Poor lifestyle choices have an impact on our health.
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A woman dies from a 10-litre a day Coke habit. Children's clothing sports advertisements for Jim Beam bourbon. These are extreme examples, but just the tip of the iceberg when it comes to the alcohol and processed food companies using the same tactics as Big Tobacco to increase profits at the same time as increasing sugar and salt in our diets.
This ''let them eat cake and drink Coke'' attitude provides a strong argument for a review of how we control the excesses of industries producing unhealthy commodities.
Most health issues in Australia are caused by lifestyle problems - poor diets, insufficient physical activity, tobacco and alcohol. Issues not usually serious enough to warrant a visit to the doctor but with potentially deadly consequences nonetheless. Sudden death caused by undiagnosed heart disease remains the first sign of a problem for thousands in this country.
Late last year the World Health Assembly put its weight behind a new target for global health - to reduce avoidable deaths from chronic diseases by 25 percent by the year 2025. The World Health Organisation was quick to follow highlighting nine target areas for Australia and its other member states. Seven targets are about lifestyle, and just two focus on medical management, the usual prescription for health problems.
So, are lifestyle diseases the fault of poor personal choices made by a public unable to control its base desires? Or a toxic food environment foisted upon the unsuspecting public by industries focused only on maximising shareholder value?
''Profits and pandemics'', published this week in The Lancet, provides new evidence about the role the food and alcohol industries have to play. These enormous transnational corporations have learned from tobacco and are now applying the same tactics to secure the food and drink markets - biased research findings, co-opted policymakers and health professionals, politicians lobbied and voters influenced against regulation. Research sponsored by food and drink companies is between four and eight times more likely to have conclusions favourable to the sponsor than research supported by another source.
These industries should be excluded from the policy-making process. With commercial success equating to public health failure, these industries need to be engaged only to deliver the agreed solution, not to identify it.
The nature of the problem was highlighted last month when regulation on health claims permissible on food packaging was passed. After 10 years of negotiation with industry the legislation was so diluted as to effectively just write into law the opportunity for industry to do whatever it pleases. Likewise, we still have no effective control on the marketing of junk food to children despite overwhelming public support for action. Perhaps because ''independent'' industry research shows there is no problem. And federal government plans for standard ''front-of-pack nutrition labelling'' look set to follow this same pattern with the food industry combating every effective measure proposed.
It makes sense for industry to fight these sorts of controls, but with the health budget ballooning, and regulation of the food industry projected to be cost saving, it would seem an obvious space for government to move into. Australian politicians have led the world in tobacco control. Let's hope the experience has emboldened them to take on another major national industry.
As for tobacco, asbestos and gun control, the solution is to remove the purveyors of the harmful commodities from the policy-setting process. The UK got it right when it created the Food Standards Agency with a board appointed to act in the public interest, a unique statutory right to publish all advice it provided to ministers, and a commitment to make policy decisions only at open board meetings. And it delivered - foods in the UK are universally less salty than in Australia and the country suffers thousands fewer strokes and heart attacks each year.
Australia urgently needs something comparable.
The politics were a little different during the reign of Louis XVI when Marie Antoinette declared to the masses: ''let them eat cake''. But nearly 200 years on that's what the population is doing. It wasn't the solution then, and neither is it today.
Bruce Neal is a senior director at the George Institute for Global Health and professor of medicine in Sydney Medical School.
expressed are those of the author, and do not necessarily
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