The Taste With Vir: Why is obesity a major public health problem now?
How obesity, in the last few decades, has become a major public health issue - the article offers insights on this.
Why have people in the West got so fat over the last three decades that obesity is now a major public health problem?
Over the years, various explanations have been offered. One early culprit was supposed to be sugar, which led to the growth of an industry based on sugar substitutes. (Though even artificial sweeteners have recently come under attack from the WHO and some people act as though they are as bad as sugar itself.)
A more recent theory has focused on wheat and fast food. Though all fast food is not based on wheat, most of it is. Pizzas are wheat-on-a-plate. Hamburgers are all about bread: The meat content is tiny in relation to the wheat overload.
A decade ago, wheat was blamed for many of America’s public health problems. The theory went something like this: Ancient varieties of wheat were fine. But most of the wheat grown today comes from newer strains and from seeds created in labs to provide higher yields for farmers. The new strains of wheat are bad for health (hence the demonisation of gluten) and make people fat. So, an immensely popular industry (fast food) that relies on unhealthy quantities of wheat is certain to contribute to obesity.
Side by side with these theories were concerns about the packaged food industry. If you look at the lists of ingredients carried in tiny print on the side of any box of packaged food, you will discover that in addition to such regulars as ‘emulsifiers’ and ‘stabilisers’, you will also find chemicals you have never previously heard of. These chemicals make the production of packaged food easier and cheaper and help it last longer on the shelves.
For some years now, activists have suggested that the chemicals may be harmful. Along with concerns about the pesticides used in agriculture, this has led to the growth of the organic food movements. Sadly, the term ‘organic’ has been so misused over the years that it does not mean very much any longer.
One of the problems with the movement against processed and junk foods has been the absence of any standard measures of damage or benefit. Who decided what is good for you or not? How does a food product get to be regarded as not harmful? Much of the time, it is just guesswork.
In recent years, as concerns about junk food have grown, critics of what are called Ultra Processed Foods (UPF) have used a food classification scheme called NOVA. It was originally created in Brazil and offers an alternative to the traditional groupings of food categories: Grains, proteins, dairy etc.
The NOVA classification’s favourite food group is Group 1, defined as food with minimal or no processing: Meat, flour, fresh vegetables etc. Group 2 is ‘processed culinary ingredients’: Oil, butter, sugar, honey etc. Group 3 is ‘processed food’: That is, ingredients from the first two groups that have been processed for preservation: Dried beans, salted nuts, smoked meats etc.
And then finally, there is Group 4: UPF meaning packaged snacks, sugary cereals, bottled drinks like Coke and Pepsi, chocolate bars, frozen pizzas etc. Pretty much all fast food comes into this category.
We may think that this does not apply to us in India because we are not part of the frozen TV dinner culture. But it applies to the Indian diet more than we realise. Instant noodles like Maggi are made in factories. Even chaat can fall in the Ultra Processed Foods category. In the old days, chaat was made with fresh ingredients. Almost everything in a serving of bhelpuri was fresh from the sev to the chutneys.
But now the more popular chaat dishes rely on food made in industrial plants. The pav for vada pav or pao bhaji or the bread for a Bombay sandwich or a bread pakora is made in a factory using chemicals and industrial methods. More and more chaatwallas are using pre-packaged sauces. And the processed cheese that turns up in street food these days is not made on a dairy farm but in an industrial unit.
The most famous advocate of the campaign against UPF is a man called Chris Van Tulleken whose book Ultra Processed People is a global bestseller. Van Tulleken recently recorded a video message for Indians warning us of the danger to our health from UPFs and the food industry itself.
Much of what Van Tulleken says is political and emotive. He attacks the food industry, accuses it of deceptions, rages against the huge profits it makes etc. For India, he also makes the point that the major food companies are multinationals seeking to suck their profits out of India. It is, he says, a form of colonialism.
If you put the politics aside, I have two or three problems with the analysis of the anti UPF lobby. The first is that despite the concerns of UPF activists over obesity, we still don’t know exactly how UPFs are harmful. The scientific links are weak; we have anecdotes and statistical studies (a sort of Super Size Me in scientific terms) instead.
Nor are we clear about whether anything the UPF faithful are saying is particularly new. After all, it was Michael Pollan who told us some years ago to eat plants not food made in plants. Yes, the NOVA classification helps but is it really a significant move forward?
And finally, there is the question of where we go from here. Many people, myself included, do not eat packaged foods, in general. I may eat the odd chocolate digestive and more Diet Coke than I should, but that’s about it. I won’t eat industrial bread, ready-meals, mass-produced cheese or chocolates, factory-made sausages etc. But I regard that as a matter of choice and one of privilege. I can afford to buy, say freshly made sausages or artisanal bread. Not everyone can; I am fortunate.
Those of us who eat fresh and organic food consider ourselves lucky. We know that one advantage of packaged food is convenience. Another is cost. (Just compare the cost of a frozen pizza with one from an artisanal pizza operation). So, we treat this as a matter of individual choice and ability-to-pay without looking down on people who opt for cheaper mass-produced options.
But the UPF lobby is now demanding we treat packaged and junk foods on par with cigarettes. UPFs are as dangerous as tobacco, it says.
Are they, really? Is that a step too far? Is there enough evidence to justify that extreme approach? Well, that depends. The restrictions on smoking, for instance, came before we found conclusive medical evidence that cigarettes were bad for health.
So ultimately, it does come down to where you decide to make your stand. I am no fan of UPFs. But I am not a fundamentalist either, the sort of man who regards eating two biscuits with a cup of tea as being on par with smoking two cigarettes or taking drugs.
Well, not yet, anyway.