Health consequences of the industrialised, Health consequences of the industrialised, globalised food systemglobalised food system

Kerin O’Dea, Director,

Sansom Institute for Health Research, University of South Australia

The shape of things to comeThe shape of things to come

The cover of ‘The Economist’, December 13-19, 2003The cover of ‘The Economist’, December 13-19, 2003

The Age, 2006The Age, 2006

Are we already there?

The Global EpidemicThe Global Epidemic

Obesity: The Global Epidemic WHO Obesity: The Global Epidemic WHO 19971997

What has changed in the past 25 years?What has changed in the past 25 years?

• The social environment – increasingly ‘obesogenic’

• ↑ sedentariness• ↓ opportunities for exercise• Central heating• Urbanised living

What has changed in the past 25 years?What has changed in the past 25 years?

• The social environment – increasingly ‘obesogenic’

• ↑ sedentariness• ↓ opportunities for exercise• Central heating• Urbanised living

• Food supply, eating patterns Portion sizes Availability of energy dense snack foods and drinks Free sugars in processed foods and drinks

• Sucrose, high fructose corn syrup

Average portion sizes in US takeaway outlets Average portion sizes in US takeaway outlets doubled between 1980 and 2000:doubled between 1980 and 2000:500 to 1200 calories500 to 1200 calories

Super Size meals can provide 2500 caloriesSuper Size meals can provide 2500 calories

Snack foods and sweetened drinks high in sugar and/or fat readily available in schools, workplaces, shopping centres, hospitals.

Low fat foodsLow fat foods

• Low fat ‘fast foods’ are frequently high in refined carbohydrates– Sucrose, high fructose corn syrup

• Frequently marketed as ‘health foods’ – Muesli bars, ‘fruit’ bars

• May have more energy and higher energy density than unsweetened ‘full fat’ versions– Yoghurt

per 100gper 100g

425 KJ425 KJ

1.4 g fat1.4 g fat

16.5 g CHO16.5 g CHO

per 100gper 100g

309 KJ309 KJ

3.2 g fat3.2 g fat

6.5 g CHO6.5 g CHO

How much sugar is in our foods?How much sugar is in our foods?

The 21The 21stst century food supply century food supply

• Highly processed– Breakfast cereals – high in free sugars– Snacks – can be ‘low fat’, but high energy– Promotion using unrelated ‘healthy’ images

• The illusion of variety• Health claims• Nutriceuticals– Enrichment with particular (popular) nutrients

• Fibre, omega-3 fats, folate, calcium, iron

“99% fruit ingredients”•72% sugars•Image of fresh fruit•Far higher energy density

““Nutritionism”Nutritionism”

• Michael Pollan• ‘The Omnivore’s Dilemma’• ‘In Defence of Food’

• Processed, highly refined foods packed with additives – preservatives, stabilisers – popular selected nutrients - their source foods often unrecognisable!

• Fibre-enriched soft drinks• Calcium-enriched fruit juice• Iron and zinc enriched cereal products

• Creates an illusion of health• Totally market-driven

The Michael Pollan solutionThe Michael Pollan solution

• When you walk down those many supermarket aisles filled with thousands of enticingly packaged processed foods

The Michael Pollan solutionThe Michael Pollan solution

• When you walk down those many supermarket aisles filled with thousands of enticingly packaged processed foods

• Don’t choose anything that your great great grandmother would not recognise!

The economics of industrialised The economics of industrialised foodfood

• High fructose corn syrup and processed saturated fats are the cheapest source of energy available – Due to huge distortions in our industrial food system– Agricultural subsidies that help the food industry not the

farmers

The economic argumentsThe economic arguments

• High fructose corn syrup and processed saturated fats are the cheapest source of energy available – Due to huge distortions in our industrial food system– Agricultural subsidies that help the food industry not the

farmers

• Is this really what is driving the obesity epidemic? • Consistent with poorer people being more obese

• Impact on type 2 diabetes and CVD?

The economic argumentsThe economic arguments

• High fructose corn syrup and processed saturated fats are the cheapest source of energy available – Due to huge distortions in our industrial food system– Agricultural subsidies that help the food industry not the

farmers

• Is this really what is driving the obesity epidemic? – Consistent with poorer people being more obese

• Impact on type 2 diabetes and CVD?

• Uneven impact across society

Fresh fruit, vegetablesLean meat, fish

Fats and oils

Sugarflour

Energy density(MJ/kg)

$ per MJ$ per MJ

Confectionary

Poverty and the food supplyPoverty and the food supply

Drewnowski and Darmon, AJCN, 2005

Impact of the food supply on risk of Impact of the food supply on risk of cardiovascular and related chronic diseascardiovascular and related chronic diseases

• Disadvantaged sectors of society carry particularly heavy burden

• Rural and remote Indigenous communities – epidemic of obesity, and premature type 2 diabetes and related

conditions including CVD, renal failure