A large serving of a sweet fizzy drink has 54 cubes of sugar
Industries that promote unhealthy habits have always attempted to influence government policy. Coca-cola has been exposed by journalists as seeking to influence the debate by funding research. Many of the scientists on the board of Public Health England have been paid very large sums by Coca-cola. Despite this it is thought that Public Health England has recommended taxing sugary drinks and sweets. The Government has suppressed the report, this has been described as disgraceful by many. The public have a right to know the recommendations of a publicly funded body. This is reminiscent of the Governments U turn on minimum price alcohol. The Government was to introduce minimum price alcohol but after a meeting with ‘industry representatives from the drinks industry’ and a large donation to the Conservative party they back tracked. This led to the BMJ declaring that the Government was ‘under the influence.
Public Health is the part of medicine concerned with the health of populations rather than the individual. It covers matters such as vaccinations, smoking bans, screening and health promotion. It is enormously important and cost effective. Improvements in sanitation in 19th century doubled life expectancy. Much of the increase in life expectancy from about 65 in the 1960’s to 80 now is a result of a decrease in smoking not medical advancements [smoking kills half of those who smoke]. Anti- smoking legislation has undoubtedly been helpful. The major public health challenges in the last 200 years concerned infectious diseases such as cholera, TB and more lately HIV epidemics. The major public health challenges of the 21st century are‘non communicable diseases’. These are heart disease, strokes, cancers, type 2 diabetes and lung problems. Obesity, smoking, alcohol and lack of exercise are major contributors to these.
Public Health measures such as bans on large bottles and portions of sugary drinks in New York, trans fats [a very harmful type of fat] in the USA and countries in Europe have been implemented to try and counter increasing obesity levels and have been shown to work. Sugary drinks seem to have an alarming impact on the developing of diabetes. Just one sugary drink leads to a 20% increased risk. It is thought that sudden easily adsorbed sugar plays havoc with insulin regulation.
The present British Government has said it does not wish to legislate. Its slogan is ‘nudging not nannying’. It has introduced major changes to public health, separating it from the NHS and has set up the Public Health Board. Companies such as Mc Donalds and Coca-cola have been given places on the Public Health Board and the Government wants to encourage the food industry (rather than to legislate) to introduce voluntary cuts to fats, sugar, and salt levels. This has caused dismay in the medical profession. Simon Capewell, a prominent public health professor, described this policy of such companies having power over health policy as ‘putting Dracula in charge of the blood bank.’ Which? (the consumer magazine) reported early this year that very little change has been achieved because of the vested interest the food industry has in promoting unhealthy products.
The argument of upholding the autonomy of the individual against those encouraging healthier habits is centuries old as can be seen from an editorial in the Times 1854. The first Public Health board had just been dismissed, cholera was rife, the ‘Great Stink’ had forced the abandonment of the Houses of Parliament. However The Times rejoiced when sanitary reformers were defeated in their attempts to clean up cities and have human excrement removed as this extract shows.
The Board of Health has fallen. We prefer to take our chance of cholera than be bullied into health. ……There is nothing a man hates as much as being cleaned against his will, or having his floors swept, his walls white washed, his pet dung heaps cleared away, all at the command of a sanitary bumbaliff’
The Times 1st Aug 1854
It was thought then that people had the ‘right to be unsanitary’ but the germ theory of disease and the cholera epidemics convinced doctors that their autonomy had to be overruled because of the public health consequences. The water companies and slum landlords and other vested interests fought them bitterly. Perhaps in another hundred years or so people will be just as incredulous at the idea that cancer causing cigarettes were sold and sugar sweetened drinks were promoted and marketed as we are now at the thought that people opposed the removal of human sewage in 1854.
The hand of industry has power and money and exerts a malign influence through advertising, funding researchers and pressurising governments. Many say they are killing people!
Advert in the 1960’s