Note from Kevin & Shirley: We’re off for the next couple of weeks, returning March 2nd. But here’s a lovely long article to keep you going till then.
Should we ban fast food or at least place restrictions on it, such as where it is sold and who it is sold to? It’s an intriguing and clearly controversial idea but it’s one that seems to be gaining increasing traction as a possible approach to tackling the obesity epidemic.
The idea draws its inspiration from the anti-tobacco campaign. For years governments in different countries relied on warnings on packets, ads on TV and in magazines, and public education campaigns to tell smokers how bad cigarettes were for them. That dissuaded some people, but millions more kept on puffing away.
So governments raised taxes, driving the price of cigarettes ever higher. Still people kept on smoking. Even news stories about the horrors that smoking inflicts on your lungs, brain and body didn’t stop people lighting up.
Then some governments, at both the national and local level, began to introduce increasingly severe bans. They outlawed smoking in the workplace. Then they banned it in restaurants, in bars, in parks and public beaches. Slowly the noose tightened till it became harder and harder to light up. Each ratcheting of the laws persuaded more and more smokers that it was finally time to quit. Millions still smoke, but much fewer than in the past.
So the lesson from the anti-tobacco fight is that just having information on how bad something is for you is not enough. There have been complaints about the stench and health affects of tobacco almost from the day in 1600 when Sir Walter Raleigh persuaded England’s Queen Elizabeth I to try smoking, yet it has taken hundreds of years to get the numbers smoking to go down rather than up.
Information alone is clearly not enough. It has to be backed up by action.
That is why some public health experts say the same approach may be needed for fast food and junk food.
We know fast food is part of the reason why so many people in so many nations around the world are overweight or obese (there are of course other reasons, but one step at a time). We also know that all the information about how bad fast food is doesn’t seem to have made much of a dent in the numbers of people eating it.
Requirements to have nutrition labels placed on products and packages doesn’t seem to have changed things, in part perhaps because most people either don’t read them or don’t seem to understand what those nutrition labels are telling them.
For instance a study published in the June 20th, 2008 issue of the Journal of Public Policy and Marketing says that many consumers do not know how to interpret the meaning of the phrase ‘trans fat content’ on the nutrition facts label. The researchers found that if the label says the product has 4 grams of trans fat, many people have no idea if that’s high or low. (It’s high. The government recommends that people consume no more than 2 grams of trans fat a day. Most Americans eat at least double that, in part because foods such as French fries in fast food restaurants can pack as much as 7gm of trans fat).
Clearly information by itself is useless if people do not know how to apply it or interpret it, so do we try and educate people how to use the information?
Well, the government already issues pamphlets and educational materials on diet, nutrition and health. So do most states and even individual city and county health departments. The internet is rich, almost overwhelmingly so, with information about diet and nutrition and health. Turn on the TV news or pick up a newspaper and it’s rare not to find some kind of health item.
But all that information hasn’t seemed to make that much of a difference. As a result that has some experts thinking that maybe it’s time to take a different approach to fast food. Ban it. Or at least severely restrict it.
Margo Wootan is the Director of Nutrition Policy at the Center for Science in the Public Interest, a public watchdog group that advocates for nutrition, health, food safety and sound science. She says “obesity is one of the most pressing and expensive health problems facing the country, we can’t afford to ignore it.”
Wooton says we need more education, consumers need better information, and schools need to do a better job of providing nutritious food for children.
But she says that alone is not going to be enough. ”Studies show a clear link between eating out and eating more calories and obesity. Children eat almost twice as many calories when they eat a meal at a restaurant compared to a meal at home.”
Sadly the problem is not unique to the U.S. Europe is rapidly catching up with us in the numbers of people who are overweight or obese. According to a study in the September, 2008 issue of the European Journal of Clinical Nutrition, Britain currently has the largest proportion of overweight or obese people in Europe with more than half the population overweight, and 17 percent of men and 21 percent of women obese. In fact one in eleven deaths in the UK is linked to being fat, that’s 50 percent more than in France.
Barbara Burlingame, Ph.D., Senior Nutrition Officer at the Food and Agriculture Organization of the United Nations in Rome, Italy (FAO) says the reasons for this global rise in obesity are easy to identify. Too little exercise, too many calories.
For more and more people their diet is mostly made up of manufactured and heavily processed foods, things that can be cooked quickly for families racing from school and work to soccer practice and swim meets. Those foods may be convenient but they are also packed with salt and sugar and fat and empty calories.
“Fat is not the only issue,” says Burlingame. “Sugar is now one of the main concerns as well”
Portion sizes are also getting bigger. Numerous studies have shown that since the 1970s food portion sizes have steadily increased, and a study from the University of North Carolina at Chapel Hill, found that the biggest portion increases were in fast food. So not only are people eating a bad diet, they are eating more of it.
Burlingame says “information alone is not the answer because by itself it doesn’t change behaviour. Self-regulation is not an effective strategy. The only effective way of reducing smoking was to ban or tightly restrict it. The same approach may be needed to change behaviour about fast food and junk food.”
Clearly we can’t ban fast food. That would be unacceptable to most people and probably unconstitutional (at least in the U.S.). But what about taxing it heavily the way we tax cigarettes, and using the money for public education and to cover the soaring medical costs of treating all the health-related problems rising from obesity?
What about limiting how it is sold and where, such as a short-lived ordinance passed by city officials in San Jose, California, preventing McDonalds and other fast-food restaurants from being within 1,000 feet of a public school?
There’s good evidence that making it harder to get can reduce consumption. In April 2008, a study by the Center for Public Health Advocacy found people who live near an abundance of fast-food restaurants have higher rates of obesity and diabetes, regardless of individual or community income. Those who didn’t have fast-food restaurants nearby didn’t eat as much.
What about age restrictions on who can buy it, preventing children under the age of, say, 14 buying fast food without an adult being present?
Some countries are already taking steps such as limiting advertising on TV, so there are no fast food ads during times when children are most likely to be watching.
What about extending those limits on advertising to stores, buses, billboards or anywhere children are likely to see them, or at the very least to make sure those ads do not target kids.
What about banning promotions or free giveaways associated with Disney or other movies that try to link fast food consumption with popular culture?
While these questions are intriguing and have support among some public health experts they understandably get a frosty reception from the food industry.
Daniel Conway is the Media Relations Manager for the California Restaurant Association. Conway says “I think it’s safe to say we’re skeptical about what kind of impact this will have on obesity. What we are certain of is that it sends the wrong messages to businesses, companies that provide good paying jobs, in the midst of a recession.”
Conway says many fast food restaurants already offer nutrition guides to their menu, and that those menus have changed substantially in the last few years and now include many healthy items such as salads.
He also says this is a very narrow approach to a very broad problem; “I think to address obesity you need a comprehensive approach; you need to educate parents and kids, you need to encourage exercise and create more parks and open spaces where families can exercise safely. Targeting fast food restaurants is a superficial way of addressing a complex issue.”
That opposition is not surprising. When people were trying to place limits on smoking they ran into strong opposition then as well, from tobacco companies and smokers, but ultimately the issue was decided not by what was best for smokers, but by what was best for society as a whole.
Just as cigarettes are taking a heavy toll on life so fast food is now contributing to another deadly problem, obesity. According to the Centers for Disease Control and Prevention obesity is now responsible for around 300,000 deaths a year, second only to tobacco-related causes.
In March 2006 the U.S. Surgeon General called obesity “the terror within” and said it would “dwarf 9-11″; but many in Congress are opposed to efforts to regulate fast-food sales.
After a series of lawsuits targeted the fast-food industry some members of the U.S. House of Representatives said the problem was not a Big Mac but a big lack of personal responsibility on the part of consumers. The House passed the so-called “Cheeseburger Bill” (more formally known as the Personal Responsibility in Food Consumption Act) to protect restaurants from obesity lawsuits. But the measure ultimately died in the Senate.
One thing is for certain, the problem of obesity is not going away. The debate over who is to blame and how to fix it has no easy answers. But at least the conversation has begun.