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19 July 2014 - Michelle's blog - Regulating for health – to nanny or not to nanny

Michelle Berriedale-Johnson
Extremely interesting FABResearch conference last week – Sugar, Fat & Food Addiction: New Approaches to the Public Health Crisis; I will be reporting on the medical aspects in next week’s newsletter.

However, two of the presentations focused not on the medical aspects of the crisis but on how a public health policy addressing it could actually be implemented.


Professor Graham MacGregor is an eminent medic specialising in cardiovascular medicine and hypertension, but he shot onto the front pages in the late 1990s with his CASH (Consensus Action on Salt and Health) Campaign. He now wants to apply the same tactics to sugar which he blames, along with ultra-processed fast foods, for the obesity and diabetes crises.

The Professor does not mince his words. The current government’s platitudes about ‘freedom of choice’ are rubbish. The socially deprived do not have choice in what they buy to eat. They buy the cheapest and most easily available food because it is cheap and available 24/7 and because they are constantly bombarded by above and below the line promotion for that food by the 10 multinational food giants who manufacture 90% of the food that we eat.

The only way that anything can be done about it is if the food manufacturers, under pressure from government, incrementally reduce sugar in all products by 40% (especially and most urgently, soft drinks), cease all forms of advertising including sports sponsorship for ‘junk’ foods, reduce portion size and limit the availability of these foods. Meanwhile, the government needs to introduce a sugar tax and, essential for all of this to happen, both scrap the current ridiculous ‘Responsibility deal’ in which the food industry ‘polices’ itself – and remove responsibility for nutrition from the Department of Health and return it to an independent agency such as the Food Standards Agency.

Somewhat more nuanced, but no less persuasive, arguments in favour of government intervention were also made by Professor Simon Capewell, Professor of Clinical Epidemiology at Liverpool University. Even though, in the current political climate,  government intervention is seen as intrusive ‘nannying’, looking back over the last 200 years, it is clear that government intervention has been crucial in all the major improvements in population health and well being: the provision of safe drinking water, sanitation, clean air, tobacco control – even the abolition of slavery. Advice, public health leaflets, ‘nudging’ simply does not work – regulation does.