272 Diet and Health
- fruit and vegetable intake;
- high body mass index;
- physical inactivity;
- alcohol;
- unsafe water, sanitation and hygiene.
In the 2003 World Cancer Report, the most comprehensive global examination of
the disease to date, the WHO stated that cancer rates could further increase by 50
per cent to 15 million new cases in 2020.^5 To stem the rise of this toll, the WHO
and the International Agency for Research on Cancer (the IARC) argued that three
issues in particular need to be tackled:
- Tobacco consumption (still the most important immediate avoidable risk to
health). - Healthy life-style and diet, in particular the frequent consumption of fruit and
vegetables and the taking of physical activity; early detection and screening of
diseases to allow prevention and cure.
In addition to these UN reports, the International Association for the Study of
Obesity (the IASO) revised its figures of the global obesity pandemic: it estimates
that 1.7 billion people are overweight or obese, a 50 per cent increase on previous
estimates. The IASO’s International Obesity Task Force stated that the revised
figures meant that most governments were simply ignoring one of the biggest risks
to world population health.^6
These reports testify to an extensive body of research and evidence from diverse
sources around the world of the link between food availability, consumption styles
and specific patterns of disease and illness. Table 13.1 confirms some of the diet-
related causes of death throughout the world. Good health and longevity were
intended to result from ensured sufficiency of supply; at the beginning of the 21st
century, far from diet-related ill health being banished from the policy agenda, it
appears to be experiencing a renewed crisis.
Under the old Productionist paradigm, the main focus was under-nutrition.
Yet at the end of the 20th century, with diseases such as heart disease, cancers,
diabetes and obesity rampant worldwide, not just in the affluent West, a new focus
must be placed on diet and inappropriate eating. In this chapter, we begin to
explore wider societal changes which impose progress in this regard through demo-
graphic shifts, maldistribution of and poor access to food, and spiralling health-
care costs. These factors add weight to our argument that the Productionist
paradigm is beyond its own sell-by date.
Policy making is failing to address the causes of these food-related health prob-
lems and too often resorts to only palliative measures. This is partly because the
Productionist paradigm’s approach to health narrows the framework for consider-
ing alternative solutions: by being centred on striving to increase output, it has
taken only a medicalized, rather than a socially determined, view of health.