We are all conscious of the tide of lifestyle diseases that is sweeping the world towards ill-health and early death. As we look at statistics of rising rates of all these lifestyle diseases – obesity, cancer, heart disease, diabetes, we realise that it is going to take more than a little multidisciplinary effort to turn the tide.
Our government is trying to change one of the factors responsible – sugar – by introducing the sugar tax. This has seen much opposition, particularly from big business. But even trade unions have opposed it. The opposition is strikingly similar to that when anti-tobacco legislation was being mooted – freedom of choice; job losses; falling tax revenues; economic hardships. But more concerning is the way that big business lobbies government representatives to try to block the legislation. One can only guess what people get out of siding with big business interests.
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I recently was perusing the American Association of Clinical Endocrinologist and American College of Endocrinology – Clinical Practice guidelines for developing a Diabetes Mellitus Comprehensive Care Plan, dated 2015. This is a large 86 page document, with hundreds of references. A team of more than 30 specialists must have spent many hours developing these guidelines.
However, at the end of the article under the section – disclosures – all but 3 of the contributors either had shares in many of the large pharmaceutical companies that produce diabetic medications or get paid for lecturing or promoting their products.
This doesn’t bode well for independence and lack of conflict of interests. It is no wonder that the section promoting lifestyle changes as a significant management strategy for reversing diabetes is so very short. And yet so much research and personal experience have proved that this intervention is far more powerful than medications both in dealing with diabetes itself, and also reducing or eliminating the complications of diabetes.
This same problem exists with dietary guidelines that are developed by government agencies. It is well known that many of the experts involved in formulating these guidelines in the USA at least are heavily influenced by powerful lobby groups in the Egg/Dairy and Agro-business industries. Often research that supports their cause is heavily subsidised, and no doubt influenced by these interest groups. Revelations about this was startlingly revealed in the hard-hitting recent movie “What the health”.
But this blog is not about delving into the politics of the happenings behind the scenes of power. There are far more persuasive and better researched movies and books that examine the intrigue involved. I merely mention these to show that we have to display a healthy cynicism when it comes to the food industry claiming to they have our best health interests at heart; and promoting their products as healthy.
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Michael Moss published his book “Salt Sugar Fat: How the food giants hooked us” back in 2013. This book reveals how food industries have through research sought to create foods that are addictive, through the subtle and not so subtle use of these three ingredients. As we saw in our last blog about food addiction, all three of these stimulate dopamine, the feel-good hormone – in our brains. Food laboratory researchers seek for the “bliss point” for these three substances – levels that create desire and comfort. Too much or too little sugar or salt makes food unpalatable. Fat though has very little upper limit of palatability – thus the fattier, the more desirable.
It would be well for us to read the ingredients and nutrition facts on the labels of some of the commonly consumed foods – particularly those that are the favourites of our children – corn and potato chips, soft drinks, breakfast cereals, sweets, chocolate bars, etc.
I was shocked to read the nutrition information on a packet of corn chips recently to discover that 20% by weight was fat. When we realise that 1 gm of fat provides almost 40 kjoules – 20 gm of fat in 100 gm packet of chips would provide nearly 800 kj. On top of that is the addition of sugar and salt – all three dopamine stimulating to seduce or create the addict.
Some years ago, one of our well-known dieticians persuaded a local restaurant to provide healthier alternatives on their menu. The experiment didn’t last long, and that particular restaurant has also disappeared into oblivion to make way for the usual high fat, feel good restaurant fare. I challenge our local food industry to try recipes that promote health – and I am not talking about Banting alternatives – we will broach that subject at a later stage. It is very difficult to eat out and not have to eat a high fat meal – either with cheese in almost every dish, or the food swimming in oil. One step in the right direction would be for chefs to be open to the concept of responding to requests from patrons to tweak their menu to suit the needs of their individual customers.
Marketing has a powerful influence on our food choices. Advertising of course appeals to our senses, and if we have had enough repetitive exposures, can have a profound influence on our behaviour. But availability also influences our decisions. Have you noticed how the queue lines at supermarkets are well stocked with products that titillate our senses with addictive fast foods. At least one of our local supermarkets has claimed that their queue line foods are more “healthful”.
The single most beneficial intervention to support your decision to eat healthfully is to never go shopping when you are hungry.
It is amazing how hunger can destroy will power! It is a good idea to eat before you go to the shops; and maybe even have a snack before going to the restaurant, so you are not as tempted to overindulge in energy dense foods.
Do I sound like a wet blanket? It all depends if you want to live healthy, happy and free from the scourges of modern living.
To healthy food choices, free from addictive substances.
Dave Glass
Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.
He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.
An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.
He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.
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