It's not public health, it's none of the council's business

 In recent days the fussbuckets have been out in force. Hardly a day passes without another proposal to judge people by their lifestyle choices. There is nothing that can’t be justified by reference to ‘health’ or ‘well-being’ especially when the proposals is accompanied by reference to ‘how much it costs the NHS’ or ‘society’.

Part of the context for this outpouring of nannying fussbucketry is that ‘overall responsibility’ for public health (i.e. some of the budgets for public health activities) transfers to local councils in April this year – hence the publication and fuss about a report from the LGIU and Westminster Council. 

Well sort of transfers – let me explain.

The recent health legislation does transfer the public health budgets to top tier local authorities (that’s counties, mets, unitaries and London boroughs). However, these budgets are ringfenced – we can’t snaffle them and use the money to provide more of better adult social care or keep libraries open. And, just as importantly, the committee that oversees this budget – called a Health & Well-being Board – is a joint body of the NHS and the local authority. Membership is defined in the statute and has to include both council officers (the Director of Public Health, for example) and councillors. Full council cannot direct or control this body nor can the council’s executive so to say that councils are taking responsibility for public health is something of a misrepresentation. The budget will sit with the council – just as the schools budget does – but the decision-making rests right where it does now with unelected officials.

Oddly enough the report from the Local Government Information Unit (LGIU) doesn’t mention any of this. Instead it focuses on all the exciting things that can now be done – including making fat people go to the gym:

Westminster council and the Local Government Information Unit say new technologies such as smart cards could be used to track claimants' use of leisure centres, allowing local authorities to dock housing and council benefit payments from those who refuse to carry out exercise prescribed by their GP.

Or rather – as is clear here – fat, poor people. 

This proposal comes of the back of the proposal to have a welfare card so folk on benefits don’t do anything naughty like buy booze, fags or mucky videos. A couple of stern Tory MPs – Alec Shelbrooke and Kris Hopkins – have wagged their fingers at us in support of this proposal.

It is all part of directing the poor towards a more purposeful life and away from those sinful pastimes – drinking, smoking, bad telly and sex – that are, these moral paragons would have us believe, the cause of their problems.

These fine men are speaking to that single mum on the estate. Stop making these unhealthy choices they say and, hey presto, your life will be transformed, folk’ll be at your door offering you a job, food will miraculously appear on the table and a man will arrive who thinks you’re something other than a convenient slot for his sexual organ. And the kids will stop snivelling too.

Or maybe our pals in Westminster are thinking about the ex-offender in a bedsit. The message is that going to the gym, cutting out the whisky and scrapping the roll-ups will change everything. Suddenly the employer will look at him and choose to ignore the rap sheet, the ex-wife will let him see the kids and people will stop asking him to do a little running around for cash, ‘no risk mate’!

Perhaps they're thinking of the retired builder. Not much cash but enough to maintain his beer gut, provide for some cheap cigars and perhaps a few bets at the weekend. For sure, stopping these bad habits will help - the bad back will go away, the hearing will magically restore and the pains up the arms from years of using power tools will be so much better!

This approach to public health – lecturing people about their lifestyle choices while ignoring why they made those choices in the first place – is a dead end. It might make a few middle class do-gooders feel better, for those Tory MPs it’s a chance to burnish their ‘tough-on-welfare-scroungers’ credentials and for councillors in Westminster is furthers their desire to kill the things that make London a great city.

But it isn’t a decent public health strategy. That would focus on things that actually are public health concerns – air quality, road safety, immunisation, access to healthcare provision, warm homes, cheaper fuel, safe food and clean streets. Personal lifestyle choices – eating drinking, smoking, sex – are just that, personal concerns. By all means make sure people know the risks but that’s where our responsibility ends. These choices are nothing to do with public health.

Making someone’s life less pleasant because you disapprove of their lifestyle is an act of ghastly authoritarianism not health care. Yet this is seemingly the only concern of so-called ‘public health’.

Well, my dear councils, it isn’t public health – it’s none of your business at all.

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Eating stuff doesn't cause cancer....

Pie. A very good pie. From Ellisons in Cullingworth

Over recent years assorted nannying fussbuckets and attention seeking "researchers" have bombarded us with tales that warn how those wonderful foods we love are giving us cancer. Not that I was taking any notice but it does seem that it was - to be polite - a little exaggerated. At least according to some American academics:

...US scientists have warned that many reports connecting familiar ingredients with increased cancer risk have little statistical significance and should be treated with caution.

"When we examined the reports, we found many had borderline or no statistical significance," said Dr Jonathan Schoenfeld of the Harvard School of Public Health in Boston.

In a paper in the American Journal of Clinical Nutrition, Schoenfeld and his co-author, John Ioannidis of Stanford University, say trials have repeatedly failed to find effects for observational studies which had initially linked various foods to cancer.

These foods included:

...flour, coffee, butter, olives, sugar, bread and salt, as well as peas, duck, tomatoes, lemon, onion, celery, carrot, parsley and lamb, together with more unusual ingredients, including lobster, tripe, veal, mace, cinnamon and mustard.

Plus, of course, as the Daily Mirror puts it - the "British breakfast":

A health warning on the British ­breakfast was lifted yesterday after scientists ruled that bacon, tea and burnt toast may not cause cancer after all.

After months of stories linking the ­nation’s favourite foods with the disease, US scientists now say there is in fact NO evidence that they are harmful.

What on earth will the Daily Mail publish now?

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Fat taxes - targeting the preferences of the poor (again)

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Why do I never hear cries of anguish and anger from those who claim to champion the interests of the poor when the matter of nannying taxes on "junk food" arises.

"Fat taxes" would have to increase the price of unhealthy food and drinks by as much as 20% in order to cut consumption by enough to reduce obesity and other diet-related diseases, experts have said. Such levies should be accompanied by subsidies on healthy foods such as fruit and vegetables to help encourage a significant shift in dietary habits, according to research published in the British Medical Journal.

And the target for these nannying fussbuckets is to change the habits of the poor - to force them to eat more expensive, less pleasing (at least to them) food. And that this will be a "benefit" to those poor people:

Although the less well-off are affected more by health-related food taxes, they may also ultimately benefit because "progressive health gains are expected because poor people consume less healthy food and have a higher incidence of most diet-related diseases, notably cardiovascular disease"

The poor, ignorant chavs don't know any better do they - they must be shoved into a change of habits, into no longer eating the stuff they like to eat because a minority of them get unhealthily fat. There's no discussion as to why so people get so fat or how support from the medical profession might help such folk. No, we make these foods - what we might call "working class" foods - more expensive because we disapprove of them.

The New Puritan's first target is becoming clear - "sugary" drinks. And, as they ever do, the chosen approach is what we might call epidemiological creativity:

Research in America found that a 35% tax on drinks sweetened with sugar sold in a canteen, which added about 28p to the price, led to a 26% drop in sales. Studies have estimated that a 20% levy on such drinks in the US would cut obesity by 3.5% and that adding 17.5% to the cost of unhealthy food products in the UK could lead to 2,700 fewer deaths from heart disease

Read the above paragraph carefully and you'll see that, while it suggests a single piece of research, it really notes findings and "estimates" from at least three wholly unrelated studies. The first one shows that, in a controlled environment, if you increase the price of something by 35% you get a big drop in sales. Nothing surprising there then. However, the writer then eases smoothly into a "studies have estimated" statement about whether those price increases would reduce 'obesity'. This is what's known, in less high-flying circles, as a "guess" - indeed, a guess designed to fit the prejudice of the author.

This creative deception is then repeated with a second estimate, this time on reduced deaths from heart disease. Here we should note that the tax (one assumes VAT since the increase is 17.5%) is applied to all "unhealthy" foods not just to the sugary drinks referred to in the other half of the sentence.

The entire paragraph - I suspect lifted straight from a press release without question or challenge by Mr Campbell the Guardian's health correspondent - is designed to deceive us, to suggest that fat taxes will save lives whereas the truth is that we have no idea at all whether fat taxes will result in such a benefit. Especially when - as we know well - rates of heart disease have been falling, year-on-year for at least three decades.

Just as with minimum pricing for alcohol, these proposals - wrapped up in supposed concerns about obesity - are merely a pseudo-scientific manifestation of arrogant middle-class prejudice.

"Oh no, we wouldn't let our Jamie go to McDonald's"


"We only use natural fruit juices - we won't have Coke in the house"

And so on - these are the thoughts driving the fat tax campaign. It is simply New Puritan disapproval. So what if rates of childhood obesity are falling - something must be done. It you're going to eat burger and chips let is be hand-formed burgers using welfare-farmed lean rare breed beef and organic, hand-cooked chunky chips rather than a Big Mac and fries. So what if ordinary folk then can't afford to treat their kids - think of the health benefits!

We should stop and think for a minute about what all this means. Not just that introducing such a tax would be a "pasty tax" on steroids but that we are targeting the preferences of the poor for no other reason than that we disapprove of them. And this - while understandable in the righteous Guardian reader - is simply wrong.

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Obesity rates are falling not rising - so why must doctors lie about this?

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We've got rather used to the various clubs of doctors - BMA, RCS and suchlike - telling us that alcohol consumption is rising when it isn't (even the BBC now recognise that it is for heaven's sake). Now these New Puritan institutions are lying about obesity:

According to the latest research, 48% of men and 43% of women in the UK will be obese by 2030, a trend that will significantly increase the prevalence of strokes, heart disease and cancer, and lead to higher costs for the NHS.

Now unfortunately, the Guardian doesn't link to that latest research. However, the latest actual statistics from the Office of National Statistics tell us that rates of obesity are falling:

Despite the government ignoring the anti-obesity lobby's urgent suggestions for traffic light labelling on food and suchlike, the latest figures show that obesity amongst men has fallen to 22% and the female obesity rate has fallen to 24%.

So something must have changed - either the Academy of Medical Royal Colleges are scandalously misinformed or else the British public has been on a massive eating binge in the last year (those latest figures are from 2011).

Ah but what about the children say the doctors:

Charlie Powell, campaigns director of the Children's Food Campaign, applauded the academy's intervention. He said: "Andrew Lansley should act on this excellent set of robust recommendations, but his track record suggests that he will once again ignore the advice of our best medical experts."

Ah yes those children - I don't have figures for everywhere but I'm pretty sure Bradford won't be out of the ordinary in terms of obese children -  here, for Year 6 children, there has been a slight fall over the past three years and the rate remains below 20% (marginally above the national average). And note that this uses the very discredited measure of Body Mass Index.

None of these actual facts supports the argument of the Academy that we should set about banning advertising & sports sponsorship, fast food outlets near schools and celebrity endorsement. Let alone introducing "fat taxes".

There really isn't a growing obesity crisis and doctors should help people who get too fat rather than seek to punish the vast majority who never get past being slightly chubby.

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Sorry Tim but every day's a feast day in our house!

For lots of trendy foodie types – the locavores and such – Tim Lang is the man. This Professor churns out media friendly material that is seized on by the advocates of “meat free” and vegetarian lives. Now this man wants us only to eat meat on feast days - for the good of our health!  Professor Lang is wrong – massively and monumentally wrong:

Prof Lang, who advises the World Health Organisation, as well as the Department for Environment, on food policy, said eating too much meat can lead to serious health issues such as obesity, heart disease and type 2 diabetes.

Taking these things in order:

Eating “too much meat” isn’t the cause of obesity. Even the dear old NHS doesn’t list meat as a cause of obesity. In pretty general terms obesity results from ingesting more calories that you can use. And the main source of those calories isn’t meat, it’s processed carbohydrates – bread, pasta, pastry, cake, chocolate bars.

Eating “too much meat” isn’t a major risk factor in heart disease. Here from Scientific American:

Now a spate of new research, including a meta-analysis of nearly two dozen studies, suggests a reason why: investigators may have picked the wrong culprit. Processed carbohydrates, which many Americans eat today in place of fat, may increase the risk of obesity, diabetes and heart disease more than fat does.

OK that focuses on how saturated fats aren’t the culprit. But nowhere, not one jot, of evidence exists that shows meat to be a serious risk factor in heart disease.

And neither is meat the main risk factor in Diabetes 2. As Diabetes UK point out the risk factors for the condition include:

1. A close member of your family has Type 2 diabetes (parent or brother or sister).
2. You're overweight or if your waist is 31.5 inches or over for women; 35 inches or over for Asian men and 37 inches or over for white and black men.
3. You have high blood pressure or you've had a heart attack or a stroke.
4. You're a woman with polycystic ovary syndrome and you are overweight.
5. You've been told you have impaired glucose tolerance or impaired fasting glycaemia.
6. If you're a woman and you've had gestational diabetes.
7. You have severe mental health problems.

Nowhere there does the word “meat” appear.

The problem isn’t just that Professor Lamb is wrong but that his nonsense (and I’ve focused on the idiocy of his health claims – the same could be said of his economic and environmental arguments) is regurgitated by the media without challenge or criticism. The Professor is an “expert” and not to be questioned.

It really is time journalists began to do their job. Like asking people like Professor Lang to provide some real evidence for their claims rather than just giving them a great headline and a thousand uncritical words.

And here every day is a feast day!

 

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Friday Fungus: Mushroom Deniers (and a flavour of what they're missing)

Out there in the world – I know you find this hard to take – there remain “mushroom deniers”. The simple act of entering “I hate mushrooms” into a Google search reveal over 1.4 million references. That’s a whole load of mushroom hatred going down out there! Some of these ‘mushroom deniers have even coined the term ‘mycophobe’ to describe their sad condition.

Some deniers have gone to the trouble of listing all the things wrong with mushrooms – a terrifying list of sins ranging from alleged ‘sliminess’, how they feel between ones toes (‘deniers’ seem strangely obsessed by the relationship between mushrooms and athlete’s foot), the smell and, of course, the taste.

Although millions of people eat mushrooms without any ill-effect - indeed, with every indication of pleasure (even great pleasure) – the deniers are always harking on about how some mushrooms are poisonous. There’s a whole forum and a Facebook group dedicated to sharing a dislike for mushrooms – a kind of support group for the terminally squeamish.

Even within my family there are mushroom deniers – my brother, my son, my nephew. And sometimes I worry – but not for long. After all – if they don’t want the joy of mushrooms, if they choose to deny the wonderfulness of fungi - that means more for me! More mushroom risotto, more Portobello mushrooms with Stilton & pine nuts and more of Kathryn’s wonderful mushroom soup.

Or how about a mushroom and cream cheese bagel? Made with fresh mushrooms gently fried with shallots, warm bagels and whatever cream cheese takes your fancy! Wonderful – think of those mushroom juices running down your chin, of licking the cheese and mushroom off your fingers and remember that ‘mushroom deniers’ are missing this joy. Spare them a thought as you go for the second helpings!

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Junk food and cabbages - why what I eat is none of the Government's business

Junk food is the secret of our success – since we started on this non-stop cycle of eating, we’ve grown taller, started living longer and generally had a much better life than our poor ancestors denied the delights of burgers, pizzas and fried chicken. Look out onto the rosy-faced, cheery young folk clutching their Big Macs and ask yourself this – why are we getting quite so fussed about the supposed problems that come from being an ounce or two overweight? And why do (rather overweight if you ask me) celebrity cooking folk take a break from making loads of money promoting supermarkets or selling overpriced pizza and lecture us on how we’re making our kids ill by giving them a bit of stodge?

Instead of junk food these bossy folk want us to eat more green stuff. You know those smelly sprouts, cabbages and spring greens you hated as a kid but eat now under sufferance because some self-appointed expert on the telly tells us it’s good for us. In fact many folk wonder what all the fuss is about with brassicas – other than how one plant can produce such an array of annoying vegetables (although it was always a disappointment to me that sprouts didn’t turn into big cabbages if you left them on the stem, in fact that big cabbages are in fact just giant sprouts – which explains a great deal). As a small relative of mine once observed, ‘if God had meant us to eat cabbage, he would’ve made it taste nice.’

Now don’t get me wrong, I am not a big consumer of so-called junk food (in the case of Big Macs not a consumer at all under any circumstances other than near death from starvation) but I really don’t see that what other folk eat is any concern of mine – or, more importantly, any concern of the Government. If people want to stuff their faces with fattening food and wash it down with fizzy-pop or cheap lager (while smoking bootleg Lambert & Butlers) that’s their business. And, if as a result such folk die a terrible painful death at 55 (as appears to be the case with half Glasgow’s population if the figures are right) that’s their problem not mine.

If you like eating cabbage – eat cabbage (or how about deep fried sprouts – might they address the Glasgow diet problem?). If you enjoy a juicy venison steak pan-fried with a red wine jus that’s great too. And if you want pizza, chips and a deep-fried mars bar, go for it. And when you’ve digested all that get out a pen and paper (or fire up the old laptop) and tell the government to butt out.

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