Better Diets for All

“In a way, the multinational food industry is providing solutions for women.”

Episode Transcript

JEREMY: Hello and welcome to another episode of Eat This Podcast with me, Jeremy Cherfas. (00:07):
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There's a strand of thought about people who eat a bad diet that runsalong the lines of, well, why don't they just make a good dish of
lentils and a nice green salad?
Or else let's just ban all advertising for junk food.

(00:31):
Or even, we should ban the manufacture of addictive, hyper palatable,ultra processed stuff.
Now, while each of those may have its merits, none of them reallytakes into account the way people actually encounter food in their
daily lives and how they choose what to eat.

(00:52):
So in this episode, I'm talking to Corinna Hawkes, director of theDivision of Agri-Food Systems and Food Safety at FAO here
in Rome. We last spoke back in 2016 when she was professor of foodpolicy at City University in
London, developing the idea of the complete food environment.

(01:17):
Her group's research in the years since has now resulted in a paperin Nature Food with a nice, bold title.
"The full picture of people's realities must be considered to deliverbetter diets for all." And that's a far
cry from simple solutions.

CORINNA: I got into this because, for a couple of reasons. (01:39):
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One was because I was doing a lot of work on food environmentpolicies -- restricting marketing to kids, taxes, nutrition labelling,
school meals programmes -- and wanting to understand how they couldhave more impact.
The other aspect was just like we need to ...
was from a food environments perspective, and I was convinced it wasall about like, if we got the food environment policy sorted, it was

(02:07):
going to solve the problem.
Just take the unhealthy food away, it's fine.
But then you realize that when you are doing that, you are actually,in a strange way, undermining women's agency because they've no longer
got a choice to choose something that's convenient, that helps solveother problems, like energy poverty.
So in a way, the multinational food industry is providing solutionsfor women.

(02:32):
And so we have to think, okay, what ...
let's embrace that complexity rather than just saying this is just asingle cause and it's evil, let's actually embrace that complexity and
see what we need to work with in order to make change.

JEREMY: In your paper, you say that despite all the policies and (02:48):
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interventions and initiatives, most people still are not eatingaccording
to government-approved guidelines.

(03:13):
But why is that?

CORINNA: There are many different elements that influence what people eat, and collectively they are not aligned to help people eat (03:15):
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well. Well, the starting point of the paper, the starting point ofthe ideas that went into the paper, was that the reason for that was
because we live in an unhealthy food environment in which the ...

(03:38):
When we're walking down the street or whatever we're doing, we're notsurrounded by foods that help us be healthy.
But what we discovered through the research that I was doing at thattime was that it's really an interaction between a whole range of
different realities of people's lives.
So I can live in the same food environment as somebody else andinteract with it in a different way, depending on how much money I

(04:06):
have, what kind of material resources, what my health is like, whatmy mental health is like, the kind of social relations that I have,
whether there's gender equity.
There's so many different elements that shape what we eat.
And we as a world haven't taken that seriously.
We just think that somehow people just decide what they eat.

(04:27):
That's not the reality of how people make decisions about what toeat.

JEREMY: So if you take an example like, oh, I don't know, ultra-processed food or convenience foods, (04:35):
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there does seem to be more evidence than ever that they're not reallyvery good for us, but people choose them nevertheless.
And that's despite even ...

(04:56):
I mean, there's not much advice to avoid them yet, but people choosethem for good reasons.

CORINNA: That's right. I mean, the really important finding of the work that we were doing at that time was that it's actually very logical to choose (05:03):
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ultra-processed foods.
And sensible.
We were doing some work in South Africa, in really low incomecommunities.
And in those communities, people are living in very difficulthousing, tiny little places that are very vulnerable

(05:30):
and -- shacks really, to be absolutely honest.
And if you are in that circumstance and you're ...
you've got someone saying, yes, you should cook a really nice mealwith lots of vegetables and so on.
Well, yes.
You know, actually that that's what you want to do, but then you haveinstant noodles and you think, I'm going to save money on energy --

(05:54):
and by the way, my energy supply is completely unreliable -- so I canmake myself and my kids instant noodles.
Or I can put on a dodgy gas stove which might not even be reliable,and prepare some food.
It's actually very logical and it's also safer.
These are places where gas means that if something sets alight, thewhole place burns down and then you have no home.

(06:20):
So why not eat instant noodles?
It's sensible.
It makes sense.

JEREMY: But that's also true, people are also eating instant noodles in countries where their houses are not going to burn down, their energy (06:24):
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supply is OK.

CORINNA: There's always many different realities, and one of them is time and labor. (06:35):
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So in many industrialized countries, women, because it is stilltypically women, often work a lot of jobs
And they're often low pay jobs.
So they have to work a lot of them.
And if they're living in households where there's gender inequity,where they're still responsible for feeding their kids, and when they

(07:04):
come back from a busy day, it's the middle of the night or whateverit is when their shift finishes, or where they have to leave food out
for their kids.
Well, of course, ultra-processed food is convenient and packaged.
And another circumstance, you might have lots of time, you might noteven be working, but you might experience mental health problems -- we
live in a difficult world -- and find it really difficult to copewith all of the different aspects of our lives.

(07:29):
And the idea of then preparing food just becomes too much.
Or you may be having a sense of identity as a mother where you say, Iwant to be a
good mother, so I'm going to make my kids some nice food, and thenthe child doesn't like the food.

(07:50):
And so you feel like a bad mother because you're feeding your kidssome bad food.
So you say, I'm going to feed my kid the food that they like.
And as a mother, I am doing the right thing by feeding my childrenthe food that they like.
So there's just so many reasons that drive people towards ultra-processed foods.
And because we are treating people as atomized individuals withresponsibility for feeding their children, rather than it being a

(08:18):
social project, that we should help the world, you know, whether it'schildren, ourselves or whatever (it's not only about children) eat
better, and that collectively we need to be saying, how in the worldcan we help us all eat better, as opposed to that individual should be
doing better to feed their children?
Very judgmental.

(08:38):
We need to get away from that.

JEREMY: That's an incredible observation that actually, if you're dealing with a difficult toddler, the food industry's (08:39):
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got you covered because they know how to make stuff that eventoddlers will like.

CORINNA: They know how to make things that toddlers will like. (08:55):
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And they also understand what it's ...
how hard it is to be a parent.
And they understand that if you are finding it difficult to be aparent and you go into a place
that's selling these foods, they understand the psychology so thatthey say they know that mothers want to have a bonding moment with

(09:21):
their child, and you're more likely to have a bonding moment oversomething that a child immediately brings a smile to their face rather
than a carrot. It's just, they know that.
And so what happens is they exploit them.
They don't say, you know what?
We get that, but it's not really right.
How do we create bonding moments over food that's really going to tohelp kids be healthy, help families be healthy?

(09:47):
They say we're going to exploit that.
And because we can and there is a need, there is an emotional need, and we will exploit that.
And even though they might not use that term and they might just saywe're just giving people what they want, it's kind of weird because
they are giving people what they want, and they're also exploitingthem at the same time.

(10:09):
So it's not simple.
It's quite a complex picture.

JEREMY: But when the toddler gets older and goes to school, that's when they sort of have less choice over what they're going to eat. (10:12):
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And that's an opportunity maybe -- maybe -- to step in and say, okay,when you're at school, at least once a day, you're going to eat
healthy. So why don't school feeding programmes work so well?

CORINNA: They can work well. (10:37):
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And I think there's a lot of evidence that they should be in place,but they don't work well when they don't take take into account
children's realities.
So if they say, I know I've got a great idea, I'm going to puthealthy food and I'm going to just change the menu and put ...
They don't take into account that children might not be accustomed tothat food, especially if you're from a from a more marginalized, more

(11:03):
vulnerable family, where you haven't been exposed to healthy foods somuch.
Then you've got this food on the table and you're like, I don't likeit.
And so people ... The kids haven't got accustomed to it, so it takestime.
So that means that you have to do extra measures to help kids learnhow to like it.
But the other key element here is the social element.
If you're with other kids who are laughing at you for eating thatfood as opposed to being with you, then you're not going to do it.

(11:32):
If you're in a social space that is unpleasant, that you don't wantto be in, and you're a teenager, you're just going to leave the
school, and all over the world, whether it be India or the UK orwhatever, and you find that unhealthy food grows up around the school.
And what happens is that the kids say, I want to take some autonomy.

(11:53):
I want to enjoy time with my friends.
I'm going to exert my identity by going out and showing that I'mindependent and going and buying this unhealthy food, as opposed to
eating the potentially healthy food in schools.
Or the food in schools just tastes terrible, and nobody's modeling it.
Teachers disown it.

(12:15):
You know, they're not interested in it.
So what the evidence says is very clear, that you can design a schoolmeal programme with kids co-created with kids and young people, put it
in a nice environment, make it socially acceptable.
It works. If you don't, it doesn't work.

JEREMY: But there may well be a problem then, with some kids who are having to pay for their meals because their parents are relatively well off, and (12:32):
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others who are getting free meals, and there's a stigma associatedwith that.

CORINNA: Yeah, certainly in Western contexts that's very widespread. (12:45):
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I can't talk for all contexts, but certainly in Western contexts.
And so this is again understanding the reality of social relationsthat you can say, right, okay, we're going to give the kids ...
it's, we're just going to see it as purely as an economic thing.
So there's a narrative.

(13:05):
It's all about food prices.
Food prices is incredibly important.
But you can make something free for someone and if you don't takeinto account social relations, then you're missing this picture, which
is that it's stigmatised.
It's like, oh, they're the free -- it was like this when I was atschool -- they're the kind of kids with the free school meals.

(13:26):
And then if you're in that free school meals place, you're like, Idon't want to be here.
I'm not going to go and get that meal.
And then overall, there is a sense that, you know, these are notmeals that are desirable.
So the point is that when you're designing an intervention and apolicy, you need to take into account all of these different elements;

(13:47):
the quality of the food, yes.
Create access.
But if you only make healthy food accessible, it's not enough.
If you only make it affordable, it's not enough.
You need to think about the social aspects.
You need to think about the identity aspects, the meaning, all ofthese different things.

JEREMY: So the kids, the kids who are getting free meals and don't want free meals, in a way that kind of relates to the people who probably (14:02):
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can't afford it, but see processed food as modern and upper class,maybe higher status.

CORINNA: This is particularly the case in lower and middle income countries where new foods, new processed foods have come in and are (14:21):
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seen as modern and desirable because they upset the the standardsocial, very often very hierarchical, social relations.
Now, I'm not saying that that isn't the case in Western cultures.

(14:43):
I'm saying that, and the combination of these new foods coming in,which have been around in other places for a longer time.
And so in places like India, for example, and many Asian countries,the new foods come in and you think, I want to be modern, I want to
identify with the future and this is my future.

(15:03):
Going back to, you know, adobo or, you know, kind of fish orwhatever, like rice.
That's the past.
And for some people who are living in more impoverishedcircumstances, that past is associated with hunger.
So even though the food might have been healthy, there wasn't enoughof it -- healthier -- there wasn't enough of it.
So you might have had rice, you might have had, you know, protein ifyou were lucky, you know, a bit of vegetables and you didn't have

(15:30):
enough. So you when you think about the future, you think ...
you want to associate with having enough food.
And then what happens again is that the modern food industryunderstands that.
And they come in with advertising, and they advertise these foods ina way that says, if you want to be modern, if you want to aspire to

(15:51):
be better -- which everybody does, we all do -- eat these foods.
And so it's a combination of something that's really genuine inpeople about wanting something better, a frustration with perhaps kind
of very structured social relations but particularly genderinequities and where young people are kind of kept down, with the

(16:14):
advertising companies coming in.
So it's this combination of things that then flip people, and then wesee dietary change as a result of that.

JEREMY: When you consider people who are growing their own food ... (16:23):
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I mean, there's been a lot of noise over the past decade or so aboutso-called nutrition-sensitive agriculture, which is persuading people
to grow more nutritionally interesting things rather than what theywere growing before.

(16:45):
That seems like a good idea.
Does that work?

CORINNA: Well, look, everything can work. (16:49):
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It all depends on whether you take people's daily realities intoaccount.
So that's a really good example of how absolutely it makes intuitivesense.
People are growing, just growing too many staple foods.
And that's an important part of the diet.
But it's not diverse enough.
We know that dietary diversity is associated with good nutrition.

(17:10):
The science is very clear on that.
So how do we improve nutrition diversity for these really low incomefamilies?
Let's do nutrition-sensitive agriculture, have them grow morenutritious foods.
But if you do that without taking into account social relations, inparticular gender relations, in these contexts, you wouldn't be
successful because it's the women who feed themselves, feed theirfamilies and feed their children.

(17:35):
And it is women who are often responsible for growing foods for thefamily.
So if you say, okay, get families growing, growing this, this food,and you don't take into account the labour
demand of what is required.
And women are running around doing a hundred and one other things,then it's just not going to be successful.

(18:00):
But if you're encouraging women to grow in order to generate income,in other words, they have to sell at markets in order to generate
income, and it is men who control the income, then you end up with asituation where women are still having to do the work, but then men
take the income and that doesn't improve the nutrition at all.

JEREMY: Coming away from poverty in a way, people in people in rich countries, rich people, are also not (18:19):
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eating as well as they might.
And one of the great examples in the paper is about trying to reducethe consumption of meat, especially red meat.
You'ld think that would be ...

(18:40):
I mean, once people agree to it ...
that would be a kind of easy one, meatless mondays, whatever it mightbe.
But even that doesn't work on a kind of institutional level.

CORINNA: And that, again, I mean, there's a range of reasons for that, but that comes back to the identity and meaning that we associate with food. (18:55):
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And meat is a high status food in pretty much ...
not every culture, but in many cultures.
And in the example that I give in the paper, it's an example which isa well-reported, well-evidenced association between masculinity and

(19:16):
meat, in this case in the military, in the armed forces.
But it could be any situation where masculinity is important andwhere taking away meat was viewed
as, but hang on, you know, I associate that with being masculine,with being strong, and you're taking it away from me.

(19:39):
And you're basically saying, I'm taking that away from you, and that'staking away someone's masculinity.
And you're also taking away, in this case, the idea of a comfort foodthat people really enjoy.
So people have these very strong senses of associations with food,and that's fine.
That's reasonable.
Again, it's not this, oh, these stupid people, they don't understandthat meat is damaging the planet.

(20:03):
It's let's understand why people are coming from, you know, why isthis?
Why is this?
And actually, if you work with that, you probably can work withcommunities to move them away from meat.
It's perfectly possible.
And you should do that because the fact is, high meat consumingpopulations, it's neither healthy nor good for the planet.

(20:24):
And but let's not do it in a patronizing way.
Let's understand where people are coming from and see how we can workwith that.

JEREMY: You list in the paper, you and your colleagues list twelve different things that you ought to (20:30):
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consider in developing food policy.
That that's a lot of things to consider.
But I mean, do you have any advice for policy makers?

(20:51):
Are they supposed to consider all twelve or can they focus on one ortwo?
How does that work?

CORINNA: Yeah. You can't focus on twelve. (20:59):
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It's too many. It's unrealistic.
So what we try, and the point that we make in the paper, is actuallya process of prioritization that will vary between contexts.
And so, we were talking about gender earlier, in certain contexts,you'ld say look I'm putting this policy into place.
If I don't take into account gender relations, I'm really, really notgoing to have much impact.

(21:24):
So it's just going to be inefficient to do it.
So if I want something, if I want to get bang for my buck, I justneed to take this into account.
Now there's all of these other things around here too, but in thiscontext, they're just not as important.
The idea is that you step into people's shoes.
So in the work that we were doing in other publications, we weretracing the daily lives of people.

(21:48):
So if as a policy maker, you remove yourself from it's just becausethey can't cook, they're just not educated or it's just that, you
know, the food prices or whatever, and you actually try and stand insomeone else's shoes and you might actually begin to understand what
the issues are.

(22:09):
So that's really what we're saying.
And then you can think, in this community, in this place, these arethe areas that are really we really need to focus on.

JEREMY: The big problem with that is that every community, every situation is different. (22:19):
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And all you hear from people in big policy think tanks and whateveris: it has to work at scale.
If you want it to work at scale, you can't take account of communities.

CORINNA: The question that you raise is one that I struggle with. (22:40):
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I mean, I began and I worked for many years on national policies, andthat's, as I said earlier, that was my entry point
in the sense that, like, no one should have exposure to junk foodmarketing and so on.
And I still adhere to that.

(23:02):
So what we're really talking about is deciding on what the biggestproblem is
and among who and saying for that, what do we need to do?
And then understanding the situation in those communities.
You can't solve all of these problems all differently.

(23:26):
But just let me give you an example again, of a situation that we were-- I think it was in the Philippines -- that we were, I was working
with Unicef on this, where there was a situation of people living inrural, more rural communities,
of not having accessible transport to markets that sold food ataffordable prices.

(23:53):
The local markets were, the local stores were very expensive.
So this is very inherently local.
But when you think about it, that's really about a ruraltransportation issue.
So then you think, okay, how does this then connect in with thepeople who are looking at rural transportation?
There were people who were looking at that issue.

(24:13):
So we should get out of the idea that all of the solutions lie in theMinistry of Health and think about who it is that we need to work
with in order to scale these solutions, to think, well, ruraltransportation, it's not just about food, it's about a whole load of
things, about employment, livelihoods.
So there's other people looking at that.
Let's connect in with other people looking at other issues.

(24:37):
Because if we just say, this is just from the Ministry of Health,looking at health problems in our little community, then you're not
able to start to see the bigger picture.
So that's that's that's good policy making.
But you are right.
And I get, you know, get stuck in this sometimes in the process.
Like how do you actually, you know ...
We call it evidence of lived experience.

(24:58):
How do you gather this evidence of lived experience, you know.
We agree that this is difficult, but we say at the end of the paperthat the least that can happen is for policy makers
to come into communities and actually to try and get a sense of the ...

(25:20):
of, you know, how these things are.
I remember giving a talk when I was first ...
quite soon after starting this work, to some policy makers, and theywere really ...
They said to me afterwards, they said, I'm really taken with whatyou've said.
We're going to arrange some walks through this, through thisneighbourhood.
And just that is a move in the right direction.

JEREMY: Corinna Hawkes on how food policy makers can begin to address the reality of people's lives. (25:44):
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I'll put a link to her paper in the show notes at EatThisPodcast.com.
It is behind a paywall, but I'm sure if you ask nicely I can find youa copy.

(26:05):
I'll also link to the 2016 episode, which marked a turning point inthe high level food policy conversation, from hunger
to diet and nutrition.
And here's a thing.
When I went looking for that episode, I realized with a bit of ashock that there are now almost 300 past episodes in the archive.

(26:32):
If you're a relatively new listener, there's a lot there that youmight want to dig into.
And a final question.
Last year I offered a little quiz, one question per episode, and somepeople seem to find that fun.
So should I do that again this year?

(26:52):
Yes or no?
Let me know.
Jeremy at EatThisPodcast.com.
Okay, that'll do for now.
So from me, Jeremy Cherfas and Eat This Podcast, goodbye and thanksfor listening.