Summary
Long ago, President Eisenhower warned about the military-industrial complex. Today's parallels are the "food-industrial" and "medical-industrial" complexes that promote unhealthy products and contribute significantly to chronic diseases and healthcare costs. These complexes could be defeated by regulatory measures, such as restricting marketing of harmful products and regulating food content to improve public health. But that would require action by Wes Streeting.
A long time ago (in 1961, to be precise), President Dwight D Eisenhower of the USA warned that:
In the councils of government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex.
The potential for the disastrous rise of misplaced power exists and will persist.
We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery of defense with our peaceful methods and goals, so that security and liberty may prosper together.
Those were wise words from a person who knew more about this issue than most, as he was also the former army officer who led the liberation of Europe from the Nazis. Few in power seem to have noted what he said since then. State capture by private interests detrimental to our well-being has become considerably more commonplace in the last 63 years.
I thought of this when reading Roy Lilley's email on the NHS this morning. In it he noted:
Wherever you are on the debate about the NHS, whatever line you take, everyone will probably agree, stopping people getting sick in the first place is a good idea.
It might be more important than you think. Most of what we turn-up with, to get fixed-up, is up to us.
- WHO estimate 80% of heart disease, stroke, type 2 diabetes and 40% of cancer cases could be prevented by addressing lifestyle risk-factors.
- Obesity, often influenced by diet and physical activity, is a major risk-factor for type 2 diabetes, cardiovascular disease, and some cancers.
- Smoking is a leading cause of preventable death worldwide. About 80-90% of lung cancer cases are linked to smoking, as are the risk of heart disease and stroke.
- Excessive alcohol consumption risks liver disease, cancers and injuries.
- Lack of physical activity, associated with heart disease, type 2 diabetes, and cancers.
- Poor sleep, a compounding factor in poor health.
While it's difficult to pinpoint an exact percentage across all illnesses, studies suggest that lifestyle choices could be responsible for anywhere between 50 and 70% of all healthcare costs and a similar proportion of chronic diseases.
I am hoping he will forgive the extensive quote. You can subscribe to his mail here. It is free.
There is no doubt that Roy and the studies that he refers to are right. A great deal of the time, people in the UK are sick because:
- They eat to excess
- They eat too many ultra-processed foods
- They drink too much alcohol
- They smoke
- They don't walk enough (nothing more is needed, although it can help)
They do not do this by chance: there is a food-industrial complex (to use Eisenhowwer's terminology) that aims to make them sick as a result of the production of these items.
And then there is a medical-industrial complex called big pharma that is only too pleased to prescribe as many drugs as possible to deal with the effects of this.
So the question is, what can be done about this? Roy's answer is to build an awareness of 'wellness'. Mine is to regulate.
Of course, we can't regulate so that people walk.
However, we could remove all marketing material from products like alcohol and ultra-processed food, just as we did with tobacco. And we should. The savings to life and cost would be enormous.
We could also regulate food available for sale when cooked: the sugar content of many is wildly excessive, and artificial sweeteners should not be allowed as an alternative.
It is entirely possible to massively improve well-being, cut the cost of the NHS and extend lives by tackling the addiction to ultra-processed food and alcohol in our societies, which is much more problematic than any issue we might have with illicit drugs.
So why don't we do it? Let's go back to Eisenhower. Let me update his quite for this situation:
Only an alert and knowledgeable citizenry can compel the proper meshing of the huge food, alcohol and pharmaceutical machineries of addiction with our health goals, so that well-being and longevity may flourish together.
So what chance is there that Wes Streeting will do that? Very little I fear: he is in hock to the very industries that threaten our well-being. But we should never forget in that case that he is part of the problem and not part of the solution.
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The problem has been recognised for a long time. It was one of pillars of public health. However, the economic thinking was that humans are fully informed and make free choices. However, we have a low wage low food cost, approach to production. To sweat the assets of big businesses. Of course this results in casualties as the human assets are, as many businesses say , their most valuable resource. Funny they treat them so badly then, cut their wages to make ’em work harder, while directors and executives need inflated wages to make them work!
I question that “lifestyle choices” cause 70% of illness costs, a better term would be “the lifestyle imposed by government and big business”.
I agree Mark, it has been known about for a long while now.
Henry Dimbleby’s very valuable national food strategy raises this issue (https://www.nationalfoodstrategy.org/) though it was Prof Tim Lang’s accessible text “Feeding Britain: Our Food Problems and How to Fix Them” (Pelican Books) that introduced me to this issue.
Lang was a contributor to the Lancet commissions report, “Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems” (THE LANCET COMMISSIONS| VOLUME 393, ISSUE 10170, P447-492, FEBRUARY 02, 2019 – online open access https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31788-4/abstract) which is open access and worth reading.
I think the separation of environmental and food security (DEFRA) from public health issues is unhelpful for food systems policy thinking.
Tim is also a great guy whose office used to be one floor above mine…..
The Food Foundation gave an interesting assessment of the parties GE manifestos and since then on Labour’s action on food in its first month in power. This might be of interest to readers:
https://foodfoundation.org.uk/news/assessing-new-labour-governments-first-month-power
Food policy, though, needs joined up systems thinking between the varied departments – The Treasury, DEFRA, Health and Social Care, Public Heath England, Food Standards Agency, and Education, -and even Digital Culture, Media and Sport (advertising), Housing Communities and Local Government, (local food resiliance ) Home Office (migrant workers), Justice (prison food) and Work and Pensions (low pay). I’ve yet to see little interest from the present Treasury in food policy, though the helpful soft drinks industry levy (SDIL), or ‘sugar tax’ was a step forward in public health policy.
Quite a while ago – probably at least 15 years ago – there was an item on TV news. A large scale study had shown that the majority of all prescribed medications were either useless or harmful. Such a news item would never be broadcast now and pharmaceutical companies would likely sue if negative comments were made about specific products, unless there was plenty of evidence to support the comment.
Big Pharma dictates how chronic illness is managed within state health systems. The “pill for every ill” model dominates. New research, for example about the impact of lifestyle changes, is ignored or given little attention, in case it might reduce consumption of drugs and so reduce profits. The role of the physician seems to have been lost and the doctor’s job has dwindled to being a salesman for the drug companies.
.
A worthy line of investigation would be just how much research into the health affects of sugar has been suppressed and by whom?
The obsession with fats has also not helped, and pushed us off the scent somewhat.
“The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet” by Nina Teicholz is a very interesting book which shows how years of misleading science has impacted on policy, and in turn made the population much sicker. And how any researcher that suggested sugar was the problem rather than fat had their funding dropped. Sugar industry using many of the tactics the tobacco industry (unfortunately successfully) used years ago. And eye opening book.
The sugar lobby sought to divert attention from what they were doing
“And how any researcher that suggested sugar was the problem rather than fat had their funding dropped.”
Sugar AND fat are the problems, not one or the other. In the West, once other factors are accounted for, wholefood-eating vegans live longest, then vegetarians who eat dairy, then lacto-ovo vegetarians, and finally omnivores.
But good luck getting any policy changes along these lines. Labour is absolutely captured by the corporations, just like the Tories were in the 1980s when food started to become a political issue.
Pink Floyd’s Roger Water shared some good advice that he received from his mother: read, read, read .. learn everything you can about the subject .. and look at it from both sides .. and then you do the right thing. Source: https://youtu.be/mqx_RS2NLg0?si=T0SDreWAzocb9aN4&t=41
With that in mind, I’ve been reading material from and about “the other side” written by qualified professionals (I may have dismissed Modern Money Theory if I had not read material from professor of economics Stephanie Kelton and professor of accounting Richard Murphy)
I’ve also noted how the mainstream reacts to such views. Do they make a reasoned response, or do they resort to ad hominems, attempts to discredit, or use the weight of the law?
I can suggest the following as useful background information (I am not claiming that any of it is correct):
The Salt Fix: Why the Experts Got it All Wrong and How Eating More Might Save Your Life (2017) Dr James DiNicolantonio
https://amzn.eu/d/e6TP163
Pure, White and Deadly: How Sugar Is Killing Us and What We Can Do to Stop It (2016) John Yudkin
https://amzn.eu/d/375pYRX
The Big Fat Surprise: why butter, meat, and cheese belong in a healthy diet (2014) Nina Teicholz PhD
https://amzn.eu/d/hr4Du0i
Lies My Doctor Told Me: Medical Myths That Can Harm Your Health (2019) Dr Ken Berry
https://amzn.eu/d/9LaMoWd
The Real Anthony Fauci_ Bill Gates, Big Pharma, and the Global War on Democracy and Public Health – Robert F. Kennedy Jr. (2021)
https://amzn.eu/d/0N9f4oP
Do you have a website for these reading lists? It would be an amazing resource…
Books by David R Montgomery, particularly “What Your Food Ate”. Excellent reading lists /references.
Also Chris Van Tulleken “Ultra Processed People”.
Bit specialist but very absorbing “Nourishment” by Fred Provenza.
Thanks
Might our recent and current directive and not explorative educational set up also be another negative factor?
It imposes instructed, passive learning instead of questioning, analytical, assertive learning and attitudes which are vital for our children and our citizenry so that they may protect themselves against, and change, parasitical big businesses.
It also encourages attitudes of negative passivity instead of positive attitudes of questioning alertness and the skills of speaking out and speaking up.
P. S. According to Michael Hudson, there a three basic powers in a society:
1) The government
2) The very wealthy and influential
3) The rest of us
Are we at a phase when 1 and 2 are combined against 3?
Yes
And that is the disaster
Eisenhower was pointing out a structure of corporate capitalism that was already ingrained.
These negative product externalities were formally identified by Pigou, who then proposed a taxation model to remedy them. That was in the 1920s. We still do not have any substantive Pigovian taxes.
Possibly the banning of CFCs has been the only rapid response to supranational regulation, that was remotely successful.
The problem with living in a plutocracy has been regulatory capture weakening and delaying every regime. It dominates utterly.
Reeves capture by finance and corporate wealth interests already directs and controls the current government.
I’d like to agree that regulation works, and in a limited way it does, the recent sugary drinks case study being an improvement, but not a solution.
However, until top down government isn’t merely serving the very worst corporate agendas, the end results can only be partial.
As the very last thing controlling influences want is well informed people, Gove demonstrating how easy it is to screw up education, then that choice is also constrained.
I’d say minor incremental change is most likely, but we are scunnered in terms of major change without the political will. Finland did do it over its heart disease problem though, so there is hope.
You use the sugary drinks tax as a “partial solution”, but I look at unintended consequences. Zero sugar fizzy drinks are equally disastrous, for the sugar has been replaced by artificial sweeteners which damage the gut microbiome.
Back in the day , in the 80’s , my kids had a fizzy drink and a packet of crisps on a Friday night, as a treat – imagine trying that now ! I fear legislation would not work, only Education to the point that the companies find the product not worth manufacturing anymore.
Yes, there is always the risk of unintended consequences.
Hence my phrasing “an improvement but not a solution”
I can’t remember if I’ve shared this previously but regardless I’m convinced it should be essential viewing.
Sir Harry Burns was Chief Medical Officer for Scotland under Alex Salmond
https://youtu.be/yEh3JG74C6s?si=HuuU9FAQ-r-Qy1jr
@ AndrewN
Bravo, Harry Burns.
Thanks for posting.
Essentially the four pillars that public health sets out to address. Alcohol, Obesty, Sexual Health and Tobacco. Obesity is the hardest to tackle. Public health, never well resourced has seen its surprisingly low budget cut in real terms whilst population has grown has accentuating the decline in spending per person.
The heath linkages are well understood as are the potential benefits to the NHS. There is no lack of knowledge. To his credit Chief Medical Officer, Chris Whitty has been clear and persistent in delivering this message.
The economic case for spending on public health should excite any Heath Minister or Chancellor. Local authority public health interventions funded provide excellent value for money, with each additional year of good health achieved in the population by public health interventions costing £3,800. This is three to four times lower than the cost resulting from NHS interventions of £13,500.
When bright people/politicians make poor decisions you have have to ask why?
Some facts and stats:
https://www.health.org.uk/news-and-comment/charts-and-infographics/public-health-grant-what-it-is-and-why-greater-investment-is-needed
Only 50-70%?
I think old age accounts for a greater percentage than 70%.
The graph and accompanying text in this article is helpful
https://ukhsa.blog.gov.uk/2019/01/29/ageing-and-health-expenditure/
I have never understood why we would leave the development of medicines entirely to private profit- companies . Their incentive is to develop drugs that dont cure or prevent illness but maintain us alive but still ill.
Surely there should be an international UN-linked non profit company which would find new antibiotics even though there is no profit in them for private companies.
Of course Streeint will do nothing . Again it seems that global capitalism is becoming more and more stupid – even in its own terms – by not trying to mitigate its worst effects on the populaiton
When I was first diagnosed with diabetes a dozen or more years ago (I’m afraid family history is the main reason) my GP at the time said some wise words. “Put 10 newly-diagnosed diabetics in a room and 8 will be obese, and 2 skinny, like you”. Not much comfort, admittedly. She went on to say that we are simply not adapted to the “post-industrial revolution processed crap diet”. What she went on to explain is that we have only been eating high levels of grain-based carbohydrates for about 12,000 years – a tiny period in evolutionary terms – and still have the guts of hunter gatherers. Whilst I have always taken diet seriously, mainly scratch cooking, and wholefoods, I have found avoiding too many grains (or potatoes) very helpful. Dr Sarah Myhill writes about this, too. Sounds vert like common-sense to me https://drmyhill.co.uk/wiki/Main_Page
Opposite my office, which is near the secondary school in my village, is a branch of a competitor to Greggs. I see the skinny young things lining up to buy their sausage rolls and pasties most days, along with the obese parents and grandparents. They don’t seem to add it up, that that’s their future, unless they change their ways. I have hope about this, though, as my children and their friends rarely drink alcohol, eschew drugs, keep very fit and even scratch cook all the time even when away at Uni. I believe that 30%-50% of those in higher education have similar lifestyle choices.
On the other hand, I met with a young couple not so long ago who literally had never scratch cooked anything as they had never been taught how to peel an onion, let alone know how to grow radishes or lettuce in their garden!
It scares me how some people – as you say – knw nothing at all about what you call scratch cooking, let alone the pleasure of doing it (I enjoy it: it’s a total change of pace)
The twin forces of socialism and nimbyism have combined to make so many of us live in rabbit hutch housing with tiny kitchens. You could teach everyone how to cook from baser ingredients, they don’t have a large enough kitchen to do it, let alone a dining table. Average new build housing in Ireland is 20-40% larger per person than ours by all accounts, they are doing right.
Come on, I can cook a one pan meal in a camping gas stove. I accept the point re housing but I don’t think that makes cooking impossible.
“…I can cook a one pan meal in a camping gas stove….” I’m sure you can. But somehow you learned the basics of how to do it. I learnt by watching (mostly) my mother because the kitchen was the warm room in the house and there was space to be there.
Pokey little galley kitchens don’t allow for that sort of learning by example and almost osmosis. My mother never taught me to cook. I simply learned how to by watching and occasionally ‘helping’ in a small way.
Space matters and many modern British houses are pokey and small and frankly mean.
I accept the point that a pokey kitchen will never be the heart of a house
@ Mark Meldon,
I was what was described as “on the cusp” of type 2 and was almost one of the “skinny, like you”; being 6’2″ with, at the time, a 30″ waist.
It came about because I was supplementing my income by, helping out an agency that provided local crew for event work, mainly gigs. The agency had full-time work for about a dozen, with around 20 part-timers, drifting in and out as their other work permitted. When a stadium show comes along, they need 200, or more, which is how I got a start; before long I was one of the 20.
The problem was (and is) that you don’t get through the work involved on 2,500 kilocalories a day. I was eating a lot of energy dense food, but as I’d dropped a waist size and wasn’t carrying any spare body mass, I assumed I could eat whatever I liked – I’d just burn it off. I was very wrong.
I can cook from scratch, my mum taught me from an early age. I’d just made a bad assumption, because I’d (up ’til then) always associated type 2 with obesity. I learned the hard way that it isn’t always the case.
Thanks
There is then the question about how we can promote mental as well as physical health…
We have cats, and in the past kept chickens. Cats are reasonably long lived animals who seem to do well on a ‘manufactured’ diet.
A lot of work is done to produce healthy cat food – ironically by Mars (of bar fame) so why dont we put the same effort into feeding people properly.
It has been done in the past, for fairly obvious reasons the early work was done by the Royal Navy and back in the late 80’s when I was press-ganged the ‘Pound and Pint’ scales laid down in the 1894 Merchant Shipping Act still had to be displayed.
The book -Dr Atkin’s Age Defying Diet Revolution – published well over 20 years ago. A bit technical, but still a good source of dietary and health info and advice particularily re Diabetes type II
Thanks
Of course there are problems associated with a healthier population:
https://www.youtube.com/watch?v=p1DviQ9mva0
“Financially speaking, it is unquestionably better that people continue dying at the present rate”
— Sir Humphry
That is what worries them
Bottom line is we don’t know the answer to this seemingly simple and growing problem.
Personal upbringing and characteristics severely affect our ability to understand the choices that others make. I love cooking, partly for the reasons that Richard mentioned, but there are no grounds to assume that all would come to enjoy cooking their daily meal whether they have the facilities and the ingredients to hand or not.
I would recommend reading Dimbleby’s National Food Strategy parts 1 & 2 for some insight into the challenge. Mark Bitman’s ‘Animal Vegetable Junk’ for the same reason and for an interesting take on how to fix the issue the following extract,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719695/
Ps. A text by RFK Jr is suggested by an earlier post. The scientific community does not speak highly of Robert’s book. Science is difficult. Good science is bloody hard. In the same way that a college education doesn’t make you clever, ignorance doesn’t make you wise. Too many scientifically illiterate folks are too keen to put pen to paper. In my view they aren’t helping anyone.
Michael Power wrote: “The scientific community does not speak highly of Robert’s [Kennedy’s] book. ”
I am reminded that the economics community does not speak highly of Modern Money Theory, yet here we are.
Big Food, Big Pharma and Big Finance have ulterior motives. The information (and the science) can be manipulated.
I can recommend “A Field Guide to Lies: Critical Thinking with Statistics and the Scientific Method” by Daniel Levitin (2017)
Here is just one specific example, how Big Pharma uses “relative risk” instead of “absolute risk” to exaggerate a benefit.
“Relative Risk Reduction vs. Absolute Risk Reduction – Dr Malhotra ” (Only 5 mins)
https://www.youtube.com/watch?v=hb_oQox1YqE
For more detail, here is a 56 min talk by Norman Fenton, Professor of Risk and Information Management at Queen Mary University, London
Risks and benefits with Professor Fenton, https://www.youtube.com/watch?v=fgVpVHL8nkY
Ian wrote, ‘The information (and the science) can be manipulated.’
Doesn’t that equally apply to conspiracists with books to flog and talks to sell-out?
Michael Power wrote: “Doesn’t that equally apply to conspiracists with books to flog and talks to sell-out?”
Of course it does. But information can be checked and verified. So unless you have something specific about RFK and his book, then we’re just dealing with our opinions.
“….the former army officer who led the liberation of Europe from the Nazis.”
With a little help from the Russians who got to Berlin first at enormous cost in terms of human life.
Interesting in terms of ‘Overton windowism”. just how left wing and civilised Eisenhower was by modern standards. As a republican president he was highly supportive of the need for trades unions, I read somewhere. Possibly the last respectable POTUS. I can’t think of another one. (Jimmy Carter perhaps?)
This is a very important post, but I get the feeling you could have a blogsite on this topic alone. Just the crimes and corruption committed by Big Pharma over the past few decades would occupy a blog writer.
They do, I am sure
But that’s not going to be me
I view within the context of a bigger picture
https://theconversation.com/a-more-varied-diet-would-help-the-worlds-economy-as-well-as-its-health-236815?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20August%2019%202024%20-%203070331314&utm_content=Latest%20from%20The%20Conversation%20for%20August%2019%202024%20-%203070331314+CID_992563e2cfb2ff431b48c7250d480baf&utm_source=campaign_monitor_global&utm_term=A%20more%20varied%20diet%20would%20help%20the%20worlds%20economy%20as%20well%20as%20its%20health
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