(Title Image: superhealthykids.com)

There’s no single definition of “junk food”, but it generally means cheap, processed, high-calorie foods and drinks that contain high levels of salt, preservatives, sugar and saturated fats. At the same time they often contain little in the way of vitamins, fibre and protein.

A simplification would be “empty calories”, where people consume lots of calories from these foods and drinks, but do little if anything to work them off. The result, if a person consuming junk food on a regular basis is sedentary, is weight gain and health problems associated with a rich diet.

Junk foods typically include desserts, snacks (like crisps), fried fast foods, sugary drinks and things like chocolate and sweets – basically anything that actually tastes good and requires minimum preparation before eating or drinking.

All of this presents a number of policy problems for devolved Wales and an independent Wales too.

Why is junk food harmful?

How it’s sold to us

Most big multinationals in the food and drink industry are there because of junk food: fast food chains, drinks companies like Coca Cola and Pepsi, brewers. Big profits require big advertising budgets not only to ward off competitors in a crowded marketplace but to attract new customers – particularly the young. This means bright images, celebrity endorsements and big money sponsorships of major events like the Olympics and football tournaments.

The likes of McDonalds are going a long way to clean up their image by giving chains up-market refurbishments and pushing coffee, wraps and salads. Generally though you’ll never see tofu sponsoring the Olympics or being advertised during popular TV shows.

The closest example I can think of of a “healthy” food being sponsored in the same manner is Mo Farrah’s association with Quorn – but even then “healthy” alternatives aren’t as angelic as first appear. Meat substitutes often have high salt levels despite doing better elsewhere on things like saturated fat, while going too far in the opposite direction and becoming obsessed about food, following fad diets and “clean eating” can develop into eating disorders.

I’m a firm believer in “do whatever you want as long as you don’t harm anyone else or break the law”, but a bit of advice every now and again wouldn’t go amiss. You can still eat crisps. You can still have a take away. Just don’t live off them.

 

Potential health problems

Type II diabetes – One of the fastest-growing chronic illnesses in the western world. Type II diabetes (as opposed to other forms) is caused by an inability of the body to deal with high blood sugar (due to high sugar intake, a shortage of insulin to deal with it and a lack of exercise to burn it off). It can damage the heart, kidneys and eyes and also increases the risk of stroke. According to Diabetes UK, an estimated 177,000 people in Wales have a form of diabetes (expected to rise to 300,000 by 2025) and it costs the Welsh NHS 10% of its annual budget (~£500million) to treat.

Heart disease & cardiovascular problems – These will be caused by a combination of lack of exercise and high intake of fat and salt. A diet high in saturated and trans fats can clog and harden arteries through the build up of cholesterol, causing all manner of problems. High salt intake has been linked to an increased risk of stroke.

Gout & arthritis – Gout is caused by a build up of uric acid in the blood stream, which then deposits as crystals in certain joints resulting in pain. It’s usually caused by a diet rich in sugars, meat and seafood. Osteoarthritis – where the cartilage/shock absorber lining the joints wears down – is a natural consequence of being overweight as the skeleton and joints are put under more mechanical stress.

Poor dental health – Acids created in the mouth by sugar destroy tooth enamel leading to cavities and other assorted dental health issues. There’s overwhelming skeletal evidence that before sugar was routinely part of European diets, people on the whole (particularly the lower classes who couldn’t afford sugar) had good teeth.

Obesity – A condition where an individual carries too much body fat for a person of their height and sex, indicated by a Body Mass Index (BMI) of 30+. Obesity isn’t an illness in itself but is usually co-morbid with other illnesses like diabetes, osteoarthritis, mental health problems, heart disease etc. some of which may become chronic if a patient doesn’t lose weight. It’s right to say you can be statistically obese but medically healthy, but generally that’s not the case, particularly if body fat is stored mostly around the abdomen.

22% of the adult Welsh population and ~12% of children are obese – amongst the highest rates in Europe – and obesity is estimated to cost the Welsh NHS £73million a year. The good news is numbers have stabilised over the last few years, but they remain too high.

Is sugar addictive?

Humans are biologically preconditioned to consume the maximum amount of calories for the minimum amount of effort – it’s a basic pillar of survival. Sugar is energy-dense so we’re naturally inclined to consume foods containing a lot of it as they’re “hyperpalatable”.

As social and technological progress has outpaced biology, we no longer do the physical work that would otherwise burn off the sugar, fats etc. The calories go in, but they don’t get used. The result being weight gain, diabetes etc.

Some of the key signifiers of an addiction are binging, withdrawal and craving – and there’s some evidence that sugar meets these criteria.

Experiments on rats (Avena et.al, 2008) have shown that under certain circumstances they can become “sugar dependent” through the release of brain chemicals like dopamine – and this could apply in other animals too, including humans.

There’s less consensus on whether this counts as an “addiction” as food is a basic necessity for survival – unlike alcohol, other drugs, gambling etc. However, sugar in isolation could be an addictive component in food in the same way nicotine is in cigarettes – which would justify a change in policy towards sugar.


Current Policy & The “Pop Tax”

As public health is devolved, responsibility lies with the Welsh Government (read more recent discussion on this at Senedd busts a gut). I’m not going to go into any great detail there, but the Welsh Government backs public information schemes like Change4Life. The Senedd held yet another debate on it earlier this week too – you can read the transcript here.

Some areas of concern – within devolved competence – include: healthy school meals, the importance of PE in the National Curriculum (more here), encouraging walking and cycling and preventing children learning bad habits from parents. When it comes to dealing with junk food itself, however, devolved powers are limited.

One new policy set to be introduced soon is a tax on sugary drinks (including alcoholic drinks). Following lobbying by various groups and celebrities, in 2013, Plaid Cymru became the first political party in the UK to formally advocate it (Dr Plaid’s NHS Treatment Plan). The party estimated it could raise ~£60million a year – which they intended to use to fund medical recruitment and reduce the number of obese adults by ~9,000.

The First Minister argued it would be counter-productive as consumption of sugary drinks would have to remain high to fund the new doctors. He forgot that the same principle applies to “sin taxes” on tobacco, gambling and alcohol.

Plaid’s mistake (if you can call it that) was hypothecating the proposed tax specifically for medical recruitment. If they had suggested the money went into the general taxation pot, the First Minister’s argument (which was on shaky ground in the first place) wouldn’t have stood up and he would’ve had a harder time trying to bat it away.

Ultimately, Plaid won that war even if victory was down to the Conservatives in Westminster, with the UK Government announcing the introduction of a Soft Drinks Industry Levy in March 2016 (outlined in the graphic above).

Similar taxes have been successfully introduced in France, Mexico, Hungary and Finland. Research from the British Medical Journal suggests the sugary drinks tax has cut sales of soft drinks liable to the tax by 12% in Mexico, with sales shifting to untaxed drinks (which presumably includes artificially sweetened and no sugar alternatives).

That last point underlines one of the big problems with a sugary drinks tax. Next time you’re in a supermarket, take a look at soft drinks aisle and you’ll notice many soft drinks don’t contain much, if any, sugar now. Soft drinks are an easy target, but bigger culprits include fat and sugar laden foods and lack of exercise.

Junk Food & Independence

The “pop tax” is on the way, and while many public health areas are devolved to Wales, there are some key – and very significant ones – that aren’t and would only be available to us through independence.

Changing Behaviour

  • The sugary drinks levy could be expanded to apply to coffees, teas and hot chocolate. Cane sugar sachets in cafes, pubs and restaurants could also be subject to the levy and no longer offered for free.
  • Introduce a “fat, sugar and salt tax” along the same lines as the sugary drinks levy, but aimed at companies producing, serving or importing foods with high fat, sugar and salt content. There would inevitably be exemptions, like milk, unprocessed cheese etc.
  • Introduce a single, mandatory colour coding/traffic light system for food manufacturers and outlets that serve food. At the moment it’s voluntary and there’s no single unified scheme.
  • Continue to promote breast-feeding, as there’s a link between breast-fed children and lower levels of obesity in later life.
  • Regulate to ensure all vending machines in schools, hospitals and public spaces only offer healthy options.
  • I could go into this in more detail, but fully implement the Active Travel Act 2013 (for obvious reasons)
  • Continue the Child Measurement Programme and introduce targeted measures at the families of 4 and 5 year olds who are recorded as obese. This should be done sensitively and avoid hectoring, and could include things like family diet plans, exercise ideas and counselling (if needed).
  • Introduce more cooking and nutrition lessons into the National Curriculum – particularly for primary schools – and encourage children and parents to try recipes at home together from scratch.
  • Use some of the proceeds from sugar/fat taxes to subsidise food co-operatives in deprived areas – levels of obesity and poor diet are historically higher amongst poorer households. Currently around 300 are run in Wales and provide households with a selection of fruit and vegetables (as well as some other things like eggs) often at a discounted rate.

Advertising & Access

The Welsh Government can already do many of the things I’ve mentioned, but regulation of advertising is non-devolved and unlikely to be devolved unless broadcasting is devolved or Wales becomes independent. It’s probably one of the most important tools available.

 

  • Social media adverts for junk food aimed at children/under-16s are subject to a self-imposed ban by the food industry as of December 2016. This could obviously be extended to include pre-watershed television, childrens’ TV stations, internet videos, radio and non-broadcast media like newspapers, magazines and billboards.
  • Include broadcasting restrictions on the depictions of junk food in the same way as smoking and drinking alcohol (i.e. not showing someone playing computer games whilst eating Doritos and drinking Red Bull).
  • Ban sports teams and major events in Wales from being sponsored by companies that would be liable to pay either the fat and salt tax or sugary drinks levy.
  • Minimum nutritional standards for school meals could be introduced, up to and including a ban on packed lunches and/or banning under-16s from leaving school premises during lunch time (to eat). Switching to a cashless/smartcard payment system (similar to Japan’s Taspo card) could encourage take-up of school meals and reduce the stigma of free school meals.
  • Pass regulations to ensure sweets, crisps and chocolates are displayed above eye-level and ban supermarkets and stores from selling sweets, fizzy drinks and chocolate at tills (to combat “pester power”).

Draconian Measures

I should state I’m not in favour of most of these and believe taxation and proper regulation should be enough to change behaviour – I’m just throwing these out there for you. However, if the situation doesn’t turn around in the next decade, you can expect political parties and the medical profession to start talking up some of these.

 

  • Introduce a Japanese-style “Metabo Law” where middle-aged men and women will have to meet minimum and maximum waist sizes once a year. Individuals failing to meet the standards are sent for counselling or medical advice, while employers and local authorities would be fined by the government (for failing in their duty of care).
  • Parents, guardians and local authorities could be charged with neglect if their children (or children under their care) become morbidly obese during primary school, based on a failure of caregivers to provide necessary medical care – in this case a healthy diet and encouraging exercise.
  • Fire and rescue services could charge households (or, perhaps better, housing associations and landlords) that require their assistance to move extremely obese people in an emergencypolitely termed a “bariatric rescue”. Some fire services elsewhere in the UK already do (Northamptonshire Fire Service charges £630 per hour, per engine).
  • The “nuclear option” would be to delay access to NHS treatment, adoption, social housing, disability benefits and fertility treatment for the morbidly obese (BMI of 40+) unless they have an underlying condition that’s caused their obesity (like a mobility issue, hyperthyroid syndrome), or make a conscious effort to lose weight under GP clinic supervision. This would be part of a wider debate on whether people with self-inflicted or lifestyle-related injuries and diseases (alcohol-related injuries, smokers, drug addicts, amateur athletes, “daredevils”) should be charged for, at the very least, emergency NHS care.
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