From Policy to Plate: A Deep Dive into Public Health Nutrition

In this episode of Sound Living, Dr. Mike Banna and public health nutrition expert Jenny Rosborough dissect the complex interplay between individual diet and the broader food environment shaped by policy and industry. Jenny shares her experience from the Jamie Oliver Group and policy work, offering insights into the sugar tax, calorie labeling debates, and the pervasive influence of ultra-processed foods. They explore the challenges of balancing corporate interests with public health goals, the impact of delayed legislation, and the critical need for a fair food system that prioritizes equitable access to nutritious options. The conversation concludes with a discussion on empowering individuals amidst these systemic challenges and the vital role of evidence-based information dissemination by organizations like the BSLM.

This episode was recorded in 2022. Its discussion of public health, nutrition policy, and the food environment remains highly relevant today.

Guest:

Jenny Rosborough RNutr (@hellohealthyyou_)

Episode Transcript

Mike: Hello and welcome to this episode of Sound Living. (00:28):
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Mike: Today I am joined by Jenny Rosborough, who I've known for quite some time now actually. (00:31):
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Mike: I think actually I first met you Jenny, didn't I, at the, we did an event for, (00:37):
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Mike: we called it Nutrition by the Experts, didn't we? (00:43):
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Mike: And it was a good few years ago and it was sort of under the auspices of the (00:46):
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Mike: BSLM at the time, but it was very early on in the early days of the BSLM. (00:51):
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Mike: But it'd be interesting to know if anyone listening to this was at that event. (00:56):
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Mike: But we obviously chat regularly on social media and talk about many things related (00:59):
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Mike: to food and nutrition and not just about crisps. (01:06):
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Mike: So I'm just going to get into things today because I think we've got a lot to get through. (01:08):
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Mike: And I'm really excited to have this discussion with you because you've taught (01:13):
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Mike: me a lot about public health and about public health nutrition interventions, (01:16):
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Mike: which is something that I never really understood before I sort of came to your (01:20):
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Mike: talks and stuff so I'm really excited for people listening to this to learn about that as well. (01:25):
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Mike: So before we go into that can you just tell us a little bit about your professional (01:31):
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Mike: roles and how they interplay with one another because you've got a very interesting (01:35):
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Mike: professional background I think. (01:40):
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Jenny: Yeah sure so quite broad currently I (01:42):
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Jenny: work four days a week as head of nutrition for the (01:45):
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Jenny: Jamie Oliver group that role in and of itself is (01:48):
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Jenny: super varied because we've got kind of product development recipe (01:51):
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Jenny: development we've also got the campaigning side um (01:54):
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Jenny: so it's definitely bringing lots of different areas of nutrition together um (01:58):
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Jenny: and then freelance consultancy wise i'll always focus more on the policy side (02:02):
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Jenny: of things so for example a couple of years ago i was well actually i just totally (02:06):
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Jenny: blocked out covid years probably about three four years ago i was working on (02:11):
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Jenny: implementing the transport for london um. (02:15):
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Jenny: Unhealthy food ad ban restrictions and (02:18):
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Jenny: so implementing that with the mayor's office i'm currently working (02:22):
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Jenny: with the food foundation on some policy briefings so (02:25):
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Jenny: big variety but prior to that i was at action and sugar (02:28):
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Jenny: a campaign group who worked talking to government and (02:31):
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Jenny: the food industry to really try to get them to (02:34):
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Jenny: improve the food environment in order to improve population (02:37):
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Jenny: health and before that i was working on (02:40):
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Jenny: a child weight management family kind (02:43):
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Jenny: of lifestyle intervention program and that (02:46):
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Jenny: was behavior change nutrition physical activity and that was (02:49):
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Jenny: writing those and then training health professionals all across the UK (02:52):
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Jenny: and also internationally to try and change those individual (02:55):
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Jenny: behaviors so the relevance of kind of bringing that up is that (02:58):
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Jenny: my background initially was on working with individuals and groups and behavior (03:00):
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Jenny: change and then realizing that in order to help with behavior change we really (03:04):
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Jenny: needed to make it much broader and look at the food environment and that was (03:09):
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Jenny: so challenging or made it so challenging for families to make some changes so (03:13):
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Jenny: that that's where i'm at now. (03:17):
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Mike: Amazing and i find that all really interesting because i think that's a journey (03:18):
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Mike: that a lot of us as health professionals can relate to in the sense that, (03:23):
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Mike: i think the more that we learn about well we might call it lifestyle medicine (03:27):
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Mike: for the purposes of this podcast but whether we're talking about generally behavior (03:32):
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Mike: change whether it's weight loss getting more exercise um changing our lifestyles (03:35):
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Mike: essentially which is what we're (03:41):
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Mike: generally talking about when when we're we're at bslm events or on the bslm (03:42):
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Mike: podcast um when we're doing those things we realize more and more from working (03:46):
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Mike: with individuals and from understanding where people come from and where people (03:52):
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Mike: want to get to and the the kind of. (03:58):
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Mike: The mismatch between those things how (04:02):
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Mike: much of it is actually impacted on by environmental factors (04:05):
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Mike: or other factors that might be beyond our control and (04:08):
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Mike: i think we all go into this with this sort of (04:12):
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Mike: slightly naive idea that if we just tell people (04:15):
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Mike: to lose weight or tell people to do more exercise or tell (04:19):
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Mike: people to eat a minimally processed mostly plant-based whole foods diet that (04:21):
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Mike: that's just what will happen um and i think it's only once you once you've either (04:27):
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Mike: experienced sort of those issues yourself or worked with people who experienced (04:31):
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Mike: those issues that i think you can truly realize, (04:36):
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Mike: actually how much more is involved in people changing their lifestyles and it's really, (04:40):
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Mike: i don't know i i don't know about you i sometimes find it a bit depressing because (04:46):
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Mike: sometimes it feels like well what you know what can we do but we will get we (04:51):
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Mike: will get onto that as part of the, (04:54):
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Mike: as part of the discussion one thing that I wanted to ask you about that because (04:57):
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Mike: a lot like one of the things that we will be talking about obviously is the (05:01):
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Mike: the food industry you know versus policy change versus public health and all (05:04):
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Mike: that kind of stuff and you mentioned that part of your role, (05:08):
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Mike: is working for the Jamie Oliver group and I know that that you know that group (05:11):
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Mike: particularly has a very long history of being involved in campaigns for trying (05:17):
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Mike: to improve health and things like that. (05:22):
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Mike: But do you ever struggle between like the balance between that sort of corporate (05:25):
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Mike: side of nutrition and the um you know the the campaigning and the consultancy and that sort of stuff. (05:29):
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Jenny: It's a good question i think like it's straight (05:36):
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Jenny: in with the controversy no it's a (05:39):
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Jenny: really good question it's important as well because actually i think (05:42):
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Jenny: it's been really valuable to like (05:45):
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Jenny: my public health policy hat um because (05:48):
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Jenny: i really understand the challenges and the limitations um (05:52):
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Jenny: you know when you're in a role where (05:55):
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Jenny: you are kind of telling others what to do and (05:58):
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Jenny: government and food industry it's very different to being (06:01):
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Jenny: in that role where you're actually helping to put food on the (06:03):
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Jenny: table um and all the kind of difficulties and constraints (06:06):
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Jenny: that come with that but actually it just reinforces my policy work even more (06:09):
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Jenny: because i think what we all know anyone who works in (06:12):
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Jenny: the food industry is that if we don't level the playing (06:14):
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Jenny: field then it's impossible for some companies to (06:17):
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Jenny: kind of stick their head above the parapet and you know go (06:20):
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Jenny: off on a tangent and do great things when (06:23):
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Jenny: lots and the majority are lagging (06:27):
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Jenny: behind it's just not sometimes commercially viable so it really what it does (06:30):
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Jenny: is you'll see the good um companies the good food industry companies really (06:34):
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Jenny: asking for that legislation they want it to be more mandatory they want more (06:38):
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Jenny: level playing field um to make it kind of possible for everyone across the board (06:41):
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Jenny: to to make healthier changes and put more nutritious foods on the shelf and. (06:46):
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Mike: And actually that leads us on quite nicely to um (06:50):
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Mike: it was actually the thing that i sort of (06:53):
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Mike: first learned from you which was about the sugar tax i don't know if anybody listening (06:56):
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Mike: can relate to this but a number of years ago before i really understood (06:59):
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Mike: about any of this stuff i think along (07:02):
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Mike: with a lot of a lot of people in the public i (07:05):
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Mike: felt quite frustrated at the demonization of certain types of food groups in (07:09):
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Mike: you know in the fitness industry and sometimes in general life we often see (07:13):
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Mike: it in tv programs and things and i think what's really interesting is the difference between i guess um. (07:17):
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Mike: You know, public health interventions that have to be much more broad and like (07:26):
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Mike: individual interventions. (07:33):
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Mike: So for example, we might say that on an individual level, we might not want (07:34):
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Mike: somebody to demonize specific food groups because it might not be beneficial (07:38):
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Mike: to them because if they cut out a food group that they really enjoy, (07:42):
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Mike: then that might reduce their adherence to dietary change and all of that sort of stuff as well. (07:46):
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Mike: So I had at that time come from this background of, (07:50):
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Mike: you know, of initially I guess (07:53):
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Mike: being something of a victim of you know diet culture (07:56):
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Mike: and all of those sorts of ways of talking about things and and (07:59):
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Mike: thinking that you know carbs were bad or sugar (08:01):
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Mike: was bad for example and then I'd come around to this way of thinking (08:05):
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Mike: that we shouldn't be demonizing these things and then (08:08):
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Mike: suddenly stuff comes out about you know the sugar tax (08:11):
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Mike: and wanting to to put a sugar tax on food and I couldn't (08:14):
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Mike: really get my head around why on one hand we (08:17):
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Mike: shouldn't be demonizing these food groups but then on another hand on a country (08:20):
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Mike: level we were basically being told or i thought we were to to demonize sugar (08:23):
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Mike: and that sugar was the reason that people were obese but of course that actually (08:28):
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Mike: wasn't the case and you explained this to me really well back in the day so (08:32):
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Mike: i'd love if you could explain it for the benefit of our listeners now if possible. (08:35):
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Jenny: Yeah i actually think you just kind of introduced that so (08:39):
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Jenny: well because i there was there's always backlash against policies (08:42):
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Jenny: around you know this demonization that's (08:45):
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Jenny: always the word that if you're talking about sugar for example then (08:48):
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Jenny: you're demonizing it now there's lots of people that do demonize sugar (08:51):
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Jenny: you know and unnecessarily so and i work for a (08:55):
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Jenny: sugar you know a campaign group that's sole purpose (08:57):
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Jenny: was to reduce sugar and improve the nutritional composition of (09:00):
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Jenny: food we never once would have said you know cut sugar from (09:03):
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Jenny: your diet and put that message on it on the individual because there (09:06):
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Jenny: there's always those extremes um and that's (09:09):
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Jenny: not what it was about it was about us knowing as (09:12):
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Jenny: a population we consume two to three more times sugar (09:15):
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Jenny: than is recommended that is having health (09:18):
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Jenny: consequences across the board and particularly (09:21):
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Jenny: in children and tooth extractions and lots of different areas and that we needed (09:24):
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Jenny: to help manage that now the focus was always on what can we get the industry (09:29):
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Jenny: to do to take the amount of sugar the unnecessary amount of sugar out of their products um. (09:35):
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Jenny: And I think, you know, this is a classic example where it's really hard to make (09:43):
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Jenny: policies that are sensible and reasonable land well in a media headline. (09:47):
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Jenny: How it gets translated and communicated can be so damaging, really. (09:51):
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Jenny: And I think that's one of my biggest frustrations. (09:55):
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Jenny: But essentially what the sugar tax was, soft drinks industry levy. (09:57):
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Jenny: So that meant it was a levy on the manufacturer, not the individual, purely on soft drinks. (10:00):
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Jenny: That's where we are currently. that's because sugary (10:07):
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Jenny: drinks were the biggest contributing source of sugar in the diets it's (10:10):
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Jenny: also quite easy to remove sugar from drinks easier (10:14):
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Jenny: than it is in in food so if the (10:16):
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Jenny: manufacturer had more than five percent sugar in their drink then (10:19):
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Jenny: they would have to pay a tax essentially and that (10:22):
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Jenny: tax money was hypothecated to go into it (10:26):
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Jenny: was ring fenced to go into children's like healthy (10:29):
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Jenny: breakfast and activity clubs and and things like that so that's (10:31):
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Jenny: how it started off initially anyway so what (10:35):
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Jenny: that ended up doing was really encouraging the manufacturers to (10:38):
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Jenny: reduce the amount of sugar in their drinks um and (10:41):
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Jenny: a lot of the backlash from industry at the time was you know that this is going (10:44):
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Jenny: to really affect food industry it's going to affect their profits it's going (10:48):
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Jenny: to affect jobs that's the argument that was being made at the time but actually (10:51):
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Jenny: not none of that um has happened and as a result we've as a population the year (10:56):
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Jenny: after that was implemented in 2018, (11:00):
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Jenny: we bought 10% less sugar from soft drinks, even though the sales of soft drinks still increased. (11:03):
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Jenny: So business-wise, there's been a lot of kind of promotion of lower sugar drinks. (11:10):
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Jenny: So the sales haven't dropped, but still as a population, we're consuming a lot more. (11:15):
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Jenny: So that's a good example of successful public health policy that is not relying (11:20):
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Jenny: on individuals to go against natural instinct and having to kind of. (11:25):
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Jenny: Fight again that fight against the urge to have you (11:30):
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Jenny: know high sugar foods all the time it's just naturally if you (11:33):
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Jenny: take it out of the product at source eventually people become (11:36):
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Jenny: used to it we don't notice as much and um yet (11:39):
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Jenny: you're consuming a lot less so the demonizing it's kind of the opposite of that (11:42):
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Jenny: it's not kind of putting that pressure on the individual because i agree it's (11:45):
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Jenny: not about individuals not being aware and not making changes and i'm sure we'll (11:49):
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Jenny: get into this but i do agree like you don't want to be really strict and on (11:52):
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Jenny: you know talk about food in an unhealthy way all the time because that's not helpful either. (11:55):
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Mike: But and i think another really interesting aspect (12:00):
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Mike: of it that again we've discussed previously and i remember you (12:03):
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Mike: showing a graph that demonstrated this is that one of (12:06):
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Mike: the biggest criticisms like that is often (12:09):
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Mike: thrown at those sorts of interventions is the (12:12):
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Mike: the nanny state in inverted in inverted commas like (12:15):
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Mike: stop stopping us from drinking as much sugar as we want (12:18):
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Mike: and that actually i think you showed a graph that demonstrated (12:21):
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Mike: that reformulation over the last i think (12:25):
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Mike: it was 20 or 30 years you'll be able to to tell us (12:28):
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Mike: more about it was that companies were putting more and more and more and more (12:31):
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Mike: sugar over the years so it wasn't that we want these foods to taste like they (12:35):
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Mike: did when we were kids they actually don't taste like they did when we were kids (12:38):
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Mike: because they've added loads more sugar and all we're asking them to do is to (12:42):
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Mike: go back on that because it was a cheap way of. (12:45):
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Jenny: Yeah of. (12:48):
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Mike: Reformulating things i think some time ago is that right. (12:49):
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Jenny: That's really well remembered i was like what was (12:51):
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Jenny: that graph but actually i know what it was that was the chocolate bars it was reducing (12:54):
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Jenny: sugar and chocolate bars since 1990 i think that was um action (12:57):
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Jenny: on sugar produced um that research and (13:00):
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Jenny: yeah so lots of people get really upset that you're going to kind of change (13:04):
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Jenny: this famous like you know old school recipe that's gone through the ages first (13:07):
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Jenny: of all those famous recipes are different every country that you'll go um and (13:11):
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Jenny: second of all they have been changing all the time but just not in the favor (13:16):
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Jenny: of health in the opposite direction and usually that can get a better profit (13:21):
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Jenny: margin for the food industry. (13:25):
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Mike: Yeah, it is really interesting. I think that it's so fascinating to me that (13:28):
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Mike: when public health interventions take place, (13:34):
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Mike: people sort of seem to be more trusting of food companies and their own decisions (13:37):
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Mike: to reformulate things than they do in public health and the decisions to try (13:42):
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Mike: and reformulate products for our health. (13:48):
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Mike: And it seems really that seems so bizarre to me that we're really trusting of like. (13:51):
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Jenny: Yes you. (13:56):
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Mike: Know kellogg's and everyone not that i'm suggesting on the purposes of this (13:57):
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Mike: podcast that we shouldn't trust anybody. (14:01):
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Jenny: But you. (14:03):
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Mike: Know it just it fascinates me that that people will will trust specific organizations (14:04):
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Mike: and have more like i guess brand loyalty to those brands than they would to (14:09):
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Mike: to brands that are actually associated with trying to keep us alive. (14:14):
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Jenny: I guess it just. (14:18):
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Mike: Seems like a confusing scenario. (14:20):
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Jenny: I think you hit the down on the head it's the brand loyalty it's the marketing (14:22):
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Jenny: you know the brands we really do like they're very very (14:25):
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Jenny: clever with their marketing that's been another big issue in you (14:28):
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Jenny: know public health as well is the marketing of these um less healthy ultra processed (14:31):
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Jenny: foods um that really do influence what we eat they'll argue that it doesn't (14:36):
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Jenny: but then you know they're spending their big budgets on them we all know that (14:42):
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Jenny: advertising works there's lots and lots of evidence around you know normalizing (14:45):
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Jenny: the foods that we consume, (14:48):
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Jenny: making us want to try them more, (14:50):
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Jenny: but we did have a public health policy that is meant to be coming into force at the beginning of, (14:52):
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Jenny: next year but now it's been delayed a year which is very frustrating alongside (15:00):
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Jenny: public health policies on price promotions and that was a recent decision by (15:04):
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Jenny: Boris Johnson when he was clutching on. (15:10):
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Jenny: To try and stay popular amongst other kind of conservatives who did not want (15:13):
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Jenny: those policies so just got rid of them at the last minute and I think what was (15:18):
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Jenny: particularly frustrating actually around those decisions was the fact that they (15:22):
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Jenny: were the reasons for that were missold to the public So, for example, (15:26):
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Jenny: price promotion, so your volumes, buy one, get one, freeze. (15:30):
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Jenny: They were saying that they were going to delay the implementation of that because (15:34):
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Jenny: of the cost of living crisis. (15:38):
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Jenny: Now, what those policies are actually shown to do is to manipulate us into buying more. (15:40):
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Jenny: Otherwise, supermarkets would literally be given away for food for free, (15:44):
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Jenny: which isn't a viable business model for them. So they're definitely not doing that. (15:47):
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Jenny: But that's how it's sold to us. But we spend 20% more than we would have. (15:51):
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Jenny: We buy more and we eat more. (15:55):
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Jenny: Um and the other thing you touched on there that i thought was (15:58):
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Jenny: interesting was the whole nanny's day argument which (16:01):
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Jenny: again is really really frustrating because i think that argument comes (16:04):
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Jenny: up time and time again like the government shouldn't intervene with (16:07):
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Jenny: what we eat um and it shouldn't intervene (16:10):
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Jenny: with our autonomy but the question is never about well (16:13):
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Jenny: what level of autonomy do we have as individuals because my (16:16):
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Jenny: level of autonomy would be different to boris johnson's which would (16:19):
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Jenny: be different to you know another family or another (16:22):
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Jenny: person we all have different levels of autonomy and when (16:24):
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Jenny: it comes to what we're eating it's not as simple as just making a (16:28):
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Jenny: healthy choice and you know use that in inverted commas because so many things (16:31):
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Jenny: influence what we purchase and why we purchase it and that is the reason why (16:35):
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Jenny: there's a need for legislation to make healthier food accessible for all but (16:39):
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Jenny: it always comes back to this well you're just telling people what to do and (16:43):
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Jenny: it's a nanny state and I think we do have to get better at explaining that concept to people. (16:46):
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Mike: And like, so for example, because you touched on the multi-purchase thing that (16:51):
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Mike: Boris Johnson did a U-turn on recently. (16:57):
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Mike: And I suppose what my question is about that is, (17:01):
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Mike: do you think that when politicians make those decisions, (17:05):
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Mike: and obviously I'm not asking you to comment individually on Boris Johnson or (17:09):
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Mike: on this particular thing, But when stuff like that happens and these U-turns (17:13):
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Mike: get made quite obviously for reasons of benefiting that particular political party, (17:17):
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Mike: do we think it's because that party benefits financially? (17:25):
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Mike: Like so because the food industry are lobbying them (17:30):
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Mike: or they have connections to people within the industry and they have people (17:33):
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Mike: influencing those decisions or do you think it's more of a political decision (17:38):
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Mike: because they think that the general public will be more likely to to perhaps (17:42):
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Mike: vote for them or be happy with them if they're seen to be behaving in a certain (17:46):
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Mike: way you know while making those decisions. (17:50):
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Jenny: Both of the above um yeah (17:53):
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Jenny: definitely both because like in order to keep (17:56):
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Jenny: their seat to keep their job they have to be popular like that's (17:59):
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Jenny: the long and short of it so they need you know they tend to go with (18:02):
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Jenny: that that's the rule like if you're going to put a policy out there (18:05):
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Jenny: how do we make it popular with the public like we'll always (18:08):
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Jenny: do some public polling you know to try and make (18:11):
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Jenny: the case and that kind of thing um and there is industry lobbying as well so (18:14):
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Jenny: it's both of those things really which does make it really difficult because (18:19):
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Jenny: you end up having industry at the table a lot you know with some of these kind (18:22):
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Jenny: of um public health conversations And I'm not to say that the expertise there isn't warranted, (18:27):
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Jenny: but obviously for some, there are ulterior motives as well. (18:32):
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Jenny: So to have industry kind of setting their own homework, market their own homework, (18:35):
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Jenny: let's say, it makes it definitely less impactful. (18:40):
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Mike: And so the U-turn has obviously been done on that policy, but the other policy (18:45):
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Mike: about junk food advertising, that's just been delayed, has it? (18:52):
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Jenny: So both of them actually have been just delayed. But I think now, (18:56):
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Jenny: in the meantime, we're going to get another government. (19:01):
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Jenny: So actually, to see where we land there, I think is going to be interesting. (19:03):
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Jenny: And it's important for us to obviously keep that pressure on. (19:06):
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Jenny: None of this is about saying people shouldn't eat certain foods, (19:08):
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Jenny: you should cut them out all the time it's just that we constantly we have innate (19:13):
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Jenny: preferences for these types of foods they're really normalized in our diet um (19:16):
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Jenny: and we are constantly having to kind of battle against, (19:20):
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Jenny: willpower or our means you know a lot of them are kind of cheaper and more readily (19:24):
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Jenny: available and accessible all the time to go out of our way for a more nutritious (19:28):
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Jenny: diet and this all of these policies all they're really designed to do is put (19:31):
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Jenny: the healthier foods front and center stage which we just haven't, (19:35):
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Jenny: it's the opposite at the moment. (19:39):
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Mike: 100%. And like I say, this is somebody who, as you know, has been on a journey (19:42):
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Mike: of behaviour change myself. (19:47):
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Mike: And I find it genuinely a real struggle because... (19:48):
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Mike: I, again, don't like to demonize those foods. I like to very much incorporate (19:53):
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Mike: them into my diet, but I do like to have some level of control over how and when I do that. (19:57):
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Mike: And I certainly think, like, it's so innately obvious. (20:03):
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Mike: You know, when you stop at a service station and you want to get some food, it's so much easier, (20:07):
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Mike: like a hundred times easier to order something that is, you know, (20:12):
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Mike: ultra processed uh cheap delicious (20:16):
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Mike: and you know you need to have a (20:21):
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Mike: huge amount of willpower to be trying to go against that and we (20:23):
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Mike: know that willpower is a finite resource and it's something that you (20:26):
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Mike: know that we all struggle with but particularly people who are trying to change (20:29):
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Mike: their lifestyles it's like having to be you know having to drag yourself uphill (20:33):
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Mike: you know it's hard enough day to day making all these choices when you do have (20:38):
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Mike: that autonomy but then when you're constantly thrust into those situations it (20:42):
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Mike: genuinely makes it really really challenging. (20:46):
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Mike: Um and that's and that's another question that i wanted (20:49):
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Mike: to ask you about actually which has just sort of popped (20:52):
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Mike: into my head now because it's it's a fairly recent (20:55):
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Mike: addition to the the situation and it's something that i i know (20:58):
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Mike: has had an impact on on me and and how i eat out (21:01):
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Mike: and we've we've discussed it very briefly previously (21:04):
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Mike: and that's calories on menus um and i (21:07):
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Mike: i mean i i have found it astounding to (21:10):
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Mike: to be in situations where i've gone back (21:13):
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Mike: to places that i used to eat out at (21:16):
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Mike: regularly and i've looked at things that i (21:19):
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Mike: would have assumed to contain a certain rough you know certain rough number (21:22):
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Mike: of calories and we're looking at things containing probably double the amount (21:26):
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Mike: of calories and i think we know that you know calories aren't the be-all and (21:31):
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Mike: end-all of health but i think that we also know that over consumption of calories (21:35):
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Mike: is much easier when you're eating, (21:39):
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Mike: foods that are more processed. (21:42):
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Mike: And it is one of, (21:44):
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Mike: biggest challenges that faces us as a nation from (21:47):
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Mike: like a health perspective as well like when you consider that (21:50):
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Mike: from an energy balance perspective most of (21:53):
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Mike: us might need a couple of thousand calories and then you go to (21:56):
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Mike: a pub and you order a steak and and it comes (21:59):
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Mike: up as 1500 calories for one of your supposed (22:02):
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Mike: three meals plus snacks a day it does raise (22:05):
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Mike: some questions particularly when you know that might (22:08):
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Mike: be in an offer for two courses for 15 pounds or (22:11):
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Mike: whatever so you're also having another course or three courses even plus potentially (22:14):
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Mike: a drink that's got alcohol in it too and you know by the time you actually factor (22:18):
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Mike: all of those things in it's it's it's you know like a huge amount and i assume (22:22):
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Mike: that the adding calories to menus was something that was intended to lead to (22:28):
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Mike: things like reformulation like with the sugar tax is that fair. (22:34):
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Jenny: Yeah that's definitely fair you know there's there's (22:37):
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Jenny: two elements there first of all we've had more transparency in retail (22:41):
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Jenny: supermarket for years about what's in the food (22:44):
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Jenny: that they're selling um we need to catch up with (22:47):
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Jenny: the out of home because if they don't if they're not (22:50):
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Jenny: held to account the restaurants um cafes those (22:53):
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Jenny: kind of places then it's a free-for-all so (22:57):
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Jenny: you know there's one element that can it shift behaviors there's um (23:00):
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Jenny: small kind of studies or evidence shown (23:04):
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Jenny: at the moment there's going to be a lot more parried out um to (23:07):
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Jenny: suggest you know that it would like shift in small (23:10):
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Jenny: amounts and to be honest people dismiss that sometimes that's but we gain we (23:13):
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Jenny: gain weight over time incrementally so it's not like you know actually those (23:18):
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Jenny: small kind of changes over time um or small reductions are beneficial as well (23:23):
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Jenny: so we shouldn't kind of dismiss those and it's about kind of over a whole population um and over time um, (23:27):
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Jenny: But one of the main things that we want to do here is hopefully encourage reformulation (23:33):
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Jenny: across that part of the industry, because really it's been a bit of a free for all. (23:39):
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Jenny: There's evidence that shows that ones that have voluntarily labelled the nutrition (23:46):
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Jenny: in their meals tend to be lower in fat and salt, for example. (23:51):
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Jenny: So we need to see what the evidence shows now. (23:55):
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Jenny: The policy is actually going to be implemented as well. That's really, (23:59):
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Jenny: really important. But the reformulation aspect and kind of that transparency (24:01):
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Jenny: for the food industry, I think, hopefully should start to bring up to more of (24:05):
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Jenny: like a level that we see with food retail. (24:11):
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Mike: And you, I mean, I know this is probably quite a difficult question to answer, (24:15):
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Mike: but do you ultimately think that the calories on menus is a positive move? (24:19):
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Mike: Because it's had a lot of, it's (24:24):
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Mike: had a lot of, I suppose, criticism is the fairest way of saying, isn't it? (24:26):
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Jenny: Yeah totally and like you know I definitely (24:31):
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Jenny: pay a lot of attention you know to that (24:34):
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Jenny: criticism I think it's really important and people are worried about the impact (24:37):
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Jenny: that it might have on people with eating disorders who already kind of struggle (24:40):
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Jenny: to go out and eat and I you know totally appreciate that and I think we do need (24:45):
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Jenny: a lot more research here and to see you know what that kind of shows I think that. (24:49):
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Jenny: Also, on the flip side of that, we never talk about the consequences of not (24:55):
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Jenny: doing these policies, you know, and the reasons why they are implemented as well. (24:59):
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Jenny: And public health polling generally on these policies, there was a public health (25:04):
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Jenny: England poll and I think it was around 79, 80 percent of support, (25:07):
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Jenny: you know, because generally people like to see this information or like to have it available. (25:11):
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Jenny: Whether or not they, you know, use it, it might be a special occasion that they're (25:15):
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Jenny: eating out or there might be someone that's eating out for the fifth time, you know, that week. (25:19):
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Jenny: So it really varies as to when you're going to kind of use it (25:23):
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Jenny: and make a decision based on it as well um there (25:26):
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Jenny: is so there does tend to be a lot of public support but i think that (25:29):
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Jenny: that is the quiet um well you (25:32):
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Jenny: have a louder minority and a lot of the majority of people who (25:34):
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Jenny: wouldn't necessarily be negatively impact are not kind. (25:38):
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Jenny: Of speaking up saying it's the best thing ever they're just (25:40):
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Jenny: not saying anything um so yeah i (25:43):
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Jenny: think it is a really tricky one i think that we need (25:46):
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Jenny: to keep an eye on all of that I think you know it's (25:49):
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Jenny: really problematic if we're in a society where we're putting some nutrition (25:52):
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Jenny: labeling on foods and that that's a massive (25:55):
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Jenny: cause for concern you know with people's kind (25:58):
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Jenny: of mental health and the impact that then has on physical health like (26:01):
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Jenny: that just shows where we're at and government health (26:04):
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Jenny: service obviously need to provide a lot more there in terms of supporting (26:08):
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Jenny: those individuals as well but you know it's really (26:11):
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Jenny: difficult to marry up public health policies with clinical disorders (26:14):
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Jenny: that require you know specialist help so (26:17):
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Jenny: yeah I think it's important to be aware of it all definitely (26:20):
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Jenny: you know none of it should be dismissed and all (26:23):
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Jenny: concerns need to be spoken about definitely but I think we'll have to see what (26:26):
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Jenny: the evidence in the long run shows because no one wants to provide a you know (26:33):
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Jenny: a policy that is more damaging than good this is the challenge with public health (26:36):
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Jenny: policy it's for the majority not every individual Thank you. (26:41):
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Mike: And that's a really good point, because I think that's what we forget is that (26:47):
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Mike: actually when you're implementing a policy, you're implementing the same policy (26:50):
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Mike: for a huge population, all of whom have different backgrounds. (26:55):
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Mike: I think people underestimate just quite how difficult it is to decide on what (26:59):
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Mike: sorts of policies are beneficial on an overall basis. (27:04):
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Mike: And I don't know that there are necessarily any policies that have absolutely (27:07):
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Mike: no risk involved in them because there are population level interventions. (27:13):
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Mike: But I think something that it demonstrates really interestingly to me is I suppose, (27:18):
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Mike: how normalized eating out has become like actually (27:25):
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Mike: you consider really eating out is a is a privilege it's (27:28):
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Mike: not sort of something that that that you expect that necessarily everybody is (27:31):
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Mike: able to do all the time but some of the reactions to it are as though you know (27:35):
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Mike: eating out is such a basic human right that you know anything that impacts on (27:40):
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Mike: it in any negative way or makes you want to do it slightly less might be something (27:45):
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Mike: that's really, really negative. (27:49):
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Mike: And I find that really interesting because actually, if eating out was something (27:51):
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Mike: that people were doing once a month or once every six weeks, (27:54):
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Mike: I don't think people would be too fussed about what the calories were on the menus. (27:58):
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Mike: But I think the fact of the matter is that people are actually eating out several (28:02):
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Mike: times a week in a lot of situations. (28:05):
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Mike: And it's because of that that they're finding it to have a huge impact. (28:07):
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Mike: I mean, I know like even from a personal perspective, it is (28:10):
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Mike: really irritating because you you know you're forced (28:13):
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Mike: to confront the truth and actually in some situations you don't you just kind (28:16):
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Mike: of want to disregard it but is it healthy to disregard the truth or is it healthy (28:21):
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Mike: to address why the truth bothers you I suppose in a way and and for some people you know there is again, (28:27):
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Mike: from an eating disorder perspective it's really tough because I (28:36):
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Mike: think it's fair to say that the levels of support (28:39):
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Mike: available to those suffering from eating disorders isn't (28:42):
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Mike: where it should be on a you know on a nationwide sort of level so (28:45):
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Mike: you know anything that seems to potentially have (28:48):
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Mike: a chance of having a further negative impact on that (28:52):
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Mike: is just going to of course be met by that (28:55):
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Mike: community with you know real upset as (28:58):
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Mike: as one can understand um but then at the same time there's like you say there's (29:02):
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Mike: there's the whole population to consider and it's tough to keep it's tough to (29:08):
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Mike: keep arguments and discussions in perspective because generally speaking they're (29:13):
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Mike: not spoken in proportion with the size of the. (29:17):
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Mike: Population or the number of people that they might affect and all of those (29:20):
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Mike: sorts of things and how much they might affect those people and like you say (29:23):
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Mike: we don't really know what the evidence is on implementing it or really on not (29:26):
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Mike: implementing it although we have seen you know you know the fact that it hasn't (29:32):
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Mike: been implemented for a long time so we sort of have a fair idea that. (29:38):
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Mike: We know that things you know from an eating out perspective we know that that's (29:42):
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Mike: something that people probably do more of than is quote unquote healthy. (29:45):
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Jenny: Yeah and. (29:50):
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Mike: It's tough to talk about health isn't it when it comes to nutrition because it's (29:51):
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Mike: really difficult to define what healthy is because we've (29:54):
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Mike: got the idea that you know it is psychologically healthy to go (29:57):
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Mike: and meet up with friends and go out for dinner or go out for dinner as a family (30:00):
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Mike: or whatever but it might not always be physically healthy and and you know balancing (30:04):
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Mike: up all of those aspects of health are really really important um and it's not (30:10):
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Mike: about neglecting one over the other it's about balancing them. (30:15):
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Jenny: Yeah definitely they're totally related i found the argument around this of like you know, (30:18):
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Jenny: we shouldn't have a calories on menus because it's a special occasion like (30:23):
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Jenny: and i'm like are people just eating out of a special occasion maybe but there's (30:27):
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Jenny: a lot of kind of a grab and go kind of you know this policy covers (30:30):
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Jenny: like all of those areas as well so i'm thinking about like the place you'd (30:33):
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Jenny: go to grab like your daily sandwich and things like that um as (30:36):
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Jenny: well but i think what is going to be really unhelpful (30:39):
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Jenny: with this policy is if the restaurants (30:43):
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Jenny: um cafes etc do not make (30:46):
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Jenny: sure they have nutritious options on the menu because if (30:50):
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Jenny: you go and all you're seeing is high calorie but and (30:52):
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Jenny: you want to have something that you know is more nutritious in that particular (30:55):
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Jenny: occasion maybe you won't one day you will one day you won't it's fine um then (30:59):
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Jenny: and there's nothing available i think that's gonna be really frustrating and (31:03):
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Jenny: i think the the hope is that maybe companies will become more aware of that (31:08):
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Jenny: and industry will start making sure there's those options on there. (31:11):
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Jenny: You have to find ways to... (31:15):
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Jenny: Force change across the industry so this (31:18):
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Jenny: is one example obviously legislation is another (31:21):
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Jenny: example we need government to make sure they're doing a whole raft (31:24):
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Jenny: of policies this is if you know just one like this by itself (31:27):
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Jenny: which they can think would rely on individual choice is not going to (31:30):
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Jenny: work you know so if it's in amongst a food environment that is also health promoting (31:33):
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Jenny: in general then i think you know it would be more helpful but if they're putting (31:39):
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Jenny: loads of calories for high calorie meals on the menu with no options to change (31:42):
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Jenny: into something if people want to then obviously that's going to be a bit pointless. (31:47):
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Mike: Yeah yeah no i agree and i suppose we've sort of circled this topic quite a (31:51):
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Mike: bit but i i'd like to ask the question a little bit more directly i suppose (31:58):
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Mike: um i think it's fair to say that as you know as a nation we certainly struggle (32:01):
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Mike: with being healthy with you You know, (32:07):
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Mike: I think that there's a certain perception that our health in terms of our lifestyle (32:11):
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Mike: health and lifestyle factors has deteriorated over the last few decades. (32:15):
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Mike: And it's improved in many other ways. But just from a lifestyle perspective, (32:20):
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Mike: we seem to be struggling a lot more. (32:23):
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Mike: I suppose what my question is, (32:26):
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Mike: is how much of a role do you think the food industry has played in that? (32:29):
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Mike: And how has it managed to achieve such an impact? (32:33):
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Jenny: I think in the national food strategy they talk (32:38):
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Jenny: about something called the junk food cycle i know (32:41):
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Jenny: lots of people might not like the term junk food but i suppose they've (32:44):
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Jenny: used it because it's what the public will understand um (32:47):
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Jenny: and that talks about the fact that (32:50):
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Jenny: first of all we're hardwired to like certain foods (32:53):
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Jenny: kind of high high sugar high fat (32:56):
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Jenny: kind of those ultra palatable foods um (32:59):
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Jenny: we naturally tend to like more so if (33:02):
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Jenny: they're the one we also like foods that we know and that we're familiar with. (33:06):
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Jenny: So if they're the ones on the shelves they become really (33:09):
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Jenny: normalized we eat what we like um they (33:12):
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Jenny: also tend to be cheaper because they have cheaper ingredients (33:15):
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Jenny: in them less nutrients and more cheaper ingredients then um (33:18):
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Jenny: companies are making more of a profit from them so then they're putting (33:22):
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Jenny: more advertising spend into them because they can so then these (33:25):
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Jenny: are the foods that are then constantly kind of reaching the top (33:28):
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Jenny: all the time and they're making all the profit and that (33:31):
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Jenny: really keeps us in this cycle so as much (33:34):
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Jenny: as we say that individuals you know or humans are (33:37):
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Jenny: in this kind of cycle of struggling and to (33:40):
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Jenny: make those healthier choices sometimes it's the same (33:44):
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Jenny: for industry in a way so that's why (33:47):
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Jenny: you need kind of government to intervene as well so whether it's kind of incentives (33:49):
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Jenny: for companies financial rewards taxes subsidies all those different things in (33:53):
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Jenny: order to you know encourage them to be pumping their advertising spending everything (33:58):
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Jenny: into the healthier products instead we need to it's a whole cultural shift really. (34:04):
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Mike: And so do you think that the the main issue has been (34:10):
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Mike: because i i think obviously we know that food environment has had (34:13):
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Mike: a huge impact which sort of (34:16):
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Mike: bits of the food environment do we do we think is has been the main sort of (34:19):
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Mike: culprits is it the formulation is it the marketing is it the availability or (34:24):
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Mike: is it is it just a combination of all of them and and that's why public health (34:32):
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Mike: strategy sort of seems to focus on a mixture of all of those things. (34:36):
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Jenny: Yeah it's all of them together and i think what they all do (34:38):
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Jenny: together is normalize the foods that we (34:41):
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Jenny: eat um so you know culturally i think a (34:44):
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Jenny: lot of the conversation now is moving towards ultra (34:47):
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Jenny: processed foods because we talk a lot about reformulation and that's (34:50):
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Jenny: really looking at foods where they're at and changing (34:53):
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Jenny: the nutritional composition so if we eat since it could be changing (34:57):
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Jenny: the amount of salt reducing the amount of salt in um products (35:00):
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Jenny: on the shelves or the amount of sugar whatever it is (35:04):
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Jenny: um but now we also need to look at (35:07):
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Jenny: the bigger picture which is if we're eating a lot of these we're (35:09):
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Jenny: reformulating them but we're still eating a lot of these ultra processed foods where there (35:12):
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Jenny: is evidence that links more over consumption of (35:15):
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Jenny: those foods um then that's going to (35:18):
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Jenny: be an issue if we keep putting more and more of those on the (35:21):
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Jenny: shelves so i think that public health policy is about to get more broader (35:24):
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Jenny: those conversations are definitely happening you know to kind (35:27):
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Jenny: of look at the types of food the level of processing as (35:30):
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Jenny: well as the nutritional composition um and that's you (35:33):
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Jenny: know based on emerging evidence and we (35:36):
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Jenny: definitely need more evidence it's very current at the moment but (35:39):
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Jenny: i think we need to consider that whole bigger picture of culturally the types (35:42):
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Jenny: of foods that we're eating the packaged foods on the go all of the time how (35:46):
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Jenny: that's become really normalized not saying there's not a need for it like that (35:49):
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Jenny: obviously obviously is but it's obviously impact in health across the population (35:52):
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Jenny: so what do we need to do to intervene with that now? (35:57):
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Mike: Because because yeah i think i think that's another factor that (36:03):
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Mike: often gets ignored like we often we often lay blame (36:05):
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Mike: sort of firmly at the food industry's feet and sort of say you (36:09):
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Mike: know they're they're forcing us to eat all of this (36:12):
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Mike: convenience food but actually a lot of (36:15):
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Mike: us really need convenience food (36:17):
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Mike: to be available because we just want to keep making our (36:20):
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Mike: lives as easy as possible because we've got other aspects (36:23):
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Mike: of pressure on our lifestyles like be it people who (36:27):
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Mike: are shift workers who are raising families single parents (36:29):
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Mike: um people who just don't have enough time to (36:33):
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Mike: to prepare their food and who also don't have you know (36:37):
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Mike: i know there's obviously an access issue with regards to accessing certain (36:40):
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Mike: types of food etc understanding how to cook (36:43):
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Mike: education there's so many different aspects to making (36:46):
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Mike: these more kind of convenient choices but there is a lot of pressure from the (36:48):
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Mike: public to make choices more convenient you will often find won't you that people (36:52):
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Mike: will choose the ready peeled ready prepared vegetables even if they're more (36:56):
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Mike: expensive like so often people are people are sort of happy to pay more for (37:01):
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Mike: the convenient stuff as well which sometimes is actually cheaper to produce. (37:05):
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Jenny: Yeah and that's a massive question i think it's kind of like it reminds you (37:08):
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Jenny: of status quo bias a little bit just in terms of it's become so i think the (37:13):
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Jenny: industry created a lot of solutions for us that became very normalized so consequently, (37:18):
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Jenny: like we see that as the norm and we try to improve that (37:25):
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Jenny: rather than saying hang on how did this become the norm you (37:28):
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Jenny: know kids snuck in for example it's not to say that (37:31):
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Jenny: nutritious kind of snacks whole food types of snacks aren't (37:34):
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Jenny: beneficial for growing children at all but this whole market of (37:37):
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Jenny: pre-packaged kind of after school things I think (37:41):
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Jenny: that the industry do create that need (37:44):
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Jenny: and that normalization of how we should be eating as well um so (37:47):
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Jenny: yeah I did what did I hear the other day someone say (37:51):
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Jenny: that we're trying to almost solve a cultural (37:54):
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Jenny: issue with technical solutions you know (37:58):
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Jenny: through improving the reformulation and things like that which do need to be (38:01):
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Jenny: done you can't neglect that because you'll be throwing the baby out with the (38:04):
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Jenny: bath water you know if we said no to that or things like salt reduction reformulation (38:07):
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Jenny: programs have been really really impactful and positive but when are we gonna (38:11):
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Jenny: step back and try and gradually change you know the whole kind of cultural food that we eat. (38:16):
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Mike: And i suppose like that's that (38:23):
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Mike: is a big question like what do you i mean what (38:26):
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Mike: do you think we need to do as a nation to (38:29):
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Mike: improve our health if you (38:33):
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Mike: were like i was gonna say you can be you can choose what role you can either (38:35):
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Mike: be queen or president or prime minister but whatever you are basically in charge (38:41):
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Mike: of the country and it's your job to fix health what would you what do you think (38:45):
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Mike: from a nutritional perspective would be the the greatest thing that we could do. (38:50):
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Jenny: I thought you were going to ask me to channel my inner boris (38:53):
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Jenny: johnson then for a minute um what would i do (38:56):
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Jenny: i say that's such i would never ask anyone such a thing um that's (38:59):
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Jenny: such a big question i think (39:03):
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Jenny: you know first of all first and foremost you've (39:06):
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Jenny: got to make a food system that is fair and equitable across (39:10):
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Jenny: the board because you know that's not the case and it (39:13):
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Jenny: comes back to you know that nanny state argument um and (39:16):
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Jenny: government saying that they think people should have their (39:20):
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Jenny: own autonomy well that doesn't exist we (39:23):
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Jenny: don't have you know equal autonomy we don't have like some (39:25):
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Jenny: individuals will have more than others so we know (39:28):
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Jenny: that government intervene with our choices whether it's (39:32):
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Jenny: a policy or whether it's not putting a policy in place (39:35):
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Jenny: because if they're not making a fair equitable food (39:38):
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Jenny: system and making you know healthy nutritious (39:41):
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Jenny: food available and affordable to everyone then (39:43):
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Jenny: actually that that's not providing choice like (39:47):
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Jenny: we haven't got a choice there so that I think (39:50):
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Jenny: that's the the main thing is making sure there are policies as a (39:52):
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Jenny: fundamental human right that kids are fed (39:55):
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Jenny: and have access to healthy foods um I (39:58):
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Jenny: definitely we know through you know research (40:03):
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Jenny: studies that overall the number (40:06):
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Jenny: of policies over the past 30 years or so I think there's been 14 (40:10):
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Jenny: or so sorry papers um around public (40:13):
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Jenny: health policies that would help to reduce obesity within those (40:16):
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Jenny: 14 different papers there's nearly 700 policies. (40:20):
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Jenny: We haven't seen any difference and people will say oh that's. (40:23):
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Jenny: Because you know public health policies don't work but it wasn't it's because they haven't been. (40:26):
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Jenny: Implemented um or they haven't been evaluated or they all relied on just education. (40:29):
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Jenny: Alone and that's a paper at cambridge uni and that has been really really telling (40:35):
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Jenny: so definitely I would promote intervention for positive reasons and making sure (40:39):
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Jenny: that as an absolute baseline all kids would have access to a healthy and nutritious diet. (40:43):
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Jenny: What would you do? (40:51):
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Mike: Because I think that's another massive issue. Well, I think that exactly the same thing. (40:52):
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Mike: But no, I think that's the other thing is that from the perspective of actually (40:57):
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Mike: what is it that is affecting our health, I think there's like this dichotomy, (41:02):
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Mike: I think, because a lot of people think it's just obesity. (41:08):
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Mike: But actually, there's also this kind of counter-side of almost kids starving. (41:11):
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Mike: There's malnutrition going on in young kids because they're not (41:18):
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Mike: getting the nutrients that they need and um there's issues (41:21):
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Mike: with regards to um inequality and (41:23):
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Mike: you know access inequality food availability inequality food environment inequality (41:27):
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Mike: like i think there is a huge equality issue and i think that that's what makes (41:32):
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Mike: it so difficult but i think that also the obesity issue is and i i'm not an (41:37):
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Mike: expert on this so i've obviously got my opinions And I'm sort of, you know, (41:42):
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Mike: reticent to kind of really display them because they're not perhaps as educated as they should be. (41:46):
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Mike: But I think that they sort of tie into one another because it is the over-reliance (41:53):
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Mike: on the cheaper, more processed foods that are minimally nutritious that is causing this sort of counter. (41:57):
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Mike: I don't really want to call it a starvation because it isn't that (42:07):
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Mike: but it is a you know it's a it's a it's a suboptimal inadequate (42:10):
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Mike: level of nutrition in kids but it's (42:14):
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Mike: also like doing that is also implementing this cultural change that you're talking (42:17):
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Mike: about and perpetuating it because people are becoming more and more reliant (42:24):
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Mike: and are normalizing these sorts of ultra processed foods that you know a lot of which didn't exist. (42:31):
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Mike: Decades ago like you know and and (42:37):
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Mike: the kind of the wide range of products that that (42:41):
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Mike: now exist that that we almost feel (42:44):
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Mike: that we couldn't go without because we'd be demonizing them (42:47):
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Mike: and and you know denying ourselves these pleasurable food experiences (42:49):
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Mike: uh they didn't exist (42:53):
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Mike: 50 years ago so what were people doing then people weren't having (42:55):
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Mike: to make huge sacrifices to go (42:58):
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Mike: without those foods um i think that (43:01):
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Mike: there is that i think there's a massive portion control issue (43:04):
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Mike: i think both even you know even from the (43:07):
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Mike: perspective of stuff like you know recipes that (43:10):
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Mike: you find online but definitely when (43:13):
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Mike: it comes to stuff like um restaurant meals i mean portions are enormous you've (43:16):
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Mike: got people you know who are like some people will struggle to finish the food (43:24):
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Mike: some people will make themselves finish the food because we were still raised (43:29):
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Mike: in a culture where you shouldn't waste food as well. (43:32):
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Mike: So you've got all of these counteracting sort of aspects of culture that only (43:35):
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Mike: serve to further this disparity between... (43:41):
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Mike: Decent and healthy nutrition and (43:46):
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Mike: where we actually are um and it's (43:49):
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Mike: much easier to perpetuate the the unhealthy things (43:52):
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Mike: than it is to perpetuate the healthy ones and i think again we (43:55):
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Mike: are we are fighting that dichotomy because on one hand on the (43:59):
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Mike: individual basis we don't want to demonize food types (44:01):
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Mike: we don't want to demonize enjoyable food (44:05):
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Mike: experiences we want people to have a wide range of of (44:08):
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Mike: enjoyable foods and we want people to enjoy their eating but (44:11):
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Mike: then if you if you look at you know going out for dinner (44:15):
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Mike: again you can either choose this (44:18):
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Mike: like hideously boring awful salad that's (44:21):
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Mike: got like 800 calories in it for no reason (44:24):
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Mike: and is disgusting or you can choose (44:27):
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Mike: a um like a you (44:30):
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Mike: know a meal that's actually potentially got a decent amount (44:33):
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Mike: of vegetables and protein and all of that sort of (44:36):
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Mike: stuff but has just been cooked in a sea of oil (44:39):
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Mike: and butter and for no reason has (44:42):
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Mike: 1500 calories even though it's meant to just be grilled fish and (44:45):
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Mike: vegetables for example like i i just think that that there just sort of seems (44:47):
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Mike: to be this huge lack of understanding and um i just answered my own question (44:51):
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Mike: significantly more ramblingly than than you did so i don't you'd have thought (44:56):
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Mike: i'd have thought of my own answer but i enjoyed that i think there's just there's (45:01):
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Mike: i think the difficulty is, (45:04):
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Mike: is balancing public health and individual health. (45:05):
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Mike: And I think that's what sort of leads me to my final question. (45:08):
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Mike: And I'm asking a lot of my guests this question because I think it is a really interesting one. (45:11):
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Mike: I think that it's really important that we recognise the roles that other aspects (45:15):
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Mike: of society play in our health, the things that are sort of beyond our control. (45:21):
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Mike: It's really important that we recognise and acknowledge those because otherwise we (45:25):
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Mike: feel like we're just putting all of this pressure on people to make individual (45:29):
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Mike: change when that's hard but at (45:32):
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Mike: the same time sometimes i worry that that you know us (45:35):
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Mike: always saying oh well you know it's the food (45:39):
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Mike: industry's fault or it's advertising's fault or it's (45:41):
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Mike: your food environment's fault it's really helpful in (45:44):
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Mike: the sense that it helps to take the pressure off people but sometimes (45:47):
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Mike: i wonder if it's a bit disempowering because we can't change (45:50):
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Mike: the food environment or advertising or any of those things overnight (45:53):
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Mike: but these things are having a negative impact (45:56):
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Mike: on people's health right now so often the (46:00):
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Mike: responsibility for behavior change is lying at (46:02):
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Mike: the individual level and so i suppose my question is (46:05):
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Mike: as individual health professionals treating individual patients or clients or (46:08):
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Mike: whoever we're seeing how do we kind of like empower them to make those individual (46:13):
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Mike: changes while also helping them to have an understanding that this isn't necessarily their fault. (46:20):
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Jenny: It's such a good question. It's on my mind a lot, actually, (46:27):
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Jenny: just that thing around if we're talking about the food environment, (46:31):
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Jenny: we have to put a lot of pressure on government and the food industry and saying, (46:35):
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Jenny: you know, all the responsibility that they have to change population health, (46:38):
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Jenny: that we need to be careful that we're not disempowering people, (46:41):
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Jenny: that we're not saying that individuals can't make any changes. (46:44):
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Jenny: Individuals absolutely can like we said (46:47):
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Jenny: the amount of change that they can make would be (46:50):
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Jenny: so dependent on a lot of circumstances um which is why we have so much you know (46:52):
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Jenny: health inequality because some people have more means to make healthier choices (46:58):
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Jenny: than others and that can be not just money but time education etc as well um (47:02):
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Jenny: so the policy stuff is really about you know. (47:09):
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Jenny: Again making um it fairer making (47:12):
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Jenny: it more equitable but at an individual level (47:15):
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Jenny: in the current environment that we live in there is (47:18):
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Jenny: an element of self-regulation that we need and i (47:21):
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Jenny: think we're almost getting to the point where people are shying away from that (47:24):
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Jenny: completely like it's a really bad thing but a lot of people want (47:27):
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Jenny: information they want to be able to take control of their health (47:30):
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Jenny: and and i don't think we should dismiss that (47:33):
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Jenny: either so i think the main thing around those conversations and (47:36):
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Jenny: you know I'm not doing one-to-one kind of clinic setting um (47:39):
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Jenny: sessions obviously like like you do so I feel a (47:43):
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Jenny: bit reluctant to give you my suggestions but for (47:46):
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Jenny: me the crux of it all is the stigma side of it it's how to raise those conversations (47:49):
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Jenny: and currently and you you know you'd only have to talk about to your smart well-educated (47:54):
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Jenny: well-meaning friends a conversation around obesity and what we eat and people (48:00):
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Jenny: will always argue back with you that it's individual responsibility. (48:06):
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Jenny: People always consider what we're eating at the point of when people are putting (48:09):
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Jenny: food into their mouth without thinking about this whole raft of issues that (48:13):
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Jenny: have contributed to getting there in the first place. So, you know, I think... (48:17):
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Jenny: For us to help share the message about the complexities that contribute to why (48:22):
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Jenny: we eat, what to eat, to help reduce the stigma there, because we massively oversimplify (48:27):
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Jenny: it at the moment, is really important. (48:32):
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Jenny: When we're having those conversations, we can be empowering, (48:34):
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Jenny: but we obviously listen and we understand what's difficult for that particular (48:36):
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Jenny: individual versus a telling of what to do. (48:39):
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Jenny: So I think the stigma part, the awareness part is probably key there, (48:42):
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Jenny: but we definitely still want to empower change. (48:47):
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Jenny: People do make changes like you know there is there is evidence that shows that (48:49):
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Jenny: people do make changes they are able to make change it can lead to health benefits (48:52):
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Jenny: but the problem is that it's not really um something that everyone is able to do. (48:56):
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Mike: That's really useful thank you and this leads me on to my final question of (49:04):
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Mike: the podcast what do you think the bslm can do as an organization to try and (49:08):
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Mike: help the health of the nation in the best possible way. (49:15):
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Jenny: I think this is going to be such a cop-out answer but it's it's about educating (49:18):
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Jenny: on all of this stuff for a start it's about increasing that awareness i think you know there's a lot of, (49:24):
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Jenny: like ill-informed nutrition information out (49:32):
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Jenny: there social media platforms um that (49:36):
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Jenny: tend to get a lot of attention because they're (49:39):
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Jenny: semi-controversial or they're what people want to hear versus what's helpful (49:42):
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Jenny: and because they've got a lot of attention we seem to put you (49:45):
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Jenny: know give them more credit like they are right (49:48):
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Jenny: um and so i think organizations like bslm (49:51):
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Jenny: just really need to be reinforcing kind (49:54):
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Jenny: of credible evidence-based messages all (49:58):
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Jenny: the time is the best that you can do because there's so much out there at the (50:01):
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Jenny: moment you know there's a lot of messages getting (50:04):
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Jenny: traction around you have to pay a fortune for a personalized (50:08):
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Jenny: nutrition in order to be you know healthier or calories (50:11):
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Jenny: are completely redundant you know lots (50:15):
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Jenny: of headlines basically um that are (50:18):
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Jenny: not nuanced but get a lot of traction and then those messages end up filtering (50:22):
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Jenny: through to a lot of health professionals that i do think is a big risk so i (50:25):
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Jenny: think it's just making sure that yeah there's evidence-based and pragmatic messages (50:29):
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Jenny: that's what it comes down to i've definitely changed from being a idealist to (50:33):
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Jenny: a realist in my career yeah. (50:38):
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Mike: No i i can definitely relate to i could definitely relate to that and it's um, (50:41):
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Mike: It's been really like an interesting, I guess, journey for me as a clinician because. (50:46):
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Mike: My kind of thoughts and views on healthy eating have changed over the years (50:55):
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Mike: from when before I had no interest in it to when I was interested in it to starting (51:00):
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Mike: to learn about it to then starting to learn about all of the things that I'd (51:07):
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Mike: got wrong about it to start with. (51:10):
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Mike: And what has really fascinated me is that at each step of that journey, (51:13):
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Mike: my own biases and my own thoughts and my own ideas had, you know, (51:17):
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Mike: had the potential to impact on my patients in ways that I wasn't necessarily (51:22):
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Mike: fully cognizant of at the time. (51:25):
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Mike: So, you know, if I was seeing that, you know, the paleo diet was really great (51:28):
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Mike: for me and patients might be asking me or, (51:34):
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Mike: you know, noticing my own physical changes or asking me questions about (51:38):
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Mike: losing weight or eating healthily you know (51:41):
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Mike: my own sort of experiences with those things would potentially (51:44):
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Mike: have an impact on those discussions and what (51:48):
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Mike: you then realize as you go through life and you start to (51:51):
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Mike: learn more about things is that you you often apply a lot (51:54):
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Mike: of your own biases clinically like you (51:57):
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Mike: know even to the point where I might assume (52:00):
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Mike: that my patients don't want to cut out carbs because (52:03):
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Mike: I don't want to cut out carbs but actually some of (52:06):
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Mike: my patients might benefit from these other different ways of doing (52:09):
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Mike: things that we have to be sort of (52:11):
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Mike: more open-minded because I guess what (52:14):
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Mike: always worries me with nutrition is because there's so (52:17):
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Mike: many conflicting views and I think from a scientific perspective and it's interesting (52:21):
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Mike: like I've spoken a lot to a lot of very highly scientific nutritional people (52:25):
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Mike: about this I think that in the scientific nutritional community there isn't (52:31):
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Mike: actually that much discord but it's. (52:36):
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Mike: Within the social media nutrition community, for example, or within the news (52:39):
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Mike: nutritional community or within people's own individual health beliefs and between (52:44):
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Mike: clinicians, there is a lot of disagreement about the best way of doing things, (52:48):
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Mike: probably because different things tend to suit different people in different ways, right? (52:51):
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Mike: So then there becomes this conflict where everybody's (52:55):
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Mike: arguing about the best way to do things and often the (52:59):
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Mike: way of arguing something is to discredit something else and (53:02):
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Mike: from an evidence based perspective it's quite easy to (53:04):
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Mike: discredit a lot of things when comparing them to other things but from a lifestyle (53:07):
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Mike: perspective and from a behavior change perspective actually some things might (53:11):
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Mike: have no evidence behind them but might be a quite useful method to employ for (53:17):
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Mike: somebody because it might fit in with something like a shift pattern, for example. (53:21):
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Mike: And I think that's what becomes so difficult is because you can kind of get (53:26):
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Mike: over caught up with discrediting things. (53:30):
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Mike: And I think if we had more of an honest approach, whereby the people who were (53:32):
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Mike: talking about non evidence based approaches were being more honest about the (53:36):
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Mike: fact that they might not be backed with evidence, but they might aslute people (53:40):
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Mike: for those specific reasons. (53:43):
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Mike: Then it would make life a lot easier but that isn't always (53:44):
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Mike: the case um and i think that (53:47):
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Mike: that's the difference again between sort of idealism and (53:50):
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Mike: realism and and understanding that actually you know (53:53):
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Mike: real life is very (53:57):
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Mike: different to the textbooks and is very (54:00):
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Mike: different to social media um and sometimes if (54:03):
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Mike: you aren't a nutritionist or a (54:06):
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Mike: dietician yourself it can be genuinely really (54:09):
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Mike: hard to kind of cut through all of the all of the different (54:12):
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Mike: ways that people talk about this because people (54:15):
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Mike: use a lot of authority bias and people (54:18):
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Mike: have got things to sell and it can make it really (54:21):
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Mike: really challenging so i think again it's another one of the things that (54:24):
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Mike: the public is working against when trying to make positive behavior (54:27):
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Mike: change is actually which messages do they actually listen to (54:30):
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Mike: and i think the bslm has a big role to (54:33):
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Mike: play in this sort of situation by making sure that we (54:36):
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Mike: try our best to disseminate good information to (54:38):
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Mike: people um and as part of that i (54:42):
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Mike: would like to say a huge thank you to you for um (54:45):
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Mike: disseminating what i think has been some really useful information today so (54:49):
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Mike: thank you very much for speaking me today speaking to me today um if people (54:53):
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Mike: want to follow your musings or um read more of your work or anything like that (54:57):
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Mike: how best would they do that um. (55:02):
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Jenny: I'm not a massive social media person but i am on instagram and twitter at hello (55:06):
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Jenny: healthy you um jenny ross bra um so yeah that's probably the best place. (55:10):
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Mike: Awesome we will include that in the show notes and thank you so much again for (55:15):
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Mike: speaking to me today and hopefully we will speak again soon thanks for having (55:20):
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Mike: me thanks for listening everyone. (55:22):
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