Britain’s diet is more deadly than Covid
Our food system is creating a huge health crisis yet politicians are too worried about nannying and too in thrall to business to act.
I have been aware of this since 2004, when I did an Obesity and Diabetes training course. Back then, the tutor was highlighting the key interventions needed to come from Government. But unfortunately, the food industry is too much of a money machine.
What do you think is the biggest cause of avoidable illness and death in this country? Smoking? Drinking? Drugs? Wrong on every count. The thing that is most likely to kill you before your time is the very thing you need to stay alive: food.
Not all food, of course. Not the kind that, even now, springs to mind when we imagine sitting down to eat: something freshly made, from recognisable ingredients, in a kitchen, by a human. But most of the food eaten in this country is nothing like that. Ultra-processed food — meaning a packaged product, generally high in calories and low in nutrients, containing unfamiliar ingredients that have been through multiple stages of industrial processing — makes up 57 per cent of the British diet. We eat more of this stuff than any other European nation.
More than 80 per cent of the processed food sold in the UK is so unhealthy that, under World Health Organisation guidelines, it is considered unsafe for marketing to children. It doesn’t do adults any good, either. Our diet of cheap, sugary, fatty food is making us pile on the pounds. Sixty per cent of adults in this country are overweight or obese, and by 2060 that proportion is expected to reach 80 per cent.
The side-effects of obesity include depression, anxiety, infertility, high blood pressure, painful joints, breathlessness and broken sleep. That is before we even get to the big ones: cancer, dementia, heart failure and type 2 diabetes, which has its own attendant risks of blindness, peripheral neuropathy and limb amputation. By 2035 the NHS is expected to spend more on treating type 2 diabetes — just one of the multitude of illnesses caused by bad diet — than it does on all cancers today. Already, the Organisation for Economic Co-operation and Development estimates that the UK economy loses £74 billion a year in reduced workforce productivity, shortened lives and NHS costs because of conditions related to a high BMI.
It is extraordinary that there is not a public uproar about this. Imagine if a novel virus started killing and disabling people on such a scale, and with no end in sight. You don’t have to imagine it: we know how far politicians and the public will go to combat such a threat. Unlike Covid, however, the plague of diet-related disease has crept up on us stealthily, under the seductive guise of “choice”. Our food system has slid into dysfunction, taking our bodies with it. This change has been sufficiently gradual to lull us into a kind of helpless submission. No matter how bad the headlines, the British public (and political class) can’t seem to muster an appropriate level of fear. Instead, we recoil instinctively into what we believe to be “common-sense” solutions. Too often, those solutions are not just wrong but counterproductive.
Between 1996 and 2020 successive governments introduced 689 different policies intended to halt our national weight gain. Yet we keep getting fatter and sicker. This is because such policies nearly always come at the problem from the wrong angle. They start from the assumption — shared by most in this country — that dietary ill health is chiefly an issue of personal responsibility; that the answer must be to educate the masses in healthy eating, encourage us to exercise and leave the rest to individual willpower. This feels like common sense. We know our bodies grow or shrink depending on what we put into them and feel a rush of impatience at the idea of blaming “the system” for our expanding waistlines. Surely it is up to each of us to take responsibility for what we eat?
This line of thought fails to address the sheer scale of the problem. In 1950 under 1 per cent of the UK population was clinically obese. Today, the figure is 28 per cent. Are we to believe that, in the intervening years, the population has suffered a massive collapse of willpower? Of course not. Humans have not changed. The food system has.
Many people find it hard to imagine that a food “system” really exists, let alone that it could be shaping their behaviour. The purpose of my new book, Ravenous, is to lift the lid on that system, to show how the vast, complex, strangely invisible machinery that feeds us actually works, and what it is doing to us and our planet. Seventy years ago it was widely assumed the world was on the brink of running out of food. The global population was rising fast — projected to increase from 2.5 billion to nine billion over the coming century. How could all these people be fed?
The so-called Green Revolution saved the day. Scientists developed new, higher-yielding crop breeds. By combining these with artificial fertiliser, pesticides, herbicides and high-tech machinery, farmers could generate much bigger harvests. As expected, the global population boomed. There are eight billion people on the planet today yet the threat of mass starvation has receded. Globally, we produce around 50 per cent more calories per head than we need. (Much more if you include the crops we feed to livestock to get meat.)
Now that revolution’s side-effects are beginning to kill us. The environmental costs of the modern industrial food system are staggering. It is the number one cause of global deforestation, drought, freshwater pollution, soil degradation and biodiversity collapse. After the energy industry it is the biggest cause of climate change, responsible for 25 to 30 per cent of global greenhouse gas emissions. All this, in turn, poses a grave threat to the food system. Unpredictable weather events, poor soil, the decline in pollinating insects, drought, floods, rising sea levels: these are by far the biggest dangers to our food security (bigger even than President Putin’s war in Ukraine). Climate change is already affecting agricultural yields. The parched summer last year produced dismal harvests in Europe. In Italy the worst drought for 70 years led to a drop of about 45 per cent in corn and animal feed crops. In France maize crops were 28 per cent below forecasts.
More recently we’ve seen how a freak cold snap in Spain and Morocco led to vegetable shortages here, exacerbated by a peculiarity of our local food system. UK supermarkets buy most of their produce on fixed-price contracts in order to offer cheap products at stable prices to consumers. They are reluctant to pay more for produce, even when it is in short supply. In continental Europe supermarkets responded to the shortages by paying over the odds to wholesalers, outbidding UK retailers. This meant passing on higher prices to their consumers, which in turn reduced demand — but their shelves were full. I was sent a photo of shrink-wrapped cucumbers, packaged and labelled for a UK supermarket, for sale in a market on the Costa Brava. The producer had simply followed the money.
However, the fundamental threat to our food security is environmental. Our rapacious food system is destroying the ecosystem upon which it depends. And then there is the damage being done to our bodies. Biologically, we are hunter-gatherers. If you have to search for everything you eat, it makes sense to look for things that give you more calories than you expend. When we eat honey, for example, our taste buds respond with intense pleasure: a natural feedback mechanism to reward us for finding such a bountiful source of energy. The same is true of chocolate ice cream. It contains six times as many calories as broccoli and our appetite for it is correspondingly powerful.
This craving is strongest when fat and sugar are combined in a ratio of 1:2, the ratio in breast milk. Food manufacturers use this formula in products such as ice cream, milk chocolate and biscuits, knowing we find it irresistible. Even allegedly savoury products such as ready meals are often doused with sugar and oil to give them a “moreish”’ flavour. Processed food tends to be low in water and insoluble fibre. This is known to slow down the body’s “satiety” signals, the feeling of fullness, so we eat more of it. Because each mouthful is more calorific (and less nutritious) than a mouthful of broccoli the consequences of eating just a little bit more are greater too.
As well as being easy to sell, this kind of food is cheap to make. The Green Revolution has created an abundance of sugar, flour and vegetable oil. So companies have a financial incentive to develop and promote foods that chiefly use these ingredients. They do so not just to capture a bigger slice of the market but to grow the market itself. Young marketeers are taught about the “consumption effect”: people who have more food in their home will eat more of it. In-store promotions such as the classic “bogof” deal (buy one, get one free) are explicitly designed to persuade shoppers to buy more than they intended. Chocolate has an “expandability” of 93 per cent, meaning if you run a bogof on chocolate, customers will on average consume almost twice as much as they would have without the promotion.
The average Briton now consumes five times more crisps than in 1972. We eat 1.5 times as much breakfast cereal (which has become far more sugary). You only have to cast your eye around your local supermarket, where fresh ingredients form a thin coastline around the great landmass of processed, packaged food, to see how the consumer landscape has changed. Confectionery alone — a small section of the processed food market — is worth £3.9 billion. By contrast, the entire fruit and veg market in the UK is worth £2.2 billion per year.
The bigger the market, the greater the economies of scale. Highly processed foods are, on average, three times cheaper per calorie than healthier foods. This is one reason why bad diet is a particularly acute problem among the poorest. How we eat is one of the clearest markers of inequality. A diet of cheap junk food has the peculiar quality that it can make you simultaneously overweight and undernourished. Children in the poorest areas of England are both fatter and significantly shorter than those in the richest areas at ages ten and 11. (The average five-year-old in the UK is shorter than their peers in nearly all other high-income countries.)
Dietary ill health is a major reason why, at the height of the pandemic, people in the most deprived areas were twice as likely to die from Covid. Even before then, the upward trajectory of life expectancy in the UK had begun to slow and, in some areas, go into reverse. Women in the most deprived 10 per cent of neighbourhoods in England now die 3.6 months younger than they did in 2010. Their life expectancy is 7.7 years shorter than that of women in the richest areas. The differential for men is 9.5 years. For “healthy life expectancy” — the number of years a person spends in good health — there is a gap of 19 years between rich and poor.
The problems created by our food system are too enormous and too entrenched to fix through individual willpower alone. Government intervention is required. But politicians are extremely nervous about interfering in matters as personal as what we eat. They are easily intimidated by noisy libertarians, within their own parties and in the media, who punish any whiff of nanny-statism. And they are susceptible to scaremongering from industry lobbyists who fight hard to maintain the multibillion-pound status quo.
Food company bosses have mastered the art of polite intransigence, making sympathetic noises about doing the right thing while refusing to do it. Any politician who attempts to force through change using legislation will be visited by a stream of hand-wringing chief executive’s assuring them, in tone of regretful pragmatism, that such a law would wipe out their profits and put an irreparable hole in the economy.
I recently left my role as lead non-executive director of the Department of Food and Rural Affairs because I can no longer swallow my frustration. There are so many things the government could do to shift the food system on to a better track. (For a full list, please do read my book.) Far from endangering the economy, acting now would prevent us sliding further and further into ill health, low productivity, dwindling tax receipts and a health service so overwhelmed by diet-related disease that it sucks the national coffers dry.
Instead, we are paralysed by political indecision. No, worse — we are going backwards.
Having promised in 2020 to bring in restrictions on junk-food promotions and advertising to children, the government has now “delayed” this until the next election. If it can’t even bring itself to enact this fairly modest – and hugely popular – policy, what hope is there for wider systemic change?
Part of the difficulty is that responsibility for food policy is spread across multiple, often competing, government departments. Too often, these departments end up acting as client states for the industries they represent. It is up to the Treasury, for example, to decide whether food companies should be taxed on the sugar they put into processed food. (This was one of the recommendations I made in the National Food Strategy, an independent report for the government published in 2021.) The Department for Digital, Culture, Media and Sport decides whether, and when, the advertising of junk food to children should be restricted. The Department for Education decides who is eligible for free school meals. And the Department of Health and Social Care is left to clear up the mess.
Bringing together these fiefdoms in order to force through reform requires strong, consistent leadership at the top. The political tumult of recent years has made that impossible.
And yet the system is fixable. In fact, change is inevitable. Sooner or later, the damage done by our current food system will become politically and economically unsustainable. The question is: how much suffering are we prepared to inflict on ourselves before we intervene? Do we really want to wait until a crisis becomes a catastrophe?