthy ways.’

What quickly becomes obvious is that this report was written by a committee, the kind of committee where everyone gets to have their pet concerns included. As such, the obesity discussion becomes a proxy for all sorts of other concerns. The report declares: ‘Poverty, poor housing, racial segregation, lack of access to quality education, and limited access to healthcare contribute to the uneven wellbeing of some groups of people, especially those living in historically disadvantaged communities.’ Such issues are, of course, a genuine concern, but do we really have to talk about kids getting fat before we can begin to tackle these fundamentally social problems?

In fact, rather than tackle social disadvantage, the report talks about creating incentives to encourage the ‘right’ choices. Some of them seem quite reasonable, like making it easier for people without transport to get to shops that sell a range of fresh foods, or providing safe alternative routes for cycling. Others feel like an attempt to squeeze in concerns that are only tangentially related to obesity, like encouraging breastfeeding or putting limits on how much time children can watch TV or play video games. What starts out as an attempt to trim children’s waistlines soon turns into the micromanagement of every aspect of their lives, from how they are fed to how long they spend in front of a screen.

Reading the IoM/NRC report felt like stepping into a timewarp. All of these ideas have been kicking around, or have been implemented, in the UK over the past few years. One difference is the greater involvement of the state in our everyday affairs in the UK. The state provides midwives, so they’re told to nag new mothers about breastfeeding. The state regulates TV and has banned ‘junk’ food adverts during shows with a high proportion of child viewers. The state controls local planning regulations and can shut down fast-food restaurants that are deemed to be too close to schools. Increasingly, food has become the key issue through which the authorities – here and in the US – communicate a moral agenda and seek to police and reshape our personal behaviour and interpersonal relations.

With their immense powers of propaganda and interventionism, the authorities are using panicky stories about health to determine how we live. But neither charities nor the government knows what is best for us, especially if they are prepared to use junk science to try to micromanage our lives. A little less food-obsessed state and charity intervention in our lives, and a bit more trust of everyday people, would go down a treat right now.

Rob Lyons is deputy editor of spiked.