Diet and Health: Diseases and Food 307Implications for Policy
This chapter has sketched the bare bones of a highly complex global picture of
diet-related health. Over the last half-century, epidemiologists have generated
many facts, figures and arguments about the role of food in the creation and pre-
vention of ill health, linking what humans eat with their patterns of disease. They
raise a number of important questions: how much of a risk does poor diet pose?
What proportion of the known incidence of key diseases like cancer, heart disease,
diabetes and microbiological poisoning can be attributed to the food supply? What
levels of certainty can be applied to the many studies that have been produced? Is
diet a bigger factor than, say, tobacco or genetics? For policy makers, the uncom-
fortable fact is that the pattern of diet-related diseases summarized in this chapter
appears to be closely associated with the Productionist paradigm. Whilst the para-
digm had as its objective the need to produce enough to feed people, its harvest of
ill health was mainly sown in the name of economic development. Yet the public
health message is clear: if diet is inappropriate or inadequate, population ill health
will follow. Diet is one of the most alterable factors in human health, but despite
strong evidence for intervention, public policy has only implemented lesser meas-
ures such as labelling and health education while the supply chain remains legiti-
mized to produce the ingredients of heart disease, cancer, obesity and their
diet-related degenerative diseases.
In making these tough assertions, we are aware that to piece together all food
research evidence is immensely complex: more research is always needed; scientific
understanding inevitably advances and is refined along the way. But surely, there is
enough evidence for action. Certainly there is no shortage of reports and studies
with which to inform policy. Calling for more research ought not to be an excuse
for policy inaction. Policy procrastination is merely poor political prioritization.
Policy attention needs to shift from the overwhelming focus, enshrined in the
Productionist paradigm, on under-consumption and under-supply to a new focus
on the relationship between the oversupply of certain foodstuffs, excessive mar-
keting and malconsumption, and do so simultaneously within and between coun-
tries. Historically, there has been too much focus on public education as the main
driver of health delivery; the diet and health messages, while welcome, have not
always had the widespread or long-lasting effect that current data suggests is
needed. While there have been reductions, for example, in coronary heart disease
mortality rates in affluent societies, this is not universally true, and health educa-
tion as framed in the West may not be universally appropriate. The food supply
chain itself must be reframed and must target wider, more health-appropriate
goals.
Even rich countries are struggling to provide and fund equitable solutions to
problems caused by diet: drugs and surgery, designer health foods, scientific
research and public health education. But for developing countries, the majority of
humanity, who have even fewer resources and weaker health care infrastructure,
the picture is even more desperate. At the heart of the food policy challenge is the