Food Industry and Health
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Presentation exploring the food industry and its contribution to obesity in Ireland. How did we get here and what can we do?
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Food Industry and Health
- 1. Industry/Corporate Responsibility and Health 1 Louise O’ Flynn BA 111440908 EH6025
- 2. 2
- 3. Ireland-Global Burden of Disease Disability Adjusted Life Years • Ischemic Heart Disease • Lower Back Pain • Depression Risk Factors • Dietary Risks • Tobacco Smoking • High Blood Pressure 3
- 4. Tobacco Smoking - Risk Factor #2 for disease burden - Cardiovascular Disease (29%) - Diabetes - Cancer - Respiratory Disease - 6million deaths per year 4
- 5. Tobacco Control - World Health Organisation - 2005 Framework Convention on Tobacco Control (FCTC) - MPOWER - National Tobacco Control Office (NTCO) 5
- 6. All that work for the second risk factor in Ireland… What about the first? 6
- 8. Fat - Trans Fat: Natural vs. Artificial - Saturated Fat: Cholesterol - Polyunsaturated Fat - Monounsaturated Fat 8
- 9. Salt/Sodium - Excess consumption = Increased Blood Pressure (#3) - Increased Blood Pressure = Increased risk of Cardiovascular Disease (Heart Disease and Stroke) 9 - 75% Processed/Restaurant Foods - 1 in 6 U.S. Children – High Blood Pressure
- 11. Obesity - Adults - 1b Overweight, 400m Obese - Children* - 17.6m overweight - Overweight = Hypertension, Diabetes, Atherosclerosis** - Cardiovascular Disease 11
- 12. Childhood Obesity Growing Up in Ireland Study - 19% Overweight - 7% Obese - 30% Girls, 22% Boys - Social Class inequalities 12
- 13. Diet – The new tobacco? 13
- 14. From Tobacco Control to Food Control - MPOWER Strategy - Product labels - Education – Control - Food Industry vs. Public Health 14
- 16. Recommendations - Diet conception-adulthood - Multiple influences- Home, School, Environment, Media - Individual & Food Industry Responsibility - Public Health Policy - Research - Legal Actions 16
- 17. 17 Summary • Heart Disease DALY no.1 • Risk Factor no.2 Tobacco = Controlled • Risk Factor no.1 Dietary Risks ≠ Controlled • Fat & Salt – Obesity – Serious Health Problems • Who is to blame? • Regardless, important to take control as Public Health specialists • Lots of work left to be done in the area
- 18. Reference List 1. Sim F, McKee, M, editors. Issues in Public Health. Berkshire: Open University Press; 2011. 2. American Heart Association. About Cardiac Arrest [Internet]. Dallas: American Heart Association; 2013 [updated 2013 February 26th; accessed on 2014 November 5th]. Available from: http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About- Cardiac-Arrest_UCM_307905_Article.jsp 3. GBD Profile: Ireland. Seattle: Institute for Health Metrics and Evaluation; 2010. 4. Cholesterol "Get the Facts" [Internet]. 1st ed. Galway: CROI; 2011 [accessed on 2 November 2014]. Available from: https://www.croi.ie/heart- health/publications 5. Tobaccoatlas.org. Harm - from the Tobacco Atlas [Internet]. 2014 [accessed on 5 November 2014]. Available from: http://tobaccoatlas.org/harm 6. Tobaccoatlas.org. Solutions - from the Tobacco Atlas [Internet]. 2014 [accessed on 13 November 2014]. Available from: http://tobaccoatlas.org/solutions 7. Ntco.ie. Office of Tobacco Control [Internet]. 2014 [accessed on 16 November 2014]. Available from: http://www.ntco.ie/ 8. Quit.ie. Quit.ie - Help information and advice on how to quit smoking from the HSE [Internet]. 2014 [accessed on 20 November 2014]. Available from: http://www.quit.ie/ 18
- 19. Reference List Contd. 9. Cdc.gov. Nutrition for Everyone: Basics: Dietary Fat | DNPAO | CDC [Internet]. 2014 [accessed on 13 November 2014]. Available from: http://www.cdc.gov/nutrition/everyone/basics/fat/index.html 10. Choosemyplate.gov. ChooseMyPlate.gov [Internet]. 2014 [accessed on 1 November 2014]. Available from: http://www.choosemyplate.gov/ 11. Prevention D, Prevention C. CDC - Salt Home DHDSP [Internet]. Cdc.gov. 2014 [accessed on 20 November 2014]. Available from: http://www.cdc.gov/salt/index.htm 12. Heller M. DASH Diet Home for Healthy Weight Loss, Lower Blood Pressure & Cholesterol [Internet]. Dashdiet.org. 2014 [accessed on 20 November 2014]. Available from: http://dashdiet.org/ 13. Perry IJ, Browne G, Loughrey M, Harrington J, Lutomski J, Fitzgerald AP (2010). Dietary salt intake and related risk factors in the Irish population. A report for Safefood Ireland. ISBN: 978-1-905767-14-4 14. World-heart-federation.org. Cardiovascular disease risk factors - Obesity | World Heart Federation [Internet]. 2014 [accessed on 15 November 2014]. Available from: http://www.world-heart-federation.org/cardiovascular- health/cardiovascular-disease-risk-factors/obesity/ 19
- 20. Reference List Contd. 15. Overweight and Obesity Among 9 year olds. Dublin: Government Publications; 2011. 16. Who.int. WHO | Commission on Ending Childhood Obesity [Internet]. 2014 [accessed on 2 November 2014]. Available from: http://www.who.int/end-childhood-obesity/en/ 17. Who.int. WHO | Diet and physical activity: a public health priority [Internet]. 2014 [accessed on 7 November 2014]. Available from: http://www.who.int/dietphysicalactivity/en/ 18. Safefood.eu. Let's Say No [Internet]. 2014 [accessed on 3 November 2014]. Available from: http://www.safefood.eu/Childhood-Obesity/Lets-Say-No.aspx 19. Littlesteps.eu. Home - Little Steps [Internet]. 2014 [accessed on 8 November 2014]. Available from: http://littlesteps.eu 20. Kefauver J. Trouble in the Food Aisle. Bus Source Comp. 2014; 50(2):82-82 21. Mello MM Rimm EB Studdert DM. The McLawsuit: The Fast Food Industry and Legal Accountability for Obesity. Health Aff. 2003; 22(6): 207-16 22. Bagaric M Erbacher S. Fat and the law: who should take the blame? J Law Med. 2005; 12(3): 323-39 23. Fenn JJ. The assault on bad food: tobacco style litigation as an element of the comprehensive scheme to fight obesity. Food Drug Law J. 2012; 67(1): 65-8120
Editor's Notes
- “Food, Trade and Health” Chapter 10, Issues in Public Health book. Focus on Ireland. Food Industry Responsibility and Health will be the main focus of this presentation. Childhood Obesity will be looked at as the main Public Health issue that we need to address. The Tobacco Industry and Tobacco Control will be examined as inspiration to tackle the Food Industry and the associated public health issues. The possibility of Food Control will be considered from a policy, legal, and multifaceted approach. (1)
- Brief mention of Heart attack and Cardiac Arrest. "How did they (the men in the pictures) get here?” "Heart Attack": caused by a blockage that stops blood flow to the heart - may cause Cardiac Arrest. "Cardiac Arrest": Abrupt loss of heart function in patient who may or may not have had heart disease. Heart's electrical system malfunctions. Cardiac arrest can be caused by -Any heart condition/disease eg. Ischemic Heart Disease (Heart Attack may lead to Cardiac Arrest) -Cardiomyopathy (thickened heart muscle from High Blood Pressure or valvular heart disease) -Drugs (Heart medications/recreational) (2)
- Why focus on Heart Disease, Heart Attack, or Cardiac Arrest? Ireland (2010) – Disability Adjusted Life Years (DALY) Measure of Burden of Disease in a population = Years of life lost to premature death + years of life lived with disability/sickness. Top cause of DALY in Ireland 1-Ischemic Heart Disease Top 3 Risk Factors (account for the most disease burden in Ireland) 1. Dietary Risks 2. Tobacco Smoking 3. High Blood Pressure (3) All of which are risk factors for Ischemic Heart Disease, therefore, Cardiac Arrest. As well as lack of exercise, alcohol consumption, stress, and high cholesterol. All of these risk factors can be controlled by the individual, unlike family history, age, or sex. (4)
- First we will take a look at the second leading risk factor of disease burden in Ireland – Tobacco Smoking. The single most preventable cause of death. By 2030 increase to 8million deaths per year. In last decade deaths from tobacco smoking tripled. Second hand smoke responsible for 600’000 deaths per year. (5) So what did we do about this?...
- Global- WHO Framework Convention on Tobacco Control (FCTC) 2004 - MPOWER Monitor tobacco use and prevention policies Protect people from tobacco smoke Offer help to quit tobacco use Warn about the dangers of tobacco Enforce bans on tobacco advertising, promotion and sponsorship Raise taxes on tobacco Half of world population covered by at least one. Tobacco Control – A mainstream Public Health Issue -Surveillance (of prevalence and success of control) -Smoking Ban (Ireland 2004)- Both direct and second hand benefits -Support in quitting – Helplines -If quit before diseased in: +1yr excess risk of Cardiovascular Disease halved, +15years same as non smoker -Education – Media Campaigns/Advocacy -Product Labelling – Pictorial, awaiting plain (in Australia 2012) -Advertising Ban -Tax increases -Legal measures against Tobacco Industry (6). Ireland- Signed FCTC in 2005 National Tobacco Control Office (NTCO)- Legislation, Information, Advice (7) QUIT.ie- Support, Contacts, Media Advertisement (Gerry Collins) (8) HSE support, advice, advocacy.
- Would we not put an equal amount of work, if not more, into the leading risk factor for disease burden in Ireland. #1 Dietary Risks. Going to focus on two main damaging nutrients- Fat Increased Cholesterol Risk Factor for Ischemic Heart Disease/Heart Disease/Heart Attack/Cardiac Arrest Salt Increased Blood Pressure (BP) ((Risk Factor #3-High BP)) High BP may lead to Ischemic Heart Disease, Heart Disease, Heart Attack, and/or Cardiac Arrest.
- Bad Fats: -Trans Fat Natural: Meat and dairy products. Artificial: Hydrogenated oil (cheap, increases shelf life). Increases bad cholesterol (risk factor for Heart Disease), May also decrease good cholesterol. Found in foods such as- fried food, savoury snacks (popcorn), frozen pizza, cake… Restaurants may use hydrogenated oil. -Saturated Fat (Solid fat). Found in cheese, fatty meat, whole dairy products, ice cream, coconut oil (in cookies etc). High in bad cholesterol which increases risk for Heart Disease. Good Fats: Polyunsaturated/Monounsaturated fats. Found in: nuts, vegetable oil, fish, omega 3&6. Recommendations by CDC: Individual: Education re: nutrition. Monitor and change bad eating habits when educated. Industry: Food labels. Reformulate food. Policy: Restrict food which has adverse health effects with policy’s (U.S. >0.05g of artificial trans fat restricted in 20%). (9) (10)
- Centre for Disease Control (CDC) vital stats 90% of U.S. children aged 6-18 have too much salt in their diet. A decrease in salt and an increase Potassium (potato, citrus fruit) = Decreased Blood Pressure (11) DASH Diet “Dietary Approaches to Stop Hypertension” Lower BP by eating carbohydrates, fruit, veg, less fat, wholegrains, high fibre, potassium, calcium, low fat dairy. Lowers BP at prehypertension/hypertension stage. (12) (13) Too much salt also increases risks of asthma, osteporosis, stomach cancer, and has a number of other adverse health effects. 86% of men and 67% of women consume >6g of salt a day (tolerable upper limit = 5.8g). Food Policy changes- People will make healthier choices voluntarily or forcibly if we: Ban saturated fat/excess sodium (Public Health Policy) Remove unhealthy ingredients from food (Food Industry) Guide public choice through taxing (Public Health Policy) education (Education) or provision of cheap/free fruit and veg (Public Health campaigns). (13)
- What does this overconsumption of the wrong foods mean for population health?
- *‘Children’ here refers to under 5 years old **(Atherosclerosis-artery wall thickens due to the build up of White Blood Cells) World Heart Federation Statistics. Obesity to Cardiovascular Disease Fat, especially intra-abdominal (big belly), has a significant impact on metabolism. Affects BP, blood lipid levels, and ability to use insulin effectively; therefore, is a risk factor for diabetes which is a risk factor of Cardiovascular Disease. As fat increases, risk of developing Type 2 diabetes and hypertension rises steeply. Statistics show 58% of diabetes and 21% of Ischemic Heart Disease are attributable to a Body Mass Index (BMI) above 21. (14)
- A longitudinal study with both infant and child cohorts. Social class inequalities may mean a lack of education, unequal access to good quality food, inaffordability of good quality food, etc. (15)
- What can we do? Use the success of tobacco control to tackle the food industry and it’s negative health effects.
- Monitor food patterns and obesity prevention strategies Protect children from unhealthy, damaging food and marketing ploys Offer advice and support for dietary changes and exercise Warn about the adverse health effects of a poor diet Enforce bans on fast food advertisement, promotion, and sponsorship Raise taxes on fast food/unhealthy food and decrease healthy food prices Product labels to show dangers of obesity Education for children and adults to allow self control in a supportive environment Positive healthy diet advocacy in media (1)
- World Health Organization Global Strategy on Ending Childhood Obesity Commission on Ending Childhood Obesity Ireland- Health Service Executive SafeFood Little Steps WHO -First meeting in July 2014 -Established in 2004 (16) (17) HSE SafeFood (18) “Let’s Say No” Campaign Website- tips and tricks for saying no in child friendly way, recommendation to keep a treats diary. TV/Media- “1 in 4 children here right now are overweight, risk factors” advertisements Recommendation of fruit snacks instead of sugary, walk to school instead of drive, say no in shop instead of several times during the week at home, smaller portions, water instead of sugary drinks. Little Steps (19) Tips about healthy eating and getting active . Food pyramid (ROI) & Food Plate (NI).
- Issue for people of all ages Recommended to breastfeed 0-6months and 6months-2years with food. 2) Prevention and Treatment- Eat less, exercise more. Family, school, and media influences should work together. Home- Healthy food and physical activity. School- Healthy food only and Physical Education. Advertisement- Fast Food marketing campaigns not to target children. Living area- Open, safe, spaces to play, explore, and learn in an active way. 3) Food Industry- Promotes unhealthy food/harm to health, Relationships with public persons eg. Sponsership/payments. Toxic Environment- Promotes eating and limits exercise. Need to detoxify environment. Sedentary Lifestyle- 75% of time awake inactive, waching tv, academic chosen over physical education, car preferred (for safety & access reasons). 4) Public Health Policy Tax fast food Labels to warn of adverse health effects on unhealthy food. Ban advertisements for fast food, especially those aimed at children. Public Health campaigns to encourage health. Ban relations between food industry and public figures. 5) Research Needed re: Diet, P.E., behaviour, environment, pharmaceutical treatment and prevention. (1) 6) Legal action- 2014 Food Policy activist groups vs. food manufacturers and retailers Using the tobacco strategy to take legal action against the food industry Best litigation = the targeting of children to market food and ultimately obesity Violations against Federal Trade Commission (FTC) and Food and Drug Administration (FDA) with deception in advertising (20) 2003 Pelman vs. McDonalds Overweight children lawsuit against McDonalds- wanting compensation for obesity related health problems Raises the question - Who is responsible for the economic and publich health costs of obesity? Case ridiculed by public (personal choice, own responsibility and fault) but this was initial response to tobacco control also. Standpoint- deceptive advertisements, provision of unsafe food, lack of warnings for consumers regarding the risks of consumption. (21) 2005 Australia Unsuccessful litigations and legal action View of personal responsibility, free will, autonomy. Best option is to make nutritional advice labels compulsory on all food industry products and restrict the advertisement of unhealthy food to children-Policy measures. (22) 2012 Need for a comprehensive and multi-faceted scheme. The Food Industry (and Tobacco) ignore dangers, act only on profit, and disregard public health concerns. Only way to get to Food Industry is financial eg. legal damage awards, fraud, deception etc. However, the notion that consumers have enough information to take sole responsibility for food choice is unrealistic. Education, media, schools etc. (23)