Picking over the panic on a plate

This essay is based on a speech to the Bessansap 2012 conference in The Hague, Netherlands, in June 2012.

Panics about food seem to be ever present. But they don’t tell us much about our food, which is more plentiful, of better quality and more affordable than ever before. What food panics do show, however, is that we live in a society where individuals feel vulnerable about the future and this vulnerability has been exploited to serve the interests of campaigners, sections of the medical profession, and the political class. But such panics also raise questions about the role of science in society today, and the way that science is reported.

A few years ago, I used to write a regular feature for spiked called ‘Don’t Panic’. Every week or two, I would take up a new scare story in the media, explaining why people thought there was something to be worried about. I would then try to suggest, in just three or four paragraphs, why we should not panic after all.

We ended that column in 2007 but when I was writing this, I went back to look at the last few columns I wrote. They reveal just what a wide range of things we seem to be worrying about today:

● Does red meat cause breast cancer?
● Does sitting still for long periods at work lead to deep-vein thrombosis?
● Do vitamin pills actually shorten our lives?
● Do children in Britain and America really have among the worst quality of life in the developed world?
● Is there an epidemic of childhood obesity?
● Are polar bears on the verge of extinction?

In among all of those different issues featured in ‘Don’t Panic’, one theme came back time and again: the effect that the food we eat has on our health.

If we are to believe the newspapers and television news, food is really terrifying stuff. Red meat causes cancer, particularly bowel cancer. Processed red meat causes even more cancer. Pesticides in our food are slowly poisoning us. Multinational biotech corporations are tinkering with plant DNA to create so-called frankenfoods. Cost-cutting agricultural feed companies fed cow protein to cows and we ended up with mad cow disease. Manufactured food is stuffed full of salt, which raises our blood pressure; or trans fats, which clog our arteries; or sugar, which causes diabetes.

And if it is not our health that is at risk, then it is the health of the planet. Transporting food around the world requires burning lots of fossil fuels that cause climate change. Clearing rainforests causes more emissions. The cows that are put on that cleared land to feed our insatiable appetite for hamburgers also belch methane into the atmosphere. Nitrogen fertilisers run off into rivers and seas and kill the marine life there.

I don’t want to suggest that there is no truth in any of that litany. But I do think this fear of food is very strange. That’s because when it comes to food, we are the luckiest generation in human history.

This is the best time to dine ever

If we roll back 100 years, we get a clearer sense of just how much things have improved. Back in 1912, around 11 per cent of the UK workforce was working in agriculture, compared to about one per cent today. Machinery was limited, artificial fertilisers were non-existent – and there were very real concerns that supplies of naturally occurring fertilisers would run low. Pesticides were primitive. All food was ‘organic’ back then; it was also a lot more expensive and the process of producing it was a lot less efficient in terms of both land and labour. An awful lot of our food was locally produced, too. It had to be. Such developments as modern refrigeration, rapid transport and sophisticated logistics were still a long way off.

When food arrived in town, it had to be bought by housewives going into one shop at a time – one shop for meat, the next for vegetables, another for bread, and so on. Women – it was pretty much always women – faced the equivalent of a supermarket checkout queue at each of four or five different shops almost every day. What a chore. Food couldn’t be stored all that well at home, so it needed to be cooked pretty much immediately, although in poorer households, cooking facilities often amounted to an overworked frying pan or a feeble stove that was expensive to fuel. In London on a Sunday, many households would put all their ingredients into a pot then take it round to the local baker to put in his oven to cook. Many people lived on a dull diet mostly of bread and potatoes that wiped out a sizeable chunk of their incomes.

If a committee had sat down back then to work out some kind of idealised food system for the future, what would they have been hoping for? First and foremost, they would have wanted a plentiful supply of food that wasn’t constantly at the mercy of the next bad harvest. They would also have wanted that food to be nutritious and cost only about 10 per cent of a family’s income, so that families could spend their money on more interesting things instead. They would want to be able to bring foods from around the country, indeed from around the world, to get away from the same old boring diet. What if spices and oils and other ingredients only found in other countries could be bought whenever you wanted them and at a cost equivalent to just a few minutes of work?

The women on the committee – if they had allowed any women on a committee in 1912, which is doubtful – would surely have demanded an end to the hassle of the daily shop and the grind of dragging heavy bags of shopping home. How about, they might suggest, if most people could have their own motorised transport to take them to – let’s call them ‘super shops’ – where a wide range of goods could be obtained in one trip? Or even better, wouldn’t it be nice if you could give the shop an order in detail and they could deliver it to you at a time convenient to you?

And how about getting rid of the need to cook every day or at least making the process of cooking more convenient? So, for example, these female committee members might suggest being able to buy meals that had been cooked already by other people that they could just put in their own oven to heat up. The really optimistic women on the committee might even suggest that someone could come up with some kind of ‘magic heating box’ that could cook the food in just a couple of minutes.

(At this point, the men on the committee might start rolling their eyes about these mad women. Whatever next, they might say, a machine that sucks the dirt out of carpets? A special device that not only washed clothes, but dried them too?)

Well, guess what? We got the lot. Food is now cheaper, more plentiful, in greater variety, easier to obtain and more convenient to cook than ever before. Whether you want to have a dinner party with wine for your friends or a microwave meal in minutes to eat alone, the choice is there for you.

Yet health and environmental campaigners have found a whole new bunch of things to worry about. The most extreme eco-activists around food would have us return to a past where what you ate was determined by the time of year, the area you happened to live in, or the money in your pocket. Because food, they say, should be expensive. That would be a step backwards, to a time when the next meal could never be guaranteed and where millions of people worked in back-breaking jobs to keep us all fed. I prefer our fossil-fuelled cornucopia. Our food system is not perfect; occasionally parts of it are irrational. But we must surely recognise that we have made enormous progress in the past hundred years.

Just how explosive is the ‘obesity timebomb’?

It seems that we don’t want to count our blessings. Instead, we swing between one view of food and another. On the one hand, we see food as a lifestyle choice, expressing our personality, allowing us to be creative and so on. The biggest selling books in the UK are often those by famous chefs and TV food personalities like Jamie Oliver. There are endless TV shows about cooking. In the UK, we have four different versions of MasterChef, for example.

On the other hand, we are very fearful about food. Not only should we count our blessings about the things that have improved, but I also think these modern fears are exaggerated. In fact, I think those fears have little to do with food.

Perhaps the biggest fear in relation to food is about obesity. The numbers are certainly impressive and scary. In the UK, the proportion of people defined as obese has doubled since 1993, from 13 per cent to 26 per cent. I know the Dutch are among the slimmest people in Europe, but again obesity rates pretty much doubled in the Netherlands between 1990 and 2010, but from a lower starting point to the UK. In America, a third of the population is obese. Recent figures suggest about one in seven African Americans are morbidly obese. For a man of average height, to be morbidly obese means being roughly 30 kilograms (66 pounds) over the World Health Organisation’s ideal weight range. Obesity is, in turn, associated with serious diseases like cardiovascular disease and type-2 diabetes. There are claims that this generation of children will die, on average, at a younger age than their parents.

I think we need to treat these claims with some scepticism. For example, counting the numbers of people who have crossed a certain line on a graph is just one way of getting a picture of weight change. Another would be to look at average body mass index (BMI). In the UK, in the same period that obesity rates went up from 13 per cent to 26 per cent, average BMI has gone up from 26 to 27. In other words, for a man of average height, about three or four kilos. Suddenly, that doesn’t look so bad. It seems that everyone has got a little bit fatter, but those who have a propensity to gain weight have got fatter faster than the majority. Very fat people, who were once rare, are now more common, but they still represent a small percentage of the population.

Being morbidly obese can be a serious problem. Those who have a BMI of more than 40 are also considerably more likely to develop a number of chronic illnesses. Their life expectancy is lower, on average, than that of slimmer people. Even the simple fact of carrying around 20, 30, even 40 kilos more than you would like to is at best an irritant, and at worst downright depressing.

But there are grounds for questioning this gloomy prognosis. For example, the existence of a so-called ‘obesity timebomb’ – where life expectancy declines because so many people are dying of weight-related diseases – co-exists in the mind of the British media alongside a pensions timebomb – where governments will be bankrupted by the fact that people are living so much longer. Despite the fact that obesity is supposed to be this enormous problem, estimates of life expectancy are still rising; in both the UK and the Netherlands, children born today can expect to live until they are 80 years old on average.

Secondly, studies in the US suggest that the risks of dying for those who are mildly obese are not very different to those who are of a supposedly ideal weight. In America, official figures suggest that the people with the longest life expectancy are those who are in the ‘overweight’ category.

We also need to ask if it is fat itself that makes us ill. If so, how do we explain that people who are fat but fit – and I don’t mean marathon runners, simply people who take moderate exercise for at least 30 minutes for five days per week – seem to have similar health outcomes to those who are slim but sedentary? If fat is the problem, why does it appear that weight loss has limited impact on health outcomes, but yo-yo dieting – that is, weight loss followed by weight gain, repeated a number of times – seems to be, if anything, worse for you than simply remaining fat? If, as many claim, we eat too much and exercise too little, why is dieting so rarely a lasting cure for obesity? Have we all just become morally weak in recent years, unable to resist the urge of all this fattening food around us?

I think that it is more likely that while obesity is correlated to illness, for the most part obesity does not cause that illness. Instead, I think both obesity and diseases like type-2 diabetes are caused by another common factor. One such factor getting a lot of attention as a possible explanation is the amount of carbohydrate in our diets, which has risen as we have been bombarded with advice to avoid fat. Maybe the problem – to the degree that there is one – is the kind of things that we eat, not how much we eat.

Making large sections of the population worry about their waistlines and what they eat is unlikely to make a significant impact on health outcomes. However, it could have some significant unintended consequences. A recent report from members of the UK parliament expressed concern at the numbers of children who now have body-image problems and how many children are dieting. Children as young as five are expressing dissatisfaction with how they look. Half of teenage girls and one third of boys have tried dieting to lose weight. This worries me. The last thing growing children need to be doing is deliberately restricting their food intake.

As members of the UK parliament point out, children are picking up on the anxieties of their parents, which include obsessing about our weight. But they are also being taught about healthy eating from a very young age in schools, so it is ironic that one group of parliamentarians are worrying about food fears inspired by the policies of their colleagues who obsess about obesity.

So to sum up: obesity is a problem. It’s enough of a problem that the vast majority of fat people would love to find a simple way of achieving lasting weight loss. But it is also greatly exaggerated as a risk to our health.

The McStats behind the food panics

Let’s take another example, one I’ve mentioned in passing already: red meat and processed meat and a link to colorectal cancer. There have been numerous studies that have made this link. In March this year, a widely publicised study from Harvard School of Medicine suggested that eating small quantities of red or processed meat could increase the risk of death by 20 per cent. That fits in well with the risks found in other studies. The Harvard study received a lot of publicity and it seems today that many people assume that red meat and processed meat cause cancer, that this stream of similar findings must add up to a conclusive case against red meat.

However, any study involving our lifestyles, particularly our eating habits, is extremely difficult to undertake. First of all, there is the practical problem of measuring what people ate, which is usually done from memory using questionnaires. Secondly, when people eat more of one kind of food, they may well be eating less of another. For example, more meat might mean fewer vegetables. So any negative effect you find may be due to the absence of one kind of food rather than the presence of another. Perhaps it is the food that is eaten with meat that is the problem – for example, if you like your meat on a barbecue, you may have it with beer and eat it in soft, white fibre-free bread. Could that be the real cause? Another problem is the way foods get lumped together. For example, the fat profile of beef is quite different to the fat profile of lamb, so putting both under the heading of red meat can be misleading. The same could be said for fruit: the metabolic effects of eating bananas are very different from eating berries, because bananas contain a lot more readily available sugar than most berries.

So, food studies are particularly open to what are called confounding factors.

Most importantly, we need to be really specific and clear about what a study is really telling us. What we can really say about such a study is not that red meat causes cancer but that the kind of people who say they eat a lot of red meat may also be at a higher risk of cancer. But people who eat a lot of red meat and those who don’t eat meat at all – or don’t admit to it – are different in many other ways apart from their attitudes to meat. The family that likes to eat at McDonald’s regularly is, on average, very different from a vegetarian family in ways that go beyond what foods they eat.

The researchers in the Harvard study tried to control for some of these differences, but how could they possibly control both for all the differences between these groups that they knew about, and all the differences that they weren’t aware of? We know from their report that the people with the biggest risk of cancer were frequently much fatter, ate more food generally and drank and smoked more, too. The differences in those cases were much greater than the differences in red meat consumption. It is a little astonishing that in those circumstances that they could so confidently proclaim that red meat was the problem. Add all this together and the conclusions from this study – and others that have come to broadly similar results – must be treated with extreme caution.

Indeed, the US National Cancer Institute has noted ‘in epidemiologic research, [increases in risk of less than 100 per cent] are considered small and are usually difficult to interpret. Such increases may be due to chance, statistical bias, or the effects of confounding factors that are sometimes not evident.’ I think it is worth making a comparison with one lifestyle choice that we know has a very substantial impact on the risk of disease: smoking. While the supposed risk from red meat is an increase in the risk of cancer of 20 per cent, the risk from active smoking for lung cancer is more like 2,000 per cent. We can be very confident that smoking causes many cases of lung cancer. We cannot have anything like that confidence about red meat and cancer.

Finally, there are the old problems of relative risks and absolute risks, and the age at which these cancers occur. So, if the lifetime risk of bowel cancer is five per cent and the risk increases by 20 per cent due to eating red meat, that puts the lifetime risk at six per cent. And those people that develop cancer and die from it tend to be old. In the Harvard study, as far as I could tell, 80 per cent of the people involved, regardless of their red meat consumption, lived past the age of 75.

When we finally get to the point of drawing conclusions and giving advice, what is the best we can tell people, based on a study like this? This study, conducted by one of the world’s leading schools of public health using very large numbers of subjects. The best we can say is that if the study is correct, then people can avoid foods, which clearly bring them pleasure, for the whole of their lives, in exchange for a year or two more of old age. If people follow such advice to the letter, they may not die of colorectal cancer, but they may die of boredom.

Why the diet of scare stories?

But in many ways, the specifics of whether meat causes cancer or eating a certain kind of food makes you fat are less interesting than why such stories, which sound very definitive in print but are really much more ambiguous, get into print in the way that they do.

Some of this is down to professional pressures, both for researchers and journalists. First there is the issue of devising a study that will actually attract funding. As well as being a journalist, I do some work as a webmaster for a university research department and the other day I was posting adverts on the website for new professorships. And, to be blunt, the adverts seemed to be saying ‘we’ll make you a professor if you a well-known researcher who can bring in lots of research grants’. Clearly, then, universities now have to be very aware of what kinds of research will bring in the money.

The other side of the equation is the pressure on funding bodies to produce research that has social impact. When money is tight, there will always be the temptation to concentrate on research that brings answers to questions that seem directly relevant to everyday questions like, for example, what should we eat to stay healthy?

Second, there is the temptation to highlight positive findings at the expense of negative or inconclusive results. If I’m convinced that red meat causes cancer, I may very well be tempted to emphasise aspects of a study’s results that confirm my hypothesis. Actually, I think it is entirely legitimate to do that, too, as long as we understand that each new piece of research is a new contribution to the scientific debate, which must always remain open-ended and provisional. We want to find regularities and rules that govern our lives and the way in which the world operates, we want to find meaning in the storm of information and experience. Taking sides in such debates is important in the process of clarification. Where this goes wrong is in the shape of the activist researcher, the person who believes that society should implement a certain policy then goes out to find evidence to make the case for that policy.

The third step on the road from research idea to newspaper scare story is the communications department. These PR people are there to promote the institution or the publication in which a study appears. They are also very often staffed with journalists. So they know what makes a good story – and sometimes the good story is not really an accurate reflection of research findings.

Fourth, the busy newsdesk that receives the press release is often not staffed by people with a particular background in science. They know that a press release that says ‘You are going to die of X if you eat Y’ will make a good news story. People will want to read or watch that. What those newsdesk journalists may lack is the time or the tools to question whether the study in question is correct. If the press release is from a well-known institution or the study in question published in a respected journal, then it seems reasonable to assume there must be some truth in it. Here, the tentative findings of a single study transform into ‘Scientists have discovered that [fill in the food] will kill you’.

But there is much more to this misplaced reporting than just these professional pressures. For one thing, readers and viewers themselves seem to be more open to stories about health than they were in the past. I think this is because of some important social changes. I think it is these wider social changes that are really important right now.

Faffing over food as a substitute for ideology

First we have to take a look at the political context. We are living in an era where ideology is, at best, very weak. As an example, in the UK we have three main parties, all of which are desperately trying to avoid being accused of standing for what they used to stand for. The Labour Party is embarrassed every time someone mentions that they are funded by trade unions, and constantly wants to reassure everyone that they will ignore the unions if they get back into power. (This is a safe bet, actually. The Labour Party has been screwing the workers for decades.) You then have the Conservative Party, which is now in the process of promoting gay marriage. Politicians that just a few years ago were voting in favour of banning the state-funded promotion of homosexuality are now promoting the idea of same-sex marriage. And then you have the Liberal Democrats, who are now so illiberal that they want to pretty much ban anything that’s bad for you or enjoyable – or at least make it much more expensive.

In other words, our politicians have given up on big principles. Now they say that they will do ‘whatever works’. This is called evidence-based policy. The trouble is that whenever you decide your policy according to the evidence, then it makes it extremely tempting for everyone – politicians, campaigners, researchers and so on – to create, massage or manipulate evidence to suit whatever policy they want enacted. Evidence-based policy becomes policy-based evidence.

That should be very troubling for anyone who thinks that science should be about a disinterested pursuit of truth because the closer that science gets to policy, the greater the danger that science will be distorted and corrupted by those pressures.

The end of ideology also means the end of any attempt to change the things that politics used to be about. Politicians barely pretend now to have any influence over the economy, for example. The endless problems of the Euro and the inability of politicians to take decisive action are testament to that. So what can politicians actually do? I think there is a strong tendency for governments now to micromanage our lives. What we eat, smoke, drink, how we have sex, how we raise our children, and many other areas of life that were once out of bounds are now of interest to political leaders. But in order to justify that interference, they need evidence. They need science.

So the ultimate argument in politics now is not a philosophical belief in the merits of a policy. It is now simply to say ‘The Science says…’ So an issue like climate change has become a battleground for all sorts of different interests to project policies. What should be policy debates about the future running of society are dressed up as debates about temperature change or the frequency of ‘extreme weather events’. We have two things now: science, the questioning and critical attempt to understand the world; and The Science, the bastard love child of a political class devoid of ideas and a coterie of researchers and medics suffering from megalomania.

Here’s another question posed by this changed political environment. How on earth do I, as an ordinary citizen, exercise any influence over my life? We are choosing between two, three, four parties that largely think the same thing. On top of that, the trade unions that many people were members of in the past are now weak. So when employers make redundancies or cut wages, the isolated individual has no real power to stop them. The other ways in which we lived as communities – like churches or other organisations – are not as strong as they used to be either. Even the family is no longer as secure as it once was. No wonder people feel generally more vulnerable than in the past.

So when change happens, we experience it negatively, as something to be feared. The one person that I can really fundamentally rely on is me. But I’m just flesh and blood. What if my body fails me? I think, in indirect and subtle ways, that general social uncertainty expresses itself in a profound risk consciousness, particularly about the future and particularly about our health.

These are all powerful pressures to produce a kind of science that is narrow, policy-orientated and driven by the desire – among some people, not all – to create fear to justify action.

This is bad news for science, I think. Science still has a well-earned reputation for making our lives better and improving our understanding of the world. When I was growing up, I marvelled about how science was going to feed the world or allow us to travel among the planets. But a variety of social pressures is distorting science. If we are not careful, people may react against science. We really don’t want that.

What do we do? Well, being ruthless in applying the rational scepticism of science to every claim, even apparently scientific ones, would be a very good place to start. Good scientists and journalists are always asking ‘Is it true?’, even about their own beliefs. I think that is a very healthy attitude.

But I think we need something else, too. What is often missing from popular debate in the West today – scientific, political, economic – is the notion of progress, a society for our children and grandchildren that won’t just be the same as today, something that will be radically different from today and much, much better. Now we aim for longer lives rather than better lives. We aim to reduce our footprint on the earth when we could be shaping the planet to meet human needs. We look at a rising population and we simply aim to eat. We have lowered our horizons, we fear the future rather than embrace it.

Embracing the future and having faith in the ability of humanity to solve problems is not easy in such a gloomy and pessimistic era. But I really do think we need to try. The alternative is to spend our time fretting about every aspect of our lives and to allow ourselves to be manipulated by authoritarians in the name of our health.

In vampire folklore, those bloodsuckers couldn’t enter your home unless you invited them in. Similarly, the parasites who hype up food and health panics won’t be able to mess with our heads if we don’t allow them in.

Rob Lyons is deputy editor of spiked.

This essay is based on a speech to the Bessansap 2012 conference in The Hague, Netherlands, in June 2012 and first appeared in spiked plus.