SECOND OPINION:Fresh produce is the key ingredient in battle against obesity, writes JACKY JONES
IT IS good news that virtually all political parties in the coming election aim to prioritise the development of the agri-food business in Ireland. This sector of the economy is regarded as being central to economic growth and creating employment over the next few years.
The development of the agri-food sector will also help to prevent Ireland’s growing health problems of obesity and type 2 diabetes. We have to hope that whatever political parties form the next government, they don’t make the same mess of agriculture and food as the previous one did with the building industry. But this is a risk unless the impact of this sector on health is considered from the start.
What you might ask has agriculture and the food business got to do with obesity and diabetes? An article in the latest bulletin from the World Health Organisation describes the connection. Modern technologies such as those involved in food production, farming and food processing, make available a huge variety of more calorie-dense food than 20 or 30 years ago.
Processed foods by definition nearly always contain more sugar and fat than natural food because they are designed to be tempting and easy to eat. People with type 2 diabetes, which is directly related to obesity, produce an abundance of insulin in response to this food environment that encourages them to ingest more calories than ever before without many physical demands such as walking, cycling or physical work. In contrast, it is hard to overeat traditional foods such as fresh vegetables.
The agriculture and food policies pursued by the new government must incentivise the greater production and marketing of foods that satisfy appetites and tastes and are less calorie-dense. This will probably involve changing taxation and subsidy policies. Michael Pollan, author of many books on food, puts how we should eat if we want to be healthy very succinctly. Eat food. Not too much. Mostly plants. This is the short answer to what has become the incredibly complicated business of feeding ourselves properly. What he means by food is plants as they come out of the ground or are grown by farmers. Anything else is a food-like substance made from what used to be food before it was processed and packaged.
The food industry, nutrition and exercise experts have a vested interest in complicating the question of what we should eat and how much physical activity we should take. This has happened to such an extent that we need media programmes such as Operation Transformation, which uses all kinds of experts, to encourage people to do what used to come naturally.
Knowing what food to eat and how much exercise to take is seriously unprofitable if you are a food company, and risks jobs if you are a dietitian or personal trainer. It is no coincidence that obesity and type 2 diabetes began to become health problems in tandem with the increases in the numbers of experts and the amount of food that is now processed.
According to the HSE advisory group on diabetes, “the number of people affected by diabetes in Ireland is growing at such an alarming rate that it threatens to overwhelm the health service”. They estimate that diabetes care consumes about 10 per cent of the overall health budget. About 150,000 adults have type 2 diabetes now and it is thought that this figure will be 180,000 by 2015 if the incidence of obesity continues to increase at its current alarming rate. Type 2 diabetes is largely preventable by eating well and taking regular exercise. Physical inactivity is a major risk factor.
The new Global Recommendations on Physical Activity published by the WHO outlines how much physical activity we all need. A child aged five to 17 needs at least 60 minutes of moderate to vigorous activity daily. Adults of all ages need at least 150 minutes of moderate intensity, aerobic, physical activity every week. Additional health benefits, such as reducing breast cancer risk, can be achieved by doing 300 minutes a week. Adults over 65 also need additional activities to enhance balance on three or more days per week. Irish guidelines are similar and are available at getirelandactive.ie.
The HSE service plan for 2011 does not contain anything on how obesity and type 2 diabetes can be prevented by working in partnership with the agri-food sector and local authorities.
Its target for 2011 is to provide a structured diabetes programme of care to 3,880 people. We need to lobby the new government and the HSE over the coming months to ensure that these partnerships happen, that good Irish food stays natural, is widely and cheaply available, and is processed as little as possible.
Dr Jacky Jones retired recently as regional manager of health promotion at the HSE